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Shaw L, Lawal HM, Briscoe S, Garside R, Thompson Coon J, Rogers M, Melendez‐Torres GJ. Patient, carer and family experiences of seeking redress and reconciliation following a life-changing event: Systematic review of qualitative evidence. Health Expect 2023; 26:2127-2150. [PMID: 37452516 PMCID: PMC10632635 DOI: 10.1111/hex.13820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 06/30/2023] [Accepted: 07/01/2023] [Indexed: 07/18/2023] Open
Abstract
INTRODUCTION We conducted a systematic review of qualitative evidence to improve understanding of the processes and outcomes of redress and reconciliation following a life-changing event from the perspectives of individuals experiencing the event and their families. METHODS We searched six bibliographic databases for primary qualitative evidence exploring the views of individuals who have experienced a life-changing event, and/or their family or carers, of redress or reconciliation processes. This was supplemented with targeted database searches, forward and backward citation chasing and searches of Google Scholar and relevant websites. Title and abstract and full-text screening were undertaken independently by two reviewers. Data extraction and quality appraisal were conducted by one reviewer and checked by a second. We used a best-fit framework synthesis approach, drawing upon procedural and restorative justice concepts. FINDINGS Fifty-three studies (61 papers) were eligible for inclusion. Forty-one studies (47 papers) were included in the synthesis, from which we identified four themes. Three themes 'Transparency', 'Person-centered' and 'Trustworthy' represent the procedural elements required to support a fair and objective process. The fourth, 'Restorative justice' encapsulates how a fair process feels to those who have experienced a life-changing event. This theme highlights the importance of an empathic relationship between the different parties involved in the redress-reconciliation process and the significance of being able to engage in meaningful action. CONCLUSION Our findings highlight the procedural aspects and context of redress-reconciliation processes required to ensure that the process and outcomes are experienced as fair. These criteria may be applied to the processes used to investigate both recent and historical patient safety events. PUBLIC CONTRIBUTION One member of the public affiliated with the Exeter Policy Research Programme Evidence Review Facility helped develop the review protocol. Two people with experience of medically life-changing events provided insight which corroborated our findings and identified important limitations of the evidence included in this review.
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Affiliation(s)
- Liz Shaw
- Exeter Policy Research Programme Evidence Review Facility, Faculty of Health and Life Sciences, St Luke's campusUniversity of ExeterExeterUK
| | - Hassanat M. Lawal
- Exeter Policy Research Programme Evidence Review Facility, Faculty of Health and Life Sciences, St Luke's campusUniversity of ExeterExeterUK
| | - Simon Briscoe
- Exeter Policy Research Programme Evidence Review Facility, Faculty of Health and Life Sciences, St Luke's campusUniversity of ExeterExeterUK
| | - Ruth Garside
- Exeter Policy Research Programme Evidence Review Facility, Faculty of Health and Life Sciences, St Luke's campusUniversity of ExeterExeterUK
| | - Jo Thompson Coon
- Exeter Policy Research Programme Evidence Review Facility, Faculty of Health and Life Sciences, St Luke's campusUniversity of ExeterExeterUK
| | - Morwenna Rogers
- Exeter Policy Research Programme Evidence Review Facility, Faculty of Health and Life Sciences, St Luke's campusUniversity of ExeterExeterUK
| | - G. J. Melendez‐Torres
- Exeter Policy Research Programme Evidence Review Facility, Faculty of Health and Life Sciences, St Luke's campusUniversity of ExeterExeterUK
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Madsen C, Korona-Bailey J, Janvrin ML, Schoenfeld AJ, Koehlmoos TP. Opioid prescribing and use in the Military Health System: a framework synthesis, FY2016-FY2021. Pain Med 2023; 24:1133-1137. [PMID: 37280084 PMCID: PMC10546480 DOI: 10.1093/pm/pnad072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 05/02/2023] [Accepted: 06/01/2023] [Indexed: 06/08/2023]
Abstract
BACKGROUND Opioid misuse is a nationwide issue and is of particular concern with regard to military readiness. The 2017 National Defense Authorization Act charges the Military Health System with greater oversight of opioid use and mitigation of misuse. METHODS We synthesized published articles using secondary analysis of TRICARE claims data, a nationally representative database of 9.6 million beneficiaries. We screened 106 articles for inclusion and identified 17 studies for data abstraction. Framework analysis was conducted, which assessed prescribing practices, patient use, and optimum length of opioid prescriptions after surgery, trauma, and common procedures, as well as factors leading to sustained prescription opioid use. RESULTS Across the studies, sustained prescription opioid use after surgery was low overall, with <1% of opioid-naïve patients still receiving opioids more than 1 year after spinal surgery or trauma. In opioid-exposed patients who had undergone spine surgery, sustained use was slightly lower than 10%. Higher rates of sustained use were associated with more severe trauma and depression, as well as with prior use and initial opioid prescriptions for low back pain or other undefined conditions. Black patients were more likely to discontinue opioid use than were White patients. CONCLUSIONS Prescribing practices are well correlated with degree of injury or intensity of intervention. Sustained prescription opioid use beyond 1 year is rare and is associated with diagnoses for which opioids are not the standard of care. More efficient coding, increased attention to clinical practice guidelines, and use of tools to predict risk of sustained prescription opioid use are recommended.
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Affiliation(s)
- Cathaleen Madsen
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD 20817, United States
- Uniformed Services University of the Health Sciences, Bethesda, MD 20814, United States
| | - Jessica Korona-Bailey
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD 20817, United States
- Uniformed Services University of the Health Sciences, Bethesda, MD 20814, United States
| | - Miranda Lynn Janvrin
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD 20817, United States
- Uniformed Services University of the Health Sciences, Bethesda, MD 20814, United States
| | - Andrew J Schoenfeld
- Center for Surgery and Public Health, Department of Orthopaedic Surgery, Harvard Medical School, Brigham & Women’s Hospital, Boston, MA 02115, United States
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Cunningham J, M. Briggs A, Cottrell E, Doyle F, Dziedzic K, Finney A, Murphy P, Paskins Z, Sheridan E, Swaithes L, P. French H. Barriers and facilitators to the implementation of osteoarthritis management programmes in primary or community care settings: a systematic review and qualitative framework synthesis protocol. HRB Open Res 2021; 4:102. [PMID: 34746643 PMCID: PMC8543168 DOI: 10.12688/hrbopenres.13377.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2021] [Indexed: 12/29/2022] Open
Abstract
Despite consistent international guidelines for osteoarthritis (OA) management, evidence-based treatments are underutilised. OA management programmes (OAMPs) are being implemented internationally to address this evidence-practice gap. An OAMP is defined as a 'model of evidence-based, non-surgical OA care that has been implemented in a real-world setting'. Our objective is to identify, synthesise and appraise qualitative research identifying anticipated or experienced micro (individual/behavioural), meso (organisational) or macro (context/system) level barriers or facilitators to the implementation of primary or community care-based OAMPs. Five electronic databases will be searched for papers published between 2010 and 2021. Qualitative or mixed-methods studies that include qualitative data on the anticipated or experienced barriers or facilitators to the implementation of primary or community care-based OAMPs, from the perspective of service users or service providers, will be included. The review will be reported using the PRISMA and ENTREQ guidelines. A data extraction form will be used to provide details of the included studies. Data will be analysed and identified barriers and facilitators will be mapped onto an appropriate implementation framework, such as the Theoretical Domains Framework. The appropriate JBI critical appraisal tools will be used to assess methodological quality, while the GRADE-CERQual approach will be used to assess confidence in the findings. Translation of evidence-based guidelines into practice is challenging and reliant on the quality of implementation. By comparing and contrasting anticipated and experienced barriers, this review will determine the extent of congruence between the two, and provide valuable insights into the views and experiences of key stakeholders involved in the implementation of OAMPs. The mapping of identified barriers and facilitators to behaviour change theory will enhance the applicability and construct validity of our findings and will offer significant utility for future development and implementation of OAMPs. Registration: This protocol was registered with PROSPERO (CRD42021255698) on 15/07/21.
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Affiliation(s)
- Joice Cunningham
- School of Physiotherapy, Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences, Dublin, Ireland
| | - Andrew M. Briggs
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Elizabeth Cottrell
- Impact Accelerator Unit, Versus Arthritis Primary Care Centre, School of Medicine, Keele University, Staffordshire, ST5 5BG, UK
| | - Frank Doyle
- Department of Health Psychology, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
| | - Krysia Dziedzic
- Impact Accelerator Unit, Versus Arthritis Primary Care Centre, School of Medicine, Keele University, Staffordshire, ST5 5BG, UK
| | - Andrew Finney
- Impact Accelerator Unit, Versus Arthritis Primary Care Centre, School of Medicine, Keele University, Staffordshire, ST5 5BG, UK
| | - Paul Murphy
- RCSI Library, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Zoe Paskins
- Impact Accelerator Unit, Versus Arthritis Primary Care Centre, School of Medicine, Keele University, Staffordshire, ST5 5BG, UK
- Haywood Academic Rheumatology Centre, Midland Partnership NHS Foundation Trust, Stoke-on-Trent, ST6 7AG, UK
| | - Eoin Sheridan
- School of Physiotherapy, Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences, Dublin, Ireland
| | - Laura Swaithes
- Impact Accelerator Unit, Versus Arthritis Primary Care Centre, School of Medicine, Keele University, Staffordshire, ST5 5BG, UK
| | - Helen P. French
- School of Physiotherapy, Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences, Dublin, Ireland
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Shaw L, Nunns M, Briscoe S, Anderson R, Thompson Coon J. A "Rapid Best-Fit" model for framework synthesis: Using research objectives to structure analysis within a rapid review of qualitative evidence. Res Synth Methods 2020; 12:368-383. [PMID: 33006277 DOI: 10.1002/jrsm.1462] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 08/03/2020] [Accepted: 09/28/2020] [Indexed: 11/08/2022]
Abstract
The short time frame associated with rapid reviews can be challenging for researchers conducting qualitative evidence synthesis. In these circumstances a Best-Fit Framework Synthesis, drawing upon existing theory and/or research, may be conducted to rapidly make sense of qualitative evidence. This article discusses a "Rapid Best-Fit" approach to conducting Framework Synthesis within an 6-week rapid systematic review of qualitative evidence. In the absence of a suitable theoretical model to inform the synthesis, we drew upon our research objectives to structure a framework, and to identify the studies which contained the most relevant data. Themes from these studies were used to revise the initial framework before inductive thematic synthesis finalized theme content. This "Rapid Best-Fit" approach yielded results aligned with the needs of the commissioners of the review and is a useful addition to qualitative synthesis methods, allowing for the incorporation of diverse views and experiences into fast-paced decision making scenarios.
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Affiliation(s)
- Liz Shaw
- College of Medicine and Health, University of Exeter, St Lukes Campus, University of Exeter, Devon, Exeter, EX1 2LU, UK
| | - Michael Nunns
- College of Medicine and Health, University of Exeter, St Lukes Campus, University of Exeter, Devon, Exeter, EX1 2LU, UK
| | - Simon Briscoe
- College of Medicine and Health, University of Exeter, St Lukes Campus, University of Exeter, Devon, Exeter, EX1 2LU, UK
| | - Rob Anderson
- College of Medicine and Health, University of Exeter, St Lukes Campus, University of Exeter, Devon, Exeter, EX1 2LU, UK
| | - Jo Thompson Coon
- College of Medicine and Health, University of Exeter, St Lukes Campus, University of Exeter, Devon, Exeter, EX1 2LU, UK
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Carton AM, Cordwell J, Steinhardt K. A framework synthesis reviewing the impact of neonatal care unit admission on early caregiver-infant relationships. J Adv Nurs 2020; 76:3258-3272. [PMID: 33058269 DOI: 10.1111/jan.14538] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 06/29/2020] [Accepted: 07/23/2020] [Indexed: 11/30/2022]
Abstract
AIMS To critically review and synthesize qualitative research pertaining to the establishment of early caregiver-infant relationships in the neonatal care unit (NCU). BACKGROUND It is well-established that bonding and attachment, established across the prenatal and early childhood periods, affect child cognitive and behavioural development. Proximity, reciprocity, and commitment are key to the formation of these early relationships. It is intuitively likely that an admission to the NCU may affect early reciprocal caregiver-infant relationships. DESIGN A qualitative best-fit framework synthesis. DATA SOURCES A systematic search of four databases (PsycINFO, MEDLINE, British Nursing Index and CINAHL) was conducted, from January 2000-December 2018. REVIEW METHODS The RATS quality appraisal tool was used to evaluate study quality. To ensure reliability, 20% of studies were randomly selected for independent rating. A "best-fit" synthesis approach using an existing framework of early parent-infant attachment and bonding was adopted to synthesize the review findings. FINDINGS Twenty studies, from an original 3,526 unique articles, were included in the review. Studies varied in the extent to which they demonstrated transparency of procedures and in the quality of recruitment information provided. The meta-synthesis demonstrated that proximity, reciprocity, and commitment were affected by admission to a NCU and identified that parental reflections on bonding and the role of staff in this process, were important factors to consider. CONCLUSIONS Caregiver-infant relationships are affected by admission to the NCU. The review theoretically supports moves to Family Integrated Care. Units should evaluate caregiver emotional state and consider the role of peer support. IMPACT The synthesis revealed that areas typically implicated in the formation of attachment and bonds were affected by admission to a NCU. Results have implications on the clinical care delivered as part of neonatal care.
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Affiliation(s)
- Amelia Myri Carton
- Oxford Institute for Clinical Psychology Training, Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - Jacinta Cordwell
- Oxford Children's Hospital, The John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Karen Steinhardt
- Oxford Children's Hospital, The John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
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Brunton G, Oliver S, Thomas J. Innovations in framework synthesis as a systematic review method. Res Synth Methods 2020; 11:316-330. [PMID: 32090479 DOI: 10.1002/jrsm.1399] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 01/25/2020] [Accepted: 02/04/2020] [Indexed: 01/09/2023]
Abstract
Framework synthesis is one systematic review method employed to address health care practice and policy. Adapted from framework analysis methods, it has been used increasingly, using both qualitative and mixed-method systematic review methods. This article demonstrates a spectrum of approaches to framework synthesis that are dependent on the extent to which theory is tentative, emergent, refined, or established; and that stakeholder involvement may help to understand the topic's complexity where theory is more nascent. The choice of approach depends on the degree of match with existing theories and, in the absence of existing theory, the scale and heterogeneity of the literature to be managed.
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Affiliation(s)
- Ginny Brunton
- OntarioTech University, Faculty of Health Sciences, School of Nursing, Oshawa, ON, Canada
- University College London Institute of Education, EPPI-Centre, London, UK
- McMaster University, McMaster Midwifery Research Centre, Hamilton, ON, Canada
| | - Sandy Oliver
- University College London Institute of Education, EPPI-Centre, London, UK
- University of Johannesburg Faculty of Humanities, Africa Centre for Evidence, Johannesburg, South Africa
| | - James Thomas
- University College London Institute of Education, EPPI-Centre, London, UK
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Wadephul F, Jarrett PM, Jomeen J, Martin CR. A mixed methods review to develop and confirm a framework for assessing midwifery practice in perinatal mental health. J Adv Nurs 2018; 74:2258-2272. [PMID: 29989193 DOI: 10.1111/jan.13786] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 04/27/2018] [Accepted: 06/01/2018] [Indexed: 11/30/2022]
Abstract
AIM To ascertain whether a new framework examining midwifery practice in perinatal mental health (PMH) is supported by the research literature. BACKGROUND The identification and care of women with PMH problems is increasingly considered part of midwifery practice. Research suggests that many midwives lack knowledge, skills and confidence. It would be useful to be able to determine barriers and facilitators to effective clinical practice. The authors propose a framework comprising five potentially measurable domains which have an impact on midwives' ability to identify, assess and care for women with PMH problems. DESIGN This mixed-methods review uses an innovative qualitative convergent design based on framework synthesis. DATA SOURCES Relevant electronic databases were searched for the period from January 2007-December 2016; 33 studies from nine countries met the inclusion criteria. REVIEW METHODS Study quality was assessed using critical appraisal tools. Study findings were mapped onto the five domains of the framework: knowledge, confidence, attitudes, illness perception and infrastructure. Findings were then synthesized for each domain. RESULTS All five domains are substantially represented in the literature, thus supporting the proposed framework. Several sub-domains and relationships between domains were identified. Varying levels of knowledge, confidence, attitudes and illness perceptions were found; evidence suggests that midwives benefit from further training within these domains. Features of organizational infrastructure act as barriers or facilitators to effective care; these need to be addressed at organizational level. CONCLUSION The proposed framework was confirmed and can be used to inform practice, policy and research.
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Affiliation(s)
- Franziska Wadephul
- School of Health and Social Work, Faculty of Health Sciences, University of Hull, Hull, UK
| | | | - Julie Jomeen
- School of Health and Social Work, Faculty of Health Sciences, University of Hull, Hull, UK
| | - Colin R Martin
- Institute for Clinical and Applied Health Research, Faculty of Health Sciences, University of Hull
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Asghari S, Hurd J, Marshall Z, Maybank A, Hesselbarth L, Hurley O, Farrell A, Kendall CE, Rourke SB, Becker M, Johnston S, Lundrigan P, Rosenes R, Bibeau C, Liddy C. Challenges with access to healthcare from the perspective of patients living with HIV: a scoping review & framework synthesis. AIDS Care 2018; 30:963-972. [PMID: 29397762 DOI: 10.1080/09540121.2018.1435848] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Accessing healthcare can be difficult but the barriers multiply for people living with HIV (PLHIV). To improve access and the health of PLHIV, we must consider their perspectives and use them to inform standard practice. A better understanding of the current literature related to healthcare access from the perspective of PLHIV, can help to identify evidence gaps and highlight research priorities and opportunities. To identify relevant peer-reviewed publications, search strategies were employed. Electronic and grey literature databases were explored. Articles were screened based on their title and abstract and those that met the screening criteria, were reviewed in full. Data analysis was conducted using a collaborative approach that included knowledge user consultation. Initial concepts were extracted, summarized and through framework synthesis, developed into emerging and final themes. From 20,678 articles, 326 articles met the initial screening criteria and 64 were reviewed in full. The final themes identified, in order of most to least frequent were: Acceptability, Availability, Accessibility, Affordability, Other Barriers, Communication, Satisfaction, Accommodation, Preferences and Equity in Access. The most frequently discussed concepts related to negative interactions with staff, followed by long wait times, limited household resources or inability to pay fees, and fear of one's serostatus being disclosed. Knowledge users were in agreement with the categorization of initial concepts and final themes; however, some gaps in the literature were identified. Specific changes are critical to improving access to healthcare for PLHIV. These include improving availability by ensuring staff and healthcare professionals have proper training, cultivating acceptability and reducing stigma through improving HIV awareness, increasing accessibility through increased HIV information for PLHIV and improved dissemination of this information to increase patient knowledge and health awareness. Finally, ensuring proper protocols are implemented and followed to guarantee patient confidentiality and overall satisfaction with healthcare services are recommended.
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Affiliation(s)
- Shabnam Asghari
- a Department of Family Medicine , Memorial University of Newfoundland, Health Sciences Centre , St. John's , NL , Canada
| | - Jillian Hurd
- a Department of Family Medicine , Memorial University of Newfoundland, Health Sciences Centre , St. John's , NL , Canada
| | - Zack Marshall
- b School of Social Work , McGill University , Montreal , QC , Canada
| | - Allison Maybank
- a Department of Family Medicine , Memorial University of Newfoundland, Health Sciences Centre , St. John's , NL , Canada
| | - Lydia Hesselbarth
- a Department of Family Medicine , Memorial University of Newfoundland, Health Sciences Centre , St. John's , NL , Canada
| | - Oliver Hurley
- a Department of Family Medicine , Memorial University of Newfoundland, Health Sciences Centre , St. John's , NL , Canada
| | - Alison Farrell
- a Department of Family Medicine , Memorial University of Newfoundland, Health Sciences Centre , St. John's , NL , Canada
| | - Claire E Kendall
- c Bruyere Research Institute , University of Ottawa , Ottawa , ON , Canada
| | - Sean B Rourke
- d Li Ka Shing Knowledge Institute , St. Michael's Hospital , Toronto , ON , Canada
| | - Marissa Becker
- e Centre for Global Public Health , University of Manitoba , Winnipeg , MB , Canada
| | - Sharon Johnston
- c Bruyere Research Institute , University of Ottawa , Ottawa , ON , Canada
| | - Phil Lundrigan
- c Bruyere Research Institute , University of Ottawa , Ottawa , ON , Canada
| | - Ron Rosenes
- c Bruyere Research Institute , University of Ottawa , Ottawa , ON , Canada
| | - Christine Bibeau
- c Bruyere Research Institute , University of Ottawa , Ottawa , ON , Canada
| | - Clare Liddy
- c Bruyere Research Institute , University of Ottawa , Ottawa , ON , Canada
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Phillips P, Lumley E, Duncan R, Aber A, Woods HB, Jones GL, Michaels J. A systematic review of qualitative research into people's experiences of living with venous leg ulcers. J Adv Nurs 2017; 74:550-563. [PMID: 28960514 DOI: 10.1111/jan.13465] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2017] [Indexed: 11/30/2022]
Abstract
AIM To systematically identify, evaluate and synthesize qualitative research that examined the symptoms and health-related quality of life themes that are important from the perspective of patients with venous leg ulceration. BACKGROUND Venous leg ulceration is a common chronic condition; the symptoms and associated treatments have a negative effect on health-related quality of life. Qualitative research methods can provide insight into the personal experiences of patients with venous leg ulceration. DESIGN Qualitative evidence synthesis (using framework synthesis). DATA SOURCES Multiple electronic databases including MEDLINE, EMBASE, PsycINFO and CINAHL were comprehensively searched from inception to November 2015. REVIEW METHODS Systematic identification, quality assessment and synthesis of existing qualitative research were performed; framework synthesis was conducted on included studies. An inductive approach was used and emergent themes were identified. The final stage in the synthesis involved the development of new interpretations. RESULTS Thirteen studies met the inclusion criteria; the overall quality of the included studies was good. Four overarching themes were identified; physical impact, psychological impact, social impact and treatment and, in these, further subthemes were identified. Ulcer and treatment-related pain, as well as odour and exudate appeared to have significant and direct negative effects on quality of life, with additional and cumulative effects on sleep, mobility and mood. CONCLUSION The themes identified in this review should be considered by professionals providing services, care and treatment for venous leg ulcer patients and in the selection, or development, of patient-reported outcome measures for use with this population.
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Affiliation(s)
- Patrick Phillips
- School of Health and Related Research, University of Sheffield, Sheffield, UK.,Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Elizabeth Lumley
- School of Health and Related Research, University of Sheffield, Sheffield, UK.,Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Rosie Duncan
- School of Health and Related Research, University of Sheffield, Sheffield, UK.,Department of Nursing and Midwifery, Sheffield Hallam University, Sheffield, UK
| | - Ahmed Aber
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Helen Buckley Woods
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Georgina L Jones
- Department of Psychology, School of Social Sciences, Leeds Beckett University, Leeds, UK
| | - Jonathan Michaels
- School of Health and Related Research, University of Sheffield, Sheffield, UK
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Abstract
BACKGROUND Nanotechnology is a promising area in industry with a broad range of applications including in the agri-food sector. Several studies have investigated the potential benefits deriving from use of nanomaterials in the context of the whole food chain drawing scenarios of benefits but also potential for concerns. Among the agri-food sector, animal production has potential for nanomaterial application but also for safety concerns due to the possibility of nanomaterial accumulation along the farm-to-fork path. Scope and Approach: The aim of this work was to define the state of the art of nanomaterial applications in the animal production sector by assessing data belonging to recently publishes studies. To do this, a qualitative synthesis approach was applied to build a fit-for-purpose framework and to summarise relevant themes in the context of effectiveness, feasibility and health concerns. Key findings and conclusions: Nanomaterials have potential for use in a wide range of applications from feed production and farming to food packaging, including several detection tools designed for the benefit of consumer protection. The current high degree of variability in nanomaterials tested and in study designs impairs external validation of research results. Further research is required to clearly define which safe nanomaterial applications have the potential to reach the market.
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Affiliation(s)
- Simone Belluco
- a Food Safety Department , Istituto Zooprofilattico Sperimentale delle Venezie , Legnaro (PD) , Italy.,b Department of Animal Medicine, Production and Health , University of Padua , Legnaro (PD) , Italy
| | - Federica Gallocchio
- a Food Safety Department , Istituto Zooprofilattico Sperimentale delle Venezie , Legnaro (PD) , Italy
| | - Carmen Losasso
- a Food Safety Department , Istituto Zooprofilattico Sperimentale delle Venezie , Legnaro (PD) , Italy
| | - Antonia Ricci
- a Food Safety Department , Istituto Zooprofilattico Sperimentale delle Venezie , Legnaro (PD) , Italy
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McCaffrey N, Bradley S, Ratcliffe J, Currow DC. What Aspects of Quality of Life Are Important From Palliative Care Patients' Perspectives? A Systematic Review of Qualitative Research. J Pain Symptom Manage 2016; 52:318-328.e5. [PMID: 27216362 DOI: 10.1016/j.jpainsymman.2016.02.012] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Revised: 02/03/2016] [Accepted: 02/26/2016] [Indexed: 10/21/2022]
Abstract
CONTEXT Despite the availability of numerous tools professing to measure quality of life (QOL) in the palliative care setting, no single instrument includes all patient-valued domains. OBJECTIVES To identify which aspects of QOL are important from palliative care patients' perspectives, aiding coverage, and content validity evaluation of available tools. METHODS A systematic review and synthesis of qualitative research was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. ASSIA, CINAHL, Cochrane library, Embase, Medline, PsycINFO, and PubMed were searched from database inception to December 31, 2015. Published, peer-reviewed, English-language articles reporting primary qualitative data investigating QOL domains in adults with a progressive, life-limiting illness were included. Studies a priori exploring a chosen aspect of QOL were not included. Articles scoring ≤2 on reporting quality were excluded. Framework synthesis was used to identify key themes across the studies. RESULTS Overall, 3589 articles were screened and 24 studies were included. Eight important aspects of QOL were identified: physical; personal autonomy; emotional; social; spiritual; cognitive; healthcare; and preparatory. All but one study discussed spiritual aspects, whereas only six studies mentioned cognitive aspects. CONCLUSION A broad range of domains are important to the QOL of people with life-limiting illnesses receiving palliation. Refinement of measures is needed to help ensure services address issues valued by patients such as preparation for death and aspects of health care provision, elements which are seldom included in currently available preference-based measures used to inform value for money decisions in palliative care.
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Affiliation(s)
- Nicola McCaffrey
- Flinders Clinical Effectiveness, Flinders University, Bedford Park, South Australia, Australia; Palliative and Supportive Services, Flinders University, Bedford Park, South Australia, Australia.
| | - Sandra Bradley
- Palliative and Supportive Services, Flinders University, Bedford Park, South Australia, Australia
| | - Julie Ratcliffe
- Flinders Clinical Effectiveness, Flinders University, Bedford Park, South Australia, Australia
| | - David C Currow
- Palliative and Supportive Services, Flinders University, Bedford Park, South Australia, Australia
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