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Hegde SK, Rao S, D’souza RK, Baliga MS. Efficacy of Eicosapentaenoic Acid (EPA) Containing Protein Supplement in Preventing Weight Loss in Head and Neck Cancer Patients Undergoing Curative Radiotherapy: Retrospective Observations with Historical Controls. Indian J Otolaryngol Head Neck Surg 2024; 76:587-595. [PMID: 38440501 PMCID: PMC10909067 DOI: 10.1007/s12070-023-04217-y] [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: 06/01/2023] [Accepted: 09/04/2023] [Indexed: 03/06/2024] Open
Abstract
Weight loss is a major issue in Head and Neck cancer (HNC) patients undergoing curative radiotherapy. The principal objective of the study was to observe whether eicosapentaenoic acid (EPA) containing protein supplement was effective in mitigating the weight loss during in hospitalized HNC undergoing curative radiotherapy. A retrospective study was performed based on clinical, treatment and nutritional data of 53 patients received EPA containing supplement during their curative radiotherapy from October 2014 to January 2015 and was compared with 88 historical control group of patients (October 2013 to June 2014) who had indigenous protein rich diet planned by the dietician in the period immediately before the implementation of providing EPA containing protein supplement to the patients. The data was stratified based on gender, age, weight, treatment modalities, stage and site of cancer and analysed using unpaired t test. A p value of < 0.05 was considered significant. The results indicate there was no significant difference in the patient tumor and clinical details. The results indicate that the percent change in weight loss was less in the EPA cohorts when calculated from weight (P < 0.006) and Body Mass Index (BMI) perspective (P < 0.003). Detail analysis suggested that beneficial effects were more in males (P < 0.01), people affected with oral cancer (P < 0.02), people below the age of 40 (P < 0.001), and in people with early stage cancer (P < 0.003). Cumulatively all these results suggest that administering EPA containing protein supplement was effective in arresting weight loss in HNC patients undergoing curative radiotherapy.
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Affiliation(s)
- Sanath Kumar Hegde
- Department of Radiation Oncology, Mangalore Institute of Oncology, Pumpwell, Mangalore, 575002 Karnataka India
| | - Suresh Rao
- Department of Radiation Oncology, Mangalore Institute of Oncology, Pumpwell, Mangalore, 575002 Karnataka India
| | - Rhea Katherine D’souza
- Clinical Nutrition, Mangalore Institute of Oncology, Pumpwell, Mangalore, Karnataka 575002 India
- Research Unit, Mangalore Institute of Oncology, Pumpwell, Mangalore, Karnataka 575002 India
| | - Manjeshwar Shrinath Baliga
- Clinical Nutrition, Mangalore Institute of Oncology, Pumpwell, Mangalore, Karnataka 575002 India
- Research Unit, Mangalore Institute of Oncology, Pumpwell, Mangalore, Karnataka 575002 India
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Sands M, Aiken AM, Cumming O, Aunger R. The effect of behavioural interventions targeting hand hygiene practices among nurses in high-income hospital settings: a systematic review. Public Health Rev 2020; 41:29. [PMID: 33372645 PMCID: PMC7720577 DOI: 10.1186/s40985-020-00141-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 11/04/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Hand hygiene is a critical behaviour for infection control but efforts to raise compliance among clinical professionals have been met with mixed success. The aim of this systematic review was to identify the effectiveness of the behaviour change techniques utilised in recent hand hygiene interventions that seek to improve hand hygiene compliance among nurses in hospitals in high-income countries. Nurses are at the frontline of healthcare delivery, and so improving their HH behaviour and thus increasing HHC rates will have a relatively large impact on reducing transmission and preventing healthcare acquired infections. METHODS High-quality studies among nurses in high-income countries were surveyed from the scientific literature, following PRISMA guidelines, to identify which kinds of behaviour change mechanisms have been used to effectively increase hand hygiene compliance. Only seven studies met all inclusion criteria. A formal meta-analysis was not conducted due to the heterogeneity of the included studies. Instead, the review analysed studies in line with the Intervention Component Analysis approach to identify which differences in intervention characteristics appear to be important. Analysis proceeded in two steps: first, the Effective Practice and Organization of Care Data Extraction Checklist was used to identify the study design and to describe the intervention, target population, setting, results, outcome measures, and analytic approach. The second step involved inferring the behavioural change techniques used in the complex study interventions. Following coding, logic models were then inferred for each study to identify the Theory of Change behind each intervention. These Theories of Change were then examined for suggestions as to which BCTs were likely to have been responsible for any effectiveness observed. RESULTS Goals and planning (to achieve specific ends), comparison of behaviour (to peers or some ideal) and feedback and monitoring (observing and providing feedback about behaviour or outcomes) were the most frequently used behaviour change technique groupings used across studies and within interventions. CONCLUSION The complexity of the interventions used and lack of sufficient studies makes assignment of responsibility for behaviour change to specific behaviour change techniques difficult. Delivery channels and activities identified in the study Theories of Change were also highly individualized and so difficult to compare. However, we identified a temporal shift in types of techniques used in these recent studies on HH interventions, as compared with studies from prior to the review period. These newer interventions did not focus on providing access to alcohol-based hand rub or trying to solely encourage administrative support. Instead, they had nurses create goals and plan how to best facilitate HH, compared both individuals' and the group's behaviour to others, and focused on providing feedback.
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Affiliation(s)
- Madeline Sands
- Department of Infectious Disease, London School of Hygiene and Tropical Medicine, London, UK
- University of Arizona College of Medicine, Tucson, AZ USA
| | - Alexander M. Aiken
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Oliver Cumming
- Department of Infectious Disease, London School of Hygiene and Tropical Medicine, London, UK
| | - Robert Aunger
- Department of Infectious Disease, London School of Hygiene and Tropical Medicine, London, UK
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Body composition changes in patients with head and neck cancer under active treatment: a scoping review. Support Care Cancer 2020; 28:4613-4625. [PMID: 32533436 DOI: 10.1007/s00520-020-05487-w] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 04/20/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND Head and neck cancer patients have the second highest malnutrition prevalence, when compared with other oncological patients. They experience significant weight loss before diagnosis, during and after treatment, and even during the first year of follow-up. However, the prognostic value of weight loss depends on body mass index, and this may be associated with low skeletal muscle mass, masking its loss. Thus, weight loss itself poorly predicts outcome in head and neck cancer patients when compared with depleted skeletal muscle mass, illustrating the inadequacy of body mass index as an accurate method to reflect nutritional status. A synthesis is needed of the body composition changes occurring in head and neck cancer patients during treatment, as well as of the methods to assess it. OBJECTIVE The aim of this scoping review is to examine and map the body composition changes in head and neck cancer patients under oncological treatment with curative intent. A further objective is to determine which methods are used to assess body composition in these patients. INCLUSION CRITERIA Types of participants: The current review considered head and neck cancer patients, aged 18 years or older. CONCEPT This scoping review considered all studies that focused on the body composition changes. CONTEXT This scoping review considered the studies that evaluated the body composition changes in the context of treatment with curative intent. Surgical treatment approach was excluded to avoid excess heterogeneity in the data. Types of sources: This scoping review considered only published studies, with abstract available. SEARCH STRATEGY A three-step search strategy was undertaken. This review was limited to studies published in English, Spanish, and Portuguese during 2000-2019. DATA EXTRACTION The data extracted included author(s)/year of publication, aims and purpose of the study, sample size, study design, type of treatment, measurement points and component(s) of body composition evaluated, body composition assessment methods, and main results/findings. PRESENTATION OF RESULTS Head and neck cancer patients suffer from serious loss of lean body mass, skeletal muscle, or free fat mass, after treatment compared with baseline. Further, nutritional deterioration is evident and occurs up to 8-12 months after treatment. Bioelectrical impedance analysis is one of the body composition assessment tools that has the great advantage for being available on a regular basis for assessment of body composition in head and neck cancer patients. However, it cannot be recommended for clinical decision making until further validation. CONCLUSION Head and neck cancer patients experience a significant depletion of lean body mass, fat-free mass, and skeletal muscle, accompanied by body fat mass, while undergoing (chemo)radiotherapy. This can be demonstrated either by triceps skinfold thickness, bioelectrical impedance analysis, dual-energy x-ray absorptiometry, or computed tomography. This loss has a remarkable impact on their survival, on their quality of life, and on the risk for post-operative complications and may result in a reduced response to cancer treatment. Thus, body composition assessment should become an integral component of the care of head and neck cancer patients, beyond weight and body mass index, and should be carried out at different times throughout treatment.
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Al Rawahi SH, Asimakopoulou K, Masood M, Al Bulushi NM, Al Yaqoobi KH, Newton JT. The Psychological Models of Health-related Behavior in Understanding Sugars Intake in Adults: A Review. Oman Med J 2020; 35:e114. [PMID: 32308991 PMCID: PMC7151060 DOI: 10.5001/omj.2020.32] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Accepted: 04/30/2019] [Indexed: 12/19/2022] Open
Abstract
Free sugars intake plays a major role in dental caries formation and other general health issues such as obesity. Therefore, interventions, which assist individuals or populations in the control of their free sugars intake, are of central importance in caries prevention strategies. There is good evidence that behavioral interventions benefit from a foundation in conceptual theories of behavior change founded on empirical data. In this review, we discuss the future application of seven theories, including six common psychological theories in predicting and developing interventions to reduce free sugars intake related to dental caries among adults. For each model, we summarize its key features and the data derived from its application in general and oral health settings and make recommendations for future research. We searched Medline, PsycINFO, Global Health, PubMed, and Embase databases to identify items dealing with dental caries, adults, sugars intake, and six psychological theories. These included the Transtheoretical Model of Change, Theory of Planned Behavior, Social Cognitive Theory, Information-Motivation-Behavioral Skills model, PRIME Theory, and Behavior Change Wheel theories. We searched literature published in the last 10 years, and priority was given to systematic reviews and randomized control trials. Although there is extensive literature on the application of the six psychological theories, there is a gap in knowledge about their effectiveness in reducing free sugars intake related to dental caries among adults. There is a need for better-designed trials of interventions based on the clear operationalization of psychological constructs to reduce sugars intake among the adult population.
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Affiliation(s)
| | - Koula Asimakopoulou
- Department of Population and Patient Health, Dental Institute, King’s College London, London, UK
| | - Mohd Masood
- Dentistry and Oral Health, La Trobe Rural Health School, La Trobe University, Melbourne, Australia
| | | | | | - Jonathon Timothy Newton
- Department of Population and Patient Health, Dental Institute, King’s College London, London, UK
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Bonomo P, Paderno A, Mattavelli D, Zenda S, Cavalieri S, Bossi P. Quality Assessment in Supportive Care in Head and Neck Cancer. Front Oncol 2019; 9:926. [PMID: 31620372 PMCID: PMC6759470 DOI: 10.3389/fonc.2019.00926] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 09/04/2019] [Indexed: 01/03/2023] Open
Abstract
Quality assessment is a key issue in every clinical intervention, to be periodically performed so to measure the adherence to standard and to possibly implement strategies to improve its performance. This topic is rarely discussed for what concerns supportive care; however, it is necessary to verify the quality of the supportive measures; “supportive care makes excellent cancer care possible,” as stated by the Multinational Association of Supportive Care in Cancer (MASCC). In this regard, the quality of supportive care in head and neck cancer patients is a crucial topic, both to allow administration of treatments according to planned dose intensity or surgical indications and to maintain or improve patients' quality of life. This paper aims to provide insight on state of the art supportive care and its future developments for locally advanced and recurrent/metastatic head and neck cancer, with a focus on quality assessment in relation to surgery, radiotherapy, and systemic therapy.
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Affiliation(s)
- Pierluigi Bonomo
- Department of Radiation Oncology, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| | - Alberto Paderno
- Unit of Otorhinolaryngology, Department of Surgical Specialties, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Davide Mattavelli
- Unit of Otorhinolaryngology, Department of Surgical Specialties, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Sadamoto Zenda
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Stefano Cavalieri
- Head and Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Paolo Bossi
- Medical Oncology Unit, Department of Medical Oncology, ASST Spedali Civili di Brescia, Brescia, Italy.,Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
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Hansen CR, O'Mahony D, Kearney PM, Sahm LJ, Cullinan S, Huibers C, Thevelin S, Rutjes AW, Knol W, Streit S, Byrne S. Identification of behaviour change techniques in deprescribing interventions: a systematic review and meta-analysis. Br J Clin Pharmacol 2018; 84:2716-2728. [PMID: 30129139 PMCID: PMC6255994 DOI: 10.1111/bcp.13742] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 07/31/2018] [Accepted: 08/12/2018] [Indexed: 12/19/2022] Open
Abstract
AIMS Deprescribing interventions safely and effectively optimize medication use in older people. However, questions remain about which components of interventions are key to effectively reduce inappropriate medication use. This systematic review examines the behaviour change techniques (BCTs) of deprescribing interventions and summarizes intervention effectiveness on medication use and inappropriate prescribing. METHODS MEDLINE, EMBASE, Web of Science and Academic Search Complete and grey literature were searched for relevant literature. Randomized controlled trials (RCTs) were included if they reported on interventions in people aged ≥65 years. The BCT taxonomy was used to identify BCTs frequently observed in deprescribing interventions. Effectiveness of interventions on inappropriate medication use was summarized in meta-analyses. Medication appropriateness was assessed in accordance with STOPP criteria, Beers' criteria and national or local guidelines. Between-study heterogeneity was evaluated by I-squared and Chi-squared statistics. Risk of bias was assessed using the Cochrane Collaboration Tool for randomized controlled studies. RESULTS Of the 1561 records identified, 25 studies were included in the review. Deprescribing interventions were effective in reducing number of drugs and inappropriate prescribing, but a large heterogeneity in effects was observed. BCT clusters including goals and planning; social support; shaping knowledge; natural consequences; comparison of behaviour; comparison of outcomes; regulation; antecedents; and identity had a positive effect on the effectiveness of interventions. CONCLUSIONS In general, deprescribing interventions effectively reduce medication use and inappropriate prescribing in older people. Successful deprescribing is facilitated by the combination of BCTs involving a range of intervention components.
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Affiliation(s)
- Christina R. Hansen
- Pharmaceutical Care Research Group, School of Pharmacy, Cavanagh Pharmacy BuildingUniversity College CorkCorkIreland
- Section for Social and Clinical Pharmacy, Department of Pharmacy, Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagen ØDenmark
| | - Denis O'Mahony
- Department of MedicineUniversity College CorkCorkIreland
- Department of Geriatric MedicineCork University HospitalCorkIreland
| | | | - Laura J. Sahm
- Pharmaceutical Care Research Group, School of Pharmacy, Cavanagh Pharmacy BuildingUniversity College CorkCorkIreland
- Pharmacy DepartmentMercy University HospitalCorkIreland
| | - Shane Cullinan
- School of Pharmacy, Royal College of Surgeons of IrelandDublinIreland
| | - C.J.A. Huibers
- Department of Geriatric Medicine and Expertise Centre Pharmacotherapy in Old PersonsUniversity Medical Centre UtrechtUtrechtThe Netherlands
| | - Stefanie Thevelin
- Clinical Pharmacy Research Group, Louvain Drug Research InstituteUniversité Catholique de LouvainBrusselsBelgium
| | - Anne W.S. Rutjes
- Institute of Social and Preventive MedicineUniversity of Bern, Switzerland & Institute of Primary Health Care (BIHAM), University of BernSwitzerland
| | - Wilma Knol
- Department of Geriatric Medicine and Expertise Centre Pharmacotherapy in Old PersonsUniversity Medical Centre UtrechtUtrechtThe Netherlands
| | - Sven Streit
- Institute of Primary Health Care (BIHAM)University of BernBernSwitzerland
| | - Stephen Byrne
- Pharmaceutical Care Research Group, School of Pharmacy, Cavanagh Pharmacy BuildingUniversity College CorkCorkIreland
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Newton JT, Asimakopoulou K. Behavioral models for periodontal health and disease. Periodontol 2000 2018; 78:201-211. [DOI: 10.1111/prd.12236] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Jonathon T. Newton
- Unit of Social and Behavioural Sciences; Population & Patient Health; King's College London; Guy's Hospital; London UK
| | - Koula Asimakopoulou
- Unit of Social and Behavioural Sciences; Population & Patient Health; King's College London; Guy's Hospital; London UK
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Patient adherence to swallowing exercises in head and neck cancer. Curr Opin Otolaryngol Head Neck Surg 2018; 25:175-181. [PMID: 28266944 DOI: 10.1097/moo.0000000000000356] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PURPOSE OF REVIEW A younger population and improved treatments for head and neck cancer (HNC) mean that more people are now living longer with the consequences of treatment, including long-term swallowing problems (dysphagia). Exercises aim to improve swallowing function, however highly variable adherence rates are currently reported, with no standard measure of adherence. RECENT FINDINGS Measuring adherence to swallowing exercises depends on the definition of 'adherence', the tools used to measure adherence, and the acceptable threshold that is used to constitute adherence or nonadherence. Particular barriers to swallowing exercise adherence include the burden of treatment, the commitment required to undertake a home-based exercise programme and the difficulty in motivating patients to exercise before swallowing problems have become apparent. Findings from the wider literature on general exercise interventions highlight the importance of external and patient-related factors on adherence, including patient beliefs, social support, self-regulation and goal setting. SUMMARY Key barriers and motivators to adherence are presented, which will have implications for the design of future swallowing exercise interventions. The relevance of behaviour change theory in facilitating adherence is highlighted, with ongoing studies used to exemplify how behaviour change components and analysis of patient beliefs can be incorporated into intervention development.
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Behaviour change technique taxonomy: a method of describing head and neck cancer dysphagia intervention delivery. Curr Opin Otolaryngol Head Neck Surg 2017; 25:182-187. [PMID: 28306585 DOI: 10.1097/moo.0000000000000360] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW The purpose of the review is to examine the current state of the art of dysphagia intervention delivery description and to propose use of a new tool to facilitate this: the behaviour change technique taxonomy version 1 (BCTTv1). RECENT FINDINGS Describing intervention delivery is difficult, and published research in the field of speech and language therapy (SLT) does not include detail on this key aspect of research protocols. Interventions themselves are often poorly delineated, and a way is needed of classifying how these interventions are delivered in practice. SUMMARY Use of the BCTTv1 would facilitate clarity and transparency in intervention delivery description and have positive implications for research, clinical practice and undergraduate teaching if employed by the SLT profession.
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Govender R, Smith CH, Taylor SA, Barratt H, Gardner B. Swallowing interventions for the treatment of dysphagia after head and neck cancer: a systematic review of behavioural strategies used to promote patient adherence to swallowing exercises. BMC Cancer 2017; 17:43. [PMID: 28068939 PMCID: PMC5223405 DOI: 10.1186/s12885-016-2990-x] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Accepted: 12/09/2016] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Dysphagia is a significant side-effect following treatment for head and neck cancers, yet poor adherence to swallowing exercises is frequently reported in intervention studies. Behaviour change techniques (BCTs) can be used to improve adherence, but no review to date has described the techniques or indicated which may be more associated with improved swallowing outcomes. METHODS A systematic review was conducted to identify behavioural strategies in swallowing interventions, and to explore any relationships between these strategies and intervention effects. Randomised and quasi-randomised studies of head and neck cancer patients were included. Behavioural interventions to improve swallowing were eligible provided a valid measure of swallowing function was reported. A validated and comprehensive list of 93 discrete BCTs was used to code interventions. Analysis was conducted via a structured synthesis approach. RESULTS Fifteen studies (8 randomised) were included, and 20 different BCTs were each identified in at least one intervention. The BCTs identified in almost all interventions were: instruction on how to perform the behavior, setting behavioural goals and action planning. The BCTs that occurred more frequently in effective interventions, were: practical social support, behavioural practice, self-monitoring of behaviour and credible source for example a skilled clinician delivering the intervention. The presence of identical BCTs in comparator groups may diminish effects. CONCLUSIONS Swallowing interventions feature multiple components that may potentially impact outcomes. This review maps the behavioural components of reported interventions and provides a method to consistently describe these components going forward. Future work may seek to test the most effective BCTs, to inform optimisation of swallowing interventions.
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Affiliation(s)
- Roganie Govender
- University College London, Health Behaviour Research Centre & University College London Hospital, Head & Neck Cancer Centre, Ground Floor Central, 250 Euston Road, London, NW1 2PQ UK
| | - Christina H. Smith
- Division of Psychology & Language Sciences University College London, London, UK
| | - Stuart A. Taylor
- Centre for Medical Imaging, University College London, London, UK
| | - Helen Barratt
- Department of Applied Health Research, University College London, London, UK
| | - Benjamin Gardner
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), Kings College London, London, UK & UCL Department of Epidemiology & Public Health, University College London, London, UK
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Self-management interventions to improve skin care for pressure ulcer prevention in people with spinal cord injuries: a systematic review protocol. Syst Rev 2016; 5:150. [PMID: 27600153 PMCID: PMC5011862 DOI: 10.1186/s13643-016-0323-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Accepted: 08/22/2016] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Pressure ulcers are a serious, common, lifelong, and costly secondary complication of spinal cord injury (SCI). Community-dwelling people with a SCI can prevent them with appropriate skin care (i.e. pressure relieving activities, skin checks). Adherence to skin care remains suboptimal however, and self-management interventions that focus on improving this have been designed. Little is known on their content, effectiveness, or theoretical basis. The aim of the proposed systematic review is to synthesize the literature on self-management interventions to improve skin care in people with a SCI. Specific objectives are to describe these interventions in relation to their content, effectiveness, theory base, and adherence to reporting guidelines for intervention description. METHODS The search strategy will combine an electronic search of nine bibliographic databases (MEDLINE, Embase, PsycInfo, CENTRAL, CINAHL, Rehabdata, CIRRIE, PEDro, ERIC) and two trial registers with a manual search of relevant reference lists. Predefined eligibility criteria will be applied in a two-phase selection process involving title and abstract screening, followed by full-text screening. A data extraction spreadsheet will be applied to included papers. Intervention content will be coded using two taxonomies (behaviour change taxonomy; PRISMS self-management support taxonomy). A validated tool (Theory Coding Scheme) and the Template for Intervention Description and Replication (TIDieR) will be used to examine theoretical basis and assess adherence to reporting guidelines for intervention description. A small number of heterogeneous studies are likely to be included in this review therefore a narrative synthesis is planned. DISCUSSION This systematic review will help identify the gaps and priorities to guide future research activities in this area. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42016033191.
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Wells M, King E, Toft K, MacAulay F, Patterson J, Dougall N, Hulbert-Williams N, Boa S, Slaven E, Cowie J, McGarva J, Niblock PG, Philp J, Roe J. Development and feasibility of a Swallowing intervention Package (SiP) for patients receiving radiotherapy treatment for head and neck cancer-the SiP study protocol. Pilot Feasibility Stud 2016; 2:40. [PMID: 27965858 PMCID: PMC5153906 DOI: 10.1186/s40814-016-0079-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 07/07/2016] [Indexed: 01/27/2023] Open
Abstract
Background Head and neck cancer (HNC) is the sixth most common cancer worldwide, and the functional, psychological and social consequences of HNC cancer and its treatment can be severe and chronic. Dysphagia (swallowing problems) affects up to two thirds of patients undergoing combined chemoradiotherapy. Recent reviews suggest that prophylactic swallowing exercises may improve a range of short- and long-term outcomes; however, the importance of psychological and behavioural factors on adherence to swallowing exercises has not been adequately studied. This study aims to develop and test the feasibility of a Swallowing intervention Package (SiP) designed in partnership with patients, speech and language therapists (SLTs) and other members of the head and neck multi-disciplinary team (MDT), for patients undergoing chemoradiotherapy (CRT) or radiotherapy (RT) for head and neck cancer. Methods/design This feasibility study uses quantitative and qualitative research methods, within a quasi-experimental design, to assess whether patients will tolerate and adhere to the SiP intervention, which aspects of the intervention can be implemented and which cannot, whether treatment fidelity can be achieved across different contexts, whether study processes and outcome measures will be feasible and acceptable and to what extent the intervention is likely to have an impact on swallowing dysfunction and quality of life. Patients are being recruited from five sites in Scotland and England (three interventions and two usual care). The SLT based in the relevant intervention centre teaches the exercise programme and provides supporting materials. A combination of patient-reported outcome measures (PROMs), adherence measures and clinical swallowing assessments are used prior to intervention (baseline), at the end of treatment, 3 and 6 months post-treatment. Discussion This collaborative study has taken a unique approach to the development of a patient-centred and evidence-based swallowing intervention. The introduction of an e-SiP app provides an exploration of the use of technology in delivering this intervention. The study provides an opportunity to examine the feasibility of delivering and participating in a supported swallowing intervention across several different NHS sites and will provide the evidence needed to refine intervention and study processes for a future trial. Trial registration NCRI portfolio, 18192 & 20259
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Affiliation(s)
- Mary Wells
- NMAHP Research Unit, University of Stirling, Stirling, UK
| | - Emma King
- NMAHP Research Unit, University of Stirling, Stirling, UK
| | | | | | | | - Nadine Dougall
- NMAHP Research Unit, University of Stirling, Stirling, UK
| | | | | | | | - Julie Cowie
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | | | | | | | - Justin Roe
- The Royal Marsden NHS Foundation Trust, London, UK
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Jovicic A, Gardner B, Belk C, Kharicha K, Iliffe S, Manthorpe J, Goodman C, Drennan V, Walters K. Identifying the content of home-based health behaviour change interventions for frail older people: a systematic review protocol. Syst Rev 2015; 4:151. [PMID: 26538082 PMCID: PMC4634580 DOI: 10.1186/s13643-015-0138-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 10/19/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Meeting the needs of the growing number of older people is a challenge for health and social care services. Home-based interventions aiming to modify health-related behaviours of frail older people have the potential to improve functioning and well-being. Previous reviews have focused on whether such interventions are effective, rather than what might make them effective. Recent advances in behavioural science make possible the identification of potential 'active ingredients' of effective interventions, such as component behaviour change techniques (BCTs), and intended intervention functions (IFs; e.g. to educate, to impart skills). This paper reports a protocol for a systematic review that seeks to (a) identify health behaviour change interventions for older frail people, (b) describe the content of these interventions, and (c) explore links between intervention content and effectiveness. The protocol is reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) 2015 guidelines. METHODS/DESIGN Studies will be identified through a systematic search of 15 electronic databases, supplemented by citation tracking. Studies will be retained for review where they report randomised controlled trials focusing on home-based health promotion delivered by a health professional for frail older people in community settings, written in English, and either published from 1980 onwards, or, for registered trials only, unpublished but completed with results obtainable from authors. Interventions will be coded for their content (BCTs, IFs) and for evidence of effectiveness (outcome data relating to behavioural and health outcomes). Analyses will describe characteristics of all interventions. Interventions for which effectiveness data are available will be categorised into those showing evidence of effectiveness versus those showing no such evidence. The potential for each intervention characteristic to contribute to change in behaviour or health outcomes will be estimated by calculating the percentage of all interventions featuring those characteristics that have shown effectiveness. DISCUSSION Results will reveal the strategies that have been drawn on within home-based interventions to modify the health behaviours of frail older people, and highlight those more associated with positive changes in behaviour and health. Findings from this review will provide a useful basis for understanding, developing, and implementing behaviour change interventions in this field. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42014010370.
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Affiliation(s)
- Ana Jovicic
- Department of Primary Care and Population Health, University College London, Royal Free Hospital, Rowland Hill Street, London, NW3 2PF, UK.
| | - Benjamin Gardner
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK. .,UCL Centre for Behaviour Change, University College London, London, UK.
| | - Celia Belk
- Department of Primary Care and Population Health, University College London, Royal Free Hospital, Rowland Hill Street, London, NW3 2PF, UK.
| | - Kalpa Kharicha
- Department of Primary Care and Population Health, University College London, Royal Free Hospital, Rowland Hill Street, London, NW3 2PF, UK.
| | - Steve Iliffe
- Department of Primary Care and Population Health, University College London, Royal Free Hospital, Rowland Hill Street, London, NW3 2PF, UK.
| | - Jill Manthorpe
- Social Care Workforce Research Unit, King's College London, London, UK.
| | - Claire Goodman
- Centre for Research in Primary and Community Care, University of Hertfordshire, Hertfordshire, UK.
| | - Vari Drennan
- Centre for Health and Social Care Research, St George's, University of London, London, UK.
| | - Kate Walters
- Department of Primary Care and Population Health, University College London, Royal Free Hospital, Rowland Hill Street, London, NW3 2PF, UK.
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