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Ye HMY, Xiao LD, Ullah S, Chang RHC. Hospital nurses perceived challenges and opportunities in the care of people with dementia: A mixed-methods systematic review. J Clin Nurs 2024; 33:2849-2884. [PMID: 38544319 DOI: 10.1111/jocn.17144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 03/05/2024] [Accepted: 03/18/2024] [Indexed: 07/09/2024]
Abstract
AIM To synthesise evidence from the literature on hospital nurses' perceived challenges and opportunities in the care of people with dementia. BACKGROUND People with dementia often have longer lengths of hospital stay and poorer health outcomes compared to those without dementia. Nurses play a pivotal role in the care of people with dementia. However, there is a scarcity of systematic reviews that synthesise the challenges and opportunities they perceive. METHODS A mixed-methods systematic review was conducted with a database search covering Ageline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Emcare, Embase, Medline, PsycINFO, ProQuest, Scopus and Web of Science in April 2022. In total, 27 articles that met the selection criteria were critically reviewed and included in this systematic review. Data from the selected articles were extracted and synthesised using a convergent segregated approach. RESULTS Three main themes and eight subthemes were identified. Theme 1 described nurse-related factors consisting of the lack of capability in dementia care, experiencing multiple sources of stress and opportunities for nurses to improve dementia care. Theme 2 revealed people living with dementia-related factors including complex care needs and the need to engage family carers in care. Theme 3 explained organisation-related factors comprising the lack of organisational support for nurses and people with dementia and opportunities for quality dementia care. CONCLUSION Hospital nurses experience multidimensional challenges in the care of people with dementia. Opportunities to overcome those challenges include organisational support for nurses to develop dementia care capability, reduce their stress and partner with the family caregivers. RELEVANCE TO CLINICAL PRACTICE Hospitals will need to build an enabling environment for nurses to develop their capabilities in the care of people with dementia. Further research in empowering nurses and facilitating quality dementia care in acute care hospitals is needed. REPORTING METHOD The review followed the PRISMA 2020 checklist. PATIENT OR PUBLIC CONTRIBUTION No.
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Affiliation(s)
- Helen Mei-Yan Ye
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Lily Dongxia Xiao
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Shahid Ullah
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Rita Hui-Chen Chang
- School of Nursing and Midwifery, Western Sydney University, Sydney, New South Wales, Australia
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McMinn LE, Kloess JA, Stephenson Z. Empowering Young People with Special Educational Needs to Recognize and Report Child Sexual Exploitation and Abuse: A Mixed-Methods Review. TRAUMA, VIOLENCE & ABUSE 2024; 25:2503-2520. [PMID: 38164801 PMCID: PMC11155205 DOI: 10.1177/15248380231217047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
Young people with special educational needs (SEN), such as intellectual disability and/or autism, are particularly vulnerable to child sexual exploitation and abuse (CSEA). This mixed-methods systematic literature review consolidates findings in respect to how young people with SEN are currently being taught about CSEA in the UK, incorporating empirical and practice-based findings to counteract publication bias. Key databases were searched, and relevant organizations were contacted regarding studies published between 2015 and 2022 (inclusive). Thirteen articles met the inclusion criteria. Of these, 10 adopted a qualitative methodology, and three a mixed-methods approach. The thematic synthesis of the qualitative studies identified the following themes: (a) beliefs and stereotypes about CSEA, vulnerability. and risk have led to young people with SEN being misinformed and misunderstood, and (b) anxiety about the topic of sex and abuse creates polarized views regarding CSEA education in adult guardians of young people with SEN. Themes are discussed in the context of societal biases in respect to vulnerability and risk, and these biases are considered to have a negative effect on how young people with SEN are supported. The findings of this review encourage providers of CSEA awareness education to be mindful of not endorsing harmful stereotypes, and to involve parent-carers as much as possible. This review additionally encourages services and organizations to increase focus on practitioner reflexivity and regular training to counteract potential biases in respect to gender, vulnerability, and risk.
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Finn M, Walsh A, Rafter N, Mellon L, Chong HY, Naji A, O'Brien N, Williams DJ, McCarthy SE. Effect of interventions to improve safety culture on healthcare workers in hospital settings: a systematic review of the international literature. BMJ Open Qual 2024; 13:e002506. [PMID: 38719514 PMCID: PMC11086522 DOI: 10.1136/bmjoq-2023-002506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 04/17/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND In an era of safety systems, hospital interventions to build a culture of safety deliver organisational learning methodologies for staff. Their benefits to hospital staff are unknown. We examined the literature for evidence of staff outcomes. Research questions were: (1) how is safety culture defined in studies with interventions that aim to enhance it?; (2) what effects do interventions to improve safety culture have on hospital staff?; (3) what intervention features explain these effects? and (4) what staff outcomes and experiences are identified? METHODS AND ANALYSIS We conducted a mixed-methods systematic review of published literature using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The search was conducted in MEDLINE, EMBASE, CINAHL, Health Business Elite and Scopus. We adopted a convergent approach to synthesis and integration. Identified intervention and staff outcomes were categorised thematically and combined with available data on measures and effects. RESULTS We identified 42 articles for inclusion. Safety culture outcomes were most prominent under the themes of leadership and teamwork. Specific benefits for staff included increased stress recognition and job satisfaction, reduced emotional exhaustion, burnout and turnover, and improvements to working conditions. Effects were documented for interventions with longer time scales, strong institutional support and comprehensive theory-informed designs situated within specific units. DISCUSSION This review contributes to international evidence on how interventions to improve safety culture may benefit hospital staff and how they can be designed and implemented. A focus on staff outcomes includes staff perceptions and behaviours as part of a safety culture and staff experiences resulting from a safety culture. The results generated by a small number of articles varied in quality and effect, and the review focused only on hospital staff. There is merit in using the concept of safety culture as a lens to understand staff experience in a complex healthcare system.
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Affiliation(s)
- Mairead Finn
- Graduate School of Healthcare Management, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Aisling Walsh
- Department of Public Health and Epidemiology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Natasha Rafter
- Department of Public Health and Epidemiology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Lisa Mellon
- Department of Health Psychology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Hui Yi Chong
- School of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Abdullah Naji
- School of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Niall O'Brien
- Library Services, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - David J Williams
- Department of Geriatric and Stroke Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Siobhan Eithne McCarthy
- Graduate School of Healthcare Management, Royal College of Surgeons in Ireland, Dublin, Ireland
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Cucolo DF, de Campos Oliveira JL, Rossit RAS, Mininel VA, Perroca MG, Silva JAMD. Effects of interprofessional practice on nursing workload in hospitals: A systematic review. Int J Health Plann Manage 2024; 39:824-843. [PMID: 38353613 DOI: 10.1002/hpm.3779] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/14/2024] [Accepted: 01/29/2024] [Indexed: 05/06/2024] Open
Abstract
OBJECTIVE To synthesise scientific evidence on interprofessional practice in hospital care and the effects on nursing workload. METHODS Systematic mixed method review, registered in PROSPERO (CRD42021225627) and conducted in the following databases: CINAHL, Medline, Web of Science and Scopus, with no restrictions on the publication period of the studies. Primary studies were recruited on nurses' interprofessional practice (actions and interactions with other professional categories) in hospitals and the effects on one or more dimensions of nursing workload (quantitative, qualitative, physical, cognitive, emotional, time and variation). Scientific articles available in open access, in English, Spanish or Portuguese, were included. The searches were carried out in January 2021. The studies were evaluated by pairs of independent researchers to verify methodological quality, through the Mixed Method Appraisal Tool, and data extraction. To summarise the studies, thematic analysis was adopted. RESULTS A total of 1774 publications were assessed for eligibility and 17 studies were included. Of these, two were mixed methods, four were qualitative, and 11 were quantitative, published between 2011 and 2020. The main scenarios investigated were Intensive Care Units and/or Inpatient Units. During data analysis, three thematic categories emerged: Interprofessional practice in coping with emotional overload; Time dedicated by nurses to professional communication; and Working conditions and patient care. The third category consisted of three subthemes: Conflict and flexibility in the context of practice; Working conditions and interprofessional practice; and Effects on patient care. CONCLUSIONS The evidence points to the emotional overload of nurses in the face of uncooperative practices. Interprofessional actions, especially communicative ones, demand nurses' time and impact the care provided. The results contribute to political decisions and health work management.
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Affiliation(s)
- Danielle Fabiana Cucolo
- Postgraduate Program, Multiprofessional Residency in Health at the Pontifícia Universidade Católica de Campinas, Campinas, Brazil
- Postgraduate Program, Masters Course in Nursing at the Medical School of São José do Rio Preto, São José do Rio Preto, Brazil
| | - João Lucas de Campos Oliveira
- Nursing School of the Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Postgraduate Program in Nursing at the UFRGS and Clinical Nursing Service at Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | | | - Vivian Aline Mininel
- Postgraduate Nursing Program at the Federal University of São Carlos (UFSCar), Sao Carlos, Brazil
- Nursing Department at the UFSCar, Sao Carlos, Brazil
- Center de Recherche sur le Travail et le Développement, Conservatoire National des Arts et Métiers (CRDT-Cnam), Paris, France
| | - Marcia Galan Perroca
- Postgraduate Program, Masters Course in Nursing at the Medical School of São José do Rio Preto, São José do Rio Preto, Brazil
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Shelley D, Davis D, Bail K, Heland R, Paterson C. Oncology Nurses' Experiences of Using Health Information Systems in the Delivery of Cancer Care in a Range of Care Settings: A Systematic Integrative Review. Semin Oncol Nurs 2024; 40:151579. [PMID: 38402020 DOI: 10.1016/j.soncn.2023.151579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 12/19/2023] [Accepted: 12/30/2023] [Indexed: 02/26/2024]
Abstract
OBJECTIVES This systematic review aimed to identify oncology nurses' experiences of using health information systems (HIS) in the delivery of cancer care. DATA SOURCES The electronic databases searched included CINAHL, MEDLINE (EBSCO host), SCOPUS, Web of Science Core Collection, Google Scholar, OVID, and ProQuest Central (using advanced search strategy) and hand searching of reference lists of the included articles and relevant systematic reviews. Studies published in English language were examined. CONCLUSION Twenty-six studies were included. Three themes emerged: (1) the transparency and application of the nursing process within HIS, (2) HIS enhancing and facilitating communication between nurses and patients, and (3) the impact of HIS on the elements of person-centered care. Nurses' experiences with HIS were overall positive. However, digital systems do not fully capture all elements of the nursing processes; this was confirmed in this review, through the nurses' lens. Most studies used HIS for symptom reporting and monitoring within non-inpatient settings and largely biomedical and lack insight into the person-centeredness and overall holistic care. IMPLICATIONS FOR NURSING PRACTICE There are evidently varied views of HIS adoption across the globe. HIS can improve health-related quality of life and symptom burden, including self-reporting of symptoms among patients. However, there is a need for ongoing high-quality research, and clearer reporting than is evident in the current 26 studies, to fully understand the impact of HIS within the nursing processes and patient outcomes across all specialty cancer fields.
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Affiliation(s)
- Delilah Shelley
- PhD Candidate-Nursing, Faculty of Health, University of Canberra, Canberra, Australia.
| | - Deborah Davis
- Professor of Midwifery, Faculty of Health, University of Canberra, Canberra, Australia
| | - Kasia Bail
- Associate Professor of Nursing and Midwifery, Faculty of Health, University of Canberra, Canberra, Australia
| | - Rebecca Heland
- Chief Nursing & Midwifery Information Officer, ACT Health Directorate, ACT Health, Canberra, Australia
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Susiku E, Hewitt-Taylor J, Akudjedu TN. Graduate competencies, employability and the transnational Radiography workforce shortage: A systematic literature review of current pre-registration Radiography education and training models. Radiography (Lond) 2024; 30:457-467. [PMID: 38211453 DOI: 10.1016/j.radi.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 11/01/2023] [Accepted: 01/02/2024] [Indexed: 01/13/2024]
Abstract
INTRODUCTION Transnational mobility of the Radiography workforce is challenged due to issues with standardisation of current education and training models which has added to the workforce shortage. To address the growing volume, scope and complexity of clinical Radiography service delivery, educational models need to be given a critical look for transnational relevance in modern times. This study aims to synthesise the characteristics of current pre-registration radiography educational programmes linked with effective knowledge, skill acquisition, and graduate employability to address the current workforce challenges through the development of newer training models. METHODS Using a mixed methods systematic review approach, secondary data was obtained from an EBSCOhost search involving key databases including MEDLINE, CINAHL, Academic Search Ultimate, ScienceDirect, and SCOPUS. Themes were developed following a result-based convergent data synthesis. RESULTS Forty articles met the predefined inclusion criteria following the study identification and screening phases. The included studies were conducted from across diverse settings including both low- and middle-income countries (LMIC) and high-income countries (HIC). Two broad themes were developed from the findings including: 1. Factors influencing graduate employability and 2) Radiography education and training programme characteristics. CONCLUSION The findings highlight and advocate for an innovative model for Radiography education and underscores the significance of graduates possessing multi-modality skills, varied competencies, and effective accreditation processes for training. Prioritising alignment with industry needs and holistic skill development is vital to closing the employability gap, ultimately improving graduate skills and competencies to address workforce shortage while improving patient care outcomes. IMPLICATIONS FOR PRACTICE Radiography training institutions should explore the development of new innovative models for multi-modality pre-registration education. This should offer adaptable routes that align seamlessly with the evolving regulatory, technological, and clinical trends.
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Affiliation(s)
- E Susiku
- Institute of Medical Imaging & Visualisation, Department of Medical Science & Public Health, Faculty of Health & Social Sciences, Bournemouth University, UK
| | - J Hewitt-Taylor
- Centre for Public Health, Faculty of Science and Technology, Bournemouth University, UK
| | - T N Akudjedu
- Institute of Medical Imaging & Visualisation, Department of Medical Science & Public Health, Faculty of Health & Social Sciences, Bournemouth University, UK.
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Greyson D, Goh G. Education components of school vaccine mandates: An environmental scan. Vaccine 2023; 41:7089-7095. [PMID: 37923695 DOI: 10.1016/j.vaccine.2023.09.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 09/26/2023] [Accepted: 09/27/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND School vaccine mandates (SVMs) are population health interventions that require monitoring and communicating about vaccination of school-aged children, with an aim of controlling infectious disease outbreaks. While 43 % of World Health Organization member states report having some sort of SVM, their details vary. A newer element of some SVMs is an "education component" requiring compulsory information, education, or counseling of parents/guardians who decline to vaccinate their children for non-medical reasons. METHODS This environmental scan sought, mapped, and synthesized evidence on the existence, format, and impacts of education components of SVMs in 18 affluent Organization for Economic Co-operation and Development comparator countries. FINDINGS We found current SVMs in nine of the 18 comparator countries, but education components to those SVMs only in Canada (n = 2) and the U.S. (n = 9), where such policies were made at the provincial/state level. The earliest was implemented in 2011 and most recent has not yet been implemented. Education components were used as requirements for obtaining non-medical exemptions from SVMs, and involved either an informational paper to be read and signed, a counseling or information session from a health professional (public health worker or licensed provider such as family doctor), or an online module to be completed. Peer-reviewed research on in-person sessions suggests association with at least short-term increased vaccine uptake and reduction of non-medical exemptions. Available data on online module education components suggests similar impacts, but research to date is limited. CONCLUSION SVMs with educational components are uncommon but have been increasing since 2011. The details of these education components vary, although topics covered in online modules are relatively consistent. Evidence to date suggests at least short-term reduction in non-medical exemptions associated with implementation of SVM education components, but additional research is required to follow-up and confirm, especially as regards online education modules.
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Affiliation(s)
- Devon Greyson
- School of Population and Public Health, University of British Columbia, Vancouver, Canada; Vaccine Evaluation Center, British Columbia Children's Hospital Research Institute, Vancouver, Canada.
| | - Gerry Goh
- School of Population and Public Health, University of British Columbia, Vancouver, Canada; School of Information, University of British Columbia, Vancouver, Canada
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Akore Yeboah E, Adegboye ARA, Kneafsey R. Perceptions, attitudes, awareness and perspectives towards sustainability practices and climate change among nurses: a systematic review protocol. BMJ Open 2023; 13:e071965. [PMID: 37798033 PMCID: PMC10565322 DOI: 10.1136/bmjopen-2023-071965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 09/19/2023] [Indexed: 10/07/2023] Open
Abstract
INTRODUCTION Climate change has been described as the most significant threat to humanity and human health to have emerged this century. It is widely accepted that contemporary human activities are the major causes of climate change. It is also acknowledged that damaging human activities could be amenable to change through proactive environmental behaviours. Healthcare professionals have the potential to promote climate advocacy and mitigation through collective effort and individual actions. However, research suggests that nurses may not be aware of their potential to effect positive action. This review will synthesise evidence regarding nurses' perceptions, attitudes, awareness and perspectives towards sustainable nursing practices and climate change. METHODS AND ANALYSIS The Joanna Briggs Institute (JBI) methodology for mixed-methods systematic reviews will be applied to this proposed systematic review. It will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. CINAHL, PsycINFO, SCOPUS and PubMed databases will be searched. Data appraisal will be completed using the JBI and Mixed Methods Assessment Tool critical appraisal tool. Data synthesis and integration will follow the JBI convergent integrated approach. ETHICS AND DISSEMINATION In compliance with university ethics requirements for secondary research and postgraduate researchers, ethical approval will be sought from the Coventry University Ethics Committee, UK. Dissemination of findings will be achieved through peer-review publications, conference presentations and seminars with local, national and international audiences.
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Affiliation(s)
| | | | - Rosie Kneafsey
- Research Centre for Healthcare and Communities, Coventry University, Coventry, UK
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French B, Daley D, Groom M, Cassidy S. Risks Associated With Undiagnosed ADHD and/or Autism: A Mixed-Method Systematic Review. J Atten Disord 2023; 27:1393-1410. [PMID: 37341291 PMCID: PMC10498662 DOI: 10.1177/10870547231176862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/22/2023]
Abstract
BACKGROUND The two most prevalent neurodevelopmental disorders-Attention Deficit Hyperactivity Disorder (ADHD) and Autism (ASD)-(ASD/ADHD) strongly impact individuals' functions. This is worsened when individuals are undiagnosed and risks such as increased imprisonments, depression or drug misuse are often observed. This systematic review synthesizes the risks associated with late/undiagnosed ASD/ADHD. METHODS Four databases were searched (Medline, Scopus, PsychInfor, and Embase). Published studies exploring the impact of undiagnosed ASD/ADHD were included. Exclusion criteria included, lack of diagnosis status, studies not solely on ASD or ADHD, gray literature and studies not in English. The findings were summarize through a narrative synthesis. RESULTS Seventeen studies were identified, 14 on ADHD and three on ASD. The narrative synthesis identified three main themes: (1) Health, (2) Offending behavior, and (3) Day-to-day impact. The risks highlighted a significant impact on mental wellbeing and social interactions, higher risks of substance abuse, accidents and offending behavior as well as lower levels of income and education. DISCUSSION The findings suggest that undiagnosed ASD/ADHD is linked to many risks and negative outcomes affecting individuals, their families, and the wider society. The restricted number of studies on ASD are a limitation to the generalization of these findings Implications for research and practice are discussed, highlighting the importance of screening and acknowledging the possibility of ASD/ADHD in many settings such as psychiatric and forensic.
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Mew L, Heaslip V, Immins T, Wainwright T. What Is Important to the Younger Person (≤50 Years) When Having a Total Hip Arthroplasty: A Systematic Literature Review. Orthop Nurs 2023; 42:213-229. [PMID: 37494902 PMCID: PMC10405792 DOI: 10.1097/nor.0000000000000955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/28/2023] Open
Abstract
Total hip arthroplasties (THAs) are usually performed in older patients. Despite a growing number of THAs in younger adults, it is unclear whether they have similar priorities in recovery compared with their older counterparts. The purpose of this systematic review was to explore younger patients' priorities when undergoing a THA. Multiple databases were searched in September 2021 prioritizing qualitative data. This review was reported using the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Of 14,495 articles screened, nine remained for analysis. Four common themes were discovered: improving function and mobility; pain; relationships; and patient expectations and education. However, there was insufficient information to clarify whether these themes could be attributed directly to younger adults undergoing a THA. The absence of research on THA patients younger than 50 years results in the loss of the voices of these patients. Further research is essential to ensure their needs are identified, addressed, and met.
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Affiliation(s)
- Louise Mew
- Correspondence: Louise Mew, BSc, Research and Development Department, Academic Centre, Milton Keynes University Hospital, Standing Way, Milton Keynes, MK6 5LD, United Kingdom ()
| | - Vanessa Heaslip
- Louise Mew, BSc, Milton Keynes University Hospital, Milton Keynes, Buckinghamshire, United Kingdom
- Vanessa Heaslip, PhD, Department of Nursing Science, Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, United Kingdom; and Department of Social Work, Stavanger University, Stavanger, Norway
- Tikki Immins, MSc, Orthopaedic Research Institute, Bournemouth University, Bournemouth, United Kingdom
- Thomas Wainwright, PhD, Orthopaedic Research Institute, Bournemouth University, Bournemouth, United Kingdom; and Physiotherapy Department, University Hospitals Dorset NHS Foundation Trust, Poole, United Kingdom
| | - Tikki Immins
- Louise Mew, BSc, Milton Keynes University Hospital, Milton Keynes, Buckinghamshire, United Kingdom
- Vanessa Heaslip, PhD, Department of Nursing Science, Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, United Kingdom; and Department of Social Work, Stavanger University, Stavanger, Norway
- Tikki Immins, MSc, Orthopaedic Research Institute, Bournemouth University, Bournemouth, United Kingdom
- Thomas Wainwright, PhD, Orthopaedic Research Institute, Bournemouth University, Bournemouth, United Kingdom; and Physiotherapy Department, University Hospitals Dorset NHS Foundation Trust, Poole, United Kingdom
| | - Thomas Wainwright
- Louise Mew, BSc, Milton Keynes University Hospital, Milton Keynes, Buckinghamshire, United Kingdom
- Vanessa Heaslip, PhD, Department of Nursing Science, Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, United Kingdom; and Department of Social Work, Stavanger University, Stavanger, Norway
- Tikki Immins, MSc, Orthopaedic Research Institute, Bournemouth University, Bournemouth, United Kingdom
- Thomas Wainwright, PhD, Orthopaedic Research Institute, Bournemouth University, Bournemouth, United Kingdom; and Physiotherapy Department, University Hospitals Dorset NHS Foundation Trust, Poole, United Kingdom
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Boone LD, Rodgers MM, Baur A, Vitek E, Epstein C. An integrative review of factors and interventions affecting the well-being and safety of nurses during a global pandemic. Worldviews Evid Based Nurs 2023; 20:107-115. [PMID: 36811445 DOI: 10.1111/wvn.12630] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 11/26/2022] [Accepted: 11/29/2022] [Indexed: 02/24/2023]
Abstract
BACKGROUND Nurses experienced physical and mental exhaustion during the COVID-19 pandemic. Understanding the impact of the pandemic on nurses and effective strategies to support them is critical for increasing nurse resilience and reducing burnout. AIMS The aims of this study were (1) to synthesize the literature examining how factors associated with the COVID-19 pandemic affected the well-being and safety of nurses (2) and to review interventions which may promote nurse mental health during crises. METHODS Using an integrative review approach, a comprehensive search of the literature was conducted in March 2022 using the following databases: PubMed, CINAHL, Scopus, and Cochrane. We included quantitative, qualitative, and mixed-method primary research articles published in English in peer-reviewed journals from March 2020 through February 2021. Included articles focused on nurses caring for COVID-19 patients and addressed psychological factors, supportive hospital leadership strategies, or interventions to support well-being. Studies were excluded if they focused on professions outside of nursing. Included articles were summarized and appraised for quality. Findings were synthesized using content analysis. RESULTS Of the 130 articles initially identified, 17 were included. Articles were quantitative (n = 11), qualitative (n = 5), and mixed methods (n = 1). Three themes were identified: (1) loss of life, hope, and professional identity; (2) lack of visible and supportive leadership; and (3) insufficient planning and response. These experiences contributed to increased symptoms of anxiety, stress, depression, and moral distress in nurses.
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Affiliation(s)
- Lesa D Boone
- School of Nursing, University of North Carolina at Greensboro, Greensboro, NC, USA
| | - Melanie M Rodgers
- School of Nursing, University of North Carolina at Greensboro, Greensboro, NC, USA
| | - April Baur
- School of Nursing, University of North Carolina at Greensboro, Greensboro, NC, USA
| | - Elaine Vitek
- School of Nursing, University of North Carolina at Greensboro, Greensboro, NC, USA
| | - Crystal Epstein
- School of Nursing, University of North Carolina at Greensboro, Greensboro, NC, USA
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Ijezie OA, Healy J, Davies P, Balaguer-Ballester E, Heaslip V. Quality of life in adults with Down syndrome: A mixed methods systematic review. PLoS One 2023; 18:e0280014. [PMID: 37126503 PMCID: PMC10150991 DOI: 10.1371/journal.pone.0280014] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 03/30/2023] [Indexed: 05/02/2023] Open
Abstract
BACKGROUND As the life expectancy of adults (aged ≥ 18 years) with Down syndrome increases for a plethora of reasons including recognition of rights, access, and technological and medical advances, there is a need to collate evidence about their quality of life. OBJECTIVE Using Schalock and Verdugo's multidimensional quality of life assessment model, this systematic review aimed to identify, synthesise and integrate the quantitative and qualitative evidence on quality of life in adults with Down syndrome via self-and proxy-reporting. METHODS Five databases were systematically searched: MEDLINE, CINAHL, PsycINFO, Scopus, and Web of Science to identify relevant articles published between 1980 and 2022 along with grey literature and reference lists from relevant studies. A mixed methods systematic review was performed according to the Joanna Briggs Institute methodology using the convergent integrated approach. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS Thirty-nine studies were included: 20 quantitative, 17 qualitative, and 2 mixed methods studies. The synthesised findings were grouped into the 8 core domains of quality of life: personal development, self-determination, interpersonal relations, social inclusion, rights, emotional, physical and material well-being. Of the 39 studies, 30 (76.92%) reported on emotional well-being and 10 (25.64%) on rights. Only 7 (17.94%) studies reported that adults with Down syndrome have a good quality of life centred around self-determination and interpersonal relations. Most adults with Down syndrome wanted to become more independent, have relationships, participate in the community, and exercise their human rights. Self-reported quality of life from adults with Down syndrome was rated higher than proxy reported quality of life. Discrepancies in quality of life instruments were discovered. CONCLUSION This review highlighted the need for a better systematic approach to improving the quality of life in adults with Down syndrome in targeted areas. Future research is required to evaluate self-and proxy-reporting methods and culture-specific quality of life instruments that are more appropriate for adults with Down syndrome. In addition, further studies should consider including digital assistive technologies to obtain self-reported quality of life data in adults with Down syndrome. INTERNATIONAL PROSPECTIVE REGISTER OF SYSTEMATIC REVIEWS REGISTRATION NUMBER CRD42019140056.
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Affiliation(s)
- Ogochukwu Ann Ijezie
- Department of Computing and Informatics, Bournemouth University, Poole, United Kingdom
| | - Jane Healy
- Department of Social Science and Social Work, Bournemouth University, Lansdowne, United Kingdom
| | - Philip Davies
- Department of Computing and Informatics, Bournemouth University, Poole, United Kingdom
| | - Emili Balaguer-Ballester
- Department of Computing and Informatics, Bournemouth University, Poole, United Kingdom
- Bernstein Centre for Computational Neuroscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Vanessa Heaslip
- School of Health and Society, University of Salford, Manchester, United Kingdom
- Department of Social Studies, University of Stavanger, Stavanger, Norway
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13
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Varga S, Ryan T, Moore T, Seymour J. What are the perceptions of intensive care staff about their sedation practices when caring for a mechanically ventilated patient?: A systematic mixed-methods review. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2022; 4:100060. [PMID: 38745639 PMCID: PMC11080319 DOI: 10.1016/j.ijnsa.2021.100060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 12/22/2021] [Accepted: 12/31/2021] [Indexed: 11/15/2022] Open
Abstract
Background Sedation is used alongside mechanical ventilation for patients in intensive care units internationally; its use is complex and multifaceted. Existing evidence shows that the ways health care professionals use sedation significantly impacts patient outcomes, including how long someone spends on a ventilator, length of stay in intensive care and recovery. Objective Our study aimed to systematically review and synthesize qualitative and quantitative evidence about how intensive care staff perceive sedation practices when looking after sedated and mechanically ventilated patients. Design We performed a systematic integrated mixed-methods literature review collecting qualitative and quantitative studies according to inclusion and exclusion criteria. Studies were included if they were published from 2009 and focused on perceptions of staff working in general adult intensive care units and caring for mechanically ventilated patients. Settings General adult intensive care units. Participants Health care professionals working in adult intensive care units. Methods Screening, data extraction and quality appraisal was undertaken by SV. Screening for inclusion and quality issues were reviewed by TR, TM and JS. The following databases: Embase, BNI, PubMed, Scopus, AMED, CINAHL, ASSIA, The Cochrane Library and Google Scholar. We used an assessment tool called the Mixed Methods Appraisal Tool. The studies were assessed and analysed by transforming the qualitative and quantitative data into 'text-in-context' statements. The statements were then synthesized using thematic analysis. Results Eighteen studies were included from ten countries, fourteen quantitative and four qualitative. Three overarching themes were identified: 'Variation in Decision Making', 'Challenges in Decision Making' and 'Thinking Outside the Box'. Existing studies revealed that there is considerable variation in most aspects of perceived sedation practice. Staff face challenges with interprofessional collaboration and sedation practice, and there are barriers to using sedation protocols and light sedation. There is also evidence that there is a need for health care professionals to develop coping strategies to help them facilitate lighter sedation. Conclusions A review of a decade of evidence shows that variation in decision making and challenges in decision making should be addressed to improve the care of the sedated and ventilated patient, and improve the caregiving experience for staff. Staff continue to require support with sedation practice, especially in light sedation. Research should now focus on how to help staff cope with looking after lightly sedated patients. In addition, future studies should focus on exploring sedation practices using qualitative methods as there is a dearth of qualitative evidence. Tweetable abstract Staff perceive a range of complex challenges that explain some of the variability in sedation practice for the ventilated patient in ICU.
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Affiliation(s)
- Sarah Varga
- Division of Nursing and Midwifery, Health Sciences School, Sheffield S10 2HQ, United Kingdom
| | - Tony Ryan
- Division of Nursing and Midwifery, Health Sciences School, Sheffield S10 2HQ, United Kingdom
| | - Tracey Moore
- Division of Nursing and Midwifery, Health Sciences School, Sheffield S10 2HQ, United Kingdom
| | - Jane Seymour
- Division of Nursing and Midwifery, Health Sciences School, Sheffield S10 2HQ, United Kingdom
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14
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Finn M, Mellon L, Walsh A, O'Brien N, Williams DJ, Rafter N, McCarthy SE. 'What effect do safety culture interventions have on health care workers in hospital settings?' A systematic review of the international literature. HRB Open Res 2022; 5:48. [PMID: 37485071 PMCID: PMC10357077 DOI: 10.12688/hrbopenres.13576.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2022] [Indexed: 07/25/2023] Open
Abstract
Introduction: Interventions designed to improve safety culture in hospitals foster organisational environments that prevent patient safety events and support organisational and staff learning when events do occur. A safety culture supports the required health workforce behaviours and norms that enable safe patient care, and the well-being of patients and staff. The impact of safety culture interventions on staff perceptions of safety culture and patient outcomes has been established. To-date, however, there is no common understanding of what staff outcomes are associated with interventions to improve safety culture and what staff outcomes should be measured. Objectives: The study seeks to examine the effect of safety culture interventions on staff in hospital settings, globally. Methods and Analysis: A mixed methods systematic review will be conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Searches will be conducted using the electronic databases of MEDLINE, EMBASE, CINAHL, Health Business Elite, and Scopus. Returns will be screened in Covidence according to inclusion and exclusion criteria. The mixed-methods appraisal tool (MMAT) will be used as a quality assessment tool. The Cochrane Collaboration's tool for assessing risk of bias in randomised trials and non-randomised studies of interventions will be employed to verify bias. Synthesis will follow the Joanna Briggs Institute methodological guidance for mixed methods reviews, which recommends a convergent approach to synthesis and integration. Discussion: This systematic review will contribute to the international evidence on how interventions to improve safety culture may support staff outcomes and how such interventions may be appropriately designed and implemented.
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Affiliation(s)
- Mairéad Finn
- Graduate School of Healthcare Management, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Lisa Mellon
- Department of Public Health and Epidemiology, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Aisling Walsh
- Department of Public Health and Epidemiology, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Niall O'Brien
- Library Services, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - David J. Williams
- Department of Geriatric and Stroke Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Natasha Rafter
- Department of Public Health and Epidemiology, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Siobhán E. McCarthy
- Graduate School of Healthcare Management, RCSI University of Medicine and Health Sciences, Dublin, Ireland
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15
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Harper KJ, McAuliffe K, Parsons DN. Barriers and facilitating factors influencing implementation of occupational therapy home assessment recommendations: A mixed methods systematic review. Aust Occup Ther J 2022; 69:599-624. [PMID: 35674225 PMCID: PMC9796587 DOI: 10.1111/1440-1630.12823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 05/27/2022] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Low implementation rates of occupational therapy home assessment recommendations have previously been reported. The objective was to identify and describe the barriers and facilitating factors that influence implementation of home assessment recommendations. METHODS A mixed methods systematic review consisting of studies involving adults living in the community who received an occupational therapy home assessment was conducted. Seven databases were last searched in August 2021. Study quality was assessed using the Joanna Briggs Institute (JBI) critical appraisal tools (SUMARI) dependent on study design. Data synthesis followed the convergent integrated approach. Findings were mapped to the theoretical Capability Opportunity Motivation Behaviour (COM-B) model of health behaviour change. RESULTS From 5,540 citations, 22 articles met the criteria for the systematic review. Implementation of occupational therapy home assessment recommendations ranged between 55% and 90%. Six synthesised findings were identified. Capability barriers included a patient's cognitive and physical ability. Motivation barriers included a perceived lack of need and stigma; patient reported decreased involvement and lack of choice. Opportunity barriers included limited family or carer involvement, carer stress, level of service provision available, including funding, therapy dosage and timing and environmental restrictions. Overall facilitators included patient-centred care, including choice and understanding need, individualised tailored recommendations, involvement of families and carers, provision of written record and strategies to support implementation. Results were limited by methodological weaknesses in identified studies and heterogeneity in the definition and measurement of implementation impacting on comparison. Specific intervention components were often poorly described. CONCLUSION The theoretical model elucidates priority factors to address for promoting implementation of home assessment recommendations. Future high-quality research clearly defining intervention components is required to support short- and long-term implementation of recommendations in the home environment. Behaviour change techniques could be utilised to support home assessment practices in future research.
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Affiliation(s)
- Kristie J. Harper
- Occupational Therapy DepartmentSir Charles Gairdner HospitalNedlandsWestern AustraliaAustralia,Curtin School of Allied Health, Occupational TherapyCurtin UniversityBentleyWestern AustraliaAustralia
| | - Kelly McAuliffe
- Occupational Therapy DepartmentSir Charles Gairdner HospitalNedlandsWestern AustraliaAustralia
| | - Dave N. Parsons
- Curtin School of Allied Health, Occupational TherapyCurtin UniversityBentleyWestern AustraliaAustralia,St. John of God Midland Public and Private HospitalMidlandWestern AustraliaAustralia
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16
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Mullen A, Browne G, Hamilton B, Skinner S, Happell B. Safewards: An integrative review of the literature within inpatient and forensic mental health units. Int J Ment Health Nurs 2022; 31:1090-1108. [PMID: 35365947 PMCID: PMC9544259 DOI: 10.1111/inm.13001] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 03/14/2022] [Accepted: 03/18/2022] [Indexed: 11/27/2022]
Abstract
Mental health inpatient units are complex and challenging environments for care and treatment. Two imperatives in these settings are to minimize restrictive practices such as seclusion and restraint and to provide recovery-oriented care. Safewards is a model and a set of ten interventions aiming to improve safety by understanding the relationship between conflict and containment as a means of reducing restrictive practices. To date, the research into Safewards has largely focused on its impact on measures of restrictive practices with limited exploration of consumer perspectives. There is a need to review the current knowledge and understanding around Safewards and its impact on consumer safety. This paper describes a mixed-methods integrative literature review of Safewards within inpatient and forensic mental health units. The aim of this review was to synthesize the current knowledge and understanding about Safewards in terms of its implementation, acceptability, effectiveness and how it meets the needs of consumers. A systematic database search using Medline, CINAHL, Embase and PsychInfo databases was followed by screening and data extraction of findings from 19 articles. The Mixed Methods Appraisal Tool (MMAT) was used to assess the quality of empirical articles, and the Johanna Brigg's Institute (JBI's) Narrative, Opinion, Text-Assessment and Review Instrument (NOTARI) was used to undertake a critical appraisal of discussion articles. A constant comparative approach was taken to analysing the data and six key categories were identified: training, implementation strategy, staff acceptability, fidelity, effectiveness and consumer perspectives. The success of implementing Safewards was variously determined by a measured reduction of restrictive practices and conflict events, high fidelity and staff acceptability. The results highlighted that Safewards can be effective in reducing containment and conflict within inpatient mental health and forensic mental health units, although this outcome varied across the literature. This review also revealed the limitations of fidelity measures and the importance of involving staff in the implementation. A major gap in the literature to date is the lack of consumer perspectives on the Safewards model, with only two papers to date focusing on the consumers point of view. This is an important area that requires more research to align the Safewards model with the consumer experience and improved recovery orientation.
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Affiliation(s)
- Antony Mullen
- University of Newcastle, Callaghan, New South Wales, Australia.,Hunter New England Mental Health, Newcastle, New South Wales, Australia
| | - Graeme Browne
- University of Newcastle, Callaghan, New South Wales, Australia
| | - Bridget Hamilton
- Centre for Mental Health Nursing, Department of Nursing, School of Health Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Stephanie Skinner
- Hunter New England Mental Health, C/- Centre for Psychotherapy, James Fletcher Hospital, Newcastle, New South Wales, Australia
| | - Brenda Happell
- University of Newcastle, Callaghan, New South Wales, Australia
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17
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Allan J, Cameron J, Bruno J. A Systematic Review of Recreational Nitrous Oxide Use: Implications for Policy, Service Delivery and Individuals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11567. [PMID: 36141850 PMCID: PMC9517250 DOI: 10.3390/ijerph191811567] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 09/09/2022] [Accepted: 09/09/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Nitrous oxide (N2O) is a dissociative anaesthetic that is sometimes used recreationally. The prevalence of N2O use is difficult to quantify but appears to be increasing. Research on N2O harms and application of harm reduction strategies are limited. The aim of this mixed method systematic review was to collate and synthesise the disparate body of research on recreational nitrous oxide use to inform harm reduction approaches tailored for young people. METHODS To identify publications reporting the recreational use of N2O, a search of public health, psychology and social science databases was conducted. Databases included PubMed, CIHNAL, PsycINFO, Scopus and Web of Science. Grey literature and Google advanced search were also used. Due to limited published literature on the recreational use of N2O, no limit was placed on publication date or study type. A thematic synthesis extracted descriptive and analytical themes from the selected studies. Quality appraisal was conducted using the CASP Tool for Qualitative studies and the Joanna Briggs Institute case report assessment tool. RESULTS The search retrieved 407 reports. Thirty-four were included in the final analysis, including sixteen case reports. The included studies were primarily concerned with raising awareness of the apparently increasing use and subsequently increasing harms of recreational N2O use. There was limited reference to policy or legislative responses in any published studies, no suggestions for harm reduction strategies or application of service level responses. In general, individuals lack awareness of N2O-related harms. CONCLUSION The review found three key areas that deserve further consideration including: (1) policy, (2) service delivery, and (3) harm associated with N2O use. We recommend a top-down (policy) and bottom-up (services delivery/services users) approach to harm reduction for N2O use which also includes further consultation and research with both groups. Future research could explore young people's experience of N2O use including benefits and problems to inform contextually relevant harm reduction strategies.
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Affiliation(s)
- Julaine Allan
- School of Health and Society, University of Wollongong, Wollongong, NSW 2522, Australia
- Rural Health Research Institute, Charles Sturt University, Orange, NSW 2800, Australia
| | - Jacqui Cameron
- School of Health and Society, University of Wollongong, Wollongong, NSW 2522, Australia
- Department of Social Work, The University of Melbourne, Parkville, VIC 3010, Australia
| | - Juliana Bruno
- School of Health and Society, University of Wollongong, Wollongong, NSW 2522, Australia
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18
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Hong S, Lee J, Lee J, Chang JH, Park CG, Kim TH. What we need to know about uncertainty in illness among people with primary malignant brain tumours: A mixed-methods systematic review. J Clin Nurs 2022. [PMID: 36071659 DOI: 10.1111/jocn.16499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 07/27/2022] [Accepted: 08/05/2022] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To identify the characteristics of uncertainty in illness (UI) among people with primary malignant brain tumours (PMBT). BACKGROUND High recurrence rates and complex symptoms cause uncertainty in people with PMBT. Given the characteristics of PMBT, reviewing UI among people with PMBT will benefit future research and clinical intervention development. DESIGN A mixed-methods systematic review. METHODS We performed a mixed-methods systematic review (PubMed, CINAHL, Embase, PsycINFO, Scopus and Cochrane Library), including studies on UI among people with PMBT, searched from the databases' inception to the search date. The initial search was conducted in July 2021, with an additional search in March 2022. The major search terms were PMBT and UI, and no limitations were placed on the study design. The Cochrane tool was used to evaluate the risk of bias in randomised controlled trials, and JBI checklists were used to evaluate quasi-experimental studies, survey methodology studies and a case study. This review was reported using the PRISMA 2020 checklist. Both quantitative and qualitative research data were extracted, analysed and then integrated in three stages of a mixed-methods systematic review. RESULTS Eleven studies were included. Due to physical, psychological and social risk factors, the UI progression of people with PMBT was complex and ambiguous, although they adapted to the PMBT diagnosis and treatment process. Subsequently, we proposed a model of UI among people with PMBT. CONCLUSIONS UI has multidimensional characteristics, and healthcare providers need to consider these aspects for people with PMBT. RELEVANCE TO CLINICAL PRACTICE The proposed model provides directions for nursing practice and future research. Nurses caring for people with PMBT should comprehend their UI and intervene accordingly. PATIENT OR PUBLIC CONTRIBUTION This review incorporated data including people with PMBT in hospitals and communities. This analysis contributes to the clinical-to-community nursing transition process for people with PMBT.
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Affiliation(s)
- Soomin Hong
- College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, Seoul, Korea
| | - JuHee Lee
- College of Nursing and Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Korea.,Yonsei Evidence Based Nursing Centre of Korea: A JBI Affiliated Group, Seoul, Korea
| | - Jiyeon Lee
- College of Nursing and Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Korea
| | - Jong Hee Chang
- Department of Neurosurgery, Yonsei University College of Medicine.,Brain Tumor Center, Severance Hospital, Yonsei University Health System, Seoul, Korea
| | | | - Tae Hee Kim
- Office of Administration and Education, Division of Nursing, Yongin Severance Hospital, Yonsei University Health System, Yongin, Korea
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19
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Finn M, Mellon L, Walsh A, O'Brien N, Williams DJ, Rafter N, McCarthy SE. ‘What effect do safety culture interventions have on health care workers in hospital settings?’ A systematic review of the international literature. HRB Open Res 2022. [DOI: 10.12688/hrbopenres.13576.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Introduction: Interventions designed to improve safety culture in hospitals foster organisational environments that prevent patient safety events and support organisational and staff learning when events do occur. A safety culture supports the required health workforce behaviours and norms that enable safe patient care, and the well-being of patients and staff. The impact of safety culture interventions on staff perceptions of safety culture and patient outcomes has been established. To-date, however, there is no common understanding of what staff outcomes are associated with interventions to improve safety culture and what staff outcomes should be measured. Objectives: The study seeks to examine the effect of safety culture interventions on staff in hospital settings, globally. The research questions are: 1) what effects do interventions to improve safety culture have on staff? 2) What intervention features, safety culture domains or other factors explain these effects? 3) What staff outcomes and experiences are identified? Methods and Analysis: A mixed methods systematic review will be conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Searches will be conducted using the electronic databases of MEDLINE, EMBASE, CINAHL, Health Business Elite, and Scopus. Returns will be screened in Covidence according to inclusion and exclusion criteria. The mixed-methods appraisal tool (MMAT) will be used as a quality assessment tool. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials and non-randomised studies of interventions will be employed to verify bias. Synthesis will follow the Joanna Briggs Institute methodological guidance for mixed methods reviews, which recommends a convergent approach to synthesis and integration. Discussion: This systematic review will contribute to the international evidence on how interventions to improve safety culture may support staff outcomes and how such interventions may be appropriately designed and implemented.
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Kumah EA, McSherry R, Bettany‐Saltikov J, van Schaik P, Hamilton S, Hogg J, Whittaker V. Evidence-informed practice versus evidence-based practice educational interventions for improving knowledge, attitudes, understanding, and behavior toward the application of evidence into practice: A comprehensive systematic review of UG student. CAMPBELL SYSTEMATIC REVIEWS 2022; 18:e1233. [PMID: 36911346 PMCID: PMC9013402 DOI: 10.1002/cl2.1233] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
BACKGROUND To produce graduates with strong knowledge and skills in the application of evidence into healthcare practice, it is imperative that all undergraduate health and social care students are taught, in an efficient manner, the processes involved in applying evidence into practice. The two main concepts that are linked to the application of evidence into practice are "evidence-based practice" and "evidence-informed practice." Globally, evidence-based practice is regarded as the gold standard for the provision of safe and effective healthcare. Despite the extensive awareness of evidence-based practice, healthcare practitioners continue to encounter difficulties in its implementation. This has generated an ongoing international debate as to whether evidence-based practice should be replaced with evidence-informed practice, and which of the two concepts better facilitate the effective and consistent application of evidence into healthcare practice. OBJECTIVES The primary objective of this systematic review was to evaluate and synthesize literature on the effectiveness of evidence-informed practice versus evidence-based practice educational interventions for improving knowledge, attitudes, understanding, and behavior of undergraduate health and social care students toward the application of evidence into practice. Specifically, we planned to answer the following research questions: (1) Is there a difference (i.e., difference in content, outcome) between evidence-informed practice and evidence-based practice educational interventions? (2) Does participating in evidence-informed practice educational interventions relative to evidence-based practice educational interventions facilitate the application of evidence into practice (as measured by, e.g., self-reports on effective application of evidence into practice)? (3) Do both evidence-informed practice and evidence-based practice educational interventions targeted at undergraduate health and social care students influence patient outcomes (as measured by, e.g., reduced morbidity and mortality, absence of nosocomial infections)? (4) What factors affect the impact of evidence-informed practice and evidence-based practice educational interventions (as measured by, e.g., course content, mode of delivery, multifaceted interventions, standalone intervention)? SEARCH METHODS We utilized a number of search strategies to identify published and unpublished studies: (1) Electronic databases: we searched Academic Search Complete, Academic search premier, AMED, Australian education index, British education index, Campbell systematic reviews, Canada bibliographic database (CBCA Education), CINAHL, Cochrane Library, Database of Abstracts of Reviews on Effectiveness, Dissertation Abstracts International, Education Abstracts, Education complete, Education full text: Wilson, ERIC, Evidence-based program database, JBI database of systematic reviews, Medline, PsycInfo, Pubmed, SciELO (Scientific Electronic Library Online), and Scopus; (2) A web search using search engines such as Google and Google scholar; (3) Grey literature search: we searched OpenGrey (System for Information on Grey Literature in Europe), System for information on Grey Literature, the Society for Research on Educational Effectiveness, and Virginia Henderson Global Nursing e-Repository; (4) Hand searching of journal articles; and (5) Tracking bibliographies of previously retrieved studies. The searches were conducted in June 2019. SELECTION CRITERIA We planned to include both quantitative (including randomized controlled trials, non-randomized controlled trials, quasi-experimental, before and after studies, prospective and retrospective cohort studies) and qualitative primary studies (including, case series, individual case reports, and descriptive cross-sectional studies, focus groups, and interviews, ethnography, phenomenology, and grounded theory), that evaluate and compare the effectiveness of any formal evidence-informed practice educational intervention to evidence-based practice educational intervention. The primary outcomes were evidence-informed practice and evidence-based practice knowledge, attitudes, understanding, and behavior. We planned to include, as participants, undergraduate pre-registration health and social care students from any geographical area. DATA COLLECTION AND ANALYSIS Two authors independently screened the search results to assess articles for their eligibility for inclusion. The screening involved an initial screening of the title and abstracts, and subsequently, the full-text of selected articles. Discrepancies were resolved through discussion or consultation with a third author. We found no article eligible for inclusion in this review. MAIN RESULTS No studies were found which were eligible for inclusion in this review. We evaluated and excluded 46 full-text articles. This is because none of the 46 studies had evaluated and compared the effectiveness of evidence-informed practice educational interventions with evidence-based practice educational interventions. Out of the 46 articles, 45 had evaluated solely, the effectiveness of evidence-based practice educational interventions and 1 article was on evidence-informed practice educational intervention. Hence, these articles were excluded as they did not meet the inclusion criteria. AUTHORS' CONCLUSIONS There is an urgent need for primary studies evaluating the relative effectiveness of evidence-informed practice and evidence-based practice educational interventions targeted at improving undergraduate healthcare students' competencies regarding the application of evidence into practice. Such studies should be informed by current literature on the concepts (i.e., evidence-informed practice and evidence-based practice) to identify the differences, similarities, as well as appropriate content of the educational interventions. In this way, the actual effect of each of the concepts could be determined and their effectiveness compared.
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Affiliation(s)
| | - Robert McSherry
- Faculty of Health and Social CareUniversity of ChesterChesterUK
| | | | - Paul van Schaik
- School of Social Sciences, Humanities and LawTeesside UniversityMiddlesbroughUK
| | - Sharon Hamilton
- School of Health and Life SciencesTeesside UniversityMiddlesbroughUK
| | - Julie Hogg
- School of Health and Life SciencesTeesside UniversityMiddlesbroughUK
| | - Vicki Whittaker
- School of Health and Life SciencesTeesside UniversityMiddlesbroughUK
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21
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Panday J, Taneja S, Popoola A, Pack R, Greyson D, McDonald SD, Black M, Murray-Davis B, Darling E, Vanstone M. Clinician responses to cannabis use during pregnancy and lactation: a systematic review and integrative mixed-methods research synthesis. Fam Pract 2022; 39:504-514. [PMID: 34791187 PMCID: PMC9155166 DOI: 10.1093/fampra/cmab146] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Perinatal cannabis use is increasing, and clinician counselling is an important aspect of reducing the potential harm of cannabis use during pregnancy and lactation. To understand current counselling practices, we conducted a systematic review and integrative mixed-methods synthesis to determine "how do perinatal clinicians respond to pregnant and lactating patients who use cannabis?" METHODS We searched 6 databases up until 2021-05-31. Eligible studies described the attitudes, perceptions, or beliefs of perinatal clinician about cannabis use during pregnancy or lactation. Eligible clinicians were those whose practice particularly focusses on pregnant and postpartum patients. The search was not limited by study design, geography, or year. We used a convergent integrative analysis method to extract relevant findings for inductive analysis. RESULTS Thirteen studies were included; describing perspectives of 1,366 clinicians in 4 countries. We found no unified approach to screening and counselling. Clinicians often cited insufficient evidence around the effects of perinatal cannabis use and lacked confidence in counselling about use. At times, this meant clinicians did not address cannabis use with patients. Most counselled for cessation and there was little recognition of the varied reasons that patients might use cannabis, and an over-reliance on counselling focussed on the legal implications of use. CONCLUSION Current approaches to responding to cannabis use might result in inadequate counselling. Counselling may be improved through increased education and training, which would facilitate conversations to mitigate the potential harm of perinatal cannabis use while recognizing the benefits patients perceive.
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Affiliation(s)
- Janelle Panday
- Department of Family Medicine, McMaster University, Hamilton, Canada
| | - Shipra Taneja
- Department of Family Medicine, McMaster University, Hamilton, Canada
| | - Anuoluwa Popoola
- Department of Family Medicine, McMaster University, Hamilton, Canada
| | - Rachael Pack
- Center for Education Research and Innovation, Schulich School of Medicine and Dentistry, Western University, London, Canada
| | - Devon Greyson
- Department of Communication, University of Massachusetts Amherst, Amherst, United States.,School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Sarah D McDonald
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, McMaster University, Hamilton, Canada.,Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Canada.,Department of Radiology, McMaster University, Hamilton, Canada
| | - Morgan Black
- Department of Family Medicine, McMaster University, Hamilton, Canada
| | - Beth Murray-Davis
- Department of Obstetrics and Gynecology, McMaster University, Hamilton, Canada.,Department of Obstetrics and Gynecology, McMaster Midwifery Research Centre, McMaster University, Hamilton, Canada
| | - Elizabeth Darling
- Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Canada.,Department of Obstetrics and Gynecology, McMaster University, Hamilton, Canada.,Department of Obstetrics and Gynecology, McMaster Midwifery Research Centre, McMaster University, Hamilton, Canada
| | - Meredith Vanstone
- Department of Family Medicine, McMaster University, Hamilton, Canada
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Vanstone M, Panday J, Popoola A, Taneja S, Greyson D, McDonald SD, Pack R, Black M, Murray-Davis B, Darling E. Pregnant People's Perspectives On Cannabis Use During Pregnancy: A Systematic Review and Integrative Mixed-Methods Research Synthesis. J Midwifery Womens Health 2022; 67:354-372. [PMID: 35445514 PMCID: PMC9324983 DOI: 10.1111/jmwh.13363] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 02/14/2022] [Accepted: 02/18/2022] [Indexed: 11/28/2022]
Abstract
Introduction Rates of perinatal cannabis use are rising, despite clinical evidence about the potential for harm. Accordingly, pregnant and lactating people who perceive a benefit from cannabis use may have a difficult time making informed decisions about cannabis use. Methods We conducted a systematic review of mixed‐methods research to synthesize existing knowledge on the perspectives of pregnant people and their partners about cannabis use in pregnancy. Six health and social science databases were searched up until May 30, 2021. There were no methodological, time, or geographic limits applied. We employed a convergent integrative approach to the inductive analysis of findings from all studies. Results We identified 26 studies describing views of 17,781 pregnant and postpartum people about cannabis use in pregnancy. No studies describing the views of partners were identified, and only one study specifically addressed the perspectives of lactating people. Comparative analysis revealed that whether cannabis was studied alone or grouped with other substances resulted in significant diversity in descriptions of participant decision‐making priorities and perceptions of risks and benefits. Studies of cannabis alone demonstrated a complex decision‐making process whereby perceived benefits are balanced against the available information about risk, which is often unclear and uncertain. Clear and helpful information was difficult to identify, and health care providers were not described as a helpful and trusted resource for decision‐making. Discussion Decision‐making about cannabis use is difficult for pregnant and lactating people who perceive a benefit from this use, although this decisional difficulty is seldom reflected in studies that examine cannabis as one of multiple substances that pregnant or lactating people may use. Our review suggests several approaches clinicians may take to encourage open and supportive conversations to facilitate informed decisions about cannabis use during the perinatal period.
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Affiliation(s)
- Meredith Vanstone
- Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Janelle Panday
- Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Anuoluwa Popoola
- Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Shipra Taneja
- Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Devon Greyson
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Communication, University of Massachusetts Amherst, Amherst, Massachusetts
| | - Sarah D McDonald
- Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, Canada.,Department of Radiology, McMaster University, Hamilton, Ontario, Canada.,Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada
| | - Rachael Pack
- Center for Education Research and Innovation, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Morgan Black
- Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Beth Murray-Davis
- Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, Canada.,McMaster Midwifery Research Centre, McMaster University, Hamilton, Ontario, Canada
| | - Elizabeth Darling
- Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, Canada.,Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada.,McMaster Midwifery Research Centre, McMaster University, Hamilton, Ontario, Canada
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Lifestyle Interventions through Participatory Research: A Mixed-Methods Systematic Review of Alcohol and Other Breast Cancer Behavioural Risk Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020980. [PMID: 35055801 PMCID: PMC8775986 DOI: 10.3390/ijerph19020980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 01/10/2022] [Accepted: 01/12/2022] [Indexed: 11/17/2022]
Abstract
Breast cancer is one of the most frequently diagnosed cancers in women globally. Sex and advancing age represent the dominant risk factors, with strong evidence of alcohol as a modifiable risk factor. The carcinogenic nature of alcohol has been known for over twenty years; however, this has failed to translate into significant behavioural, practice, or policy change. As a result, women have not benefitted from this research and, by extension, have been exposed to unnecessary breast cancer risk. Participatory research presents a solution to research translation in public health through the collaboration of impacted populations with academics in research. This systematic review examines peer-reviewed research studies where participants were involved in the research process and the outcomes related to breast cancer prevention (either alcohol or broader lifestyle modification). Seven of the eight studies reported positive effects, and the collaboration between academic researchers and impacted populations may have supported positive outcomes. Women were receptive and responsive to participatory approaches, and their participation is important to address socially entrenched behaviours such as alcohol consumption. Participatory research presents opportunities for future interventions to improve (or address) modifiable risk factors for breast cancer.
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Kiwanuka F, Sak-Dankosky N, Alemayehu YH, Nanyonga RC, Kvist T. The evidence base of nurse-led family interventions for improving family outcomes in adult critical care settings: A mixed method systematic review. Int J Nurs Stud 2022; 125:104100. [PMID: 34736074 PMCID: PMC8560087 DOI: 10.1016/j.ijnurstu.2021.104100] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 09/05/2021] [Accepted: 09/25/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND The COVID-19 pandemic has exacerbated the consequences of a patient's admission to critical care settings, causing families to face more psychosocial issues than in previous years. Thus, nurses and other clinicians need to keep abreast of interventions that support the families of critical care patients. OBJECTIVE To provide evidence of nurse-led family interventions and their family outcomes in adult critical care settings. DESIGN A mixed method systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis checklist. DATA SOURCES The search included both a screen of relevant databases (PubMed, Scopus, Cumulative Index of Nursing and Allied Health Literature, and the Cochrane Library) and the screening of citations in relevant articles. Studies published in the English language between January 2010 and October 2020 were considered. The final database searches were performed on 20 October 2020. METHODS Screening and eligibility assessment were conducted using the Rayyan software. Studies describing the family outcomes of nurse-led interventions in adult critical care settings through either qualitative or quantitative methods were included, i.e., the mixed method synthesis permitted the inclusion of either qualitative or quantitative findings. Article quality was evaluated by three authors using the Joanna Briggs Institute's critical appraisal tools. FINDINGS A total of 15 studies - two trials, eight quasi-experimental studies, four qualitative, and one mixed method met the inclusion criteria. The described interventions were organized into five categories: educational/informational; family involvement in care; diary; communication; and bundled interventions. These categories varied in terms of elements, delivery, and family outcomes. Nurse-led interventions that resulted in small to medium improvements in family outcomes included educational interventions with digital storytelling, a bundled approach, informational nursing interventions, and nurse-driven emotional support. The included studies (n = 2) that investigated family rounds in the ICU reported that this approach did not noticeably influence family outcomes. CONCLUSION The differences in the intervention elements, tools, and outcomes evaluated in this review reflect the diversity of family needs, and that numerous interventions have already been developed to promote family health in critical care settings. The evidence suggests that interdisciplinary nurse-led family interventions can improve family outcomes. Tweetable abstract: Interprofessional nurse-led family interventions draw on diverse approaches and improve family outcomes in adult critical care settings.
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Affiliation(s)
- Frank Kiwanuka
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio 70211, Finland.
| | | | - Yisak Hagos Alemayehu
- Department of Nursing, Adigrat University of Medical and Health Sciences, Adigrat, Ethiopia
| | | | - Tarja Kvist
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio 70211, Finland
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Brothers TD, Lewer D, Bonn M, Webster D, Harris M. Social and structural determinants of injecting-related bacterial and fungal infections among people who inject drugs: protocol for a mixed studies systematic review. BMJ Open 2021; 11:e049924. [PMID: 34373309 PMCID: PMC8354281 DOI: 10.1136/bmjopen-2021-049924] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 07/26/2021] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION Injecting-related bacterial and fungal infections are a common complication among people who inject drugs (PWID), associated with significant morbidity and mortality. Invasive infections, including infective endocarditis, appear to be increasing in incidence. To date, preventive efforts have focused on modifying individual-level risk behaviours (eg, hand-washing and skin-cleaning) without much success in reducing the population-level impact of these infections. Learning from successes in HIV prevention, there may be great value in looking beyond individual-level risk behaviours to the social determinants of health. Specifically, the risk environment conceptual framework identifies how social, physical, economic and political environmental factors facilitate and constrain individual behaviour, and therefore influence health outcomes. Understanding the social and structural determinants of injecting-related bacterial and fungal infections could help to identify new targets for prevention efforts in the face of increasing incidence of severe disease. METHODS AND ANALYSIS This is a protocol for a systematic review. We will review studies of PWID and investigate associations between risk factors (both individual-level and social/structural-level) and the incidence of hospitalisation or death due to injecting-related bacterial infections (skin and soft-tissue infections, bacteraemia, infective endocarditis, osteomyelitis, septic arthritis, epidural abscess and others). We will include quantitative, qualitative and mixed methods studies. Using directed content analysis, we will code risk factors for these infection-related outcomes according to their contributions to the risk environment in type (social, physical, economic or political) and level (microenvironmental or macroenvironmental). We will also code and present risk factors at each stage in the process of drug acquisition, preparation, injection, superficial infection care, severe infection care or hospitalisation, and outcomes after infection or hospital discharge. ETHICS AND DISSEMINATION As an analysis of the published literature, no ethics approval is required. The findings will inform a research agenda to develop and implement social/structural interventions aimed at reducing the burden of disease. PROSPERO REGISTRATION NUMBER CRD42021231411.
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Affiliation(s)
- Thomas D Brothers
- UCL Collaborative Centre for Inclusion Health, Institue of Epidemiology and Health Care, University College London, London, UK
- Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Dan Lewer
- UCL Collaborative Centre for Inclusion Health, Institue of Epidemiology and Health Care, University College London, London, UK
| | - Matthew Bonn
- Canadian Association of People Who Use Drugs, Dartmouth, Nova Scotia, Canada
| | - Duncan Webster
- Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
- Division of Infectious Diseases, Saint John Regional Hospital, Saint John, New Brunswick, Canada
| | - Magdalena Harris
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
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Mckenzie G, Willis C, Shields N. Barriers and facilitators of physical activity participation for young people and adults with childhood-onset physical disability: a mixed methods systematic review. Dev Med Child Neurol 2021; 63:914-924. [PMID: 33559889 DOI: 10.1111/dmcn.14830] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/11/2021] [Indexed: 12/19/2022]
Abstract
AIM To understand the attitudes, barriers, and facilitators to physical activity participation for young people and adults with childhood-onset physical disability. METHOD Seven electronic databases (Embase, MEDLINE, PsychINFO, AMED, CINAHL, SPORTDiscus, and ERIC) were searched to November 2019. English language studies were included if they investigated attitudes, barriers, or facilitators to physical activity for young people (≥15y) or adults with childhood-onset physical disabilities. Two reviewers applied eligibility criteria and assessed methodological quality. Data were synthesized in three stages: (1) thematic analysis into descriptive themes, (2) thematic synthesis via conceptual framework, and (3) an interpretive synthesis of the thematic results. RESULTS Nineteen studies were included. Methodological quality varied, with only four qualitative studies and one quantitative study meeting all quality items. An overarching theme of 'finding the right balance' emerged. Six subthemes relating to capability, opportunity, and motivation contributed to physical activity participation being seen as 'the right fit' or 'all too hard'. The interpretive synthesis found social connections, social environment support, and an appropriate physical environment were essential to 'finding the right balance' to be physically active. INTERPRETATION Physical activity participation for young people and adults with childhood-onset physical disabilities is primarily influenced by the social and physical environment. What this paper adds Physical activity participation for young people and adults with childhood-onset physical disabilities is primarily influenced by environmental factors. 'Finding the right balance' between enabling and inhibitory factors was important to physical activity participation being perceived as 'the right fit'. The opportunity for social connection is an important motivator for physical activity participation for young people and adults. The physical environment continues to act as a barrier to physical activity participation for those with physical disabilities.
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Affiliation(s)
- Georgia Mckenzie
- Department of Physiotherapy, Podiatry and Prosthetics and Orthotics, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC, Australia
| | - Claire Willis
- Department of Physiotherapy, Podiatry and Prosthetics and Orthotics, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC, Australia
| | - Nora Shields
- Department of Physiotherapy, Podiatry and Prosthetics and Orthotics, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC, Australia
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Hanf M, Hirt J, van den Akker M. Primary care professionals' attitudes towards digital health interventions for common mental disorders: study protocol for a mixed methods systematic review. BMJ Open 2021; 11:e045657. [PMID: 34127490 PMCID: PMC8204153 DOI: 10.1136/bmjopen-2020-045657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION Mental disorders such as depression are common, and an estimated 264 million people are affected by them throughout the world. In recent years, studies on digital health interventions to treat mental disorders have shown evidence of their efficacy, and interest in using them has increased as a result. In the primary care setting, depression and anxiety are the two most frequently diagnosed and treated mental disorders. When they do not refer them to specialists, primary care professionals such as general practitioners treat patients with mental disorders themselves but have insufficient time to treat them adequately. Furthermore, there is a shortage of psychotherapists and those that exist have long waiting lists for an appointment. The purpose of this mixed methods systematic review is to explore the attitudes of primary care professionals towards the use of digital health interventions in the treatment of patients with mental disorders. Their attitudes will provide an indication whether digital mental health interventions can effectively complement standard care in the primary care setting. METHODS AND ANALYSIS We searched for qualitative, quantitative and mixed methods studies published in English, German, Spanish, Russian, French and Dutch after January 2010 for inclusion in the review. The included studies must involve digital mental health interventions conducted via computer and/or mobile devices in the primary care setting. The search was conducted in July 2020 in the following electronic bibliographic databases: MEDLINE, Embase, CINAHL, PsycINFO and Web of Science Core Collection. Two reviewers will independently screen titles, abstracts and full texts and extract data. We will use the 'Integrated methodology' framework to combine both quantitative and qualitative data. ETHICS AND DISSEMINATION Ethical approval is not required. We will disseminate the results of the mixed methods systematic review in a peer-reviewed journal and scientific conferences. PROSPERO REGISTRATION NUMBER CRD42020188879.
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Affiliation(s)
- Maria Hanf
- Institute of General Practice, University of Frankfurt, Frankfurt am Main, Germany
| | - Julian Hirt
- Center for Dementia Care, Institute of Applied Nursing Sciences, Department of Health, University of Applied Sciences of Eastern Switzerland, St Gallen, Switzerland
- International Graduate Academy, Institute for Health and Nursing Science, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Marjan van den Akker
- Institute of General Practice, University of Frankfurt, Frankfurt am Main, Germany
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
- Department of Public Health and Primary Care, Katholieke Universiteit Leuven, Academic Centre for General Practice, Leuven, Belgium
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Batten J, Brackett A. Ensuring Rigor in systematic reviews: Part 5, quality appraisal, data extraction, synthesis. Heart Lung 2021; 50:615-617. [PMID: 34090176 DOI: 10.1016/j.hrtlng.2021.04.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 04/01/2021] [Indexed: 12/19/2022]
Affiliation(s)
- Janene Batten
- Harvey Cushing/John Hay Whitney Medical Library, 333 Cedar Street, New Haven, 06510, USA.
| | - Alexandria Brackett
- Harvey Cushing/John Hay Whitney Medical Library, 333 Cedar Street, New Haven, 06510, USA.
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Abstract
OBJECTIVE The objective of this paper is to outline the updated methodological approach for conducting a JBI mixed methods systematic review with a focus on data synthesis, specifically, methods related to how data are combined and the overall integration of the quantitative and qualitative evidence. INTRODUCTION Mixed methods systematic reviews provide a more complete basis for complex decision-making than that currently offered by single method reviews, thereby maximizing their usefulness to clinical and policy decision-makers. Although mixed methods systematic reviews are gaining traction, guidance regarding the methodology of combining quantitative and qualitative data is limited. In 2014, the JBI Mixed Methods Review Methodology Group developed guidance for mixed methods systematic reviews; however, since the introduction of this guidance, there have been significant developments in mixed methods synthesis. As such, the methodology group recognized the need to revise the guidance to align it with the current state of knowledge on evidence synthesis methodology. METHODS Between 2015 and 2019, the JBI Mixed Methods Review Methodology Group undertook an extensive review of the literature, held annual face-to-face meetings (which were supplemented by teleconferences and regular email correspondence), sought advice from experts in the field, and presented at scientific conferences. This process led to the development of guidance in the form of a chapter in the JBI Manual for Evidence Synthesis, the official guidance for conducting JBI systematic reviews. In 2019, the guidance was ratified by the JBI International Scientific Committee. RESULTS The updated JBI methodological guidance for conducting a mixed methods systematic review recommends that reviewers take a convergent approach to synthesis and integration whereby the specific method utilized is dependent on the nature/type of questions that are posed in the systematic review. The JBI guidance is primarily based on Hong et al. and Sandelowski's typology on mixed methods systematic reviews. If the review question can be addressed by both quantitative and qualitative research designs, the convergent integrated approach should be followed, which involves data transformation and allows reviewers to combine quantitative and qualitative data. If the focus of the review is on different aspects or dimensions of a particular phenomenon of interest, the convergent segregated approach is undertaken, which involves independent synthesis of quantitative and qualitative data leading to the generation of quantitative and qualitative evidence, which are then integrated together. CONCLUSIONS The updated guidance on JBI mixed methods systematic reviews provides foundational work to a rapidly evolving methodology and aligns with other seminal work undertaken in the field of mixed methods synthesis. Limitations to the current guidance are acknowledged, and a series of methodological projects identified by the JBI Mixed Methods Review Methodology Group to further refine the methodology are proposed. Mixed methods reviews offer an innovative framework for generating unique insights related to the complexities associated with health care quality and safety.
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Sousa RCRD, Araújo-Monteiro GKND, Souto RQ, Santos RCD, Leal CQAM, Nascimento NDM. Interventions to prevent elder abuse in the community: a mixed-methods systematic review. Rev Esc Enferm USP 2021; 55:e3677. [PMID: 33886908 DOI: 10.1590/s1980-220x2019033203677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 08/03/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To identify the interventions proposed in the literature aimed at preventing elder abuse among community-residing elders. METHOD This was a mixed-methods systematic review that followed the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols checklist. The protocol of this systematic review was registered in the International Prospective Register of Systematic Reviews. We included studies published between January 2004 and December 2019 in the databases: LILACS, IBECS, CUMED, CINAHL, MEDLINE and SciELO. The methodological quality of each study included was performed using the Mixed Methods Appraisal Tool. RESULTS Seven studies formed the final sample. Two groups emerged after the analyses: the primary level intervention group, which used health education and coexisting elder abuse groups; and the secondary intervention level, focused mostly on the mental health care of victims of elder abuse. CONCLUSION There is still a shortage of intervention studies to prevent elder abuse. All the studies selected had a positive outcome, and all interventions can be implemented in nursing care practice.
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de la Cuesta-Benjumea C, Arredondo-González CP, Lidón-Cerezuela B, Abad-Corpa E. [Fall prevention in older people and their families: a qualitative synthesis]. GACETA SANITARIA 2020; 35:186-192. [PMID: 33268110 DOI: 10.1016/j.gaceta.2019.10.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 10/28/2019] [Accepted: 10/29/2019] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To analyse and synthesize the evidence on fall prevention of people older than 65 years and their family care providers METHOD: Qualitative synthesis, which is a part of a convergent systematic integrative review. Forty-one qualitative studies were retained for full text scrutiny. Nine studies on family care providers were selected for this synthesis. RESULTS Care providing, and kinship relationships mediated family care providers' interventions to prevent falls in older people. The fall of the dependent relative constitutes a turning point in these relationships. Family care providers are vulnerable to having a fall themselves and therefore receivers of preventive interventions. CONCLUSIONS Taking into account the context of care and family relations will improve the effectiveness of preventive interventions and will facilitate adherence. Fall prevention policy and programmes must pay better attention to the health and wellbeing of family care providers.
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Affiliation(s)
- Carmen de la Cuesta-Benjumea
- Departamento de Psicología de la Salud, Universidad de Alicante, Alicante, España; Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, España
| | | | | | - Eva Abad-Corpa
- Departamento de Enfermería, Universidad de Murcia, Murcia, España; Hospital Reina Sofía, Servicio Murciano de Salud, Murcia, España; IMIB-Arrixaca; Investén-iscii, Murcia, España; CIBERFES, Murcia, España
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Stern C, Lizarondo L, Carrier J, Godfrey C, Rieger K, Salmond S, Apóstolo J, Kirkpatrick P, Loveday H. Methodological guidance for the conduct of mixed methods systematic reviews. JBI Evid Synth 2020; 18:2108-2118. [DOI: 10.11124/jbisrir-d-19-00169] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Jansen R, Reid M. Communication Technology Use by Caregivers of Adolescents With Mental Health Issues: Systematic Review. JMIR Mhealth Uhealth 2020; 8:e13179. [PMID: 32663143 PMCID: PMC7468639 DOI: 10.2196/13179] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 12/11/2019] [Accepted: 05/14/2020] [Indexed: 11/22/2022] Open
Abstract
Background Caregivers of adolescents with mental health issues experience challenges that may result in the caregivers having a variety of unmet needs. There is a growing need to support these caregivers. Effective support to strengthen positive caregiving behavior in caregivers may address their challenges. Communication technologies offer novel opportunities to assist these caregivers and may contribute to strengthening caregiver behavior. However, little is known about the use of communication technologies among caregivers of adolescents with mental health issues. Objective The study aimed to answer the question: “What is the best evidence available to strengthen positive behavior of caregivers of adolescents with mental health issues using communication technology.” Methods A systematic review of articles published between January 2007 and August 2018 was conducted. Searches included articles of multiple study designs from EBSCO Host and Scopus platforms with prespecified eligibility criteria. Methodological quality was evaluated using the applicable Critical Appraisal Skills Programme and Joanna Briggs Institute assessment tools. Results The search yielded 1746 articles. Altogether, 5 articles met the eligibility criteria and were included in the review for data synthesis. Data analysis and synthesis identified three thematic conclusions reflecting the types of communication technologies used, caregivers as the target population, and strengthening of positive behavior through determinants of the Integrated Model of Behavior Prediction. Conclusions The review reported the usefulness of communication technology by caregivers. Caregivers also demonstrated improvement in self-efficacy, knowledge, parent-child communication, and parental skills reflecting positive behavior. Although the use of communication technology is expanding as a supportive intervention to address caregivers’ needs, the evidence for usefulness among caregivers of adolescents with mental health issues is still scarce. More research and information related to preferred methods of communication delivery among caregivers of adolescents is still needed.
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Affiliation(s)
- Ronelle Jansen
- School of Nursing, Faculty of Health Science, University of the Free State, Bloemfontein, South Africa
| | - Marianne Reid
- School of Nursing, Faculty of Health Science, University of the Free State, Bloemfontein, South Africa
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Martin SL, McCann JK, Gascoigne E, Allotey D, Fundira D, Dickin KL. Mixed-Methods Systematic Review of Behavioral Interventions in Low- and Middle-Income Countries to Increase Family Support for Maternal, Infant, and Young Child Nutrition during the First 1000 Days. Curr Dev Nutr 2020; 4:nzaa085. [PMID: 32607463 PMCID: PMC7311193 DOI: 10.1093/cdn/nzaa085] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 05/08/2020] [Accepted: 05/13/2020] [Indexed: 02/06/2023] Open
Abstract
Fathers, grandmothers, and other family members' influence on maternal, infant, and young child nutrition (MIYCN) is widely recognized, yet synthesis of the effectiveness of engaging them to improve nutrition practices during the first 1000 d is lacking. We examined the impact of behavioral interventions to engage family members in MIYCN in low- and middle-income countries through a mixed-methods systematic review. We screened 5733 abstracts and included 35 peer-reviewed articles on 25 studies (16 with quantitative and 13 with qualitative data). Most quantitative studies focused on early breastfeeding, primarily engaging fathers or, less often, grandmothers. Most found positive impacts on exclusive breastfeeding rates and family members' knowledge and support. The few quantitative studies on complementary feeding, maternal nutrition, and multiple outcomes also suggested benefits. Qualitative themes included improved nutrition behaviors, enhanced relationships, and challenges due to social norms. Interventions engaging family members can increase awareness and build support for MIYCN, but more rigorous study designs are needed. This systematic review is registered at PROSPERO as CRD42018090273, https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=90273.
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Affiliation(s)
- Stephanie L Martin
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Juliet K McCann
- Program in International Nutrition, Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
| | - Emily Gascoigne
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Diana Allotey
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Dadirai Fundira
- Program in International Nutrition, Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
| | - Katherine L Dickin
- Program in International Nutrition, Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
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Havill N, Fleming LK, Knafl K. Well siblings of children with chronic illness: A synthesis research study. Res Nurs Health 2019; 42:334-348. [PMID: 31418465 DOI: 10.1002/nur.21978] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 07/20/2019] [Indexed: 11/12/2022]
Abstract
Well siblings of chronically ill children experience family disruptions that profoundly affect them. Previous research focusing on well siblings' experiences has often produced inconsistent findings, likely the result of varying study designs and samples. The purposes of this synthesis research study were twofold: (a) to assess the applicability of existing grounded theory of sibling response to a child's cancer to a wider range of childhood conditions; and (b) to refine the existing theory to reflect the experiences of the broader sample. Data for the synthesis came from a National Institute of Nursing Research-funded mixed-methods synthesis examining the intersection of childhood chronic illness and family life. The current analysis was based on well sibling results extracted from 78 research reports published between 2000 and 2014. An existing grounded theory, Creating a Tenuous Balance (CTB), was discovered at the outset of analysis and used as the primary framework for coding and synthesizing results. The focus of most studies was siblings' responses to 14 chronic conditions, with cancer being the most often studied. Results reflected siblings' perspectives of their experiences as well as perspectives of parents and the ill child. The analysis substantiated all four patterns of sibling behavior included in CTB, with the patterns of adapting to changes in personal and family life, and handling strong emotions being especially challenging aspects of the sibling experience. Moreover, the results expanded several aspects of CTB. The analysis provided evidence of the applicability of the theory to a varied group of chronic conditions and enabled us to identify important areas for developing interventions to support siblings.
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Affiliation(s)
- Nancy Havill
- Division of Nursing, University of North Carolina Hospitals, Chapel Hill, North Carolina
| | - Louise K Fleming
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Kathleen Knafl
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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French B, Sayal K, Daley D. Barriers and facilitators to understanding of ADHD in primary care: a mixed-method systematic review. Eur Child Adolesc Psychiatry 2019; 28:1037-1064. [PMID: 30552584 PMCID: PMC6675769 DOI: 10.1007/s00787-018-1256-3] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 11/14/2018] [Indexed: 11/06/2022]
Abstract
Attention deficit hyperactivity disorder (ADHD) is a developmental disorder affecting up to 5% of children and adults and is underdiagnosed in many European countries. The process of access to care for this disorder is complex and variable across countries. In general, those affected, or their caregiver, will seek help through their primary care practitioners who are then often responsible for referral to other professionals for diagnosis and provision of treatment. Previous studies have highlighted that many barriers to recognition exist in primary care settings (such as misconceptions, lack of education or lack of resources), preventing access to care for this population and potentially affecting diagnosis rate. This systematic review aims to establish the barriers and facilitators with regard to attitudes, beliefs and experiences of ADHD within primary care. Electronic searches of multiple databases identified 3898 articles of which 48 met our inclusion criteria-primary care professionals from any country, understanding, knowledge, awareness, attitude and recognition of ADHD. Four main themes were identified: (1) need for education, (2) misconceptions and stigma, (3) constraints with recognition, management and treatment, and (4) multidisciplinary approach. The findings suggest many interacting factors are at play in the recognition of ADHD by primary care practitioners with a strong recurring theme of a significant need for better education on ADHD. Implications for research and practice are discussed, suggesting that educational interventions for primary care practitioners could improve the recognition of ADHD in this setting.
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Affiliation(s)
- B French
- Division of Psychiatry & Applied Psychology, University of Nottingham, Nottingham, UK
- Centre for ADHD and Neurodevelopmental Disorders Across the Lifespan (CANDAL), Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - K Sayal
- Division of Psychiatry & Applied Psychology, University of Nottingham, Nottingham, UK
- Centre for ADHD and Neurodevelopmental Disorders Across the Lifespan (CANDAL), Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - D Daley
- Division of Psychiatry & Applied Psychology, University of Nottingham, Nottingham, UK.
- Centre for ADHD and Neurodevelopmental Disorders Across the Lifespan (CANDAL), Institute of Mental Health, University of Nottingham, Nottingham, UK.
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Kumah EA, McSherry R, Bettany‐Saltikov J, Hamilton S, Hogg J, Whittaker V, van Schaik P. PROTOCOL: Evidence-informed practice versus evidence-based practice educational interventions for improving knowledge, attitudes, understanding, and behavior toward the application of evidence into practice: A comprehensive systematic review of undergraduate students. CAMPBELL SYSTEMATIC REVIEWS 2019; 15:e1015. [PMID: 37131476 PMCID: PMC8356512 DOI: 10.1002/cl2.1015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Affiliation(s)
| | - Robert McSherry
- School of Health and Social CareTeesside UniversityMiddlesbroughUK
| | | | - Sharon Hamilton
- School of Health and Social CareTeesside UniversityMiddlesbroughUK
| | - Julie Hogg
- School of Health and Social CareTeesside UniversityMiddlesbroughUK
| | - Vicki Whittaker
- School of Health and Social CareTeesside UniversityMiddlesbroughUK
| | - Paul van Schaik
- School of Social Sciences, Humanities LawTeesside UniversityMiddlesbroughUK
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Wranik WD, Price S, Haydt SM, Edwards J, Hatfield K, Weir J, Doria N. Implications of interprofessional primary care team characteristics for health services and patient health outcomes: A systematic review with narrative synthesis. Health Policy 2019; 123:550-563. [PMID: 30955711 DOI: 10.1016/j.healthpol.2019.03.015] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 03/11/2019] [Accepted: 03/23/2019] [Indexed: 01/19/2023]
Abstract
Interprofessional primary care (IPPC) teams are promoted as an alternative to single profession physician practices in primary care with focus on preventive care and chronic disease management. Characteristics of teams can have an impact on their performance. We synthesized quantitative, qualitative or mixed-methods evidence addressing the design of IPPC teams. We searched Ovid MEDLINE, Embase, CINAHL, and PAIS using search terms focused on IPPC teams. Studies were included if they discussed the influence of team structure, organization, financial arrangements, or policies and procedures, or either health care processes or outputs, health outcomes, or costs, and were conducted in Australia, Canada, the United Kingdom or New Zealand between 2003 and 2016. We screened 11,707 titles, 5366 abstracts, and selected 77 full text articles (38 qualitative, 31 quantitative and 8 mixed-methods). Literature focused on the implications of team characteristics on team processes, such as teamwork, collaboration, or satisfaction of patients or providers. Despite heterogeneity of contexts, some trends are observable: shared space, common vision and goals, clear definitions of roles, and leadership as important to good teamwork. The impacts of these on health care outputs or patient health are not clear. To move the state of knowledge beyond perception of what works well for IPPC teams, researchers should focus on quantitative causal inference about the linkages between team characteristics and patient health.
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Affiliation(s)
- Wiesława Dominika Wranik
- School of Public Administration, Faculty of Management, Dalhousie University, Canada; Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Canada.
| | - Sheri Price
- School of Nursing, Faculty of Health Professions, Dalhousie University, Canada
| | - Susan M Haydt
- School of Public Administration, Faculty of Management, Dalhousie University, Canada
| | | | - Krista Hatfield
- School of Journalism and Communication, Carleton University, Canada
| | - Julie Weir
- Halifax Partnership, Dalhousie University, Canada
| | - Nicole Doria
- Maritime SPOR Support Unit, Dalhousie University, Canada
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The development of a role description and competency map for pharmacists in an interprofessional care setting. Int J Clin Pharm 2019; 41:391-407. [DOI: 10.1007/s11096-019-00808-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Accepted: 03/01/2019] [Indexed: 10/27/2022]
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Millington P, Hellawell M, Graham C, Edwards L. Healthcare practice placements: back to the drawing board? ACTA ACUST UNITED AC 2019. [DOI: 10.12968/bjhc.2019.25.3.145] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Paul Millington
- Lecturer in Physiotherapy, University of Bradford, Bradford, UK
| | - Michael Hellawell
- Physiotherapy Professional Lead, University of Bradford, Bradford, UK
| | - Claire Graham
- Physiotherapy Programme Lead, University of Bradford, Bradford, UK
| | - Lisa Edwards
- Lecturer in Physiotherapy, University of Bradford, Bradford, UK
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Dufour É, Duhoux A, Bolduc J. Measured and perceived effects of audit and feedback on nursing performance: a mixed methods systematic review protocol. Syst Rev 2019; 8:38. [PMID: 30709416 PMCID: PMC6357419 DOI: 10.1186/s13643-019-0956-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 01/21/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The use of audit and feedback (A&F) interventions in health care has been demonstrated to generally be effective on medical teams. However, literature suggests that the response of nurses to this type of intervention may differ from that of other types of health professionals, in relation to their roles, power, and to the configuration of nursing care activities. To our knowledge, no review has been conducted on A&F interventions with nurses. The objective of this systematic review is to examine the evidence of measured and perceived effects of A&F interventions on nurses' performance. METHODS A mixed methods systematic review design with thematic and narrative synthesis is used. Studies reporting quantitative and qualitative data on the effects of A&F interventions specific to nursing care are considered for inclusion. Studies will be appraised for quality using the Mixed Methods Appraisal Tool. Quantitative and qualitative data will be summarized in narrative and tabular form and will be synthetized using a segregated methodologies approach. DISCUSSION Results will describe the characteristics of A&F with nurses, as well as the measured and perceived effects specific to nursing care. The associations between the characteristics and the effects as well as the concordance between measured and perceived effects will be presented. We anticipate that combining the evidence from qualitative and quantitative studies will allow us to provide relevant insight that can inform the design of better suited A&F interventions for nurses. Audit and feedback interventions demonstrate potential for improving the performance of nursing care. As their effectiveness varies greatly depending on the context and the professionals involved, a better understanding of the associations between its characteristics and the measured and perceived effects is valuable for improving the effectiveness of A&F. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42018104973.
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Affiliation(s)
- Émilie Dufour
- Faculty of Nursing, Université de Montréal, C.P. 6128 succ. Centre-Ville Montréal Marguerite-d'Youville Campus, Montréal, QC, H3C 3J7, Canada.
| | - Arnaud Duhoux
- Faculty of Nursing, Université de Montréal, C.P. 6128 succ. Centre-Ville Montréal Marguerite-d'Youville Campus, Montréal, QC, H3C 3J7, Canada.,CR-CSIS (Centre de recherche Charles-Le Moyne - Saguenay-Lac-Saint-Jean sur les innovations en santé) Université de Sherbrooke, Longueuil Campus, Longueuil, QC, J4K 0A8, Canada
| | - Jolianne Bolduc
- ESPUM (École de santé publique de l'Université de Montréal), Université de Montréal, Montréal, QC, H3N 1X9, Canada
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Booth A, Moore G, Flemming K, Garside R, Rollins N, Tunçalp Ö, Noyes J. Taking account of context in systematic reviews and guidelines considering a complexity perspective. BMJ Glob Health 2019; 4:e000840. [PMID: 30775011 PMCID: PMC6350703 DOI: 10.1136/bmjgh-2018-000840] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Revised: 09/26/2018] [Accepted: 09/28/2018] [Indexed: 12/19/2022] Open
Abstract
Systematic review teams and guideline development groups face considerable challenges when considering context within the evidence production process. Many complex interventions are context-dependent and are frequently evaluated within considerable contextual variation and change. This paper considers the extent to which current tools used within systematic reviews and guideline development are suitable in meeting these challenges. The paper briefly reviews strengths and weaknesses of existing approaches to specifying context. Illustrative tools are mapped to corresponding stages of the systematic review process. Collectively, systematic review and guideline production reveals a rich diversity of frameworks and tools for handling context. However, current approaches address only specific elements of context, are derived from primary studies which lack information or have not been tested within systematic reviews. A hypothetical example is used to illustrate how context could be integrated throughout the guideline development process. Guideline developers and evidence synthesis organisations should select an appropriate level of contextual detail for their specific guideline that is parsimonious and yet sensitive to health systems contexts and the values, preferences and needs of their target populations.
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Affiliation(s)
- Andrew Booth
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Graham Moore
- School of Social Sciences, Cardiff University, Cardiff, UK
| | - Kate Flemming
- Department of Health Sciences, The University of York, York, UK
| | - Ruth Garside
- European Centre for Environment and Human Health, University of Exeter, Truro, UK
| | - Nigel Rollins
- Department of Maternal, Newborn, Child and Adolescent Health, World Health Organization, Genève, Switzerland
| | - 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
| | - Jane Noyes
- School of Social Sciences, Bangor University, Wales, UK
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Cranwell M, Gavine A, McSwiggan L, Kelly TB. What happens for informal caregivers during transition to increased levels of care for the person with dementia? A systematic review protocol. Syst Rev 2018; 7:91. [PMID: 29945664 PMCID: PMC6020322 DOI: 10.1186/s13643-018-0755-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 06/12/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Dementia is a globally prevalent disease that requires ongoing and increasing levels of care, often provided in the first instance by informal caregivers. Supporting transitions in informal caregiving in dementia is a pertinent issue for caregivers, care providers and governments. There is no existing systematic review that seeks to identify and map the body of literature regarding the review question: 'What happens for informal caregivers during transition to increased levels of care for the person with dementia?' METHODS/DESIGN ASSIA, CINAHL+, MEDLINE, PsycINFO, SCIE, Social Service Abstracts and Web of Science will be systematically searched. Specialist dementia research libraries will be contacted. Reviews identified as relevant during the search process, their reference lists, and reference lists of accepted papers will be hand-searched. Qualitative, quantitative and mixed methods studies that seek to represent the experiences of, or examine the impact upon, informal caregivers during transition to increased formal care for the person with dementia will be eligible for inclusion. Synthesis will be segregated into qualitative and quantitative papers. Findings will be summarised, and the review will be prepared for publication. DISCUSSION The review will seek to identify potentially vulnerable groups in need of support and as such, inform the practice of those offering support. It will also inform future research by highlighting areas in which current literature is insubstantial. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42017067248.
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Affiliation(s)
- Marianne Cranwell
- School of Education and Social Work, University of Dundee, Room 2.34 Carnelly Building, Dundee, DD1 4HN UK
| | - Anna Gavine
- School of Nursing and Health Sciences, University of Dundee, Dundee, DD1 4HN UK
| | - Linda McSwiggan
- School of Nursing and Health Sciences, University of Dundee, Dundee, DD1 4HN UK
| | - Timothy B. Kelly
- School of Education and Social Work, University of Dundee, Room 2.34 Carnelly Building, Dundee, DD1 4HN UK
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Jennings AA, Foley T, Walsh KA, Coffey A, Browne JP, Bradley CP. General practitioners' knowledge, attitudes and experiences of managing behavioural and psychological symptoms of dementia: protocol of a mixed methods systematic review and meta-ethnography. Syst Rev 2018; 7:62. [PMID: 29685175 PMCID: PMC5913890 DOI: 10.1186/s13643-018-0732-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 04/13/2018] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND In the context of rising dementia prevalence, the workload of general practitioners (GPs) in dementia care is set to increase. However, there are many aspects of dementia care that GPs find challenging. Behavioural and psychological symptoms of dementia (BPSD) affect the majority of people with dementia and is an aspect of dementia care that GPs find particularly difficult to manage. The aim of this mixed methods systematic review is to undertake a synthesis of qualitative and quantitative studies on GPs' knowledge, attitudes and experiences of managing BPSD. METHODS Seven electronic bibliographic databases will be searched from inception to present. All qualitative or quantitative studies that explore the knowledge, attitude or experiences of GPs towards the management of BPSD in community and/or residential settings will be eligible for inclusion. A meta-ethnography will be conducted to synthesise included studies. Primary outcome measures will include GPs' experiences of managing BPSD, GPs' knowledge of BPSD and their attitude to different approaches to the management of BPSD, in particular their attitude to non-pharmacological approaches. All included papers will be independently assessed for methodological validity by two reviewers using the following tools: the Joanna Briggs Institute checklist for qualitative research, the Effective Public Health Practice Project (EPHPP) tool for intervention studies and the National Institute of Health (NIH) quality assessment tool for observational and analytical cross-sectional studies. As there is no agreed quality assessment tool for descriptive cross-sectional studies, an original tool will be developed. Two independent reviewers will apply the Confidence in the Evidence from Reviews of Qualitative Research (CERQual) tool to the review findings. The results will be reported in line with the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) statement. DISCUSSION This study will be the first systematic review that synthesises the existing literature of GPs' knowledge, attitudes and experiences of managing BPSD in community and residential care. This review will improve our understanding of GPs' perspectives on the management of BPSD, and the results will be used to inform the development of an intervention to improve the management of BPSD in general practice. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42017054916 .
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Affiliation(s)
| | - Tony Foley
- Department of General Practice, University College Cork, Cork, Ireland
| | - Kieran A. Walsh
- School of Public Health, University College Cork, Cork, Ireland
- Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Ireland
- Centre for Gerontology and Rehabilitation, School of Medicine, University College Cork, Cork, Ireland
| | - Alice Coffey
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - John P. Browne
- School of Public Health, University College Cork, Cork, Ireland
| | - Colin P. Bradley
- Department of General Practice, University College Cork, Cork, Ireland
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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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Lietz P, Kos J, Dix K, Trevitt J, Uljarevic M, O'Grady E. Protocol for a Systematic Review: Interventions for Anxiety in School-Aged Children with Autism Spectrum Disorder (ASD): A Mixed-Methods Systematic Review. CAMPBELL SYSTEMATIC REVIEWS 2018; 14:1-48. [PMID: 37131388 PMCID: PMC8427966 DOI: 10.1002/cl2.217] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
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Ashton CK, O’Brien-Langer A, Olson K, Silverstone PH. Qualitative Reflections: CASA's Trauma and Attachment Group (TAG) Program for Youth who have Experienced Early Developmental Trauma. JOURNAL OF THE CANADIAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY = JOURNAL DE L'ACADEMIE CANADIENNE DE PSYCHIATRIE DE L'ENFANT ET DE L'ADOLESCENT 2017; 26:12-20. [PMID: 28331499 PMCID: PMC5349278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 10/21/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE We demonstrated previously that the Trauma and Attachment Group (TAG) program for youth in middle childhood significantly improved caregiver/child attachment relationships, reduced children's symptoms of attachment trauma, and increased the caregiver's ability for self-reflection. Here we examine the perspectives of both those administering and those taking part in this intensive dyad-based group intervention. METHODS Utilizing an ethnographic design we collected and analyzed qualitative data obtained through a focus group and interviews with program facilitators, as well as interviews with participating caregivers. Data were collected from six TAG facilitators through a formal focus group interview (n=4), and informal interviews with TAG facilitators unable to attend the focus group (n=2). Four interviews were also carried out with caregivers (three females and one male). Thematic analysis of the focus group and interview transcripts was conducted. RESULTS Three key themes were identified in the focus group and interview data: Relationship as locus of change, Group process, and Psychoeducation-based content. That the TAG program provides psychoeducation about the effects of trauma to caregiver/child dyads in a group setting appears important in supporting the effectiveness of the program. Structured parent-child play and sensory activities together ("kit-time") were also highly valued. CONCLUSIONS This qualitative study suggests that establishment of a healthy and focused caregiver/child relationship may be the key mechanism to promoting change in relationships that have been challenged by adverse effects of early developmental trauma. Further evaluation may help to identify other components that contribute to the success of the program.
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Affiliation(s)
| | | | - Karin Olson
- Faculty of Nursing, University of Alberta, Edmonton, Alberta
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de la Cuesta-Benjumea C, Henriques MA, Abad-Corpa E, Roe B, Orts-Cortés MI, Lidón-Cerezuela B, Avendaño-Céspedes A, Oliver-Carbonell JL, Sánchez-Ardila C. “Falls prevention among older people and care providers: protocol for an integrative review”. J Adv Nurs 2017; 73:1722-1734. [DOI: 10.1111/jan.13245] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2016] [Indexed: 11/27/2022]
Affiliation(s)
| | | | - Eva Abad-Corpa
- University of Murcia; Murcia España
- Institute for Bio-health Research of Murcia (IMIB); Murcia España
- Nursing and Healthcare Research Unit (Investen-isciii); Carlos III Health Institute; Madrid España
| | - Brenda Roe
- University of Edge Hill; Ormskirk Lancashire UK
| | - María Isabel Orts-Cortés
- University of Alicante; Alicante España
- Nursing and Healthcare Research Unit (Investen-isciii); Carlos III Health Institute; Madrid España
| | - Beatriz Lidón-Cerezuela
- University of Murcia; Murcia España
- Institute for Bio-health Research of Murcia (IMIB); Murcia España
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Baker JD. The Purpose, Process, and Methods of Writing a Literature Review. AORN J 2016; 103:265-9. [PMID: 26924364 DOI: 10.1016/j.aorn.2016.01.016] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Accepted: 01/22/2016] [Indexed: 11/30/2022]
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50
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Carreño-Moreno SP, Chaparro-Díaz L. Calidad de vida de los cuidadores de personas con enfermedad crónica. AQUICHAN 2016. [DOI: 10.5294/aqui.2016.16.4.4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
El alto impacto epidemiológico, social, económico y cultural de las enfermedades crónicas no transmisibles afecta el significado de calidad de vida en las personas que las padecen y en sus cuidadores familiares. Objetivo: describir la forma como se construye el significado de calidad de vida de cuidadores de personas con enfermedad crónica. Método: investigación desarrollada con la propuesta de metasíntesis cualitativa de Sandelowski y Barroso. Resultados: se presentan tres momentos en la trayectoria: 1) se afecta (destrucción celular programada); 2) se trasforma (autocontrol del desarrollo y crecimiento), y 3) se resignifica (condensación); y cuatro factores condicionantes para la construcción del significado de calidad de vida para el cuidador como son el soporte social, la espiritualidad, la habilidad para cuidar y el tiempo. Conclusiones: la calidad de vida se afecta y se reconstruye en virtud del significado que el cuidador tenga de esta.
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