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Leow T, Li WW, Miller DJ, McDermott B. Prevalence of university non-continuation and mental health conditions, and effect of mental health conditions on non-continuation: a systematic review and meta-analysis. J Ment Health 2024:1-16. [PMID: 38588717 DOI: 10.1080/09638237.2024.2332812] [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: 10/11/2023] [Accepted: 02/15/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND University non-continuation, also termed as university dropout in literature, is a concern for institutions. Elevated stress levels, mental distress, and psychiatric issues affect academic performance and thus may contribute to non-continuation. There is a lack of systematic reviews exploring the link between mental health and university non-continuation. AIM This systematic review aims to bridge this gap, by investigating the prevalence of non-continuation and mental health conditions among university students, and the impact of mental health on university non-continuation. METHODS Following PRISMA guidelines this review synthesized data from 67 studies, utilising both narrative synthesis and meta-analytic techniques. RESULTS The results revealed that the included studies reported a range of university non-continuation rates (5.9% to 43.6%) with a pooled prevalence of 17.9%, 95% CI [14.2%, 22.3%]. The prevalence of mental health concerns among students varied widely (2.2% to 83.6%), with a pooled prevalence of 26.3%, 95% CI [16.0%, 40.0%]. Depression, OR = 1.143 (95% CI [1.086, 1.203] p<.001), stress, OR = 1.413 (95% CI [1.106, 1.805], p=.006), and other mental health conditions, OR = 1.266 (95% CI [1.133, 1.414], p<.001), were associated with higher non-continuation. CONCLUSION Some mental health conditions elevate non-continuation risks, and addressing mental health may enhance student retention in higher education.
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Affiliation(s)
- Timothy Leow
- Department of Psychology, James Cook University, Townsville, Australia
- Mental Health Service Group, Townsville Hospital and Health Service, Townsville, Australia
| | - Wendy Wen Li
- Department of Psychology, James Cook University, Townsville, Australia
| | - Dan J Miller
- Department of Psychology, James Cook University, Townsville, Australia
| | - Brett McDermott
- Department of Psychology, James Cook University, Townsville, Australia
- Department of Medicine, Tasmanian Centre for Mental Health Service Innovation, Townsville, Australia
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Zhao DW, Robinson SG, Pozzar R, Leiter R, Walsh C, Siemens I, Lovrics E, Cellarius V, Mahtani R, Jia Z. The Evolving Roles and Expectations of Inpatient Palliative Care Through COVID-19: a Systematic Review and Meta-synthesis. J Gen Intern Med 2024; 39:661-682. [PMID: 38100009 DOI: 10.1007/s11606-023-08564-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 12/01/2023] [Indexed: 03/28/2024]
Abstract
BACKGROUND Palliative care performed a central role in responding to the systemic suffering incurred by the COVID-19 pandemic. Yet, few studies have elucidated the inpatient palliative care specialists' experiences and perceptions. OBJECTIVE Systematically review and synthesize the evolving roles and expectations of inpatient palliative care specialists in response to COVID-19. DESIGN A systematic review and meta-synthesis informed by Thomas and Harden's framework and Pozzar et al.'s approach was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. DATA SOURCES MEDLINE, EMBASE, CINAHL, and PubMed were systematically searched for articles published between December 2019 and March 2023. We included all peer-reviewed qualitative and mixed-method literature studying the roles and expectations of inpatient palliative care specialists. A mixed-method appraisal tool was used for quality assessment. RESULTS Of 3869 unique articles, 52 were included. Studies represented North American (n = 23), European (n = 16), South American (n = 4), Oceanic (n = 2), Asian (n = 2), West African (n = 1), Middle Eastern (n = 1), and inter-continental settings (n = 3). Most were reported in English (n = 50), conducted in 2020 (n = 28), and focused on the perspectives of inpatient palliative care clinicians (n = 28). Three descriptive themes captured the roles and expectations of inpatient palliative care specialists: shifting foundations, reorienting to relationships, and evolving identity. Two analytical themes were synthesized: palliative care propagates compassion through a healing presence, and palliative care enhances the systemic response to suffering through nimble leadership. CONCLUSION Inpatient palliative care specialists responded to the COVID-19 pandemic by establishing their healing presence and leading with their adaptability. To develop institutionally tailored and collaborative responses to future pandemics, future studies are needed to understand how inpatient palliative care clinicians are recognized and valued within their institutions.
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Affiliation(s)
- Dylan Weisman Zhao
- Department of Translational Medicine, School of Medicine, Queen's University, Kingston, Ontario, Canada.
- Temmy Latner Centre for Palliative Care, Sinai Health, Toronto, Ontario, Canada.
| | - Shahar Geva Robinson
- Faculty of Health Sciences, Ben-Gurion University of Negev, Soroka University Medical Centre, Beer Sheva, Israel
| | - Rachel Pozzar
- Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Richard Leiter
- Harvard Medical School, Boston, MA, USA
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA, USA
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Chris Walsh
- Temmy Latner Centre for Palliative Care, Sinai Health, Toronto, Ontario, Canada
| | - Isaac Siemens
- Temmy Latner Centre for Palliative Care, Sinai Health, Toronto, Ontario, Canada
- Division of Palliative Care, Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Emily Lovrics
- Temmy Latner Centre for Palliative Care, Sinai Health, Toronto, Ontario, Canada
- Division of Palliative Care, Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Victor Cellarius
- Temmy Latner Centre for Palliative Care, Sinai Health, Toronto, Ontario, Canada
- Division of Palliative Care, Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Ramona Mahtani
- Temmy Latner Centre for Palliative Care, Sinai Health, Toronto, Ontario, Canada
- Division of Palliative Care, Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Zhimeng Jia
- Temmy Latner Centre for Palliative Care, Sinai Health, Toronto, Ontario, Canada
- Division of Palliative Care, Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
- Program in Global Palliative Care, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
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Crawford GB, Lakhani A, Palmer L, Sebalj M, Rolan P. A systematic review of qualitative research exploring patient and health professional perspectives of breakthrough cancer pain. Support Care Cancer 2023; 31:619. [PMID: 37812248 PMCID: PMC10562491 DOI: 10.1007/s00520-023-08076-9] [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: 03/28/2023] [Accepted: 09/25/2023] [Indexed: 10/10/2023]
Abstract
PURPOSE Breakthrough cancer pain (BtCP) is a prevalent health issue which is difficult to manage. A plethora of quantitative research in this area exists. There is a paucity of research on the perspectives of health professionals and patients surrounding domains impacting effective treatment, including definitions of BtCP, treatment, and education opportunities. This review aims to identify and synthesize the extent of qualitative research exploring health professional and patient perspectives of BtCP. METHODS A systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) approach was undertaken. The approach was registered with Prospero. MEDLINE, EMBASE, and Web of Science were searched for peer-reviewed literature published any date prior to May 19, 2022. Eligible sources must have considered health professional and/or patient perspectives of BtCP. A narrative synthesis approach was utilized. RESULTS Three sources met the review criteria. One source explored nurse perspectives, while two sources explored patient perspectives. Study quality was moderate to high. Overlapping themes across the three studies included communication, defining BtCP, impact of BtCP, management of BtCP, perceptions of BtCP, analgesia and pain relief, and training and professional development. CONCLUSION Given limited research investigating clinician and patient perspectives of BtCP, a rich understanding informed by exploratory qualitative methods around identification, best management strategies, professional development, and factors promoting and inhibiting best practice remains unclear. Further qualitative inquiry is warranted, and it is expected such research will inform BtCP clinical guidelines.
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Affiliation(s)
- G B Crawford
- Faculty of Health & Medical Sciences, University of Adelaide, Adelaide Medical School, North Terrace, Adelaide, SA, 5000, Australia.
- Northern Adelaide Palliative Service, Northern Adelaide Local Health Network, Modbury Hospital, 41-69 Smart Road, Modbury, SA, 5092, Australia.
| | - A Lakhani
- The School of Psychology and Public Health, La Trobe University, 360 Collins St, Melbourne, VIC, 3000, Australia
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, University Drive, Logan CampusMeadowbrook, QLD, 4131, Australia
- Palliative Care Department, Eastern Health, 251 Mountain Highway, Wantirna, VIC, 3152, Australia
| | - L Palmer
- Faculty of Health & Medical Sciences, University of Adelaide, Adelaide Medical School, North Terrace, Adelaide, SA, 5000, Australia
- Northern Adelaide Palliative Service, Northern Adelaide Local Health Network, Modbury Hospital, 41-69 Smart Road, Modbury, SA, 5092, Australia
| | - M Sebalj
- The School of Psychology and Public Health, La Trobe University, 360 Collins St, Melbourne, VIC, 3000, Australia
| | - P Rolan
- Faculty of Health & Medical Sciences, University of Adelaide, Adelaide Medical School, North Terrace, Adelaide, SA, 5000, Australia
- Northern Adelaide Pain Service, Northern Adelaide Local Health Network, Modbury Hospital, 41-69 Smart Road, Modbury, SA, 5092, Australia
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Viana JN, Pilbeam C, Howard M, Scholz B, Ge Z, Fisser C, Mitchell I, Raman S, Leach J. Maintaining High-Touch in High-Tech Digital Health Monitoring and Multi-Omics Prognostication: Ethical, Equity, and Societal Considerations in Precision Health for Palliative Care. OMICS : A JOURNAL OF INTEGRATIVE BIOLOGY 2023; 27:461-473. [PMID: 37861713 DOI: 10.1089/omi.2023.0120] [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: 10/21/2023]
Abstract
Advances in digital health, systems biology, environmental monitoring, and artificial intelligence (AI) continue to revolutionize health care, ushering a precision health future. More than disease treatment and prevention, precision health aims at maintaining good health throughout the lifespan. However, how can precision health impact care for people with a terminal or life-limiting condition? We examine here the ethical, equity, and societal/relational implications of two precision health modalities, (1) integrated systems biology/multi-omics analysis for disease prognostication and (2) digital health technologies for health status monitoring and communication. We focus on three main ethical and societal considerations: benefits and risks associated with integration of these modalities into the palliative care system; inclusion of underrepresented and marginalized groups in technology development and deployment; and the impact of high-tech modalities on palliative care's highly personalized and "high-touch" practice. We conclude with 10 recommendations for ensuring that precision health technologies, such as multi-omics prognostication and digital health monitoring, for palliative care are developed, tested, and implemented ethically, inclusively, and equitably.
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Affiliation(s)
- John Noel Viana
- Australian National Centre for the Public Awareness of Science, College of Science, The Australian National University, Canberra, Australia
- Responsible Innovation Future Science Platform, Commonwealth Scientific and Industrial Research Organisation, Brisbane, Australia
| | - Caitlin Pilbeam
- School of Medicine and Psychology, College of Health and Medicine, The Australian National University, Canberra, Australia
| | - Mark Howard
- Monash Data Futures Institute, Monash University, Clayton, Australia
- Department of Philosophy, School of Philosophical, Historical and International Studies, Monash University, Clayton, Australia
| | - Brett Scholz
- School of Medicine and Psychology, College of Health and Medicine, The Australian National University, Canberra, Australia
| | - Zongyuan Ge
- Monash Data Futures Institute, Monash University, Clayton, Australia
- Department of Data Science & AI, Monash University, Clayton, Australia
| | - Carys Fisser
- Australian National Centre for the Public Awareness of Science, College of Science, The Australian National University, Canberra, Australia
- School of Medicine and Psychology, College of Health and Medicine, The Australian National University, Canberra, Australia
| | - Imogen Mitchell
- School of Medicine and Psychology, College of Health and Medicine, The Australian National University, Canberra, Australia
- Intensive Care Unit, Canberra Hospital, Canberra, Australia
| | - Sujatha Raman
- Australian National Centre for the Public Awareness of Science, College of Science, The Australian National University, Canberra, Australia
| | - Joan Leach
- Australian National Centre for the Public Awareness of Science, College of Science, The Australian National University, Canberra, Australia
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Vinnicombe S, Bianchim MS, Noyes J. A review of reviews exploring patient and public involvement in population health research and development of tools containing best practice guidance. BMC Public Health 2023; 23:1271. [PMID: 37391764 PMCID: PMC10311710 DOI: 10.1186/s12889-023-15937-9] [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: 12/20/2022] [Accepted: 05/19/2023] [Indexed: 07/02/2023] Open
Abstract
INTRODUCTION Patient and public involvement (PPI) is increasingly seen as something that is integral to research and of importance to research funders. There is general recognition that PPI is the right thing to do for both moral and practical reasons. The aim of this review of reviews is to examine how PPI can be done 'properly' by looking at the evidence that exists from published reviews and assessing it against the UK Standards for Public Involvement in Research, as well as examining the specific features of population health research that can make PPI more challenging. METHODS A review of reviews and development of best practice guidance was carried out following the 5-stage Framework Synthesis method. RESULTS In total 31 reviews were included. There is a lack of current research or clarity around Governance and Impact when findings are mapped against UK Standards for Public Involvement in Research. It was also clear that there is little knowledge around PPI with under-represented groups. There are gaps in knowledge about how to ensure key specific attributes of population health research are addressed for PPI team members - particularly around how to deal with complexity and the data-driven nature of the research. Four tools were produced for researchers and PPI members to further improve their PPI activity within population health research and health research more generally, including a framework of recommended actions to address PPI in population health research, and guidance on integrating PPI based on the UK Standards for Public Involvement in Research. CONCLUSIONS Facilitating PPI in population health research is challenging due to the nature of this type of research and there is far less evidence on how to do PPI well in this context. The tools can help researchers identify key aspects of PPI that can be integrated when designing PPI within projects. Findings also highlight specific areas where more research or discussion is needed.
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Affiliation(s)
- Soo Vinnicombe
- School of Medical and Health Sciences, Bangor University, Bangor, UK
| | - Mayara S Bianchim
- School of Medical and Health Sciences, Bangor University, Bangor, UK
| | - Jane Noyes
- School of Medical and Health Sciences, Bangor University, Bangor, UK.
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Kelly M, Mitchell I, Walker I, Mears J, Scholz B. End-of-life care in natural disasters including epidemics and pandemics: a systematic review. BMJ Support Palliat Care 2023; 13:1-14. [PMID: 33731463 DOI: 10.1136/bmjspcare-2021-002973] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 03/01/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND Natural disasters are becoming more frequent and severe, and place additional strains on end-of-life care services and users. Although end-of-life and palliative care are considered essential components of disaster planning and response, there are gaps in understandings about their real-life application, and how natural disasters impact end-of-life care. OBJECTIVE To synthesise existing evidence of the impacts of natural disasters (eg, bushfires, communicable pandemics, etc) on end-of-life care. METHODS A systematic review with a narrative synthesis was undertaken. The review was registered on PROSPERO (registration: CRD42020176319). PubMed, Scopus, PsycINFO, Science Direct and Web of Science were searched for studies published in English between 2003 and 2020, with findings explicitly mentioning end-of-life care impacts in relation to a natural disaster. Articles were appraised for quality using a JBI-QARI tool. RESULTS Thirty-six empirical studies met the inclusion criteria and quality assessment. Findings were synthesised into three key themes: impacts on service provision, impacts on service providers and impacts on service users. This review demonstrates that natural disasters impact profoundly on end-of-life care, representing a stark departure from a palliative care approach. CONCLUSIONS Clinical practitioners, policy makers and researchers must continue to collaborate for viable solutions to achieve universal access to compassionate and respectful end-of-life care, during natural disasters. Using models, policies and practices already developed in palliative care, involving those most impacted in disaster planning and anticipating barriers, such as resource shortages, enables development of end-of-life care policies and practices that can be rapidly implemented during natural disasters.
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Affiliation(s)
- Marguerite Kelly
- Medical School, Australian National University, Acton, Australian Capital Territory, Australia
| | - Imogen Mitchell
- Medical School, Australian National University, Acton, Australian Capital Territory, Australia
| | - Iain Walker
- Research School of Psychology, Australian National University, Acton, Australian Capital Territory, Australia
| | - Jane Mears
- School of Social Science, Western Sydney University - Liverpool City Campus, Liverpool, New South Wales, Australia
| | - Brett Scholz
- Medical School, Australian National University, Acton, Australian Capital Territory, Australia
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Sansó N, Leiva JP, Vidal‐Blanco G, Galiana L, West M. The measurement of compassionate leadership: Adaptation and Spanish validation of the compassionate leadership self-reported scale. Scand J Caring Sci 2022; 36:1165-1179. [PMID: 35355300 PMCID: PMC9790542 DOI: 10.1111/scs.13079] [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: 09/16/2021] [Accepted: 03/12/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND A culture of shared leadership is widespread among palliative care teams based on a commitment to valuing and including all people equally. As compassion is a core value for end-of-life care work, compassionate leadership may be the best way to lead in palliative care. AIMS The aims of this study were twofold: (1) to adapt and validate the Compassionate Leadership Self-reported Scale in a sample of palliative care professionals; and (2) to study the relation between compassionate leadership and associated concepts of self-compassion, awareness and self-care. METHODS A cross-sectional survey of 296 Spanish end-of-life care professionals was conducted. Analyses included descriptive statistics, a confirmatory factor analysis (CFA) with four-correlated factors, reliability estimates and a structural model. RESULTS Results suggested there were medium to high levels of compassionate leadership in the sample. The CFA showed an adequate overall fit: χ2 (98) = 277.595 (p < 0.001); CFI = 0.986; SRMR = 0.047; RMSEA = 0.088 [0.076, 0.100]. Reliability estimates for four subscales of compassionate leadership (attending, understanding, empathising and helping) were also adequate, ranging from 0.72 to 0.96. Finally, the structural model predicting compassionate leadership suggested that the dimensions of attending and understanding were most highly related to positive self-compassion and awareness; empathising, to self-care and awareness; and helping, to positive self-compassion and self-care. CONCLUSION The Compassionate Leadership Scale has adequate psychometric properties when used to assess compassionate leadership in the context of end-of-life care. Our results indicate that self-compassion, awareness and self-care are important correlates of such compassionate leadership.
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Affiliation(s)
- Noemí Sansó
- Department of Nursing and PhysiotherapyUniversity of the Balearic IslandsMallorcaSpain,Balearic Islands Health Research Institute (IDISBA)MallorcaSpain
| | - Juan P. Leiva
- Support and Palliative Care TeamHospital ManacorMallorcaSpain
| | | | - Laura Galiana
- Department of Methodology for the Behavioral SciencesUniversity of ValenciaValenciaSpain
| | - Michael West
- The King’s FundLondonUK,Department of Organizational PsychologyLancaster UniversityLancasterUK,Aston UniversityBirminghamUK
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Virdun C, Luckett T, Lorenz K, Davidson P, Phillips J. Preferences of patients with palliative care needs and their families for engagement with service improvement work within the hospital setting: A qualitative study. Palliat Med 2022; 36:1129-1139. [PMID: 35634933 DOI: 10.1177/02692163221100108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND There is growing recognition of the importance of involving patients and families with lived experiences of illness in healthcare service quality improvement, research and implementation initiatives. Ensuring input from people with palliative care needs is important, but how to enable this is not well understood. AIM To seek the perspectives of Australian patients with palliative care needs, and their family members, to elicit their views on how to best contribute to inpatient palliative care quality improvement initiatives. DESIGN An exploratory qualitative study, using semi-structured interviews. SETTING/PARTICIPANTS Eligible participants were adult patients with palliative care needs receiving care within a hospital setting, and their family members. Recruitment occurred through: five hospitals in New South Wales, Australia; and snowballing. RESULTS Fifty participants took part (21 patients and 29 family members). Results confirmed four themes: (1) Mechanisms for providing feedback about care quality need to be supportive and individualised; (2) The clinician-patient/family power imbalance makes real time feedback challenging to provide; (3) Willingness to contribute varies according to diagnosis, timing and role and (4) Face to face feedback is preferred for health service improvement work. CONCLUSIONS Enabling meaningful consumer input to quality improvement requires careful consideration due to the unique requirements of the palliative care population. Embedding tailored outcome and experience measures to inform real-time care provision coupled with focussed opportunities for input into service improvement may best foster improvements in inpatient palliative care, founded in what matters most for people requiring this care.
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Affiliation(s)
- Claudia Virdun
- School of Nursing, Faculty of Health, Queensland University of Technology, Kelvin Grove, QLD, Australia.,Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney (UTS), Ultimo, NSW, Australia
| | - Tim Luckett
- Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney (UTS), Ultimo, NSW, Australia
| | - Karl Lorenz
- Stanford University School of Medicine, Stanford, CA, USA
| | - Patricia Davidson
- Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney (UTS), Ultimo, NSW, Australia.,University of Wollongong, Wollongong, NSW, Australia.,St Vincent's Hospital Sydney, Darlinghurst, NSW, Australia
| | - Jane Phillips
- School of Nursing, Faculty of Health, Queensland University of Technology, Kelvin Grove, QLD, Australia.,Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney (UTS), Ultimo, NSW, Australia
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Scholz B, Bevan A. Toward more mindful reporting of patient and public involvement in healthcare. RESEARCH INVOLVEMENT AND ENGAGEMENT 2021; 7:61. [PMID: 34503584 PMCID: PMC8427839 DOI: 10.1186/s40900-021-00308-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 08/23/2021] [Indexed: 05/26/2023]
Abstract
Understanding of the value of patient and public involvement in research has grown in recent years, but so too has uncertainty about how best to practice and how best to report such involvement in research outputs. One way proposed to report such involvement is through checklists, such as the GRIPP2, which aims to improve quality, transparency, and consistency in such reporting. We critique the unproblematised use of such a tool because of two main concerns. First, being asked to complete a GRIPP2 for a recent publication felt divisive given that the service user researcher was as much a member of the authorship team as the other researchers (whose involvement did not necessitate a checklist). Second, checklists do not actually address the power imbalances and tokenism that is rife in patient and public involvement in research. Indeed, the false sense of objectivity fostered by meeting the minimum requirements of the checklist means that researchers may not go further to engage in reflexive research practices and reporting. Rather than rote use of such checklists, we recommend mindful reflexive reporting in research outputs of patient and public involvement processes. We also recommend future iterations of the GRIPP consider (a) incorporating criteria about whether the checklist is completed by or with service user researchers or not, (b) addressing criteria that position service user research as needing to be justified, and (c) expanding the "critical perspective" element of the checklist to explicitly consider power differentials.
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Affiliation(s)
- Brett Scholz
- ANU Medical School, Ngunnawal Country, The Australian National University, 54 Mills Rd, Acton, ACT, 2601, Australia.
| | - Alan Bevan
- School of Psychology, Kaurna Country, North Terrace, The University of Adelaide, Adelaide, SA, 5000, Australia
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10
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Ellis U, Kitchin V, Vis-Dunbar M. Identification and Reporting of Patient and Public Partner Authorship on Knowledge Syntheses: Rapid Review. J Particip Med 2021; 13:e27141. [PMID: 34110293 PMCID: PMC8235296 DOI: 10.2196/27141] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 04/12/2021] [Accepted: 05/11/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Patient and public involvement (PPI) in health research is an area of growing interest. Several studies have examined the use and impact of PPI in knowledge syntheses (systematic, scoping, and related reviews); however, few studies have focused specifically on the patient or public coauthorship of such reviews. OBJECTIVE This study seeks to identify published systematic and scoping reviews coauthored by patient or public partners and examine the characteristics of these coauthored reviews, such as which journals publish them, geographic location of research teams, and terms used to describe patient or public partner authors in affiliations, abstracts, or article text. METHODS We searched CAB Direct, CINAHL, Cochrane Database of Systematic Reviews (Ovid), Embase (Ovid), MEDLINE (Ovid), and PsycInfo from 2011 to May 2019, with a supplementary search of several PPI-focused databases. We refined the Ovid MEDLINE search by examining frequently used words and phrases in relevant search results and searched Ovid MEDLINE using the modified search strategy in June 2020. RESULTS We screened 13,998 results and found 37 studies that met our inclusion criteria. In line with other PPI research, we found that a wide range of terms were used for patient and public authors in author affiliations. In some cases, partners were easy to identify with titles such as patient, caregiver or consumer representative, patient partner, expert by experience, citizen researcher, or public contributor. In 11% (n=4) of studies, they were identified as members of a panel or advisory council. In 27% (n=10) of articles, it was either impossible or difficult to tell whether an author was a partner solely from the affiliation, and confirmation was found elsewhere in the article. We also investigated where in the reviews the partner coauthors' roles were described, and when possible, what their specific roles were. Often, there was little or no information about which review tasks the partner coauthors contributed to. Furthermore, only 14% (5/37) of reviews mentioned patient or public involvement as authors in the abstract; involvement was often only indicated in the author affiliation field or in the review text (most often in the methods or contributions section). CONCLUSIONS Our findings add to the evidence that searching for coproduced research is difficult because of the diversity of terms used to describe patient and public partners, and the lack of consistent, detailed reporting about PPI. For better discoverability, we recommend ensuring that patient and public authorships are indicated in commonly searched database fields. When patient and public-authored research is easier to find, its impact will be easier to measure.
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Affiliation(s)
- Ursula Ellis
- Woodward Library, University of British Columbia, Vancouver, BC, Canada
| | - Vanessa Kitchin
- Woodward Library, University of British Columbia, Vancouver, BC, Canada
| | - Mathew Vis-Dunbar
- University of British Columbia Okanagan Library, Kelowna, BC, Canada
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Li WW, Chhabra J, Singh S. Palliative care education and its effectiveness: a systematic review. Public Health 2021; 194:96-108. [PMID: 33873061 DOI: 10.1016/j.puhe.2021.02.033] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 01/27/2021] [Accepted: 02/05/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Palliative care education (PCE) is an important public health approach to palliative care and is crucial to improving its utilisation. The present study aims to develop a comprehensive understanding of PCE and its effectiveness. METHOD A systematic review approach, including narrative synthesis, was used to review qualitative and quantitative studies published in the English language between January 1969 and January 2019, focussing on PCE programs. RESULTS Thirty-nine research studies were included in the systematic review. The target audience of the included studies were mostly healthcare professionals, followed by family caregivers. Definitions of death and palliative care, symptom management and communication were leading themes in the reviewed PCE programs. The educational resources used in PCE programs were mainly self-developed teaching materials, with some programs utilising eLearning resources. The included PCE programs were effective in improving knowledge, attitude and confidence in palliative care and the satisfaction of participant learning experience. CONCLUSION PCE is a useful tool to improve knowledge of, confidence in and attitudes towards palliative care amongst healthcare professionals and carers. To make palliative care a public health issue, PCE should be expanded to the public and policy-makers.
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Affiliation(s)
- W W Li
- Department of Psychology, James Cook University, Australia.
| | - J Chhabra
- Department of Psychology, James Cook University, Australia
| | - S Singh
- Department of Psychology, James Cook University, Singapore
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Scholz B, Happell B, Gordon S, Warner T, Roper C, Ellis P, Waks S, Platania-Phung C. 'People Just Need to Try It to Be Converted!': A Picture of Consumer Mental Health Research in Australia and New Zealand. Issues Ment Health Nurs 2021; 42:249-255. [PMID: 32790538 DOI: 10.1080/01612840.2020.1795763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
A range of barriers that impede collaborations between consumer researchers and other researchers have been identified, despite clear acknowledgement of the benefits of this approach in the literature. Recent research has questioned whether the costs of collaborative research outweigh the benefits. The overarching aim of the current study is to better understand non-consumer researchers' attitudes to, and issues concerning, engagement with consumer researchers. Non-consumer researchers from mental health disciplines were invited to participate in the cross-sectional Consumers as Researchers in Mental Health survey, and to respond to open-ended questions about their experiences of collaborative research with consumer researchers. The findings demonstrate a range of benefits associated with collaborations with consumer researchers - including increased relevance and credibility of research, and greater translation of research findings into changes in health policy, service, research and education. Collaborations were found to be varied and not limited by research design, decision-making styles, or research topic. Understanding these benefits within the context of identified barriers can make an important contribution to the proliferation of mental health consumer researcher roles.
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Affiliation(s)
- Brett Scholz
- ANU Medical School, College of Health and Medicine, The Australian National University, Canberra, Australia
| | - Brenda Happell
- School of Nursing and Midwifery, Faculty of Health and Medicine, Hunter Medical Research Institute, and Priority Centre for Health Behaviour, University of Newcastle, University Drive, Callaghan, New South Wales, Australia
| | - Sarah Gordon
- Department of Psychological Medicine, School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand
| | - Terri Warner
- School of Nursing and Midwifery, Faculty of Health and Medicine, The University of Newcastle, University Drive, Callaghan, New South Wales, Australia.,ACT Mental Health Consumer Network, Canberra, Australia
| | - Cath Roper
- Centre for Psychiatric Nursing, Department of Nursing, Faculty of Health Sciences, The University of Melbourne, Victoria, Australia
| | - Pete Ellis
- Department of Psychological Medicine, School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand Wellington South
| | - Shifra Waks
- School of Nursing and Midwifery, University of Newcastle, University Drive, Callaghan, New South Wales, Australia
| | - Chris Platania-Phung
- Australian College of Applied Psychology, Conjoint Lecturer, School of Nursing and Midwifery, Faculty of Health and Medicine, University of Newcastle, University Drive, Callaghan, New South Wales, Australia
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Johnson H, Ogden M, Brighton LJ, Etkind SN, Oluyase AO, Chukwusa E, Yu P, de Wolf-Linder S, Smith P, Bailey S, Koffman J, Evans CJ. Patient and public involvement in palliative care research: What works, and why? A qualitative evaluation. Palliat Med 2021; 35:151-160. [PMID: 32912087 PMCID: PMC7797607 DOI: 10.1177/0269216320956819] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Public involvement is increasingly considered a prerequisite for high-quality research. However, involvement in palliative care is impeded by limited evidence on the best approaches for populations affected by life-limiting illness. AIM To evaluate a strategy for public involvement in palliative care and rehabilitation research, to identify successful approaches and areas for improvement. DESIGN Co-produced qualitative evaluation using focus groups and interviews. Thematic analysis undertaken by research team comprising public contributors and researchers. SETTING/PARTICIPANTS Researchers and public members from a palliative care and rehabilitation research institute, UK. RESULTS Seven public members and 19 researchers participated. Building and maintaining relationships, taking a flexible approach and finding the 'right' people were important for successful public involvement. Relationship building created a safe environment for discussing sensitive topics, although public members felt greater consideration of emotional support was needed. Flexibility supported involvement alongside unpredictable circumstances of chronic and life-limiting illness, and was facilitated by responsive communication, and opportunities for in-person and virtual involvement at a project- and institution-level. However, more opportunities for two-way feedback throughout projects was suggested. Finding the 'right' people was crucial given the diverse population served by palliative care, and participants suggested more care needed to be taken to identify public members with experience relevant to specific projects. CONCLUSION Within palliative care research, it is important for involvement to focus on building and maintaining relationships, working flexibly, and identifying those with relevant experience. Taking a strategic approach and developing adequate infrastructure and networks can facilitate public involvement within this field.
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Affiliation(s)
- Halle Johnson
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
| | - Margaret Ogden
- Patient and Public Contributor, Cicely Saunders Institute, King's College London, London, UK
| | - Lisa Jane Brighton
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
| | - Simon Noah Etkind
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
| | - Adejoke O Oluyase
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
| | - Emeka Chukwusa
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
| | - Peihan Yu
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
| | - Susanne de Wolf-Linder
- Institute of Nursing, School of Health Professions, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Pam Smith
- Patient and Public Contributor, Cicely Saunders Institute, King's College London, London, UK
| | - Sylvia Bailey
- Patient and Public Contributor, Cicely Saunders Institute, King's College London, London, UK
| | - Jonathan Koffman
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
| | - Catherine J Evans
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK.,Sussex Community NHS Foundation Trust, Brighton General Hospital, Brighton, UK
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Scholz B, Goncharov L, Emmerich N, Lu VN, Chapman M, Clark SJ, Wilson T, Slade D, Mitchell I. Clinicians' accounts of communication with patients in end-of-life care contexts: A systematic review. PATIENT EDUCATION AND COUNSELING 2020; 103:1913-1921. [PMID: 32650998 DOI: 10.1016/j.pec.2020.06.033] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 06/02/2020] [Accepted: 06/29/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Communication between patients and end-of-life care providers requires sensitivity given the context and complexity involved. This systematic review uses a narrative approach to synthesise clinicians' understandings of communication in end-of-life care. METHODS A systematic, narrative synthesis approach was adopted given the heterogeneity across the 83 included studies. The review was registered prospectively on PROSPERO (ID: CRD42019125155). Medline was searched for all articles catalogued with the MeSH terms "palliative care," "terminal care" or "end-of-life care," and "communication". Articles were assessed for quality using a modified JQI-QARI tool. RESULTS The findings highlight the centrality and complexity of communication in end-of-life care. The challenges identified by clinicians in relation to such communication include the development of skills necessary, complexity of interpersonal interactions, and ways in which organisational factors impact upon communication. Clinicians are also aware of the need to develop strategies for interdisciplinary teams to improve communication. CONCLUSION Training needs for effective communication in end-of-life contexts are not currently being met. PRACTICE IMPLICATIONS Clinicians need more training to address the lack of skills to overcome interactional difficulties. Attention is also needed to address issues in the organisational contexts in which such communication occurs.
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Affiliation(s)
- Brett Scholz
- Medical School, The Australian National University, Canberra, Australia.
| | - Liza Goncharov
- School of Literature, Languages and Linguistics, The Australian National University, Canberra, Australia
| | - Nathan Emmerich
- Medical School, The Australian National University, Canberra, Australia
| | - Vinh N Lu
- College of Business and Economics, The Australian National University, Canberra, Australia
| | - Michael Chapman
- Medical School, The Australian National University, Canberra, Australia; Canberra Health Service, ACT Health, Canberra, Australia
| | - Shannon J Clark
- School of Literature, Languages and Linguistics, The Australian National University, Canberra, Australia
| | - Tracey Wilson
- Medical Intensive Care Unit, University of Maryland, Baltimore, USA
| | - Diana Slade
- School of Literature, Languages and Linguistics, The Australian National University, Canberra, Australia
| | - Imogen Mitchell
- Medical School, The Australian National University, Canberra, Australia; Canberra Health Service, ACT Health, Canberra, Australia
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15
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Virdun C, Luckett T, Gilmore I, Brassil M, Lilian R, Lorenz K, Phillips J. Involving consumers with palliative care needs and their families in research: A case study. Collegian 2019. [DOI: 10.1016/j.colegn.2019.08.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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