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Abstract
INTRODUCTION Over the last two decades, patient portals have emerged as a noticeable eHealth strategy. To date, research on patient portals has been rapidly increasing. Our umbrella review aims to provide a meta-level synthesis to make sense of the evidence on patient portals from published systematic reviews (SRs). METHODS We will employ a modified version of the Joanna Briggs Institute umbrella review method. The search strategy encompasses multiple databases. The inclusion criterion is specific to SRs focused on patient portal. Patients or public were not involved in this work. ANALYSIS Two researchers will independently screen titles/abstracts and then full-text articles against the inclusion/exclusion criteria. Methodological quality of included reviews will be assessed and data will be extracted from the final selection of reviews. These reviews will be categorised into quantitative, qualitative and/or mixed-synthesis groups based on information about the design of primary studies provided in the reviews. Correspondingly, we will create quantitative, qualitative and/or mixed-synthesis Excel data-extraction tables. Within each table, data will be extracted with the reference to primary studies as reported in the reviews, and will be synthesised into themes and then a smaller number of findings/outcomes. Modified Grading of Recommendations Assessment, Development and Evaluation (GRADE) and Confidence in the Evidence from Reviews of Qualitative research (CERQual) tools will be applied to assess the strength of evidence at the level of each finding/outcome. The output of our umbrella review will consist of summary of findings tables and evidence profile tables. A narrative meta-level synthesis will be provided. We will use the clinical adoption meta-model as an organising framework. ETHICS AND DISSEMINATION As an outcome of this review, we will create a guidance and roadmap to be used in a future Delphi study to gather feedback from Canadian eHealth stakeholders. We will also present at conferences and publish the final report. The umbrella review does not require ethical approval. PROSPERO REGISTRATION NUMBER CRD42018096657.
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Affiliation(s)
- Olga Petrovskaya
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Francis Lau
- School of Health Information Science, Faculty of Human and Social Development, University of Victoria, Victoria, Canada
| | - Marcy Antonio
- School of Health Information Science, Faculty of Human and Social Development, University of Victoria, Victoria, Canada
- School of Nursing, Faculty of Human and Social Development, University of Victoria, Victoria, Canada
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Skovgaard LL, Wadmann S, Hoeyer K. A review of attitudes towards the reuse of health data among people in the European Union: The primacy of purpose and the common good. Health Policy 2019; 123:564-571. [PMID: 30961905 PMCID: PMC6558994 DOI: 10.1016/j.healthpol.2019.03.012] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 03/13/2019] [Accepted: 03/14/2019] [Indexed: 12/14/2022]
Abstract
Studies of attitudes towards reuse of health data mainly from the UK. Studies show lack of awareness of current usages of health data among people living in the EU. Studies report positive attitudes towards the sharing of health data. Concerns about commercial use of health data is expressed in the studies. Attitudes towards informed consent are inconsistent.
Health data are used for still more purposes, and policies are enacted to facilitate data reuse within the European Union. This literature synthesis explores attitudes among people living in the European Union towards the use of health data for purposes other than treatment. Our findings indicate that while a majority hold positive attitudes towards the use of health data for multiple purposes, the positive attitudes are typically conditional on the expectation that data will be used to further the common good. Concerns evolve around the commercialisation of data, data security and the use of data against the interests of the people providing the data. Studies of these issues are limited geographically as well as in scope. We therefore identify a need for cross-national exploration of attitudes among people living in the European Union to inform future policies in health data governance.
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Affiliation(s)
- Lea L Skovgaard
- Department of Public Health, University of Copenhagen, Øster Farigmagsgade 5, 1014 Copenhagen K, Denmark.
| | - Sarah Wadmann
- The Danish Center for Social Science Research, VIVE, Herluf Trolles Gade 11. 1052, Copenhagen K, Denmark
| | - Klaus Hoeyer
- Department of Public Health, University of Copenhagen, Øster Farigmagsgade 5, 1014 Copenhagen K, Denmark
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Willis S, Neil R, Mellick MC, Wasley D. The Relationship Between Occupational Demands and Well-Being of Performing Artists: A Systematic Review. Front Psychol 2019; 10:393. [PMID: 30886598 PMCID: PMC6409325 DOI: 10.3389/fpsyg.2019.00393] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 02/08/2019] [Indexed: 12/22/2022] Open
Abstract
Background: Performing artists are exposed to a range of occupational demands from organisational, interpersonal and intrapersonal sources, which may impact their well-being. The aim of this systematic review was to evaluate and synthesise the literature where researchers have considered the relationship between occupational demands and well-being in performing artists. Methods: A mixed-methods systematic review was conducted including professional and student performing artists. Quantitative, qualitative and mixed-methods study designs were eligible for inclusion in the review. A total of 14 databases were searched from their inception through to October 2017, including MEDLINE, EMBASE, and Scopus. Critical appraisal was conducted using the Mixed-Methods Appraisal Tool and results presented as a narrative synthesis. Results: A total of 20 studies were included in the review, comprising of quantitative (n = 7), qualitative (n = 9) and mixed-methods (n = 4) study designs. Several frameworks of occupational stress and well-being were explored in relation to the results. Organisational, social and emotional demands were associated with lower well-being. Conversely, music-making, performance activities and social support were reported to be resources and were related to higher well-being. Conclusion: This systematic review highlights the need for researchers in this field to adopt methodologically robust study designs, which are informed by appropriate theoretical frameworks. The paucity of high quality and theoretically informed research in this area is a hindrance to the development of evidence-based interventions for this population.
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Affiliation(s)
- Simone Willis
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
| | - Rich Neil
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
| | - Mikel Charles Mellick
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
| | - David Wasley
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
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Watson JA, Ryan CG, Cooper L, Ellington D, Whittle R, Lavender M, Dixon J, Atkinson G, Cooper K, Martin DJ. Pain Neuroscience Education for Adults With Chronic Musculoskeletal Pain: A Mixed-Methods Systematic Review and Meta-Analysis. THE JOURNAL OF PAIN 2019; 20:1140.e1-1140.e22. [PMID: 30831273 DOI: 10.1016/j.jpain.2019.02.011] [Citation(s) in RCA: 185] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 02/03/2019] [Accepted: 02/23/2019] [Indexed: 12/16/2022]
Abstract
Chronic musculoskeletal pain (CMP) is an urgent global public health concern. Pain neuroscience education (PNE) is an intervention used in the management of CMP aiming to reconceptualize an individual's understanding of their pain as less threatening. This mixed-methods review undertook a segregated synthesis of quantitative and qualitative studies to investigate the clinical effectiveness, and patients' experience of, PNE for people with CMP. Electronic databases were searched for studies published between January 1, 2002, and June 14, 2018. Twelve randomized, controlled trials (n = 755 participants) that reported pain, disability, and psychosocial outcomes and 4 qualitative studies (n = 50 participants) that explored patients experience of PNE were included. The meta-analyzed pooled treatment effects for PNE versus control had low clinical relevance in the short term for pain (-5.91/100; 95% confidence interval [CI], -13.75 to 1.93) and disability (-4.09/100; 95% CI, -7.72 to -.45) and in the medium term for pain (-6.27/100; 95% CI, -18.97 to 6.44) and disability (-8.14/100; 95% CI, -15.60 to -.68). The treatment effect of PNE for kinesiophobia was clinically relevant in the short term (-13.55/100; 95% CI, -25.89 to -1.21) and for pain catastrophizing in the medium term (-5.26/52; 95% CI, -10.59 to .08). A metasynthesis of 23 qualitative findings resulted in the identification of 2 synthesized findings that identified several key components important for enhancing the patient experience of PNE, such as allowing the patient to tell their own story. These components can enhance pain reconceptualization, which seems to be an important process to facilitate patients' ability to cope with their condition. The protocol was published on PROSPERO (CRD42017068436). Perspective: We outline the effectiveness of PNE for the management of pain, disability, and psychosocial outcomes in adults with CMP. Key components that can enhance the patient experience of PNE, such as allowing the patient to tell their own story, are also presented. These components may enhance pain reconceptualization.
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Affiliation(s)
- James A Watson
- School of Health and Social Care, Teesside University, Middlesbrough, Tees Valley, TS1 3BX, United Kingdom.
| | - Cormac G Ryan
- School of Health and Social Care, Teesside University, Middlesbrough, Tees Valley, TS1 3BX, United Kingdom
| | - Lesley Cooper
- School of Health and Social Care, Teesside University, Middlesbrough, Tees Valley, TS1 3BX, United Kingdom
| | - Dominic Ellington
- North Tees and Hartlepool NHS Foundation Trust, University Hospital of North Tees, Hardwick Road, Stockton on Tees, Cleveland, TS19 8PE, United Kingdom
| | - Robbie Whittle
- North Tees and Hartlepool NHS Foundation Trust, University Hospital of North Tees, Hardwick Road, Stockton on Tees, Cleveland, TS19 8PE, United Kingdom
| | - Michael Lavender
- North Tees and Hartlepool NHS Foundation Trust, University Hospital of North Tees, Hardwick Road, Stockton on Tees, Cleveland, TS19 8PE, United Kingdom
| | - John Dixon
- School of Health and Social Care, Teesside University, Middlesbrough, Tees Valley, TS1 3BX, United Kingdom
| | - Greg Atkinson
- School of Health and Social Care, Teesside University, Middlesbrough, Tees Valley, TS1 3BX, United Kingdom
| | - Kay Cooper
- The Scottish Centre for Evidenced-Based, Multi-professional Practice: A Joanna Briggs Institute Centre of Excellence, School of Health Sciences, Robert Gordon University, Aberdeen, AB10 7QG, United Kingdom
| | - Denis J Martin
- School of Health and Social Care, Teesside University, Middlesbrough, Tees Valley, TS1 3BX, United Kingdom
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Noyes J, Booth A, Moore G, Flemming K, Tunçalp Ö, Shakibazadeh E. Synthesising quantitative and qualitative evidence to inform guidelines on complex interventions: clarifying the purposes, designs and outlining some methods. BMJ Glob Health 2019; 4:e000893. [PMID: 30775016 PMCID: PMC6350750 DOI: 10.1136/bmjgh-2018-000893] [Citation(s) in RCA: 180] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 10/01/2018] [Accepted: 10/06/2018] [Indexed: 01/28/2023] Open
Abstract
Guideline developers are increasingly dealing with more difficult decisions concerning whether to recommend complex interventions in complex and highly variable health systems. There is greater recognition that both quantitative and qualitative evidence can be combined in a mixed-method synthesis and that this can be helpful in understanding how complexity impacts on interventions in specific contexts. This paper aims to clarify the different purposes, review designs, questions, synthesis methods and opportunities to combine quantitative and qualitative evidence to explore the complexity of complex interventions and health systems. Three case studies of guidelines developed by WHO, which incorporated quantitative and qualitative evidence, are used to illustrate possible uses of mixed-method reviews and evidence. Additional examples of methods that can be used or may have potential for use in a guideline process are outlined. Consideration is given to the opportunities for potential integration of quantitative and qualitative evidence at different stages of the review and guideline process. Encouragement is given to guideline commissioners and developers and review authors to consider including quantitative and qualitative evidence. Recommendations are made concerning the future development of methods to better address questions in systematic reviews and guidelines that adopt a complexity perspective.
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Affiliation(s)
- Jane Noyes
- School of Social Sciences, Bangor University, Wales, UK
| | - Andrew Booth
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Graham Moore
- School of Social Sciences, Cardiff University, Wales, UK
| | - Kate Flemming
- Department of Health Sciences, The University of York, York, UK
| | - Özge Tunçalp
- Department of Reproductive Health and Research including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
| | - Elham Shakibazadeh
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Cardoso V, Trevisan I, Cicolella DDA, Waterkemper R. SYSTEMATIC REVIEW OF MIXED METHODS: METHOD OF RESEARCH FOR THE INCORPORATION OF EVIDENCE IN NURSING. ACTA ACUST UNITED AC 2019. [DOI: 10.1590/1980-265x-tce-2017-0279] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
ABSTRACT Objective: to describe some methodological considerations on the Systematic Review of Mixed Methods developed by the Joanna Briggs Institute, seeking to disseminate the use of this methodology, exemplifying its use and demonstrating the benefits for nursing research. Method: it is an article of reflection. Result: it can be seen that the Systematic Review of Mixed Methods demonstrates that it is a research method that aligns with the characteristics of nursing care, making it possible to make a broader analysis of the different aspects of care such as: the viability of an activity or intervention, its adequacy to a specific context, the significance of the intervention for the patient and their effectiveness. Conclusion: the possibility of incorporating scientific evidence into the clinical practice by the decision making, increasing the focus of care and bringing benefits to the patients as well as the public policies is envisaged. This method values the context of care, cost-effectiveness and the preferences of patients, caregivers and health care providers.
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Affiliation(s)
- Vanessa Cardoso
- Universidade Federal de Ciências da Saúde de Porto Alegre, Brasil
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Hong QN, Pluye P. Systematic reviews: A brief historical overview. EDUCATION FOR INFORMATION 2018. [DOI: 10.3233/efi-180219] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Quan Nha Hong
- Department of Family Medicine, McGill University, Montréal, QC, Canada
- Method Development Platform, Quebec SPOR SUPPORT Unit, Montréal, QC, Canada
| | - Pierre Pluye
- Department of Family Medicine, McGill University, Montréal, QC, Canada
- Method Development Platform, Quebec SPOR SUPPORT Unit, Montréal, QC, Canada
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Ferras‐Hernandez X, Nylund PA. Clusters as Innovation Engines: The Accelerating Strengths of Proximity. EUROPEAN MANAGEMENT REVIEW 2018. [DOI: 10.1111/emre.12330] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | - Petra A. Nylund
- Faculty of Business and Communication StudiesUniversity of Vic Vic Spain
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O’Sullivan G, O’Higgins S, Caes L, Saetes S, McGuire BE, Stinson J. Self-management needs of Irish adolescents with Juvenile Idiopathic Arthritis (JIA): how can a Canadian web-based programme meet these needs? Pediatr Rheumatol Online J 2018; 16:68. [PMID: 30409209 PMCID: PMC6225653 DOI: 10.1186/s12969-018-0287-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 10/29/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Juvenile Idiopathic Arthritis (JIA) affects over 1000 children and adolescents in Ireland, potentially impacting health-related quality-of-life. Accessible self-management strategies, including Internet-based interventions, can support adolescents in Ireland where specialist rheumatology care is geographically-centralised within the capital city. This study interviewed adolescents with JIA, their parents, and healthcare professionals to (i) explore the self-management needs of Irish adolescents; and (ii) evaluate the acceptability of an adapted version of a Canadian JIA self-management programme (Teens Taking Charge: Managing Arthritis Online, or TTC) for Irish users. METHODS Focus groups and interviews were conducted with Irish adolescents with JIA (N = 16), their parents (N = 13), and Irish paediatric healthcare professionals (HCPs; N = 22). Adolescents were aged 12-18 (Mage = 14.19 years), and predominantly female (62.5%). Participants identified the needs of adolescents with JIA and evaluated the usefulness of the TTC programme. Data were analysed using a thematic analysis approach. RESULTS Five themes emerged: independent self-management; acquiring skills and knowledge to manage JIA; unique challenges of JIA in Ireland; views on web-based interventions; and understanding through social support. Adolescents acknowledged the need for independent self-management and gradually took additional responsibilities to achieve this goal. However, they felt they lacked information to manage their condition independently. Parents and adolescents emphasised the need for social support and felt a peer-support scheme could provide additional benefit to adolescents if integrated within the TTC programme. All participants endorsed the TTC programme to gain knowledge about JIA and offered suggestions to make the programme relevant to Irish users. CONCLUSIONS There is scope for providing easily-accessible, accurate information to Irish families with JIA. The acceptability of adapting an existing JIA self-management intervention for Irish users was confirmed.
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Affiliation(s)
- Grace O’Sullivan
- Centre for Pain Research; School of Psychology, College of Arts, Social Sciences & Celtic Studies, Galway, NUI Ireland
| | - Siobhán O’Higgins
- Centre for Pain Research; School of Psychology, College of Arts, Social Sciences & Celtic Studies, Galway, NUI Ireland
| | - Line Caes
- Division of Psychology; Faculty of Natural Sciences, University of Stirling, Stirling, Scotland, UK
| | - Sophia Saetes
- Centre for Pain Research; School of Psychology, College of Arts, Social Sciences & Celtic Studies, Galway, NUI Ireland
| | - Brian E. McGuire
- Centre for Pain Research; School of Psychology, College of Arts, Social Sciences & Celtic Studies, Galway, NUI Ireland
| | - Jennifer Stinson
- The Hospital for Sick Children, Toronto, Canada
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
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Tatar O, Thompson E, Naz A, Perez S, Shapiro GK, Wade K, Zimet G, Gilca V, Janda M, Kahn J, Daley E, Rosberger Z. Factors associated with human papillomavirus (HPV) test acceptability in primary screening for cervical cancer: A mixed methods research synthesis. Prev Med 2018; 116:40-50. [PMID: 30172799 DOI: 10.1016/j.ypmed.2018.08.034] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 07/27/2018] [Accepted: 08/27/2018] [Indexed: 01/14/2023]
Abstract
Primary screening for cervical cancer is transitioning from the longstanding Pap smear towards implementation of an HPV-DNA test, which is more sensitive than Pap cytology in detecting high-risk lesions and offers greater protection against invasive cervical carcinomas. Based on these results, many countries are recommending and implementing HPV testing-based screening programs. Understanding what factors (e.g., knowledge, attitudes) will impact on HPV test acceptability by women is crucial for ensuring adequate public health practices to optimize cervical screening uptake. We used mixed methods research synthesis to provide a categorization of the relevant factors related to HPV primary screening for cervical cancer and describe their influence on women's acceptability of HPV testing. We searched Medline, Embase, PsycINFO, CINAHL, Global Health and Web of Science for journal articles between January 1, 1980 and October 31, 2017 and retained 22 empirical articles. Our results show that while most factors associated with HPV test acceptability are included in the Health Belief Model and/or Theory of Planned Behavior (e.g., attitudes, knowledge), other important factors are not encompassed by these theoretical frameworks (e.g., health behaviors, negative emotional reactions related to HPV testing). The direction of influence of psychosocial factors on HPV test acceptability was synthesized based on 14 quantitative studies as: facilitators (e.g., high perceived HPV test benefits), barriers (e.g., negative attitudes towards increased screening intervals), contradictory evidence (e.g., sexual history) and no impact (e.g., high perceived severity of HPV infection). Further population-based studies are needed to confirm the impact of these factors on HPV-based screening acceptability.
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Affiliation(s)
- Ovidiu Tatar
- Lady Davis Institute for Medical Research, Jewish General Hospital, 4333 Cote Ste-Catherine Road, Montreal, Quebec H3T1E4, Canada.
| | - Erika Thompson
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie, Blvd., EAD 709M, Fort Worth, TX 76107-2699, USA.
| | - Anila Naz
- Lady Davis Institute for Medical Research, Jewish General Hospital, 4333 Cote Ste-Catherine Road, Montreal, Quebec H3T1E4, Canada.
| | - Samara Perez
- Lady Davis Institute for Medical Research, Jewish General Hospital, 4333 Cote Ste-Catherine Road, Montreal, Quebec H3T1E4, Canada; Department of Psychology, McGill University, 2001 McGill College Avenue, Montreal, Quebec, Canada.
| | - Gilla K Shapiro
- Lady Davis Institute for Medical Research, Jewish General Hospital, 4333 Cote Ste-Catherine Road, Montreal, Quebec H3T1E4, Canada; Department of Psychology, McGill University, 2001 McGill College Avenue, Montreal, Quebec, Canada.
| | - Kristina Wade
- Lady Davis Institute for Medical Research, Jewish General Hospital, 4333 Cote Ste-Catherine Road, Montreal, Quebec H3T1E4, Canada.
| | - Gregory Zimet
- Indiana University School of Medicine, Section of Adolescent Medicine, 410 West 10th Street, HS 1001, Indianapolis, IN 46202, USA.
| | - Vladimir Gilca
- Institut National de Santé Publique du Québec, 945 Wolfe Avenue, Québec, Quebec G1V 5B3, Canada.
| | - Monika Janda
- Queensland University of Technology, Faculty of Health, Brisbane, Australia.
| | - Jessica Kahn
- University of Cincinnati (Ohio), Division of Adolescent and Transition Medicine, MLC 4000, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229-3039, USA.
| | - Ellen Daley
- University of South Florida, Department of Community and Family Health, 13201 Bruce B. Downs Blvd, MDC 56, Tampa, FL 33612, USA.
| | - Zeev Rosberger
- Lady Davis Institute for Medical Research, Jewish General Hospital, 4333 Cote Ste-Catherine Road, Montreal, Quebec H3T1E4, Canada; Department of Psychology, McGill University, 2001 McGill College Avenue, Montreal, Quebec, Canada.
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Abelsson A, Lundberg L. Simulation as a means to develop firefighters as emergency care professionals. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2018; 25:650-657. [PMID: 30362390 DOI: 10.1080/10803548.2018.1541122] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Objective. The aim of this study was to evaluate the simulated emergency care performed by firefighters and their perception of simulation as an educational method. Methods. This study had a mixed method with both a quantitative and a qualitative approach. Data were collected by simulation assessment, a questionnaire and written comments. Descriptive analysis was conducted on the quantitative data whereas a qualitative content analysis was conducted on the qualitative data. Finally, a contingent analysis was used where a synthesis configured both the quantitative and the qualitative results into a narrative result. Results. The cognitive workload that firefighters face during simulated emergency care is crucial for learning. In this study, the severity and complexity of the scenarios provided were higher than expected by the firefighters. Clearly stated conditions for the simulation and constructive feedback were considered positive for learning. Patient actors induced realism in the scenario, increasing the experience of stress, in comparison to a manikin. Conclusion. Simulation in a realistic on-scene environment increases firefighters' cognitive ability to critically analyze problems and manage emergency care. Simulation of emergency care developed the firefighters as professionals.
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Affiliation(s)
- Anna Abelsson
- a School of Health Sciences, Jönköping University , Sweden
| | - Lars Lundberg
- b Swedish Armed Forces Centre for Defence Medicine , Sweden.,c PreHospen - Centre for Prehospital Research, University of Borås , Sweden
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Hardman DI, Geraghty AW, Lewith G, Lown M, Viecelli C, Bishop FL. From substance to process: A meta-ethnographic review of how healthcare professionals and patients understand placebos and their effects in primary care. Health (London) 2018; 24:315-340. [PMID: 30238795 DOI: 10.1177/1363459318800169] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Research suggests that a 'placebo' can improve conditions common in primary care including pain, depression and irritable bowel syndrome. However, disagreement persists over the definition and clinical relevance of placebo treatments. We conducted a meta-ethnographic, mixed-research systematic review to explore how healthcare professionals and patients understand placebos and their effects in primary care. We conducted systematic literature searches of five databases - augmented by reference chaining, key author searches and expert opinion - related to views on placebos, placebo effects and placebo use in primary care. From a total of 34 eligible quantitative, qualitative and mixed-methods articles reporting findings from 28 studies, 21 were related to healthcare professionals' views, 11 were related to patients' views and two were related to both groups. In the studies under review, healthcare professionals reported using placebos at markedly different frequencies. This was highly influenced by how placebos were defined in the studies. Both healthcare professionals and patients predominantly defined placebos as material substances such as 'inert' pills, despite this definition being inconsistent with current scientific thinking. However, healthcare professionals also, but less prevalently, defined placebos in a different way: as contextual processes. This better concurs with modern placebo definitions, which focus on context, ritual, meaning and enactivism. However, given the enduring ubiquity of substance definitions, for both healthcare professionals and patients, we question the practical, clinical validity of stretching the term 'placebo' towards its modern iteration. To produce 'placebo effects', therefore, primary healthcare professionals may be better off abandoning placebo terminology altogether.
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Sørensen M, Stenberg U, Garnweidner-Holme L. A Scoping Review of Facilitators of Multi-Professional Collaboration in Primary Care. Int J Integr Care 2018; 18:13. [PMID: 30220896 PMCID: PMC6137624 DOI: 10.5334/ijic.3959] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2017] [Accepted: 08/15/2018] [Indexed: 01/20/2023] Open
Abstract
INTRODUCTION Multi-professional collaboration (MPC) is essential for the delivery of effective and comprehensive care services. As in other European countries, primary care in Norway is challenged by altered patient values and the increased expectations of health administrations to participate in team-based care. This scoping review reports on the organisational, processual, relational and contextual facilitators of collaboration between general practitioners (GP) and other healthcare professionals (HCPs) in primary care. METHODS A systematic search in specialist and Scandinavian databases retrieved 707 citations. Following the inclusion criteria, nineteen studies were considered eligible and examined according to Arksey and O'Malley's methodological framework for scoping reviews. The retrieved literature was analysed employing a content analysis approach. A group of stakeholders commented on study findings to enhance study validity. RESULTS Primary care research into MPC is immature and emerging in Norway. Our analysis showed that introducing common procedures for documentation and handling of patient data, knowledge sharing, and establishing local specialised multi-professional teams, facilitates MPC. The results indicate that advancements in work practices benefit from an initial system-level foundation with focus on local management and MPC leadership. Further, our results show that it is preferable to enhance collaborative skills before introducing new professional teams, roles and responsibilities. Investing in professional relations could build trust, respect and continuity. In this respect, sufficient time must be allocated during the working day for professionals to share reflections and engage in mutual learning. CONCLUSION There is a paucity of research concerning the application and management of MPC in Norwegian primary care. The work practices and relations between professionals, primary care institutions and stakeholders on a macro level is inadequate. Health care is a complex system in which HCPs need managerial support to harvest the untapped benefits of MPC in primary care. As international research demonstrates, local managers must be supported with infrastructure on a macro level to understand the embedding of practice and look at what professionals actually do and how they work.
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Affiliation(s)
- Monica Sørensen
- Department of Nursing and Health Promotion, Oslo Metropolitan University, St. Olavs Plass, 0130 Oslo, NO
- The Norwegian Directorate of Health, St. Olavs Plass, 0130 Oslo, NO
| | - Una Stenberg
- The Norwegian National Advisory Unit on Learning and Mastery in Health, Oslo University Hospital, Trondheimsveien 235, 0586 Oslo, NO
| | - Lisa Garnweidner-Holme
- Department of Nursing and Health Promotion, Oslo Metropolitan University, St. Olavs Plass, 0130 Oslo, NO
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Public involvement in health research systems: a governance framework. Health Res Policy Syst 2018; 16:79. [PMID: 30081919 PMCID: PMC6080531 DOI: 10.1186/s12961-018-0352-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 07/13/2018] [Indexed: 01/21/2023] Open
Abstract
Background Growing interest in public involvement in health research has led to organisational and policy change. Additionally, an emerging body of policy-oriented scholarship has begun to identify the organisational and network arrangements that shape public involvement activity. Such developments suggest the need to clearly conceptualise and characterise public involvement in health research in terms of governance. Methods We drew on an established health research system framework to analyse governance functions related to public involvement, adapting scoping review methods to identify evidence from a corpus of journal papers and policy reports. We drew on the logics of aggregation and top down configuration, using a qualitative interpretive approach to combine and link findings from different studies into framework categories. Results We identified a total of 32 scholarly papers and 13 policy reports (n = 45 included papers) with relevance to governance for public involvement. Included papers were broadly consonant in identifying the need for activity to specify and support public involvement across all four governance functions of stewardship, financing, creating and sustaining resources, and research production and use. However, different visions for public involvement, and the activity required to implement it and achieve impact, were particularly evident with respect to the stewardship function, which seeks to set overall directions for research while addressing the potentially competing demands of a system’s many constituents. Conclusions A governance perspective has considerable value for public involvement in health research systems, supporting efforts to coordinate and institutionalise the burgeoning public involvement enterprise. Furthermore, it highlights challenges for what is, ultimately, a highly political intervention, suggesting that diverse publics must be both involved within health research systems and enrolled as governors of them. Electronic supplementary material The online version of this article (10.1186/s12961-018-0352-7) contains supplementary material, which is available to authorized users.
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Liao H, Hitchcock J. Reported credibility techniques in higher education evaluation studies that use qualitative methods: A research synthesis. EVALUATION AND PROGRAM PLANNING 2018; 68:157-165. [PMID: 29602062 DOI: 10.1016/j.evalprogplan.2018.03.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 02/27/2018] [Accepted: 03/03/2018] [Indexed: 06/08/2023]
Abstract
This synthesis study examined the reported use of credibility techniques in higher education evaluation articles that use qualitative methods. The sample included 118 articles published in six leading higher education evaluation journals from 2003 to 2012. Mixed methods approaches were used to identify key credibility techniques reported across the articles, document the frequency of these techniques, and describe their use and properties. Two broad sets of techniques were of interest: primary design techniques (i.e., basic), such as sampling/participant recruitment strategies, data collection methods, analytic details, and additional qualitative credibility techniques (e.g., member checking, negative case analyses, peer debriefing). The majority of evaluation articles reported use of primary techniques although there was wide variation in the amount of supporting detail; most of the articles did not describe the use of additional credibility techniques. This suggests that editors of evaluation journals should encourage the reporting of qualitative design details and authors should develop strategies yielding fuller methodological description.
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Affiliation(s)
- Hongjing Liao
- School of English for Specific Purposes, Beijing Foreign Studies University, 2 Xisanhuan Beilu, Beijing, 100089, China.
| | - John Hitchcock
- Instructional Systems Technology, Director of the Center for Evaluation & Education Policy (CEEP), Indiana University, United States.
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Christiansen A, Coventry L, Graham R, Jacob E, Twigg D, Whitehead L. Intentional rounding in acute adult healthcare settings: A systematic mixed-method review. J Clin Nurs 2018; 27:1759-1792. [PMID: 29603820 DOI: 10.1111/jocn.14370] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2018] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To determine the impact of intentional rounding on patient and nursing outcomes and identify the barriers and facilitators surrounding implementation. BACKGROUND Intentional rounding is an organised approach whereby health professionals' regularly check on patients to ensure their fundamental care needs are met. Despite wide scale adoption of intentional rounding, there is limited evidence to inform practice. METHODS This systematic mixed-method review was conducted using the Joanna Briggs Institute methodology. Databases CINAHL, MEDLINE, EMBASE, COCHRANE, SCOPUS and WEB of SCIENCE were searched to identify research studies published in English between January 2006-January 2017 that reported on intentional rounding and patient and nursing staff outcomes. Studies were assessed for methodological quality. The findings were synthesised into themes using a narrative approach. RESULTS Twenty-one studies were included in the review. Six studies reported a reduction in the number of falls, and a further five studies reported a reduction in call bell use following the introduction of intentional rounding. Nurses' satisfaction and attitudes towards intentional rounding were reported in seven studies with equivocal results. The quality of the studies was weak making comparisons difficult. CONCLUSIONS While results suggest positive outcomes for falls and call bell use, conclusions on the available data are overshadowed by the quality of the studies. Well-designed studies are required to advance evidence in this field. RELEVANCE TO CLINICAL PRACTICE The evidence on intentional rounding is mixed and suggests that the introduction of intentional rounding should be accompanied by a protocol for robust evaluation to measure the impact of this process change. This should be accompanied by standardised reporting measures to enable comparisons and contribute to the quality of available evidence on intentional rounding.
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Affiliation(s)
- Angela Christiansen
- Centre for Nursing, Midwifery & Health Services Research, School of Nursing & Midwifery, Edith Cowan University, Joondalup, Perth, WA, Australia
| | - Linda Coventry
- Centre for Nursing, Midwifery & Health Services Research, School of Nursing & Midwifery, Edith Cowan University, Joondalup, Perth, WA, Australia.,Centre for Nursing Research, Sir Charles Gairdner Hospital, Nedlands, Perth, WA, Australia
| | - Renée Graham
- Centre for Nursing, Midwifery & Health Services Research, School of Nursing & Midwifery, Edith Cowan University, Joondalup, Perth, WA, Australia
| | - Elisabeth Jacob
- Centre for Nursing, Midwifery & Health Services Research, School of Nursing & Midwifery, Edith Cowan University, Joondalup, Perth, WA, Australia
| | - Di Twigg
- Centre for Nursing, Midwifery & Health Services Research, School of Nursing & Midwifery, Edith Cowan University, Joondalup, Perth, WA, Australia.,Centre for Nursing Research, Sir Charles Gairdner Hospital, Nedlands, Perth, WA, Australia
| | - Lisa Whitehead
- Centre for Nursing, Midwifery & Health Services Research, School of Nursing & Midwifery, Edith Cowan University, Joondalup, Perth, WA, Australia
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‘It makes your life worthwhile. It gives you a purpose in living’: mobility experiences among active older adults with low income. AGEING & SOCIETY 2018. [DOI: 10.1017/s0144686x18000181] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
ABSTRACTThe World Health Organization claims that mobility is vital to healthy ageing and is the best guarantee of older adults being able to cope and remain in their homes and communities. Mobility enables older adults to maintain their physical health, independence and participation in society. In general, mobility is examined objectively, from a quantitative perspective where mobility is measured as physical movement (e.g.physical activity) and/or travel behaviour (e.g.trips, modes and distances). The predominant focus on the functional aspects of mobility tends to overlook the subjective (e.g.perceptions, attitudes and motivations) and temporal dimensions of older adults’ mobility experiences. Using a constructivist grounded theory methodology, we conducted 24 in-depth interviews with six highly active community-dwelling older adults with low income, aged 65 or over, over a period of four years. Our analysis identified the following themes: maintaining a sense of self, being resourceful, openness to engagement, engaging in superficial contact, experiencing social capital, accessing transportation, leaving the immediate neighbourhood and facing affordability. Findings illustrate that intrapersonal factors, in addition to environmental (built, social and cultural) and temporal-level factors, play a crucial role in mobility. In the future, this gained knowledge can be incorporated into approaches to study the multiple interrelated factors and their interrelations that influence older adults’ mobility.
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68
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Stakeholders’ Perspectives on Communication and Collaboration Following School Reintegration of a Seriously Ill Child: A Literature Review. CHILD & YOUTH CARE FORUM 2018. [DOI: 10.1007/s10566-018-9443-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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69
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Revisiting the difference between mixed methods and multimethods: Is it all in the name? ACTA ACUST UNITED AC 2018. [DOI: 10.1007/s11135-018-0700-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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70
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Vindrola-Padros C, Vindrola-Padros B. Quick and dirty? A systematic review of the use of rapid ethnographies in healthcare organisation and delivery. BMJ Qual Saf 2017; 27:321-330. [PMID: 29263139 DOI: 10.1136/bmjqs-2017-007226] [Citation(s) in RCA: 88] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 10/27/2017] [Accepted: 11/11/2017] [Indexed: 11/03/2022]
Abstract
BACKGROUND The ability to capture the complexities of healthcare practices and the quick turnaround of findings make rapid ethnographies appealing to the healthcare sector, where changing organisational climates and priorities require actionable findings at strategic time points. Despite methodological advancement, there continue to be challenges in the implementation of rapid ethnographies concerning sampling, the interpretation of findings and management of field research. The purpose of this review was to explore the benefits and challenges of using rapid ethnographies to inform healthcare organisation and delivery and identify areas that require improvement. METHODS This was a systematic review of the literature using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We used the Mixed Methods Appraisal Tool to assess the quality of the articles. We developed the search strategy using the Population, Intervention, Comparison, Outcomes, Settingframework and searched for peer-reviewed articles in MEDLINE, CINAHL PLUS, Web of Science and ProQuest Central. We included articles that reported findings from rapid ethnographies in healthcare contexts or addressing issues related to health service use. RESULTS 26 articles were included in the review. We found an increase in the use of rapid ethnographies in the last 2‰years. We found variability in terminology and developed a typology to clarify conceptual differences. The studies generated findings that could be used to inform policy and practice. The main limitations of the studies were: the poor quality of reporting of study designs, mainly data analysis methods, and lack of reflexivity. CONCLUSIONS Rapid ethnographies have the potential to generate findings that can inform changes in healthcare practices in a timely manner, but greater attention needs to be paid to the reflexive interpretation of findings and the description of research methods. TRIAL REGISTRATION NUMBER CRD42017065874.
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71
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Contextualizing the twin concepts of systematicity and transparency in information systems literature reviews. EUR J INFORM SYST 2017. [DOI: 10.1057/s41303-016-0020-3] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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72
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Tobiano G, Bucknall T, Sladdin I, Whitty JA, Chaboyer W. Patient participation in nursing bedside handover: A systematic mixed-methods review. Int J Nurs Stud 2017; 77:243-258. [PMID: 29149634 DOI: 10.1016/j.ijnurstu.2017.10.014] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 08/30/2017] [Accepted: 10/22/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND Numerous reviews of nursing handover have been undertaken, but none have focused on the patients' role. OBJECTIVES To explore how patient participation in nursing shift-to-shift bedside handover can be enacted. DESIGN Systematic mixed- methods review. DATA SOURCES Three search strategies were undertaken in July-August 2016: database searching, backwards citation searching and forward citation searching. To be included, papers had to either be research or quality improvement (QI) projects focusing on the patient role. Fifty-four articles were retrieved, including 21 studies and 25 QI projects. REVIEW METHODS Screening, data extraction and quality appraisal was undertaken systematically by two reviewers. Research studies and QI projects were synthesised separately using thematic synthesis, then the results of this synthesis were combined using a mixed-method synthesis table. RESULTS Segregated synthesis of research of patients' perceptions revealed two contrasting categories; patient-centred handover and nurse-centred handover. Segregated synthesis of research of nurses' perceptions included three categories: viewing the patient as an information resource; dealing with confidential and sensitive information; and enabling patient participation. The segregated synthesis of QI projects included two categories: nurse barrier to enacting patient participation in bedside handover; and involving patients in beside handover. Once segregated findings were configured, we discovered that the patient's role in bedside handover involves contributing clinical information related to their care or progress, which may influence patient safety. Barriers related to nurses' concerns for the consequences of encouraging patient participation, worries for sharing confidential and sensitive information and feeling hesitant in changing their handover methods. The way nurses approach patients, and how patient-centred they are, constitute further potential barriers. Strategies to improve patient participation in handover include training nurses, making handovers predictable for patients and involving both patients and nurses throughout the change process. CONCLUSIONS Using research and QI projects allowed diverse findings to expand each other and identify gaps between research and heuristic knowledge. Our review showed the tension between standardising handovers and making them predictable for patient participation, while promoting tailored and flexible handovers. Further investigation of this issue is required, to understand how to train nurses and patient views. Many barriers and strategies identified were from QI projects and the nurse perspective, thus caution interpreting results is required. We recommend steps be taken in the future to ensure high quality QI projects.
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Affiliation(s)
- Georgia Tobiano
- Menzies Health Institute Queensland, Griffith University, Gold Coast Campus,Parklands Drive, Southport, QLD 4222 Australia.
| | - Tracey Bucknall
- Centre for Quality and Patient Safety, School of Nursing and Midwifery, Faculty of Health, Deakin University and Alfred Health, 221 Burwood Hwy, Burwood, Victoria 3125, Australia; Alfred Health, The Alfred, 55 Commercial Rd, Melbourne, VIC 3004 Australia.
| | - Ishtar Sladdin
- Menzies Health Institute Queensland, Griffith University, Gold Coast Campus,Parklands Drive, Southport, QLD 4222 Australia.
| | - Jennifer A Whitty
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich NR4 7TJ, United Kingdom.
| | - Wendy Chaboyer
- National Centre of Research Excellence in Nursing Interventions for Hospitalised Patients, Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Parklands Drive, Southport, QLD 4222 Australia.
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Condon C, O’Regan D, MacDermott E, Killeen O. Self-management needs of children with JIA in Ireland: a qualitative survey of families. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2017. [DOI: 10.1080/21679169.2017.1342865] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Cillin Condon
- Physiotherapy Discipline, Trinity College Dublin, Dublin, Ireland
| | - David O’Regan
- Physiotherapy Discipline, Trinity College Dublin, Dublin, Ireland
| | - Emma MacDermott
- Pediatric Rheumatology, Our Lady’s Hospital for Children, Dublin, Ireland
| | - Orla Killeen
- Pediatric Rheumatology, Our Lady’s Hospital for Children, Dublin, Ireland
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Prior J, Hubbard P, Rai T. Using residents' worries about technology as a way of resolving environmental remediation dilemmas. THE SCIENCE OF THE TOTAL ENVIRONMENT 2017; 580:882-899. [PMID: 28012655 DOI: 10.1016/j.scitotenv.2016.12.035] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 11/26/2016] [Accepted: 12/04/2016] [Indexed: 06/06/2023]
Abstract
The choice of technologies used to remediate contaminated environments are increasingly made via engagement with affected local residents. Despite this, little is known about how residents perceive remediation technology applications. Building on the findings of broader technology worry research, and drawing on data from a telephone survey of 2009 residents living near thirteen contaminated sites in Australia, regression analysis of closed-ended survey questions and coding analysis of open-ended survey questions are combined to identify the main predictors of worries concerning particular remediation technologies, and how worry affects them. This suggests respondents are more worried about the application of chemical remediation technologies than the application of physical and thermal technologies, which in turn caused more worry than the application of biotechnology. The paper suggests that these worries can be reduced via direct engagement with residents about remediation technologies, suggesting that such engagement can provide knowledge that improves remediation technology decisions.
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Affiliation(s)
- Jason Prior
- Institute for Sustainable Futures, University of Technology Sydney, Australia.
| | - Phil Hubbard
- Department of Geography, King's College London, United Kingdom
| | - Tapan Rai
- School of Mathematical and Physical Sciences, University of Technology Sydney, Australia
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75
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Franklin C, Zhang A, Froerer A, Johnson S. Solution Focused Brief Therapy: A Systematic Review and Meta-Summary of Process Research. JOURNAL OF MARITAL AND FAMILY THERAPY 2017; 43:16-30. [PMID: 27757976 DOI: 10.1111/jmft.12193] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This article presents a systematic review of the process research on solution-focused brief therapy (SFBT). We searched published and unpublished studies in English across five databases, five major journals, two book chapters, and four websites to locate studies that investigate why and how SFBT works. Thirty-three studies that used various research methods were located and included for further analysis using a meta-summary approach. The findings supported the significance of the co-construction process within SFBT and the effects of specific types of SFBT techniques. The most empirical support was found for the strength-oriented techniques in comparison to the other techniques and for the co-construction of meaning. Current studies require replications with larger samples and experimental designs that study SFBT process in relationship to outcomes.
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76
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Stenberg U, Haaland-Øverby M, Fredriksen K, Westermann KF, Kvisvik T. A scoping review of the literature on benefits and challenges of participating in patient education programs aimed at promoting self-management for people living with chronic illness. PATIENT EDUCATION AND COUNSELING 2016; 99:1759-1771. [PMID: 27461944 DOI: 10.1016/j.pec.2016.07.027] [Citation(s) in RCA: 85] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 07/14/2016] [Accepted: 07/16/2016] [Indexed: 05/06/2023]
Abstract
OBJECTIVE To give a comprehensive overview of benefits and challenges from participating in group based patient education programs that are carried out by health care professionals and lay participants, aimed at promoting self-management for people living with chronic illness. METHODS We searched 8 literature databases. Full text articles meeting the inclusion criteria were retrieved and reviewed. Arksey and O'Malley's framework for scoping studies guided the review process and thematic analysis was undertaken to synthesize extracted data. RESULTS Of the 5935 titles identified, 47 articles were included in this review. The participants experienced the programs as beneficial according to less symptom distress and greater awareness of their own health, improved self-management strategies, peer support, learning and hope. CONCLUSION A substantial evidence base supports the conclusion that group based self-management patient education programs in different ways have been experienced as beneficial, but more research is needed. PRACTICE IMPLICATIONS The insights gained from this review can enable researchers, health care professionals, and participants to understand the complexity in evaluating self-management patient education programs, and constitute a basis for a more standardized and systematic evaluation. The results may also encourage health care professionals in planning and carrying out programs in cooperation with lay participants.
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Affiliation(s)
- Una Stenberg
- Norwegian National Advisory Unit on Learning and Mastery in Health, Oslo University Hospital, Postboks 4959 Nydalen, 0424 Oslo, Norway; Center for Shared Decision Making and Collaborative Care Research, Oslo University Hospital, Postboks 4959 Nydalen, 0424 Oslo, Norway.
| | - Mette Haaland-Øverby
- Norwegian National Advisory Unit on Learning and Mastery in Health, Oslo University Hospital, Postboks 4959 Nydalen, 0424 Oslo, Norway.
| | - Kari Fredriksen
- Learning and Mastery Center, Stavanger University Hospital, Postboks 8100, 4068 Stavanger, Norway.
| | - Karl Fredrik Westermann
- Norwegian National Advisory Unit on Learning and Mastery in Health, Oslo University Hospital, Postboks 4959 Nydalen, 0424 Oslo, Norway.
| | - Toril Kvisvik
- Patient Education Resource Center, Møre and Romsdal Hospital, Herman Døhlens vei 1, 6508 Kristiansund, Norway.
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Le Floch B, Bastiaens H, Le Reste JY, Lingner H, Hoffman RD, Czachowski S, Assenova R, Koskela TH, Klemenc-Ketis Z, Nabbe P, Sowinska A, Montier T, Peremans L. Which positive factors determine the GP satisfaction in clinical practice? A systematic literature review. BMC FAMILY PRACTICE 2016; 17:133. [PMID: 27619913 PMCID: PMC5020554 DOI: 10.1186/s12875-016-0524-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2016] [Accepted: 08/25/2016] [Indexed: 11/10/2022]
Abstract
Background Looking at what makes General Practitioners (GPs) happy in their profession, may be important in increasing the GP workforce in the future. The European General Practice Research Network (EGPRN) created a research team (eight national groups) in order to clarify the factors involved in GP job satisfaction throughout Europe. The first step of this study was a literature review to explore how the satisfaction of GPs had been studied before. The research question was “Which factors are related to GP satisfaction in Clinical Practice?” Methods Systematic literature review according to the PRISMA statement. The databases searched were Pubmed, Embase and Cochrane. All articles were identified, screened and included by two separate research teams, according to inclusion or exclusion criteria. Then, a qualitative appraisal was undertaken. Next, a thematic analysis process was undertaken to capture any issue relevant to the research question. Results The number of records screened was 458. One hundred four were eligible. Finally, 17 articles were included. The data revealed 13 subthemes, which were grouped into three major themes for GP satisfaction. First there were general profession-related themes, applicable to many professions. A second group of issues related specifically to a GP setting. Finally, a third group was related to professional life and personal issues. Conclusions A number of factors leading to GP job satisfaction, exist in literature They should be used by policy makers within Europe to increase the GP workforce. The research team needs to undertake qualitative studies to confirm or enhance those results. Electronic supplementary material The online version of this article (doi:10.1186/s12875-016-0524-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- B Le Floch
- ERCR SPURBO, Department of General Practice, Université de Bretagne Occidentale, Faculté de Médecine et des Sciences de la Santé, 22, avenue Camille Desmoulins CS 93837 29238, Brest, CEDEX 3, France.
| | - H Bastiaens
- Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - J Y Le Reste
- ERCR SPURBO, Department of General Practice, Université de Bretagne Occidentale, Faculté de Médecine et des Sciences de la Santé, 22, avenue Camille Desmoulins CS 93837 29238, Brest, CEDEX 3, France
| | - H Lingner
- Centre for Public Health and Healthcare, Hannover Medical School, Hannover, Germany
| | - R D Hoffman
- Department of Family Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - R Assenova
- Department of General Practice, Medical University of Plovdiv, Faculty of Medicine, Plovdiv, Bulgaria
| | - T H Koskela
- Department of General Practice, University of Tampere, Tampere, Finland
| | - Z Klemenc-Ketis
- Department of Family Medicine, University of Ljubljana, Faculty of Medicine, Ljubljana, Slovenia.,Department of Family Medicine, University of Maribor, Faculty of Medicine, Maribor, Slovenia
| | - P Nabbe
- ERCR SPURBO, Department of General Practice, Université de Bretagne Occidentale, Faculté de Médecine et des Sciences de la Santé, 22, avenue Camille Desmoulins CS 93837 29238, Brest, CEDEX 3, France
| | - A Sowinska
- Department of English, Nicolaus Copernicus University, Torun, Poland
| | - T Montier
- ERCR SPURBO, Department of General Practice, Université de Bretagne Occidentale, Faculté de Médecine et des Sciences de la Santé, 22, avenue Camille Desmoulins CS 93837 29238, Brest, CEDEX 3, France.,Unité INSERM 1078, SFR 148 ScInBioS, Université Européenne de Bretagne, Faculté de Médecine et des Sciences de la Santé, Brest, France
| | - L Peremans
- Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Department of Nursing and Midwifery, Faculty of Medicine and Health Sciences, Universiteit Antwerp, Antwerp, Belgium.,Mental Health and Wellbeing Research Group, Vrije Universiteit Brussel, Ixelles, Belgium
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Cragun D, Pal T, Vadaparampil ST, Baldwin J, Hampel H, DeBate RD. Qualitative Comparative Analysis: A Hybrid Method for Identifying Factors Associated with Program Effectiveness. JOURNAL OF MIXED METHODS RESEARCH 2016; 10:251-272. [PMID: 27429602 PMCID: PMC4941817 DOI: 10.1177/1558689815572023] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Qualitative comparative analysis (QCA) was developed over 25 years ago to bridge the qualitative and quantitative research gap. Upon searching PubMed and the Journal of Mixed Methods Research, this review identified 30 original research studies that utilized QCA. Perceptions that QCA is complex and provides few relative advantages over other methods may be limiting QCA adoption. Thus, to overcome these perceptions, this article demonstrates how to perform QCA using data from fifteen institutions that implemented universal tumor screening (UTS) programs to identify patients at high risk for hereditary colorectal cancer. In this example, QCA revealed a combination of conditions unique to effective UTS programs. Results informed additional research and provided a model for improving patient follow-through after a positive screen.
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Affiliation(s)
| | - Tuya Pal
- Moffitt Cancer Center, Tampa, FL, USA
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Tvistholm N, Munch L, Danielsen AK. Constipation is casting a shadow over everyday life - a systematic review on older people's experience of living with constipation. J Clin Nurs 2016; 26:902-914. [PMID: 27271918 DOI: 10.1111/jocn.13422] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2016] [Indexed: 12/19/2022]
Abstract
AIMS AND OBJECTIVES To explore and summarise best evidence of how constipation affects the daily living of older people from their own perspective. Furthermore, to assess how interventions aimed at treating constipation in older people affect patient-reported outcome such as quality of life. BACKGROUND Constipation is a common and overlooked problem with an impact on everyday life, especially among older people. Older people seem to have individual preconceptions on constipation which can influence the strategies used to prevent and treat constipation. DESIGN A systematic review, integrating findings from both qualitative and quantitative studies. METHOD Systematic searches were carried out in PubMed, CINAHL, PsycINFO and EMBASE on the 31st of July 2014. A search strategy was constructed with key concepts identified using PICO to identify quantitative studies and PIC(o) to identify qualitative studies. Search terms included constipation, elderly, aged, elderly people, aged people, quality of life, patient experience, patient perspective, meaning, emotion, psychological. Reference lists were searched manually. RESULTS A total of nine studies were included in the review, five quantitative and four qualitative. Three main themes crystallised from the results of the included studies: bodily experiences, everyday life shadowed by constipation and adverse psychological effects. CONCLUSION Constipation among older people was connected to subjective and comprehensive experiences. It had a negative impact on physical and mental well-being as well as the social life of older people. The review also showed that older people had individual and personal strategies, based on their own beliefs. RELEVANCE TO CLINICAL PRACTICE Healthcare professionals need to be aware of the experiences of living with constipation as well as the range of strategies used by patients to prevent and treat constipation. The patient perspective on constipation needs to be integrated in the strategies and actions carried out by healthcare professionals.
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Affiliation(s)
- Nina Tvistholm
- Institute of Nursing, Metropolitan University College, Copenhagen N, Denmark
| | - Lene Munch
- Institute of Nursing, Metropolitan University College, Copenhagen N, Denmark
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Carragher J, McGaughey J. The effectiveness of peer mentoring in promoting a positive transition to higher education for first-year undergraduate students: a mixed methods systematic review protocol. Syst Rev 2016; 5:68. [PMID: 27101733 PMCID: PMC4840870 DOI: 10.1186/s13643-016-0245-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 04/13/2016] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The global transfer of nursing and midwifery education to higher education institutes has led to student nurses and midwives experiencing challenges previously faced by traditional third-level students, including isolation, loneliness, financial difficulties and academic pressure. These challenges can contribute to increased stress and anxiety levels which may be detrimental to the successful transition to higher education, thus leading to an increase in attrition rates. Peer mentoring as an intervention has been suggested to be effective in supporting students in the transition to third-level education through enhancing a sense of belongingness and improving student satisfaction, engagement and retention rates. This proposed systematic review aims to determine the effectiveness of peer mentoring in enhancing levels of student engagement, sense of belonging and overall satisfaction of first-year undergraduate students following transition into higher education. METHODS MEDLINE, Web of Knowledge, ProQuest, Embase, CINAHL, ERIC, PsycINFO and CENTRAL databases will be searched for qualitative, quantitative and mixed methods studies on the implementation of peer assessment strategies in higher education institutes (HEIs) or universities for full-time, first-year adult students (>17 years). Included studies will be limited to the English language. The quality of included studies will be assessed using a validated Mixed Methods Appraisal Tool (MMAT). The findings will be presented as a narrative synthesis or meta-analysis as appropriate following sequential explanatory synthesis. DISCUSSION The review will provide clear, non-biased evidence-based guidance to all third-level educators on the effectiveness of peer-mentoring programmes for first-year undergraduates. The review is necessary to help establish which type of peer mentoring is most effective. The evidence from qualitative and quantitative studies drawn from the international literature will be utilised to illustrate the best way to implement and evaluate peer mentoring as an effective intervention and will be useful in guiding future research and practice in this area. These findings may be applied internationally across all disciplines.
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Affiliation(s)
- Jean Carragher
- />School of Health and Science, Dundalk Institute of Technology, Dublin Road, Dundalk, Co. Louth Ireland
| | - Jennifer McGaughey
- />School of Nursing & Midwifery, Medical Biology Centre, Queen’s University Belfast, 97 Lisburn Road, Belfast, Northern Ireland
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81
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Bytautas JP, Gheihman G, Dobrow MJ. A scoping review of online repositories of quality improvement projects, interventions and initiatives in healthcare. BMJ Qual Saf 2016; 26:296-303. [PMID: 27099359 DOI: 10.1136/bmjqs-2015-005092] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Revised: 03/09/2016] [Accepted: 04/02/2016] [Indexed: 11/03/2022]
Abstract
BACKGROUND Quality improvement (QI) is becoming an important focal point for health systems. There is increasing interest among health system stakeholders to learn from and share experiences on the use of QI methods and approaches in their work. Yet there are few easily accessible, online repositories dedicated to documenting QI activity. METHODS We conducted a scoping review of publicly available, web-based QI repositories to (i) identify current approaches to sharing information on QI practices; (ii) categorise these approaches based on hosting, scope and size, content acquisition and eligibility, content format and search, and evaluation and engagement characteristics; and (iii) review evaluations of the design, usefulness and impact of their online QI practice repositories. The search strategy consisted of traditional database and grey literature searches, as well as expert consultation, with the ultimate aim of identifying and describing QI repositories of practices undertaken in a healthcare context. RESULTS We identified 13 QI repositories and found substantial variation across the five categories. The QI repositories used different terminology (eg, practices vs case studies) and approaches to content acquisition, and varied in terms of primary areas of focus. All provided some means for organising content according to categories or themes and most provided at least rudimentary keyword search functionality. Notably, none of the QI repositories included evaluations of their impact. DISCUSSION With growing interest in sharing and spreading best practices and increasing reliance on QI as a key contributor to health system performance, the role of QI repositories is likely to expand. Designing future QI repositories based on knowledge of the range and type of features available is an important starting point for improving their usefulness and impact.
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Affiliation(s)
- Jessica P Bytautas
- Department of Public Health, Helsingin Yliopisto Laaketieteellinen tiedekunta, Helsinki, Finland.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | | | - Mark J Dobrow
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
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82
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Affiliation(s)
- David Gough
- EPPI-Centre, Social Science Research Unit, University College London, London, WC1H 0NR, UK.
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83
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Knafl K, Leeman J, Havill NL, Crandell JL, Sandelowski M. The Contribution of Parent and Family Variables to the Well-Being of Youth With Arthritis. JOURNAL OF FAMILY NURSING 2015; 21:579-616. [PMID: 26318728 DOI: 10.1177/1074840715601475] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Among developed countries, the reported prevalence of juvenile idiopathic arthritis (JIA) varies from 16 to 150 per 100,000. Previous reviews have identified risks faced by children with chronic conditions and indicate a relationship between parent/family characteristics and child adaptation. This analysis provides a mixed-methods synthesis of 29 research reports addressing the intersection of family life and JIA. Data were extracted using a structured template, and effect sizes were calculated for reported relationships between variables. Results were coded using a scheme that differentiated types of family factors. Meta-analysis revealed a moderately strong positive relationship between parent and child psychological functioning, and a medium negative relationship between family conflict and child psychosocial well-being, and parental depression and child physical functioning. Thematic analysis of qualitative results identified parenting challenges related to pain management and regimen demands. Results indicate that interventions to enhance parenting competence and family relationships may improve caregiver and patient outcomes.
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84
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Davey S, Davey A, Singh JV. Options for a Health System Researcher to Choose in Meta Review (MR) Approaches-Meta Narrative (MN) and Meta Triangulation (MT). Indian J Community Med 2015; 40:152-7. [PMID: 26170537 PMCID: PMC4478654 DOI: 10.4103/0970-0218.158843] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Accepted: 06/20/2014] [Indexed: 11/24/2022] Open
Abstract
Two new approaches in systematic reviewing i.e. Meta-narrative review(MNR) (which a health researcher can use for topics which are differently conceptualized and studied by different types of researchers for policy decisions) and Meta-triangulation review(MTR) (done to build theory for studying multifaceted phenomena characterized by expansive and contested research domains) are ready for penetration in an arena of health system research. So critical look at which approach in Meta-review is better i.e. Meta-narrative review or Meta-triangulation review, can give new insights to a health system researcher. A systematic review on 2 key words-“meta-narrative review” and “meta-triangulation review” in health system research, were searched from key search engines, such as Pubmed, Cochrane library, Bio-med Central and Google Scholar etc till 21st March 2014 since last 20 years. Studies from both developed and developing world were included in any form and scope to draw final conclusions. However unpublished data from thesis was not included in systematic review. Meta-narrative review is a type of systematic review which can be used for a wide range of topics and questions involving making judgments and inferences in public health. On the other hand Meta-triangulation review is a three-phased, qualitative meta-analysis process which can be used to explore variations in the assumptions of alternative paradigms, gain insights into these multiple paradigms at one point of time and addresses emerging themes and the resulting theories.
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Affiliation(s)
- Sanjeev Davey
- Department of Community Medicine, Muzaffarnagar Medical College, Muzaffarnagar, Uttar Pradesh, India
| | - Anuradha Davey
- Department of Subharti Medical College, Meerut, Uttar Pradesh, India
| | - Jai Vir Singh
- Department of Community Medicine, Muzaffarnagar Medical College, Muzaffarnagar, Uttar Pradesh, India
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85
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Oliver S. Advantages of concurrent preparation and reporting of systematic reviews of quantitative and qualitative evidence. J R Soc Med 2015; 108:108-11. [PMID: 25792617 DOI: 10.1177/0141076815575231] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Sandy Oliver
- Social Science Research Unit, UCL Institute of Education, University of London, London, WC1H 0AL, UK
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86
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Leeman J, Sandelowski M, Havill NL, Knafl K. Parent-to-Child Transition in Managing Cystic Fibrosis: A Research Synthesis. JOURNAL OF FAMILY THEORY & REVIEW 2015; 7:167-183. [PMID: 26279680 PMCID: PMC4532343 DOI: 10.1111/jftr.12070] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Although parents and children must adhere to five primary treatments for cystic fibrosis (CF), and their roles transition over time, the scope of CF studies often has been limited to one treatment regimen or to children within a specified age range. The purpose of this mixed research synthesis study is to integrate findings from qualitative and quantitative studies addressing the transition of CF management from parent to child, as well as factors related to adherence across treatments and over time. An existing grounded theory was used as a framework to synthesize findings in 17 reports from 16 studies. The results confirm the theory and posit three additional factors that may influence parent-to-child transition of care management.
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Affiliation(s)
- Jennifer Leeman
- School of Nursing, University of North Carolina at Chapel Hill
| | | | - Nancy L Havill
- School of Nursing, University of North Carolina at Chapel Hill
| | - Kathleen Knafl
- School of Nursing, University of North Carolina at Chapel Hill
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87
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Petticrew M. Time to rethink the systematic review catechism? Moving from 'what works' to 'what happens'. Syst Rev 2015; 4:36. [PMID: 25875303 PMCID: PMC4384311 DOI: 10.1186/s13643-015-0027-1] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Accepted: 03/10/2015] [Indexed: 01/08/2023] Open
Abstract
Systematic review methods are developing rapidly, and most researchers would recognise their key methodological aspects, such as a closely focussed question, a comprehensive search, and a focus on synthesising 'stronger' rather than 'weaker' evidence. However, it may be helpful to question some of these underlying principles, because while they work well for simpler review questions, they may result in overly narrow approaches to more complex questions and interventions. This commentary discusses some core principles of systematic reviews, and how they may require further rethinking, particularly as reviewers turn their attention to increasingly complex issues, where a Bayesian perspective on evidence synthesis, which would aim to assemble evidence - of different types, if necessary - in order to inform decisions', may be more productive than the 'traditional' systematic review model. Among areas identified for future research are the examination of publication bias in qualitative research; research on the efficiency and potential biases of comprehensive searches in different disciplines; and the use of Bayesian methods in evidence synthesis. The incorporation of a systems perspective into systematic reviews is also an area which needs rapid development.
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Affiliation(s)
- Mark Petticrew
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK.
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88
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Knafl K, Leeman J, Havill N, Crandell J, Sandelowski M. Delimiting family in syntheses of research on childhood chronic conditions and family life. FAMILY PROCESS 2015; 54:173-84. [PMID: 25264114 PMCID: PMC4419369 DOI: 10.1111/famp.12101] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Synthesis of family research presents unique challenges to investigators who must delimit what will be included as a family study in the proposed review. In this paper, the authors discuss the conceptual and pragmatic challenges of conducting systematic reviews of the literature on the intersection between family life and childhood chronic conditions. A proposed framework for delimiting the family domain of interest is presented. The framework addresses both topical salience and level of relevance and provides direction to future researchers, with the goal of supporting the overall quality of family research synthesis efforts. For users of synthesis studies, knowledge of how investigators conceptualize the boundaries of family research is important contextual information for understanding the limits and applicability of the results.
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Affiliation(s)
- Kathleen Knafl
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC
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89
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90
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91
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Royce S, Khann S, Yadav RP, Mao ET, Cattamanchi A, Sam S, Handley MA. Identifying multidrug resistance in previously treated tuberculosis patients: a mixed-methods study in Cambodia. Int J Tuberc Lung Dis 2014; 18:1299-306. [PMID: 25299861 PMCID: PMC4214146 DOI: 10.5588/ijtld.14.0116] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING Previously treated tuberculosis (TB) patients are a priority for drug susceptibility testing (DST) to identify cases with multidrug-resistant TB (MDR-TB). A Cambodia study found that one third of smear-positive previously treated patients had DST results. OBJECTIVE To quantify the gaps in the detection of MDR-TB in previously treated TB patients in Cambodia, and describe health workers' perspectives on barriers, facilitators and potential interventions. DESIGN Analysis of Cambodia's 2004-2012 case notifications and semi-structured interviews with stakeholders. RESULTS The proportion of previously treated notifications varied significantly across provinces in 2010-2012. If there had been no attrition along the path to detecting MDR-TB among smear-positive notified cases in 2012, an estimated 75 additional MDR-TB cases could have been identified, which would double the number actually detected. Most were lost due to misclassification of previously treated patients as 'new'. Barriers include patients' reluctance to disclose and staff difficulty in eliciting treatment history, partly attributed to the availability of streptomycin (SM) only in hospitals. Facilitators include collection of sputum for DST even if previously treated patients are not receiving SM, streamlining sputum transportation and prompt reporting of results. CONCLUSION Improved monitoring, supportive staff supervision and training, patient education, and correct classification of previously treated cases are essential for improving the detection of MDR-TB.
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Affiliation(s)
- S Royce
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - S Khann
- Cambodia Office, World Health Organization, Phnom Penh, Cambodia
| | - R P Yadav
- Cambodia Office, World Health Organization, Phnom Penh, Cambodia
| | - E T Mao
- National Centre for Tuberculosis and Leprosy Control, Phnom Penh, Cambodia
| | - A Cattamanchi
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, San Francisco General Hospital, University of California San Francisco, San Francisco, California, USA
| | - S Sam
- Cambodian Health Committee, Phnom Penh, Cambodia
| | - M A Handley
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
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92
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Ekblad S, Persson-Valenzuela UB. Lifestyle course as an investment in perceived improved health among newly arrived women from countries outside Europe. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:10622-40. [PMID: 25321877 PMCID: PMC4210998 DOI: 10.3390/ijerph111010622] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Revised: 09/23/2014] [Accepted: 10/10/2014] [Indexed: 11/16/2022]
Abstract
Family reunification was the most common reason (34%) for resettlement in Sweden in 2013. About one-fifth of the population is foreign-born. This study used mixed methods to evaluate a culturally tailored clinical health-promotion intervention. The intervention was conducted by licensed clinicians and a local coordinator. Sessions were five-weeks long, two hours a week. The quantitative data cover results from 54 participants, mainly Arabic and Somali-speaking, who participated in 10 groups. The participants' perceived health improved significantly over the three measures. They also shared that their health significantly improved according to moderate effect size. The qualitative data, analyzed using revised content analysis, reflected one general theme: "the intervention is an investment in perceived improved health", and four categories: "perceived increased health literacy", "strength, empowerment and security", "finding a new lifestyle", and "the key to entry into Swedish society is language". An intervention focusing on the prevention of ill-health, on health as a human right, and on empowerment, and aimed at female newcomers, has practical implications.
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Affiliation(s)
- Solvig Ekblad
- Cultural Medicine Unit, Department of Learning, Information, Management and Ethics, Karolinska Institutet, SE-171 77 Stockholm, Sweden.
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93
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Abstract
Although qualitative researches (QR) are invaluable in understanding complex healthcare situations, the quantitative systematic reviews could not treat them. To improve quality of healthcare services, results of QR should be considered in healthcare decision-making processes. Several methods and theories for synthesizing evidences of QR have been developed. In order to activate the narrative reviews and mixed methods reviews in Korean healthcare academies, I arranged the related nomenclatures and suggested some issues to conduct them.
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Affiliation(s)
- Jong-Myon Bae
- Department of Preventive Medicine, Jeju National University School of Medicine, Jeju, Korea
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94
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Janamian T, Jackson CL, Glasson N, Nicholson C. A systematic review of the challenges to implementation of the patient‐centred medical home: lessons for Australia. Med J Aust 2014; 201:S69-73. [DOI: 10.5694/mja14.00295] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Accepted: 05/29/2014] [Indexed: 11/17/2022]
Affiliation(s)
- Tina Janamian
- Centre of Research Excellence in Primary Health Care Microsystems, University of Queensland, Brisbane, QLD
| | - Claire L Jackson
- Discipline of General Practice, University of Queensland, Brisbane, QLD
- Centres for Primary Care Reform Research Excellence, University of Queensland, Brisbane, QLD
| | - Nicola Glasson
- Faculty of Medicine, James Cook University, Townsville, QLD
| | - Caroline Nicholson
- Discipline of General Practice, University of Queensland, Brisbane, QLD
- Mater–UQ Centre for Primary Healthcare Innovation, Mater Health Services, Brisbane, QLD
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95
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Haregu TN, Setswe G, Elliott J, Oldenburg B. National Responses to HIV/AIDS and Non-Communicable Diseases in Developing Countries: Analysis of Strategic Parallels and Differences. J Public Health Res 2014; 3:99. [PMID: 25170505 PMCID: PMC4140380 DOI: 10.4081/jphr.2014.99] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Accepted: 02/28/2014] [Indexed: 11/27/2022] Open
Abstract
HIV/AIDS and non-communicable diseases (NCDs) epidemics may have many important similarities in their aetiology, pathogenesis and management. Evidence about the similarities and differences between the national responses HIV/AIDS and NCDs is essential for an integrated response. The objective of this study was to examine the parallels and differences between national responses to HIV/AIDS and NCDs in selected developing countries. This study applied a strategic level comparative case study approach as its study design. The main construct was national response to HIV/AIDS and NCDs. The 4 overarching themes were policy response, institutional mechanism, programmatic response and strategic information. Four countries were purposively selected as cases. Data were collected and triangulated from a multiple sources. The focus of analysis included identifying items for comparison, characteristics to be compared, degrees of similarity, and strategic importance of similarities. Analysis of data was qualitative content analysis with within-case, between-case, and across-case comparisons. While the nature of the disease and the contents of national HIV/AIDS and NCD policies are different, the policy processes involved are largely similar. Functional characteristics of programmatic response to HIV/AIDS and NCDs are similar. But the internal constituents are different. Though both HIV and NCDs require both a multi-sectorial response and a national coordination mechanism, the model and the complexity of the coordination are different. Strategic information frameworks for HIV/AIDS and NCDs use similar models. However, the indicators, targets and priorities are different. In conclusion, the national responses between HIV/AIDS and NCDs are largely similar in approaches and functions but different in content. Significance for public health This study explores the parallels and differences between national responses to HIV/AIDS and non-communicable diseases (NCDs). The identified parallels can be the basis for integrated response to HIV/AIDS and NCDs. In contrast, the important differences are essential for maintaining the integrity of the responses to HIV/AIDS and NCDs in the process of integration.
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Affiliation(s)
- Tilahun Nigatu Haregu
- Department of Epidemiology and Preventive Medicine, Monash University , Melbourne, Australia
| | - Geoffrey Setswe
- School of Health Sciences, Monash University , Ruimsig, South Africa
| | - Julian Elliott
- Infectious Disease Unit, Alfred Hospital , Melbourne, Australia
| | - Brian Oldenburg
- Department of Epidemiology and Preventive Medicine, Monash University , Melbourne, Australia
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96
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Nicholson C, Jackson C, Marley J. A governance model for integrated primary/secondary care for the health-reforming first world - results of a systematic review. BMC Health Serv Res 2013; 13:528. [PMID: 24359610 PMCID: PMC4234138 DOI: 10.1186/1472-6963-13-528] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Accepted: 12/02/2013] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Internationally, key health care reform elements rely on improved integration of care between the primary and secondary sectors. The objective of this systematic review is to synthesise the existing published literature on elements of current integrated primary/secondary health care. These elements and how they have supported integrated healthcare governance are presented. METHODS A systematic review of peer-reviewed literature from PubMed, MEDLINE, CINAHL, the Cochrane Library, Informit Health Collection, the Primary Health Care Research and Information Service, the Canadian Health Services Research Foundation, European Foundation for Primary Care, European Forum for Primary Care, and Europa Sinapse was undertaken for the years 2006-2012. Relevant websites were also searched for grey literature. Papers were assessed by two assessors according to agreed inclusion criteria which were published in English, between 2006-2012, studies describing an integrated primary/secondary care model, and had reported outcomes in care quality, efficiency and/or satisfaction. RESULTS Twenty-one studies met the inclusion criteria. All studies evaluated the process of integrated governance and service delivery structures, rather than the effectiveness of services. They included case reports and qualitative data analyses addressing policy change, business issues and issues of clinical integration. A thematic synthesis approach organising data according to themes identified ten elements needed for integrated primary/secondary health care governance across a regional setting including: joint planning; integrated information communication technology; change management; shared clinical priorities; incentives; population focus; measurement - using data as a quality improvement tool; continuing professional development supporting joint working; patient/community engagement; and, innovation. CONCLUSIONS All examples of successful primary/secondary care integration reported in the literature have focused on a combination of some, if not all, of the ten elements described in this paper, and there appears to be agreement that multiple elements are required to ensure successful and sustained integration efforts. Whilst no one model fits all systems these elements provide a focus for setting up integration initiatives which need to be flexible for adapting to local conditions and settings.
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Affiliation(s)
- Caroline Nicholson
- Discipline of General Practice, University of Queensland, Brisbane, Australia
- Mater/UQ Centre for Primary Health Care Innovation, Mater Health Services, Level 2 JP Kelly Building, Raymond Tce, South Brisbane, Qld 4101, Australia
| | - Claire Jackson
- Discipline of General Practice, University of Queensland, Brisbane, Australia
| | - John Marley
- Discipline of General Practice, University of Queensland, Brisbane, Australia
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97
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Danielsen AK, Burcharth J, Rosenberg J. Spouses of patients with a stoma lack information and support and are restricted in their social and sexual life: a systematic review. Int J Colorectal Dis 2013; 28:1603-12. [PMID: 23900653 DOI: 10.1007/s00384-013-1749-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/15/2013] [Indexed: 02/04/2023]
Abstract
PURPOSE A permanent stoma has a large impact on everyday life with several physical, mental, and social impairments for the individual. It seems obvious that if persons with stomas are affected socially by the stoma creation, it is likely that the family and/or relatives will be affected as well. The objective of this systematic review was to explore how stoma creation may affect spouses of patients with stomas. METHODS A systematic review was undertaken based on database searches including studies published from 1950 to 2012. We applied a method of synthesis based on narrative summaries of both qualitative and quantitative results being assessed in parallel processes and finally included in a joint synthesis of results on a study level. RESULTS We identified 17 studies and included 6 studies. Spouses wanted to be more involved in the stoma education and specifically wanted more focus on the psychosocial aspects of stoma creation. Furthermore, spouses' sexual life was seriously affected, and their social life was restricted. In general, spouses wished for more support from the health care sector as well as from family and friends. CONCLUSIONS There is a need for further research focusing on spouses or relatives. Talking about worries and concerns regarding the new life situation may alleviate suffering and reduce uncertainty. Stoma nurses and other health professionals play an important role in the care of patients as well as spouses, and a greater insight into the worries and concerns affecting spouses is warranted to improve postoperative counseling and education.
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Affiliation(s)
- Anne Kjaergaard Danielsen
- Department of Surgery, Herlev Hospital, University of Copenhagen, Herlev Ringvej 75, 2730, Herlev, Denmark,
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98
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Thomson H. Improving utility of evidence synthesis for healthy public policy: the three Rs (relevance, rigor, and readability [and resources]). Am J Public Health 2013; 103:e17-23. [PMID: 23763400 PMCID: PMC4007892 DOI: 10.2105/ajph.2013.301400] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/10/2013] [Indexed: 11/04/2022]
Abstract
Systematic reviews have the potential to promote knowledge exchange between researchers and decision-makers. Review planning requires engagement with evidence users to ensure preparation of relevant reviews, and well-conducted reviews should provide accessible and reliable synthesis to support decision-making. Yet, systematic reviews are not routinely referred to by decision-makers, and innovative approaches to improve the utility of reviews is needed. Evidence synthesis for healthy public policy is typically complex and methodologically challenging. Although not lessening the value of reviews, these challenges can be overwhelming and threaten their utility. Using the interrelated principles of relevance, rigor, and readability, and in light of available resources, this article considers how utility of evidence synthesis for healthy public policy might be improved.
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Affiliation(s)
- Hilary Thomson
- MRC/CSO Social & Public Health Science Unit, Glasgow, United Kingdom.
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99
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Sandelowski M, Leeman J, Knafl K, Crandell JL. Text-in-context: a method for extracting findings in mixed-methods mixed research synthesis studies. J Adv Nurs 2013; 69:1428-37. [PMID: 22924808 PMCID: PMC3535067 DOI: 10.1111/jan.12000] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2012] [Indexed: 10/28/2022]
Abstract
AIM Our purpose in this paper is to propose a new method for extracting findings from research reports included in mixed-methods mixed research synthesis studies. BACKGROUND International initiatives in the domains of systematic review and evidence synthesis have been focused on broadening the conceptualization of evidence, increased methodological inclusiveness and the production of evidence syntheses that will be accessible to and usable by a wider range of consumers. Initiatives in the general mixed-methods research field have been focused on developing truly integrative approaches to data analysis and interpretation. DATA SOURCE The data extraction challenges described here were encountered, and the method proposed for addressing these challenges was developed, in the first year of the ongoing (2011-2016) study: Mixed-Methods Synthesis of Research on Childhood Chronic Conditions and Family. DISCUSSION To preserve the text-in-context of findings in research reports, we describe a method whereby findings are transformed into portable statements that anchor results to relevant information about sample, source of information, time, comparative reference point, magnitude and significance and study-specific conceptions of phenomena. IMPLICATIONS FOR NURSING The data extraction method featured here was developed specifically to accommodate mixed-methods mixed research synthesis studies conducted in nursing and other health sciences, but reviewers might find it useful in other kinds of research synthesis studies. CONCLUSION This data extraction method itself constitutes a type of integration to preserve the methodological context of findings when statements are read individually and in comparison to each other.
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Affiliation(s)
- Margarete Sandelowski
- University of North Carolina at Chapel Hill School of Nursing, Chapel Hill, North Carolina, USA.
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Wong G, Greenhalgh T, Westhorp G, Buckingham J, Pawson R. RAMESES publication standards: meta-narrative reviews. BMC Med 2013; 11:20. [PMID: 23360661 PMCID: PMC3558334 DOI: 10.1186/1741-7015-11-20] [Citation(s) in RCA: 196] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Accepted: 01/29/2013] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND Meta-narrative review is one of an emerging menu of new approaches to qualitative and mixed-method systematic review. A meta-narrative review seeks to illuminate a heterogeneous topic area by highlighting the contrasting and complementary ways in which researchers have studied the same or a similar topic. No previous publication standards exist for the reporting of meta-narrative reviews. This publication standard was developed as part of the RAMESES (Realist And MEta-narrative Evidence Syntheses: Evolving Standards) project. The project's aim is to produce preliminary publication standards for meta-narrative reviews. METHODS We (a) collated and summarized existing literature on the principles of good practice in meta-narrative reviews; (b) considered the extent to which these principles had been followed by published reviews, thereby identifying how rigor may be lost and how existing methods could be improved; (c) used a three-round online Delphi method with an interdisciplinary panel of national and international experts in evidence synthesis, meta-narrative reviews, policy and/or publishing to produce and iteratively refine a draft set of methodological steps and publication standards; (d) provided real-time support to ongoing meta-narrative reviews and the open-access RAMESES online discussion list so as to capture problems and questions as they arose; and (e) synthesized expert input, evidence review and real-time problem analysis into a definitive set of standards. RESULTS We identified nine published meta-narrative reviews, provided real-time support to four ongoing reviews and captured questions raised in the RAMESES discussion list. Through analysis and discussion within the project team, we summarized the published literature, and common questions and challenges into briefing materials for the Delphi panel, comprising 33 members. Within three rounds this panel had reached consensus on 20 key publication standards, with an overall response rate of 90%. CONCLUSION This project used multiple sources to draw together evidence and expertise in meta-narrative reviews. For each item we have included an explanation for why it is important and guidance on how it might be reported. Meta-narrative review is a relatively new method for evidence synthesis and as experience and methodological developments occur, we anticipate that these standards will evolve to reflect further theoretical and methodological developments. We hope that these standards will act as a resource that will contribute to improving the reporting of meta-narrative reviews.
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Affiliation(s)
- Geoff Wong
- Centre for Primary Care and Public Health, Queen Mary University of London, London, UK.
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