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Table 2 Example of the synthesis process

From: Nurses’ experiences of caring for patients with intellectual developmental disorders: a systematic review using a meta-ethnographic approach

Study no./Reference Translatable Concept (TC) Sub-categories Content supporting TC Idiomatic translation Line of Argument synthesis
S1. Donovan, 2012. [48] The importance of a caring relationship with the client NA Participants indicated that an in-depth relationship with the client was important to them. This had often developed over a long period of time and enabled them to recognize the often-subtle changes in temperament or behavior that had occurred. Nursing people with IDD can mean having a long-term in-depth relation to be able to read and to understand the person Based on long-term relationship [Aa]
S26. Slevin & Sines, 2005. [52] Relational therapeutics NA Forming trusting relationships were considered essential. Building caring relationships was not only considered to be valuable for the client, but a holistic approach was followed in which the relationship with the total family was developed. The value placed on a humanistic approach in caring was evident. They wished to empower parents/clients and to do this they developed relationships, trust, and aligned themselves with the family. Nursing people with IDD can mean having an in-depth relation both with the patient and his/her relevant others in order to be able to provide a care that empower all included Based on long-term relationship [Aa] Rest its foundation on trust [B]
S21. Ndengeyingoma & Ruel, 2006. [54] The challenge of assuring the expected level of quality care Challenges relating to organizing care delivery Two main challenges directly affecting nursing care were identified: managing patients’ behavioral reactions and communication difficulties. Participants perceive evaluations of these patients to be incomplete. They cannot explain interventions or respond to patients’ needs as they would like. A participant exemplifies: “There is always a discomfort with a patient who has an ID; we are not used to that.. . I have sometimes been alone with such a client, and honestly, her reactions as I approached to take her vital signs made me feel helpless”. Nursing people with IDD can mean having challenges in managing the patients´ behavior and in communication Go beyond verbal communication alone [Ca]
S12. Morton-Nance & Schafer, 2012. [51] Communication NA Communication was a major barrier to understanding patients’ needs. Difficulties in communication between healthcare professionals were thought to affect the quality of palliative care. Participants raised concerns about a failure to share important information appropriately, making it difficult to meet patients’ basic needs. Patients’ inability to communicate their needs was thought by participants to exacerbate problems. Inexperience and lack of understanding, skills and training on the part of some careers significantly affected quality of care at the end of life. Nursing people with IDD can mean challenges in regards to communication between patients, health care professionals and relevant others. Nursing people with IDD can mean challenges in regards to the skills and abilities of HCPs which leads to unmet needs and poor quality of care Go beyond verbal communication alone [Ca]
Raise the bar in care for patients with IDD [Ga] Additional perspective from the core conceptualization: e.g. as in eliminating unmet care needs
  1. a=LOA synthesis interpreted to represent a tentatively distinct conceptualization of nursing