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Welch V, Dewidar O, Tanjong Ghogomu E, Abdisalam S, Al Ameer A, Barbeau VI, Brand K, Kebedom K, Benkhalti M, Kristjansson E, Madani MT, Antequera Martín AM, Mathew CM, McGowan J, McLeod W, Park HA, Petkovic J, Riddle A, Tugwell P, Petticrew M, Trawin J, Wells GA. How effects on health equity are assessed in systematic reviews of interventions. Cochrane Database Syst Rev 2022; 1:MR000028. [PMID: 35040487 PMCID: PMC8764740 DOI: 10.1002/14651858.mr000028.pub3] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Enhancing health equity is endorsed in the Sustainable Development Goals. The failure of systematic reviews to consider potential differences in effects across equity factors is cited by decision-makers as a limitation to their ability to inform policy and program decisions. OBJECTIVES: To explore what methods systematic reviewers use to consider health equity in systematic reviews of effectiveness. SEARCH METHODS We searched the following databases up to 26 February 2021: MEDLINE, PsycINFO, the Cochrane Methodology Register, CINAHL, Education Resources Information Center, Education Abstracts, Criminal Justice Abstracts, Hein Index to Foreign Legal Periodicals, PAIS International, Social Services Abstracts, Sociological Abstracts, Digital Dissertations and the Health Technology Assessment Database. We searched SCOPUS to identify articles that cited any of the included studies on 10 June 10 2021. We contacted authors and searched the reference lists of included studies to identify additional potentially relevant studies. SELECTION CRITERIA We included empirical studies of cohorts of systematic reviews that assessed methods for measuring effects on health inequalities. We define health inequalities as unfair and avoidable differences across socially stratifying factors that limit opportunities for health. We operationalised this by assessing studies which evaluated differences in health across any component of the PROGRESS-Plus acronym, which stands for Place of residence, Race/ethnicity/culture/language, Occupation, Gender or sex, Religion, Education, Socioeconomic status, Social capital. "Plus" stands for other factors associated with discrimination, exclusion, marginalisation or vulnerability such as personal characteristics (e.g. age, disability), relationships that limit opportunities for health (e.g. children in a household with parents who smoke) or environmental situations which provide limited control of opportunities for health (e.g. school food environment). DATA COLLECTION AND ANALYSIS Two review authors independently extracted data using a pre-tested form. Risk of bias was appraised for included studies according to the potential for bias in selection and detection of systematic reviews. MAIN RESULTS: In total, 48,814 studies were identified and the titles and abstracts were screened in duplicate. In this updated review, we identified an additional 124 methodological studies published in the 10 years since the first version of this review, which included 34 studies. Thus, 158 methodological studies met our criteria for inclusion. The methods used by these studies focused on evidence relevant to populations experiencing health inequity (108 out of 158 studies), assess subgroup analysis across PROGRESS-Plus (26 out of 158 studies), assess analysis of a gradient in effect across PROGRESS-Plus (2 out of 158 studies) or use a combination of subgroup analysis and focused approaches (20 out of 158 studies). The most common PROGRESS-Plus factors assessed were age (43 studies), socioeconomic status in 35 studies, low- and middle-income countries in 24 studies, gender or sex in 22 studies, race or ethnicity in 17 studies, and four studies assessed multiple factors across which health inequity may exist. Only 16 studies provided a definition of health inequity. Five methodological approaches to consider health equity in systematic reviews of effectiveness were identified: 1) descriptive assessment of reporting and analysis in systematic reviews (140 of 158 studies used a type of descriptive method); 2) descriptive assessment of reporting and analysis in original trials (50 studies); 3) analytic approaches which assessed differential effects across one or more PROGRESS-Plus factors (16 studies); 4) applicability assessment (25 studies) and 5) stakeholder engagement (28 studies), which is a new finding in this update and examines the appraisal of whether relevant stakeholders with lived experience of health inequity were included in the design of systematic reviews or design and delivery of interventions. Reporting for both approaches (analytic and applicability) lacked transparency and was insufficiently detailed to enable the assessment of credibility. AUTHORS' CONCLUSIONS There is a need for improvement in conceptual clarity about the definition of health equity, describing sufficient detail about analytic approaches (including subgroup analyses) and transparent reporting of judgments required for applicability assessments in order to consider health equity in systematic reviews of effectiveness.
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Affiliation(s)
- Vivian Welch
- Methods Centre, Bruyère Research Institute, Ottawa, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Omar Dewidar
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | | | | | | | | | - Kevin Brand
- Telfer School of Management, University of Ottawa, Ottawa, Canada
| | | | | | | | | | | | | | - Jessie McGowan
- Department of Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | | | | | | | - Alison Riddle
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Marmora, Canada
| | - Peter Tugwell
- Department of Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Mark Petticrew
- Department of Social & Environmental Health Research, Faculty of Public Health & Policy, London School of Hygiene and Tropical Medicine, London, UK
| | | | - George A Wells
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
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Tsandila Kalakou F, Aase K, Kjosavik SR, Husebø SE. Supportive care needs of men with prostate cancer after hospital discharge: multi-stakeholder perspectives. Int J Qual Stud Health Well-being 2021; 16:1960706. [PMID: 34402768 PMCID: PMC8381966 DOI: 10.1080/17482631.2021.1960706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
PURPOSE This study explored the supportive care needs of men with prostate cancer (PCa) after hospital discharge based on the perceptions of multiple stakeholders. METHODS Eight semi-structured focus groups and three individual interviews were conducted between September 2019 and January 2020, with 34 participants representing men with PCa, primary and secondary healthcare professionals, and cancer organizations in western Norway. Data was analysed using systematic text condensation. RESULTS Four categories emerged: 1) men with PCa have many information needs which should be optimally provided throughout the cancer care process; 2) various coordination efforts among stakeholders are needed to support men with PCa during follow-up; 3) supportive care resources supplement the healthcare services but knowledge about them is random; and 4) structured healthcare processes are needed to improve the services offered to men with PCa. Variations were described regarding priority, optimal mode and timeliness of supportive care needs, while alignment was concerned with establishing structures within and between stakeholders to improve patient care and coordination. CONCLUSIONS Despite alignment among stakeholders' regarding the necessity for standardization of information and coordination practices, the mixed prioritization of supportive care needs of men with PCa indicate the need for additional individualized and adapted measures.
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Affiliation(s)
- Foteini Tsandila Kalakou
- SHARE - Center for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Karina Aase
- SHARE - Center for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Svein Reidar Kjosavik
- General Practice and Care Coordination Research Group, Stavanger University Hospital, Stavanger, Norway.,Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Sissel Eikeland Husebø
- SHARE - Center for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.,Research Group of Nursing and Health Care Sciences, Stavanger University Hospital, Stavanger, Norway
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Aunan ST, Wallgren GC, Hansen BS. The value of information and support; Experiences among patients with prostate cancer. J Clin Nurs 2021; 30:1653-1664. [PMID: 33590945 DOI: 10.1111/jocn.15719] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 01/29/2021] [Accepted: 02/02/2021] [Indexed: 01/23/2023]
Abstract
AIMS AND OBJECTIVES To explore and analyse prostate cancer survivors` experiences and critical reflections of information received during their cancer trajectory. BACKGROUND Prostate cancer is one of the most prevalent cancers in men worldwide. Treatment causes side effects such as urinary incontinence, bowel changes and erection problems influencing sex life and manhood. Cancer pathways are designed to give patients and their relatives a predictable and as stress-free as possible treatment trajectory and minimise waiting time. DESIGN Qualitative, explorative research design. METHODS Focus groups with 16 prostate cancer survivors after having participated in an educational programme. The COREQ checklist was followed to ensure rigour in the study. RESULTS The main theme, 'Help me stay in control', and three subthemes, 'To be met with interest and support, enough knowledge to understand what is happening and a plan to build the new life on', emerged from qualitative analysis and highlighted the participants' need for information and support, specially scheduled at critical times in the treatment trajectory: the diagnostic phase, the treatment phase and the life after treatment. They also highlighted the need for empathy and interest from healthcare professionals and highlighted the need for arenas to discuss vulnerable topics. Contact with peers was perceived as supportive and encouraging. CONCLUSION Healthcare professionals must support prostate cancer survivors with empathy, interest and information tailored to their needs in three different phases. Continuity in information flow may increase trust and satisfaction among the prostate cancer survivors. RELEVANCE TO CLINICAL PRACTICE PCa patients' need for information varied at critical times in their treatment trajectory. HCP should meet them with empathy and interest to be able to tailor their need for information and support.
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Affiliation(s)
- Siv Tove Aunan
- Faculty of Health Sciences, Department of Caring and Ethics, University of Stavanger, Stavanger, Norway
| | - Gry Ciekals Wallgren
- Department of Haematology and Oncology, Stavanger University Hospital, Stavanger, Norway
| | - Britt Saetre Hansen
- Department of Anaesthesiology and Intensive Care, Stavanger University Hospital, Stavanger, Norway.,Faculty of Health Sciences, Quality and Safety in Health Care Systems, University of Stavanger, Stavanger, Norway
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Huntley AL, Szilassy E, Potter L, Malpass A, Williamson E, Feder G. Help seeking by male victims of domestic violence and abuse: an example of an integrated mixed methods synthesis of systematic review evidence defining methodological terms. BMC Health Serv Res 2020; 20:1085. [PMID: 33243236 PMCID: PMC7689389 DOI: 10.1186/s12913-020-05931-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 11/16/2020] [Indexed: 11/10/2022] Open
Abstract
Background Domestic violence and abuse is a violation of human rights which damages the health and wellbeing of victims, their families and their friends. There has been less research on the experiences and support needs of male victims than those of women. Historically research on men’s experiences has not focused on what constitutes effective, needs-led service provision. The aim of this paper was to conduct an integrated mixed methods synthesis of systematic review evidence on the topic of help-seeking by male victims of domestic violence and abuse. Methods An integrated mixed methods synthesis approach was taken to enhance our understanding of the complex phenomenon of help seeking by, and service provision to male victims. This process also identifies gaps in the evidence. Using previously identified systematic review data; mixed methods data from four primary-level service evaluation studies, along with expert and patient consultation were used to develop research propositions. Primary-level qualitative interview and survey data from 12 studies of men experiences were mapped onto the propositions to support them. Results Fourteen propositions were composed. Seven propositions were supported or at least partly supported by the qualitative data. These supported propositions were used to make recommendations for policy and practice particularly concerning service preferences of male victims. The remaining seven propositions were not specifically supported by the qualitative data. These unsupported propositions were used to develop research recommendations concerning the need to further understand the potential blurred boundaries of victim–perpetrator, hybrid perpetrator-victim experiences, men who are/have been victims of childhood sexual abuse and determining the level of risk for men. They also highlight the need to produce better guidance for the response of the police & the criminal justice system. Finally, they highlight the need to produce the most appropriate service for men in terms of access, linkage, substance/alcohol abuse, mental health, sexuality, and race. Conclusion Integrated mixed-methods synthesis of systematic review evidence is a relatively novel approach. This approach can lead to recommendations for policy and practice as well as highlighting gaps in the research agenda as shown in this example.
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Affiliation(s)
- Alyson L Huntley
- Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, England.
| | - Eszter Szilassy
- Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, England
| | - Lucy Potter
- Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, England
| | - Alice Malpass
- Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, England
| | - Emma Williamson
- The Centre for Gender and Violence Research, School for Policy Studies, Social Science Complex, 8 Priory Road, Bristol, BS8 1TZ, England
| | - Gene Feder
- Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, England
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Yuan Y, Hu Y, Cheng JX, Ding P. Psychological nursing approach on anxiety and depression of patients with severe urinary incontinence after radical prostatectomy - a pilot study. J Int Med Res 2019; 47:5689-5701. [PMID: 31566033 PMCID: PMC6862892 DOI: 10.1177/0300060519878014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Objective To implement a psychological intervention programme and explore its effects on anxiety and depression in patients with severe urinary incontinence following radical prostatectomy. Methods This pilot randomized controlled trial recruited patients that underwent laparoscopic radical prostatectomy. Patients were randomized to conventional nursing and psychoeducation groups. The primary outcome was the levels of anxiety and depression evaluated by the self-rating anxiety scale (SAS) and self-rating depression scale (SDS) at 3 months after urinary catheter removal. The quality of life (secondary outcome) was evaluated using the incontinence-specific quality of life scale (I-QOL). Results The study analysed 35 patients: 16 received conventional nursing and 19 received a psychoeducational intervention. There were no significant differences in the sociodemographic data and SAS, SDS and I-QOL scores between the two groups at baseline. At 3 months after catheter removal, the SAS and SDS scores in the psychoeducation group were significantly lower compared with the conventional nursing group; and the I-QOL score in the psychoeducation group was significantly higher compared with the conventional nursing group. Conclusion This pilot study suggests that the psychological nursing intervention improved the symptoms of anxiety and depression, and improved quality of life, in patients with severe urinary incontinence following radical prostatectomy.
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Affiliation(s)
- Yuan Yuan
- Department of Urinary Surgery, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Yue Hu
- Department of Urinary Surgery, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Jing-Xian Cheng
- Department of Urinary Surgery, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Ping Ding
- Department of Urinary Surgery, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China
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Gentili C, McClean S, Hackshaw-McGeagh L, Bahl A, Persad R, Harcourt D. Body image issues and attitudes towards exercise amongst men undergoing androgen deprivation therapy (ADT) following diagnosis of prostate cancer. Psychooncology 2019; 28:1647-1653. [PMID: 31141623 DOI: 10.1002/pon.5134] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 05/20/2019] [Accepted: 05/22/2019] [Indexed: 11/06/2022]
Abstract
BACKGROUND Androgen deprivation therapy (ADT) is an established treatment for prostate cancer (PCa), but its side-effects can affect body appearance and functioning. However, research into the impact of ADT on body image is limited. Exercise can help patients to counterbalance some side-effects, potentially improving body image too. However, adherence to exercise recommendations is low. Therefore, we explored body image after ADT and attitudes towards exercise. METHODS Twenty two semi-structured interviews were conducted with PCa patients receiving ADT (Mage = 67.9 years old, SD = 9.99). RESULTS Participants expressed appearance dissatisfaction focusing on body feminization. Participants exercised to counterbalance ADT side-effects and improve mood. Exercise also helped them to re-establish a sense of control over their body and experience a sense of achievement. However, some men described being worried that their appearance and physical performance would be judged by others, so they often exercised alone or gave up exercise. Time management and fatigue were also identified as exercise barriers. CONCLUSION These findings highlight the need to further investigate body image concerns and exercise barriers in PCa patients undergoing ADT. These results could also inform support groups and health care professionals on the topic. However, further research should explore the most effective and acceptable ways to provide support to PCa patients on body image issues.
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Affiliation(s)
- Caterina Gentili
- Centre for Appearance Research, Health and Applied Sciences, University of the West of England, Bristol, UK
| | - Stuart McClean
- Centre for Public Health and Wellbeing Research, Health and Applied Sciences, University of the West of England, Bristol, UK
| | | | - Amit Bahl
- University Hospitals Bristol NHS Trust, Bristol, UK
| | | | - Diana Harcourt
- Centre for Appearance Research, Health and Applied Sciences, University of the West of England, Bristol, UK
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McNeill C, Erskine A, Ellis R, Traynor M. Developing nurse match: A selection tool for evoking and scoring an applicant's nursing values and attributes. Nurs Open 2019; 6:59-71. [PMID: 30534395 PMCID: PMC6279733 DOI: 10.1002/nop2.183] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 06/10/2018] [Indexed: 12/30/2022] Open
Abstract
AIM To develop an instrument (Nurse Match: NM) for assessing a candidate's nursing values, their meaning, relative importance and emotional significance. Candidate's values to be scored against professionally preferred nursing values effectively and efficiently. DESIGN A case study-based qualitative process with quantified output. Perception of self and others in relevant contexts using bi-polar value dimensions. METHODS Respondents (N = 63) were first year nursing students completed the instrument and a feedback questionnaire. Data were analysed and scored by ipseus software using algorithm defined parameters. Statistical analysis: Minitab 17. RESULTS The instrument discriminated effectively and efficiently between year one nurses in terms of the professional quality of their inherent nursing values and attributes;created suitability scores (STOT scores) for candidate screening purposes;suitability scores closely approximated normal distributions;was valid and reliable: robust in quantitative and qualitative terms;was administered, scored and interpreted in a standard manner;was easy to understand and complete and well received by participants. The NM instrument offers a standardized, effective, user friendly, screening process for values and attributes. Development work with a group of actual applicants is required. NM is complementary to other modes of assessment.
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Affiliation(s)
| | | | | | - Marian Traynor
- School of Nursing and MidwiferyQueen's University BelfastBelfastUK
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Muntlin Athlin Å, Brovall M, Wengström Y, Conroy T, Kitson AL. Descriptions of fundamental care needs in cancer care-An exploratory study. J Clin Nurs 2018; 27:2322-2332. [DOI: 10.1111/jocn.14251] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2017] [Indexed: 12/01/2022]
Affiliation(s)
- Åsa Muntlin Athlin
- Department of Medical Sciences; Uppsala University; Uppsala Sweden
- Department of Public Health and Caring Sciences; Uppsala University; Uppsala Sweden
- Adelaide Nursing School; University of Adelaide; Adelaide SA Australia
- Department of Emergency Care and Internal Medicine; Uppsala University Hospital; Uppsala Sweden
| | - Maria Brovall
- Department of Neurobiology, Care Sciences and Society; Division of Nursing; Karolinska Institutet; Huddinge Sweden
- School of Health and Education; University of Skövde; Skövde Sweden
| | - Yvonne Wengström
- Department of Neurobiology, Care Sciences and Society; Division of Nursing; Karolinska Institutet; Huddinge Sweden
- Karolinska University Hospital; Radiumhemmet; Stockholm Sweden
| | - Tiffany Conroy
- Adelaide Nursing School; University of Adelaide; Adelaide SA Australia
- Faculty of Health Sciences; Centre for Evidence based Practice South Australia; Adelaide Nursing School; The University of Adelaide; Adelaide SA Australia
| | - Alison L. Kitson
- Adelaide Nursing School; University of Adelaide; Adelaide SA Australia
- College of Nursing and Health Sciences; Flinders University; Adelaide SA Australia
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