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Aims: The aim of this narrative synthesis was to explore the necessary and sufficient conditions required to define moral distress. Background: Moral distress is said to occur when one has made a moral judgement but is unable to act upon it. However, problems with this narrow conception have led to multiple redefinitions in the empirical and conceptual literature. As a consequence, much of the research exploring moral distress has lacked conceptual clarity, complicating attempts to study the phenomenon. Review methods: Literature relating to moral distress was systematically retrieved and subjected to relevance assessment. Narrative synthesis was the overarching framework that guided quality assessment, data analysis and synthesis. Results: In all, 152 papers underwent initial data extraction and 34 were chosen for inclusion in the narrative synthesis based on both quality and relevance. Analysis revealed different proposed conditions for the occurrence of moral distress: moral judgement, psychological and physical effects, moral dilemmas, moral uncertainty, external and internal constraints and threats to moral integrity. Conclusion: We suggest the combination of (1) the experience of a moral event, (2) the experience of 'psychological distress' and (3) a direct causal relation between (1) and (2) together are necessary and sufficient conditions for moral distress.

It is important for nurse researchers to develop critical awareness of the research methodologies and methods they employ. We argue that the phenomenological focus group is not an oxymoron. Rather, the use of focus groups can provide a greater understanding of the phenomenon under study.

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Literature reviews generally analyse and synthesis the evidence (or lack thereof) in a particular topic area and they are an increasingly popular form of scholarly activity. The scoping review is a popular literature review approach that has been adopted across the social and health sciences over the last fifteen years. With this upsurge in use, differences of opinion about how to analyse and report scoping reviews has also grown. Drawing on work carrying out a scoping review on oral health and child maltreatment, we put forward a structured approach to analysis and reporting of such reviews: the PAGER (Patterns, Advances, Gaps, Evidence for practice and Research recommendations) framework. In this article, we reflect on the strengths and limitations of the framework, drawing on examples, laying out the methodological processes, and making suggestions as to how it might improve reporting. The article makes a contribution to efforts that seek to improve the reporting and utility of scoping reviews in health and social research.

Engaging with children as co-researchers: challenges, counter-challenges and solutions Abstract of 150 words Participatory approaches have become de rigueur in social research involving children. A growing trend is research by children where researchers engage (or employ) children as co-researchers or primary researchers. In this paper we critique the ethical, methodological and practical issues associated with this participatory approach. The discussion is framed around six challenges: 1) Children lack research competence; 2) A comprehensive training programme is required; 3) Insider/outsider perspectives are difficult to balance; 4) Remuneration is complex; 5) Power differentials need to be overcome; 6) Children need to be protected. For each challenge we propose a counter-challenge. Additionally, we offer pragmatic solutions to the issues raised, so that the paper holds practical utility to social researchers who utilise this type of participatory approach. Overall we argue that despite the approach's inherent challenges, children as researchers are a powerful conduit for other children's voices.

I offer this approach for consideration by healthcare researchers as a robust means of illuminating researcher subjectivity. This is not intended as a narcissistic process; it is one that is advocated for use as part of an audit trail as a means of enhancing the rigour of qualitative research.