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Wang W, van Wijngaarden J, Wang H, Buljac-Samardzic M, Yuan S, van de Klundert J. Factors Influencing the Implementation of Foreign Innovations in Organization and Management of Health Service Delivery in China: A Systematic Review. FRONTIERS IN HEALTH SERVICES 2021; 1:766677. [PMID: 36926484 PMCID: PMC10012679 DOI: 10.3389/frhs.2021.766677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 12/02/2021] [Indexed: 11/13/2022]
Abstract
Background: China has been encouraged to learn from international innovations in the organization and management of health service delivery to achieve the national health reform objectives. However, the success and effectiveness of implementing innovations is affected by the interactions of innovations with the Chinese context. Our aim is to synthesize evidence on factors influencing the implementation of non-Chinese innovations in organization and management of health service delivery in mainland China. Methods: A systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched seven databases for peer-reviewed articles published between 2009 and 2020. Data were analyzed and combined to generate a list of factors influencing the implementation of foreign innovations in China. The factors were classified in the categories context, system, organization, innovation, users, resources, and implementation process. Results: The 110 studies meeting the inclusion criteria revealed 33 factors. Most supported by evidence is the factor integration in organizational policies, followed by the factors motivation & incentives and human resources. Some factors (e.g., governmental policies & regulations) were mentioned in multiple studies with little or no evidence. Conclusion: Evidence on factors influencing the implementation of foreign innovations in organization and management of health service delivery is scarce and of limited quality. Although many factors identified in this review have also been reported in reviews primarily considering Western literature, this review suggests that extrinsic motivation, financial incentives, governmental and organizational policies & regulations are more important while decentralization was found to be less important in China compare to Western countries. In addition, introducing innovations in rural China seems more challenging than in urban China, because of a lack of human resources and the more traditional rural culture.
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Affiliation(s)
- Wenxing Wang
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Jeroen van Wijngaarden
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Hujie Wang
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Martina Buljac-Samardzic
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Shasha Yuan
- Institute of Medical Information and Library, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Joris van de Klundert
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, Netherlands
- Mohammad Bin Salman College of Business and Entrepreneurship, King Abdullah Economic City, Saudi Arabia
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Ren LL, Tian XB, He ZC, Song EH, Tang TT. Cancer-related fatigue in hospitalised patients treated for lymphoma and its burden on family caregivers. Eur J Cancer Care (Engl) 2021; 31:e13547. [PMID: 34918408 DOI: 10.1111/ecc.13547] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 10/01/2021] [Accepted: 12/02/2021] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To investigate the prevalence of cancer-related fatigue (CRF) in patients with lymphoma and to explore the burden of CRF on the family caregivers (FCs). METHODS A cross-sectional study was conducted in a university-affiliated tertiary care hospital in China. Patients with lymphoma who received treatment in the in-patient ward of the Haematology Department were consecutively recruited. Face-to-face interviews were conducted to gather information related to the patients' sociodemographic characteristics and perceived CRF and its burden on the FCs. Cochran-Armitage trend analysis and Multivariable logistic regression analyses were employed to determine the association between CRF and the FCs' burden. RESULTS Of the 116 cancer patient-FC dyads, about 70% of patients experienced some level of fatigue, while 51% of unpaid family members suffered some degree of depression. The Cochran-Armitage trend analysis showed that the FCs' burden significantly increased with the severity of CRF. Logistic regression indicated that the FCs of the patients reporting fatigue experienced a higher burden in both the unadjusted and adjusted models. CONCLUSION The prevalence of CRF appeared to be high among patients with lymphoma. It might be important to design innovative health-promoting practices for ameliorating or preventing the impact of fatigue.
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Affiliation(s)
- Lin-Li Ren
- Department of Hematology, The Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Xiao-Bing Tian
- Department of Preventive Medicine, North Sichuan Medical College, Nanchong, China
| | - Zheng-Cang He
- Department of Hematology, The Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - En-Hui Song
- Department of Hematology, The Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Ting-Ting Tang
- Department of Hematology, The Affiliated Hospital of North Sichuan Medical College, Nanchong, China
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Agbejule OA, Hart NH, Ekberg S, Koczwara B, Ladwa R, Simonsen C, Pinkham EP, Chan RJ. Bridging the research to practice gap: a systematic scoping review of implementation of interventions for cancer-related fatigue management. BMC Cancer 2021; 21:809. [PMID: 34261438 PMCID: PMC8278687 DOI: 10.1186/s12885-021-08394-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 05/23/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Cancer-related fatigue (CRF) is one of the most common and distressing symptoms in people with cancer. Although efficacy of interventions for CRF have been extensively investigated, less has been done to ensure successful translation into routine clinical practice. The aim of this systematic scoping review was to synthesise knowledge surrounding the implementation of CRF interventions, summarise the processes and outcomes of implementation strategies used, and identify opportunities for further research. METHODS PubMed, Cochrane CENTRAL, EMBASE and CINAHL databases were searched (up to December 2020). The Cochrane Effective Practice and Organisation of Care (EPOC) Group taxonomy and the RE-AIM Framework were used to guide the evaluation of implementation strategies and outcomes, respectively. RESULTS Six studies were included. Three used an implementation framework (PARIHS, KTA, Cullens & Adams' Implementation Guide) to guide implementation. Overall, the implementation strategies used across all studies were reported to have directly resulted in immediate changes at the clinician level (e.g., increased clinician behaviours, self-efficacy, attitudes, knowledge of CRF management). No clear relationship was found between the use of implementation models and the number or type of implementation strategies used. For outcomes, Effectiveness and Implementation were the most highly reported RE-AIM measures followed by Reach then Maintenance. Adoption was the least reported. CONCLUSIONS Despite the high prevalence of CRF and evidence-based interventions for managing CRF, there is limited evidence informing the sustainable implementation of these interventions. This systematic scoping review emphasises the lack of quality CRF implementation studies presently available in the literature leading to a disconnect between effective CRF interventions, routine clinical care, and cancer survivors at present. This review highlights the need for robust study designs guided by established frameworks to methodically design and evaluate the implementation of CRF management interventions in the future.
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Affiliation(s)
- Oluwaseyifunmi Andi Agbejule
- Cancer and Palliative Care Outcomes Centre, School of Nursing, N Block, Kelvin Grove Campus,, Queensland University of Technology (QUT), Kelvin Grove, Queensland, 4059, Australia.
| | - Nicolas H Hart
- Cancer and Palliative Care Outcomes Centre, School of Nursing, N Block, Kelvin Grove Campus,, Queensland University of Technology (QUT), Kelvin Grove, Queensland, 4059, Australia
- Exercise Medicine Research Institute, Edith Cowan University, Perth, Western Australia, 6027, Australia
- Institute for Health Research, University of Notre Dame Australia, Fremantle, Western Australia, 6959, Australia
| | - Stuart Ekberg
- Cancer and Palliative Care Outcomes Centre, School of Nursing, N Block, Kelvin Grove Campus,, Queensland University of Technology (QUT), Kelvin Grove, Queensland, 4059, Australia
| | - Bogda Koczwara
- Flinders University and Flinders Medical Centre, Flinders Drive, Bedford Park, South Australia, 5048, Australia
| | - Rahul Ladwa
- Princess Alexandra Hospital, Metro South Hospital and Health Services, Woolloongabba, Queensland, 4102, Australia
- School of Medicine, University of Queensland, St Lucia, Queensland, 4072, Australia
| | - Camilla Simonsen
- Cancer and Palliative Care Outcomes Centre, School of Nursing, N Block, Kelvin Grove Campus,, Queensland University of Technology (QUT), Kelvin Grove, Queensland, 4059, Australia
- Princess Alexandra Hospital, Metro South Hospital and Health Services, Woolloongabba, Queensland, 4102, Australia
| | - Elizabeth P Pinkham
- Cancer and Palliative Care Outcomes Centre, School of Nursing, N Block, Kelvin Grove Campus,, Queensland University of Technology (QUT), Kelvin Grove, Queensland, 4059, Australia
- Princess Alexandra Hospital, Metro South Hospital and Health Services, Woolloongabba, Queensland, 4102, Australia
- School of Health and Behavioural Science, University of Queensland, St Lucia, Queensland, 4072, Australia
| | - Raymond Javan Chan
- Cancer and Palliative Care Outcomes Centre, School of Nursing, N Block, Kelvin Grove Campus,, Queensland University of Technology (QUT), Kelvin Grove, Queensland, 4059, Australia
- Princess Alexandra Hospital, Metro South Hospital and Health Services, Woolloongabba, Queensland, 4102, Australia
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Fang Y, Wang N, Shi L, Barker T, Zhang P. Pain relief during wound care for patients with a deep open wound in an orthopedic trauma department: a best practice implementation project. ACTA ACUST UNITED AC 2020; 17:2559-2569. [PMID: 31567556 DOI: 10.11124/jbisrir-d-19-00126] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVES The aim of this project was to implement best practice in pain relief during wound care for patients with deep open wounds in the orthopedic trauma department of a tertiary teaching hospital in China. INTRODUCTION Patients with deep open wounds often suffer from severe pain during wound care. Inadequate pain relief for these patients calls for evidence-based changes to close the gap between current and best practice. METHODS The current quality improvement project was carried out over six months using the JBI Practical Application of Clinical Evidence System (JBI PACES). A baseline and two follow-up audits of wound pain management practice were conducted to identify practice gaps and post implementation compliance in pain management in wound care. The sample comprised 20 patients and two dressing nurses. The Getting Research into Practice tool identified barriers to and strategies for improvement in practice. The patients' pain experiences were measured following the implementation of changes. RESULTS The baseline audit identified poor compliance with best practice. Following implementation of the recommended changes, some significant improvements in practice were made by the dressing nurses; however, these were inadequately maintained at the second post implementation audit. Patients' pain scores improved following the nurses' practice changes (t = 2.272, P > 0.05). CONCLUSION The implementation of best practice in pain relief during wound care for patients with deep open wounds has led to significant improvement in nurses' performance in the orthopedic trauma department. The most challenging barriers involved interdisciplinary collaborations and organizational structure.
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Affiliation(s)
- Yaxuan Fang
- PR China Southern Centre for Evidence Based Nursing and Midwifery Practice: A Joanna Briggs Institute Affiliated Group, School of Nursing, Southern Medical University, Guangzhou, PR China
| | - Ning Wang
- PR China Southern Centre for Evidence Based Nursing and Midwifery Practice: A Joanna Briggs Institute Affiliated Group, School of Nursing, Southern Medical University, Guangzhou, PR China
| | - Lei Shi
- PR China Southern Centre for Evidence Based Nursing and Midwifery Practice: A Joanna Briggs Institute Affiliated Group, School of Nursing, Southern Medical University, Guangzhou, PR China
| | - Timothy Barker
- Joanna Briggs Institute, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
| | - Ping Zhang
- Department of Orthopedic Trauma, Nanfang Hospital of Southern Medical University, Guangzhou, PR China
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Kim SH, Song YK, Han J, Ko YH, Lee H, Kang MJ, Park H, Lee H, Kim S. Pro-inflammatory Cytokine Levels and Cancer-related Fatigue in Breast Cancer Survivors: Effects of an Exercise Adherence Program. J Breast Cancer 2020; 23:205-217. [PMID: 32395379 PMCID: PMC7192752 DOI: 10.4048/jbc.2020.23.e22] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 03/19/2020] [Indexed: 12/26/2022] Open
Abstract
Purpose This study aimed to determine the effect of an exercise intervention on subjective cancer-related fatigue (CRF) and pro-inflammatory cytokine levels in breast cancer survivors (BCS). Methods BCS with greater than moderate CRF (≥ 4) were recruited and randomly assigned to experimental or control groups. The experimental group participated in a 12-week exercise adherence program (Better Life after Cancer - Energy, Strength, and Support; BLESS). Interleukin (IL)-6 and tumor necrosis factor-α (TNF-α) levels were determined at 3 time points (M1: baseline, M2: post-intervention, and M4: 6 months after intervention). Subjective fatigue was measured using the Korean version of the revised Piper Fatigue Scale. Results In this analysis of participants with physiological fatigue measures available (19 experimental, 21 control), there were no statistically significant differences in IL-6 (F = 1.157, p = 0.341), TNF-α levels (F = 0.878, p = 0.436), and level of fatigue (F = 2.067, p = 0.118) between the 2 groups at baseline. Fatigue in the experimental group showed statistically significant improvement compared to the control only at M2 (p = 0.022). There was no significant relationship between subjective and physiological fatigue at the 3 measurement points. Conclusion The BLESS intervention improved CRF in BCS immediately at post-intervention, and this study presents clinical feasibility for the management of CRF in BCS in the early survivorship phase who are already experiencing fatigue.
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Affiliation(s)
- Sung Hae Kim
- Department of Nursing, College of Health. Welfare and Education, Tongmyong University, Busan, Korea
| | - Yoon Kyung Song
- Department of Sports Industry Studies, Yonsei University, Seoul, Korea
| | - Jeehee Han
- College of Nursing, Yonsei University, Seoul, Korea
| | - Yun Hee Ko
- College of Nursing, Yonsei University, Seoul, Korea
| | - Hyojin Lee
- College of Nursing, Yonsei University, Seoul, Korea
| | - Min Jae Kang
- Department of Sports Industry Studies, Yonsei University, Seoul, Korea
| | - Hyunki Park
- Biobehavioral Center, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Korea
| | - Hyangkyu Lee
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, Korea
| | - Sue Kim
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, Korea
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