Loneliness is a pressing social issue for older people globally. Despite this, there is a paucity of studies on how older people themselves perceive loneliness and how service providers can support them. This study sought to address the gap using in-depth and semi-structured interviews with 60 older people and eight focus groups with aged care service providers in Australia in 2007. A purposive sampling strategy was employed to incorporate maximum participant variation. People 65 years and over were recruited from four large service providers in two Australian states. Our findings show that loneliness is influenced by private, relational and temporal dimensions and whether older people feel that they have, or are seen by others as having, a sense of connectedness with the wider community. Participants expressed the importance of maintaining social contact and having a sense of connection and belonging to the community. Our study highlights both the significance of gathering the views of older people to generate an understanding about loneliness and the need to recognise loneliness as a diverse and complex experience, bound to the context in which it is understood and perceived and not synonymous with social isolation. Such an understanding can be used to both evaluate and improve upon programmes that address loneliness and to help maintain an integration of older people in the community.

Introduction: Qualitative meta-synthesis draws together data from multiple studies and can enrich understandings of client experiences and inform health policy. Meta-ethnography is the most commonly utilised qualitative synthesis approach in healthcare; however, there is variation in the conduct and quality of many published meta-ethnographies. This paper aims to guide occupational therapists on the process of completing a meta-ethnography. Method: A systematic search of articles published from 1986-2016 was conducted. Studies which described an evaluation or critique of meta-ethnography as a research method, and consequently provided reflections or guidance on the method, were included. Two authors independently screened papers and nine relevant papers and one key text were identified. Two authors independently extracted data from identified sources. Results: The seven stages of meta-ethnography described by Noblit and Hare (1988) are presented and integrated with key advancements from subsequent publications. Stages include starting the meta-synthesis, consideration of relevant studies, reading the studies and deciding on how they should be put together, translating the studies into one another, synthesising translations and expressing the synthesis. Conclusion: Given the proliferation of qualitative methods in occupational therapy research, rigorous use of meta-ethnography has great potential to contribute to the research evidence base.

BackgroundAllied health professionals working in rural areas face unique challenges, often with limited access to resources. Accessing continuing professional development is one of those challenges and is related to retention of workforce. Effectiveness of distance learning strategies for continuing professional development in rural allied healthcare workers has not been evaluated.MethodsWe searched 17 databases and the grey literature up to September 2016 following the PRISMA guidelines. Any primary studies were included that focussed on allied health and distance delivery regardless of education topic or study design. Two independent reviewers extracted data and critically appraised the selected studies.ResultsThe search returned 5257 results. With removal of duplicate references, we reviewed 3964 article titles and abstracts; n = 206 appeared potentially eligible and were scrutinised via full text screening; n = 14 were included. Studies were published between 1997 and 2016, were of varied methodological quality and were predominantly from Australia, USA and Canada with a focus on satisfaction of learners with the delivery method or on measures of educational outcomes. Technologies used to deliver distance education included video conference, teleconference, web based platforms and virtual reality. Early papers tended to focus more on the technology characteristics than educational outcomes. Some studies compared technology based delivery to face to face modes and found satisfaction and learning outcomes to be on par. Only three studies reported on practice change following the educational intervention and, despite a suggestion there is a link between the constructs, none measured the relationship between access to continuing professional development and workforce retention.ConclusionTechnology based options of delivery have a high utility, however the complex inter-relatedness of time, use, travel, location, costs, interactivity, learning outcomes and educational design suggest a need for more sophisticated consideration by educational providers.Trial registrationRegistration with PROSPERO 30 June 2016: CRD42016041588.

The purpose of this qualitative study was to investigate the lived experience of older men taking part in community-based shed programmes. Five men, aged 65 and over, who attended two different community sheds participated in semi-structured in-depth interviews in 2007. Data were analysed thematically with six main themes emerging as follows: 'company of fellas'; 'everybody's got a story to tell'; 'still got some kick'; 'passing on your experiences'; 'get on your goat' and; 'nobody's boss'. Participation in community-based men's sheds positively influences the health and well-being of older Australian men through provision of a 'men's space' in which meaningful activities occur. Provision of community-based men's shed programmes as among a range of activity options in the community may contribute positively to the physical, mental, social and occupational health of older men.

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