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McGrath D, O’Halloran P, Prue G, Brown M, Millar J, O’Donnell A, McWilliams L, Murphy C, Hinds G, Reid J. Exercise Interventions for Women with Ovarian Cancer: A Realist Review. Healthcare (Basel) 2022; 10:healthcare10040720. [PMID: 35455897 PMCID: PMC9024745 DOI: 10.3390/healthcare10040720] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/25/2022] [Accepted: 04/02/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Despite evidence indicating the benefits of exercise interventions for women with ovarian cancer both during and following treatment, uptake is poor. There is limited research exploring the implementation of such interventions for this cohort of women. The purpose of this review was to identify implementation theories in relation to exercise interventions for women with stages I–IV ovarian cancer, both during and following treatment; to explain positive and negative contextual factors, which may help or hinder implementation; and to develop a theory on how exercise interventions for women with ovarian cancer may be implemented. Methods: This realist review sourced literature from five electronic databases: CINAHL plus, Medline, Embase, PsycINFO and Google Scholar. Methodological rigour was assessed using the relevant critical appraisal skills programme tools. Results: Nine papers were included. Two intervention stages were identified: first, optimising uptake by providing education to patients on the benefits of exercise, approaching patients when symptoms are adequately managed and offering a personalised exercise programme; second, adherence and retention are influenced by the provision of an “autoregulated” exercise programme with additional supportive infrastructure, individualised goal setting and symptom management support where required. Conclusion: Women with ovarian cancer are reluctant to engage in exercise interventions, despite the supporting evidence in terms of positive clinical outcomes. This realist review elucidates underlying mechanisms and important contextual factors that will support and guide the implementation of exercise interventions for this cohort of women.
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Affiliation(s)
- Deirdre McGrath
- School of Nursing & Midwifery, Queen’s University Belfast, Belfast BT7 1NN, UK; (P.O.); (G.P.); (M.B.); (J.R.)
- Correspondence:
| | - Peter O’Halloran
- School of Nursing & Midwifery, Queen’s University Belfast, Belfast BT7 1NN, UK; (P.O.); (G.P.); (M.B.); (J.R.)
| | - Gillian Prue
- School of Nursing & Midwifery, Queen’s University Belfast, Belfast BT7 1NN, UK; (P.O.); (G.P.); (M.B.); (J.R.)
| | - Malcolm Brown
- School of Nursing & Midwifery, Queen’s University Belfast, Belfast BT7 1NN, UK; (P.O.); (G.P.); (M.B.); (J.R.)
| | - Joanne Millar
- Belfast City Hospital, Belfast Health and Social Care Trust, Belfast BT9 7AB, UK; (J.M.); (A.O.); (L.M.); (G.H.)
| | - Adrina O’Donnell
- Belfast City Hospital, Belfast Health and Social Care Trust, Belfast BT9 7AB, UK; (J.M.); (A.O.); (L.M.); (G.H.)
| | - Lisa McWilliams
- Belfast City Hospital, Belfast Health and Social Care Trust, Belfast BT9 7AB, UK; (J.M.); (A.O.); (L.M.); (G.H.)
| | | | - Gwyneth Hinds
- Belfast City Hospital, Belfast Health and Social Care Trust, Belfast BT9 7AB, UK; (J.M.); (A.O.); (L.M.); (G.H.)
| | - Joanne Reid
- School of Nursing & Midwifery, Queen’s University Belfast, Belfast BT7 1NN, UK; (P.O.); (G.P.); (M.B.); (J.R.)
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Wearne N, Davidson B, Motsohi T, Mc Culloch M, Krause R. Radically Rethinking Renal Supportive and Palliative Care in South Africa. Kidney Int Rep 2020; 6:568-573. [PMID: 33732973 PMCID: PMC7938062 DOI: 10.1016/j.ekir.2020.11.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 11/13/2020] [Accepted: 11/17/2020] [Indexed: 12/04/2022] Open
Abstract
The incidence of end-stage kidney disease (ESKD) is increasing worldwide; however, because of resource constraints, access to lifesaving kidney replacement therapy (KRT) remains limited in the state sector in South Africa. National guidelines mandate that only patients who are transplantable be accepted into state chronic dialysis programs. Once a patient is transplanted, there is an opportunity for a new patient to access a chronic dialysis slot. Given the resource scarcity, the South African Constitutional Court has ruled that rationing of dialysis is appropriate; however, this is not without cost both to patients and decision makers. Patients, both adults and pediatric, are often placed on a palliative care (PC) pathway not through choice but through circumstance. Renal supportive care (RSC) and PC involve an interdisciplinary approach to manage patients with ESKD to ensure that symptoms are managed optimally and to provide support during advanced disease. Innovative ways to address patient care at any age must be sought to ensure nonabandonment and adequate care with our limited resources.
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Affiliation(s)
- Nicola Wearne
- Division of Nephrology and Hypertension, Groote Schuur Hospital, Nephrology and Hypertension Research Unit, University of Cape Town, Cape Town, South Africa
- Correspondence: Nicola Wearne, Department of Nephrology and Hypertension, University of Cape Town Department of Medicine Observatory, Western Cape, South Africa.
| | - Bianca Davidson
- Division of Nephrology and Hypertension, Groote Schuur Hospital, Nephrology and Hypertension Research Unit, University of Cape Town, Cape Town, South Africa
| | - Ts'epo Motsohi
- Division of Family Medicine in the School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Mignon Mc Culloch
- Department of Paediatric Nephrology, Red Cross War Memorial Children’s Hospital, Cape Town, South Africa
| | - Rene Krause
- Palliative Medicine, Division of Family Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
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Menopause uncertainty: the impact of two educational interventions among women during menopausal transition and beyond. MENOPAUSE REVIEW 2020; 19:18-24. [PMID: 32508552 PMCID: PMC7258369 DOI: 10.5114/pm.2020.95305] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Accepted: 03/05/2020] [Indexed: 11/17/2022]
Abstract
Introduction Menopause is a natural part of women's lives, which is associated with physical and mental changes and can lead to uncertainty and consequent undesirable effects in the lives of menopausal women. The present study was conducted to compare the impact of multimedia and booklet educational methods on the uncertainty about menopause during this transition period. Materials and methods In a cluster randomized trial 68 women aged 45-55 years were randomly allocated into two groups: multimedia and booklet. Data were collected using knowledge and uncertainty questionnaires about menopause in three stages, i.e. before intervention, immediately after intervention (two weeks later), and one month later. Repeated-measures analysis of variance (rANOVA) was used to compare knowledge and uncertainty scores between two groups for the duration of the study. Data were analysed using SPSS software and p values < 0.05 were considered as statistically significant. Results The results of the study indicated a high level of uncertainty in both groups before the implementation of the educational program. There was no significant difference between groups in terms of knowledge and uncertainty about menopause over time (p > 0.05). However, we found a significant increase in knowledge and a significant decrease in uncertainty scores in both groups (p < 0.001) after the interventions. Conclusions Although the findings of this study did not show a significant difference between the effect of multimedia and booklet educational methods in postmenopausal women, the high level of uncertainty of women before intervention and its significant reduction after the implementation of the educational programs indicated the importance of education throughout this period.
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Carswell C, Reid J, Walsh I, McAneney H, Lee JB, Noble H. Complex arts-based interventions for patients receiving haemodialysis: A realist review. Arts Health 2020; 13:107-133. [PMID: 32233723 DOI: 10.1080/17533015.2020.1744173] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Many patients with end-stage kidney disease require haemodialysis, a treatment that requires attending hospital three times a week for four hours each visit. This treatment impacts profoundly on mental health. Arts-based interventions for patients receiving haemodialysis could address the impact of this treatment; however, there is no consensus on methods of implementation and mechanisms underlying these interventions in specific clinical contexts. Using a realist approach, relevant articles were synthesised to inform theory relating to the mechanism and implementation of complex arts-based interventions for haemodialysis patients. The theoretical framework includes two implementation phases, firstly delivery of person-centred art activities during haemodialysis and secondly, display of completed artwork. This intervention triggers mechanisms including flow and social capital. Implementation is hindered by constraints of the haemodialysis unit and patients' lack of confidence in their artistic skills. These issues can be addressed through aflexible approach to implementation and support from healthcare professionals.
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Affiliation(s)
- Claire Carswell
- School of Nursing and Midwifery, Medical Biology Centre, Queen's University, Belfast, UK
| | - Joanne Reid
- School of Nursing and Midwifery, Medical Biology Centre, Queen's University, Belfast, UK
| | - Ian Walsh
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast UK
| | - Helen McAneney
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast UK
| | - Jenny Baxley Lee
- UF Health Shands Arts in Medicine, University of Florida, Gainesville, Florida, USA
| | - Helen Noble
- School of Nursing and Midwifery, Medical Biology Centre, Queen's University, Belfast, UK
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Chouinard AM, Larouche E, Audet MC, Hudon C, Goulet S. Mindfulness and psychoeducation to manage stress in amnestic mild cognitive impairment: A pilot study. Aging Ment Health 2019; 23:1246-1254. [PMID: 30406681 DOI: 10.1080/13607863.2018.1484890] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objectives: Amnestic mild cognitive impairment (aMCI) often corresponds to the prodromal stage of Alzheimer disease (AD). The aMCI stage represents a crucial time window to apply preventive interventions in an attempt to delay cognitive decline. Stress, one of AD's modifiable risk factors frequently co-occurring with aMCI, stands out as a key intervention target. The goal of this study was to assess the impacts of two non-pharmacological interventions, mindfulness and psychoeducation, on stress at the psychological and physiological levels among aMCI older adults. Methods: Forty-eight aMCI participants were randomized between a mindfulness-based intervention (MBI) and a psychoeducation-based intervention (PBI) for eight weekly sessions. Anxiety symptoms, perceived stress levels, cortisol awakening response (CAR), and coping strategies were assessed pre- and post-intervention. Mindfulness attitudes and time dedicated to at-home meditative practices were evaluated in the MBI group. Results: The main results revealed a slight reduction of the CAR among MBI participants who practiced meditation at home the most and a decrease in perceived stress levels in the PBI group. Both interventions enhanced problem-focused coping strategies. Conclusion: In sum, this pilot study supports the potential of MBI and PBI to reduce stress at the physiological and psychological level, respectively, and increase coping strategies in older adults at risk for AD.
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Affiliation(s)
- Anne-Marie Chouinard
- a CERVO Research Centre , Quebec , Canada.,b School of Psychology , Laval University , Quebec , Canada
| | - Eddy Larouche
- a CERVO Research Centre , Quebec , Canada.,b School of Psychology , Laval University , Quebec , Canada
| | - Marie-Claude Audet
- c School of Nutrition Sciences , University of Ottawa , Ottawa , Canada.,d The Royal's Institute of Mental Health Research , Ottawa , Canada
| | - Carol Hudon
- a CERVO Research Centre , Quebec , Canada.,b School of Psychology , Laval University , Quebec , Canada
| | - Sonia Goulet
- a CERVO Research Centre , Quebec , Canada.,b School of Psychology , Laval University , Quebec , Canada
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Scott D, Hudson P, Charnley K, Payne C, Westcott G. Development of an eHealth information resource for family carers supporting a person receiving palliative care on the island of Ireland. BMC Palliat Care 2019; 18:74. [PMID: 31470841 PMCID: PMC6717391 DOI: 10.1186/s12904-019-0457-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 08/13/2019] [Indexed: 01/22/2023] Open
Abstract
Background Many people receiving palliative care wish to die at home. Often, support from family or friends is key to ensuring that this wish is fulfilled. However, carers report feeling underprepared to undertake this role. This paper describes the process of developing a consensus and evidence based website to provide core information to help people support someone receiving palliative care on the island of Ireland. Methods The project comprised three phases: (1) a review of systematic reviews facilitated the identification of core information needs; (2) content was developed in collaboration with a Virtual Reference Group (VRG) comprising patients, carers and professionals; and, (3) subject experts within the project team worked with a web developer to précis the agreed content and ensure it was in a format that was appropriate for a website. Members of the VRG were then invited to test and approve the website before it was made available to the general public. Results Nineteen systematic reviews identified nine consensus areas of core information required by carers; a description of palliative care; prognosis and treatment of the condition; medication and pain management; personal care; specialist equipment; locally available support services; what to do in an emergency; nutrition; and, support for the carer. This information was shared with the VRG and used to develop website content. Conclusions We engaged with service users and professionals to develop an evidence-based website addressing the agreed core information needs of non-professional carers who wish to provide palliative care to a friend or relative.
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Affiliation(s)
- David Scott
- School of Nursing and Midwifery, Medical Biology Centre, Queen's University Belfast, Lisburn Road, Belfast, BT9 7BL, UK.
| | - Peter Hudson
- School of Nursing and Midwifery, Medical Biology Centre, Queen's University Belfast, Lisburn Road, Belfast, BT9 7BL, UK
| | - Karen Charnley
- All Ireland Institute of Hospice and Palliative Care, Our Lady's Hospice and Care Services, Harold's Cross, Dublin 6, Ireland
| | - Cathy Payne
- All Ireland Institute of Hospice and Palliative Care, Our Lady's Hospice and Care Services, Harold's Cross, Dublin 6, Ireland
| | - Gareth Westcott
- All Ireland Institute of Hospice and Palliative Care, Our Lady's Hospice and Care Services, Harold's Cross, Dublin 6, Ireland
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Diffin J, Byrne B, Kerr H, Price J, Abbott A, McLaughlin D, O'Halloran P. The usefulness and acceptability of a personal health record to children and young people living with a complex health condition: A realist review of the literature. Child Care Health Dev 2019; 45:313-332. [PMID: 30817012 PMCID: PMC6519173 DOI: 10.1111/cch.12652] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 02/15/2019] [Accepted: 02/24/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND There are a growing number of children and young people (CYP) with chronic health needs or complex disabilities. Increasingly, CYP with life-limiting or life-threatening conditions are surviving into adulthood. Communication between CYP, their family, and health professionals can be challenging. The use of a personal health record (PHR) is one potential strategy for improving communication by promoting CYP's health advocacy skills. However, PHR implementation has proved difficult due to technical, organisational, and professional barriers. The aim of this realist review is to identify the factors, which help or hinder the use of PHRs with CYP living with a complex health condition. METHODS Systematic realist review. Literature was sourced from six databases: Medline, Embase, CINAHL, PsychInfo, The Cochrane Library, and Science Direct (from 1946 to August Week 3 2018). The web was searched to identify grey literature. Articles were sourced from reference lists of included studies. Data were extracted using a standardised data extraction form. Two reviewers completed data extraction and synthesis. Methodological rigor was assessed using the relevant Critical Appraisal Skills Programme tool. RESULTS Nine articles were included. Contextual factors, which helped implementation, included the CYP having a high perception of need for a PHR and a high level of desire for self-management. Service providers and CYP need knowledge about the purpose and benefits of the PHR, and organisations need a dedicated person to facilitate PHR use. Mechanisms triggered by the PHR included improved understanding and knowledge of health care condition(s) for CYP, an increased feeling of control over condition(s), and more active engagement in their health care. Outcomes for CYP included improved self-advocacy and communication. CONCLUSION Clearer definitions of which young people would benefit from using a PHR must be established to inform which organisations and service providers would be best suited to PHR implementation.
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Affiliation(s)
- Janet Diffin
- School of Nursing and MidwiferyQueen's University BelfastBelfastUK
| | - Bronagh Byrne
- School of Sociology, Social Policy and Social WorkQueen's University BelfastBelfastUK
| | - Helen Kerr
- School of Nursing and MidwiferyQueen's University BelfastBelfastUK
| | - Jayne Price
- School of NursingKingston University LondonLondonUK
| | - Aine Abbott
- Aberfoyle Medical Practice Derry, Specialty Dr Palliative Medicine Foyle Hospice DerryLondonderryUK
| | - Dorry McLaughlin
- School of Nursing and MidwiferyQueen's University BelfastBelfastUK
| | - Peter O'Halloran
- School of Nursing and MidwiferyQueen's University BelfastBelfastUK
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O'Halloran P, Noble H, Norwood K, Maxwell P, Shields J, Fogarty D, Murtagh F, Morton R, Brazil K. Advance Care Planning With Patients Who Have End-Stage Kidney Disease: A Systematic Realist Review. J Pain Symptom Manage 2018; 56:795-807.e18. [PMID: 30025939 PMCID: PMC6203056 DOI: 10.1016/j.jpainsymman.2018.07.008] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 07/04/2018] [Accepted: 07/05/2018] [Indexed: 01/02/2023]
Abstract
CONTEXT Patients with end-stage kidney disease have a high mortality rate and disease burden. Despite this, many do not speak with health care professionals about end-of-life issues. Advance care planning is recommended in this context but is complex and challenging. We carried out a realist review to identify factors affecting its implementation. OBJECTIVES The objectives of this study are 1) to identify implementation theories; 2) to identify factors that help or hinder implementation; and 3) to develop theory on how the intervention may work. METHODS We carried out a systematic realist review, searching seven electronic databases: Medline, Embase, CINAHL, PsycINFO, Cochrane Library, Google Scholar, and ScienceDirect. RESULTS Sixty-two papers were included in the review. CONCLUSION We identified two intervention stages-1) training for health care professionals that addresses concerns, optimizes skills, and clarifies processes and 2) use of documentation and processes that are simple, individually tailored, culturally appropriate, and involve surrogates. These processes work as patients develop trust in professionals, participate in discussions, and clarify values and beliefs about their condition. This leads to greater congruence between patients and surrogates; increased quality of communication between patients and professionals; and increased completion of advance directives. Advance care planning is hindered by lack of training; administrative complexities; pressures of routine care; patients overestimating life expectancy; and when patients, family, and/or clinical staff are reluctant to initiate discussions. It is more likely to succeed where organizations treat it as core business; when the process is culturally appropriate and takes account of patient perceptions; and when patients are willing to consider death and dying with suitably trained staff.
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Affiliation(s)
- Peter O'Halloran
- School of Nursing and Midwifery, Queen's University Belfast, Medical Biology Centre, Belfast, United Kingdom.
| | - Helen Noble
- School of Nursing and Midwifery, Queen's University Belfast, Medical Biology Centre, Belfast, United Kingdom
| | - Kelly Norwood
- School of Psychology, Ulster University, Coleraine Campus, Coleraine, United Kingdom
| | - Peter Maxwell
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Health Sciences Building, Belfast, United Kingdom; Regional Nephrology Unit, Belfast City Hospital, Belfast, United Kingdom
| | - Joanne Shields
- Regional Nephrology Unit, Belfast City Hospital, Belfast, United Kingdom
| | - Damian Fogarty
- Regional Nephrology Unit, Belfast City Hospital, Belfast, United Kingdom
| | - Fliss Murtagh
- Wolfson Palliative Care Research Centre, Hull York Medical School, Allam Medical Building, University of Hull, Hull, United Kingdom
| | - Rachael Morton
- Sydney Medical School, University of Sydney, NSW, Australia
| | - Kevin Brazil
- School of Nursing and Midwifery, Queen's University Belfast, Medical Biology Centre, Belfast, United Kingdom
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Porter S, McConnell T, Reid J. The possibility of critical realist randomised controlled trials. Trials 2017; 18:133. [PMID: 28327182 PMCID: PMC5359862 DOI: 10.1186/s13063-017-1855-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 02/19/2017] [Indexed: 11/17/2022] Open
Abstract
Background Some realists have criticised randomised controlled trials for their inability to explain the causal relations that they identify; to take into account the influence of the social context of the interventions they evaluate; and to account for individual difference. However, among realists, there is controversy over whether it is possible to improve trials by making them realist, or whether realism and the philosophical assumptions underlying trials are incompatible. This paper contributes to the debate in Trials on this issue. The debate thus far has concentrated on the possibility of combining trial methodology with that of realist evaluation. Main body We concur with the contention that it is not feasible to combine randomised controlled trial design with the realist evaluation approach. However, we argue that a different variant of realism, critical realism, provides a more appropriate theoretical grounding for realist trials. In contrast to realist evaluation, which regards social mechanisms as an amalgam of social resources and people’s reasoning, critical realism insists on their distinction. It does so on the basis of its assertion of the need to distinguish between social structures (in which resources lie) and human agency (which is at least partly guided by reasoning). From this perspective, conceiving of social mechanisms as external to participants can be seen as a valid methodological strategy for supplementing the exclusive concentration of trials on outcomes. While accepting realist evaluation’s insistence that causality in open systems involves a configuration of multiple generative mechanisms, we adopt the critical realist interpretation of the experimental method, which sees it as creating artificial closure in order to identify the effects of specific causal mechanisms. If randomised controlled trials can be regarded as epidemiological proxies that substitute probabilistic controls over extraneous factors for closed experiments, their examination of the powers of discrete mechanisms through observation of the variation of outcomes is appropriate. Conclusion While there are still issues to be resolved, critical realist randomised controlled trials are possible and have the potential to overcome some of the difficulties faced by traditional trial designs in accounting for the influence of social context and individual interpretation.
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Affiliation(s)
- Sam Porter
- Department of Social Sciences and Social Work, Bournemouth University, R203, Royal London House, Christchurch Road, BH1 3LT, Bournemouth, UK
| | - Tracey McConnell
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, BT7 1NN, UK
| | - Joanne Reid
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, BT7 1NN, UK.
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Coles E, Cheyne H, Daniel B. Early years interventions to improve child health and wellbeing: what works, for whom and in what circumstances? Protocol for a realist review. Syst Rev 2015; 4:79. [PMID: 26047950 PMCID: PMC4464136 DOI: 10.1186/s13643-015-0068-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 06/01/2015] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Child health and wellbeing is influenced by multiple factors, all of which can impact on early childhood development. Adverse early life experiences can have lasting effects across the life course, sustaining inequalities and resulting in negative consequences for the health and wellbeing of individuals and society. The potential to influence future outcomes via early intervention is widely accepted; there are numerous policy initiatives, programmes and interventions clustered around the early years theme, resulting in a broad and disparate evidence base. Existing reviews have addressed the effectiveness of early years interventions, yet there is a knowledge gap regarding the mechanisms underlying why interventions work in given contexts. METHODS/DESIGN This realist review seeks to address the question 'what works, for whom and in what circumstances?' in terms of early years interventions to improve child health and wellbeing. The review will be conducted following Pawson's five-stage iterative realist methodology: (1) clarify scope, (2) search for evidence, (3) appraise primary studies and extract data, (4) synthesise evidence and draw conclusions and (5) disseminate findings. The reviewers will work with stakeholders in the early stages to refine the focus of the review, create a review framework and build programme theory. Searches for primary evidence will be conducted iteratively. Data will be extracted and tested against the programme theory. A review collaboration group will oversee the review process. DISCUSSION The review will demonstrate how early years interventions do or do not work in different contexts and with what outcomes and effects. Review findings will be written up following the RAMESES guidelines and will be disseminated via a report, presentations and peer-reviewed publications. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42015017832.
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Affiliation(s)
- Emma Coles
- Nursing Midwifery & Allied Health Professions Research Unit (NMAHP-RU), Scion House, University of Stirling Innovation Park, FK9 4NF, Stirling, UK.
| | - Helen Cheyne
- Nursing Midwifery & Allied Health Professions Research Unit (NMAHP-RU), Scion House, University of Stirling Innovation Park, FK9 4NF, Stirling, UK.
| | - Brigid Daniel
- School of Applied Social Science, University of Stirling, Colin Bell Building, FK9 4NF, Stirling, UK.
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