Experiences are at the core of tourism and hospitality. Understanding how to design, manage and measure such experiences has become a key topic in academic literature focused on this sector. This paper presents the characteristics of an optimal design process model for experiences, based on the results of a meta-ethnographic synthesis of such processes. The characteristics can be seen as critical success factors in delivering the right solution to the right problem efficiently and effectively. Depending on the context, starting level and aim of the design, designers can benefit from applying several different design processes. Such a process benefits from design capabilities developed in multi-disciplinary teams. Moreover, the design process aids design teams through steering the collection of explicit and tacit knowledge on problem and solution aspects with stakeholders in a specific order. The success of a design process depends on procedural knowledge of lead designers and their ability to orchestrate and integrate contributions from various disciplines and stakeholders at the right times. Existing design processes for tourism and hospitality experiences lack maturity and flexibility, resulting in them having poor structural validity. However these processes, with insights from design science, can form a base for further theoretical development.
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While luxury accommodation experience research has increased in the last decade, the field shows little accumulation of knowledge over time, requiring further foundational development. This study presents a meta-ethnographic synthesis of sixteen qualitative studies to propose a new conceptualisation of the luxury accommodation experience. The study follows Noblit and Hare (1988) seven-steps methodology for the interpretative synthesis of qualitative empirical studies, an under-utilised methodology introduced by Smit, Melissen, Font, and Gkritzali (2020) in tourism and hospitality research. The synthesis model highlights the emotional, multi-dimensional and process-driven nature of the luxury accommodation experiences, created by guests, hosts, and external others through the social interaction occurring within a physical and sensorial environment and influenced by personal and situational factors. The synthesis also underlines three factors characterising the luxury accommodation experience, congruence, culture, and collaboration, providing a foundational framework to advance hospitality luxury experience research. Implications for practitioners are also highlighted.
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PurposeThis study investigates patients’ experiences of interaction with their healthcare professionals (HCPs) during cancer treatment and identifies elements that HCPs can utilize to improve cancer care provision.MethodsPubMed, CINAHL, PsycINFO, SCOPUS, and Embase were systematically searched for relevant studies published from January 2010 until February 2022. Qualitative studies investigating adult patients’ perspectives on their interaction with HCPs during cancer treatment were included. Studies conducted during the diagnosis or end-of-life treatment phase were excluded. Duplicate removal, screening, and quality appraisal were independently performed by four reviewers using Covidence.org. We performed a thematic meta-synthesis of qualitative data extracted from studies meeting the quality criteria in three stages: excerpts coding, codes categorization, and theme identification by merging similar categories.ResultsEighty-eight studies were included for quality appraisal, of which 50 papers met the quality inclusion criteria. Three themes were identified as essential to positively perceived patient-HCP interaction: “Support, respect and agency”, “Quantity, timing, and clarity of information”, and “Confidence, honesty, and expertise”. Overall, patients experienced positive interaction with HCPs when the approach was person-centered and when HCPs possessed strong interpersonal skills. However, patients expressed negative experiences when their preferences regarding communication and the type of personal support needed were ignored.ConclusionsThis meta-synthesis emphasizes the importance for HCPs to recognize all patients’ needs, including communication and personal support preferences, to provide high-quality care. Consequently, healthcare professionals should continuously train their verbal and non-verbal communication, empathy, active listening, and collaboration skills during their undergraduate and continuing education.
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Governance of inter-organizational networks: a systematic literature review and qualitative meta-synthesis
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Objective To synthesise qualitative studies on women’s psychological experiences of physiological childbirth. Design Meta-synthesis. Methods Studies exploring women’s psychological experiences of physiological birth using qualitative methods were eligible. The research group searched the following databases: MEDLINE, CINAHL, PsycINFO, PsycARTICLES, SocINDEX and Psychology and Behavioural Sciences Collection. We contacted the key authors searched reference lists of the collected articles. Quality assessment was done independently using the Critical Appraisal Skills Programme (CASP) checklist. Studies were synthesised using techniques of meta-ethnography. Results Eight studies involving 94 women were included. Three third order interpretations were identified: ‘maintaining self-confidence in early labour’, ‘withdrawing within as labour intensifies’ and ‘the uniqueness of the birth experience’. Using the first, second and third order interpretations, a line of argument developed that demonstrated ‘the empowering journey of giving birth’ encompassing the various emotions, thoughts and behaviours that women experience during birth. Conclusion Giving birth physiologically is an intense and transformative psychological experience that generates a sense of empowerment. The benefits of this process can be maximised through physical, emotional and social support for women, enhancing their belief in their ability to birth and not disturbing physiology unless it is necessary. Healthcare professionals need to take cognisance of the empowering effects of the psychological experience of physiological childbirth. Further research to validate the results from this study is necessary.
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Background: Improved preferred gait speed in older adults is associated with increased survival rates. There are inconsistent findings in clinical trials regarding effects of exercise on preferred gait speed, and heterogeneity in interventions in the current reviews and meta-analyses. Objective: to determine the meta-effects of different types or combinations of exercise interventions from randomized controlled trials on improvement in preferred gait speed. Methods: Data sources: A literature search was performed; the following databases were searched for studies from 1990 up to 9 December 2013: PubMed, EMBASE, EBSCO (AMED, CINAHL, ERIC, Medline, PsycInfo, and SocINDEX), and the Cochrane Library. Study eligibility criteria: Randomized controlled trials of exercise interventions for older adults ≥ 65 years, that provided quantitative data (mean/SD) on preferred gait speed at baseline and post-intervention, as a primary or secondary outcome measure in the published article were included. Studies were excluded when the PEDro score was ≤4, or if participants were selected for a specific neurological or neurodegenerative disease, Chronic Obstructive Pulmonary Disease, cardiovascular disease, recent lower limb fractures, lower limb joint replacements, or severe cognitive impairments. The meta-effect is presented in Forest plots with 95 % confidence Study appraisal and synthesis methods: intervals and random weights assigned to each trial. Homogeneity and risk of publication bias were assessed. Results: Twenty-five studies were analysed in this meta-analysis. Data from six types or combinations of exercise interventions were pooled into sub-analyses. First, there is a significant positive meta-effect of resistance training progressed to 70-80 % of 1RM on preferred gait speed of 0.13 [CI 95 % 0.09-0.16] m/s. The difference between intervention- and control groups shows a substantial meaningful change (>0.1 m/s). Secondly, a significant positive meta-effect of interventions with a rhythmic component on preferred gait speed of 0.07 [CI 95 % 0.03-0.10] m/s was found. Thirdly, there is a small significant positive meta-effect of progressive resistance training, combined with balance-, and endurance training of 0.05 [CI 95 % 0.00-0.09] m/s. The other sub-analyses show non-significant small positive meta-affects. Conclusions: Progressive resistance training with high intensities, is the most effective exercise modality for improving preferred gait speed. Sufficient muscle strength seems an important condition for improving preferred gait speed. The addition of balance-, and/or endurance training does not contribute to the significant positive effects of progressive resistance training. A promising component is exercise with a rhythmic component. Keeping time to music or rhythm possibly trains higher cognitive functions that are important for gait. Limitations: The focus of the present meta-analysis was at avoiding as much heterogeneity in exercise interventions. However heterogeneity in the research populations could not be completely avoided, there are probably differences in health status within different studies.
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Objective To systematically summarize the literature on the course of pain in patients with knee osteoarthritis (OA), prognostic factors that predict deterioration of pain, the course of physical functioning, and prognostic factors that predict deterioration of physical functioning in persons with knee OA. Methods A search was conducted in PubMed, CINAHL, Embase, Psych‐INFO, and SPORTDiscus up to January 2014. A meta‐analysis and a qualitative data synthesis were performed. Results Of the 58 studies included, 39 were of high quality. High heterogeneity across studies (I2 >90%) and within study populations (reflected by large SDs of change scores) was found. Therefore, the course of pain and physical functioning was interpreted to be indistinct. We found strong evidence for a number of prognostic factors predicting deterioration in pain (e.g., higher knee pain at baseline, bilateral knee symptoms, and depressive symptoms). We also found strong evidence for a number of prognostic factors predicting deterioration in physical functioning (e.g., worsening in radiographic OA, worsening of knee pain, lower knee extension muscle strength, lower walking speed, and higher comorbidity count). Conclusion Because of high heterogeneity across studies and within study populations, no conclusions can be drawn with regard to the course of pain and physical functioning. These findings support current research efforts to define subgroups or phenotypes within knee OA populations. Strong evidence was found for knee characteristics, clinical factors, and psychosocial factors as prognostics of deterioration of pain and physical functioning.
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Study selection: Randomized controlled trials published after 2007 with (former) healthcare patients ≥ 21 years of age were included if physical activity was measured objectively using a wearable monitor for both feedback and outcome assessment. The main goal of included studies was promoting physical activity. Any concurrent strategies were related only to promoting physical activity. Data extraction: Effect sizes were calculated using a fixed-effects model with standardized mean difference. Information on study characteristics and interventions strategies were extracted from study descriptions. Data synthesis: Fourteen studies met the inclusion criteria (total n = 1,902), and 2 studies were excluded from meta-analysis. The overall effect size was in favour of the intervention groups (0.34, 95% CI 0.23–0.44, p < 0.01). Study characteristics and intervention strategies varied widely. Conclusion: Healthcare interventions using feedback on objectively monitored physical activity have a moderately positive effect on levels of physical activity. Further research is needed to determine which strategies are most effective to promote physical activity in healthcare programmes. Lay Abstract Wearable technology is progressively applied in health care and rehabilitation to provide objective insight into physical activity levels. In addition, feedback on physical activity levels delivered by wearable monitors might be beneficial for optimizing their physical activity. A systematic review and meta-analysis was conducted to evaluate the effectiveness of interventions using feedback on objectively measured physical activity in patient populations. Fourteen studies including 1902 patients were analyzed. Overall, the physical activity levels of the intervention groups receiving objective feedback on physical activity improved, compared to the control groups receiving no objective feedback. Mostly, a variety of other strategies were applied in the interventions next to wearable technology. Together with wearable technology, behavioral change strategies, such as goal-setting and action planning seem to be an important ingredient to promote physical activity in health care and rehabilitation. LinkedIn: https://www.linkedin.com/in/hanneke-braakhuis-b9277947/ https://www.linkedin.com/in/moniqueberger/
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Background: Insufficient amounts of physical activity is a risk factor for (recurrent) stroke. People with a stroke or transient ischemic attack (TIA) have a high risk of recurrent stroke and have lower levels of physical activity than their healthy peers. Though several reviews have looked at the effects of lifestyle interventions on a number of risk factors of recurrent stroke, the effectiveness of these interventions to increase the amounts of physical activity performed by people with stroke or TIA are still unclear. Therefore, the research question of this study was: what is the effect of lifestyle interventions on the level of physical activity performed by people with stroke or TIA? Method: A systematic review was conducted following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. Pubmed, Embase and Cumulative Index for Nursing and Allied Health Literature (CINAHL), were searched up to August 2018. Randomised controlled trials that compared lifestyle interventions, aimed to increase the amount of physical activity completed by participants with a stroke or TIA, with controls were included. The Physiotherapy Evidence Database (PEDro) score was used to assess the quality of the articles, and the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) method for the best evidence synthesis. Results: Eleven trials (n = 2403) met the inclusion criteria. The quality of the trials was mostly high, with 8 (73%) of trials scoring ≥6 on the PEDro scale. The overall best evidence syntheses showed moderate quality evidence that lifestyle interventions do not lead to significant improvements in the physical activity level of people with stroke or TIA. There is low quality evidence that lifestyle interventions that specifically target physical activity are effective at improving the levels of physical activity of people with stroke or TIA. Conclusion: Based on the results of this review, general lifestyle interventions on their own seem insufficient in improving physical activity levels after stroke or TIA. Lifestyle interventions that specifically encourage increasing physical activity may be more effective. Further properly powered trials using objective physical activity measures are needed to determine the effectiveness of such interventions.
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Background Wheelchair tennis, a globally popular sport, features a professional tour spanning 40 countries and over 160 tournaments. Despite its widespread appeal, information about the physical demands of wheelchair tennis is scattered across various studies, necessitating a comprehensive systematic review to synthesise available data. Objective The aim was to provide a detailed synthesis of the physical demands associated with wheelchair tennis, encompassing diverse factors such as court surfaces, performance levels, sport classes, and sexes. Methods We conducted comprehensive searches in the PubMed, Embase, CINAHL, and SPORTDiscus databases, covering articles from inception to March 1, 2023. Forward and backward citation tracking from the included articles was carried out using Scopus, and we established eligibility criteria following the Population, Exposure, Comparison, Outcome, and Study design (PECOS) framework. Our study focused on wheelchair tennis players participating at regional, national, or international levels, including both juniors and adults, and open and quad players. We analysed singles and doubles matches and considered sex (male, female), sport class (open, quad), and court surface type (hard, clay, grass) as key comparative points. The outcomes of interest encompassed play duration, on-court movement, stroke performance, and physiological match variables. The selected study designs included observational cross-sectional, longitudinal, and intervention studies (baseline data only). We calculated pooled means or mean differences with 95% confidence intervals (CIs) and employed a random-effects meta-analysis with robust variance estimation. We assessed heterogeneity using Cochrane Q and 95% prediction intervals. Results Our literature search retrieved 643 records, with 24 articles meeting our inclusion criteria. Most available information focused on international male wheelchair tennis players in the open division, primarily competing in singles on hard courts. Key findings (mean [95% CI]) for these players on hard courts were match duration 65.9 min [55.0–78.8], set duration 35.0 min [28.2–43.5], game duration 4.6 min [0.92–23.3], rally duration 6.1 s [3.7–10.2], effective playing time 19.8% [18.9–20.7], and work-to-rest ratio 1:4.1 [1:3.7–1:4.4]. Insufficient data were available to analyse play duration for female players. However, for the available data on hard court matches, the average set duration was 34.8 min [32.5–37.2]. International male players on hard court covered an average distance per match of 3859 m [1917–7768], with mean and peak average forward speeds of 1.06 m/s [0.85–1.32] and 3.55 m/s [2.92–4.31], respectively. These players executed an average of 365.9 [317.2–422.1] strokes per match, 200.6 [134.7–299.0] per set, 25.4 [16.7–38.7] per game, and 3.4 [2.6–4.6] per rally. Insufficient data were available for a meta-analysis of female players’ on-court movement and stroke performance. The average and peak heart rates of international male players on hard court were 134.3 [124.2–145.1] and 166.0 [132.7–207.6] beats per minute, and the average match heart rate expressed as a percentage of peak heart rate was 74.7% [46.4–100]. We found no studies concerning regional players or juniors, and only one study on doubles match play. Conclusions While we present a comprehensive overview of the physical demands of wheelchair tennis, our understanding predominantly centres around international male players competing on hard courts in the open division. To attain a more comprehensive insight into the sport’s physical requirements, future research should prioritise the inclusion of data on female and quad players, juniors, doubles, and matches played on clay and grass court surfaces. Such endeavours will facilitate the development of more tailored and effective training programmes for wheelchair tennis players and coaches.
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