Combining methods to conduct a systematic review and propose a conceptual and theoretical framework in socio-environmental research

This study aims to present a combination of methods and propose robust theoretical and conceptual frameworks for solving socio-environmental issues. This proposal included the Problem, Intervention, Context, and Outcome (PICO) framework and Protocol and Reporting result with Search, Appraisal, Synthesis, and Analysis framework, and develop (PSALSAR) method through SODIP steps: (i) Systematic review and meta-analysis defining the study from guiding questions; (ii) Open-source related to software and data; (iii) Data visualization and design information; (iv) Identification of gaps, challenges and trends through automation and lexicometric analysis; and (v) Proposal of theoretical and conceptual frameworks. This proposal defines the steps as support to combine and systematize information necessary to facilitate the production of this type of document using open-access software in the visualization and design of information. All these steps are replicable and essential to propose a conceptual and theoretical framework to contribute to the construction of knowledge in socio-environmental research and to propose solutions by filling in the gaps. In summary, this combination of methods shows:•The use of SODIP steps provides robustness and efficiency in carrying out review studies, facilitating the way to propose theoretical or conceptual frameworks.•Choosing to use open-source tools is essential for better evaluation and visualization of qualitative and quantitative data in review studies.•The combination of methods and data in the systematic review (scientific, political documents. and databases) supports the proposal of robust theoretical and conceptual frameworks.

Exploring vehicle-centric strategies for sustainable urban mobility: A theoretical framework for saving energy and reducing noise in transportation

Adopting energy-saving and noise-reducing technologies in vehicle transportation has the potential to mitigate urban traffic pollution and promote sustainable urban mobility. However, a universal analytical framework for obtaining the combined energy savings and noise reduction patterns in vehicles is still lacking. This study addresses this gap by integrating a fundamental traffic noise model with a vehicle energy conservation equation. A theoretical framework was constructed that establishes the relationship between vehicle noise and energy consumption, with the theoretical origins of this framework explained. By summarizing a substantial body of classical literature, the typical model's properties are analyzed through the principle of optimality, and the noise interval for combined vehicle energy-saving and noise-reducing is determined. Subsequently, a rigorous vehicle experiment was conducted to validate the proposed framework's effectiveness, utilizing synchronized data on energy consumption and noise. The findings indicate that vehicles can achieve unconstrained combined energy-saving and noise-reducing in four driving states and conditional combined energy-saving and noise-reducing in five driving states. The Recall index demonstrates a verification rate exceeding 0.62 for the combined energy-saving and noise-reducing rules. This research provides valuable insights to support energy-saving and noise-reducing measures in urban traffic.

Application of behavioural theories, models, and frameworks in pharmacy practice research based on published evidence: a scoping review

BACKGROUND

Pharmacy practice research often focuses on the design, implementation and evaluation of pharmacy services and interventions. The use of behavioural theory in intervention research allows understanding of interventions' mechanisms of action and are more likely to result in effective and sustained interventions.

AIM

To collate, summarise and categorise the reported behavioural frameworks, models and theories used in pharmacy practice research.

METHOD

PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science and EBSCO (CINAHL PLUS, British Education index, ERIC) were systematically searched to capture all pharmacy practice articles that had reported the use of behavioural frameworks, theories, or models since inception of the database. Results were filtered to include articles published in English in pharmacy practice journals. Full-text screening and data extraction were independently performed by two reviewers. A narrative synthesis of the data was adopted. Studies were reviewed for alignment to the UK Medical Research Council (MRC) framework to identify in which phase(s) of the research that the theory/model/framework had been employed.

RESULTS

Fifty articles met the inclusion criteria; a trend indicating an increasing frequency of behavioural theory/frameworks/models within pharmacy practice research was identified; the most frequently reported were Theory of Planned Behaviour and Theoretical Domains Framework. Few studies provided explicit and comprehensive justification for adopting a specific theory/model/framework and description of how it underpinned the research was lacking. The majority were investigations exploring determinants of behaviours, or facilitators and barriers to implementing or delivering a wide range of pharmacy services and initiatives within a variety of clinical settings (aligned to Phase 1 UK MRC framework).

CONCLUSION

This review serves as a useful resource for future researchers to inform their investigations. Greater emphasis to adopt a systematic approach in the reporting of the use of behavioural theories/models/frameworks will benefit pharmacy practice research and will support researchers in utilizing behavioural theories/models/framework in aspects of pharmacy practice research beyond intervention development.

Driving technology factors of carbon emissions: Theoretical framework and its policy implications for China

Empirical studies have widely examined the driving factors and methods to achieve a carbon peak; however, they seldom construct a theoretical framework and ignore the potential heterogeneity in technology. The most notable controversy is technology's different roles in carbon emissions. This study proposes an integrated theoretical framework considering the evolution of carbon emissions and presents the conditions for achieving a carbon peak. This framework shows that if the positive role of eco-friendly technology in decreasing carbon emissions is larger than the negative role of production-oriented technology in increasing carbon emissions; thus, carbon emissions do not increase (i.e. carbon peak). Additionally, this framework addresses the controversy concerning the effect of technology on carbon emissions. Our empirical results from a city-level panel dataset show that China is still moving towards achieving carbon emission reduction. Analysis of the driving mechanism reveals that production-oriented technology increases carbon emissions by increasing the production scale, consequently demanding more energy and emitting more carbon dioxide.

On the Proper Treatment of Dynamics in Cognitive Science

This essay examines the relevance of dynamical ideas for cognitive science. On its own, the mere mathematical idea of a dynamical system is too weak to serve as a scientific theory of anything, and dynamical approaches within cognitive science are too rich and varied to be subsumed under a single "dynamical hypothesis." Instead, after first attempting to dissect the different notions of "dynamics" and "cognition" at play, a more specific theoretical framework for cognitive science broadly construed is sketched. This framework draws upon not only dynamical ideas, but also such contemporaneous perspectives as situatedness, embodiment, ecological psychology, enaction, neuroethology/neuroscience, artificial life, and biogenic approaches. The paper ends with some methodological suggestions for pursuing this theoretical framework.

Weaving First Nations, Inuit, and Métis principles and values into health research processes

OBJECTIVES

In the Spring of 2021, a research team from the Dalla Lana School of Public Health completed environmental scans on nine key health-related topics to develop an anti-Indigenous racism strategy for health systems in Toronto, Ontario, Canada. To ensure we (Indigenous and non-Indigenous researchers) were respecting First Nations, Inuit, and Métis peoples, cultures, worldviews, and research methods, we weaved three frameworks of Indigenous values and principles together to create a conceptual foundation for undertaking the environmental scans.

STUDY DESIGN AND SETTING

In discussions with First Nations Elders, Métis Senators, and our research team, we chose the Seven Grandfather Teachings (Anishinaabe, a specific First Nation's life values), Inuit Qaujimajatuqangit (Inuit societal values), and the Métis Principles of Research. Further discussions provided insights for each of these guiding principles used in research projects with Indigenous peoples.

RESULTS

Through this research, we created a weaved framework reflecting the three distinct Indigenous cultures in Canada; First Nations, Métis, and Inuit.

CONCLUSION

The Weaved Indigenous Framework for Research was created for researchers to use as a guiding document as they embark upon health research with Indigenous communities. Inclusive, culturally responsive research frameworks are needed within Indigenous health research to ensure each culture can be respected and honored.

A review and analysis of the business model innovation literature

Business model innovation (BMI) is an emerging field that has attracted much attention from scholars and practitioners. However, the literature on BMI is fragmented and inconsistent, lacking a comprehensive and systematic framework. This study aims to fill this gap by conducting a literature review of 272 peer-reviewed articles on BMI published between 2010 and 2022. We analyze the articles based on six dimensions: antecedents, processes, types, barriers, outcomes, and moderators/mediators of BMI. We synthesize the findings and propose an integrated theoretical model that captures the complex relationships among these dimensions. We also identify several research gaps and directions for future studies. This study contributes to the BMI literature by providing a clearer understanding of this phenomenon and offering practical guidance for various types of businesses.

A Framework for Understanding Maternal Immunity

This is an alternative and controversial framing of the data relevant to maternal immunity. It argues for a departure from classical theory to view, interrogate and interpret existing data.

Advance care planning among African Americans: A review and synthesis of theory application

OBJECTIVES

Theoretical and conceptual frameworks are often underutilized in research, which may diminish understanding of the phenomena and contribute to the under-development of interventions. The topic of low/disparate rates of Advance Care Planning (ACP) among African Americans has been researched extensively; however, the use of theoretical and/or conceptual frameworks has not been reported. The purpose of this review is to describe theoretical and/or conceptual frameworks utilized in studies that investigated factors affecting perceptions of ACP or ACP rates among African Americans.

METHODS

Utilizing a narrative, literature review process, themes were generated, applied, and described with frequencies across broad categories of study characteristics, framework categories and key constructs, mode of framework application, and quality of framework reporting.

RESULTS

Four main types of frameworks were found with behavioral frameworks dominating the collection of studies. Complex, systems theoretical frameworks were less common. Framework use and reporting quality findings are described.

SIGNIFICANCE OF RESULTS

The problem of disparate rates of ACP among African Americans is nuanced and varied, stemming from both internal (e.g., personal, behavioral) and external factors (e.g., living conditions). While important and necessary to focus on internal, psychological factors, it is also vital to incorporate systems' theories such as the Cumulative Disadvantage Theory to better understand and demonstrate inherent complexities. Recommendations for framework use are discussed for research and clinical application. Incorporating complexity science approaches and multi-systems theories may support multi-level modeling needed to understand this problem and reduce ACP disparities in this population.

Improving the visibility and description of theory in qualitative research: The QUANTUM typology

The relationship between theory and qualitative research has been much debated. In 2014, based on an analysis of qualitative studies, we published a five-point typology on the levels of visibility expounded in such studies. The typology captured a range of theoretical visibility - from seemingly absent to consistently applied. In 2020, we undertook a project to critique and revise the typology, guided by the ADAPT-ITT framework. ADAPT-ITT was developed originally to inform the adaptation of evidence-based interventions to new geographic regions, cultural contexts or populations related to HIV. It has subsequently evolved as a helpful framework in a number of health and social fields. The ADAPT-ITT framework provides a systematic, stepwise process that allows existing interventions to be adapted, rather than creating new interventions unnecessarily. The use of ADAPT-ITT to guide the adaptation of a methodological framework (as opposed to a health intervention) is novel and we used it flexibly, as reported in this article. Core to this process was the engagement of 14 international qualitative research experts, drawn mainly from health and social science disciplines. The outcome was a revised typology, presented in this article. We offer this as a reflexive aide for the conduct and reporting of qualitative research.

Facilitators, barriers and strategies for health-system guidance implementation: a critical interpretive synthesis protocol

Background

As systematically developed statements regarding possible courses of action, health system guidance (HSG) can assist with making decisions about addressing problems or achieving goals in health systems. However, there are conceptual and methodological challenges in HSG implementation due to the complexity of health-system policy-making, the diversity of available evidence and vast differences in contexts. To address these gaps, we aim to develop a theoretical framework for supporting HSG implementation as part of a broader effort to promote evidence-informed policy-making in health systems.

Methods

To develop a theoretical framework about facilitators, barriers and strategies for HSG implementation, we will apply a critical interpretive synthesis (CIS) approach to synthesize the findings from a range of relevant literature. We will search 11 electronic databases and seven organizational websites to identify relevant published and grey literature. We will check the references of included studies and contact experts to identify additional eligible papers. Finally, we will conduct purposively sampling of the literature to fill any identified conceptual gaps. We will use relevance and five quality criteria to assess included papers. A standardized form will be developed for extracting information. We will use an interpretive analytic approach to synthesize the findings, including a constant comparative method throughout the analysis. Two independent reviewers will conduct the literature screening and relevance assessment, and disagreements will be resolved through discussion. The principal investigator will conduct data extraction and synthesis, and a second reviewer will check the sample of extracted data for consistency and accuracy.

Discussion

A new theoretical framework about facilitators, barriers and strategies for HSG implementation will be developed using a CIS approach. The HSG implementation framework could be widely used for supporting the implementation of HSG covering varied topics and in different contexts (including low-, middle- and high-income countries). In later work, we will develop a tool for supporting HSG implementation based on the theoretical framework.

Registration PROSPERO CRD42020214072. Date of Registration: 14 December 2020.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12961-022-00908-0.

Adapting routines in schools when facing challenging situations: Extending previous theories on routines by considering theories on self-regulated and collectively regulated learning

Routines play a major role in educational change in schools. But what happens if the routines performed by school staff fail to deal successfully with current challenges? What strategies aid adaptation of the routines in a specific situation? Up to now, there exists no comprehensive concept for understanding why and at what points the adapting of routines in schools in a specific situation takes a favorable or unfavorable direction. To address this gap, we propose extending theories on routines by considering theories on self-regulated and collectively regulated learning. We consider these theories to be a beneficial complement because of their broad theoretical, methodological, and empirical research base. We argue that these theories enhance the understanding of adapting routines to specific challenging situations in schools. We present a newly developed theoretical framework for dealing with specific challenging situations in schools as an interplay between routines and regulation processes. Finally, important research questions regarding the suggested approach are discussed.

Development of a theory-informed questionnaire to assess the acceptability of healthcare interventions

Background

The theoretical framework of acceptability (TFA) was developed in response to recommendations that acceptability should be assessed in the design, evaluation and implementation phases of healthcare interventions. The TFA consists of seven component constructs (affective attitude, burden, ethicality, intervention coherence, opportunity costs, perceived effectiveness, and self-efficacy) that can help to identify characteristics of interventions that may be improved. The aim of this study was to develop a generic TFA questionnaire that can be adapted to assess acceptability of any healthcare intervention.

Methods

Two intervention-specific acceptability questionnaires based on the TFA were developed using a 5-step pre-validation method for developing patient-reported outcome instruments: 1) item generation; 2) item de-duplication; 3) item reduction and creation; 4) assessment of discriminant content validity against a pre-specified framework (TFA); 5) feedback from key stakeholders.

Next, a generic TFA-based questionnaire was developed and applied to assess prospective and retrospective acceptability of the COVID-19 vaccine. A think-aloud method was employed with two samples: 10 participants who self-reported intention to have the COVID-19 vaccine, and 10 participants who self-reported receiving a first dose of the vaccine.

Results

1) The item pool contained 138 items, identified from primary papers included in an overview of reviews. 2) There were no duplicate items. 3) 107 items were discarded; 35 new items were created to maximise coverage of the seven TFA constructs. 4) 33 items met criteria for discriminant content validity and were reduced to two intervention-specific acceptability questionnaires, each with eight items. 5) Feedback from key stakeholders resulted in refinement of item wording, which was then adapted to develop a generic TFA-based questionnaire.

For prospective and retrospective versions of the questionnaire, no participants identified problems with understanding and answering items reflecting four TFA constructs: affective attitude, burden, perceived effectiveness, opportunity costs. Some participants encountered problems with items reflecting three constructs: ethicality, intervention coherence, self-efficacy.

Conclusions

A generic questionnaire for assessing intervention acceptability from the perspectives of intervention recipients was developed using methods for creating participant-reported outcome measures, informed by theory, previous research, and stakeholder input. The questionnaire provides researchers with an adaptable tool to measure acceptability across a range of healthcare interventions.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-022-07577-3.

Selecting a theoretical framework to guide research on the COVID-19 pandemic impacts on nursing care delivery and the critical care work system (using Reed's Intermodern approach to theory critique)

Understanding the impact of COVID-19 on nursing care delivery in critical care work systems is urgently needed. Theoretical frameworks guide understanding of phenomena in research. In this paper, we critique four theoretical frameworks (Donabedian's Quality Model, the Quality Health Outcomes Model, the Systems Research Organizing Model, and the Systems Engineering (SEIPS) 2.0 Model) using Reed's (2018) Intermodern philosophical perspective of nursing science. Reed's (2018) Intermodern approach to theory critique was selected for its pragmatic perspective and focus on personal and professional health and wellbeing. The SEIPS 2.0 Model was ultimately selected to guide the study of the impact of the COVID-19 Pandemic on nursing care delivery in the critical care work systems.

An Integrated Conceptual Framework of Behavioral Intervention Technologies to Promote Healthcare Utilization Among Socially-Marginalized Populations in the United States

In the U.S., socially marginalized groups disproportionately shoulder the burden of health outcomes. The evolving development of behavioral intervention technologies provides opportunities to support users in changing behaviors and improving health. No conceptual model is available to guide technology-based behavioral interventions among vulnerable groups in the new era of digitalization. Our conceptual framework combines the Behavioral Model of Healthcare Utilization (HCU) for Vulnerable Populations and the Integrated Model of Behavioral Prediction (IMBP). With the Socioecological Model leading the vertical direction, the overarching HCU-IBMP model is incorporated by the Behavioral Intervention Technology-Technological Instantiation Framework (BIT-Tech). The HCU model explains how vulnerable populations influence healthcare access and utilization behaviors by personal and contextual factors. Through the lens of the IMBP, healthcare utilization intention is highly predictable and maybe even causally correlated with the corresponding behavior. To assist the healthcare utilization intention translates into the corresponding behaviors, we employ a medium using the technological implementation in a system that can assist the end-users in adopting the desired behavior. With the integrated model that combines a technological framework with the behavioral components, the BIT-Tech guides the procedure intervention development. Our integrated conceptual framework indicated that theoretical and technical components should be considered during a technological tool development to support the research community. A real-world intervention design has been demonstrated using the framework to guide behavioral intervention technologies to promote PrEP care and utilization among racial/ethnic minority women in the U.S.

Applying World Dental Federation Theoretical Framework for Oral Health in a General Population

INTRODUCTION

The World Dental Federation (FDI) has recently proposed a new definition and theoretical framework of oral health. The theoretical framework includes 4 main components and describes the relationships amongst them. In 2020, an international work group proposed the minimum Adult Oral Health Standard Set (AOHSS) of variables to measure oral health, which was mapped onto the FDI's theoretical framework. By using an empirical data set, the proposed variables in the AOHSS and the potential interactions amongst the components of the FDI's theoretical framework can be tested. The purpose of this research was to investigate structural relations of the components of the FDI's theoretical framework of oral health based on data from a general adult population.

METHODS

Data from a previously conducted Swedish cross-sectional study focusing on oral health were utilised (N = 630; women, 55.2%; mean age, 49.7 years [SD, 19.2]). Variable selection was guided by the AOHSS. Structural equation modeling was used to analyse relationships amongst the components of the FDI's theoretical model (core elements of oral health, driving determinants, moderating factors, and overall health and well-being).

RESULTS

The Oral Health Impact Profile (OHIP)-14, xerostomia, and aesthetic satisfaction had statistically significant direct effects on overall health and well-being (p < .05). Driving determinants and moderating factors had statistically significant direct effects on all core elements of oral health (p < .05) except aesthetic satisfaction (p = .616). The predictors explained 24.1% of the variance of the latent variable overall health and well-being. Based on several indices, the proposed model showed acceptable model fit.

CONCLUSIONS

The FDI's theoretical framework can be used to describe different components of oral health and the relationship amongst them in an adult general population. Further research based on the FDI's theoretical framework in other populations and settings is needed to explore complex interactions and possible relationships that form oral health and to investigate other or additional important social determinants.

Application of theoretical frameworks on human papillomavirus vaccine interventions in the United States: systematic review and meta-analysis

PURPOSE

Theoretical frameworks are useful tools to explain the dynamics of behavioral change, develop, and implement intervention studies. The purpose of this systematic review and meta-analysis is to evaluate the application of theoretical frameworks and models to HPV vaccination intervention studies in the United States (US) from January 2006 to December 2019.

METHODS

A comprehensive search across databases, including PubMed, EMBASE, ERIC, CINAHL, Academic Search Complete, Scopus, Web of Science, and PsycINFO, was conducted. Articles were included in the systematic analysis if at least one theory was used to develop the intervention phase. All intervention studies targeting populations in the US without restrictions of age, income, sex, and ethnicity were included. Articles were included in the meta-analysis if vaccine uptake and/or vaccine completion was addressed.

RESULTS

The Health Belief Model, Motivational Interviewing, Theory of Planned Behavior, and Information-Motivation-Behavioral Skills were the most used theories. Based on theory integrity, theory rationale, and theory operationalization, most of the studies (60%) were rated high for the application of the theoretical frameworks. Our results suggest a preference for theoretical frameworks targeting individual change rather than community change and the existence of gender disparities in the application of theoretical frameworks. The association between theory and increase of likelihood in vaccine uptake and completion was not supported.

CONCLUSION

This review spotlights common issues in the application of theoretical frameworks in HPV vaccine interventions in the US. Our results suggest we are still in a developmental phase on several aspects of theory application to HPV vaccination.

Introducing Teachable Moments Matters

The Teachable Moments Matter (TMM) category of articles is designed to offer readers insight into a methodological issue identified within a companion article. Written in collaboration with one of the companion article authors, these articles provide an opportunity to focus on a challenge experienced by the authors and, in the process, provide one or more perspectives as to how to successfully navigate this issue. The Journal hopes this case-based approach will help to highlight an issue nuance in context, something that might get "lost" in the entirety of a full-length article.

Utilising an access to care integrated framework to explore the perceptions of hepatitis C treatment of hospital-based interventions among people who use drugs

BACKGROUND

Gaps remain in the hepatitis C virus (HCV) care cascade for people who use drugs (PWUD). Acute medical or surgical illnesses requiring hospitalisation are an opportunity to address addiction, but how inpatient strategies could affect HCV care accessibility for PWUD remains unknown. We explored patient perspectives of hospital-based interventions using an integrated framework of access to HCV care.

METHODS

We conducted a qualitative study of hospitalised adults (n=27) with HCV and addiction admitted to an urban academic medical centre in the United States between June and November 2019. Individual interviews were audio-recorded, transcribed, and dual-coded. We analysed data with coding specific for hospital-based interventions including screening, conducting HCV-related laboratory work-up, starting treatment, connecting with peers, and coordinating outpatient care. We analysed coded data at the semantic level for emergent themes using a framework approach based off an integrated framework of access to HCV care.

RESULTS

The majority of participants primarily used opioids (78%), were white (85%) and men (67%). Participants frequently reported HCV screening during previous hospitalisation with rare inpatient connection to HCV-related services. Participants expressed willingness to discuss HCV treatment candidacy during hospitalisation; however, lack of inpatient conversations led to perception that "nothing could be done" during admission. Participants expressed interest in completing inpatient HCV work-up to "get the ball rollin'" - consolidating care would enhance outpatient service permeability by reducing barriers. Others resisted HCV care coordination, preferring to focus on "immediate" issues including health conditions and addiction treatment. Participants also expressed openness to engaging with peers about HCV, noting shared drug use experience as critical to a peer relationship when discussing HCV.

CONCLUSION

Hospitalised PWUD have varied priorities, necessitating adaptable interventions for addressing HCV. Hospitalisation can be an opportunity to address HCV access to care including identification of treatment eligibility, consolidation of care, and facilitation of HCV-related referrals.

A review of theories and models applied in studies of social media addiction and implications for future research

With the increasing use of social media, the addictive use of this new technology also grows. Previous studies found that addictive social media use is associated with negative consequences such as reduced productivity, unhealthy social relationships, and reduced life-satisfaction. However, a holistic theoretical understanding of how social media addiction develops is still lacking, which impedes practical research that aims at designing educational and other intervention programs to prevent social media addiction. In this study, we reviewed 25 distinct theories/models that guided the research design of 55 empirical studies of social media addiction to identify theoretical perspectives and constructs that have been examined to explain the development of social media addiction. Limitations of the existing theoretical frameworks were identified, and future research areas are proposed.

Towards an interdisciplinary framework about intelligence

In recent years, advances in science, technology, and the way in which we view our world have led to an increasingly broad use of the term "intelligence". As we learn more about biological systems, we find more and more examples of complex and precise adaptive behavior in animals and plants. Similarly, as we build more complex computational systems, we recognize the emergence of highly sophisticated structures capable of solving increasingly complex problems. These behaviors show characteristics in common with the sort of complex behaviors and learning capabilities we find in humans, and therefore it is common to see them referred to as "intelligent". These analogies are problematic as the term intelligence is inextricably associated with human-like capabilities. While these issues have been discussed by leading researchers of AI and renowned psychologists and biologists highlighting the commonalities and differences between AI and biological intelligence, there have been few rigorous attempts to create an interdisciplinary approach to the modern problem of intelligence. This article proposes a comparative framework to discuss what we call "purposeful behavior", a characteristic shared by systems capable of gathering and processing information from their surroundings and modifying their actions in order to fulfill a series of implicit or explicit goals. Our aim is twofold: on the one hand, the term purposeful behavior allows us to describe the behavior of these systems without using the term "intelligence", avoiding the comparison with human capabilities. On the other hand, we hope that our framework encourages interdisciplinary discussion to help advance our understanding of the relationships among different systems and their capabilities.

Clinical and Self-Reported Measurements to Be Included in the Core Elements of the World Dental Federation's Theoretical Framework of Oral Health

INTRODUCTION

Oral health is part of general health, and oral diseases share risk factors with several non-communicable diseases. The World Dental Federation (FDI) has published a theoretical framework illustrating the complex interactions between the core elements of oral health (CEOHs): driving determinants, moderating factors, and general health and well-being. However, the framework does not specify which self-reported or clinical measurements to be included in the CEOHs.

OBJECTIVES

To explore oral health measurements relevant for a general adult population to be included in the CEOHs in the FDI's theoretical framework of oral health.

MATERIALS AND METHODS

A psychometric study was performed, using cross-sectional data from Sweden (N = 630, 54% women, mean age 49.7 years). The data set initially consisted of 186 self-reported and clinical measurements. To identify suitable measurements, the selection was discussed in different settings, including both experts and patients. Principal component analyses (PCAs) were performed to explore, reduce and evaluate measurements to be included in the three CEOHs. Internal consistency was estimated by Cronbach's Alpha.

RESULTS

The validation process yielded 13 measurements (four clinical, nine self-reported) in concordance with the CEOHs. PCAs confirmed robust validity regarding the construction, predicting 60.85% of variance, representing psychosocial function (number of measurements = 5), disease and condition status (number of measurements = 4), and physiological function (number of measurements = 4). Cronbach's Alpha indicated good to sufficient internal consistency for each component in the constructs (α = 0.88, 0.68, 0.61, respectively).

CONCLUSION

In a Swedish general adult population, 13 self-reported and clinical measurements can be relevant to include to operationalise CEOHs in the FDI's theoretical framework.

Leveraging theories in instructional design: a reflective response to OLSit framework

This paper is in response to the article entitled A Design Framework for Enhancing Engagement in Student-Centered Learning: Own It, Learn It, and Share (Lee and Hannafin in Educat Technol Res Develop 64(4):707-734, 2016). In this article, the authors proposed a theoretical framework to provide guidelines for promoting engagement in student-centered learning (SCL) based on relevant principles from different learning theories and empirical research findings. This framework connects learning theories with instructional design practices, providing theory-based instructional strategies and methods for improving student engagement in SCL. Challenges of applying this framework include customization issues, time, and resource constraints. More case examples of solving different instructional problems with this theoretical framework would help stakeholders understand how to use this framework in different contexts.

Four propositions on integrated sustainability: toward a theoretical framework to understand the environment, peace, and sustainability nexus

The sustainability agenda has evolved around a set of interconnected dilemmas regarding economic, social, and environmental goals. Progress has been made in establishing thresholds and targets that must be achieved to enable life to continue to thrive on the planet. However, much work remains to be done in articulating coherent theoretical frameworks that adequately describe the mechanisms through which sustainability outcomes are achieved. This paper reviews core concepts in the sustainability agenda to develop four propositions on integrated sustainability that collectively describe the underlying mechanisms of sustainable development. We then advance a framework for integrated sustainability and assess its viability through linear regression and principal components analysis of key selected indicators. The results provide preliminary evidence that countries with institutions that enable cooperation and regulate competition perform better in attaining integrated sustainability indicators. Our findings suggest that institutional design is important to sustainability outcomes and that further research into process-oriented mechanisms and institutional characteristics can yield substantial dividends in enabling effective sustainability policy.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s11625-021-00925-y.

Selecting a theoretical framework to explore the social and cognitive uncertainty that hepatitis C treatment represents for people who inject drugs

Emerging research models for hepatitis C eradication suggest a social network-based treatment approach among people who inject drugs. It is essential for nurses to critically examine the influence of these social networks among people who inject drugs and the impact on their hepatitis C treatment decisions. The purpose of this paper is to describe the process of selecting a theoretical framework to guide a mixed methods study exploring the perceived uncertainty of individual hepatitis C treatment behaviors existing within the social networks of people who inject drugs. Using Walker and Avant's framework for theory analysis, four established theories and models from nursing science and psychology were reviewed. Aspects of both the Social Cognitive Theory and Uncertainty in Illness Theory were combined to form a theoretical framework, the Socio-Cognitive Uncertainty Model. This new theoretical framework describes the social and cognitive uncertainty that hepatitis C virus treatment represents for people who inject drugs. Taken together, social influence and social selection can inform the nurse's understanding of hepatitis C treatment acceptability among this high-risk social network- an important consideration in the pursuit of disease eradication.

Review of Gait, Cognition, and Fall Risks with Implications for Fall Prevention in Older Adults with Dementia

BACKGROUND

Older people with cognitive impairment are at increased risk of falls; however, fall prevention strategies have limited success in this population. The aim of this paper is to review the literature to inform a theoretical framework for fall prevention in older adults with dementia.

SUMMARY

A narrative review was conducted on fall risk factors in people with cognitive impairment, the relationship between cognition and gait, and their joint impact on the risk of falls. This was used to develop a theoretical framework for fall prevention for people with dementia. Executive function and motor function are closely related as they share neuroanatomy. This close relationship has been confirmed by observational studies including neuroimaging and intervention studies. Executive function is the cognitive domain most commonly associated with gait dysfunction. Attention, sensory integration, and motor planning are the sub-domains of executive function associated with risk of falls through gait dysfunction, whereas cognitive flexibility, judgement, and inhibitory control affect risk of falls through risk-taking behaviour. Key Messages: Gait, cognition, and falls are closely related. The comorbidity and interaction between gait abnormality and cognitive impairment may underpin the high prevalence of falls in older adults with dementia. Gait assessment and cognitive assessment, particularly executive function, should be integrated in fall risk screening. Assessment results should be interpreted and utilised using a multidisciplinary approach; specific strategies such as customised gait training and behavioural modulation should be considered as part of falls prevention for people with dementia.

EPOCK study protocol: a mixed-methods research program evaluating cancer care coordination nursing occupations in France as a complex intervention

Background

Facing the increasing cancer incidence and cancer survivorship, many national strategic cancer plans have identified cancer care coordination as a priority for health service improvement. However, the high variability of practices, the diversity of definitions and underlying concepts increases the existing difficulty to standardise, replicate, transpose and assess care coordination within the French health system context. The EPOCK national study aims at evaluating practices and the working context of hospital-based cancer care coordination nurses, based on a previously designed reference framework for care coordination within the French health system context.

Methods

EPOCK is based on a comprehensive evaluation of nursing professions in cancer care coordination, considered as a complex intervention. Phase 1 (theoretical phase) will define and design a theoretical reference framework for care coordination in France through an international literature review, aiming to identify relevant models and all components of the expected framework and a structured consensus method, the Nominal group technique, aiming to select and prioritise the most relevant components already found in the literature review with regard to the French healthcare system; phase 2 (Operational phase) will consist in an in-depth analysis of practices, contexts, perceptions and attitudes related to care coordination occupations by nurses in oncology and all stakeholders (related professionals, patients and their caregivers) through a multicentric cross-sectional mixed-method evaluative study. The observed practices and contexts will be finally compared with the theoretical reference framework using both inductive and deductive approaches.

Discussion

This study will result in an evaluation framework identifying key models and key elements relative to cancer care coordination interventions that can be used to guide management of cancer care coordination nursing occupations within the French healthcare system. EPOCK would also assist in public decision-making to identify optimal targets, skills profiles and scope of actions for cancer coordination professions. Finally, EPOCK will describe typology of nurse practices in cancer care coordination and thus obtain precise preliminary information essential for drafting a medico-economic evaluation study of these new nursing professions’ impact.

Trial registration

Clinicaltrial.gov registration: NCT03350776, 11/22/2017.

Health care innovations across practice and academia: A theoretical framework

BACKGROUND

An innovation scholarly interest group used the Jobs to Be Done Theory from the business literature to provide insight into the solution-focused progress that nurses are trying to make in challenging situations.

PURPOSE

This article presents a theoretical framework for understanding the progress nurses are trying to make through health care innovations across both practice and academic environments.

METHOD

This was a qualitative descriptive study using directed content analysis. We used the Jobs to Be Done Theory to guide the development of the semistructured questionnaire and the interpretation of findings.

FINDINGS

A theoretical framework of nursing innovations was derived to summarize and visually display the pathways and linkages of challenges, innovations, and impact domains of nursing innovations. Situations and opportunities arise within the context of interconnectedness and can lead to health care innovations in care delivery, patient care interventions, role transitions, research and translational methods, communication and collaboration, technology and data, teaching methods, and processes to improve care.

DISCUSSION

This theoretical framework offers insight into the dynamic interactions of academic-practice partnerships for innovation. Workplace situations are interconnected and can result in needed innovations designed to impact care delivery.

Simulation Training in Medical Education-an Exploration Through Different Theoretical Lenses

Different theoretical frameworks offer specific, but separate, understandings of the same phenomenon. With the increasing use of simulation for training and assessment in medical education, it is vital to consider how different frameworks grant various insights into the pedagogical value of simulation. In this article, the author evaluated three exemplar theoretical frameworks, cultural-historical activity theory, cognitive load theory, and grounded theory, considering their ontological and epistemological stances, their limitations, and their application to simulation training. The greater understanding offered by this article will inform research design and interpretation of results, enabling a more theoretically poised construction of pedagogical techniques.

Systematic Review of the Relationship Between Autism Stigma and Informal Caregiver Mental Health

Families play a crucial role in determining the mental health of the autistic individual(s) they are caring for. However, the stigma associated with autism can impair caregiver health. To investigate this, empirical evidence pertaining to stigma’s impact on informal caregivers’ mental health was systematically reviewed. All twelve included studies (n = 1442 informal caregivers) consistently reported the impact of autism related stigma upon caregiver mental health to be significant, meaningful and complex. A new theoretical framework describing the relationship between stigma and caregiver mental health is constructed. Moderating variables include those both changeable through intervention (e.g. hopelessness, self-esteem, self-compassion) and not changeable (gender, culture, financial burden and time since diagnosis). Implications and recommendations for professionals, interventions and future research are proposed.

Conceptualising access in the direct-acting antiviral era: An integrated framework to inform research and practice in HCV care for people who inject drugs

As direct-acting antiviral (DAA) therapy costs fall and eligibility criteria are relaxed, people who inject drugs (PWID) will increasingly become eligible for HCV treatment. Yet eligibility does not necessarily equate to access. Amidst efforts to expand treatment uptake in this population, we seek to synthesise and clarify the conceptual underpinnings of access to health care for PWID, with a view to informing research and practice. Integrating dominant frameworks of health service utilisation, care seeking processes, and ecological perspectives on health promotion, we present a comprehensive theoretical framework to understand, investigate and intervene upon barriers and facilitators to HCV care for PWID. Built upon the concept of Candidacy, the framework describes access to care as a continually negotiated product of the alignment between individuals, health professionals, and health systems. Individuals must identify themselves as candidates for services and then work to stake this claim; health professionals serve as gatekeepers, adjudicating asserted candidacies within the context of localised operating conditions; and repeated interactions build experiential knowledge and patient-practitioner relationships, influencing identification and assertion of candidacy over time. These processes occur within a complex social ecology of interdependent individual, service, system, and policy factors, on which other established theories provide guidance. There is a pressing need for a deliberate and nuanced theory of health care access to complement efforts to document the HCV 'cascade of care' among PWID. We offer this framework as an organising device for observational research, intervention, and implementation science to expand access to HCV care in this vulnerable population. Using practical examples from the HCV literature, we demonstrate its utility for specifying research questions and intervention targets across multiple levels of influence; describing and testing plausible effect mechanisms; and identifying potential threats to validity or barriers to research translation.

Benner's model and Duchscher's theory: Providing the framework for understanding new graduate nurses' transition to practice

The transition to quality and safety in the new graduate registered nurses' practice remains problematic directly impacting patient outcomes. Effective mentoring during transition serves to enhance experiential learning, allowing the development and establishment of safe, quality nursing practice. Comprehensive understanding of the transition process, including the barriers and effective enablers to transition is the key to effective mentoring. A theoretical framework guided by Duchscher's Stages of Transition Theory and Transition Shock Model and Benner's From novice to expert model can facilitate such understanding. Nurse Theorists play an important part in shaping nurse education and practice and have provided nurse educators and leaders an understanding to shape skill acquisition and the transition process for new graduate registered nurses. The res ultantresearchmodels and theory of these influencial nurses are pertinent to transition of new graduate registered nurses. This paper outlines the theories of Duchscher and Benner and how their research formed the theoretical framework to facilitate the measurement, understanding and improvement of the safety and quality of nursing care and impact the future nursing workforce.

Preconception counselling for low health literate women: an exploration of determinants in the Netherlands

Background

Women from lower socioeconomic groups tend to be at greater risk of adverse perinatal outcomes, but are less likely to participate in preconception counselling compared to higher socioeconomic groups. This could be partly because of their limited skills to assess, understand and use health related information in ways that promote and maintain good health (health literacy skills). In this study we explored determinants of participation in preconception counselling among women with low health literacy in The Netherlands.

Methods

Potential determinants of participation in preconception counselling were derived from the literature, and mapped onto a theoretical framework, which was tested for perceived relevance and completeness in an expert review (n = 20). The framework was used to prepare face-to-face interviews with women with low health literacy and a wish to conceive (n = 139). In the interviews we explored preconception counselling awareness, knowledge, considerations, subjective norms, self-efficacy, attitude, and intention. Linear regression analyses were used to test associations with intention to participate in preconception counselling.

Results

Most women (75%) were unaware of the concept of preconception counselling and the provision of counselling, even if they lived in areas where written invitations had been disseminated. Common considerations for participation were: preparation for pregnancy; perceived lack of information; and problems in a previous pregnancy. Considerations not to participate were mostly related to perceived sufficient knowledge and perceived low risk of perinatal problems. Respondents generally had a positive attitude towards participation in preconception counselling for themselves, and 41% reported that they would participate in preconception counselling.

Conclusion

Women with low health literacy were generally unaware of the concept and provision of preconception counselling, but seemed to be interested in participation. Further research should investigate how to effectively reach and inform this group about preconception counselling. This knowledge is essential for evidence-based development of interventions to increase the accessibility and understanding of preconception counselling.

Electronic supplementary material

The online version of this article (10.1186/s12978-018-0617-1) contains supplementary material, which is available to authorized users.

CDSS-RM: a clinical decision support system reference model

Clinical Decision Support Systems (CDSS) provide aid in clinical decision making and therefore need to take into consideration human, data interactions, and cognitive functions of clinical decision makers. The objective of this paper is to introduce a high level reference model that is intended to be used as a foundation to design successful and contextually relevant CDSS systems. The paper begins by introducing the information flow, use, and sharing characteristics in a hospital setting, and then it outlines the referential context for the model, which are clinical decisions in a hospital setting. Important characteristics of the Clinical decision making process include: (i) Temporally ordered steps, each leading to new data, which in turn becomes useful for a new decision, (ii) Feedback loops where acquisition of new data improves certainty and generates new questions to examine, (iii) Combining different kinds of clinical data for decision making, (iv) Reusing the same data in two or more different decisions, and (v) Clinical decisions requiring human cognitive skills and knowledge, to process the available information. These characteristics form the foundation to delineate important considerations of Clinical Decision Support Systems design. The model includes six interacting and interconnected elements, which formulate the high-level reference model (CDSS-RM). These elements are introduced in the form of questions, as considerations, and are examined with the use of illustrated scenario-based and data-driven examples. The six elements /considerations of the reference model are: (i) Do CDSS mimic the cognitive process of clinical decision makers? (ii) Do CDSS provide recommendations with longitudinal insight? (iii) Is the model performance contextually realistic? (iv) Is the ‘Historical Decision’ bias taken into consideration in CDSS design? (v) Do CDSS integrate established clinical standards and protocols? (vi) Do CDSS utilize unstructured data? The CDSS-RM reference model can contribute to optimized design of modeling methodologies, in order to improve response of health systems to clinical decision-making challenges.

Determinants of choice of delivery place: Testing rational choice theory and habitus theory

OBJECTIVE

The current study uses two antipodal social science theories, the rational choice theory and the habitus theory, and applies these to describe how women choose between intraclinical (i.e., hospital-run birth clinics) and extraclinical (i.e., midwife-led birth centres or home births) delivery places.

DESIGN, SETTING, PARTICIPANTS, MEASUREMENTS

Data were collected in a cross-sectional questionnaire-based survey among 189 women. A list of 22 determinants, conceptualized to capture the two theoretical concepts, were rated on a 7-point Likert scale with 1 = unimportant to 7 = very important. The analytic method was structural equation modelling. A model was built, in which the rational choice theory and the habitus theory as latent variables predicted the choice of delivery place.

FINDINGS

With regards to the choice of delivery place, 89.3% of the women wanted an intraclinical and 10.7% an extraclinical delivery place at the time of their last child's birth. Significant differences between women with a choice of an intraclinical or extraclinical delivery place were found for 14 of the 22 determinants. In the structural equation model, rational choice theory determinants predicted a choice of intraclinical delivery and habitus theory determinants predicted a choice of extraclinical delivery.

KEY CONCLUSIONS

The two theories had diametrically opposed effects on the choice of delivery place. Women are more likely to decide on intraclinical delivery when arguments such as high medical standards, positive evaluations, or good advanced information are rated important. In contrast, women are more likely to decide on extraclinical delivery when factors such as family atmosphere during birth, friendliness of health care professionals, or consideration of the woman's interests are deemed important.

IMPLICATIONS FOR PRACTICE

A practical implication of our study is that intraclinical deliveries may be promoted by providing comprehensive information, data and facts on various delivery-related issues, while extraclinical deliveries may be fostered by healthcare professionals tailoring personal or social beliefs, attitudes and opinions. Our study advocates that legislation and policy- and decision-makers should support different delivery place options in order to accommodate the choices and preferences of different women. The study demonstrates the usefulness of theory for describing and explaining a complex decision-making process, here the choice of delivery place.

[Cognitive neuroscience of aging. Contributions and challenges]

The cognitive neuroscience of aging is a young discipline that has emerged as a result of the combination of: A) the theoretical and explanatory frameworks proposed by the cognitive psychology perspective throughout the second half of the twentieth century; B) the designs and methodological procedures arising from experimental psychology and the need to test the hypotheses proposed from the cognitive psychology perspective; C) the contributions of the computer sciences to the explanation of brain functions; and D) the development and use of neuroimaging techniques that have enabled the recording of brain activity in humans while tasks that test some cognitive process or function are performed. An analysis on the impact of research conducted from this perspective over the last 3decades has been carried out, including its shortcomings, as well as the potential directions and usefulness that will advantageously continue to drive this discipline in its description and explanation of the process es of cerebral and cognitive aging.

A theoretical framework for the interpretation of pharmacist workforce studies throughout the world: The labor supply curve

Despite geographic, financial, and cultural diversity, publications dealing with the pharmacist workforce throughout the world share common concerns and focus on similar topics. Their findings are presented in the literature in a seemingly unrelated way even though they are connected to one another as parts of a comprehensive theoretical structure. The purpose of this paper is to develop a theoretical model that relates some of the most salient topics addressed in the international literature on pharmacist workforce. The model is developed along two fundamental ideas. The first identifies the shape and location of the pharmacist's labor supply curve as the driving force behind all workforce decisions undertaken by pharmacists; the second argues that gender and age differences are two of the most important factors determining the shape and location of this supply curve. The paper then discusses movements along the curve attributed to changes in the wage rate, as well as displacements of the curve attributed to disparities in personal characteristics, investments in human capital, job-related preferences, opinions and perceptions, and institutional rigidities. The focus is on the individual pharmacist, not on groups of pharmacists or the profession as a whole. Works in multiple countries that address each topic are identified. Understanding these considerations is critical as employers' failure to accommodate pharmacists' preferences for work and leisure are associated with negative consequences not only for them but also for the healthcare system as a whole. Possible consequences include excessive job turnover, absenteeism, decreased institutional commitment, and lower quality of work.

Towards a theoretical model on medicines as a health need

Medicines are considered one of the main tools of western medicine to resolve health problems. Currently, medicines represent an important share of the countries' healthcare budget. In the Latin America region, access to essential medicines is still a challenge, although countries have established some measures in the last years in order to guarantee equitable access to medicines. A theoretical model is proposed for analysing the social, political, and economic factors that modulate the role of medicines as a health need and their influence on the accessibility and access to medicines. The model was built based on a narrative review about health needs, and followed the conceptual modelling methodology for theory-building. The theoretical model considers elements (stakeholders, policies) that modulate the perception towards medicines as a health need from two perspectives - health and market - at three levels: international, national and local levels. The perception towards medicines as a health need is described according to Bradshaw's categories: felt need, normative need, comparative need and expressed need. When those different categories applied to medicines coincide, the patients get access to the medicines they perceive as a need, but when the categories do not coincide, barriers to access to medicines are created. Our theoretical model, which holds a broader view about the access to medicines, emphasises how power structures, interests, interdependencies, values and principles of the stakeholders could influence the perception towards medicines as a health need and the access to medicines in Latin American countries.

Theoretical Implications of Gender, Power, and Sexual Scripts for HIV Prevention Programs Aimed at Young, Substance-Using African-American Women

HIV continues to be a major public health problem for African-American (AA) women, and the burden of new cases to our society is significant because each case is at risk of infecting others. Substance use worsens the risk of HIV transmission to AA women. We provide specific recommendations to move the concept of tailoring HIV prevention interventions for substance users forward by focusing on young, sexually active, substance-using AA women and applying a culturally relevant revision to existing theoretical frameworks to include the Sexual Script Theory and the Theory of Gender and Power. We encourage use of these theories to guide adaptation of interventions to demonstrate efficacy within this hard-to-reach population. Consistent use of theories designed to exploit powerlessness and sexual scripts as barriers to adoption of protective sexual behaviors has potential to permeate sexual and substance use networks among African-Americans. This recommendation is being made because this theoretical framework has not been used in HIV prevention interventions targeting young, sexually active, substance-using AA women.

The Step approach to Message Design and Testing (SatMDT): A conceptual framework to guide the development and evaluation of persuasive health messages

This paper provides an important and timely overview of a conceptual framework designed to assist with the development of message content, as well as the evaluation, of persuasive health messages. While an earlier version of this framework was presented in a prior publication by the authors in 2009, important refinements to the framework have seen it evolve in recent years, warranting the need for an updated review. This paper outlines the Step approach to Message Design and Testing (or SatMDT) in accordance with the theoretical evidence which underpins, as well as empirical evidence which demonstrates the relevance and feasibility of, each of the framework's steps. The development and testing of the framework have thus far been based exclusively within the road safety advertising context; however, the view expressed herein is that the framework may have broader appeal and application to the health persuasion context.

Evaluation of pedestrian safety at intersections: A theoretical framework based on pedestrian-vehicle interaction patterns

Pedestrians are the most vulnerable road users, and pedestrian safety has become a major research focus in recent years. Regarding the quality and quantity issues with collision data, conflict analysis using surrogate safety measures has become a useful method to study pedestrian safety. However, given the inequality between pedestrians and vehicles in encounters and the multiple interactions between pedestrians and vehicles, it is insufficient to simply use the same indicator(s) or the same way to aggregate indicators for all conditions. In addition, behavioral factors cannot be neglected. To better use information extracted from trajectories for safety evaluation and pay more attention on effects of behavioral factors, this paper develops a more sophisticated framework for pedestrian conflict analysis that takes pedestrian-vehicle interactions into consideration. A concept of three interaction patterns has been proposed for the first time, namely "hard interaction," "no interaction," and "soft-interaction." Interactions have been categorized under one of these patterns by analyzing profiles of speed and conflict indicators during the whole interactive processes. In this paper, a support vector machine (SVM) approach has been adopted to classify severity levels for a dataset including 1144 events extracted from three intersections in Shanghai, China, followed by an analysis of variable importance. The results revealed that different conflict indicators have different contributions to indicating the severity level under various interaction patterns. Therefore, it is recommended either to use specific conflict indicators or to use weighted indicator aggregation for each interaction pattern when evaluating pedestrian safety. The implementation has been carried out at the fourth crosswalk, and the results indicate that the proposed method can achieve a higher accuracy and better robustness than conventional methods. Furthermore, the method is helpful for better understanding underlying levels of safety from the behavioral perspective, which can also provide evidence for targeted traffic education on proper behaviors.

A review of mentorship measurement tools

OBJECTIVES

To review mentorship measurement tools in various fields to inform nursing educators on selection, application, and developing of mentoring instruments.

DESIGN

A literature review informed by PRISMA 2009 guidelines.

DATA SOURCES

Six databases: CINHAL, Medline, PsycINFO, Academic Search Premier, ERIC, Business premier resource.

REVIEW METHODS

Search terms and strategies used: mentor* N3 (behav* or skill? or role? or activit? or function* or relation*) and (scale or tool or instrument or questionnaire or inventory). The time limiter was set from January 1985 to June 2015. Extracted data were content of instruments, samples, psychometrics, theoretical framework, and utility. An integrative review method was used.

RESULTS

Twenty-eight papers linked to 22 scales were located, seven from business and industry, 11 from education, 3 from health science, and 1 focused on research mentoring. Mentorship measurement was pioneered by business with a universally accepted theoretical framework, i.e. career function and psychosocial function, and the trend of scale development is developing: from focusing on the positive side of mentorship shifting to negative mentoring experiences and challenges. Nursing educators mainly used instruments from business to assess mentorship among nursing teachers. In education and nursing, measurement has taken to a more specialised focus: researchers in different contexts have developed scales to measure different specific aspects of mentorship. Most tools show psychometric evidence of content homogeneity and construct validity but lack more comprehensive and advanced tests.

CONCLUSION

Mentorship is widely used and conceptualised differently in different fields and is less mature in nursing than in business. Measurement of mentorship is heading to a more specialised and comprehensive process. Business and education provided measurement tools to nursing educators to assess mentorship among staff, but a robust instrument to measure nursing students' mentorship is needed.

Use of theoretical and conceptual frameworks in qualitative research

AIM

To debate the definition and use of theoretical and conceptual frameworks in qualitative research.

BACKGROUND

There is a paucity of literature to help the novice researcher to understand what theoretical and conceptual frameworks are and how they should be used. This paper acknowledges the interchangeable usage of these terms and researchers' confusion about the differences between the two. It discusses how researchers have used theoretical and conceptual frameworks and the notion of conceptual models. Detail is given about how one researcher incorporated a conceptual framework throughout a research project, the purpose for doing so and how this led to a resultant conceptual model.

REVIEW METHODS

Concepts from Abbott (1988) and Witz ( 1992 ) were used to provide a framework for research involving two case study sites. The framework was used to determine research questions and give direction to interviews and discussions to focus the research.

DISCUSSION

Some research methods do not overtly use a theoretical framework or conceptual framework in their design, but this is implicit and underpins the method design, for example in grounded theory. Other qualitative methods use one or the other to frame the design of a research project or to explain the outcomes. An example is given of how a conceptual framework was used throughout a research project.

CONCLUSION

Theoretical and conceptual frameworks are terms that are regularly used in research but rarely explained. Textbooks should discuss what they are and how they can be used, so novice researchers understand how they can help with research design.

IMPLICATIONS FOR PRACTICE/RESEARCH

Theoretical and conceptual frameworks need to be more clearly understood by researchers and correct terminology used to ensure clarity for novice researchers.

Do lesbian women have a better body image? Comparisons with heterosexual women and model of lesbian-specific factors

Body dissatisfaction is prevalent among women but may be less common among lesbian women. Although research trends toward this conclusion when samples are well-matched and body mass index (BMI) is controlled for, many studies do not exhibit these characteristics. Furthermore, few studies have examined sociocultural contributors to group differences. I addressed limitations of past research with a large community sample of lesbian (n=479) and heterosexual (n=400) women. I contrasted the two sexual identity groups on several body dissatisfaction measures, and tested theoretically derived relationships between lesbian-specific cultural factors and body dissatisfaction. As predicted, lesbian women reported lower body dissatisfaction than did heterosexual women on three of four measures, and expressed a larger ideal body size. A structural equation model of lesbian-specific risk and protective factors for body dissatisfaction did not reveal significant relationships. This study represents a first attempt to model culturally specific influences on lesbian body image.

A theoretical framework to guide a study of patients' bowel symptoms and self-care strategies following sphincter-saving surgery for rectal cancer

A paucity of research is available on patients' bowel symptom experiences and self-care strategies following sphincter-saving surgery for rectal cancer. Most research undertaken to date on patients' bowel symptoms following surgery for rectal cancer has been largely atheoretical. The purpose of this paper is to describe the process of choosing a theoretical framework to guide a study of patients' bowel symptoms and self-care strategies following sphincter-saving surgery for rectal cancer. As a result of a thorough literature review, we determined that the Symptom Management Theory provided the most comprehensive framework to guide our research.

Loneliness in old age in Eastern and Western European societies: theoretical perspectives

Data from European countries participating in the Generations and Gender Surveys showed that mean loneliness scores of older adults are higher in Eastern than in Western European countries. Although co-residence is considered as one of the fundamental types of social integration, and although co-residence is more common in Eastern Europe, the mean loneliness scores of older co-resident adults in Eastern Europe are still very high. This article investigates mechanisms behind the puzzling between-country differences in social integration and loneliness. Firstly, the theoretical framework of loneliness is discussed starting from the individual's perspective using the deficit and the cognitive discrepancy approach and taking into account older adults' deprived living conditions. Secondly, mechanisms at the societal level are investigated: cultural norms, the demographical composition and differences in societal wealth and welfare. It is argued that an integrated theoretical model, as developed in this article, combining individual and societal level elements, is most relevant for understanding the puzzling reality around social integration and loneliness in country-comparative research. An illustration of the interplay of individual and societal factors in the emergence of loneliness is presented.