WorldWideScience

Sample records for qualitative systematic review

  1. Children's experiences of dialysis: a systematic review of qualitative studies

    NARCIS (Netherlands)

    Tjaden, Lidwien; Tong, Allison; Henning, Paul; Groothoff, Jaap; Craig, Jonathan C.

    2012-01-01

    Objective To describe the experiences and perspectives of children and adolescents on dialysis. Design A systematic review of qualitative studies was conducted that explored the experiences of children on dialysis. Electronic databases and reference lists of relevant articles were searched to

  2. Characteristics of Qualitative Descriptive Studies: A Systematic Review.

    Science.gov (United States)

    Kim, Hyejin; Sefcik, Justine S; Bradway, Christine

    2017-02-01

    Qualitative description (QD) is a term that is widely used to describe qualitative studies of health care and nursing-related phenomena. However, limited discussions regarding QD are found in the existing literature. In this systematic review, we identified characteristics of methods and findings reported in research articles published in 2014 whose authors identified the work as QD. After searching and screening, data were extracted from the sample of 55 QD articles and examined to characterize research objectives, design justification, theoretical/philosophical frameworks, sampling and sample size, data collection and sources, data analysis, and presentation of findings. In this review, three primary findings were identified. First, although there were some inconsistencies, most articles included characteristics consistent with the limited available QD definitions and descriptions. Next, flexibility or variability of methods was common and effective for obtaining rich data and achieving understanding of a phenomenon. Finally, justification for how a QD approach was chosen and why it would be an appropriate fit for a particular study was limited in the sample and, therefore, in need of increased attention. Based on these findings, recommendations include encouragement to researchers to provide as many details as possible regarding the methods of their QD studies so that readers can determine whether the methods used were reasonable and effective in producing useful findings. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  3. Ethical tensions: A qualitative systematic review of new graduate perceptions.

    Science.gov (United States)

    Hazelwood, Tori; Murray, Carolyn M; Baker, Amy; Stanley, Mandy

    2017-01-01

    New graduate transition into the workforce is challenging and can involve managing ethical tensions. Ethical tensions cause new graduates to doubt their capabilities due to their lack of experience. To support new graduates, we need to know what these ethical tensions are. To explore the ethical tensions perceived to occur in practice for new graduate health professionals. This qualitative systematic review involved a search of five databases (Medline, EMBASE, AMED, CINAHL and Scopus) which resulted in the retrieval of 3554 papers. After the two-phased screening process, eight studies were identified that met the inclusion criteria and had rich data on the review question. Articles were read several times, critically appraised and analysed through thematic analysis. Ethical considerations: No ethical approval was required for the systematic review. The review was conducted following well-established reporting guidelines enabling transparency and rigour. Studies originated from Australia, United States, Iran and China. One study included speech pathologists and seven were with nurses. Four themes included the following: (1) enduring an unknown workplace culture that generates uncertainty without support for new graduates; (2) being vulnerable because of distress from bullying, exclusion and being a scapegoat; (3) constraining systems and institutional restrictions that cause dilemmas; and (4) experiencing disillusionment from lost ideals about ethical practice. This review has brought to light the vulnerability of new graduates to negative workplace culture and collegial incivility. In addition, new graduates are subjected to ethical tensions created by institutional constraints which can create dilemmas and uncertainties through practice that does not align with what they anticipated. Understanding ethical tensions experienced by new graduates enables provision of informed support. There needs to be considerable cultural change for orientation and socialisation of

  4. Women's experience of menopause: a systematic review of qualitative evidence.

    Science.gov (United States)

    Hoga, Luiza; Rodolpho, Juliana; Gonçalves, Bruna; Quirino, Bruna

    2015-09-16

    Evidence shows than an estimated one billion women have experienced menopause worldwide. The experience of menopause is influenced by beliefs and values prevalent in the sociocultural setting, the background of the women, and the ways in which the women approach changes in this phase of life. Independently of the circumstances involved, women experiencing menopause need to have their care needs and corresponding support identified based on their personal and contextual perspectives. Although it is essential to provide appropriate support to women experiencing menopause, no systematic reviews have so far been conducted that focus on menopause experienced by women worldwide. The objective of this review is to identify the best available evidence related to how women experience menopause worldwide. This review considered studies that included menopausal women aged between 40 and 65 years, who have lived the transition from reproductive years through menopause and beyond. This review included only studies whose participants have lived the experience of natural menopause. Women who have had induced menopause, or with premature menopause were excluded from this review. TYPES OF INTERVENTION(S)/PHENOMENA OF INTEREST: This review considered studies that investigate women's experiences of natural menopause under the scope of different social and cultural settings. TYPES OF STUDIES: This review considered studies that have a descriptive and interpretive approach, conducted using qualitative methodology. Qualitative studies that focus on program evaluation were excluded from this review. Qualitative data including, but not limited to, study designs such as phenomenology, grounded theory, ethnography, action research and feminist research were considered for inclusion in this review. TYPES OF OUTCOMES: This review considered studies that include the following outcome measures: all aspects related both directly and indirectly to the experience of menopause, as concretely lived

  5. Factors influencing workplace health promotion intervention: a qualitative systematic review.

    Science.gov (United States)

    Rojatz, Daniela; Merchant, Almas; Nitsch, Martina

    2017-10-01

    Although workplace health promotion (WHP) has evolved over the last 40 years, systematically collected knowledge on factors influencing the functioning of WHP is scarce. Therefore, a qualitative systematic literature review was carried out to systematically identify and synthesize factors influencing the phases of WHP interventions: needs assessment, planning, implementation and evaluation. Research evidence was identified by searching electronic databases (Scopus, PubMed, Social Sciences Citation Index, ASSIA, ERIC, IBBS and PsycINFO) from 1998 to 2013, as well as by cross-checking reference lists of included peer-reviewed articles. The inclusion criteria were: original empirical research, description of WHP, description of barriers to and/or facilitators of the planning, implementation and/or evaluation of WHP. Finally, 54 full texts were included. From these, influencing factors were extracted and summarized using thematic analysis. The majority of influencing factors referred to the implementation phase, few dealt with planning and/or evaluation and none with needs assessment. The influencing factors were condensed into topics with respect to factors at contextual level (e.g. economic crisis); factors at organizational level (e.g. management support); factors at intervention level (e.g. quality of intervention concept); factors at implementer level (e.g. resources); factors at participant level (e.g. commitment to intervention) and factors referring to methodological and data aspects (e.g. data-collection issues). Factors regarding contextual issues and organizational aspects were identified across three phases. Therefore, future research and practice should consider not only the influencing factors at different levels, but also at different phases of WHP interventions. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  6. Ethical issues in public health surveillance: a systematic qualitative review.

    Science.gov (United States)

    Klingler, Corinna; Silva, Diego Steven; Schuermann, Christopher; Reis, Andreas Alois; Saxena, Abha; Strech, Daniel

    2017-04-04

    Public health surveillance is not ethically neutral and yet, ethics guidance and training for surveillance programmes is sparse. Development of ethics guidance should be based on comprehensive and transparently derived overviews of ethical issues and arguments. However, existing overviews on surveillance ethics are limited in scope and in how transparently they derived their results. Our objective was accordingly to provide an overview of ethical issues in public health surveillance; in addition, to list the arguments put forward with regards to arguably the most contested issue in surveillance, that is whether to obtain informed consent. Ethical issues were defined based on principlism. We assumed an ethical issue to arise in surveillance when a relevant normative principle is not adequately considered or two principles come into conflict. We searched Pubmed and Google Books for relevant publications. We analysed and synthesized the data using qualitative content analysis. Our search strategy retrieved 525 references of which 83 were included in the analysis. We identified 86 distinct ethical issues arising in the different phases of the surveillance life-cycle. We further identified 20 distinct conditions that make it more or less justifiable to forego informed consent procedures. This is the first systematic qualitative review of ethical issues in public health surveillance resulting in a comprehensive ethics matrix that can inform guidelines, reports, strategy papers, and educational material and raise awareness among practitioners.

  7. What matters to women during childbirth: A systematic qualitative review.

    Directory of Open Access Journals (Sweden)

    Soo Downe

    Full Text Available Design and provision of good quality maternity care should incorporate what matters to childbearing women. This qualitative systematic review was undertaken to inform WHO intrapartum guidelines.Using a pre-determined search strategy, we searched Medline, CINAHL, PsycINFO, AMED, EMBASE, LILACS, AJOL, and reference lists of eligible studies published 1996-August 2016 (updated to January 2018, reporting qualitative data on womens' childbirth beliefs, expectations, and values. Studies including specific interventions or health conditions were excluded. PRISMA guidelines were followed.Authors' findings were extracted, logged on a study-specific data form, and synthesised using meta-ethnographic techniques. Confidence in the quality, coherence, relevance and adequacy of data underpinning the resulting themes was assessed using GRADE-CERQual. A line of argument synthesis was developed.35 studies (19 countries were included in the primary search, and 2 in the update. Confidence in most results was moderate to high. What mattered to most women was a positive experience that fulfilled or exceeded their prior personal and socio-cultural beliefs and expectations. This included giving birth to a healthy baby in a clinically and psychologically safe environment with practical and emotional support from birth companions, and competent, reassuring, kind clinical staff. Most wanted a physiological labour and birth, while acknowledging that birth can be unpredictable and frightening, and that they may need to 'go with the flow'. If intervention was needed or wanted, women wanted to retain a sense of personal achievement and control through active decision-making. These values and expectations were mediated through womens' embodied (physical and psychosocial experience of pregnancy and birth; local familial and sociocultural norms; and encounters with local maternity services and staff.Most healthy childbearing women want a positive birth experience. Safety and

  8. Treatments for chronic myeloid leukemia: a qualitative systematic review

    Directory of Open Access Journals (Sweden)

    Ferdin

    2012-08-01

    Full Text Available Roxanne Ferdinand,1 Stephen A Mitchell,2 Sarah Batson,2 Indra Tumur11Pfizer, Tadworth, UK; 2Abacus International, Bicester, UKBackground: Chronic myeloid leukemia (CML is a myeloproliferative disorder of blood stem cells. The tyrosine kinase inhibitor (TKI imatinib was the first targeted therapy licensed for patients with chronic-phase CML, and its introduction was associated with substantial improvements in response and survival compared with previous therapies. Clinical trial data are now available for the second-generation TKIs (nilotinib, dasatinib, and bosutinib in the first-, second-, and third-line settings. A qualitative systematic review was conducted to qualitatively compare the clinical effectiveness, safety, and effect on quality of life of TKIs for the management of chronic-, accelerated-, or blast-phase CML patients.Methods: Included studies were identified through a search of electronic databases in September 2011, relevant conference proceedings and the grey literature.Results: In the first-line setting, the long-term efficacy (up to 8 years of imatinib has been confirmed in a single randomized controlled trial (International Randomized Study of Interferon [IRIS]. All second-generation TKIs reported lower rates of transformation, and comparable or superior complete cytogenetic response (CCyR, major molecular response (MMR, and complete molecular response rates compared with imatinib by 2-year follow-up. Each of the second-generation TKIs was associated with a distinct adverse-event profile. Bosutinib was the only second-generation TKI to report quality-of-life data (no significant difference compared with imatinib treatment. Data in the second- and third-line setting confirmed the efficacy of the second-generation TKIs in either imatinib-resistant or -intolerant patients, as measured by CCyR and MMR rates.Conclusion: Data from first-line randomized controlled trials reporting up to 2-year follow-up indicate superior response

  9. Parental views on otitis media: systematic review of qualitative studies.

    Science.gov (United States)

    Chando, Shingisai; Young, Christian; Craig, Jonathan C; Gunasekera, Hasantha; Tong, Allison

    2016-10-01

    This study aims to describe parental experiences and perspectives of caring for a child with otitis media. We conducted a systematic review of qualitative studies on parental perspectives on caring for a child with otitis media. We searched electronic databases to July 2015. Seventeen studies involving 284 participants from six countries were included. We identified seven themes: diminishing competency (guilt over failure to identify symptoms, helpless and despairing, fear of complications, disempowered and dismissed); disrupting life schedules (disturbing sleep, interfering with work, burden on family); social isolation (stigma and judgement, sick consciousness); threatening normal development (delaying growth milestones, impairing interpersonal skills, impeding education); taking ownership (recognising symptoms, diagnostic closure, working the system, protecting against physical trauma, contingency planning); valuing support (needing respite, depending on community, clinician validation); and cherishing health (relief with treatment success, inspiring resilience). The additional medical responsibilities and anxieties of parents caring for a child with otitis media, often discounted by clinicians, can be disempowering and disruptive. Chronicity can raise doubt about treatment efficacy and parental competency, and fears regarding their child's development. Care that fosters parental confidence and addresses their concerns about the child's development may improve treatment outcomes for children with otitis media. • Otitis media is a leading cause of conductive hearing loss in children. • Parental perception of the treatment burden of otitis media can potentially affect their confidence and ability to care for their child. What is New: • We identified five themes to reflect parental perspectives: diminishing competency, disrupting life schedules, social isolation, threatening normal development, taking ownership, valuing support, and cherishing health.

  10. Searching for qualitative research for inclusion in systematic reviews: a structured methodological review.

    Science.gov (United States)

    Booth, Andrew

    2016-05-04

    Qualitative systematic reviews or qualitative evidence syntheses (QES) are increasingly recognised as a way to enhance the value of systematic reviews (SRs) of clinical trials. They can explain the mechanisms by which interventions, evaluated within trials, might achieve their effect. They can investigate differences in effects between different population groups. They can identify which outcomes are most important to patients, carers, health professionals and other stakeholders. QES can explore the impact of acceptance, feasibility, meaningfulness and implementation-related factors within a real world setting and thus contribute to the design and further refinement of future interventions. To produce valid, reliable and meaningful QES requires systematic identification of relevant qualitative evidence. Although the methodologies of QES, including methods for information retrieval, are well-documented, little empirical evidence exists to inform their conduct and reporting. This structured methodological overview examines papers on searching for qualitative research identified from the Cochrane Qualitative and Implementation Methods Group Methodology Register and from citation searches of 15 key papers. A single reviewer reviewed 1299 references. Papers reporting methodological guidance, use of innovative methodologies or empirical studies of retrieval methods were categorised under eight topical headings: overviews and methodological guidance, sampling, sources, structured questions, search procedures, search strategies and filters, supplementary strategies and standards. This structured overview presents a contemporaneous view of information retrieval for qualitative research and identifies a future research agenda. This review concludes that poor empirical evidence underpins current information practice in information retrieval of qualitative research. A trend towards improved transparency of search methods and further evaluation of key search procedures offers

  11. Patients' involvement in improvement initiatives: a qualitative systematic review.

    Science.gov (United States)

    van, Claire; McInerney, Patricia; Cooke, Richard

    2015-10-01

    Over the last 20 years, quality improvement in health has become an important strategy in health services in many countries. With the emphasis on quality health care, there has been a shift in social paradigms towards including service users in their own health on different levels. There is growing evidence in literature on the positive impact on health outcomes where patients are active participants in their personal care. There is however less information available on the broader influence of users on improvement in systems. The objective of this review was to identify the barriers and enablers to patients being involved in quality improvement efforts directed towards their own health care. This review considered studies that included adults and children of any age experiencing any health problem.The review considered studies that explored patient or user participation in quality improvement and the factors enabling and hindering this processThe qualitative component of this review considered studies that focused on qualitative data, including, but not limited to, designs such as phenomenology, grounded theory, ethnography, action research and feminist research. Other texts such as opinion papers and reports were also considered. The search strategy aimed to find both published and unpublished studies. A three-step search strategy was utilized in this review. The searches using all identified keywords and index terms included the databases PubMed, PsycINFO, Medline, Scopus, EBSCOhost and CINAHL.Qualitative, text and opinion papers were considered for inclusion in this review.Closely related concepts like community involvement, family involvement, patients' involvement in their own care (for example, in the case of shared decision making), and patient centeredness in the context of a consultation were excluded. Qualitative and textual papers selected for retrieval were assessed by two independent reviewers for authenticity prior to inclusion in the review using

  12. Literature search strategies for conducting knowledge-building and theory-generating qualitative systematic reviews.

    Science.gov (United States)

    Finfgeld-Connett, Deborah; Johnson, E Diane

    2013-01-01

    To report literature search strategies for the purpose of conducting knowledge-building and theory-generating qualitative systematic reviews. Qualitative systematic reviews lie on a continuum from knowledge-building and theory-generating to aggregating and summarizing. Different types of literature searches are needed to optimally support these dissimilar reviews. Articles published between 1989-Autumn 2011. These documents were identified using a hermeneutic approach and multiple literature search strategies. Redundancy is not the sole measure of validity when conducting knowledge-building and theory-generating systematic reviews. When conducting these types of reviews, literature searches should be consistent with the goal of fully explicating concepts and the interrelationships among them. To accomplish this objective, a 'berry picking' approach is recommended along with strategies for overcoming barriers to finding qualitative research reports. To enhance integrity of knowledge-building and theory-generating systematic reviews, reviewers are urged to make literature search processes as transparent as possible, despite their complexity. This includes fully explaining and rationalizing what databases were used and how they were searched. It also means describing how literature tracking was conducted and grey literature was searched. In the end, the decision to cease searching also needs to be fully explained and rationalized. Predetermined linear search strategies are unlikely to generate search results that are adequate for purposes of conducting knowledge-building and theory-generating qualitative systematic reviews. Instead, it is recommended that iterative search strategies take shape as reviews evolve. © 2012 Blackwell Publishing Ltd.

  13. What Do Ethical Guidelines for Epidemiology Say About an Ethics Review? A Qualitative Systematic Review.

    Science.gov (United States)

    Piasecki, Jan; Waligora, Marcin; Dranseika, Vilius

    2017-06-01

    Epidemiological research is subject to an ethics review. The aim of this qualitative review is to compare existing ethical guidelines in English for epidemiological research and public health practice in regard to the scope and matter of an ethics review. Authors systematically searched PubMed, Google Scholar and Google Search for ethical guidelines. Qualitative analysis (constant comparative method) was applied to categorize important aspects of the an ethics review process. Eight ethical guidelines in English for epidemiological research were retrieved. Five main categories that are relevant to the review of epidemiological research by Institutional Review Boards/Research Ethics Committees were distinguished. Within the scope of main categories, fifty-nine subcategories were analyzed. There are important differences between the guidelines in terms of the scope and matter of an ethics review. Not all guidelines encompass all identified ethically important issues, and some do not define precisely the scope and matter of an ethics review, leaving much to the ethics of the individual researchers and the discretion of IRBs/RECs.

  14. Experiences of case management with chronic illnesses: a qualitative systematic review.

    Science.gov (United States)

    Joo, J Y; Liu, M F

    2018-03-01

    This qualitative systematic review aimed to identify and synthesize recent qualitative studies to improve understanding of the experiences and perceptions of case management interventions that individuals with chronic illnesses and their caregivers have. Case management has been shown to be effective at improving quality of care and lowering costs for individuals with chronic illnesses. However, no qualitative review has been synthesized with recent qualitative studies about case management experiences by individual with chronic illnesses. This qualitative systematic review uses a thematic synthesis method to review 10 qualitative studies published within the last 10 years, from 2007 to 2016, thereby identifying and discussing the understandings that individuals with chronic illnesses and their caregivers have about case management. From this synthesis, three themes were identified as facilitators of case management (access to healthcare resources, health status supports and emotional aid) and two themes were identified as barriers to it (low information about case management and time constraints). This is the first qualitative systematic review of the perceptions and experiences that individuals with chronic illnesses and their caregivers have about case management. The facilitators of case management can be employed to inform patients about the benefits of case management and to improve population health. The findings about barriers to case management can be used to reform case management for populations with chronic illnesses. These factors should be considered by nursing researchers and healthcare policymakers when implementing case management. © 2018 International Council of Nurses.

  15. Patient Safety Learning Systems: A Systematic Review and Qualitative Synthesis.

    Science.gov (United States)

    2017-01-01

    A patient safety learning system (sometimes called a critical incident reporting system) refers to structured reporting, collation, and analysis of critical incidents. To inform a provincial working group's recommendations for an Ontario Patient Safety Event Learning System, a systematic review was undertaken to determine design features that would optimize its adoption into the health care system and would inform implementation strategies. The objective of this review was to address two research questions: (a) what are the barriers to and facilitators of successful adoption of a patient safety learning system reported by health professionals and (b) what design components maximize successful adoption and implementation? To answer the first question, we used a published systematic review. To answer the second question, we used scoping study methodology. Common barriers reported in the literature by health care professionals included fear of blame, legal penalties, the perception that incident reporting does not improve patient safety, lack of organizational support, inadequate feedback, lack of knowledge about incident reporting systems, and lack of understanding about what constitutes an error. Common facilitators included a non-accusatory environment, the perception that incident reporting improves safety, clarification of the route of reporting and of how the system uses reports, enhanced feedback, role models (such as managers) using and promoting reporting, legislated protection of those who report, ability to report anonymously, education and training opportunities, and clear guidelines on what to report. Components of a patient safety learning system that increased successful adoption and implementation were emphasis on a blame-free culture that encourages reporting and learning, clear guidelines on how and what to report, making sure the system is user-friendly, organizational development support for data analysis to generate meaningful learning outcomes

  16. Qualitative systematic reviews: their importance for our understanding of research relevant to pain.

    Science.gov (United States)

    Seers, Kate

    2015-02-01

    This article outlines what a qualitative systematic review is and explores what it can contribute to our understanding of pain. Many of us use evidence of effectiveness for various interventions when working with people in pain. A good systematic review can be invaluable in bringing together research evidence to help inform our practice and help us understand what works. In addition to evidence of effectiveness, understanding how people with pain experience both their pain and their care can help us when we are working with them to provide care that meets their needs. A rigorous qualitative systematic review can also uncover new understandings, often helping illuminate 'why' and can help build theory. Such a review can answer the question 'What is it like to have chronic pain?' This article presents the different stages of meta-ethnography, which is the most common methodology used for qualitative systematic reviews. It presents evidence from four meta-ethnographies relevant to pain to illustrate the types of findings that can emerge from this approach. It shows how new understandings may emerge and gives an example of chronic musculoskeletal pain being experienced as 'an adversarial struggle' across many aspects of the person's life. This article concludes that evidence from qualitative systematic reviews has its place alongside or integrated with evidence from more quantitative approaches.

  17. Quantitative Analysis of Qualitative Information from Interviews: A Systematic Literature Review

    Science.gov (United States)

    Fakis, Apostolos; Hilliam, Rachel; Stoneley, Helen; Townend, Michael

    2014-01-01

    Background: A systematic literature review was conducted on mixed methods area. Objectives: The overall aim was to explore how qualitative information from interviews has been analyzed using quantitative methods. Methods: A contemporary review was undertaken and based on a predefined protocol. The references were identified using inclusion and…

  18. Robotic Stereotaxy in Cranial Neurosurgery: A Qualitative Systematic Review.

    Science.gov (United States)

    Fomenko, Anton; Serletis, Demitre

    2017-12-14

    Modern-day stereotactic techniques have evolved to tackle the neurosurgical challenge of accurately and reproducibly accessing specific brain targets. Neurosurgical advances have been made in synergy with sophisticated technological developments and engineering innovations such as automated robotic platforms. Robotic systems offer a unique combination of dexterity, durability, indefatigability, and precision. To perform a systematic review of robotic integration for cranial stereotactic guidance in neurosurgery. Specifically, we comprehensively analyze the strengths and weaknesses of a spectrum of robotic technologies, past and present, including details pertaining to each system's kinematic specifications and targeting accuracy profiles. Eligible articles on human clinical applications of cranial robotic-guided stereotactic systems between 1985 and 2017 were extracted from several electronic databases, with a focus on stereotactic biopsy procedures, stereoelectroencephalography, and deep brain stimulation electrode insertion. Cranial robotic stereotactic systems feature serial or parallel architectures with 4 to 7 degrees of freedom, and frame-based or frameless registration. Indications for robotic assistance are diversifying, and include stereotactic biopsy, deep brain stimulation and stereoelectroencephalography electrode placement, ventriculostomy, and ablation procedures. Complication rates are low, and mainly consist of hemorrhage. Newer systems benefit from increasing targeting accuracy, intraoperative imaging ability, improved safety profiles, and reduced operating times. We highlight emerging future directions pertaining to the integration of robotic technologies into future neurosurgical procedures. Notably, a trend toward miniaturization, cost-effectiveness, frameless registration, and increasing safety and accuracy characterize successful stereotactic robotic technologies. Copyright © 2017 by the Congress of Neurological Surgeons

  19. Including mixed methods research in systematic reviews: Examples from qualitative syntheses in TB and malaria control

    Science.gov (United States)

    2012-01-01

    Background Health policy makers now have access to a greater number and variety of systematic reviews to inform different stages in the policy making process, including reviews of qualitative research. The inclusion of mixed methods studies in systematic reviews is increasing, but these studies pose particular challenges to methods of review. This article examines the quality of the reporting of mixed methods and qualitative-only studies. Methods We used two completed systematic reviews to generate a sample of qualitative studies and mixed method studies in order to make an assessment of how the quality of reporting and rigor of qualitative-only studies compares with that of mixed-methods studies. Results Overall, the reporting of qualitative studies in our sample was consistently better when compared with the reporting of mixed methods studies. We found that mixed methods studies are less likely to provide a description of the research conduct or qualitative data analysis procedures and less likely to be judged credible or provide rich data and thick description compared with standalone qualitative studies. Our time-related analysis shows that for both types of study, papers published since 2003 are more likely to report on the study context, describe analysis procedures, and be judged credible and provide rich data. However, the reporting of other aspects of research conduct (i.e. descriptions of the research question, the sampling strategy, and data collection methods) in mixed methods studies does not appear to have improved over time. Conclusions Mixed methods research makes an important contribution to health research in general, and could make a more substantial contribution to systematic reviews. Through our careful analysis of the quality of reporting of mixed methods and qualitative-only research, we have identified areas that deserve more attention in the conduct and reporting of mixed methods research. PMID:22545681

  20. Including mixed methods research in systematic reviews: examples from qualitative syntheses in TB and malaria control.

    Science.gov (United States)

    Atkins, Salla; Launiala, Annika; Kagaha, Alexander; Smith, Helen

    2012-04-30

    Health policy makers now have access to a greater number and variety of systematic reviews to inform different stages in the policy making process, including reviews of qualitative research. The inclusion of mixed methods studies in systematic reviews is increasing, but these studies pose particular challenges to methods of review. This article examines the quality of the reporting of mixed methods and qualitative-only studies. We used two completed systematic reviews to generate a sample of qualitative studies and mixed method studies in order to make an assessment of how the quality of reporting and rigor of qualitative-only studies compares with that of mixed-methods studies. Overall, the reporting of qualitative studies in our sample was consistently better when compared with the reporting of mixed methods studies. We found that mixed methods studies are less likely to provide a description of the research conduct or qualitative data analysis procedures and less likely to be judged credible or provide rich data and thick description compared with standalone qualitative studies. Our time-related analysis shows that for both types of study, papers published since 2003 are more likely to report on the study context, describe analysis procedures, and be judged credible and provide rich data. However, the reporting of other aspects of research conduct (i.e. descriptions of the research question, the sampling strategy, and data collection methods) in mixed methods studies does not appear to have improved over time. Mixed methods research makes an important contribution to health research in general, and could make a more substantial contribution to systematic reviews. Through our careful analysis of the quality of reporting of mixed methods and qualitative-only research, we have identified areas that deserve more attention in the conduct and reporting of mixed methods research.

  1. Qualitative Evaluation Methods in Ethics Education: A Systematic Review and Analysis of Best Practices.

    Science.gov (United States)

    Watts, Logan L; Todd, E Michelle; Mulhearn, Tyler J; Medeiros, Kelsey E; Mumford, Michael D; Connelly, Shane

    2017-01-01

    Although qualitative research offers some unique advantages over quantitative research, qualitative methods are rarely employed in the evaluation of ethics education programs and are often criticized for a lack of rigor. This systematic review investigated the use of qualitative methods in studies of ethics education. Following a review of the literature in which 24 studies were identified, each study was coded based on 16 best practices characteristics in qualitative research. General thematic analysis and grounded theory were found to be the dominant approaches used. Researchers are effectively executing a number of best practices, such as using direct data sources, structured data collection instruments, non-leading questioning, and expert raters. However, other best practices were rarely present in the courses reviewed, such as collecting data using multiple sources, methods, raters, and timepoints, evaluating reliability, and employing triangulation analyses to assess convergence. Recommendations are presented for improving future qualitative research studies in ethics education.

  2. Quality of life among dermatology patients: a systematic review of investigations using qualitative methods.

    Science.gov (United States)

    Singh, Sanminder; Ehsani-Chimeh, Nazanin; Kornmehl, Heather; Armstrong, April W

    2017-07-13

    Quality of life may be assessed using quantitative or qualitative methods. Quantitative methods are commonly used in research settings; however, they may fail to capture the full range of patient experiences and impact on quality of life. Qualitative methods may be used to address this limitation. In this systematic review, we aim to synthesize data from articles utilizing qualitative methods to assess quality of life in dermatology patients. We performed a systematic review search using the MEDLINE, EMBASE, and SCOPUS databases. The search was conducted using the following search criteria: ("Dermatology" [MeSH]) AND ("Quality of Life" [MeSH]), AND ("Qualitative Research" [MeSH]), searching literature spanning from January 1, 1946- October 5, 2016. The systematic review of 15 articles included 533 dermatology patients. Patients expressed frustration over the unpredictability of disease symptoms and having to compensate for the subsequent limitations by altering their daily routines. Patients also reported profound helplessness due to chronic skin disease and social isolation in an effort to hide their disease. Patients noted the patient-provider relationship as a source of support and information exchange, with the goal to form easy to use treatment plans that met both physician and patient expectations. Qualitative assessment of patient quality of life can provide new insights into the patient experience and the impact of their skin disease. Qualitative methodology may capture meaningful information that may be overlooked by quantitative methods, and it should be included in quality of life research.

  3. Adolescents' Perspectives on the Barriers and Facilitators of Physical Activity: A Systematic Review of Qualitative Studies

    Science.gov (United States)

    Martins, João; Marques, Adilson; Sarmento, Hugo; Carreiro da Costa, Francisco

    2015-01-01

    This article examined qualitative studies of adolescents' perspectives about the facilitators and barriers of physical activity, published from 2007 to 2014. A systematic review of "Web of Science", "EBSCO", "Psychinfo" and "ERIC" databases was performed according to Preferred Reporting Items for Systematic…

  4. Patient expectations of treatment for back pain - A systematic review of qualitative and quantitative studies

    NARCIS (Netherlands)

    Verbeek, Jos; Sengers, Marie-José; Riemens, Linda; Haafkens, Joke

    2004-01-01

    Study Design. A systematic review of qualitative and quantitative studies. Objectives. To summarize evidence from studies among patients with low back pain on their expectations and satisfaction with treatment as part of practice guideline development. Summary of Background Data. Patients are often

  5. HIV Testing among Men Who Have Sex with Men (MSM): Systematic Review of Qualitative Evidence

    Science.gov (United States)

    Lorenc, Theo; Marrero-Guillamon, Isaac; Llewellyn, Alexis; Aggleton, Peter; Cooper, Chris; Lehmann, Angela; Lindsay, Catriona

    2011-01-01

    We conducted a systematic review of qualitative evidence relating to the views and attitudes of men who have sex with men (MSM) concerning testing for HIV. Studies conducted in high-income countries (Organisation for Economic Co-operation and Development members) since 1996 were included. Seventeen studies were identified, most of gay or bisexual…

  6. Masculinity lost: a systematic review of qualitative research on men with spinal cord injury.

    Science.gov (United States)

    Nolan, M

    2013-08-01

    Systematic, thematic, narrative review of qualitative literature. To systematically review qualitative research that explores the impact of spinal cord injury (SCI) on the gendered experience of men with SCI. A systematic search of databases and hand search of relevant journals to provide a thematic narrative review of articles, providing sufficient depth of information, relevant participant quotes and phenomenological insight into the gendered experience of men with SCI. Identified studies are summarised and common themes extracted and discussed in relation to relevant literature on masculinity, disability and health. Eight papers, representing four separate studies met the review criteria for relevance and rigour. Three broad, overlapping themes describing the gendered experience of men with SCI were identified: 'lost masculinity', outlining the impact of SCI on traditional masculine identity, 'fighting back', describing the battle to regain and reclaim masculinity and integrate disability into a revised identity and 'beyond hegemony', referring to possibilities beyond adherence to traditional masculine scripts. This review demonstrates a lack of explicit focus on men as gendered beings within the available qualitative literature. The findings are consistent with the limited quantitative data, which indicates that grappling with altered gendered identity is a central feature of life for men with SCI. Masculine identity emerges in this review as vulnerable to the impact of SCI, and given the strong links identified between masculinity, rehabilitation and health, as an aspect of experience that warrants more attention than it has received.

  7. Qualitative systematic reviews of treatment burden in stroke, heart failure and diabetes - Methodological challenges and solutions

    Science.gov (United States)

    2013-01-01

    Background Treatment burden can be defined as the self-care practices that patients with chronic illness must perform to respond to the requirements of their healthcare providers, as well as the impact that these practices have on patient functioning and well being. Increasing levels of treatment burden may lead to suboptimal adherence and negative outcomes. Systematic review of the qualitative literature is a useful method for exploring the patient experience of care, in this case the experience of treatment burden. There is no consensus on methods for qualitative systematic review. This paper describes the methodology used for qualitative systematic reviews of the treatment burdens identified in three different common chronic conditions, using stroke as our exemplar. Methods Qualitative studies in peer reviewed journals seeking to understand the patient experience of stroke management were sought. Limitations of English language and year of publication 2000 onwards were set. An exhaustive search strategy was employed, consisting of a scoping search, database searches (Scopus, CINAHL, Embase, Medline & PsycINFO) and reference, footnote and citation searching. Papers were screened, data extracted, quality appraised and analysed by two individuals, with a third party for disagreements. Data analysis was carried out using a coding framework underpinned by Normalization Process Theory (NPT). Results A total of 4364 papers were identified, 54 were included in the review. Of these, 51 (94%) were retrieved from our database search. Methodological issues included: creating an appropriate search strategy; investigating a topic not previously conceptualised; sorting through irrelevant data within papers; the quality appraisal of qualitative research; and the use of NPT as a novel method of data analysis, shown to be a useful method for the purposes of this review. Conclusion The creation of our search strategy may be of particular interest to other researchers carrying out

  8. Qualitative systematic reviews of treatment burden in stroke, heart failure and diabetes - methodological challenges and solutions.

    Science.gov (United States)

    Gallacher, Katie; Jani, Bhautesh; Morrison, Deborah; Macdonald, Sara; Blane, David; Erwin, Patricia; May, Carl R; Montori, Victor M; Eton, David T; Smith, Fiona; Batty, G David; Batty, David G; Mair, Frances S

    2013-01-28

    Treatment burden can be defined as the self-care practices that patients with chronic illness must perform to respond to the requirements of their healthcare providers, as well as the impact that these practices have on patient functioning and well being. Increasing levels of treatment burden may lead to suboptimal adherence and negative outcomes. Systematic review of the qualitative literature is a useful method for exploring the patient experience of care, in this case the experience of treatment burden. There is no consensus on methods for qualitative systematic review. This paper describes the methodology used for qualitative systematic reviews of the treatment burdens identified in three different common chronic conditions, using stroke as our exemplar. Qualitative studies in peer reviewed journals seeking to understand the patient experience of stroke management were sought. Limitations of English language and year of publication 2000 onwards were set. An exhaustive search strategy was employed, consisting of a scoping search, database searches (Scopus, CINAHL, Embase, Medline & PsycINFO) and reference, footnote and citation searching. Papers were screened, data extracted, quality appraised and analysed by two individuals, with a third party for disagreements. Data analysis was carried out using a coding framework underpinned by Normalization Process Theory (NPT). A total of 4364 papers were identified, 54 were included in the review. Of these, 51 (94%) were retrieved from our database search. Methodological issues included: creating an appropriate search strategy; investigating a topic not previously conceptualised; sorting through irrelevant data within papers; the quality appraisal of qualitative research; and the use of NPT as a novel method of data analysis, shown to be a useful method for the purposes of this review. The creation of our search strategy may be of particular interest to other researchers carrying out synthesis of qualitative studies

  9. A systematic review of qualitative evidence of cancer patients' attitudes to mindfulness.

    Science.gov (United States)

    Tate, K J; Newbury-Birch, D; McGeechan, G J

    2018-03-01

    Mindfulness has been described as a non-elaborative, non-judgmental, present-centred awareness in which each thought, feeling or sensation is acknowledged and accepted. The aim of the present study was to systematically search and synthesise qualitative evidence of cancer patients' attitudes to mindfulness. A systematic review of qualitative evidence was conducted following the SPICE framework. All cancers were included. Medline, Cinahl, Science Direct, O-Alster and New Bank were searched from the first available year to August 2016 using the search terms; wellbeing, mindfulness, qualitative. Two reviewers independently screened titles and abstracts; potentially relevant articles were retrieved and assessed independently by two reviewers. Data were extracted and quality assessed using Critical Appraisal Skills Programme (CASP) qualitative research checklist. In total, 233 studies conducted between 2005 and 2015 were identified with six included in the final analysis. Four themes were identified: Coping strategies developed through mindfulness course; Positive outcomes of mindful practice; Challenges with engaging in mindful practice; and Group identification and shared experience. The current evidence supports the view that mindfulness is an effective intervention to help people adjust to living with and beyond cancer however, more qualitative work is needed in this area. © 2017 John Wiley & Sons Ltd.

  10. A Guide to Writing a Qualitative Systematic Review Protocol to Enhance Evidence-Based Practice in Nursing and Health Care.

    Science.gov (United States)

    Butler, Ashleigh; Hall, Helen; Copnell, Beverley

    2016-06-01

    The qualitative systematic review is a rapidly developing area of nursing research. In order to present trustworthy, high-quality recommendations, such reviews should be based on a review protocol to minimize bias and enhance transparency and reproducibility. Although there are a number of resources available to guide researchers in developing a quantitative review protocol, very few resources exist for qualitative reviews. To guide researchers through the process of developing a qualitative systematic review protocol, using an example review question. The key elements required in a systematic review protocol are discussed, with a focus on application to qualitative reviews: Development of a research question; formulation of key search terms and strategies; designing a multistage review process; critical appraisal of qualitative literature; development of data extraction techniques; and data synthesis. The paper highlights important considerations during the protocol development process, and uses a previously developed review question as a working example. This paper will assist novice researchers in developing a qualitative systematic review protocol. By providing a worked example of a protocol, the paper encourages the development of review protocols, enhancing the trustworthiness and value of the completed qualitative systematic review findings. Qualitative systematic reviews should be based on well planned, peer reviewed protocols to enhance the trustworthiness of results and thus their usefulness in clinical practice. Protocols should outline, in detail, the processes which will be used to undertake the review, including key search terms, inclusion and exclusion criteria, and the methods used for critical appraisal, data extraction and data analysis to facilitate transparency of the review process. Additionally, journals should encourage and support the publication of review protocols, and should require reference to a protocol prior to publication of the

  11. Using qualitative methods to understand factors contributing to patient satisfaction among dermatology patients: a systematic review.

    Science.gov (United States)

    Gibbons, Caitlin; Singh, Sanminder; Gibbons, Brittany; Clark, Caitlin; Torres, Josefina; Cheng, Michelle Y; Wang, Elizabeth A; Armstrong, April W

    2018-05-01

    In this systematic review, we aimed to synthesize data that identify factors contributing to patient satisfaction in dermatology care using qualitative methods. We performed a comprehensive search of the literature using the PubMed database for articles published between January 1, 2000 and February 9, 2015. The initial search yielded 186 articles, of which 13 were included after applying inclusion and exclusion criteria. The systematic review of 13 articles included a total of 330 patients. Using in-field observations and semistructured interviews, studies found that qualitative methods and analysis increased the provider's sensitivity to patient needs and enhanced patient care. Analyses using qualitative methods found increased patient satisfaction in their healthcare provider is associated with (1) confidence in the provider's diagnosis, (2) perception of patient-centered, individualized recommendations and (3) quality of patient education and provider explanation during a visit. Patient satisfaction is measured using either quantitative or qualitative methods. Quantitative methods result in standardized data that often does not capture the nuances of patient experience. In contrast, qualitative methodology is integral to gathering patient perspectives on patient care and satisfaction and should be included in future research models.

  12. How are qualitative methods used in diabetes research? A 30-year systematic review.

    Science.gov (United States)

    Hennink, Monique M; Kaiser, Bonnie N; Sekar, Swathi; Griswold, Emily P; Ali, Mohammed K

    2017-02-01

    We aimed to describe how qualitative methods are used in global research on diabetes and identify opportunities whereby qualitative methods could further benefit our understanding of the human experience of diabetes and interventions to address it. We conducted a systematic review of National Library of Medicine, EMBASE, and Web of Science electronic databases to identify original research articles that used qualitative methods to study diabetes between 1980 and 2011. We identified 554 eligible articles and categorised these by geographic region, year of publication, study population, study design, research question, qualitative data collection methods, and journal type. Results show low use of qualitative methods in diabetes research over the past 30 years. The majority of articles (75%) reported using substantive qualitative research, while mixed-methods research has remained underutilised. Eighty-five per cent of articles reported studies conducted in North America or Europe, with few studies in developing countries. Most articles reported recruiting clinic-based populations (58%). Over half (54%) of research questions focused on patient experience and 24% on diabetes management. Qualitative methods can provide important insights about socio-cultural aspects of disease to improve disease management. However, they remain underutilised for understanding the diabetes experience, especially in Africa and Asia and amongst non-clinic populations.

  13. A qualitative systematic review of patients' experience of osteoporosis using meta-ethnography.

    Science.gov (United States)

    Barker, K L; Toye, F; Lowe, C J Minns

    2016-12-01

    We aimed to systematically review qualitative studies exploring the experience of living with osteoporosis to develop new conceptual understanding. We identified themes about the invisibility/visibility of osteoporosis, the experience of uncertainty of living with osteoporosis (OP) and living with an ageing body and the place of gender. The aim of this review was to systematically review the body of qualitative studies exploring the experience of living with either osteoporosis or osteopenia and to use meta-ethnography to develop new conceptual understanding. We systematically reviewed and integrated the findings of qualitative research from four bibliographic databases (Medline, Embase, Cinahl, Psychinfo) to September 2015 in order to increase our conceptual understanding of the lived experience of osteoporosis and osteopenia. Articles were appraised for quality; each was independently read by two researchers to identify concepts which were compared and developed into a conceptual model. Our findings demonstrate that coming to terms with a diagnosis of osteoporosis is linked to its relative visibility or invisibility. For some, OP has not become manifest and self-identity is intact (biographical integrity). For others, OP is profoundly manifest and self-identity is no long intact (biographical fracture). We also demonstrate that overwhelming uncertainty pervades the experience of OP. Our final theme demonstrates how the experience of OP is set within a cultural context with certain views about ageing and gender. Our synthesis has highlighted the wealth of qualitative data about osteoporosis and osteopenia. Despite the increasing body of literature on the subject, there remains a need to adjust our interactions with patients. This will allow clinicians to understand how patients can be helped to receive and understand their diagnosis and move forward in partnership with healthcare providers to promote optimal management of the disease.

  14. A guide to reading and using systematic reviews of qualitative research.

    Science.gov (United States)

    Tong, Allison; Palmer, Suetonia; Craig, Jonathan C; Strippoli, Giovanni F M

    2016-06-01

    There is an increasingly widespread policy momentum to increase patient-centred care and to improve quality of life outcomes within health services. Qualitative research methods are used to elicit in-depth and detailed insights into people's attitudes, beliefs, emotions and experiences-much of which may remain unspoken during clinical encounters. Questions about patients' beliefs and preferences for treatment can be addressed by qualitative research and inform evidence-based strategies for delivering patient-centred care. Systematic reviews of multiple primary qualitative studies bring together findings from different studies to offer new and more comprehensive understandings of social phenomena across various healthcare contexts and populations and are an emerging methodology in the literature including for care in chronic kidney disease. This article will provide a framework for the systematic review of qualitative research so readers can make sense of these study types and use them in clinical care and policy. © The Author 2014. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

  15. Dating Violence among High-Risk Young Women: A Systematic Review Using Quantitative and Qualitative Methods

    Science.gov (United States)

    Joly, Lauren E.; Connolly, Jennifer

    2016-01-01

    Our systematic review identified 21 quantitative articles and eight qualitative articles addressing dating violence among high risk young women. The groups of high-risk young women in this review include street-involved, justice-involved, pregnant or parenting, involved with Child Protective Services, and youth diagnosed with a mental health issue. Our meta-analysis of the quantitative articles indicated that 34% (CI = 0.24–0.45) of high-risk young women report that they have been victims of physical dating violence and 45% (CI = 0.31–0.61) of these young women report perpetrating physical dating violence. Significant moderator variables included questionnaire and timeframe. Meta-synthesis of the qualitative studies revealed that high-risk young women report perpetrating dating violence to gain power and respect, whereas women report becoming victims of dating violence due to increased vulnerability. PMID:26840336

  16. Dating Violence among High-Risk Young Women: A Systematic Review Using Quantitative and Qualitative Methods

    Directory of Open Access Journals (Sweden)

    Lauren E. Joly

    2016-01-01

    Full Text Available Our systematic review identified 21 quantitative articles and eight qualitative articles addressing dating violence among high risk young women. The groups of high-risk young women in this review include street-involved, justice-involved, pregnant or parenting, involved with Child Protective Services, and youth diagnosed with a mental health issue. Our meta-analysis of the quantitative articles indicated that 34% (CI = 0.24–0.45 of high-risk young women report that they have been victims of physical dating violence and 45% (CI = 0.31–0.61 of these young women report perpetrating physical dating violence. Significant moderator variables included questionnaire and timeframe. Meta-synthesis of the qualitative studies revealed that high-risk young women report perpetrating dating violence to gain power and respect, whereas women report becoming victims of dating violence due to increased vulnerability.

  17. How nurses cope with patient death: A systematic review and qualitative meta-synthesis.

    Science.gov (United States)

    Zheng, Ruishuang; Lee, Susan Fiona; Bloomer, Melissa Jane

    2018-01-01

    To review literature on nurses' coping strategies with patient death. Dealing with the loss of a patient was viewed as one of the most demanding and challenging encounters in clinical practice. Those nurses who are not competent in coping with patient death may be inadequate in supporting dying patients and their family members, and minimise the quality of end-of-life care. To get a broader understanding of how nurses cope with patient death and to develop meaningful and effective interventions, a systematic review which would help underpin the multidimensional approaches is needed. A systematic review. Exhaustive searching in ten databases: CINAHL Plus, EMBASE, MEDLINE, AMED, PsycINFO, ProQuest Health & Medical Complete, ProQuest Dissertations & Theses Global, Google Scholar, EThOS and CareSearch. Meta-aggregation was used to synthesise the findings of the included studies. This systematic review aggregated ten categories from the sixteen qualitative studies included, and then two synthesised findings were derived: intrinsic resources and extrinsic resources. The intrinsic resources consisted of setting boundaries, reflection, crying, death beliefs, life and work experience, and daily routines and activity. The extrinsic resources were comprised of talking and being heard, spiritual practices, education and programmes, and debriefing. This systematic review synthesised the findings about what resources nurses use when coping with patient death and made recommendations on future directions. Areas which could be developed to improve deficiencies that nurses had when faced with the losses of their patients were identified. Nurses need more support resources, which better assist them in coping with patient death. The results of this systematic review could provide evidence for nurses' coping strategies when dealing with patient death, and the recommendations could be employed by nurses to cope with the losses of patients. © 2017 John Wiley & Sons Ltd.

  18. Family Caregivers' Experiences of Caring for a Relative With Younger Onset Dementia: A Qualitative Systematic Review.

    Science.gov (United States)

    Cabote, Christy Joy; Bramble, Marguerite; McCann, Damhnat

    2015-08-01

    Family caregiving for people with younger onset dementia affects everyone in the family unit. This article presents findings of a qualitative systematic review exploring the experiences of family caregivers of persons with younger onset dementia. A systematic search resulted in the inclusion of five relevant articles, and two groups within the family unit were identified-child caregivers and adult and spousal caregivers. Using the thematic synthesis approach, five themes emerged: dementia damage, grief for loss of relationship, changes in family roles, positive and negative impacts of family caregiving, and transition to formal care. The review findings support increasing evidence that despite the stress of caring for a person with dementia damage, family members have the capacity to cope, adapt, and grow through their experiences. Nurses can assist families to identify their unique strengths and enhance family resiliency so they can navigate the "lonely road" of younger onset dementia. © The Author(s) 2015.

  19. Exploring the influence of local food environments on food behaviours: a systematic review of qualitative literature.

    Science.gov (United States)

    Pitt, Erin; Gallegos, Danielle; Comans, Tracy; Cameron, Cate; Thornton, Lukar

    2017-09-01

    Systematic reviews investigating associations between objective measures of the food environment and dietary behaviours or health outcomes have not established a consistent evidence base. The present paper aims to synthesise qualitative evidence regarding the influence of local food environments on food and purchasing behaviours. A systematic review in the form of a qualitative thematic synthesis. Urban localities. Adults. Four analytic themes were identified from the review including community and consumer nutrition environments, other environmental factors and individual coping strategies for shopping and purchasing decisions. Availability, accessibility and affordability were consistently identified as key determinants of store choice and purchasing behaviours that often result in less healthy food choices within community nutrition environments. Food availability, quality and food store characteristics within consumer nutrition environments also greatly influenced in-store purchases. Individuals used a range of coping strategies in both the community and consumer nutrition environments to make optimal purchasing decisions, often within the context of financial constraints. Findings from the current review add depth and scope to quantitative literature and can guide ongoing theory, interventions and policy development in food environment research. There is a need to investigate contextual influences within food environments as well as individual and household socio-economic characteristics that contribute to the differing use of and views towards local food environments. Greater emphasis on how individual and environmental factors interact in the food environment field will be key to developing stronger understanding of how environments can support and promote healthier food choices.

  20. What can qualitative research do for randomised controlled trials? A systematic mapping review

    Science.gov (United States)

    O'Cathain, A; Thomas, K J; Drabble, S J; Rudolph, A; Hewison, J

    2013-01-01

    Objective To develop an empirically based framework of the aspects of randomised controlled trials addressed by qualitative research. Design Systematic mapping review of qualitative research undertaken with randomised controlled trials and published in peer-reviewed journals. Data sources MEDLINE, PreMEDLINE, EMBASE, the Cochrane Library, Health Technology Assessment, PsycINFO, CINAHL, British Nursing Index, Social Sciences Citation Index and ASSIA. Eligibility criteria Articles reporting qualitative research undertaken with trials published between 2008 and September 2010; health research, reported in English. Results 296 articles met the inclusion criteria. Articles focused on 22 aspects of the trial within five broad categories. Some articles focused on more than one aspect of the trial, totalling 356 examples. The qualitative research focused on the intervention being trialled (71%, 254/356); the design, process and conduct of the trial (15%, 54/356); the outcomes of the trial (1%, 5/356); the measures used in the trial (3%, 10/356); and the target condition for the trial (9%, 33/356). A minority of the qualitative research was undertaken at the pretrial stage (28%, 82/296). The value of the qualitative research to the trial itself was not always made explicit within the articles. The potential value included optimising the intervention and trial conduct, facilitating interpretation of the trial findings, helping trialists to be sensitive to the human beings involved in trials, and saving money by steering researchers towards interventions more likely to be effective in future trials. Conclusions A large amount of qualitative research undertaken with specific trials has been published, addressing a wide range of aspects of trials, with the potential to improve the endeavour of generating evidence of effectiveness of health interventions. Researchers can increase the impact of this work on trials by undertaking more of it at the pretrial stage and being explicit

  1. The Full Spectrum of Clinical Ethical Issues in Kidney Failure. Findings of a Systematic Qualitative Review.

    Science.gov (United States)

    Kahrass, Hannes; Strech, Daniel; Mertz, Marcel

    2016-01-01

    When treating patients with kidney failure, unavoidable ethical issues often arise. Current clinical practice guidelines some of them, but lack comprehensive information about the full range of relevant ethical issues in kidney failure. A systematic literature review of such ethical issues supports medical professionalism in nephrology, and offers a solid evidential base for efforts that aim to improve ethical conduct in health care. To identify the full spectrum of clinical ethical issues that can arise for patients with kidney failure in a systematic and transparent manner. A systematic review in Medline (publications in English or German between 2000 and 2014) and Google Books (with no restrictions) was conducted. Ethical issues were identified by qualitative text analysis and normative analysis. The literature review retrieved 106 references that together mentioned 27 ethical issues in clinical care of kidney failure. This set of ethical issues was structured into a matrix consisting of seven major categories and further first and second-order categories. The systematically-derived matrix helps raise awareness and understanding of the complexity of ethical issues in kidney failure. It can be used to identify ethical issues that should be addressed in specific training programs for clinicians, clinical practice guidelines, or other types of policies dealing with kidney failure.

  2. The full spectrum of ethical issues in dementia care: systematic qualitative review.

    Science.gov (United States)

    Strech, Daniel; Mertz, Marcel; Knüppel, Hannes; Neitzke, Gerald; Schmidhuber, Martina

    2013-06-01

    Integrating ethical issues in dementia-specific training material, clinical guidelines and national strategy plans requires an unbiased awareness of all the relevant ethical issues. To determine systematically and transparently the full spectrum of ethical issues in clinical dementia care. We conducted a systematic review in Medline (restricted to English and German literature published between 2000 and 2011) and Google books (with no restrictions). We applied qualitative text analysis and normative analysis to categorise the spectrum of ethical issues in clinical dementia care. The literature review retrieved 92 references that together mentioned a spectrum of 56 ethical issues in clinical dementia care. The spectrum was structured into seven major categories that consist of first- and second-order categories for ethical issues. The systematically derived spectrum of ethical issues in clinical dementia care presented in this paper can be used as training material for healthcare professionals, students and the public for raising awareness and understanding of the complexity of ethical issues in dementia care. It can also be used to identify ethical issues that should be addressed in dementia-specific training programmes, national strategy plans and clinical practice guidelines. Further research should evaluate whether this new genre of systematic reviews can be applied to the identification of ethical issues in other cognitive and somatic diseases. Also, the practical challenges in addressing ethical issues in training material, guidelines and policies need to be evaluated.

  3. Systematic review of qualitative studies exploring parental experiences in the Neonatal Intensive Care Unit.

    Science.gov (United States)

    Al Maghaireh, Dua'a Fayiz; Abdullah, Khatijah Lim; Chan, Chong Mei; Piaw, Chua Yan; Al Kawafha, Mariam Mofleh

    2016-10-01

    To determine the feasibility and utility of a thematic analysis approach to synthesising qualitative evidence about parental experiences in the neonatal intensive care unit. Admission of infants to the neonatal intensive care unit is usually an unexpected event for parents who can cause them to experience psychosocial difficulties. A qualitative systematic review is the best method for exploring these parents' experiences regarding this type of admission. Systematic review. Qualitative studies in peer-reviewed journals aimed at understanding parental experiences regarding infant neonatal intensive care unit admission were identified in six electronic databases. Three reviewers selected relevant articles and assessed the quality of the methodological studies using the Critical Appraisal Skills Programme. A thematic analysis approach was used to identify the most common themes in the studies describing parental experiences in the neonatal intensive care unit. A total of eighty articles were identified; nine studies were included in this review. Four studies used semistructured interviews, three used interviews, one used self-reporting and one used both focus group and interview methodologies. Common themes across parents' experiences were the stress of hospitalisation, alteration in parenting roles and the impact of infant hospitalisation on psychological health. Having an infant hospitalised in the neonatal intensive care unit is a stressful experience for parents. This experience is the result of exposure to different stressors related to the infant's condition, an alteration in parenting roles or the neonatal intensive care unit environment and staffing. These parents suffered negative psychological effects, experienced an interrupted development of a healthy parent-infant attachment and/or felt parental role alteration. The study's findings are crucial for neonatal intensive care unit nurses to develop intervention strategies and programmes that help parents to

  4. Which learning activities enhance physiotherapy practice? A systematic review protocol of quantitative and qualitative studies.

    Science.gov (United States)

    Leahy, Edmund; Chipchase, Lucy; Blackstock, Felicity

    2017-04-17

    Learning activities are fundamental for the development of expertise in physiotherapy practice. Continuing professional development (CPD) encompasses formal and informal learning activities undertaken by physiotherapists. Identifying the most efficient and effective learning activities is essential to enable the profession to assimilate research findings and improve clinical skills to ensure the most efficacious care for clients. To date, systematic reviews on the effectiveness of CPD provide limited guidance on the most efficacious models of professional development for physiotherapists. The aim of this systematic review is to evaluate which learning activities enhance physiotherapy practice. A search of Ovid MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO (Psychological Abstracts), PEDro, Cochrane Library, AMED and Educational Resources and Information Center (ERIC) will be completed. Citation searching and reference list searching will be undertaken to locate additional studies. Quantitative and qualitative studies will be included if they examine the impact of learning activities on clinician's behaviour, attitude, knowledge, beliefs, skills, self-efficacy, work satisfaction and patient outcomes. Risk of bias will be assessed by two independent researchers. Grading of Recommendations Assessment, Development, and Evaluation (GRADE) and Confidence in the Evidence from Reviews of Qualitative research (CERQual) will be used to synthesise results where a meta-analysis is possible. Where a meta-analysis is not possible, a narrative synthesis will be conducted. PROSPERO CRD42016050157.

  5. Patients' decision making in total knee arthroplasty: a systematic review of qualitative research.

    Science.gov (United States)

    Barlow, T; Griffin, D; Barlow, D; Realpe, A

    2015-10-01

    A patient-centred approach, usually achieved through shared decision making, has the potential to help improve decision making around knee arthroplasty surgery. However, such an approach requires an understanding of the factors involved in patient decision making. This review's objective is to systematically examine the qualitative literature surrounding patients' decision making in knee arthroplasty. A systematic literature review using Medline and Embase was conducted to identify qualitative studies that examined patients' decision making around knee arthroplasty. An aggregated account of what is known about patients' decision making in knee arthroplasties is provided. Seven studies with 234 participants in interviews or focus groups are included. Ten themes are replicated across studies, namely: expectations of surgery; coping mechanisms; relationship with clinician; fear; pain; function; psychological implications; social network; previous experience of surgery; and conflict in opinions. This review is helpful in not only directing future research to areas that are not understood, or require confirmation, but also in highlighting areas that future interventions could address. These include those aimed at delivering information, which are likely to affect the satisfaction rate, demand, and use of knee arthroplasties. Cite this article: Bone Joint Res 2015;4;163-169. ©2015 Griffin.

  6. Informed Consent in Pediatric Oncology: A Systematic Review of Qualitative Literature.

    Science.gov (United States)

    Alahmad, Ghiath

    2018-01-01

    Obtaining informed consent in pediatric cancer research can be subject to important ethical challenges because of the difficulty in distinguishing between care and research, which are interrelated. Pediatric oncologists also often conduct research, such as clinical trials, on their own patients, which may influence voluntary informed consent. This review aims to determine the ethical issues encountered in obtaining informed consent in pediatric oncology by identifying and summarizing the findings of existing qualitative studies on this topic. A systematic review of qualitative studies was conducted. Medline, Embase, CINAHL, and PubMed were searched using the following terms: (oncolog* or cancer or hematol* or haematol* or leuk* or malign* or neoplasm*) and (child* or adolescent* or minor* or young people or pediatr* or paediatr*) and ethic* or moral*) and (qualitative or interview). Other sources were also mined to identify all relevant studies. The data analysis method used was thematic analysis. At the end of the search process, 2361 studies were identified. Duplicates were removed and irrelevant studies were excluded. After screening the full text of the remaining studies against our inclusion and exclusion criteria, 13 studies were included in the qualitative analysis. All studies were qualitative studies using semistructured and structured interviews, qualitative analysis of open-ended questions, and observation of informed consent conferences. Four themes were identified: parental comprehension of the trial and medical terms, influence of parental distress on decision-making, no offer of an alternative treatment, and influence of the doctor-parent relationship. Many ethical challenges affect the informed consent process. These challenges may include a lack of parental understanding, the potential influence of treating doctors, and vulnerability because of psychological status. All of these result in parents being unable to give well-informed and voluntary

  7. Using qualitative comparative analysis in a systematic review of a complex intervention.

    Science.gov (United States)

    Kahwati, Leila; Jacobs, Sara; Kane, Heather; Lewis, Megan; Viswanathan, Meera; Golin, Carol E

    2016-05-04

    Systematic reviews evaluating complex interventions often encounter substantial clinical heterogeneity in intervention components and implementation features making synthesis challenging. Qualitative comparative analysis (QCA) is a non-probabilistic method that uses mathematical set theory to study complex phenomena; it has been proposed as a potential method to complement traditional evidence synthesis in reviews of complex interventions to identify key intervention components or implementation features that might explain effectiveness or ineffectiveness. The objective of this study was to describe our approach in detail and examine the suitability of using QCA within the context of a systematic review. We used data from a completed systematic review of behavioral interventions to improve medication adherence to conduct two substantive analyses using QCA. The first analysis sought to identify combinations of nine behavior change techniques/components (BCTs) found among effective interventions, and the second analysis sought to identify combinations of five implementation features (e.g., agent, target, mode, time span, exposure) found among effective interventions. For each substantive analysis, we reframed the review's research questions to be designed for use with QCA, calibrated sets (i.e., transformed raw data into data used in analysis), and identified the necessary and/or sufficient combinations of BCTs and implementation features found in effective interventions. Our application of QCA for each substantive analysis is described in detail. We extended the original review findings by identifying seven combinations of BCTs and four combinations of implementation features that were sufficient for improving adherence. We found reasonable alignment between several systematic review steps and processes used in QCA except that typical approaches to study abstraction for some intervention components and features did not support a robust calibration for QCA. QCA was

  8. Rapid qualitative research methods during complex health emergencies: A systematic review of the literature.

    Science.gov (United States)

    Johnson, Ginger A; Vindrola-Padros, Cecilia

    2017-09-01

    The 2013-2016 Ebola outbreak in West Africa highlighted both the successes and limitations of social science contributions to emergency response operations. An important limitation was the rapid and effective communication of study findings. A systematic review was carried out to explore how rapid qualitative methods have been used during global heath emergencies to understand which methods are commonly used, how they are applied, and the difficulties faced by social science researchers in the field. We also asses their value and benefit for health emergencies. The review findings are used to propose recommendations for qualitative research in this context. Peer-reviewed articles and grey literature were identified through six online databases. An initial search was carried out in July 2016 and updated in February 2017. The PRISMA checklist was used to guide the reporting of methods and findings. The articles were assessed for quality using the MMAT and AACODS checklist. From an initial search yielding 1444 articles, 22 articles met the criteria for inclusion. Thirteen of the articles were qualitative studies and nine used a mixed-methods design. The purpose of the rapid studies included: the identification of causes of the outbreak, and assessment of infrastructure, control strategies, health needs and health facility use. The studies varied in duration (from 4 days to 1 month). The main limitations identified by the authors were: the low quality of the collected data, small sample sizes, and little time for cross-checking facts with other data sources to reduce bias. Rapid qualitative methods were seen as beneficial in highlighting context-specific issues that need to be addressed locally, population-level behaviors influencing health service use, and organizational challenges in response planning and implementation. Recommendations for carrying out rapid qualitative research in this context included the early designation of community leaders as a point of

  9. Learning outcomes for communication skills across the health professions: a systematic literature review and qualitative synthesis.

    Science.gov (United States)

    Denniston, Charlotte; Molloy, Elizabeth; Nestel, Debra; Woodward-Kron, Robyn; Keating, Jennifer L

    2017-04-07

    The aim of this study was to identify and analyse communication skills learning outcomes via a systematic review and present results in a synthesised list. Summarised results inform educators and researchers in communication skills teaching and learning across health professions. Systematic review and qualitative synthesis. A systematic search of five databases (MEDLINE, PsycINFO, ERIC, CINAHL plus and Scopus), from first records until August 2016, identified published learning outcomes for communication skills in health professions education. Extracted data were analysed through an iterative process of qualitative synthesis. This process was guided by principles of person centredness and an a priori decision guide. 168 papers met the eligibility criteria; 1669 individual learning outcomes were extracted and refined using qualitative synthesis. A final refined set of 205 learning outcomes were constructed and are presented in 4 domains that include: (1) knowledge (eg, describe the importance of communication in healthcare), (2) content skills (eg, explore a healthcare seeker's motivation for seeking healthcare),( 3) process skills (eg, respond promptly to a communication partner's questions) and (4) perceptual skills (eg, reflect on own ways of expressing emotion). This study provides a list of 205 communication skills learning outcomes that provide a foundation for further research and educational design in communication education across the health professions. Areas for future investigation include greater patient involvement in communication skills education design and further identification of learning outcomes that target knowledge and perceptual skills. This work may also prompt educators to be cognisant of the quality and scope of the learning outcomes they design and their application as goals for learning. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  10. Workplace health understandings and processes in small businesses: a systematic review of the qualitative literature.

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    MacEachen, Ellen; Kosny, Agnieszka; Scott-Dixon, Krista; Facey, Marcia; Chambers, Lori; Breslin, Curtis; Kyle, Natasha; Irvin, Emma; Mahood, Quenby

    2010-06-01

    Small businesses (SBs) play an important role in global economies, employ half of all workers, and pose distinct workplace health problems. This systematic review of qualitative peer-reviewed literature was carried out to identify and synthesize research findings about how SB workplace parties understand and enact processes related to occupational health and safety (OHS). The review was conducted as part of a larger mixed-method review and in consultation with stakeholders. A comprehensive literature search identified 5067 studies. After screening for relevance, 20 qualitative articles were identified. Quality assessment led to 14 articles of sufficient quality to be included in the meta-ethnographic findings synthesis. This review finds that SBs have distinctive social relations of work, apprehensions of workplace risk, and legislative requirements. Eight themes were identified that consolidate knowledge on how SB workplace parties understand OHS hazards, how they manage risk and health problems, and how broader structures, policies and systems shape the practice of workplace health in SBs. The themes contribute to 'layers of evidence' that address SB work and health phenomena at the micro (e.g. employer or worker behavior), meso (e.g. organizational dynamics) and macro (e.g. state policy) levels. This synthesis details the unique qualities and conditions of SBs that merit particular attention from planners and occupational health policy makers. In particular, the informal workplace social relations can limit workers' and employers' apprehension of risk, and policy and complex contractual conditions in which SBs are often engaged (such as chains of subcontracting) can complicate occupational health responsibilities. This review questions the utility of SB exemptions from OHS regulations and suggests a legislative focus on the particular needs of SBs. It considers ways that workers might activate their own workplace health concerns, and suggests that more

  11. Experiences of undergraduate nursing students in peer assisted learning in clinical practice: a qualitative systematic review.

    Science.gov (United States)

    Carey, Matthew C; Kent, Bridie; Latour, Jos M

    2018-05-01

    The objective of this qualitative systematic review was to identify and synthesize the best available evidence on experiences of peer assisted learning (PAL) among student nurses in clinical practice so as to understand the value of PAL for this population. Peer-assisted learning considers the benefits of peers working in collaboration and supporting each other in professional roles. This approach to facilitate learning is effective within universities, but there is limited exploration within the clinical practice environment. Within the UK, 50% of student nurses' learning is undertaken within clinical practice, providing a large portion of student allocation within these areas, but is unexplored in relation to PAL. Therefore, existing evidence examining PAL in clinical practice needs further exploration for a better understanding of its value to student nurses' learning. The systematic review considered studies that included male and female nursing students aged 18-50 years that explored undergraduate nursing students' experiences of PAL within the clinical practice environment. Studies that utilized designs such as phenomenology, grounded theory, ethnography, action research and feminist research were considered. Other text such as opinion papers and reports were to be considered if no qualitative studies could be located. The review excluded quantitative studies, as well as those addressing PAL outside the nursing profession and students within the nursing profession but not including undergraduate student nurses. This review considered studies that included aspects related to experiences of PAL in the clinical practice setting, as seen by undergraduate nursing students and the researcher. A three-step search strategy was undertaken to find both published and unpublished studies in English from 2003 to 2017 in various databases, and included searching of reference lists within articles selected for appraisal. Each of the included studies were assessed for

  12. A qualitative systematic review of factors influencing parents’ vaccination decision-making in the United Kingdom

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    Alice S. Forster

    2016-12-01

    Full Text Available Background: High uptake of vaccinations is crucial for disease prevention. Although overall uptake of childhood immunisations is high in the United Kingdom (UK, pockets of lower uptake remain. Novel systematic methods have not been employed when reviewing the qualitative literature examining parents’ vaccination decisions. Aims: We aimed to conduct a qualitative systematic review of studies in the UK to understand factors influencing parental decisions to vaccinate a child. Methods: On 12/2/14 we searched PsycINFO, MEDLINE, CINAHL plus, Embase, Social Policy and Practice and Web of Science for studies using qualitative methods and reporting reasons why parents in the UK had or had not immunised their child. Participant quotes and authors’ interpretations of qualitative data were extracted from the results of articles. Thematic synthesis was used to develop higher-order themes (conducted in 2015. Results: 34 papers were included. Two types of decision-making had been adopted: non-deliberative and deliberative. With non-deliberative decisions parents felt they had no choice, were happy to comply and/or relied on social norms. Deliberative decisions involved weighing up the risks and benefits, considering others’ advice/experiences and social judgement. Emotions affected deliberative decision-making. Trust in information and vaccine stakeholders was integral to all decision-making. Practical issues affected those who intended to vaccinate. Conclusions: Parents adopted two different approaches to decision-making about childhood vaccinations. By understanding more about the mechanisms underpinning parents’ vaccination behaviour, in collaboration with vaccine stakeholders, we can better design interventions to enhance informed uptake. Keywords: Thematic synthesis, Vaccination, Parents, Patient Acceptance of Health Care

  13. Key barriers to gout care: a systematic review and thematic synthesis of qualitative studies.

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    Rai, Sharan K; Choi, Hyon K; Choi, Sally H J; Townsend, Anne F; Shojania, Kam; De Vera, Mary A

    2018-04-17

    Gout care remains highly suboptimal, contributing to an increased global disease burden. To understand barriers to gout care, our aim was to provide a systematic review and thematic synthesis of qualitative studies worldwide reporting provider and patient perspectives and experiences with management. We conducted a mapped search of MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature, and Social Sciences Citation Index databases and selected qualitative studies of provider and patient perspectives on gout management. We used thematic synthesis to combine the included studies and identify key themes across studies. We included 20 studies that reported the experiences and perspectives of 480 gout patients and 120 providers spanning five different countries across three continents. We identified three predominant provider themes: knowledge gaps and management approaches; perceptions and beliefs about gout patients; and system barriers to optimal gout care (e.g. time constraints and a lack of incentives). We also identified four predominant themes among gout patients: limited gout knowledge; interactions with health-care providers; attitudes towards and experiences with taking medication; and practical barriers to long-term medication use. Our systematic review of worldwide literature consistently identified gaps in gout knowledge among providers, which is likely to contribute to patients' lack of appropriate education about the fundamental causes of and essential treatment approaches for gout. Furthermore, system barriers among providers and day-to-day challenges of taking long-term medications among patients are considerable. These factors provide key targets to improve the widespread suboptimal gout care.

  14. Ethical issues in obesity prevention for school children: a systematic qualitative review.

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    Kahrass, Hannes; Strech, Daniel; Mertz, Marcel

    2017-12-01

    Planning and conducting preventive measures against obesity for school children is beset with ethical issues which should be known to make well-informed decisions. The goal of this study was to provide a comprehensive spectrum of these ethical issues by means of a systematic review. In this context, the study also assesses the value of different search strategies for ethical literature in public health. Literature was searched in Medline, EBSCO and others. Three different search strategies with varied scopes were applied and their output was compared. Qualitative content analysis was used for extracting and categorizing ethical issues. 109 publications (published from 1995 to 2015) were finally included. The qualitative analysis resulted in 60 potentially relevant ethical issues. The three search strategies showed substantial differences regarding their search results. The presented spectrum provides an initial evidence base for dealing with ethical issues adequately. The findings of the study further suggest that a broader scope is more fruitful for systematic reviews on ethical issues in the field of public health.

  15. Optimizing lay counsellor services for chronic care in South Africa: a qualitative systematic review.

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    Petersen, Inge; Fairall, Lara; Egbe, Catherine O; Bhana, Arvin

    2014-05-01

    To conduct a qualitative systematic review on the use of lay counsellors in South Africa to provide lessons on optimizing their use for psychological and behavioural change counselling for chronic long-term care in scare-resource contexts. A qualitative systematic review of the literature on lay counsellor services in South Africa. Twenty-nine studies met the inclusion criteria. Five randomized control trials and two cohort studies reported that lay counsellors can provide behaviour change counselling with good outcomes. One multi-centre cohort study provided promising evidence of improved anti-retroviral treatment adherence and one non-randomized controlled study provided promising results for counselling for depression. Six studies found low fidelity of lay counsellor-delivered interventions in routine care. Reasons for low fidelity include poor role definition, inconsistent remuneration, lack of standardized training, and poor supervision and logistical support. Within resource-constrained settings, adjunct behaviour change and psychological services provided by lay counsellors can be harnessed to promote chronic care at primary health care level. Optimizing lay counsellor services requires interventions at an organizational level that provide a clear role definition and scope of practice; in-service training and formal supervision; and sensitization of health managers to the importance and logistical requirements of counselling. Copyright © 2014 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  16. Seasonal influenza vaccination of healthcare workers: systematic review of qualitative evidence

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    Theo Lorenc

    2017-11-01

    Full Text Available Abstract Background Most countries recommend that healthcare workers (HCWs are vaccinated seasonally against influenza in order to protect themselves and patients. However, in many cases coverage remains low. A range of strategies have been implemented to increase uptake. Qualitative evidence can help in understanding the context of interventions, including why interventions may fail to achieve the desired effect. This study aimed to synthesise evidence on HCWs’ perceptions and experiences of vaccination for seasonal influenza. Methods Systematic review of qualitative evidence. We searched MEDLINE, EMBASE and CINAHL and included English-language studies which reported substantive qualitative data on the vaccination of HCWs for seasonal influenza. Findings were synthesised thematically. Results Twenty-five studies were included in the review. HCWs may be motivated to accept vaccination to protect themselves and their patients against infection. However, a range of beliefs may act as barriers to vaccine uptake, including concerns about side-effects, scepticism about vaccine effectiveness, and the belief that influenza is not a serious illness. HCWs value their autonomy and professional responsibility in making decisions about vaccination. The implementation of interventions to promote vaccination uptake may face barriers both from HCWs’ personal beliefs and from the relationships between management and employees within the targeted organisations. Conclusions HCWs’ vaccination behaviour needs to be understood in the context of HCWs’ relationships with each other, with management and with patients. Interventions to promote vaccination should take into account both the individual beliefs of targeted HCWs and the organisational context within which they are implemented.

  17. Teenage pregnancy and social disadvantage: systematic review integrating controlled trials and qualitative studies.

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    Harden, Angela; Brunton, Ginny; Fletcher, Adam; Oakley, Ann

    2009-11-12

    To determine the impact on teenage pregnancy of interventions that address the social disadvantage associated with early parenthood and to assess the appropriateness of such interventions for young people in the United Kingdom. Systematic review, including a statistical meta-analysis of controlled trials on interventions for early parenthood and a thematic synthesis of qualitative studies that investigated the views on early parenthood of young people living in the UK. 12 electronic bibliographic databases, five key journals, reference lists of relevant studies, study authors, and experts in the field. Review methods Two independent reviewers assessed the methodological quality of studies and abstracted data. Ten controlled trials and five qualitative studies were included. Controlled trials evaluated either early childhood interventions or youth development programmes. The overall pooled effect size showed that teenage pregnancy rates were 39% lower among individuals receiving an intervention than in those receiving standard practice or no intervention (relative risk 0.61; 95% confidence interval 0.48 to 0.77). Three main themes associated with early parenthood emerged from the qualitative studies: dislike of school; poor material circumstances and unhappy childhood; and low expectations for the future. Comparison of these factors related to teenage pregnancy with the content of the programmes used in the controlled trials indicated that both early childhood interventions and youth development programmes are appropriate strategies for reducing unintended teenage pregnancies. The programmes aim to promote engagement with school through learning support, ameliorate unhappy childhood through guidance and social support, and raise aspirations through career development and work experience. However, none of these approaches directly tackles all the societal, community, and family level factors that influence young people's routes to early parenthood. A small but

  18. Young women's experiences of psychotic illness: a systematic review of qualitative research.

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    Chernomas, Wanda M; Rieger, Kendra L; Karpa, Jane V; Clarke, Diana E; Marchinko, Shelley; Demczuk, Lisa

    2017-03-01

    The relationship between young adulthood, women and psychosis was the focus for this systematic review. Age and gender are factors that can influence responses to illness. Research indicates that there are differences in how young men and women are affected biologically and psychosocially, including the presentation of a constellation of symptoms, response to anti-psychotic medications and how they assess their life circumstances. Yet in literature that examines experiences of young people with psychosis, the specific needs of young women are usually not presented separately. To better understand and address young adult women's healthcare and social service needs, a synthesis of evidence addressing the relationship between young adulthood, women and psychosis is needed. The aim of this systematic review was to synthesize the best available evidence on the experiences of young adult women (aged 18-35 years) living with a psychotic illness in the community. Specifically, the review question was:What are the experiences of young adult women living with a psychotic illness? Participants were young women between 18 and 35 years of age who were living with a psychotic illness in the community. The phenomenon of interest was the experiences of living with a psychotic illness of women aged 18-35 years in the community. Experiences were defined broadly as and inclusive of perceptions and experiences with health and social systems. The context for this review was the community setting. The current review included studies that focused on qualitative data including, but not limited to, designs such as phenomenology, grounded theory, ethnography, action research, feminist research and the qualitative component of mixed methods studies. A three-step search strategy was used to locate both published and unpublished studies. The search was limited to studies published from 1995 to the search date of May 13, 2015. Two reviewers independently appraised the nine included studies

  19. The patient experience of high technology medical imaging: A systematic review of the qualitative evidence

    International Nuclear Information System (INIS)

    Munn, Zachary; Jordan, Zoe

    2011-01-01

    Background: When presenting to an imaging department, the person who is to be imaged is often in a vulnerable state, and can experience the scan in a number of ways. It is the role of the radiographer to produce a high quality image and facilitate patient care throughout the imaging process. A qualitative systematic review was performed to synthesise the existent evidence on the patient experience of high technology medical imaging. Only papers relating to Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) were identified. Inclusion criteria: Studies that were of a qualitative design that explored the phenomenon of interest, the patient experience of high technology medical imaging. Participants included anyone who had undergone one of these procedures. Methods: A systematic search of medical and allied health databases was conducted. Articles identified during the search process that met the inclusion criteria were then critically appraised for methodological quality independently by two reviewers. Results: During the search and inclusion process, 15 studies were found that were deemed of suitable quality to be included in the review. From the 15 studies, 127 findings were extracted from the included studies. These were analysed in more detail to observe common themes, and then grouped into 33 categories. From these 33 categories, 11 synthesised findings were produced. The 11 synthesised findings highlight the diverse, unique and challenging ways in which people experience imaging with MRI and CT scanners. Conclusion: The results of the review demonstrate the diverse ways in which people experience medical imaging. All health professionals involved in imaging need to be aware of the different ways each patient may experience imaging.

  20. Methods for the thematic synthesis of qualitative research in systematic reviews

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    Harden Angela

    2008-07-01

    Full Text Available Abstract Background There is a growing recognition of the value of synthesising qualitative research in the evidence base in order to facilitate effective and appropriate health care. In response to this, methods for undertaking these syntheses are currently being developed. Thematic analysis is a method that is often used to analyse data in primary qualitative research. This paper reports on the use of this type of analysis in systematic reviews to bring together and integrate the findings of multiple qualitative studies. Methods We describe thematic synthesis, outline several steps for its conduct and illustrate the process and outcome of this approach using a completed review of health promotion research. Thematic synthesis has three stages: the coding of text 'line-by-line'; the development of 'descriptive themes'; and the generation of 'analytical themes'. While the development of descriptive themes remains 'close' to the primary studies, the analytical themes represent a stage of interpretation whereby the reviewers 'go beyond' the primary studies and generate new interpretive constructs, explanations or hypotheses. The use of computer software can facilitate this method of synthesis; detailed guidance is given on how this can be achieved. Results We used thematic synthesis to combine the studies of children's views and identified key themes to explore in the intervention studies. Most interventions were based in school and often combined learning about health benefits with 'hands-on' experience. The studies of children's views suggested that fruit and vegetables should be treated in different ways, and that messages should not focus on health warnings. Interventions that were in line with these suggestions tended to be more effective. Thematic synthesis enabled us to stay 'close' to the results of the primary studies, synthesising them in a transparent way, and facilitating the explicit production of new concepts and hypotheses

  1. Behavioural interventions for weight management in pregnancy: A systematic review of quantitative and qualitative data

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    Guillaume Louise

    2011-06-01

    Full Text Available Abstract Background There is a rising prevalence of excessive weight gain in pregnancy and an increasing number of pregnant women who are overweight or obese at the start of the pregnancy. Excessive weight gain during pregnancy is associated with adverse maternal and neonatal consequences and increases the risk of long-term obesity. Pregnancy therefore may be a key time to prevent excessive weight gain and improve the health of women and their unborn child. This systematic review sought to assess the effectiveness of behavioural interventions to prevent excessive weight gain in pregnancy and explore the factors that influence intervention effectiveness. Methods We undertook a systematic review of quantitative and qualitative evidence. This included a meta-analysis of controlled trials of diet and physical activity interventions to prevent excessive weight gain during pregnancy and a thematic synthesis of qualitative studies that investigated the views of women on weight management during pregnancy. A thorough search of eleven electronic bibliographic databases, reference lists of included studies, relevant review articles and experts in the field were contacted to identify potentially relevant studies. Two independent reviewers extracted data. RevMan software was used to perform the meta-analyses. Qualitative data was subject to thematic analysis. Both quantitative and qualitative data were aligned using a matrix framework. Results Five controlled trials and eight qualitative studies were included. The overall pooled effect size found no significant difference in gestational weight gain amongst participants in the intervention group compared with the control group (mean difference -0.28 95% CI -0.64 to 0.09. The study designs, participants and interventions all varied markedly and there was significant heterogeneity within this comparison in the meta-analysis (I2 67%. Subgroup and sensitivity analysis did not identify contextual elements that

  2. The spectrum of ethical issues in a Learning Health Care System: a systematic qualitative review.

    Science.gov (United States)

    McLennan, Stuart; Kahrass, Hannes; Wieschowski, Susanne; Strech, Daniel; Langhof, Holger

    2018-04-01

    To determine systematically the spectrum of ethical issues that is raised for stakeholders in a 'Learning Health Care System' (LHCS). The systematic review was conducted in PubMed and Google Books between the years 2007 and 2015. The literature search retrieved 1258 publications. Each publication was independently screened by two reviewers for eligibility for inclusion. Ethical issues were defined as arising when a relevant normative principle is not adequately considered or two principles come into conflict. A total of 65 publications were included in the final analysis and were analysed using an adapted version of qualitative content analysis. A coding frame was developed inductively from the data, only the highest-level categories were generated deductively for a life-cycle perspective. A total of 67 distinct ethical issues could be categorized under different phases of the LHCS life-cycle. An overarching theme that was repeatedly raised was the conflict between the current regulatory system and learning health care. The implementation of a LHCS can help realize the ethical imperative to continuously improve the quality of health care. However, the implementation of a LHCS can also raise a number of important ethical issues itself. This review highlights the importance for health care leaders and policy makers to balance the need to protect and respect individual participants involved in learning health care activities with the social value of improving health care.

  3. Resilience and the rehabilitation of adult spinal cord injury survivors: A qualitative systematic review.

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    Kornhaber, Rachel; Mclean, Loyola; Betihavas, Vasiliki; Cleary, Michelle

    2018-01-01

    To synthesize the qualitative research evidence that explored how survivors of adult spinal cord injury experience and make sense of resilience. Spinal cord injury is often a sudden and unexpected life-changing event requiring complex and long-term rehabilitation. The development of resilience is essential in determining how spinal cord injury survivors negotiate this injury and rehabilitation. A qualitative systematic review and thematic synthesis of the research evidence. CINAHL, PubMed, Embase, Scopus and PsycINFO were searched, no restriction dates were used. Methodological quality was assessed using the Critical Appraisal Skills Programme checklist. Thematic synthesis focused on how survivors of adult spinal cord injury experience and make sense of resilience. Six qualitative research articles reported the experiences of 84 spinal cord injury survivors. Themes identified were: uncertainty and regaining independence; prior experiences of resilience; adopting resilient thinking; and strengthening resilience through supports. Recovery and rehabilitation following spinal cord survivors is influenced by the individual's capacity for resilience. Resilience may be influenced by previous life experiences and enhanced by supportive nursing staff encouraging self-efficacy. Survivors identified the need for active involvement in decision-making about their care to enable a sense of regaining control of their lives. This has the potential to have a significant impact on their self-efficacy and in turn health outcomes. © 2017 John Wiley & Sons Ltd.

  4. Systematic methodological review: developing a framework for a qualitative semi-structured interview guide.

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    Kallio, Hanna; Pietilä, Anna-Maija; Johnson, Martin; Kangasniemi, Mari

    2016-12-01

    To produce a framework for the development of a qualitative semi-structured interview guide. Rigorous data collection procedures fundamentally influence the results of studies. The semi-structured interview is a common data collection method, but methodological research on the development of a semi-structured interview guide is sparse. Systematic methodological review. We searched PubMed, CINAHL, Scopus and Web of Science for methodological papers on semi-structured interview guides from October 2004-September 2014. Having examined 2,703 titles and abstracts and 21 full texts, we finally selected 10 papers. We analysed the data using the qualitative content analysis method. Our analysis resulted in new synthesized knowledge on the development of a semi-structured interview guide, including five phases: (1) identifying the prerequisites for using semi-structured interviews; (2) retrieving and using previous knowledge; (3) formulating the preliminary semi-structured interview guide; (4) pilot testing the guide; and (5) presenting the complete semi-structured interview guide. Rigorous development of a qualitative semi-structured interview guide contributes to the objectivity and trustworthiness of studies and makes the results more plausible. Researchers should consider using this five-step process to develop a semi-structured interview guide and justify the decisions made during it. © 2016 John Wiley & Sons Ltd.

  5. The swine flu vaccine, public attitudes, and researcher interpretations: a systematic review of qualitative research.

    Science.gov (United States)

    Carlsen, Benedicte; Glenton, Claire

    2016-06-24

    During pandemics, health authorities may be uncertain about the spread and severity of the disease and the effectiveness and safety of available interventions. This was the case during the swine flu (H1N1) pandemic of 2009-2010, and governments were forced to make decisions despite these uncertainties. While many countries chose to implement wide scale vaccination programmes, few accomplished their vaccination goals. Many research studies aiming to explore barriers and facilitators to vaccine uptake have been conducted in the aftermath of the pandemic, including several qualitative studies. 1. To explore public attitudes to the swine flu vaccine in different countries through a review of qualitative primary studies. 2. To describe and discuss the implications drawn by the primary study authors. Systematic review of qualitative research studies, using a broadly comparative cross case-study approach. Study quality was appraised using an adaptation of the Critical Appraisal Skills Programme (CASP) quality assessment tool. The review indicates that the public had varying opinions about disease risk and prevalence and had concerns about vaccine safety. Most primary study authors concluded that participants were uninformed, and that more information about the disease and the vaccine would have led to an increase in vaccine uptake. We find these conclusions problematic. We suggest instead that people's questions and concerns were legitimate given the uncertainties of the situation at the time and the fact that the authorities did not have the necessary information to convince the public. Our quality assessment of the included studies points to a lack of reflexivity and a lack of information about study context. We suggest that these study weaknesses are tied to primary study authors' lack of acknowledgement of the uncertainties surrounding the disease and the vaccine. While primary study authors suggest that authorities could increase vaccine uptake through increased

  6. Convergent and sequential synthesis designs: implications for conducting and reporting systematic reviews of qualitative and quantitative evidence.

    Science.gov (United States)

    Hong, Quan Nha; Pluye, Pierre; Bujold, Mathieu; Wassef, Maggy

    2017-03-23

    Systematic reviews of qualitative and quantitative evidence can provide a rich understanding of complex phenomena. This type of review is increasingly popular, has been used to provide a landscape of existing knowledge, and addresses the types of questions not usually covered in reviews relying solely on either quantitative or qualitative evidence. Although several typologies of synthesis designs have been developed, none have been tested on a large sample of reviews. The aim of this review of reviews was to identify and develop a typology of synthesis designs and methods that have been used and to propose strategies for synthesizing qualitative and quantitative evidence. A review of systematic reviews combining qualitative and quantitative evidence was performed. Six databases were searched from inception to December 2014. Reviews were included if they were systematic reviews combining qualitative and quantitative evidence. The included reviews were analyzed according to three concepts of synthesis processes: (a) synthesis methods, (b) sequence of data synthesis, and (c) integration of data and synthesis results. A total of 459 reviews were included. The analysis of this literature highlighted a lack of transparency in reporting how evidence was synthesized and a lack of consistency in the terminology used. Two main types of synthesis designs were identified: convergent and sequential synthesis designs. Within the convergent synthesis design, three subtypes were found: (a) data-based convergent synthesis design, where qualitative and quantitative evidence is analyzed together using the same synthesis method, (b) results-based convergent synthesis design, where qualitative and quantitative evidence is analyzed separately using different synthesis methods and results of both syntheses are integrated during a final synthesis, and (c) parallel-results convergent synthesis design consisting of independent syntheses of qualitative and quantitative evidence and an

  7. Health-seeking behaviour for schistosomiasis: a systematic review of qualitative and quantitative literature.

    Science.gov (United States)

    Cronin, Thomas; Sheppard, James; de Wildt, Gilles

    2013-01-01

    Schistosomiasis is a chronic and debilitating parasitic disease acquired through contact with infested freshwater. An essential component of its control is passive case finding, which, in order to be effective, requires a detailed understanding of health-seeking behaviour. This study aimed to systematically review evidence on health-seeking behaviour for schistosomiasis, in order to determine factors influencing use or non-use of modern health services for the infection. Quantitative, qualitative and mixed method studies reporting on factors related to seeking treatment from modern health services for schistosomiasis were obtained, combining electronic and hand searching. Data extraction and quality assessment of the included articles were performed, with all studies qualitatively analysed using thematic synthesis. A total of 19 studies were included in the review. Six themes were identified from the analysis: biomedical knowledge on schistosomiasis, perceptions of modern treatment and health services, financial considerations of treatment, perceptions on the symptoms, stigma of the infection, and physical location and community. These findings were consistent across studies of different design, setting and quality. Many of the themes identified echo existing literature on health-seeking behaviour. The synthesis also highlighted the role of stigma, and aspects of the physical location and community that may affect treatment-seeking for schistosomiasis. Health education programmes that intend to improve the utilisation of modern health services for the infection need to acknowledge the multiple determinants influencing their use. Future research should move beyond describing health-seeking behaviour to identifying the factors that underlay such behaviour.

  8. The Patient Experience of Hemophilia and Human Immunodeficiency Virus: A Systematic Review of Qualitative Evidence.

    Science.gov (United States)

    Omura, Kayoko; Tsuchiya, Sayaka

    by plasmapheresis from paid donors, carries a much higher risk of transmission of hepatitis B or C or HIV. Acquired autoimmune disease or AIDS, which is caused by HIV was once an incurable and fatal disease. However the anti-retro virus therapy, from the commencement of protease inhibitor based therapy in 1996, has increased the life expectancy of HIV patients. Nevertheless, adherence to highly active anti-retroviral therapy (HAART) medication by patients with hemophilia (66%-84%) is lower than that of patients with only HIV (98%) in Japan.Although the causes of low adherence of hemophilia therapy or HAART medication are considered to be associated with patient values, qualitative evidence of previous studies have not been synthesized We searched previous reviews and review protocols in the Cochrane Library, Joanna Briggs Institute Library (JBI), MEDLINE, CINAHL, PsycINFO, JBI COnNECT+ protocols. Regarding hemophilia or HIV, there were 11 systematic reviews, 7 protocols, and 128 other reviews. We excluded the reviews that were randomized controlled trials (RCTs) of treatment effects or therapies, and quantitative research of quality of life (QOL). We also excluded children as they are supervised by their parents to maintain high adherence. After the title and abstract review, 15 reviews remained and upon reading the full articles, one protocol and nine narrative reviews were identified.The systematic review protocol of Shaibu et al. investigated HIV positive adult patients on HAART focusing on the experience of HIV positive patients with patients' lifestyles and beliefs about HIV/AIDS and HAART effectiveness, and the role these play in adherence. However, the review differs from this one in terms of classification of HIV positive adults by the route of infection such as iatrogenic and sexually transmitted infection. Taking the deferent rate of adherence of HAART in Japan into consideration, we will focus on the experience of hemophilic patients with HIV.There were

  9. The impact of social media on medical professionalism: a systematic qualitative review of challenges and opportunities.

    Science.gov (United States)

    Gholami-Kordkheili, Fatemeh; Wild, Verina; Strech, Daniel

    2013-08-28

    The rising impact of social media on the private and working lives of health care professionals has made researchers and health care institutions study and rethink the concept and content of medical professionalism in the digital age. In the last decade, several specific policies, original research studies, and comments have been published on the responsible use of social media by health care professionals. However, there is no systematic literature review that analyzes the full spectrum of (1) social media-related challenges imposed on medical professionalism and (2) social media-related opportunities to both undermine and improve medical professionalism. The aim of this systematic qualitative review is to present this full spectrum of social media-related challenges and opportunities. We performed a systematic literature search in PubMed (restricted to English and German literature published between 2002 and 2011) for papers that address social media-related challenges and opportunities for medical professionalism. To operationalize "medical professionalism", we refer to the 10 commitments presented in the physicians' charter "Medical professionalism in the new millennium" published by the ABIM Foundation. We applied qualitative text analysis to categorize the spectrum of social media-related challenges and opportunities for medical professionalism. The literature review retrieved 108 references, consisting of 46 original research studies and 62 commentaries, editorials, or opinion papers. All references together mentioned a spectrum of 23 broad and 12 further-specified, narrow categories for social media-related opportunities (n=10) and challenges (n=13) for medical professionalism, grouped under the 10 commitments of the physicians' charter. The accommodation of the traditional core values of medicine to the characteristics of social media presents opportunities as well as challenges for medical professionalism. As a profession that is entitled to self

  10. The personal active aging strategies of older adults in Europe: a systematic review of qualitative evidence.

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    Klugar, Miloslav; Čáp, Juraj; Klugarová, Jitka; Marečková, Jana; Roberson, Donald N; Kelnarová, Zuzana

    2016-05-01

    There is a consensus that the aging population is beginning to impact on many facets of our life. They have more medical problems and the potential to "drain" the focus of the medical community, as well as national budgets with their accompanying medical bills. Personal strategies related to active aging will help us to better understand and identify how older adults in Europe prepare themselves for the natural process of aging and what are their personal approaches to active aging. The objective of this review was to synthesize the best available evidence regarding the older adult's perspective on the personal strategies related to active aging among older adults in Europe. This review considered studies that included older adults (age over 55 years) who live in Europe. This review considered studies that investigated older adults' perspectives on (any) personal strategies related to active aging. Europe (considering "some similarity" in health care systems and retirement policies). This review considered any qualitative designs. A three-step search strategy was used to identify published and unpublished studies. The extensive search process was conducted in October 2014 and considered published and unpublished studies from the inception of databases until October 2014. Studies published in any language which had an abstract in English, Czech and Slovak languages were considered for inclusion in this review. Studies were appraised for methodological quality by two independent reviewers using the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI). Data were extracted from the papers included in the review by two independent reviewers using the standardized JBI-QARI data extraction tool. Data synthesis was performed using the meta-aggregation approach of meta-synthesis recommended by the Joanna Briggs Institute. Fourteen studies were included in this systematic review. From these 14 studies, 42 findings were extracted; findings were

  11. Patient outcomes after critical illness: a systematic review of qualitative studies following hospital discharge.

    Science.gov (United States)

    Hashem, Mohamed D; Nallagangula, Aparna; Nalamalapu, Swaroopa; Nunna, Krishidhar; Nausran, Utkarsh; Robinson, Karen A; Dinglas, Victor D; Needham, Dale M; Eakin, Michelle N

    2016-10-26

    There is growing interest in patient outcomes following critical illness, with an increasing number and different types of studies conducted, and a need for synthesis of existing findings to help inform the field. For this purpose we conducted a systematic review of qualitative studies evaluating patient outcomes after hospital discharge for survivors of critical illness. We searched the PubMed, EMBASE, CINAHL, PsycINFO, and CENTRAL databases from inception to June 2015. Studies were eligible for inclusion if the study population was >50 % adults discharged from the ICU, with qualitative evaluation of patient outcomes. Studies were excluded if they focused on specific ICU patient populations or specialty ICUs. Citations were screened in duplicate, and two reviewers extracted data sequentially for each eligible article. Themes related to patient outcome domains were coded and categorized based on the main domains of the Patient Reported Outcomes Measurement Information System (PROMIS) framework. A total of 2735 citations were screened, and 22 full-text articles were eligible, with year of publication ranging from 1995 to 2015. All of the qualitative themes were extracted from eligible studies and then categorized using PROMIS descriptors: satisfaction with life (16 studies), including positive outlook, acceptance, gratitude, independence, boredom, loneliness, and wishing they had not lived; mental health (15 articles), including symptoms of post-traumatic stress disorder, anxiety, depression, and irritability/anger; physical health (14 articles), including mobility, activities of daily living, fatigue, appetite, sensory changes, muscle weakness, and sleep disturbances; social health (seven articles), including changes in friends/family relationships; and ability to participate in social roles and activities (six articles), including hobbies and disability. ICU survivors may experience positive emotions and life satisfaction; however, a wide range of mental

  12. Older persons' experiences and perspectives of receiving social care: a systematic review of the qualitative literature.

    Science.gov (United States)

    de São José, José; Barros, Rosanna; Samitca, Sanda; Teixeira, Ana

    2016-01-01

    The topic of social care for older people has gained increasing attention from the part of academics, professionals, policy makers and media. However, we know little about this topic from the perspectives of older persons, which hinders future developments in terms of theory, empirical research, professional practice and social policy. This article presents and discusses a systematic review of relevant qualitative research-based evidence on the older persons' experiences and perspectives of receiving social care published between 1990 and September 2014. This review aimed to obtain answers to the following questions: How is the reception of social care experienced by the older persons? What are the negative and positive aspects of these experiences? What are the factors which influence the experiences? The synthesis of the findings of reviewed papers identified six analytical themes: asking for care as a major challenge; ambivalences; (dis)engagement in decisions concerning care; multiple losses as outcomes of receiving social care; multiple strategies to deal with losses originated by the ageing process; and properties of 'good care'. These themes are discussed from the point of view of their implications for theory, care practice and social policy, and future research. © 2015 John Wiley & Sons Ltd.

  13. The concept and definition of therapeutic inertia in hypertension in primary care: a qualitative systematic review.

    Science.gov (United States)

    Lebeau, Jean-Pierre; Cadwallader, Jean-Sébastien; Aubin-Auger, Isabelle; Mercier, Alain; Pasquet, Thomas; Rusch, Emmanuel; Hendrickx, Kristin; Vermeire, Etienne

    2014-07-02

    Therapeutic inertia has been defined as the failure of health-care provider to initiate or intensify therapy when therapeutic goals are not reached. It is regarded as a major cause of uncontrolled hypertension. The exploration of its causes and the interventions to reduce it are plagued by unclear conceptualizations and hypothesized mechanisms. We therefore systematically searched the literature for definitions and discussions on the concept of therapeutic inertia in hypertension in primary care, to try and form an operational definition. A systematic review of all types of publications related to clinical inertia in hypertension was performed. Medline, EMbase, PsycInfo, the Cochrane library and databases, BDSP, CRD and NGC were searched from the start of their databases to June 2013. Articles were selected independently by two authors on the basis of their conceptual content, without other eligibility criteria or formal quality appraisal. Qualitative data were extracted independently by two teams of authors. Data were analyzed using a constant comparative qualitative method. The final selection included 89 articles. 112 codes were grouped in 4 categories: terms and definitions (semantics), "who" (physician, patient or system), "how and why" (mechanisms and reasons), and "appropriateness". Regarding each of these categories, a number of contradictory assertions were found, most of them relying on little or no empirical data. Overall, the limits of what should be considered as inertia were not clear. A number of authors insisted that what was considered deleterious inertia might in fact be appropriate care, depending on the situation. Our data analysis revealed a major lack of conceptualization of therapeutic inertia in hypertension and important discrepancies regarding its possible causes, mechanisms and outcomes. The concept should be split in two parts: appropriate inaction and inappropriate inertia. The development of consensual and operational definitions

  14. The lived experiences of being physically active when morbidly obese: A qualitative systematic review.

    Science.gov (United States)

    Toft, Bente Skovsby; Uhrenfeldt, Lisbeth

    2015-01-01

    The aim is to identify facilitators and barriers for physical activity (PA) experienced by morbidly obese adults in the Western world. Inactivity and a sedentary lifestyle have become a major challenge for health and well-being, particularly among persons with morbid obesity. Lifestyle changes may lead to long-term changes in activity level, if facilitators and barriers are approached in a holistic way by professionals. To develop lifestyle interventions, the perspective and experiences of this group of patients are essential for success. The methodology of the systematic review followed the seven-step procedure of the Joanna Briggs Institute and was published in a protocol. Six databases were searched using keywords and index terms. Manual searches were performed in reference lists and in cited citations up until March 2015. The selected studies underwent quality appraisal in the Joanna Briggs-Qualitative Assessment and Review Instrument. Data from primary studies were extracted and were subjected to a hermeneutic text interpretation and a data-driven coding in a five-step procedure focusing on meaning and constant targeted comparison through which they were categorized and subjected into a meta-synthesis. Eight papers were included for the systematic review, representing the experiences of PA among 212 participants. One main theme developed from the meta-data analysis: "Identity" with the three subthemes: "considering weight," "being able to," and "belonging with others." The theme and subthemes were merged into a meta-synthesis: "Homecoming: a change in identity." The experiences of either suffering or well-being during PA affected the identity of adults with morbid obesity either by challenging or motivating them. A change in identity may be needed to feel a sense of "homecoming" when active.

  15. The lived experiences of being physically active when morbidly obese: A qualitative systematic review

    Directory of Open Access Journals (Sweden)

    Bente Skovsby Toft

    2015-09-01

    Full Text Available The aim is to identify facilitators and barriers for physical activity (PA experienced by morbidly obese adults in the Western world. Inactivity and a sedentary lifestyle have become a major challenge for health and well-being, particularly among persons with morbid obesity. Lifestyle changes may lead to long-term changes in activity level, if facilitators and barriers are approached in a holistic way by professionals. To develop lifestyle interventions, the perspective and experiences of this group of patients are essential for success. The methodology of the systematic review followed the seven-step procedure of the Joanna Briggs Institute and was published in a protocol. Six databases were searched using keywords and index terms. Manual searches were performed in reference lists and in cited citations up until March 2015. The selected studies underwent quality appraisal in the Joanna Briggs-Qualitative Assessment and Review Instrument. Data from primary studies were extracted and were subjected to a hermeneutic text interpretation and a data-driven coding in a five-step procedure focusing on meaning and constant targeted comparison through which they were categorized and subjected into a meta-synthesis. Eight papers were included for the systematic review, representing the experiences of PA among 212 participants. One main theme developed from the meta-data analysis: “Identity” with the three subthemes: “considering weight,” “being able to,” and “belonging with others.” The theme and subthemes were merged into a meta-synthesis: “Homecoming: a change in identity.” The experiences of either suffering or well-being during PA affected the identity of adults with morbid obesity either by challenging or motivating them. A change in identity may be needed to feel a sense of “homecoming” when active.

  16. Barriers to effective management of type 2 diabetes in primary care: qualitative systematic review

    Science.gov (United States)

    Rushforth, Bruno; McCrorie, Carolyn; Glidewell, Liz; Midgley, Eleanor; Foy, Robbie

    2016-01-01

    Background Despite the availability of evidence-based guidance, many patients with type 2 diabetes do not achieve treatment goals. Aim To guide quality improvement strategies for type 2 diabetes by synthesising qualitative evidence on primary care physicians’ and nurses’ perceived influences on care. Design and setting Systematic review of qualitative studies with findings organised using the Theoretical Domains Framework. Method Databases searched were MEDLINE, Embase, CINAHL, PsycInfo, and ASSIA from 1980 until March 2014. Studies included were English-language qualitative studies in primary care of physicians’ or nurses’ perceived influences on treatment goals for type 2 diabetes. Results A total of 32 studies were included: 17 address general diabetes care, 11 glycaemic control, three blood pressure, and one cholesterol control. Clinicians struggle to meet evolving treatment targets within limited time and resources, and are frustrated with resulting compromises. They lack confidence in knowledge of guidelines and skills, notably initiating insulin and facilitating patient behaviour change. Changing professional boundaries have resulted in uncertainty about where clinical responsibility resides. Accounts are often couched in emotional terms, especially frustrations over patient compliance and anxieties about treatment intensification. Conclusion Although resources are important, many barriers to improving care are amenable to behaviour change strategies. Improvement strategies need to account for differences between clinical targets and consider tailored rather than ‘one size fits all’ approaches. Training targeting knowledge is necessary but insufficient to bring about major change; approaches to improve diabetes care need to delineate roles and responsibilities, and address clinicians’ skills and emotions around treatment intensification and facilitation of patient behaviour change. PMID:26823263

  17. The school environment and student health: a systematic review and meta-ethnography of qualitative research.

    Science.gov (United States)

    Jamal, Farah; Fletcher, Adam; Harden, Angela; Wells, Helene; Thomas, James; Bonell, Chris

    2013-09-03

    There is increasing interest in promoting young people's health by modifying the school environment. However, existing research offers little guidance on how the school context enables or constrains students' health behaviours, or how students' backgrounds relate to these processes. For these reasons, this paper reports on a meta-ethnography of qualitative studies examining: through what processes does the school environment (social and physical) influence young people's health? Systematic review of qualitative studies. Sixteen databases were searched, eliciting 62,329 references which were screened, with included studies quality assessed, data extracted and synthesized using an adaptation of Noblit and Hare's meta-ethnographic approach. Nineteen qualitative studies were synthesised to explore processes through which school-level influences on young people's health might occur. Four over-arching meta-themes emerged across studies focused on a range of different health issues. First, aggressive behaviour and substance use are often a strong source of status and bonding at schools where students feel educationally marginalised or unsafe. Second, health-risk behaviours are concentrated in unsupervised 'hotspots' at the school. Third, positive relationships with teachers appear to be critical in promoting student wellbeing and limiting risk behaviour; however, certain aspects of schools' organisation and education policies constrain this, increasing the likelihood that students look for a sense of identity and social support via health-risk behaviours. Fourth, unhappiness at school can cause students to seek sources of 'escape', either by leaving school at lunchtime or for longer unauthorized spells or through substance use. These meta-themes resonate with Markham and Aveyard's theory of human functioning and school organisation, and we draw on these qualitative data to refine and extend this theory, in particular conceptualising more fully the role of young people

  18. The Views and Experiences of Smokers Who Quit Smoking Unassisted. A Systematic Review of the Qualitative Evidence

    OpenAIRE

    Smith, Andrea L.; Carter, Stacy M.; Dunlop, Sally M.; Freeman, Becky; Chapman, Simon

    2015-01-01

    Background Unassisted cessation ? quitting without pharmacological or professional support ? is an enduring phenomenon. Unassisted cessation persists even in nations advanced in tobacco control where cessation assistance such as nicotine replacement therapy, the stop-smoking medications bupropion and varenicline, and behavioural assistance are readily available. We review the qualitative literature on the views and experiences of smokers who quit unassisted. Method We systematically searched ...

  19. A Systematic Review and Synthesis of Qualitative Research: The Influence of School Context on Symptoms of Attention Deficit Hyperactivity Disorder

    Science.gov (United States)

    Gwernan-Jones, Ruth; Moore, Darren A.; Cooper, Paul; Russell, Abigail Emma; Richardson, Michelle; Rogers, Morwenna; Thompson-Coon, Jo; Stein, Ken; Ford, Tamsin J.; Garside, Ruth

    2016-01-01

    This systematic review and synthesis of qualitative research explored contextual factors relevant to non-pharmacological interventions for attention deficit hyperactivity disorder (ADHD) in schools. We conducted meta-ethnography to synthesise 34 studies, using theories of stigma to further develop the synthesis. Studies suggested that the…

  20. A systematic review of qualitative research on the meaning and characteristics of mentoring in academic medicine.

    Science.gov (United States)

    Sambunjak, Dario; Straus, Sharon E; Marusic, Ana

    2010-01-01

    Mentorship is perceived to play a significant role in the career development and productivity of academic clinicians, but little is known about the characteristics of mentorship. This knowledge would be useful for those developing mentorship programs. To complete a systematic review of the qualitative literature to explore and summarize the development, perceptions and experiences of the mentoring relationship in academic medicine. Medline, PsycINFO, ERIC, Scopus and Current Contents databases from the earliest available date to December 2008. We included studies that used qualitative research methodology to explore the meaning and characteristics of mentoring in academic medicine. Two investigators independently assessed articles for relevance and study quality, and extracted data using standardized forms. No restrictions were placed on the language of articles. A total of 8,487 citations were identified, 114 full text articles were assessed, and 9 articles were selected for review. All studies were conducted in North America, and most focused on the initiation and cultivation phases of the mentoring relationship. Mentoring was described as a complex relationship based on mutual interests, both professional and personal. Mentees should take an active role in the formation and development of mentoring relationships. Good mentors should be sincere in their dealings with mentees, be able to listen actively and understand mentees' needs, and have a well-established position within the academic community. Some of the mentoring functions aim at the mentees' academic growth and others at personal growth. Barriers to mentoring and dysfunctional mentoring can be related to personal factors, relational difficulties and structural/institutional barriers. Successful mentoring requires commitment and interpersonal skills of the mentor and mentee, but also a facilitating environment at academic medicine's institutions.

  1. Comparing interprofessional and interorganizational collaboration in healthcare: A systematic review of the qualitative research.

    Science.gov (United States)

    Karam, Marlène; Brault, Isabelle; Van Durme, Thérèse; Macq, Jean

    2018-03-01

    Interprofessional and interorganizational collaboration have become important components of a well-functioning healthcare system, all the more so given limited financial resources, aging populations, and comorbid chronic diseases. The nursing role in working alongside other healthcare professionals is critical. By their leadership, nurses can create a culture that encourages values and role models that favour collaborative work within a team context. To clarify the specific features of conceptual frameworks of interprofessional and interorganizational collaboration in the healthcare field. This review, accordingly, offers insights into the key challenges facing policymakers, managers, healthcare professionals, and nurse leaders in planning, implementing, or evaluating interprofessional collaboration. This systematic review of qualitative research is based on the Joanna Briggs Institute's methodology for conducting synthesis. Cochrane, JBI, CINAHL, Embase, Medline, Scopus, Academic Search Premier, Sociological Abstract, PsycInfo, and ProQuest were searched, using terms such as professionals, organizations, collaboration, and frameworks. Qualitative studies of all research design types describing a conceptual framework of interprofessional or interorganizational collaboration in the healthcare field were included. They had to be written in French or English and published in the ten years between 2004 and 2014. Sixteen qualitative articles were included in the synthesis. Several concepts were found to be common to interprofessional and interorganizational collaboration, such as communication, trust, respect, mutual acquaintanceship, power, patient-centredness, task characteristics, and environment. Other concepts are of particular importance either to interorganizational collaboration, such as the need for formalization and the need for professional role clarification, or to interprofessional collaboration, such as the role of individuals and team identity. Promoting

  2. Enablers and barriers to implementing collaborative care for anxiety and depression: a systematic qualitative review.

    Science.gov (United States)

    Overbeck, Gritt; Davidsen, Annette Sofie; Kousgaard, Marius Brostrøm

    2016-12-28

    Collaborative care is an increasingly popular approach for improving quality of care for people with mental health problems through an intensified and structured collaboration between primary care providers and health professionals with specialized psychiatric expertise. Trials have shown significant positive effects for patients suffering from depression, but since collaborative care is a complex intervention, it is important to understand the factors which affect its implementation. We present a qualitative systematic review of the enablers and barriers to implementing collaborative care for patients with anxiety and depression. We developed a comprehensive search strategy in cooperation with a research librarian and performed a search in five databases (EMBASE, PubMed, PsycINFO, ProQuest, and CINAHL). All authors independently screened titles and abstracts and reviewed full-text articles. Studies were included if they were published in English and based on the original qualitative data on the implementation of a collaborative care intervention targeted at depression or anxiety in an adult patient population in a high-income country. Our subsequent analysis employed the normalization process theory (NPT). We included 17 studies in our review of which 11 were conducted in the USA, five in the UK, and one in Canada. We identified several barriers and enablers within the four major analytical dimensions of NPT. Securing buy-in among primary care providers was found to be critical but sometimes difficult. Enablers included physician champions, reimbursement for extra work, and feedback on the effectiveness of collaborative care. The social and professional skills of the care managers seemed critical for integrating collaborative care in the primary health care clinic. Day-to-day implementation was also found to be facilitated by the care managers being located in the clinic since this supports regular face-to-face interactions between physicians and care managers

  3. Necessity and feasibility of improving mental health services in China: A systematic qualitative review.

    Science.gov (United States)

    Zhao, Xudong; Liu, Liang; Hu, Chengping; Chen, Fazhan; Sun, Xirong

    2017-07-01

    It has been nearly 40 years since the reform and opening up of Mainland China. The mental health services system has developed rapidly as a part of the profound socioeconomic changes that ensued. However, its development has not been as substantial as other areas of medical care. For the current qualitative systematic review, we searched databases, including China Biology Medicine disc, Weipu, China National Knowledge Infrastructure, Wanfang digital periodical full text data, China's important newspaper full text database, China Statistical Yearbook database, etc. The content of primary research, literature, and policy papers about the evolution and development of Chinese mental health services was systemically reviewed and analysed by using thematic analysis. Two main themes relative to the necessity and feasibility of reforming the current mental health services system emerged. We discuss 5 corresponding subthemes under the umbrella of the necessity of improving the current treatment, rehabilitation, prevention, and service systems and 7 requirements for the feasibility of reforming the current system. We conclude that as the development of the Chinese economy and the spirit of humanistic care continue, the improvement and reformation of the mental health services system are both necessary and feasible. Copyright © 2017 John Wiley & Sons, Ltd.

  4. Barriers in the social and healthcare assistance for transgender persons: A systematic review of qualitative studies.

    Science.gov (United States)

    Aylagas-Crespillo, Marina; García-Barbero, Óscar; Rodríguez-Martín, Beatriz

    2017-11-01

    To explore the barriers to requesting social and healthcare assistance perceived by transgender persons and professionals involved in the assistance. A meta-study, qualitative systematic review, of studies published in English or Spanish, exploring the barriers, perceived by transgender persons and social and healthcare professionals, that transgender persons have when they seek social and healthcare assistance was carried out in the following databases Medline (PubMed), Scopus, Web of Science, Spanish National Research Council, CUIDEN, ProQuest, PsycINFO and CINAHL. Two thousand two hundred and sixty-one articles were found in the databases searched. Seven articles met all inclusion criteria and were included in this review. The professionals highlight the uncertainty when treating transgender persons and their lack of training. Transgender persons highlight the lack of information and the sense of helplessness it creates. Perceptions of transphobia, the fragmentation of services, administrative barriers, the lack of cultural sensitivity and professional training are also considered barriers to assistance. The findings of this study provide key information for the design of plans and programmes to improve the quality of social and health care for transgender persons. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  5. Current practice of public involvement activities in biomedical research and innovation: a systematic qualitative review.

    Science.gov (United States)

    Lander, Jonas; Hainz, Tobias; Hirschberg, Irene; Strech, Daniel

    2014-01-01

    A recent report from the British Nuffield Council on Bioethics associated 'emerging biotechnologies' with a threefold challenge: 1) uncertainty about outcomes, 2) diverse public views on the values and implications attached to biotechnologies and 3) the possibility of creating radical changes regarding societal relations and practices. To address these challenges, leading international institutions stress the need for public involvement activities (PIAs). The objective of this study was to assess the state of PIA reports in the field of biomedical research. PIA reports were identified via a systematic literature search. Thematic text analysis was employed for data extraction. After filtering, 35 public consultation and 11 public participation studies were included in this review. Analysis and synthesis of all 46 PIA studies resulted in 6 distinguishable PIA objectives and 37 corresponding PIA methods. Reports of outcome translation and PIA evaluation were found in 9 and 10 studies respectively (20% and 22%). The paper presents qualitative details. The state of PIAs on biomedical research and innovation is characterized by a broad range of methods and awkward variation in the wording of objectives. Better comparability of PIAs might improve the translation of PIA findings into further policy development. PIA-specific reporting guidelines would help in this regard. The modest level of translation efforts is another pointer to the "deliberation to policy gap". The results of this review could inform the design of new PIAs and future efforts to improve PIA comparability and outcome translation.

  6. Product development public-private partnerships for public health: a systematic review using qualitative data.

    Science.gov (United States)

    De Pinho Campos, Katia; Norman, Cameron D; Jadad, Alejandro R

    2011-10-01

    Almost a decade ago, public health initiated a number of innovative ventures to attract investments from multinational drug companies for the development of new drugs and vaccines to tackle neglected diseases (NDs). These ventures - known as product development public-private partnerships (PD PPPs) - represent the participation of the public and private actors toward the discovery and development of essential medicines to reduce the suffering of over one billion people worldwide living with NDs. This systematic review aimed to identify empirical-based descriptive articles to understand critical elements in the partnership process, and propose a framework to shed light on future guidelines to support better planning, design and management of existing and new forms of PPPs for public health. Ten articles met the inclusion criteria and were analyzed and synthesized using qualitative content analysis. The findings show that the development stage of PD PPPs requires a careful initiation and planning process including discussion on values and shared goals, agreement on mutual interests & equality of power relation, exchange of expertise & resources, stakeholder engagement, and assessment of the local health capacity. The management stage of PD PPPs entails transparency, extensive communication and participatory decision-making among partner organizations. This review illustrates the difficulties, challenges and effective responses during the partnering process. This model of collaboration may offer a way to advance population health at present, while creating streams of innovation that can yield future social and financial dividends in enhancing the public's health more widely. Copyright © 2011 Elsevier Ltd. All rights reserved.

  7. Decision-making in rectal and colorectal cancer: systematic review and qualitative analysis of surgeons' preferences.

    Science.gov (United States)

    Broc, Guillaume; Gana, Kamel; Denost, Quentin; Quintard, Bruno

    2017-04-01

    Surgeons are experiencing difficulties implementing recommendations not only owing to incomplete, confusing or conflicting information but also to the increasing involvement of patients in decisions relating to their health. This study sought to establish which common factors including heuristic factors guide surgeons' decision-making in colon and rectal cancers. We conducted a systematic literature review of surgeons' decision-making factors related to colon and rectal cancer treatment. Eleven of 349 identified publications were eligible for data analyses. Using the IRaMuTeQ (Interface of R for the Multidimensional Analyses of Texts and Questionnaire), we carried out a qualitative analysis of the significant factors collected in the studies reviewed. Several validation procedures were applied to control the robustness of the findings. Five categories of factors (i.e. patient, surgeon, treatment, tumor and organizational cues) were found to influence surgeons' decision-making. Specifically, all decision criteria including biomedical (e.g. tumor information) and heuristic (e.g. surgeons' dispositional factors) criteria converged towards the factor 'age of patient' in the similarity analysis. In the light of the results, we propose an explanatory model showing the impact of heuristic criteria on medical issues (i.e. diagnosis, prognosis, treatment features, etc.) and thus on decision-making. Finally, the psychosocial complexity involved in decision-making is discussed and a medico-psycho-social grid for use in multidisciplinary meetings is proposed.

  8. A qualitative systematic review of studies using the normalization process theory to research implementation processes.

    Science.gov (United States)

    McEvoy, Rachel; Ballini, Luciana; Maltoni, Susanna; O'Donnell, Catherine A; Mair, Frances S; Macfarlane, Anne

    2014-01-02

    There is a well-recognized need for greater use of theory to address research translational gaps. Normalization Process Theory (NPT) provides a set of sociological tools to understand and explain the social processes through which new or modified practices of thinking, enacting, and organizing work are implemented, embedded, and integrated in healthcare and other organizational settings. This review of NPT offers readers the opportunity to observe how, and in what areas, a particular theoretical approach to implementation is being used. In this article we review the literature on NPT in order to understand what interventions NPT is being used to analyze, how NPT is being operationalized, and the reported benefits, if any, of using NPT. Using a framework analysis approach, we conducted a qualitative systematic review of peer-reviewed literature using NPT. We searched 12 electronic databases and all citations linked to six key NPT development papers. Grey literature/unpublished studies were not sought. Limitations of English language, healthcare setting and year of publication 2006 to June 2012 were set. Twenty-nine articles met the inclusion criteria; in the main, NPT is being applied to qualitatively analyze a diverse range of complex interventions, many beyond its original field of e-health and telehealth. The NPT constructs have high stability across settings and, notwithstanding challenges in applying NPT in terms of managing overlaps between constructs, there is evidence that it is a beneficial heuristic device to explain and guide implementation processes. NPT offers a generalizable framework that can be applied across contexts with opportunities for incremental knowledge gain over time and an explicit framework for analysis, which can explain and potentially shape implementation processes. This is the first review of NPT in use and it generates an impetus for further and extended use of NPT. We recommend that in future NPT research, authors should explicate

  9. Patient adherence to tuberculosis treatment: a systematic review of qualitative research.

    Science.gov (United States)

    Munro, Salla A; Lewin, Simon A; Smith, Helen J; Engel, Mark E; Fretheim, Atle; Volmink, Jimmy

    2007-07-24

    Tuberculosis (TB) is a major contributor to the global burden of disease and has received considerable attention in recent years, particularly in low- and middle-income countries where it is closely associated with HIV/AIDS. Poor adherence to treatment is common despite various interventions aimed at improving treatment completion. Lack of a comprehensive and holistic understanding of barriers to and facilitators of, treatment adherence is currently a major obstacle to finding effective solutions. The aim of this systematic review of qualitative studies was to understand the factors considered important by patients, caregivers and health care providers in contributing to TB medication adherence. We searched 19 electronic databases (1966-February 2005) for qualitative studies on patients', caregivers', or health care providers' perceptions of adherence to preventive or curative TB treatment with the free text terms "Tuberculosis AND (adherence OR compliance OR concordance)". We supplemented our search with citation searches and by consulting experts. For included studies, study quality was assessed using a predetermined checklist and data were extracted independently onto a standard form. We then followed Noblit and Hare's method of meta-ethnography to synthesize the findings, using both reciprocal translation and line-of-argument synthesis. We screened 7,814 citations and selected 44 articles that met the prespecified inclusion criteria. The synthesis offers an overview of qualitative evidence derived from these multiple international studies. We identified eight major themes across the studies: organisation of treatment and care; interpretations of illness and wellness; the financial burden of treatment; knowledge, attitudes, and beliefs about treatment; law and immigration; personal characteristics and adherence behaviour; side effects; and family, community, and household support. Our interpretation of the themes across all studies produced a line

  10. Patient adherence to tuberculosis treatment: a systematic review of qualitative research.

    Directory of Open Access Journals (Sweden)

    Salla A Munro

    2007-07-01

    Full Text Available BACKGROUND: Tuberculosis (TB is a major contributor to the global burden of disease and has received considerable attention in recent years, particularly in low- and middle-income countries where it is closely associated with HIV/AIDS. Poor adherence to treatment is common despite various interventions aimed at improving treatment completion. Lack of a comprehensive and holistic understanding of barriers to and facilitators of, treatment adherence is currently a major obstacle to finding effective solutions. The aim of this systematic review of qualitative studies was to understand the factors considered important by patients, caregivers and health care providers in contributing to TB medication adherence. METHODS AND FINDINGS: We searched 19 electronic databases (1966-February 2005 for qualitative studies on patients', caregivers', or health care providers' perceptions of adherence to preventive or curative TB treatment with the free text terms "Tuberculosis AND (adherence OR compliance OR concordance". We supplemented our search with citation searches and by consulting experts. For included studies, study quality was assessed using a predetermined checklist and data were extracted independently onto a standard form. We then followed Noblit and Hare's method of meta-ethnography to synthesize the findings, using both reciprocal translation and line-of-argument synthesis. We screened 7,814 citations and selected 44 articles that met the prespecified inclusion criteria. The synthesis offers an overview of qualitative evidence derived from these multiple international studies. We identified eight major themes across the studies: organisation of treatment and care; interpretations of illness and wellness; the financial burden of treatment; knowledge, attitudes, and beliefs about treatment; law and immigration; personal characteristics and adherence behaviour; side effects; and family, community, and household support. Our interpretation of the

  11. How is depression experienced around the world? A systematic review of qualitative literature.

    Science.gov (United States)

    Haroz, E E; Ritchey, M; Bass, J K; Kohrt, B A; Augustinavicius, J; Michalopoulos, L; Burkey, M D; Bolton, P

    2017-06-01

    To date global research on depression has used assessment tools based on research and clinical experience drawn from Western populations (i.e., in North American, European and Australian). There may be features of depression in non-Western populations which are not captured in current diagnostic criteria or measurement tools, as well as criteria for depression that are not relevant in other regions. We investigated this possibility through a systematic review of qualitative studies of depression worldwide. Nine online databases were searched for records that used qualitative methods to study depression. Initial searches were conducted between August 2012 and December 2012; an updated search was repeated in June of 2015 to include relevant literature published between December 30, 2012 and May 30, 2015. No date limits were set for inclusion of articles. A total of 16,130 records were identified and 138 met full inclusion criteria. Included studies were published between 1976 and 2015. These 138 studies represented data on 170 different study populations (some reported on multiple samples) and 77 different nationalities/ethnicities. Variation in results by geographical region, gender, and study context were examined to determine the consistency of descriptions across populations. Fisher's exact tests were used to compare frequencies of features across region, gender and context. Seven of the 15 features with the highest relative frequency form part of the DSM-5 diagnosis of Major Depressive Disorder (MDD). However, many of the other features with relatively high frequencies across the studies are associated features in the DSM, but are not prioritized as diagnostic criteria and therefore not included in standard instruments. The DSM-5 diagnostic criteria of problems with concentration and psychomotor agitation or slowing were infrequently mentioned. This research suggests that the DSM model and standard instruments currently based on the DSM may not adequately

  12. Patient beliefs and attitudes to taking statins: systematic review of qualitative studies.

    Science.gov (United States)

    Ju, Angela; Hanson, Camilla S; Banks, Emily; Korda, Rosemary; Craig, Jonathan C; Usherwood, Tim; MacDonald, Peter; Tong, Allison

    2018-06-01

    Statins are effective in preventing cardiovascular disease (CVD) events and are recommended for at-risk individuals but estimated adherence rates are low. To describe patients' perspectives, experiences, and attitudes towards taking statins. Systematic review of qualitative studies reporting perspectives of patients on statins. PsycINFO, CINAHL, Embase, MEDLINE, and PhD dissertations from inception to 6 October 2016 were searched for qualitative studies on adult patients' perspectives on statins. All text and participant quotations were extracted from each article and analysed by thematic synthesis. Thirty-two studies involving 888 participants aged 22-93 years across eight countries were included. Seven themes were identified: confidence in prevention (trust in efficacy, minimising long-term catastrophic CVD, taking control, easing anxiety about high cholesterol); routinising into daily life; questioning utility (imperceptible benefits, uncertainties about pharmacological mechanisms); medical distrust (scepticism about overprescribing, pressure to start therapy); threatening health (competing priorities and risks, debilitating side effects, toxicity to body); signifying sickness (fear of perpetual dependence, losing the battle); and financial strain. An expectation that statins could prevent CVD and being able to integrate the statin regimen in daily life facilitated acceptance of statins among patients. However, avoiding the 'sick' identity and prolonged dependence on medications, uncertainties about the pharmacological mechanisms, risks to health, side effects, costs, and scepticism about clinicians' motives for prescribing statins were barriers to uptake. Shared decision making that addresses the risks, reasons for prescribing, patient priorities, and implementing strategies to minimise lifestyle intrusion and manage side effects may improve patient satisfaction and continuation of statins. © British Journal of General Practice 2018.

  13. The essence of frailty: A systematic review and qualitative synthesis on frailty concepts and definitions.

    Science.gov (United States)

    Junius-Walker, Ulrike; Onder, Graziano; Soleymani, Dagmar; Wiese, Birgitt; Albaina, Olatz; Bernabei, Roberto; Marzetti, Emanuele

    2018-05-31

    One of the major threats looming over the growing older population is frailty. It is a distinctive health state characterised by increased vulnerability to internal and external stressors. Although the presence of frailty is well acknowledged, its concept and operationalisation are hampered by the extraordinary phenotypical and biological complexity. Yet, a widely accepted conception is needed to offer tailored policies and approaches. The ADVANTAGE Group aims to analyse the diverse frailty concepts to uncover the essence of frailty as a basis for a shared understanding. A systematic literature review was performed on frailty concepts and definitions from 2010 onwards. Eligible publications were reviewed using concept analysis that led to the extraction of text data for the themes "definition", "attributes", "antecedents", "consequences", and "related concepts". Qualitative description was used to further analyse the extracted text passages, leading to inductively developed categories on the essence of frailty. 78 publications were included in the review, and 996 relevant text passages were extracted for analysis. Five components constituted a comprehensive definition: vulnerability, genesis, features, characteristics, and adverse outcomes. Each component is described in more detail by a set of defining and explanatory criteria. An underlying functional perspective of health or its impairments is most compatible with the entity of frailty. The recent findings facilitate a focus on the relevant building blocks that define frailty. They point to the commonalities of the diverse frailty concepts and definitions. Based on these components, a widely accepted broad definition of frailty comes into range. Copyright © 2018 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  14. A qualitative systematic review of the reasons for parental attendance at the emergency department with children presenting with minor illness.

    Science.gov (United States)

    Butun, Ahmet; Hemingway, Pippa

    2018-01-01

    Over 5 million children attend the Emergency Department (ED) annually in England with an ever-increasing paediatric emergency caseload echoed globally. Approximately 60% of children present with illness and the majority have non-urgent illness creating burgeoning pressures on children's ED and this crisis resonates globally. To date no qualitative systematic review exists that focuses on the parental reasons for childhood attendance at the ED in this sub-group. To identify parental reasons for attending ED for their children presenting with minor illness. A qualitative systematic review was conducted against inclusion/exclusion criteria. Five electronic databases and key journals were searched in June 2015. 471 studies were identified and following study selection, 4 qualitative studies were included. Nine themes were identified e.g. dissatisfaction with family medical services, perceived advantages of ED and 'child suffering' with novel and insightful sub-themes of 'hereditary anxiety', 'taking it off our hands', ED as a 'magical place'. This novel qualitative systematic review examined parental attendance presenting with childhood minor illness of interest to emergency care reformers and clinicians. ED attendance is complex and multifactorial but parents provide vital insight to ED reformers on parental reasons for ED attendance in this sub-group. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Health professionals' experience of teamwork education in acute hospital settings: a systematic review of qualitative literature.

    Science.gov (United States)

    Eddy, Kylie; Jordan, Zoe; Stephenson, Matthew

    2016-04-01

    Teamwork is seen as an important element of patient care in acute hospital settings. The complexity of the journey of care for patients highlights the need for health professionals to collaborate and communicate clearly with each other. Health organizations in western countries are committed to improving patient safety through education of staff and teamwork education programs have been integral to this focus. There are no current systematic reviews of the experience of health professionals who participate in teamwork education in acute hospital settings. The objective of this systematic review was to search for the best available evidence on the experiences of health professionals who participate in teamwork education in acute hospital settings. This review considered studies reporting on experiences of registered health professionals who work in acute hospitals. This included medical, nursing and midwifery and allied health professionals. The focus of the meta-synthesis was the experiences and reflections of health professionals who were involved in teamwork education in acute hospital settings. The geographical context for this review was acute hospitals in rural or metropolitan settings in Australia and overseas countries. The review focused on the experiences of health professionals who work in acute hospitals and participated in teamwork education programs. This review considered studies that focused on qualitative data including, but not limited to, designs such as phenomenology, grounded theory, ethnography, action research and feminist research.In the absence of research studies, other text such as opinion papers, discussion papers and reports were considered. Studies published in English and from 1990 to 2013 were included in this review. The literature search for relevant papers occurred between 13 September and 26 October 2013. A three-step search strategy was utilized in this review. The databases searched were PubMed, CINAHL, Embase and Scopus. The

  16. Patient-centeredness in physiotherapy : What does it entail? A systematic review of qualitative studies

    NARCIS (Netherlands)

    Wijma, Amarins J.; Bletterman, Anouck N; Clark, Jacqui R; Vervoort, Sigrid C J M; Beetsma, Anneke; Keizer, Doeke; Nijs, Jo; van Wilgen, C. Paul

    2017-01-01

    PURPOSE: The literature review is aimed at examining and summarizing themes related to patient-centeredness identified in qualitative research from the perspectives of patients and physiotherapists. Following the review, a secondary aim was to synthesize the themes to construct a proposed conceptual

  17. Organizational determinants of interprofessional collaboration in integrative health care: systematic review of qualitative studies.

    Directory of Open Access Journals (Sweden)

    Vincent C H Chung

    Full Text Available CONTEXT: Inteprofessional collaboration (IPC between biomedically trained doctors (BMD and traditional, complementary and alternative medicine practitioners (TCAMP is an essential element in the development of successful integrative healthcare (IHC services. This systematic review aims to identify organizational strategies that would facilitate this process. METHODS: We searched 4 international databases for qualitative studies on the theme of BMD-TCAMP IPC, supplemented with a purposive search of 31 health services and TCAM journals. Methodological quality of included studies was assessed using published checklist. Results of each included study were synthesized using a framework approach, with reference to the Structuration Model of Collaboration. FINDINGS: Thirty-seven studies of acceptable quality were included. The main driver for developing integrative healthcare was the demand for holistic care from patients. Integration can best be led by those trained in both paradigms. Bridge-building activities, positive promotion of partnership and co-location of practices are also beneficial for creating bonding between team members. In order to empower the participation of TCAMP, the perceived power differentials need to be reduced. Also, resources should be committed to supporting team building, collaborative initiatives and greater patient access. Leadership and funding from central authorities are needed to promote the use of condition-specific referral protocols and shared electronic health records. More mature IHC programs usually formalize their evaluation process around outcomes that are recognized both by BMD and TCAMP. CONCLUSIONS: The major themes emerging from our review suggest that successful collaborative relationships between BMD and TCAMP are similar to those between other health professionals, and interventions which improve the effectiveness of joint working in other healthcare teams with may well be transferable to promote better

  18. Tuberculosis in migrant populations. A systematic review of the qualitative literature.

    Directory of Open Access Journals (Sweden)

    Bruno Abarca Tomás

    Full Text Available The re-emergence of tuberculosis (TB in low-incidence countries and its disproportionate burden on immigrants is a public health concern posing specific social and ethical challenges. This review explores perceptions, knowledge, attitudes and treatment adherence behaviour relating to TB and their social implications as reported in the qualitative literature.Systematic review in four electronic databases. Findings from thirty selected studies extracted, tabulated, compared and synthesized.TB was attributed to many non-exclusive causes including air-born transmission of bacteria, genetics, malnutrition, excessive work, irresponsible lifestyles, casual contact with infected persons or objects; and exposure to low temperatures, dirt, stress and witchcraft. Perceived as curable but potentially lethal and highly contagious, there was confusion around a condition surrounded by fears. A range of economic, legislative, cultural, social and health system barriers could delay treatment seeking. Fears of deportation and having contacts traced could prevent individuals from seeking medical assistance. Once on treatment, family support and "the personal touch" of health providers emerged as key factors facilitating adherence. The concept of latent infection was difficult to comprehend and while TB screening was often seen as a socially responsible act, it could be perceived as discriminatory. Immigration and the infectiousness of TB mutually reinforced each another exacerbating stigma. This was further aggravated by indirect costs such as losing a job, being evicted by a landlord or not being able to attend school.Understanding immigrants' views of TB and the obstacles that they face when accessing the health system and adhering to a treatment programme-taking into consideration their previous experiences at countries of origin as well as the social, economic and legislative context in which they live at host countries- has an important role and should be

  19. Neonatal care practices in sub-Saharan Africa: a systematic review of quantitative and qualitative data.

    Science.gov (United States)

    Bee, Margaret; Shiroor, Anushree; Hill, Zelee

    2018-04-16

    Recommended immediate newborn care practices include thermal care (immediate drying and wrapping, skin-to-skin contact after delivery, delayed bathing), hygienic cord care and early initiation of breastfeeding. This paper systematically reviews quantitative and qualitative data from sub-Saharan Africa on the prevalence of key immediate newborn care practices and the factors that influence them. Studies were identified by searching relevant databases and websites, contacting national and international academics and implementers and hand-searching reference lists of included articles. English-language published and unpublished literature reporting primary data from sub-Saharan Africa (published between January 2001 and May 2014) were included if it met the quality criteria. Quantitative prevalence data were extracted and summarized. Qualitative data were synthesized through thematic analysis, with deductive coding used to identify emergent themes within each care practice. A framework approach was used to identify prominent and divergent themes. Forty-two studies were included as well as DHS data - only available for early breastfeeding practices from 33 countries. Results found variation in the prevalence of immediate newborn care practices between countries, with the exception of skin-to-skin contact after delivery which was universally low. The importance of keeping newborn babies warm was well recognized, although thermal care practices were sub-optimal. Similar factors influenced practices across countries, including delayed drying and wrapping because the birth attendant focused on the mother; bathing newborns soon after delivery to remove the dirt and blood; negative beliefs about the vernix; applying substances to the cord to make it drop off quickly; and delayed breastfeeding because of a perception of a lack of milk or because the baby needs to sleep after delivery or does not showing signs of hunger. The majority of studies included in this review came

  20. A Systematic Review of Research Strategies Used in Qualitative Studies on School Bullying and Victimization.

    Science.gov (United States)

    Patton, Desmond Upton; Hong, Jun Sung; Patel, Sadiq; Kral, Michael J

    2017-01-01

    School bullying and victimization are serious social problems in schools. Most empirical studies on bullying and peer victimization are quantitative and examine the prevalence of bullying, associated risk and protective factors, and negative outcomes. Conversely, there is limited qualitative research on the experiences of children and adolescents related to school bullying and victimization. We review qualitative research on school bullying and victimization published between 2004 and 2014. Twenty-four empirical research studies using qualitative methods were reviewed. We organize the findings from these studies into (1) emic, (2) context specific, (3) iterative, (4) power relations, and (5) naturalistic inquiry. We find that qualitative researchers have focused on elaborating on and explicating the experiences of bully perpetrators, victims, and bystanders in their own words. Directions for research and practice are also discussed. © The Author(s) 2015.

  1. Researching children's perspectives in pediatric palliative care: A systematic review and meta-summary of qualitative research.

    Science.gov (United States)

    Ghirotto, Luca; Busani, Elena; Salvati, Michela; Di Marco, Valeria; Caldarelli, Valeria; Artioli, Giovanna

    2018-05-29

    Qualitative research is pivotal in gaining understanding of individuals' experiences in pediatric palliative care. In the past few decades, the number of qualitative studies on pediatric palliative care has increased slightly, as has interest in qualitative research in this area. Nonetheless, a limited number of such studies have included the first-person perspective of children. The aim of this article is to understand the contribution of previous qualitative research on pediatric palliative care that included the voices of children. A systematic review of qualitative studies and a meta-summary were conducted. MEDLINE, CINAHL, PsycINFO, PsycARTICLES, and ERIC were searched without limitations on publication date or language. Eligible articles were qualitative research articles in which the participants were children ranging in age from 3 to 18 years.ResultWe retrieved 16 qualitative research articles reporting on 12 unique studies, and we selected two mixed-method articles. The meta-summary shows eight themes: the relationship with professional caregivers, pain and its management, "living beyond pain," the relationship between pediatric patients and their families, children's view on their treatment and service provision, meanings children give to their end-of-life situation, consequences of clinical decisions, and the relationships among children in pediatric palliative care and their peers.Significance of resultsThis meta-summary presents the "state of the art" of pediatric palliative care qualitative research on children and highlights additional research areas that warrant qualitative study.

  2. Rigorous, robust and systematic: Qualitative research and its contribution to burn care. An integrative review.

    Science.gov (United States)

    Kornhaber, Rachel Anne; de Jong, A E E; McLean, L

    2015-12-01

    Qualitative methods are progressively being implemented by researchers for exploration within healthcare. However, there has been a longstanding and wide-ranging debate concerning the relative merits of qualitative research within the health care literature. This integrative review aimed to exam the contribution of qualitative research in burns care and subsequent rehabilitation. Studies were identified using an electronic search strategy using the databases PubMed, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Excerpta Medica database (EMBASE) and Scopus of peer reviewed primary research in English between 2009 to April 2014 using Whittemore and Knafl's integrative review method as a guide for analysis. From the 298 papers identified, 26 research papers met the inclusion criteria. Across all studies there was an average of 22 participants involved in each study with a range of 6-53 participants conducted across 12 nations that focussed on burns prevention, paediatric burns, appropriate acquisition and delivery of burns care, pain and psychosocial implications of burns trauma. Careful and rigorous application of qualitative methodologies promotes and enriches the development of burns knowledge. In particular, the key elements in qualitative methodological process and its publication are critical in disseminating credible and methodologically sound qualitative research. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

  3. Barriers and enablers in primary care clinicians' management of osteoarthritis: protocol for a systematic review and qualitative evidence synthesis.

    Science.gov (United States)

    Egerton, T; Diamond, L; Buchbinder, R; Bennell, K; Slade, S C

    2016-05-27

    Osteoarthritis is a highly prevalent and disabling condition. Primary care management of osteoarthritis is generally suboptimal despite evidence for several modestly effective interventions and the availability of high-quality clinical practice guidelines. This report describes a planned study to synthesise the views of primary care clinicians on the barriers and enablers to following recommended management of osteoarthritis, with the aim of providing new interpretations that may facilitate the uptake of recommended treatments, and in turn improve patient care. A systematic review and meta-synthesis of qualitative studies. 5 databases will be searched using key search terms for qualitative research, evidence-based practice, clinical practice guidelines, osteoarthritis, beliefs, perceptions, barriers, enablers and adherence. A priori inclusion/exclusion criteria include availability of data from primary care clinicians, reports on views regarding management of osteoarthritis, and studies using qualitative methods for both data collection and analysis. At least 2 independent reviewers will identify eligible reports, conduct a critical appraisal of study conduct, extract data and synthesise reported findings and interpretations. Synthesis will follow thematic analysis within a grounded theory framework of inductive coding and iterative theme identification. The reviewers plus co-authors will contribute to the meta-synthesis to find new themes and theories. The Confidence in the Evidence from Reviews of Qualitative research (CERQual) approach will be used to determine a confidence profile of each finding from the meta-synthesis. The protocol has been registered on PROSPERO and is reported using the Preferred Reporting Items for Systematic Review and Meta-Analyses Protocols (PRISMA-P) guidelines. Ethical approval is not required. The systematic review will be published in a peer-reviewed journal. The results will help to inform policy and practice and assist in the

  4. Parental experiences of providing skin-to-skin care to their newborn infant—Part 1: A qualitative systematic review

    Directory of Open Access Journals (Sweden)

    Agneta Anderzén-Carlsson

    2014-10-01

    Full Text Available Aim: To describe parental experiences of providing skin-to-skin care (SSC to their newborn infants. Background: SSC care for newborn infants has been reported to have positive physiological and psychological benefits to the infants and their parents. No systematic review regarding parental experiences has been identified. Design: In this first part of a meta-study, the findings of a systematic literature review on parental experience of SSC care are presented. Data sources: Four databases were searched, without year or language limitations, up until December 2013. Manual searches were performed in reference lists and in a bibliography of the topic. Review methods: After a quality-appraisal process, data from the original articles were extracted and analysed using qualitative content analysis. Results: The systematic and manual searches led to the inclusion of 29 original qualitative papers from nine countries, reporting experiences from 401 mothers and 94 fathers. Two themes that characterized the provision of SSC emerged: a restoring experience and an energy-draining experience. Conclusion: This review has added scientific and systematic knowledge about parental experiences of providing SSC. Further research about fathers’ experiences is recommended.

  5. Midwives' and health visitors' collaborative relationships: A systematic review of qualitative and quantitative studies.

    Science.gov (United States)

    Aquino, Maria Raisa Jessica Ryc V; Olander, Ellinor K; Needle, Justin J; Bryar, Rosamund M

    2016-10-01

    Interprofessional collaboration between midwives and health visitors working in maternal and child health services is widely encouraged. This systematic review aimed to identify existing and potential areas for collaboration between midwives and health visitors; explore the methods through which collaboration is and can be achieved; assess the effectiveness of this relationship between these groups, and ascertain whether the identified examples of collaboration are in line with clinical guidelines and policy. A narrative synthesis of qualitative and quantitative studies. Fourteen electronic databases, research mailing lists, recommendations from key authors and reference lists and citations of included papers. Papers were included if they explored one or a combination of: the areas of practice in which midwives and health visitors worked collaboratively; the methods that midwives and health visitors employed when communicating and collaborating with each other; the effectiveness of collaboration between midwives and health visitors; and whether collaborative practice between midwives and health visitors meet clinical guidelines. Papers were assessed for study quality. Eighteen papers (sixteen studies) met the inclusion criteria. The studies found that midwives and health visitors reported valuing interprofessional collaboration, however this was rare in practice. Findings show that collaboration could be useful across the service continuum, from antenatal care, transition of care/handover, to postnatal care. Evidence for the effectiveness of collaboration between these two groups was equivocal and based on self-reported data. In relation, multiple enablers and barriers to collaboration were identified. Communication was reportedly key to interprofessional collaboration. Interprofessional collaboration was valuable according to both midwives and health visitors, however, this was made challenging by several barriers such as poor communication, limited resources, and

  6. Facilitating problem-based learning among undergraduate nursing students: A qualitative systematic review.

    Science.gov (United States)

    Wosinski, Jacqueline; Belcher, Anne E; Dürrenberger, Yvan; Allin, Anne-Claude; Stormacq, Coraline; Gerson, Linda

    2018-01-01

    The purpose of this study was to identify and synthesize the best available evidence on the perspective of undergraduate nursing students on facilitating elements that contribute to their success with PBL. a qualitative systematic review of the literature according to meta-aggregative methodology using the JBI SUMARI system was conducted. Data was collected across CINAHL, Medline, Embase, Eric, Teacher Reference Center and reference lists. Out of 378 articles, 101 were retrieved for examination and eight were retained after methodological analysis. 51 findings, matched with a verbatim, were extracted and aggregated in five categories: 1) in PBL, the nursing tutor models clinical reasoning and leadership skills; 2) the quality of group interactions is critical to the success of nursing students with PBL; 3) nursing students go through the process of learning with PBL; 4) through PBL, nursing students acquire skills that foster clinical reasoning; and 5) when the PBL method is used as intended, nursing students understand its purpose and process. These categories were aggregated in two syntheses worded as recommendation for practice. The synthesized recommendations are: 1) tutors should be trained to effectively guide the team work of undergraduate nursing students along the PBL process in order for them to achieve its goal; and 2) nursing students should be securely introduced to PBL and experience the development of their clinical reasoning through PBL. Future research should focus on the strategies undergraduate nursing students use to succeed with PBL and the effectiveness of PBL in enhancing critical thinking and collaboration skills. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  7. Men's perspectives of prostate cancer screening: A systematic review of qualitative studies.

    Directory of Open Access Journals (Sweden)

    Laura J James

    Full Text Available Prostate cancer is the most commonly diagnosed non-skin cancer in men. Screening for prostate cancer is widely accepted; however concerns regarding the harms outweighing the benefits of screening exist. Although patient's play a pivotal role in the decision making process, men may not be aware of the controversies regarding prostate cancer screening. Therefore we aimed to describe men's attitudes, beliefs and experiences of prostate cancer screening.Systematic review and thematic synthesis of qualitative studies on men's perspectives of prostate cancer screening. Electronic databases and reference lists were searched to October 2016.Sixty studies involving 3,029 men aged from 18-89 years, who had been screened for prostate cancer by Prostate Specific Antigen (PSA or Digital Rectal Examination (DRE and not screened, across eight countries were included. Five themes were identified: Social prompting (trusting professional opinion, motivation from family and friends, proximity and prominence of cancer; gaining decisional confidence (overcoming fears, survival imperative, peace of mind, mental preparation, prioritising wellbeing; preserving masculinity (bodily invasion, losing sexuality, threatening manhood, medical avoidance; avoiding the unknown and uncertainties (taboo of cancer-related death, lacking tangible cause, physiological and symptomatic obscurity, ambiguity of the procedure, confusing controversies; and prohibitive costs.Men are willing to participate in prostate cancer screening to prevent cancer and gain reassurance about their health, particularly when supported or prompted by their social networks or healthcare providers. However, to do so they needed to mentally overcome fears of losing their masculinity and accept the intrusiveness of screening, the ambiguities about the necessity and the potential for substantial costs. Addressing the concerns and priorities of men may facilitate informed decisions about prostate cancer screening

  8. Recovery in Psychosis from a Service User Perspective: A Systematic Review and Thematic Synthesis of Current Qualitative Evidence.

    Science.gov (United States)

    Wood, L; Alsawy, S

    2017-11-29

    There is a growing number of qualitative accounts regarding recovery from psychosis from a service user perspective. The aim of this study was to conduct a systematic review of these qualitative accounts. A thematic synthesis was utilised to synthesise and analyse seventeen studies included in the review. Studies were included if they used a qualitative methodology to explore service users' experiences of recovery from psychosis as a primary research question. All included studies were subjected to a quality assessment. The analysis outlined three subordinate themes: the recovery journey, facilitators of recovery (e.g. faith and spirituality, personal agency and hope), and barriers to recovery (e.g. stigma and discrimination, negative effects of mental health services and medication). Recovery is an idiosyncratic process but includes key components which are important to people who experience psychosis. These should be explored within clinical practice.

  9. Economic Analyses in Anterior Cruciate Ligament Reconstruction: A Qualitative and Systematic Review.

    Science.gov (United States)

    Saltzman, Bryan M; Cvetanovich, Gregory L; Nwachukwu, Benedict U; Mall, Nathan A; Bush-Joseph, Charles A; Bach, Bernard R

    2016-05-01

    As the health care system in the United States (US) transitions toward value-based care, there is an increased emphasis on understanding the cost drivers and high-value procedures within orthopaedics. To date, there has been no systematic review of the economic literature on anterior cruciate ligament reconstruction (ACLR). To evaluate the overall evidence base for economic studies published on ACLR in the orthopaedic literature. Data available on the economics of ACLR are summarized and cost drivers associated with the procedure are identified. Systematic review. All economic studies (including US-based and non-US-based) published between inception of the MEDLINE database and October 3, 2014, were identified. Given the heterogeneity of the existing evidence base, a qualitative, descriptive approach was used to assess the collective results from the economic studies on ACLR. When applicable, comparisons were made for the following cost-related variables associated with the procedure for economic implications: outpatient versus inpatient surgery (or outpatient vs overnight hospital stay vs >1-night stay); bone-patellar tendon-bone (BPTB) graft versus hamstring (HS) graft source; autograft versus allograft source; staged unilateral ACLR versus bilateral ACLR in a single setting; single- versus double-bundle technique; ACLR versus nonoperative treatment; and other unique comparisons reported in single studies, including computer-assisted navigation surgery (CANS) versus traditional surgery, early versus delayed ACLR, single- versus double-incision technique, and finally the costs of ACLR without comparison of variables. A total of 24 studies were identified and included; of these, 17 included studies were cost identification studies. The remaining 7 studies were cost utility analyses that used economic models to investigate the effect of variables such as the cost of allograft tissue, fixation devices, and physical therapy, the percentage and timing of revision

  10. Palliative care experiences of adult cancer patients from ethnocultural groups: a qualitative systematic review protocol.

    Science.gov (United States)

    Busolo, David; Woodgate, Roberta

    2015-01-01

    palliative care. Ethnocultural meanings of illness, suffering and dying define the theoretical underpinnings that patients and healthcare providers draw upon in their relations. Furthermore, Baker suggests that the provision and receipt of palliative care is more related to culture or ethnicity than to age, education, socioeconomic status or other variables. Moreover, culture affects communication, decision-making, response to symptoms, treatment choices and emotional expression at the end of life.Palliative care patients often regard recommendations from healthcare providers as very useful. Similarly, healthcare providers may find ethnocultural knowledge beneficial in the provision of palliative care. When ethnocultural knowledge is lacking, healthcare providers, especially those with minimal training on ethnocultural issues, may provide unsatisfactory palliative care. Similarly, when ethnocultural differences are overlooked or inadequately addressed, inferior care often occurs. Inferior care which may involve inequality in utilization of and access to palliative care services, pain and symptom management and location of death, is especially disturbing when adequate palliative care resources exist in some health institutions.Although qualitative and quantitative research has been conducted in this area, no systematic review compiling findings on ethnocultural patients' experiences of palliative care has been conducted or is underway as per the Joanna Briggs Institute Database of Systematic Reviews and Implementation Reports, Cochrane Database of Systematic Reviews or PROSPERO. The purpose of this systematic review is to summarize findings of qualitative studies that focus on ethnocultural patients' experience of palliative care. (ABSTRACT TRUNCATED)

  11. Barriers and facilitators of interventions for improving antiretroviral therapy adherence: a systematic review of global qualitative evidence.

    Science.gov (United States)

    Ma, Qingyan; Tso, Lai Sze; Rich, Zachary C; Hall, Brian J; Beanland, Rachel; Li, Haochu; Lackey, Mellanye; Hu, Fengyu; Cai, Weiping; Doherty, Meg; Tucker, Joseph D

    2016-01-01

    Qualitative research on antiretroviral therapy (ART) adherence interventions can provide a deeper understanding of intervention facilitators and barriers. This systematic review aims to synthesize qualitative evidence of interventions for improving ART adherence and to inform patient-centred policymaking. We searched 19 databases to identify studies presenting primary qualitative data on the experiences, attitudes and acceptability of interventions to improve ART adherence among PLHIV and treatment providers. We used thematic synthesis to synthesize qualitative evidence and the CERQual (Confidence in the Evidence from Reviews of Qualitative Research) approach to assess the confidence of review findings. Of 2982 references identified, a total of 31 studies from 17 countries were included. Twelve studies were conducted in high-income countries, 13 in middle-income countries and six in low-income countries. Study populations focused on adults living with HIV (21 studies, n =1025), children living with HIV (two studies, n =46), adolescents living with HIV (four studies, n =70) and pregnant women living with HIV (one study, n =79). Twenty-three studies examined PLHIV perspectives and 13 studies examined healthcare provider perspectives. We identified six themes related to types of interventions, including task shifting, education, mobile phone text messaging, directly observed therapy, medical professional outreach and complex interventions. We also identified five cross-cutting themes, including strengthening social relationships, ensuring confidentiality, empowerment of PLHIV, compensation and integrating religious beliefs into interventions. Our qualitative evidence suggests that strengthening PLHIV social relationships, PLHIV empowerment and developing culturally appropriate interventions may facilitate adherence interventions. Our study indicates that potential barriers are inadequate training and compensation for lay health workers and inadvertent disclosure of

  12. Systematic review

    DEFF Research Database (Denmark)

    Enggaard, Helle

    Title: Systematic review a method to promote nursing students skills in Evidence Based Practice Background: Department of nursing educate students to practice Evidence Based Practice (EBP), where clinical decisions is based on the best available evidence, patient preference, clinical experience...... and resources available. In order to incorporate evidence in clinical decisions, nursing students need to learn how to transfer knowledge in order to utilize evidence in clinical decisions. The method of systematic review can be one approach to achieve this in nursing education. Method: As an associate lecturer...... I have taken a Comprehensive Systematic Review Training course provide by Center of Clinical Guidelines in Denmark and Jonna Briggs Institute (JBI) and practice in developing a systematic review on how patients with ischemic heart disease experiences peer support. This insight and experience...

  13. The full spectrum of ethical issues in the care of patients with ALS: a systematic qualitative review.

    Science.gov (United States)

    Seitzer, F; Kahrass, H; Neitzke, G; Strech, D

    2016-02-01

    Dealing systematically with ethical issues in amyotrophic lateral sclerosis (ALS) care requires an unbiased awareness of all the relevant ethical issues. The aim of the study was to determine systematically and transparently the full spectrum of ethical issues in ALS care. We conducted a systematic review in Medline and Google Books (restricted to English and German literature published between 1993 and 2014). We applied qualitative text analysis and normative analysis to categorise the spectrum of ethical issues in ALS care. The literature review retrieved 56 references that together mentioned a spectrum of 103 ethical issues in ALS care. The spectrum was structured into six major categories that consist of first and second-order categories of ethical issues. The systematically derived spectrum of ethical issues in ALS care presented in this paper raises awareness and understanding of the complexity of ethical issues in ALS care. It also offers a basis for the systematic development of informational and training materials for health professionals, patients and their relatives, and society as a whole. Finally, it supports a rational and fair selection of all those ethical issues that should be addressed in health policies, position papers and clinical practice guidelines. Further research is needed to identify ways to systematically select the most relevant ethical issues not only in the clinical environment, but also for the development of clinical practice guidelines.

  14. Reviewing the research methods literature: principles and strategies illustrated by a systematic overview of sampling in qualitative research.

    Science.gov (United States)

    Gentles, Stephen J; Charles, Cathy; Nicholas, David B; Ploeg, Jenny; McKibbon, K Ann

    2016-10-11

    Overviews of methods are potentially useful means to increase clarity and enhance collective understanding of specific methods topics that may be characterized by ambiguity, inconsistency, or a lack of comprehensiveness. This type of review represents a distinct literature synthesis method, although to date, its methodology remains relatively undeveloped despite several aspects that demand unique review procedures. The purpose of this paper is to initiate discussion about what a rigorous systematic approach to reviews of methods, referred to here as systematic methods overviews, might look like by providing tentative suggestions for approaching specific challenges likely to be encountered. The guidance offered here was derived from experience conducting a systematic methods overview on the topic of sampling in qualitative research. The guidance is organized into several principles that highlight specific objectives for this type of review given the common challenges that must be overcome to achieve them. Optional strategies for achieving each principle are also proposed, along with discussion of how they were successfully implemented in the overview on sampling. We describe seven paired principles and strategies that address the following aspects: delimiting the initial set of publications to consider, searching beyond standard bibliographic databases, searching without the availability of relevant metadata, selecting publications on purposeful conceptual grounds, defining concepts and other information to abstract iteratively, accounting for inconsistent terminology used to describe specific methods topics, and generating rigorous verifiable analytic interpretations. Since a broad aim in systematic methods overviews is to describe and interpret the relevant literature in qualitative terms, we suggest that iterative decision making at various stages of the review process, and a rigorous qualitative approach to analysis are necessary features of this review type

  15. Children's experiences of living with a parent with mental illness: A systematic review of qualitative studies using thematic analysis.

    Science.gov (United States)

    Yamamoto, Rumi; Keogh, Brian

    2018-03-01

    WHAT IS KNOWN ABOUT THE SUBJECT?: There are many qualitative studies that explore what it is like for children who live with a parent who has a mental illness. These studies are sometimes criticized because they have small sample sizes which limits their application. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: We conducted a systematic review of qualitative papers with an aim to strengthening our understanding of what it is like for children who live with a parent who has a mental illness. We used stringent criteria to make sure that only the voices of children affected by parental mental illness were included in the review. In addition, the paper presents a timely update on previous reviews completed in this area. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The findings of this review highlight the impact that parental mental illness has on children and the important role that mental health nurses can play in maximizing opportunities for building resilience in affected children. Mental health nurses are in a key position to provide timely and age-appropriate information and support to both parents and children to assist in the development of appropriate coping and support mechanisms. Introduction This paper brings together what is known about what it is like for children who live with a parent with a mental illness with a view to strengthening our understanding of their experiences. This paper presents an update on previous reviews that were completed in this area and used a systematic approach and stringent inclusion/exclusion criteria to ensure that the voices of children were central in the included papers. A systematic review of this nature could not be located in the literature. Aims This paper presents the findings of a systematic review which explored the experiences of children who were affected by parental mental illness. Methods CINAHL, PubMed, PsychINFO, Pubmesh and EMBASE were searched for qualitative studies which explored children's experiences, and

  16. Experiences of community-dwelling older adults with the use of telecare in home care services: a qualitative systematic review.

    Science.gov (United States)

    Karlsen, Cecilie; Ludvigsen, Mette Spliid; Moe, Carl Erik; Haraldstad, Kristin; Thygesen, Elin

    2017-12-01

    The aging population will lead to a rise in the number of people with age-related diseases, and increasing demand for home care services. Telecare is seen as a solution to this challenge by promoting aging in place. Nevertheless, there is still a poor understanding of older adults' experiences with the actual use of telecare. The aim of this review was to identify and synthesize the best available qualitative evidence of community-dwelling older adults' experience with the use of telecare in home care services. This review considered studies that focused on qualitative data, examining older adults' experiences with the use of active and passive technology devices, such as personal alarms and sensor technology, in the context of home care services. This review systematically searched the databases Scopus, CINAHL, PsycINFO, and SveMed+ to find both published and unpublished studies in English, Norwegian, Swedish and Danish, from 2005 to 2017. Methodological quality of the included studies was assessed independently by two reviewers using the Joanna Briggs Institute Qualitative Assessment and Review Instrument. Qualitative data were extracted from papers included in the review using the standardized Qualitative Assessment and Review Instrument from the Joanna Briggs Institute. Qualitative research findings were pooled using the Joanna Briggs Institute Qualitative Assessment and Review Instrument, and involved aggregation and synthesis of findings. A total of 118 findings from 11 studies were aggregated into 20 categories. The categories generated seven synthesized findings: 1) Aging in place is desired; however, it may also be related to feeling isolated and lonely. 2) Telecare contributes to safety, security, and aging in place. 3) Privacy is not seen as a problem by most older adults because the technology is intended to help them live safely in their own home. 4) Some telecare devices have side effects, especially new technology. Some devices do not work outside

  17. Adult women's experiences of urinary incontinence: a systematic review of qualitative evidence.

    Science.gov (United States)

    Mendes, Adilson; Hoga, Luiza; Gonçalves, Bruna; Silva, Pâmela; Pereira, Priscilla

    2017-05-01

    Women are affected dramatically by urinary incontinence (UI). This disease is currently considered as epidemic. The objective of this review is to identify, through the best available evidence, how women experience UI worldwide. The current review included studies of adult women who had experienced UI. Women with UI from various social and cultural settings were included in this review. Qualitative data including, but not limited to, study designs such as phenomenology, grounded theory, ethnography, action research and feminist research were included in this review. All aspects related to the experience of UI endured by women were considered. An initial search of MEDLINE (PubMed) and CINAHL was done, followed by the exploration of all the databases and all identified studies, published in English, Spanish, French and Portuguese. The databases searched were CINAHL, PubMed, PsycINFO, Lilacs, Scielo, BVS, BVS-Psi, Scopus, Embase, Sociological Abstracts, Dissertation Abstracts International and the University of São Paulo Dissertations and Thesis bank and gray literature. Each primary study was assessed by two independent reviewers for methodological quality. The Joanna Briggs Institute Qualitative Appraisal and Review Instrument (JBI-QARI) data extraction form for interpretive and critical research was used to appraise the methodological quality of all papers. Qualitative data were extracted using the JBI-QARI. Qualitative research findings were synthesized using the JBI-QARI. From the 28 studies were included, 189 findings were extracted and they were grouped into 25 categories and eight synthesized findings: (i) cultural and religious backgrounds and personal reluctance contribute to delays in seeking UI treatment; (ii) the inevitable and regrettable problem of UI endured silently and alone affects women's daily activities and their social roles; (iii) poor knowledge and the vague nature of the symptoms mask the fact that UI is a disease; (iv) the experiences

  18. Factors Influencing Household Uptake of Improved Solid Fuel Stoves in Low- and Middle-Income Countries: A Qualitative Systematic Review

    Directory of Open Access Journals (Sweden)

    Stanistreet Debbi

    2014-08-01

    Full Text Available Household burning of solid fuels in traditional stoves is detrimental to health, the environment and development. A range of improved solid fuel stoves (IS are available but little is known about successful approaches to dissemination. This qualitative systematic review aimed to identify factors that influence household uptake of IS in low- and middle-income countries. Extensive searches were carried out and studies were screened and extracted using established systematic review methods. Fourteen qualitative studies from Asia, Africa and Latin-America met the inclusion criteria. Thematic synthesis was used to synthesise data and findings are presented under seven framework domains. Findings relate to user and stakeholder perceptions and highlight the importance of cost, good stove design, fuel and time savings, health benefits, being able to cook traditional dishes and cleanliness in relation to uptake. Creating demand, appropriate approaches to business, and community involvement, are also discussed. Achieving and sustaining uptake is complex and requires consideration of a broad range of factors, which operate at household, community, regional and national levels. Initiatives aimed at IS scale up should include quantitative evaluations of effectiveness, supplemented with qualitative studies to assess factors affecting uptake, with an equity focus.

  19. Systematic review

    DEFF Research Database (Denmark)

    Bager, Palle; Chauhan, Usha; Greveson, Kay

    2017-01-01

    of evidence is needed and the aim of this article was to systematically review the evidence of IBD advice lines. MATERIALS AND METHODS: A broad systematic literature search was performed to identify relevant studies addressing the effect of advice lines. The process of selection of the retrieved studies...... was undertaken in two phases. In phase one, all abstracts were review by two independent reviewers. In phase two, the full text of all included studies were independently reviewed by two reviewers. The included studies underwent quality assessment and data synthesis. RESULTS: Ten published studies and 10...... congress abstracts were included in the review. The studies were heterogeneous both in scientific quality and in the focus of the study. No rigorous evidence was found to support that advice lines improve disease activity in IBD and correspondingly no studies reported worsening in disease activity. Advice...

  20. The influence of workplace culture on nurses' learning experiences: a systematic review of qualitative evidence.

    Science.gov (United States)

    Davis, Kate; White, Sarahlouise; Stephenson, Matthew

    2016-06-01

    A healthy workplace culture enables nurses to experience valuable learning in the workplace. Learning in the workplace enables the provision of evidence-based and continuously improving safe patient care, which is central to achieving good patient outcomes. Therefore, nurses need to learn within a workplace that supports the implementation of evidence-based, professional practice and enables the best patient outcomes; the influence of workplace culture may play a role in this. The purpose of this review was to critically appraise and synthesize the best available qualitative evidence to understand both the nurses' learning experiences within the workplace and the factors within the workplace culture that influence those learning experiences. Registered and enrolled nurses regulated by a nursing and midwifery board and/or recognized health practitioner regulation agency (or their international equivalent). This review considered studies that described two phenomena of interest: the nurses' learning experience, either within an acute healthcare workplace or a workplace-related learning environment and the influence of workplace culture on the nurses' learning experience (within the workplace or workplace-related learning environment). This review considered studies that included nurses working in an acute healthcare organization within a Western culture. This review considered studies that focused on qualitative evidence and included the following research designs: phenomenological, grounded theory and critical theory. Published and unpublished studies in English from 1980 to 2013 were identified using a three-step search strategy, searching various databases, and included hand searching of the reference lists within articles selected for appraisal. For studies meeting the inclusion criteria, methodological quality was assessed using a standardized checklist from the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI). Qualitative data

  1. Using Qualitative Research to Overcome the Shortcomings of Systematic Reviews When Designing of a Self-Management Intervention for Advanced Cancer Pain

    Directory of Open Access Journals (Sweden)

    Kate Flemming

    2016-09-01

    Full Text Available Objectives: To identify the key components for a self-management intervention for advanced cancer pain using evidence drawn from systematic reviews of complex interventions and syntheses of qualitative research. Methods: Evidence from up-to-date systematic reviews was prioritized. Searches were initially undertaken to identify the systematic reviews of effectiveness in Cinahl, Medline, Embase, PsycInfo, and the Cochrane Database of systematic reviews from 2009 to June 2014, using validated search terms. Subsequent searches to identify the qualitative systematic reviews were undertaken in Cinahl, Medline, Embase, and PsycInfo from 2009 to January 2015. The results of the two sets of reviews were integrated using methods based on constant comparative techniques. Results: Four systematic reviews examining interventions for the self-management of advanced cancer pain were identified. Although each review recommended some attributes of a pain management intervention, it was not possible to determine the essential key components. Subsequent searches for qualitative evidence syntheses identified three reviews. These were integrated with the effectiveness reviews. The integration identified key components for a self-management intervention including individualized approaches to care, the importance of addressing patients’ knowledge, skills, and attitudes toward pain management, and the significance of team approaches and inter-disciplinary working in the management of pain. Conclusion: Implementing the findings from systematic reviews of complex interventions is often hindered by a lack of understanding of important contextual components of care, often provided by qualitative research. Using both types of data to provide answers for practice demonstrates the benefits of incorporating qualitative research in reviews of complex interventions by ensuring the strengths of qualitative and quantitative research are combined and that their respective

  2. A systematic review of the health and well-being impacts of school gardening: synthesis of quantitative and qualitative evidence.

    Science.gov (United States)

    Ohly, Heather; Gentry, Sarah; Wigglesworth, Rachel; Bethel, Alison; Lovell, Rebecca; Garside, Ruth

    2016-03-25

    School gardening programmes are increasingly popular, with suggested benefits including healthier eating and increased physical activity. Our objectives were to understand the health and well-being impacts of school gardens and the factors that help or hinder their success. We conducted a systematic review of quantitative and qualitative evidence (PROSPERO CRD42014007181). We searched multiple databases and used a range of supplementary approaches. Studies about school gardens were included if they reported on physical or mental health or well-being. Quantitative studies had to include a comparison group. Studies were quality appraised using appropriate tools. Findings were narratively synthesised and the qualitative evidence used to produce a conceptual framework to illustrate how benefits might be accrued. Evidence from 40 articles (21 quantitative studies; 16 qualitative studies; 3 mixed methods studies) was included. Generally the quantitative research was poor. Evidence for changes in fruit and vegetable intake was limited and based on self-report. The qualitative research was better quality and ascribed a range of health and well-being impacts to school gardens, with some idealistic expectations for their impact in the long term. Groups of pupils who do not excel in classroom activities were thought to particularly benefit. Lack of funding and over reliance on volunteers were thought to threaten success, while involvement with local communities and integration of gardening activities into the school curriculum were thought to support success. More robust quantitative research is needed to convincingly support the qualitative evidence suggesting wide ranging benefits from school gardens.

  3. Public open space characteristics influencing adolescents' use and physical activity: A systematic literature review of qualitative and quantitative studies.

    Science.gov (United States)

    Van Hecke, Linde; Ghekiere, Ariane; Veitch, Jenny; Van Dyck, Delfien; Van Cauwenberg, Jelle; Clarys, Peter; Deforche, Benedicte

    2018-04-06

    The objective of this systematic review was to provide insight into the specific characteristics of public open spaces (POS) associated with adolescents' POS visitation and physical activity (PA). Qualitative research suggests many characteristics to be associated with POS visitation and PA. Quantitative evidence confirmed a positive association between presence of trails, playgrounds and specific types of sports fields (e.g. basketball) with POS visitation and PA, whereas safety and aesthetics seemed subordinate. Suggestions for future research, as well as some methodological recommendations are provided. Copyright © 2018 Elsevier Ltd. All rights reserved.

  4. Return to Play After Hamstring Injuries: A Qualitative Systematic Review of Definitions and Criteria.

    Science.gov (United States)

    van der Horst, Nick; van de Hoef, Sander; Reurink, Gustaaf; Huisstede, Bionka; Backx, Frank

    2016-06-01

    More than half of the recurrent hamstring injuries occur within the first month after return-to-play (RTP). Although there are numerous studies on RTP, comparisons are hampered by the numerous definitions of RTP used. Moreover, there is no consensus on the criteria used to determine when a person can start playing again. These criteria need to be critically evaluated, in an attempt to reduce recurrence rates and optimize RTP. To carry out a systematic review of the literature on (1) definitions of RTP used in hamstring research and (2) criteria for RTP after hamstring injuries. Systematic review. Seven databases (PubMed, EMBASE/MEDLINE, CINAHL, PEDro, Cochrane, SPORTDiscus, Scopus) were searched for articles that provided a definition of, or criteria for, RTP after hamstring injury. There were no limitations on the methodological design or quality of articles. Content analysis was used to record and analyze definitions and criteria for RTP after hamstring injury. Twenty-five papers fulfilled inclusion criteria, of which 13 provided a definition of RTP and 23 described criteria to support the RTP decision. "Reaching the athlete's pre-injury level" and "being able to perform full sport activities" were the primary content categories used to define RTP. "Absence of pain", "similar strength", "similar flexibility", "medical staff clearance", and "functional performance" were core themes to describe criteria to support the RTP decision after hamstring injury. Only half of the included studies provided some definition of RTP after hamstring injury, of which reaching the athlete's pre-injury level and being able to perform full sport activities were the most important. A wide variety of criteria are used to support the RTP decision, none of which have been validated. More research is needed to reach a consensus on the definition of RTP and to provide validated RTP criteria to facilitate hamstring injury management and reduce hamstring injury recurrence. PROSPERO

  5. Smoke-free homes: what are the barriers, motivators and enablers? A qualitative systematic review and thematic synthesis.

    Science.gov (United States)

    Passey, Megan E; Longman, Jo M; Robinson, Jude; Wiggers, John; Jones, Laura L

    2016-03-17

    To thematically synthesise primary qualitative studies of the barriers, motivators and enablers of smoke-free homes (SFHs). Systematic review and thematic synthesis. Searches of MEDLINE, EBM Reviews (Cochrane Database of Systematic Reviews), PsycINFO, Global Health, CINAHL, Web of Science, Informit and EMBASE, combining terms for families, households and vulnerable populations; SFH and secondhand smoke; and qualitative research, were supplemented by searches of PhD theses, key authors, specialist journals and reference lists. We included 22 articles, reporting on 18 studies, involving 646 participants. peer-reviewed; English language; published from 1990 onwards (to week 3 of April 2014); used qualitative data collection methods; explored participants' perspectives of home smoking behaviours; and the barriers, motivators and enablers to initiating and/or maintaining a SFH. 1 of 3 authors extracted data with checking by a second. A thematic synthesis was performed to develop 7 core analytic themes: (1) knowledge, awareness and risk perception; (2) agency and personal skills/attributes; (3) wider community norms and personal moral responsibilities; (4) social relationships and influence of others; (5) perceived benefits, preferences and priorities; (6) addiction and habit; (7) practicalities. This synthesis highlights the complexity faced by many households in having a SFH, the practical, social, cultural and personal issues that need to be addressed and balanced by households, and that while some of these are common across study settings, specific social and cultural factors play a critical role in shaping household smoking behaviours. The findings can inform policy and practice and the development of interventions aimed at increasing SFHs. CRD42014014115. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  6. Characteristics of the Japanese Diet Described in Epidemiologic Publications: A Qualitative Systematic Review.

    Science.gov (United States)

    Suzuki, Nozomu; Goto, Yoshihito; Ota, Haruka; Kito, Kumiko; Mano, Fumika; Joo, Erina; Ikeda, Kaori; Inagaki, Nobuya; Nakayama, Takeo

    2018-01-01

    International interest in the Japanese diet has grown in recent years. The aim of this systematic review was to evaluate and organize the Japanese diet and dietary characteristics from an epidemiological perspective, mainly focusing on the nutritional and dietary elements. PubMed, Web of Science, Japan Medical Abstracts Society, JDream III, and CiNii databases were searched. The eligibility criteria included research with an epidemiological study design that was either cross-sectional, cohort, or case-control-based that defined the dietary patterns of the Japanese diet using dietary pattern analysis. A total of 39 research articles that described the Japanese diet were included. The data that were extracted included the following: implementing country, location, study design, participant characteristics, key outcomes, methods used in the analysis of dietary patterns, and descriptions of the Japanese diet. As a result of the systematic review analyzing the descriptions of the Japanese diet from 39 selected articles, we were able to aggregate the descriptions into 16 categories from 33 factors. After performing a content analysis using a further aggregation of categories, we found that the top three applicable categories were soybeans/soybean-derived products, seafood, and vegetables; these were followed by rice and miso soup. The Japanese dietary content was found to be diverse based on an examination of epidemiological studies; however, we were able to aggregate the content into 16 categories. The Japanese diet is considered to be a dietary pattern that contains a combination of factors: the dietary staple, side dishes, and soup.

  7. Systematic review

    DEFF Research Database (Denmark)

    Lødrup, Anders Bergh; Reimer, Christina; Bytzer, Peter

    2013-01-01

    in getting off acid-suppressive medication and partly explain the increase in long-term use of PPI. A number of studies addressing this issue have been published recently. The authors aimed to systematically review the existing evidence of clinically relevant symptoms caused by acid rebound following PPI...

  8. Systematic review

    DEFF Research Database (Denmark)

    Christensen, Troels Dreier; Spindler, Karen-Lise Garm; Palshof, Jesper Andreas

    2016-01-01

    to earlier diagnosis and improved survival. Method: In this paper, we describe the incidence as well as characteristics associated with BM based on a systematic review of the current literature, following the PRISMA guidelines. Results: We show that the incidence of BM in CRC patients ranges from 0.6 to 3...

  9. Physiotherapists' beliefs and attitudes influence clinical practice in chronic low back pain: a systematic review of quantitative and qualitative studies.

    Science.gov (United States)

    Gardner, Tania; Refshauge, Kathryn; Smith, Lorraine; McAuley, James; Hübscher, Markus; Goodall, Stephen

    2017-07-01

    What influence do physiotherapists' beliefs and attitudes about chronic low back pain have on their clinical management of people with chronic low back pain? Systematic review with data from quantitative and qualitative studies. Quantitative and qualitative studies were included if they investigated an association between physiotherapists' attitudes and beliefs about chronic low back pain and their clinical management of people with chronic low back pain. Five quantitative and five qualitative studies were included. Quantitative studies used measures of treatment orientation and fear avoidance to indicate physiotherapists' beliefs and attitudes about chronic low back pain. Quantitative studies showed that a higher biomedical orientation score (indicating a belief that pain and disability result from a specific structural impairment, and treatment is selected to address that impairment) was associated with: advice to delay return to work, advice to delay return to activity, and a belief that return to work or activity is a threat to the patient. Physiotherapists' fear avoidance scores were positively correlated with: increased certification of sick leave, advice to avoid return to work, and advice to avoid return to normal activity. Qualitative studies revealed two main themes attributed to beliefs and attitudes of physiotherapists who have a relationship to their management of chronic low back pain: treatment orientation and patient factors. Both quantitative and qualitative studies showed a relationship between treatment orientation and clinical practice. The inclusion of qualitative studies captured the influence of patient factors in clinical practice in chronic low back pain. There is a need to recognise that both beliefs and attitudes regarding treatment orientation of physiotherapists, and therapist-patient factors need to be considered when introducing new clinical practice models, so that the adoption of new clinical practice is maximised. [Gardner T

  10. The Experiences of and Attitudes toward Non-Pharmacological Interventions for Attention-Deficit/hyperactivity Disorder Used in School Settings: A Systematic Review and Synthesis of Qualitative Research

    Science.gov (United States)

    Moore, Darren A.; Gwernan-Jones, Ruth; Richardson, Michelle; Racey, Daniel; Rogers, Morwenna; Stein, Ken; Thompson-Coon, Jo; Ford, Tamsin J.; Garside, Ruth

    2016-01-01

    School-based non-pharmacological interventions are an important part of the treatment of attention-deficit/hyperactivity disorder (ADHD). We aimed to systematically review qualitative literature relating to the experience of and attitudes towards school-based non-pharmacological interventions for ADHD. Systematic searches of 20 electronic…

  11. How do people of South Asian origin understand and experience depression? A protocol for a systematic review of qualitative literature.

    Science.gov (United States)

    Mooney, Roisin; Trivedi, Daksha; Sharma, Shivani

    2016-08-30

    Individuals from Black and Asian Minority Ethnic (BAME) groups are less likely to receive a diagnosis and to engage with treatment for depression. This review aims to draw on international literature to summarise what is known about how people specifically of South Asian origin, migrants and non-migrants, understand and experience depressive symptoms. The resulting evidence base will further inform practices aimed at encouraging help-seeking behaviour and treatment uptake. A systematic review and thematic synthesis of qualitative literature conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Using predefined inclusion and exclusion criteria, electronic searches will be conducted across 16 databases. Study quality will be assessed using the Critical Appraisal Skills Programme (CASP). Data will be extracted independently by 2 reviewers. Ethical approval is not required. A comprehensive evidence base of how people from South Asian backgrounds conceptualise and experience depression will better inform the design and delivery of mental health initiatives and advance directions for future research. Findings will be published in a peer-reviewed journal, and disseminated through existing networks for professionals, researchers, patients and the public. CRD42015026120. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  12. A Qualitative Systematic Review of Older Persons’ Perceptions of Health, Ill Health, and Their Community Health Care Needs

    Directory of Open Access Journals (Sweden)

    Anne Lise Holm

    2013-01-01

    Full Text Available The aim of this qualitative systematic review was to report a synthesis of older persons’ perceptions of health, ill health, and their community health care needs. The review questions were what characterizes older persons’ perceptions of health and ill health? and what are their community health care needs? Ten studies were identified in a systematic search for relevant qualitative papers published between January 2000 and January 2013 in the following electronic databases: PubMed, EBSCOhost/Academic Search Premier, and CINAHL. Publications were evaluated for quality, and a thematic analysis was performed. Two main themes were interpreted on a higher level: reconciliation with how life has become: and desire to regain their identity and sense of self-worth despite disability. Two themes emerged: creating meaning led to the experience of being valued in health care and society and a mental struggle to regain independence with the help of caregivers. Of special interest is the finding of perceptions related to the fear of becoming dependent on caregivers as well as the sorrow and pain caused by encountering caregivers who did not understand their desire to create meaning in their lives or their struggle for autonomy and independency.

  13. The role of the family in supporting the self-management of chronic conditions: A qualitative systematic review.

    Science.gov (United States)

    Whitehead, Lisa; Jacob, Elisabeth; Towell, Amanda; Abu-Qamar, Ma'en; Cole-Heath, Amanda

    2018-01-01

    To explore the contribution of family members in promoting and supporting the self-management of chronic conditions amongst adult family members. The prevalence of chronic disease continues to grow globally. The role of the family in chronic condition management and support for self-management has received little attention. A systematic review of qualitative literature using the Joanna Briggs Institute approach for qualitative systematic reviews. Ovid (MEDLINE, CINAHL and PsycINFO) were searched for the period of database inception-2016. The QARI (Qualitative Assessment and Review Instrument) critical appraisal instrument was used to assess the quality of each study. Using the Joanna Briggs Institute-QARI data extraction tool, findings related to the family role in the self-management of chronic conditions were extracted and each finding rated according to Joanna Briggs Institute-QARI levels of credibility. Findings were categorised and synthesised to produce a final set of aggregated findings. Families were key in constructing an environment that was conducive to family engagement and support. Adaptation within the family included maintaining cohesion between family members, normalisation and contextualisation of the chronic condition. Whilst evidence on the value of the family in promoting positive health outcomes is clear, research on how families can specifically support the self-management of chronic conditions is emerging. Family adaptability has been found to be the most powerful predictor of carer depression. Families may need support to change their home and family organisation to adapt to the challenges they face overtime. Change in roles and subsequent adaptation can be stressful, even for those family members at a distance. Nurses working in hospital and community settings can play an important role in assessing how families are adapting to living with chronic illness and to explore strategies to cope with challenges in the home setting. © 2017 John

  14. Conflicts of interest in randomised controlled surgical trials: systematic review and qualitative and quantitative analysis

    Directory of Open Access Journals (Sweden)

    Probst Pascal

    2016-09-01

    Full Text Available Conflicts of interest may lead to biased trial designs and unbalanced interpretation of study results. We aimed to evaluate the reporting of potential conflicts of interest in full publications of surgical randomised controlled trials (RCTs. A systematic literature search was performed in CENTRAL, MEDLINE and EMBASE (1985–2014 to find all surgical RCTs of medical devices and perioperative pharmacological or nutritional interventions. The information on conflicts of interest was evaluated both quantitatively and qualitatively, and the development of stated conflicts over time was studied. Of 7934 articles, 444 met the inclusion criteria. In 93 of 444 trials (20.9%, conflicts of interest were disclosed. In half of the cases, the information provided was insufficient to permit conclusions regarding possible influence on the trials. Information about conflicts of interest has increased continuously during the last decades (1985–1994: 0%, 1995–2004: 2.8% and 2005–2014: 33.0%; p<0.001. Among the 115 industry-funded trials, industry participation was considered as a potential conflict of interest in 24 cases (20.9%. Over the past three decades, only every 10th trial has provided appropriate information on conflicts of interest. However, transparency is crucial for the reliability of evidence-based medicine. There is an urgent need for the full disclosure of all conflicts of interest in surgical publishing and for transparency regarding cooperation between academia and industry.

  15. Outcome following phrenic nerve transfer to musculocutaneous nerve in patients with traumatic brachial palsy: a qualitative systematic review.

    Science.gov (United States)

    de Mendonça Cardoso, Marcio; Gepp, Ricardo; Correa, José Fernando Guedes

    2016-09-01

    The phrenic nerve can be transferred to the musculocutaneous nerve in patients with traumatic brachial plexus palsy in order to recover biceps strength, but the results are controversial. There is also a concern about pulmonary function after phrenic nerve transection. In this paper, we performed a qualitative systematic review, evaluating outcomes after this procedure. A systematic review of published studies was undertaken in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement. Data were extracted from the selected papers and related to: publication, study design, outcome (biceps strength in accordance with BMRC and pulmonary function) and population. Study quality was assessed using the "strengthening the reporting of observational studies in epidemiology" (STROBE) standard or the CONSORT checklist, depending on the study design. Seven studies were selected for this systematic review after applying inclusion and exclusion criteria. One hundred twenty-four patients completed follow-up, and most of them were graded M3 or M4 (70.1 %) for biceps strength at the final evaluation. Pulmonary function was analyzed in five studies. It was not possible to perform a statistical comparison between studies because the authors used different parameters for evaluation. Most of the patients exhibited a decrease in pulmonary function tests immediately after surgery, with recovery in the following months. Study quality was determined using STROBE in six articles, and the global score varied from 8 to 21. Phrenic nerve transfer to the musculocutaneous nerve can recover biceps strength ≥M3 (BMRC) in most patients with traumatic brachial plexus injury. Early postoperative findings revealed that the development of pulmonary symptoms is rare, but it cannot be concluded that the procedure is safe because there is no study evaluating pulmonary function in old age.

  16. End of life care in sub-Saharan Africa: a systematic review of the qualitative literature

    Directory of Open Access Journals (Sweden)

    Pool Robert

    2011-03-01

    Full Text Available Abstract Background End of life (EoL care in sub-Saharan Africa still lacks the sound evidence-base needed for the development of effective, appropriate service provision. It is essential to make evidence from all types of research available alongside clinical and health service data, to ensure that EoL care is ethical and culturally appropriate. This article aims to synthesize qualitative research on EoL care in sub-Saharan Africa to inform policy, practice and further research. It seeks to identify areas of existing research; describe findings specifically relevant to the African context; and, identify areas lacking evidence. Methods Relevant literature was identified through eight electronic databases: AMED, British Nursing Index & Archive, CINAHL, EMBASE, IBSS, MEDLINE, PsycINFO, and the Social Sciences Citation Index; and hand searches. Inclusion criteria were: published qualitative or mixed-method studies in sub-Saharan Africa, about EoL care. Study quality was assessed using a standard grading scale. Relevant data including findings and practice recommendations were extracted and compared in tabular format. Results Of the 407 articles initially identified, 51 were included in the qualitative synthesis. Nineteen came from South Africa and the majority (38 focused on HIV/AIDS. Nine dealt with multiple or unspecified conditions and four were about cancer. Study respondents included health professionals, informal carers, patients, community members and bereaved relatives. Informal carers were typically women, the elderly and children, providing total care in the home, and lacking support from professionals or the extended family. Twenty studies focused on home-based care, describing how programmes function in practice and what is needed to make them effective. Patients and carers were reported to prefer institutional care but this needs to be understood in context. Studies focusing on culture discussed good and bad death, culture

  17. Experiences of cancer patients in a patient navigation program: a qualitative systematic review.

    Science.gov (United States)

    Tan, Clarice Hwee Hoon; Wilson, Sally; McConigley, Ruth

    2015-03-12

    A patient navigation program is a model of care which entails trained personnel providing individualized and assistive care to adult oncology patients to help the patients overcome barriers. A further aim of the program is to achieve continuity of care as patients experience the complex healthcare system. Patient navigation is a new model of care in many institutions, and as such the experiences of patients in the patient navigation program remains inconclusive. The review seeks to understand the experiences of adult patients in patient navigation programs and how patient navigators impact the challenges patients encounter in the cancer care continuum. Participants of interest were adult cancer patients more than 18 years of age who are receiving or have received cancer care and are in a patient navigation program or had been in a hospital patient navigation program. Types of intervention(s)/phenomena of interest: The phenomenon of interest was the experiences of adult cancer patients who used patient navigation programs in hospital including how patient navigators impact on the challenges patients encounter in the cancer care continuum. Types of studies: This review considered studies that focused on qualitative data including, but not limited to, designs such as phenomenology, grounded theory, action research and exploratory studies. The review includes patient navigation programs within a hospital setting. Types of outcome: The review sought to understand the experiences of patients with cancer in patient navigation programs in the hospital. A three-step search strategy was used. An initial search to identify keywords was undertaken in PubMed and Science Direct followed by an expanded search using all identified keywords and index terms specific to each included database. The reference lists of included papers were then searched for any other relevant studies. Each paper was assessed independently by two reviewers for methodological quality using the Joanna

  18. Student and educator experiences of maternal-child simulation-based learning: a systematic review of qualitative evidence.

    Science.gov (United States)

    MacKinnon, Karen; Marcellus, Lenora; Rivers, Julie; Gordon, Carol; Ryan, Maureen; Butcher, Diane

    2017-11-01

    Although maternal-child care is a pillar of primary health care, there is a global shortage of maternal-child health care providers. Nurse educators experience difficulties providing undergraduate students with maternal-child learning experiences for a number of reasons. Simulation has the potential to complement learning in clinical and classroom settings. Although systematic reviews of simulation are available, no systematic reviews of qualitative evidence related to maternal-child simulation-based learning (SBL) for undergraduate nursing students and/or educators have been located. The aim of this systematic review was to identify the appropriateness and meaningfulness of maternal-child simulation-based learning for undergraduate nursing students and nursing educators in educational settings to inform curriculum decision-making. The review questions are: INCLUSION CRITERIA TYPES OF PARTICIPANTS: Pre-registration or pre-licensure or undergraduate nursing or health professional students and educators. Experiences of simulation in an educational setting with a focus relevant to maternal child nursing. Qualitative research and educational evaluation using qualitative methods. North America, Europe, Australia and New Zealand. A three-step search strategy identified published studies in the English language from 2000 until April 2016. Identified studies that met the inclusion criteria were retrieved and critically appraised using the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI) by at least two independent reviewers. Overall the methodological quality of the included studies was low. Qualitative findings were extracted by two independent reviewers using JBI-QARI data extraction tools. Findings were aggregated and categorized on the basis of similarity in meaning. Categories were subjected to a meta-synthesis to produce a single comprehensive set of synthesized findings. Twenty-two articles from 19 studies were included in the review

  19. Potential value of systematic reviews of qualitative evidence in informing user-centered health and social care: findings from a descriptive overview.

    Science.gov (United States)

    Dalton, Jane; Booth, Andrew; Noyes, Jane; Sowden, Amanda J

    2017-08-01

    Systematic reviews of quantitative evidence are well established in health and social care. Systematic reviews of qualitative evidence are increasingly available, but volume, topics covered, methods used, and reporting quality are largely unknown. We provide a descriptive overview of systematic reviews of qualitative evidence assessing health and social care interventions included on the Database of Abstracts of Reviews of Effects (DARE). We searched DARE for reviews published between January 1, 2009, and December 31, 2014. We extracted data on review content and methods, summarized narratively, and explored patterns over time. We identified 145 systematic reviews conducted worldwide (64 in the UK). Interventions varied but largely covered treatment or service delivery in community and hospital settings. There were no discernible patterns over time. Critical appraisal of primary studies was conducted routinely. Most reviews were poorly reported. Potential exists to use systematic reviews of qualitative evidence when driving forward user-centered health and social care. We identify where more research is needed and propose ways to improve review methodology and reporting. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. The experiences of people living with epilepsy in developing countries: a systematic review of qualitative evidence.

    Science.gov (United States)

    Tanywe, Asahngwa; Matchawe, Chelea; Fernandez, Ritin

    2016-05-01

    Epilepsy is a global public health problem affecting people of all ages, sex, races, nations and social class. The majority of the 50 million people with epilepsy live in developing countries, with a prevalence rate of five to 10 people per 1000. The disease poses an enormous psychological, social and economic burden on patients. An estimated 90% of people with epilepsy in developing countries do not receive treatment due to sociocultural, economic and political factors. Current treatment interventions are limited to the clinical management of the disease and are largely driven by the healthcare provider's perspective, ignoring the experiences of people living with epilepsy (PLWE). The aim of this review was to identify, critically appraise, extract, synthesize and present the best and most current available evidence on the experiences of PLWE in developing countries. • What are the experiences of PLWE regarding the causes of their condition?• What are the experiences of PLWE regarding treatment of epilepsy?• How has epilepsy shaped the social relationships of the affected persons? People living with epilepsy in developing countries (Africa, Asia, Eastern Europe and Latin America).The experiences of PLWE in developing countries with particular attention on the causes, treatment and its impact on their social relationships.Primary research studies with a qualitative design not limited to phenomenology, ethnography, grounded theory, ethnomethodology, phenomenography, critical theory, interpretative or feminist analysis, case study, narrative studies and action research. Qualitative studies conducted in hospitals and community settings in developing countries. A three-step search strategy was used to identify published and unpublished studies in the English language from the 1990s to the present. Identified studies that met the inclusion criteria were retrieved and critically appraised by two independent reviewers prior to their inclusion using the Joanna Briggs

  1. Patients’ perspectives on the medical primary–secondary care interface: systematic review and synthesis of qualitative research

    Science.gov (United States)

    Sampson, Rod; Cooper, Jamie; Barbour, Rosaline; Polson, Rob; Wilson, Philip

    2015-01-01

    Objectives To synthesise the published literature on the patient experience of the medical primary–secondary care interface and to determine priorities for future work in this field aimed at improving clinical outcomes. Design Systematic review and metaethnographic synthesis of primary studies that used qualitative methods to explore patients’ perspectives of the medical primary–secondary care interface. Setting International primary–secondary care interface. Data sources EMBASE, MEDLINE, CINAHL Plus with Full text, PsycINFO, Psychology and Behavioural Sciences Collection, Health Business Elite, Biomedica Reference Collection: Comprehensive Library, Information Science & Technology Abstracts, eBook Collection, Web of Science Core Collection: Citation Indexes and Social Sciences Citation Index, and grey literature. Eligibility criteria for selecting studies Studies were eligible for inclusion if they were full research papers employing qualitative methodology to explore patients’ perspectives of the medical primary–secondary care interface. Review methods The 7-step metaethnographic approach described by Noblit and Hare, which involves cross-interpretation between studies while preserving the context of the primary data. Results The search identified 690 articles, of which 39 were selected for full-text review. 20 articles were included in the systematic review that encompassed a total of 689 patients from 10 countries. 4 important areas specific to the primary–secondary care interface from the patients’ perspective emerged: barriers to care, communication, coordination, and ‘relationships and personal value’. Conclusions and implications of key findings Patients should be the focus of any transfer of care between primary and secondary systems. From their perspective, areas for improvement may be classified into four domains that should usefully guide future work aimed at improving quality at this important interface. Trial registration number

  2. Psychosocial factors that shape patient and carer experiences of dementia diagnosis and treatment: a systematic review of qualitative studies.

    Directory of Open Access Journals (Sweden)

    Frances Bunn

    2012-10-01

    Full Text Available Early diagnosis and intervention for people with dementia is increasingly considered a priority, but practitioners are concerned with the effects of earlier diagnosis and interventions on patients and caregivers. This systematic review evaluates the qualitative evidence about how people accommodate and adapt to the diagnosis of dementia and its immediate consequences, to guide practice.We systematically reviewed qualitative studies exploring experiences of community-dwelling individuals with dementia, and their carers, around diagnosis and the transition to becoming a person with dementia. We searched PubMed, PsychINFO, Embase, CINAHL, and the British Nursing Index (all searched in May 2010 with no date restrictions; PubMed search updated in February 2012, checked reference lists, and undertook citation searches in PubMed and Google Scholar (ongoing to September 2011. We used thematic synthesis to identify key themes, commonalities, barriers to earlier diagnosis, and support identified as helpful. We identified 126 papers reporting 102 studies including a total of 3,095 participants. Three overarching themes emerged from our analysis: (1 pathways through diagnosis, including its impact on identity, roles, and relationships; (2 resolving conflicts to accommodate a diagnosis, including the acceptability of support, focusing on the present or the future, and the use or avoidance of knowledge; and (3 strategies and support to minimise the impact of dementia. Consistent barriers to diagnosis include stigma, normalisation of symptoms, and lack of knowledge. Studies report a lack of specialist support particularly post-diagnosis.There is an extensive body of qualitative literature on the experiences of community-dwelling individuals with dementia on receiving and adapting to a diagnosis of dementia. We present a thematic analysis that could be useful to professionals working with people with dementia. We suggest that research emphasis should shift

  3. The experience of initiating injection drug use and its social context: a qualitative systematic review and thematic synthesis.

    Science.gov (United States)

    Guise, Andy; Horyniak, Danielle; Melo, Jason; McNeil, Ryan; Werb, Dan

    2017-12-01

    Understanding the experience of initiating injection drug use and its social contexts is crucial to inform efforts to prevent transitions into this mode of drug consumption and support harm reduction. We reviewed and synthesized existing qualitative scientific literature systematically to identify the socio-structural contexts for, and experiences of, the initiation of injection drug use. We searched six databases (Medline, Embase, PsychINFO, CINAHL, IBSS and SSCI) systematically, along with a manual search, including key journals and subject experts. Peer-reviewed studies were included if they qualitatively explored experiences of or socio-structural contexts for injection drug use initiation. A thematic synthesis approach was used to identify descriptive and analytical themes throughout studies. From 1731 initial results, 41 studies reporting data from 1996 participants were included. We developed eight descriptive themes and two analytical (higher-order) themes. The first analytical theme focused on injecting initiation resulting from a social process enabled and constrained by socio-structural factors: social networks and individual interactions, socialization into drug-using identities and choices enabled and constrained by social context all combine to produce processes of injection initiation. The second analytical theme addressed pathways that explore varying meanings attached to injection initiation and how they link to social context: seeking pleasure, responses to increasing tolerance to drugs, securing belonging and identity and coping with pain and trauma. Qualitative research shows that injection drug use initiation has varying and distinct meanings for individuals involved and is a dynamic process shaped by social and structural factors. Interventions should therefore respond to the socio-structural influences on injecting drug use initiation by seeking to modify the contexts for initiation, rather than solely prioritizing the reduction of individual

  4. Living with symptoms of attention deficit hyperactivity disorder in adulthood: a systematic review of qualitative evidence.

    Science.gov (United States)

    Bjerrum, Merete B; Pedersen, Preben U; Larsen, Palle

    2017-04-01

    Attention deficit hyperactivity disorder (ADHD) relates to four dimensions of behavior: inattentiveness, restlessness, impulsiveness and hyperactivity. Symptoms affect multiple areas of daily life such as academic performance and social functioning. Despite the negative effects of ADHD, people diagnosed with ADHD do not necessarily regard themselves as being impaired. However, it is unclear how adults with ADHD experience and manage their symptoms. To identify and synthesize the best available evidence on how adults experience living with ADHD. Adults with confirmed ADHD diagnosis. How adults with ADHD experience and manage the symptoms of ADHD and links between protective factors provided by relatives, friends, fellow students, mentors and colleagues. Studies based on qualitative data, including, but not limited to, designs within phenomenology, grounded theory, content analysis or ethnography. A three-step search strategy identified published and unpublished qualitative studies from 1990 to July 2015. Studies meeting the inclusion criteria were independently assessed by two reviewers using the standardized critical appraisal instrument from the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI). Data were extracted from 10 included studies using the JBI-QARI. Qualitative research findings were synthesized using the JBI-QARI. A total of 103 findings from 10 studies were aggregated into 16 categories that were meta-synthesized into four synthesized findings: "Adults are aware of being different from others and strive to be an integrated, accepted part of the community;" "Adults with ADHD are creative and inventive;" "Adults with ADHD develop coping strategies in striving for a healthy balance in life" and "For adults with ADHD, accomplishing and organizing tasks in everyday life is a challenge but it can also be rewarding." Adults with ADHD have problems stemming from ADHD symptoms in relation to interacting in social relationships

  5. Causes of medication administration errors in hospitals: a systematic review of quantitative and qualitative evidence.

    Science.gov (United States)

    Keers, Richard N; Williams, Steven D; Cooke, Jonathan; Ashcroft, Darren M

    2013-11-01

    Underlying systems factors have been seen to be crucial contributors to the occurrence of medication errors. By understanding the causes of these errors, the most appropriate interventions can be designed and implemented to minimise their occurrence. This study aimed to systematically review and appraise empirical evidence relating to the causes of medication administration errors (MAEs) in hospital settings. Nine electronic databases (MEDLINE, EMBASE, International Pharmaceutical Abstracts, ASSIA, PsycINFO, British Nursing Index, CINAHL, Health Management Information Consortium and Social Science Citations Index) were searched between 1985 and May 2013. Inclusion and exclusion criteria were applied to identify eligible publications through title analysis followed by abstract and then full text examination. English language publications reporting empirical data on causes of MAEs were included. Reference lists of included articles and relevant review papers were hand searched for additional studies. Studies were excluded if they did not report data on specific MAEs, used accounts from individuals not directly involved in the MAE concerned or were presented as conference abstracts with insufficient detail. A total of 54 unique studies were included. Causes of MAEs were categorised according to Reason's model of accident causation. Studies were assessed to determine relevance to the research question and how likely the results were to reflect the potential underlying causes of MAEs based on the method(s) used. Slips and lapses were the most commonly reported unsafe acts, followed by knowledge-based mistakes and deliberate violations. Error-provoking conditions influencing administration errors included inadequate written communication (prescriptions, documentation, transcription), problems with medicines supply and storage (pharmacy dispensing errors and ward stock management), high perceived workload, problems with ward-based equipment (access, functionality

  6. Medication taking in coronary artery disease: a systematic review and qualitative synthesis.

    Science.gov (United States)

    Rashid, Mohammed A; Edwards, Duncan; Walter, Fiona M; Mant, Jonathan

    2014-01-01

    Despite the compelling evidence supporting cardiovascular medications in the secondary prevention of coronary artery disease, many patients discontinue treatment. In this synthesis, we sought to understand from a patient perspective the factors that promote medication persistence. We systematically searched 7 databases (MEDLINE, Embase, PsycINFO, SCOPUS, CINAHL, ASSIA, and SSCI) for published qualitative research about the medication-taking experiences of patients with coronary artery disease and their partners. Articles were assessed for quality using a modified CASP (Critical Appraisal Skills Programme) checklist. Synthesis was undertaken using well-established meta-ethnographic approaches. We included 17 articles in the final synthesis from the United Kingdom (6), Europe (5), United States (4), China (1), and Australia (1), with a total sample size of 391 patients. Analyses suggested that some patients hold fatalistic beliefs about their disease, whereas others believe they have been cured by interventions; both can lead to failure to take medication. Patients who adapt to being a "heart patient" are positive about medication taking. Some individuals dislike taking tablets generally and are wary of long-term effects. Relationships with prescribing clinicians are of critical importance for patients, with inaccessibility and insensitive terminology negatively affecting patients' perceptions about treatments. Strategies to promote higher persistence of secondary prevention medications in patients with coronary artery disease need to recognize the key role of the prescribing clinician. Providing medication-specific information at the time of initiating therapy, improving the transition between secondary and primary care, and explaining the risk of disease recurrence may all help to modify patient attitudes toward drugs to prevent further cardiovascular disease.

  7. Systematic review of qualitative literature on occupational health and safety legislation and regulatory enforcement planning and implementation.

    Science.gov (United States)

    MacEachen, Ellen; Kosny, Agnieszka; Ståhl, Christian; O'Hagan, Fergal; Redgrift, Lisa; Sanford, Sarah; Carrasco, Christine; Tompa, Emile; Mahood, Quenby

    2016-01-01

    The ability of occupational health and safety (OHS) legislation and regulatory enforcement to prevent workplace injuries and illnesses is contingent on political, economic, and organizational conditions. This systematic review of qualitative research articles considers how OHS legislation and regulatory enforcement are planned and implemented. A comprehensive search of peer-reviewed, English-language articles published between 1990 and 2013 yielded 11 947 articles. We identified 34 qualitative articles as relevant, 18 of which passed our quality assessment and proceeded to meta-ethnographic synthesis. The synthesis yielded four main themes: OHS regulation formation, regulation challenges, inspector organization, and worker representation in OHS. It illuminates how OHS legislation can be based on normative suppositions about worker and employer behavior and shaped by economic and political resources of parties. It also shows how implementation of OHS legislation is affected by "general duty" law, agency coordination, resourcing of inspectorates, and ability of workers to participate in the system. The review identifies methodological gaps and identifies promising areas for further research in "grey" zones of legislation implementation.

  8. Qualitative synthesis and systematic review of otolaryngology in undergraduate medical education.

    Science.gov (United States)

    Ishman, Stacey L; Stewart, C Matthew; Senser, Ethan; Stewart, Rosalyn W; Stanley, James; Stierer, Kevin D; Benke, James R; Kern, David E

    2015-12-01

    Although 25% of primary care complaints are otolaryngology related, otolaryngology instruction is not required in most medical schools. Our aim was to systematically review existing literature on the inclusion of otolaryngology in undergraduate medical education. PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, and Education Resources Information Center. Our search encompassed all indexed years through December 29, 2014. Inclusion criteria were English language, original human data, and a focus on medical student education. Data regarding study design, teacher, educational topic, educational methods, and setting were extracted from each article. Two investigators independently reviewed all articles. Our initial search yielded 436 articles; 87 underwent full-text evaluation and 47 remained in the final review. The majority of studies were conducted in the United States (40%), United Kingdom (23%), and Canada (17%) and represented a single institutional experience. Studies were classified as needs assessments (36%), curriculum descriptions (15%), educational methods (36%), and skills assessments (32%); 81% were levels of evidence 3 or 4. Most reports indicated that otolaryngology rotations are not compulsory. Studies indicated the need for increased exposure to otolaryngology. Educational methods such as team-based learning, simulation, online learning, and clinical skills assessments may offer ways to increase exposure without overburdening clinical faculty and require further study. Data suggest that a universal otolaryngology medical student curriculum would be valuable and aid in resource sharing across institutions. We recommend that an assessment be performed to determine topics and skills that should comprise this curriculum. NA. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  9. Understanding Outdoor Gyms in Public Open Spaces: A Systematic Review and Integrative Synthesis of Qualitative and Quantitative Evidence.

    Science.gov (United States)

    Lee, Janet Lok Chun; Lo, Temmy Lee Ting; Ho, Rainbow Tin Hung

    2018-03-25

    (1) Background: An outdoor gym (OG) is environmental infrastructure built in a public open space to promote structured physical activity. The provision of OGs is increasingly seen as an important strategy to realize public health agendas promoting habitual physical activity. A systematic review was conducted to synthesize characteristics of OG and OG users' experiences and perceptions in different cultural contexts; (2) Methods: Online searches of multidisciplinary databases were conducted in health, sport and recreation, and urban planning disciplines. Characteristics of OGs were synthesized by integrating evidence from quantitative, qualitative, and mix-methods studies. The experiences and perceptions of OG users from both qualitative data and survey responses were synthesized through framework analysis; (3) Results: Nine studies met the inclusion criteria (three quantitative studies, four mixed-methods studies, and two pure qualitative studies). None were excluded on the basis of quality. OGs mainly serve adult and older adult population groups. Their size, design, and instructional support vary across studies. The inclusion of functional types of equipment did not have a unified standard. Regarding experiences and perceptions of OGs, five major themes emerged: "health", "social connectedness", "affordable", "support", and "design and promotion"; (4) Conclusions: The OG characteristics synthesis guides the direction in further studies regarding exploration of design parameters. The qualitative and quantitative synthesis revealed that health was a central theme of users' experiences. OGs are also spaces where community-dwellers can find social connectedness while participating in structured physical activity at no cost. Findings from this review create knowledge support for OG as environmental infrastructure for further research and facilitate the understanding of users' experiences and perceptions of OGs in different cultural contexts.

  10. Understanding Outdoor Gyms in Public Open Spaces: A Systematic Review and Integrative Synthesis of Qualitative and Quantitative Evidence

    Science.gov (United States)

    Lee, Janet Lok Chun; Lo, Temmy Lee Ting

    2018-01-01

    (1) Background: An outdoor gym (OG) is environmental infrastructure built in a public open space to promote structured physical activity. The provision of OGs is increasingly seen as an important strategy to realize public health agendas promoting habitual physical activity. A systematic review was conducted to synthesize characteristics of OG and OG users’ experiences and perceptions in different cultural contexts; (2) Methods: Online searches of multidisciplinary databases were conducted in health, sport and recreation, and urban planning disciplines. Characteristics of OGs were synthesized by integrating evidence from quantitative, qualitative, and mix-methods studies. The experiences and perceptions of OG users from both qualitative data and survey responses were synthesized through framework analysis; (3) Results: Nine studies met the inclusion criteria (three quantitative studies, four mixed-methods studies, and two pure qualitative studies). None were excluded on the basis of quality. OGs mainly serve adult and older adult population groups. Their size, design, and instructional support vary across studies. The inclusion of functional types of equipment did not have a unified standard. Regarding experiences and perceptions of OGs, five major themes emerged: “health”, “social connectedness”, “affordable”, “support”, and “design and promotion”; (4) Conclusions: The OG characteristics synthesis guides the direction in further studies regarding exploration of design parameters. The qualitative and quantitative synthesis revealed that health was a central theme of users’ experiences. OGs are also spaces where community-dwellers can find social connectedness while participating in structured physical activity at no cost. Findings from this review create knowledge support for OG as environmental infrastructure for further research and facilitate the understanding of users’ experiences and perceptions of OGs in different cultural contexts

  11. Effects of e-learning in a continuing education context on nursing care: a review of systematic qualitative, quantitative and mixed studies reviews (protocol).

    Science.gov (United States)

    Rouleau, Geneviève; Gagnon, Marie-Pierre; Côté, José; Payne-Gagnon, Julie; Hudson, Emilie; Bouix-Picasso, Julien; Dubois, Carl-Ardy

    2017-10-16

    Continuing education (CE) is imperative to the future of professional nursing. The use of e-learning by registered nurses for CE is spreading. A review of systematic reviews will be conducted to develop a broad picture of the effects of e-learning in a CE context on nursing care. Systematic qualitative, quantitative and mixed studies reviews published in English, French or Spanish from 1 January 2006 will be included. The outcomes of interest will be extracted and analysed inductively and deductively from the Nursing Care Performance Framework; some themes include nursing resources, nurses' practice environment, processes, professional satisfaction, and nursing sensitive outcomes. Three reviewers will independently screen first the title and abstract of the papers, and then the full texts in order to assess eligibility. Two teams of two reviewers will extract the selected reviews' characteristics and data. The results from various types of reviews will be integrated using a data-based convergent synthesis design. We will conduct a thematic synthesis and transform all quantitative and mixed data into qualitative data. Ethics approval is not required for review of systematic reviews. We will summarise evidence concerning the negative, neutral and positive effects of various forms of e-learning on different aspects of nursing care. If we find gaps in the literature, we will highlight them and suggest ideas for further research. We will also focus on positive effects and present, if possible, the components and characteristics of e-learning interventions that were found to be successful. We will present this protocol and results in international conferences in nursing, medical, and health informatics domains. We will also submit the results of our work for peer-review publication in a journal indexed in the international bibliographic database of biomedical information. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017

  12. Women's maternity care needs and related service models in rural areas: A comprehensive systematic review of qualitative evidence.

    Science.gov (United States)

    Hoang, Ha; Le, Quynh; Ogden, Kathryn

    2014-12-01

    Understanding the needs of rural women in maternity care and service models available to them is significant for the development of effective policies and the sustainability of rural communities. Nevertheless, no systematic review of studies addressing these needs has been conducted. To synthesise the best available evidence on the experiences of women's needs in maternity care and existing service models in rural areas. Literature search of ten electronic databases, digital theses, and reference lists of relevant studies applying inclusion/exclusion criteria was conducted. Selected papers were assessed using standardised critical appraisal instruments from JBI-QARI. Data extracted from these studies were synthesised using thematic synthesis. 12 studies met the inclusion criteria. There were three main themes and several sub-themes identified. A comprehensive set of the maternity care expectations of rural women was reported in this review including safety (7), continuity of care (6) and quality of care (6), and informed choices needs (4). In addition, challenges in accessing maternity services also emerged from the literature such as access (6), risk of travelling (9) and associated cost of travel (9). Four models of maternity care examined in the literature were medically led care (5), GP-led care (4), midwifery-led care (7) and home birth (6). The systematic review demonstrates the importance of including well-conducted qualitative studies in informing the development of evidence-based policies to address women's maternity care needs and inform service models. Synthesising the findings from qualitative studies offers important insight for informing effective public health policy. Copyright © 2014 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  13. Should we add clonidine to local anesthetic for peripheral nerve blockade? A qualitative systematic review of the literature.

    Science.gov (United States)

    McCartney, Colin J L; Duggan, Edel; Apatu, Emma

    2007-01-01

    Although clonidine has been shown to prolong analgesia in central neuraxial blocks, its use in peripheral nerve blocks remains controversial. We performed a systematic review of the current literature to determine the benefit of adding clonidine to peripheral nerve blocks. A systematic, qualitative review of double-blind randomized controlled trials on the benefit of clonidine as an adjunct to peripheral nerve block was performed. Studies were identified by searching PubMed (www.ncbi.nlm.nih.gov/entrez) and EMBASE (www.embase.com) databases (July 1991 to October 2006) for terms related to clonidine as an adjunct to peripheral nerve blocks. Studies were classified as supportive if the use of clonidine demonstrated reduced pain and total analgesic consumption, or prolonged block duration versus negative if no difference was found. Twenty-seven studies were identified that met the inclusion criteria. Five studies included a systemic control group. The total number of patients reviewed was 1,385. The dose of clonidine varied from 30 to 300 mug. Overall 15 studies supported the use of clonidine as an adjunct to peripheral nerve blocks with 12 studies failing to show a benefit. Based on qualitative analysis, clonidine appeared to prolong analgesia when added to intermediate-acting local anesthetics for axillary and peribulbar blocks. Clonidine improves duration of analgesia and anesthesia when used as an adjunct to intermediate-acting local anesthetics for some peripheral nerve blocks. Side-effects appear to be limited at doses up to 150 mug. Evidence is lacking for the use of clonidine as an adjunct to local anesthetics for continuous catheter techniques. Further research is required to examine the peripheral analgesic mechanism of clonidine.

  14. Patients' perspectives on the medical primary-secondary care interface: systematic review and synthesis of qualitative research.

    Science.gov (United States)

    Sampson, Rod; Cooper, Jamie; Barbour, Rosaline; Polson, Rob; Wilson, Philip

    2015-10-15

    To synthesise the published literature on the patient experience of the medical primary-secondary care interface and to determine priorities for future work in this field aimed at improving clinical outcomes. Systematic review and metaethnographic synthesis of primary studies that used qualitative methods to explore patients' perspectives of the medical primary-secondary care interface. International primary-secondary care interface. EMBASE, MEDLINE, CINAHL Plus with Full text, PsycINFO, Psychology and Behavioural Sciences Collection, Health Business Elite, Biomedica Reference Collection: Comprehensive Library, Information Science & Technology Abstracts, eBook Collection, Web of Science Core Collection: Citation Indexes and Social Sciences Citation Index, and grey literature. Studies were eligible for inclusion if they were full research papers employing qualitative methodology to explore patients' perspectives of the medical primary-secondary care interface. The 7-step metaethnographic approach described by Noblit and Hare, which involves cross-interpretation between studies while preserving the context of the primary data. The search identified 690 articles, of which 39 were selected for full-text review. 20 articles were included in the systematic review that encompassed a total of 689 patients from 10 countries. 4 important areas specific to the primary-secondary care interface from the patients' perspective emerged: barriers to care, communication, coordination, and 'relationships and personal value'. Patients should be the focus of any transfer of care between primary and secondary systems. From their perspective, areas for improvement may be classified into four domains that should usefully guide future work aimed at improving quality at this important interface. PROSPERO CRD42014009486. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  15. Pregnant women's perceptions of gestational weight gain: A systematic review and meta-synthesis of qualitative research.

    Science.gov (United States)

    Vanstone, Meredith; Kandasamy, Sujane; Giacomini, Mita; DeJean, Deirdre; McDonald, Sarah D

    2017-10-01

    Excess gestational weight gain has numerous negative health outcomes for women and children, including high blood pressure, diabetes, and cesarean section (maternal) and high birth weight, trauma at birth, and asphyxia (infants). Excess weight gain in pregnancy is associated with a higher risk of long-term obesity in both mothers and children. Despite a concerted public health effort, the proportion of pregnant women gaining weight in excess of national guidelines continues to increase. To understand this phenomenon and offer suggestions for improving interventions, we conducted a systematic review of qualitative research on pregnant women's perceptions and experiences of weight gain in pregnancy. We used the methodology of qualitative meta-synthesis to analyze 42 empirical qualitative research studies conducted in high-income countries and published between 2005 and 2015. With this synthesis, we provide an account of the underlying factors and circumstances (barriers, facilitators, and motivators) that pregnant women identify as important for appropriate weight gain. We also offer a description of the strategies identified by pregnant women as acceptable and appropriate ways to promote healthy weight gain. Through our integrative analysis, we identify women's common perception on the struggle to enact health behaviors and physical, social, and environmental factors outside of their control. Effective and sensitive interventions to encourage healthy weight gain in pregnancy must consider the social environment in which decisions about weight take place. © 2016 John Wiley & Sons Ltd.

  16. Youth social withdrawal behavior (hikikomori): A systematic review of qualitative and quantitative studies.

    Science.gov (United States)

    Li, Tim M H; Wong, Paul W C

    2015-07-01

    Acute and/or severe social withdrawal behavior among youth was seen as a culture-bound psychiatric syndrome in Japan, but more youth social withdrawal cases in different countries have been discovered recently. However, due to the lack of a formal definition and diagnostic tool for youth social withdrawal, cross-cultural observational and intervention studies are limited. We aimed to consolidate existing knowledge in order to understand youth social withdrawal from diverse perspectives and suggest different interventions for different trajectories of youth social withdrawal. This review examined the current available scientific information on youth social withdrawal in the academic databases: ProQuest, ScienceDirect, Web of Science and PubMed. We included quantitative and qualitative studies of socially withdrawn youths published in English and academic peer-reviewed journals. We synthesized the information into the following categories: (1) definitions of youth social withdrawal, (2) developmental theories, (3) factors associated with youth social withdrawal and (4) interventions for socially withdrawn youths. Accordingly, there are diverse and controversial definitions for youth social withdrawal. Studies of youth social withdrawal are based on models that lead to quite different conclusions. Researchers with an attachment perspective view youth social withdrawal as a negative phenomenon, whereas those who adopt Erikson's developmental theory view it more positively as a process of seeking self-knowledge. Different interventions for socially withdrawn youths have been developed, mainly in Japan, but evidence-based practice is almost non-existent. We propose a theoretical framework that views youth social withdrawal as resulting from the interplay between psychological, social and behavioral factors. Future validation of the framework will help drive forward advances in theory and interventions for youth social withdrawal as an emerging issue in developed

  17. Perceptions, experiences and preferences of patients receiving a clinician's touch during intimate care and procedures: a qualitative systematic review.

    Science.gov (United States)

    O'Lynn, Chad; Cooper, Adam; Blackwell, Lisa

    2017-11-01

    Clinical practice frequently involves the practitioner touching patients' bodies in areas that are highly personal. If inappropriately performed, such intimate touch may result in much anxiety, confusion and misinterpretation. Examination of evidence is necessary to guide practice in this area to mitigate risks and foster optimal clinician-patient relations and care. The objective of this qualitative systematic review was to identify and synthesize findings on the perceptions, experiences and preferences of patients receiving a clinician's touch during intimate care and procedures INCLUSION CRITERIA TYPES OF PARTICIPANTS: The current review considered studies that included patients who had received a clinician's touch during intimate care and procedures. The current review considered qualitative studies that evaluated patients' perceptions, experiences and preferences of a clinician's touch during intimate care and procedures. The current review considered studies that collected qualitative data and included studies using designs such as phenomenology, grounded theory, ethnography, action research, qualitative description, focus group methodology and feminist research. In the absence of research studies, other text such as opinion papers and reports were considered. The current review considered studies that included patients' perceptions, experiences and preferences of a clinician's touch during intimate care and procedures. Intimate care is likely to occur in any clinical setting where patients need assistance with personal care, where physical examinations occur, or in settings were gynecologic, genitourinary, lower intestinal, dermatologic, cardiac or other procedures involving highly personal areas of the body are performed. A three-step search strategy was used to find published and unpublished studies in English from 1970 to 2016, searching various databases which included searches of reference lists of studies selected for appraisal. Included studies were

  18. Smoking, food, and alcohol cues on subsequent behavior: a qualitative systematic review.

    Science.gov (United States)

    Veilleux, Jennifer C; Skinner, Kayla D

    2015-03-01

    Although craving is a frequent phenomenon in addictive behaviors, and laboratory paradigms have robustly established that presentation of cues can elicit self-reported craving responses, extant work has not established whether cue exposure influences subsequent behavior. We systematically review extant literature assessing the effects of cue exposure to smoking, food, and alcohol cues on behavioral outcomes framed by three questions: (1) Is there value in distinguishing between the effects of cue exposure on behavior from the responses to cues (e.g., self-reported craving) predicting behavior?; (2) What are the effect of cues on behavior beyond lapse, such as broadly considering both target-syntonic (e.g., do cigarette cues predict smoking-related behaviors) and target-dystonic behaviors (e.g., do cigarette cues predict other outcomes besides smoking)?; (3) What are the lessons to be learned from examining cue exposure studies across smoking, food and alcohol domains? Evidence generally indicates an effect of cue exposure on both target-syntonic and target-dystonic behavior, and that self-report cue-reactivity predicts immediate target-syntonic outcomes. Effects of smoking, food and alcohol cues on behavior are compared to elucidate generalizations about the effects of cue exposure as well as methodological differences that may serve the study of craving in the future. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Chronic obstructive pulmonary disease patients' experience with pulmonary rehabilitation: a systematic review of qualitative research.

    Science.gov (United States)

    de Sousa Pinto, Juliana Maria; Martín-Nogueras, Ana María; Morano, Maria Tereza Aguiar Pessoa; Macêdo, Tereza Efigênia Pessoa Morano; Arenillas, José Ignacio Calvo; Troosters, Thierry

    2013-08-01

    The aim of this study was to give an in-depth consideration of the chronic obstructive pulmonary disease (COPD) patients' subjective view of the impact of pulmonary rehabilitation (PR) on their lives. A systematic review in PubMed, Embase, CINAHL and PsychInfo databases yielded 3306 articles, of which 387 were duplicates, 263 remained after screening abstract and title; of them, 4 were excluded (editorial or due to lacking of full text) remaining a total of 259 for full text reading. Among these, eight studies met the inclusion criteria and were finally included. The meta-ethnography approach synthesized an understanding of the studies, which focused on constructing interpretations and developed a 'line-of-argument' synthesis. The psychosocial support of PR contributes to the patients' strength and desire for participation and the health education leads to illness-perception learning. Both psychosocial support and health education develop patients' empowerment, while PR promotes opportunities to health transitions. The empowerment experienced by the patients in taking advantage of these opportunities leads to positive impacts over time. If they do not exploit these occasions, negative impacts arise in their life, which make the treatment assistance or follow-up more difficult. The COPD patients' feedback revealed that PR promotes a better 'way of life', well-being and important behavioural changes towards health promotion.

  20. Parental decision-making in uptake of the MMR vaccination: a systematic review of qualitative literature.

    Science.gov (United States)

    Allan, N; Harden, J

    2015-12-01

    Controversy has surrounded MMR vaccination in the aftermath of Wakefield's 1998 paper suggesting links between MMR and the development of pervasive developmental disorder in children. The paper sparked off media debate and contributed to a lack of parental trust in health-care providers and reduction in MMR uptake. This review aims to identify and evaluate research on the subject, with a view to present the reasons behind, and influences on parental decision-making in relation to MMR. Systematic search strategy identified 14 relevant papers on which thematic analysis was performed. Themes identified were categorized as follows: perceptions of risk; roles and responsibility; experience and knowledge. There were limited changes in parental decision-making factors over the time period despite an increase in uptake. Many studies fail to differentiate between accepters and rejecters, making it difficult to draw out clear conclusions. Policymakers need to adapt information provided to address these concerns. Future research should focus more on distinguishing between accepters and rejecters to determine which factors can alter outcome. © The Author 2014. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  1. Acknowleding attributes that enable the career academic nurse to thrive in the tertiary education sector: A qualitative systematic review.

    Science.gov (United States)

    Wyllie, Aileen; DiGiacomo, Michelle; Jackson, Debra; Davidson, Patricia; Phillips, Jane

    2016-10-01

    To optimise the career development in early career academic nurses by providing an overview of the attributes necessary for success. Evidence of early prospective career planning is necessary to optimise success in the tertiary sector. This is particularly important for nurse academics given the profession's later entry into academia, the ageing nursing workforce and the continuing global shortage of nurses. A qualitative systematic review. Academic Search Complete, CINAHL, Medline, ERIC, Professional Development Collection and Google Scholar databases were searched; resulting in the inclusion of nine qualitative nurse-only focussed studies published between 2004 and 2014. The studies were critically appraised and the data thematically analysed. Three abilities were identified as important to the early career academic nurse: a willingness to adapt to change, an intention to pursue support and embodying resilience. These abilities give rise to attributes that are recommended as key to successful academic career development for those employed on a continuing academic basis. The capacity to rely on one's own capabilities is becoming seen as increasingly important. It is proposed that recognition of these attributes, their skilful application and monitoring outlined in the review are recommended for a successful career in academia. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

  2. Working with interpreters in cross-cultural qualitative research in the context of a developing country: systematic literature review.

    Science.gov (United States)

    Shimpuku, Yoko; Norr, Kathleen F

    2012-08-01

    This article is a report of a systematic literature review describing how cross-cultural researchers conducted qualitative studies with interpreters in Tanzania. The purpose was to draw methodological implications for working with interpreters within the context of developing countries. In a growing number of cross-cultural nursing studies in developing countries, interpreters play a crucial role for imparting verbal and cultural understanding. In many studies, however, the interpreters' role and their influences on the findings are not adequately described, and therefore the study credibility is weakened. Cross-cultural qualitative studies conducted with interpreters in Tanzania were searched in four databases. Meeting our inclusion criteria were 20 studies published from 1994-2009. We used Garrard's Matrix Method following Wallin and Ahlström's framework to analyse how cross-cultural researchers described the role of interpreters. We identified three major patterns of how researchers worked with interpreters: (i) invisible assistance, (ii) independent fieldwork and (iii) integrated collaboration. In many studies, interpreters' information was limited. They were often asked to collect data in the field without the presence of the researcher. They were integrated into the research process beyond data collection, such as subject recruitment, review of interviews, transcription and translation and analysis. From planning of research to dissemination of the findings, nurse researchers should carefully consider interpreters' influences on the findings. They may use a set of questions we developed for working with interpreters in developing countries to systematically describe the interpreter's role and maximize their research credibility. © 2012 Blackwell Publishing Ltd.

  3. Understanding factors affecting patient and public engagement and recruitment to digital health interventions: a systematic review of qualitative studies.

    Science.gov (United States)

    O'Connor, Siobhan; Hanlon, Peter; O'Donnell, Catherine A; Garcia, Sonia; Glanville, Julie; Mair, Frances S

    2016-09-15

    Numerous types of digital health interventions (DHIs) are available to patients and the public but many factors affect their ability to engage and enrol in them. This systematic review aims to identify and synthesise the qualitative literature on barriers and facilitators to engagement and recruitment to DHIs to inform future implementation efforts. PubMed, MEDLINE, CINAHL, Embase, Scopus and the ACM Digital Library were searched for English language qualitative studies from 2000 - 2015 that discussed factors affecting engagement and enrolment in a range of DHIs (e.g. 'telemedicine', 'mobile applications', 'personal health record', 'social networking'). Text mining and additional search strategies were used to identify 1,448 records. Two reviewers independently carried out paper screening, quality assessment, data extraction and analysis. Data was analysed using framework synthesis, informed by Normalization Process Theory, and Burden of Treatment Theory helped conceptualise the interpretation of results. Nineteen publications were included in the review. Four overarching themes that affect patient and public engagement and enrolment in DHIs emerged; 1) personal agency and motivation; 2) personal life and values; 3) the engagement and recruitment approach; and 4) the quality of the DHI. The review also summarises engagement and recruitment strategies used. A preliminary DIgital Health EnGagement MOdel (DIEGO) was developed to highlight the key processes involved. Existing knowledge gaps are identified and a number of recommendations made for future research. Study limitations include English language publications and exclusion of grey literature. This review summarises and highlights the complexity of digital health engagement and recruitment processes and outlines issues that need to be addressed before patients and the public commit to digital health and it can be implemented effectively. More work is needed to create successful engagement strategies and better

  4. Risk perception and its role in attitudes toward blood transfusion: a qualitative systematic review.

    Science.gov (United States)

    Ngo, Ly Thi; Bruhn, Roberta; Custer, Brian

    2013-04-01

    Despite improvements in blood safety making transfusion a much safer clinical procedure, the general public still perceives it as risky. We systematically reviewed available literature to examine evidence regarding the reasons and causes behind this perception. Electronic databases including PubMed, Cochrane Library, and EMBASE for literature dating back to the 1980s were searched. Eligible studies collected information on blood recipients' demographics, measures of risk domains (sets of values that risks encompass), and general knowledge of blood transfusion in terms of risks and benefits. Each study was assessed for quality of data, research method, and relevant findings. A scoring system was used to subjectively rate the overall quality of each study. Each study was reviewed for its method of data collection and information abstracted on hazards and conceptual dimensions used to measure risk. Risk perception between blood transfusion and other hazards including alternatives to transfusion were compared. Fifteen studies met the inclusion criteria, all of which were conducted outside the United States, with most of the studies published more than 10 years ago and conducted by only 3 research groups. Five studies were rated as being very good, four good, five fair, and one of poor quality. The finding of the studies consistently show that objective or raw knowledge is not correlated with risk perception, but subjective or calibrated knowledge is. Thus, it is what people think they know rather than what they actually do know that influences risk perception of transfusion. Of the 3 common conceptual domains-dread, unknown risk, and benefits-blood transfusion was found to be of intermediate dread, intermediate unknown risk, and most beneficial compared with other hazards. Donated blood was found to have lower perceived risk than all other alternatives to transfusion, except for use of autologous blood. There is a lack of recent studies on allogeneic transfusion

  5. Barriers and Facilitators to Safe Food Handling among Consumers: A Systematic Review and Thematic Synthesis of Qualitative Research Studies.

    Directory of Open Access Journals (Sweden)

    Ian Young

    Full Text Available Foodborne illness has a substantial health and economic burden on society, and most cases are believed to be due to unsafe food handling practices at home. Several qualitative research studies have been conducted to investigate consumers' perspectives, opinions, and experiences with safe food handling at home, and these studies provide insights into the underlying barriers and facilitators affecting their safe food handling behaviours. We conducted a systematic review of previously published qualitative studies in this area to synthesize the main across-study themes and to develop recommendations for future consumer interventions and research. The review was conducted using the following steps: comprehensive search strategy; relevance screening of abstracts; relevance confirmation of articles; study quality assessment; thematic synthesis of the results; and quality-of-evidence assessment. A total of 39 relevant articles reporting on 37 unique qualitative studies were identified. Twenty-one barriers and 10 facilitators to safe food handling were identified, grouped across six descriptive themes: confidence and perceived risk; knowledge-behaviour gap; habits and heuristics; practical and lifestyle constraints; food preferences; and societal and social influences. Our overall confidence that each barrier and facilitator represents the phenomenon of interest was rated as high (n = 11, moderate (11, and low (9. Overarching analytical themes included: 1 safe food handling behaviours occur as part of a complex interaction of everyday consumer practices and habituation; 2 most consumers are not concerned about food safety and are generally not motivated to change their behaviours based on new knowledge about food safety risks; and 3 consumers are amenable to changing their safe food handling habits through relevant social pressures. Key implications and recommendations for research, policy and practice are discussed.

  6. Barriers and Facilitators to Safe Food Handling among Consumers: A Systematic Review and Thematic Synthesis of Qualitative Research Studies

    Science.gov (United States)

    Young, Ian; Waddell, Lisa

    2016-01-01

    Foodborne illness has a substantial health and economic burden on society, and most cases are believed to be due to unsafe food handling practices at home. Several qualitative research studies have been conducted to investigate consumers’ perspectives, opinions, and experiences with safe food handling at home, and these studies provide insights into the underlying barriers and facilitators affecting their safe food handling behaviours. We conducted a systematic review of previously published qualitative studies in this area to synthesize the main across-study themes and to develop recommendations for future consumer interventions and research. The review was conducted using the following steps: comprehensive search strategy; relevance screening of abstracts; relevance confirmation of articles; study quality assessment; thematic synthesis of the results; and quality-of-evidence assessment. A total of 39 relevant articles reporting on 37 unique qualitative studies were identified. Twenty-one barriers and 10 facilitators to safe food handling were identified, grouped across six descriptive themes: confidence and perceived risk; knowledge-behaviour gap; habits and heuristics; practical and lifestyle constraints; food preferences; and societal and social influences. Our overall confidence that each barrier and facilitator represents the phenomenon of interest was rated as high (n = 11), moderate (11), and low (9). Overarching analytical themes included: 1) safe food handling behaviours occur as part of a complex interaction of everyday consumer practices and habituation; 2) most consumers are not concerned about food safety and are generally not motivated to change their behaviours based on new knowledge about food safety risks; and 3) consumers are amenable to changing their safe food handling habits through relevant social pressures. Key implications and recommendations for research, policy and practice are discussed. PMID:27907161

  7. Specialist antenatal clinics for women at high risk of preterm birth: a systematic review of qualitative and quantitative research.

    Science.gov (United States)

    Malouf, Reem; Redshaw, Maggie

    2017-02-02

    Preterm birth (PTB) is the leading cause of perinatal morbidity and mortality. Women with previous prenatal loss are at higher risk of preterm birth. A specialist antenatal clinic is considered as one approach to improve maternity and pregnancy outcomes. A systematic review of quantitative, qualitative and mixed method studies conducted on women at high risk of preterm birth (PTB). The review primary outcomes were to report on the specialist antenatal clinics effect in preventing or reducing preterm birth, perinatal mortality and morbidity and women's perceptions and experiences of a specialist clinic whether compared or not compared with standard antenatal care. Other secondary maternal, infant and economic outcomes were also determined. A comprehensive search strategy was carried out in English within electronic databases as far back as 1980. The reviewers selected studies, assessed the quality, and extracted data independently. Results were summarized and tabulated. Eleven studies fully met the review inclusion criteria, ten were quantitative design studies and only one was a qualitative design study. No mixed method design study was included in the review. All were published after 1989, seven were conducted in the USA and four in the UK. Results from five good to low quality randomised controlled trials (RCTs), all conducted before 1990, did not illustrate the efficacy of the clinic in reducing preterm birth. Whereas results from more recent low quality cohort studies showed some positive neonatal outcomes. Themes from one good quality qualitative study reflected on the emotional and psychological need to reduce anxiety and stress of women referred to such a clinic. Women expressed their negative emotional responses at being labelled as high risk and positive responses to being assessed and treated in the clinic. Women also reported that their partners were struggling to cope emotionally. Findings from this review were mixed. Evidence from cohort studies

  8. Invited review: A systematic review and qualitative analysis of treatments other than conventional antimicrobials for clinical mastitis in dairy cows.

    Science.gov (United States)

    Francoz, D; Wellemans, V; Dupré, J P; Roy, J P; Labelle, F; Lacasse, P; Dufour, S

    2017-10-01

    Clinical mastitis is an important disease in dairies. Its treatment is mainly based on the use of antimicrobial drugs. Numerous non-antimicrobial drugs and treatment strategies have already been reported for clinical mastitis treatment, but data on their efficacy have never been collated in a systematic way. The objective of this systematic review was to identify treatments other than conventional antimicrobials for the treatment of clinical mastitis in lactating dairy cows. A systematic review was performed with studies written in English or French selected from CAB Abstracts, PubMed, and Web of Science from January 1970 to June 2014. Controlled clinical trials, observational studies, and experimental challenges were retained. Lactating dairy cows with clinical mastitis were the participant of interest. All treatments other than conventional antimicrobials for clinical mastitis during lactation were retained. Only studies comparing the treatment under investigation to a negative or positive control, or both, were included. Outcomes evaluated were clinical and bacteriological cure rates and milk production. Selection of the study, data extraction, and assessment of risk of bias was performed by 3 reviewers. Assessment of risk of bias was evaluated using the Cochrane Collaboration tool for systematic review of interventions. A total of 2,451 manuscripts were first identified and 39 manuscripts corresponding to 41 studies were included. Among these, 22 were clinical trials, 18 were experimental studies, and 1 was an observational study. The treatments evaluated were conventional anti-inflammatory drugs (n = 14), oxytocin with or without frequent milk out (n = 5), biologics (n = 9), homeopathy (n = 5), botanicals (n = 4), probiotics (n = 2), and other alternative products (n = 2). All trials had at least one unclear or high risk of bias. Most trials (n = 13) did not observe significant differences in clinical or bacteriological cure rates in comparison with negative

  9. Work-based learning in health care organisations experienced by nursing staff: A systematic review of qualitative studies.

    Science.gov (United States)

    Nevalainen, Marja; Lunkka, Nina; Suhonen, Marjo

    2018-03-01

    The aim of this review is to systematically summarise qualitative evidence about work-based learning in health care organisations as experienced by nursing staff. Work-based learning is understood as informal learning that occurs inside the work community in the interaction between employees. Studies for this review were searched for in the CINAHL, PubMed, Scopus and ABI Inform ProQuest databases for the period 2000-2015. Nine original studies met the inclusion criteria. After the critical appraisal by two researchers, all nine studies were selected for the review. The findings of the original studies were aggregated, and four statements were prepared, to be utilised in clinical work and decision-making. The statements concerned the following issues: (1) the culture of the work community; (2) the physical structures, spaces and duties of the work unit; (3) management; and (4) interpersonal relations. Understanding the nurses' experiences of work-based learning and factors behind these experiences provides an opportunity to influence the challenges of learning in the demanding context of health care organisations. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Student and educator experiences of maternal-child simulation-based learning: a systematic review of qualitative evidence protocol.

    Science.gov (United States)

    MacKinnon, Karen; Marcellus, Lenora; Rivers, Julie; Gordon, Carol; Ryan, Maureen; Butcher, Diane

    2015-01-01

    , enhancing nurses' abilities to build upon previous knowledge and past experiences, and manage new or unfamiliar situations.Simulation has previously been integrated into nursing curricula in a "piecemeal" fashion that lacks an integrative pedagogy or theoretical approach. More recently a number of theoretical and pedagogical frameworks and best practice standards have been published. In April 2014 a preliminary search of literature (in CINAHL, Medline, Academic Search Complete and Web of Science) was conducted with guidance from our library specialist to test the search strategy and ensure that there would be enough qualitative findings to include in the systematic review. A preliminary scan of the abstracts from these searches demonstrated that many experiential case reports with qualitative findings were missed with the use of research limiters (including our search strategy specifically constructed to retrieve qualitative research) so the decision was made to err on the side of caution by searching more broadly and review a larger number of abstracts for inclusion in the study. However, a number of reports with qualitative findings were identified. For example, from a review of the abstracts from a CINAHL search dated April 17, qualitative research papers (including two dissertations), 12 evaluation study reports, six mixed methods studies and nine case reports with qualitative findings were identified. It is timely then to review qualitative studies to better understand the meaningfulness and appropriateness of integrating maternal-child simulation-based learning activities in undergraduate nursing education programs.A search of both the Cochrane Library of Systematic Reviews and the Joanna Briggs Institute Database of Systematic Reviews and Implementation Reports has been conducted. No systematic reviews of qualitative studies of maternal-child simulation-based learning for undergraduate or pre-registration nursing students in educational settings are evident in the

  11. What environmental factors influence resumption of valued activities post stroke: a systematic review of qualitative and quantitative findings.

    Science.gov (United States)

    Jellema, Sandra; van Hees, Suzanne; Zajec, Jana; van der Sande, Rob; Nijhuis-van der Sanden, Maria Wg; Steultjens, Esther Mj

    2017-07-01

    Identify the environmental factors that influence stroke-survivors' reengagement in personally valued activities and determine what specific environmental factors are related to specific valued activity types. PubMed, CINAHL and PsycINFO were searched until June 2016 using multiple search-terms for stroke, activities, disability, and home and community environments. An integrated mixed-method systematic review of qualitative, quantitative and mixed-design studies was conducted. Two researchers independently identified relevant studies, assessed their methodological quality and extracted relevant findings. To validly compare and combine the various findings, all findings were classified and grouped by environmental category and level of evidence. The search yielded 4024 records; 69 studies were included. Most findings came from low-evidence-level studies such as single qualitative studies. All findings were consistent in that the following factors facilitated reengagement post-stroke: personal adapted equipment; accessible environments; transport; services; education and information. Barriers were: others' negative attitudes and behaviour; long distances and inconvenient environmental conditions (such as bad weather). Each type of valued activity, such as mobility or work, had its own pattern of environmental influences, social support was a facilitator to all types of activities. Although in many qualitative studies others' attitudes, behaviour and stroke-related knowledge were seen as important for reengagement, these factors were hardly studied quantitatively. A diversity of environmental factors was related to stroke-survivors' reengagement. Most findings came from low-evidence-level studies so that evidence on causal relationships was scarce. In future, more higher-level-evidence studies, for example on the attitudes of significant others, should be conducted.

  12. In their own words: a synthesis of the qualitative research on the experiences of adults seeking asylum. A systematic review of qualitative findings in forced migration.

    Science.gov (United States)

    Hoare, Thomas; Vidgen, Andrew; Roberts, Neil

    2017-12-01

    Quantitative research indicates that some forced migrants have mental health needs. Asylum seekers are a group of forced migrants applying for asylum status in a host country, and are often subject to rights restrictions and threat of deportation, though little is known about subjective experiences of the asylum journey and process of claiming asylum. The current paper therefore describes a systematic review of the qualitative literature, examining asylum seekers experiences of asylum journey, from country of origin, to arrival and adaptation to host countries. A search of four databases yielded 122 studies. Inclusion/exclusion criteria were applied and 15 studies were retained and critically appraised. The country where research was conducted, study aims, sample characteristics and methodological approaches were all critically reviewed for included studies. Study aims fell into four themes; 'an aspect of the asylum seeker journey'; 'psychological distress and wellbeing'; 'cultural identity and adaptation to new environment' and 'social welfare, employment and housing'. Studies were generally high quality and indicate issues around choice of asylum destination, distress created by uncertainty around asylum decision and hostile reactions of host communities. However, few studies have examined the experiences of asylum seekers specifically, which is important given the unique circumstances of this population.

  13. Health System Decision Makers' Feedback on Summaries and Tools Supporting the Use of Systematic Reviews: A Qualitative Study

    Science.gov (United States)

    Ellen, Moriah E.; Lavis, John N.; Wilson, Michael G.; Grimshaw, Jeremy; Haynes, R. Brian; Ouimet, Mathieu; Raina, Parminder; Gruen, Russell

    2014-01-01

    Health system managers and policy makers need timely access to high quality, policy-relevant systematic reviews. Our objectives were to obtain managers' and policy makers' feedback about user-friendly summaries of systematic reviews and about tools related to supporting or assessing their use. Our interviews identified that participants prefer key…

  14. Experiences of acute pain in children who present to a healthcare facility for treatment: a systematic review of qualitative evidence.

    Science.gov (United States)

    Pope, Nicole; Tallon, Mary; McConigley, Ruth; Leslie, Gavin; Wilson, Sally

    2017-06-01

    Pain is a universal and complex phenomenon that is personal, subjective and specific. Despite growing knowledge in pediatric pain, management of children's pain remains sub-optimal and is linked to negative behavioral and physiological consequences later in life. As there is no synthesis of these studies, it was timely to undertake a systematic review. To identify, evaluate and synthesize the existing qualitative evidence on children's experiences of acute pain, including pain management, within a healthcare facility. Children aged four to 18 years (inclusive) attending a healthcare facility who experienced acute pain associated with any injury, medical condition or treatment. Children's experiences and perceptions of their acute pain, pain management and expectations of others in managing their pain. Studies on children's experiences of pain in the postoperative context were excluded as a systematic review exploring this phenomenon had previously been published. Studies reporting on children's experiences of chronic pain were also excluded. Any healthcare facility including general practitioners' surgeries, hospitals, emergency departments and outpatient clinics. Qualitative studies including phenomenology, grounded theory, ethnography, action research and feminist research designs. Using a three-step search strategy, databases were searched in December 2015 to identify both published and unpublished articles from 2000 to 2015. Studies published in languages other than English were excluded. All studies that met the inclusion criteria were assessed by at least two independent reviewers for methodological quality using a standardized critical appraisal tool from the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI). Data were extracted from the papers included in the review using standardized data extraction tool from JBI-QARI. Findings were pooled using JBI-QARI. Findings were rated according to their level of credibility and

  15. Experiences of and support for nurses as second victims of adverse nursing errors: a qualitative systematic review.

    Science.gov (United States)

    Cabilan, C J; Kynoch, Kathryn

    2017-09-01

    Second victims are clinicians who have made adverse errors and feel traumatized by the experience. The current published literature on second victims is mainly representative of doctors, hence nurses' experiences are not fully depicted. This systematic review was necessary to understand the second victim experience for nurses, explore the support provided, and recommend appropriate support systems for nurses. To synthesize the best available evidence on nurses' experiences as second victims, and explore their experiences of the support they receive and the support they need. Participants were registered nurses who made adverse errors. The review included studies that described nurses' experiences as second victims and/or the support they received after making adverse errors. All studies conducted in any health care settings worldwide. The qualitative studies included were grounded theory, discourse analysis and phenomenology. A structured search strategy was used to locate all unpublished and published qualitative studies, but was limited to the English language, and published between 1980 and February 2017. The references of studies selected for eligibility screening were hand-searched for additional literature. Eligible studies were assessed by two independent reviewers for methodological quality using a standardized critical appraisal instrument from the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI QARI). Themes and narrative statements were extracted from papers included in the review using the standardized data extraction tool from JBI QARI. Data synthesis was conducted using the Joanna Briggs Institute meta-aggregation approach. There were nine qualitative studies included in the review. The narratives of 284 nurses generated a total of 43 findings, which formed 15 categories based on similarity of meaning. Four synthesized findings were generated from the categories: (i) The error brings a considerable emotional burden to the

  16. Living with, managing and minimising treatment burden in long term conditions: a systematic review of qualitative research.

    Science.gov (United States)

    Demain, Sara; Gonçalves, Ana-Carolina; Areia, Carlos; Oliveira, Rúben; Marcos, Ana Jorge; Marques, Alda; Parmar, Ranj; Hunt, Katherine

    2015-01-01

    'Treatment burden', defined as both the workload and impact of treatment regimens on function and well-being, has been associated with poor adherence and unfavourable outcomes. Previous research focused on treatment workload but our understanding of treatment impact is limited. This research aimed to systematically review qualitative research to identify: 1) what are the treatment generated disruptions experienced by patients across all chronic conditions and treatments? 2) what strategies do patients employ to minimise these treatment generated disruptions? The search strategy centred on: treatment burden and qualitative methods. Medline, CINAHL, Embase, and PsychINFO were searched electronically from inception to Dec 2013. No language limitations were set. Teams of two reviewers independently conducted paper screening, data extraction, and data analysis. Data were analysed using framework synthesis informed by Cumulative Complexity Model. Eleven papers reporting data from 294 patients, across a range of conditions, age groups and nationalities were included. Treatment burdens were experienced as a series of disruptions: biographical disruptions involved loss of freedom and independence, restriction of meaningful activities, negative emotions and stigma; relational disruptions included strained family and social relationships and feeling isolated; and, biological disruptions involved physical side-effects. Patients employed "adaptive treatment work" and "rationalised non-adherence" to minimise treatment disruptions. Rationalised non-adherence was sanctioned by health professionals at end of life; at other times it was a "secret-act" which generated feelings of guilt and impacted on family and clinical relationships. Treatments generate negative emotions and physical side effects, strain relationships and affect identity. Patients minimise these disruptions through additional adaptive work and/or by non-adherence. This affects physical outcomes and care

  17. Living with, managing and minimising treatment burden in long term conditions: a systematic review of qualitative research.

    Directory of Open Access Journals (Sweden)

    Sara Demain

    Full Text Available 'Treatment burden', defined as both the workload and impact of treatment regimens on function and well-being, has been associated with poor adherence and unfavourable outcomes. Previous research focused on treatment workload but our understanding of treatment impact is limited. This research aimed to systematically review qualitative research to identify: 1 what are the treatment generated disruptions experienced by patients across all chronic conditions and treatments? 2 what strategies do patients employ to minimise these treatment generated disruptions?The search strategy centred on: treatment burden and qualitative methods. Medline, CINAHL, Embase, and PsychINFO were searched electronically from inception to Dec 2013. No language limitations were set. Teams of two reviewers independently conducted paper screening, data extraction, and data analysis. Data were analysed using framework synthesis informed by Cumulative Complexity Model. Eleven papers reporting data from 294 patients, across a range of conditions, age groups and nationalities were included. Treatment burdens were experienced as a series of disruptions: biographical disruptions involved loss of freedom and independence, restriction of meaningful activities, negative emotions and stigma; relational disruptions included strained family and social relationships and feeling isolated; and, biological disruptions involved physical side-effects. Patients employed "adaptive treatment work" and "rationalised non-adherence" to minimise treatment disruptions. Rationalised non-adherence was sanctioned by health professionals at end of life; at other times it was a "secret-act" which generated feelings of guilt and impacted on family and clinical relationships.Treatments generate negative emotions and physical side effects, strain relationships and affect identity. Patients minimise these disruptions through additional adaptive work and/or by non-adherence. This affects physical outcomes and

  18. The perspective of healthcare providers and patients on health literacy: a systematic review of the quantitative and qualitative studies.

    Science.gov (United States)

    Rajah, Retha; Ahmad Hassali, Mohamed Azmi; Jou, Lim Ching; Murugiah, Muthu Kumar

    2018-03-01

    Health literacy (HL) is a multifaceted concept, thus understanding the perspective of healthcare providers, patients, and the system is vital. This systematic review examines and synthesises the available studies on HL-related knowledge, attitude, practice, and perceived barriers. CINAHL and Medline (via EBSCOhost), Google Scholar, PubMed, ProQuest, Sage Journals, and Science Direct were searched. Both quantitative and/or qualitative studies in the English language were included. Intervention studies and studies focusing on HL assessment tools and prevalence of low HL were excluded. The risk of biasness reduced with the involvement of two reviewers independently assessing study eligibility and quality. A total of 30 studies were included, which consist of 19 quantitative, 9 qualitative, and 2 mixed-method studies. Out of 17 studies, 13 reported deficiency of HL-related knowledge among healthcare providers and 1 among patients. Three studies showed a positive attitude of healthcare providers towards learning about HL. Another three studies demonstrated patients feel shame exposing their literacy and undergoing HL assessment. Common HL communication techniques reported practiced by healthcare providers were the use of everyday language, teach-back method, and providing patients with reading materials and aids, while time constraint was the most reported HL perceived barriers by both healthcare providers and patients. Significant gaps exists in HL knowledge among healthcare providers and patients that needs immediate intervention. Such as, greater effort placed in creating a health system that provides an opportunity for healthcare providers to learn about HL and patients to access health information with taking consideration of their perceived barriers.

  19. What Influences Patient-Therapist Interactions in Musculoskeletal Physical Therapy? Qualitative Systematic Review and Meta-Synthesis.

    Science.gov (United States)

    O'Keeffe, Mary; Cullinane, Paul; Hurley, John; Leahy, Irene; Bunzli, Samantha; O'Sullivan, Peter B; O'Sullivan, Kieran

    2016-05-01

    Musculoskeletal physical therapy involves both specific and nonspecific effects. Nonspecific variables associated with the patient, therapist, and setting may influence clinical outcomes. Recent quantitative research has shown that nonspecific factors, including patient-therapist interactions, can influence treatment outcomes. It remains unclear, however, what factors influence patient-therapist interaction. This qualitative systematic review and meta-synthesis investigated patients' and physical therapists' perceptions of factors that influence patient-therapist interactions. Eleven databases were searched independently. Qualitative studies examining physical therapists' and patients' perceptions of factors that influence patient-therapist interactions in musculoskeletal settings were included. Two reviewers independently selected articles, assessed methodological quality using the Critical Appraisal Skills Programme (CASP), and performed the 3 stages of analysis: extraction of findings, grouping of findings (codes), and abstraction of findings. Thirteen studies were included. Four themes were perceived to influence patient-therapist interactions: (1) physical therapist interpersonal and communication skills (ie, presence of skills such as listening, encouragement, confidence, being empathetic and friendly, and nonverbal communication), (2) physical therapist practical skills (ie, physical therapist expertise and level of training, although the ability to provide good education was considered as important only by patients), (3) individualized patient-centered care (ie, individualizing the treatment to the patient and taking patient's opinions into account), and (4) organizational and environmental factors (ie, time and flexibility with care and appointments). Only studies published in English were included. A mix of interpersonal, clinical, and organizational factors are perceived to influence patient-therapist interactions, although research is needed to identify

  20. Understanding what helps or hinders asthma action plan use: a systematic review and synthesis of the qualitative literature.

    Science.gov (United States)

    Ring, Nicola; Jepson, Ruth; Hoskins, Gaylor; Wilson, Caroline; Pinnock, Hilary; Sheikh, Aziz; Wyke, Sally

    2011-11-01

    To understand better what helps and/or hinders asthma action plan use from the professionals and patients/carers perspective. Systematic review and qualitative synthesis (using meta-ethnography). Nineteen studies (20 papers) were included in an analysis of patients/carers' and professionals' views. Seven main influences on action plan implementation were identified including perceived un-helpfulness and irrelevance of the plans. Translation and synthesis of the original authors' interpretations suggested that action plan promotion and use was influenced by professional and patient/carers' asthma beliefs and attitudes and patient/carer experiences of managing asthma. Action plan use is hindered because professionals and patients/carers have different explanatory models of asthma, its management and their respective roles in the management process. Patients/carers, based on their experiential knowledge of their condition, perceive themselves as capable, effective in managing their asthma, but health professionals do not always share this view. Professionally provided medically focused action plans that do not 'fit' with and incorporate the patients'/carers' views of asthma, and their management strategies, will continue to be under-utilised. Professionals need to develop a more patient-centred, partnership-based, approach to the joint development and review of action plans, recognising the experiential asthma knowledge of patients/carers. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  1. Seeking, accepting and declining help for emotional distress in cancer: A systematic review and thematic synthesis of qualitative evidence.

    Science.gov (United States)

    Carolan, C M; Smith, A; Davies, G R; Forbat, L

    2018-03-01

    Many individuals affected by cancer who experience emotional distress report not wanting help. This review aims to understand why individuals affected by cancer seek, accept or decline help for emotional distress and what influences these actions. A systematic review and thematic synthesis of the qualitative literature was conducted. Using pre-defined search terms, four electronic databases were searched from January 2000 to May 2016. Pre-determined inclusion and exclusion criteria were then applied. Identified papers were quality appraised. In total, 32 papers were included in the synthesis. Four themes emerged from data synthesis: attaining normality-the normality paradox; being emotionally literate; perceptions of help; needs-support gap. Attaining normality is ideographic, context dependent and temporally situated; some individuals maintain normality by not seeking/declining help whereas others seek/accept help to achieve a new normality. Thus, attaining normality paradoxically functions to explain both why individuals sought/accepted help or did not seek/declined help. Data indicate that a context dependent, systems thinking approach is merited to enhance psychosocial care. In particular, clinicians must actively explore the personal context of an individual's distress to ensure that help desired and help offered are mutually understood. Further research must address the limitations of the current evidence base to advance theoretical understanding. © 2017 John Wiley & Sons Ltd.

  2. Management of sleep bruxism in adults: a qualitative systematic literature review

    NARCIS (Netherlands)

    Manfredini, D.; Ahlberg, J.; Winocur, E.; Lobbezoo, F.

    2015-01-01

    This paper updates the bruxism management review published by Lobbezoo et al. in 2008 (J Oral Rehabil 2008; 35: 509-23). The review focuses on the most recent literature on management of sleep bruxism (SB) in adults, as diagnosed with polysomnography (PSG) with audio-video (AV) recordings, or with

  3. The school environment and student health: a systematic review and meta-ethnography of qualitative research

    OpenAIRE

    Jamal, Farah; Fletcher, Adam; Harden, Angela; Wells, Helene; Thomas, James; Bonell, Chris

    2013-01-01

    Background\\ud There is increasing interest in promoting young people’s health by\\ud modifying the school\\ud environment. However, existing research offers little guidance on how\\ud the school context\\ud enables or constrains students’ health behaviours, or how students’ backgr\\ud ounds relate to\\ud these processes. For these reasons, this paper reports on a meta-et\\ud hnography of qualitative\\ud studies examining: through what processes does the school environment (s\\ud ocial and physical)\\ud...

  4. Older adults' perspectives on the process of becoming users of assistive technology: a qualitative systematic review and meta-synthesis.

    Science.gov (United States)

    Larsen, Stina Meyer; Mortensen, Rikke Falgreen; Kristensen, Hanne Kaae; Hounsgaard, Lise

    2018-04-22

    To identify, synthesize, and evaluate existing literature concerning the process of becoming a user of assistive technology (AT). A systematic review and meta-synthesis were carried out. Five bibliographic databases (MEDLINE via PubMed, CINAHL, Web of Science, PsycINFO and SocINDEX) were systematically searched up to 13 th of March 2017, using two sets of search terms: (i) elderly and synonyms and (ii) assistive technology and similar words, and combined with a qualitative research filter. Articles were screened, read and critically assessed. The meta-synthesis was guided by Ricoeur's theory of interpretation. Seventeen out of 4645 articles were included. Five phases emerged relating to the process of becoming a user of AT: phase A: Evaluating need, phase B: Acknowledging need, phase C: Incorporating the AT into daily life, phase D: Using the AT, and phase E: Future use. Three transitions, describing factors essential to moving from one phase to the next, were identified; from phase A-B: Valued activities are threatened, from phase B-C: Obtaining the AT and from phase C-D: Trust in the AT. No transition was identified from phase D-E. The meta-synthesis led to a deeper understanding of the process of older adults becoming users of AT, by exploring findings across the included articles. The identified phases and transitions in the systematic review serve as an analytical framework for understanding the process from the older adult's perspective. This review advocates for using a client-centred approach throughout the entire delivery process. Implications for rehabilitation The process of the older adult becoming a user of AT involves an individualized time factor, and this supports the practice of individualized follow-up. The process of becoming a user of AT is closely related to self-image; healthcare professionals should support not only the use of AT but also the older adult's emotional adjustment to a new self-image. The process is highly influenced by the older

  5. Do Public Involvement Activities in Biomedical Research and Innovation Recruit Representatively? A Systematic Qualitative Review.

    Science.gov (United States)

    Lander, Jonas; Hainz, Tobias; Hirschberg, Irene; Bossert, Sabine; Strech, Daniel

    2016-01-01

    Public involvement activities (PIAs) may contribute to the governance of ethically challenging biomedical research and innovation by informing, consulting with and engaging the public in developments and decision-making processes. For PIAs to capture a population's preferences (e.g. on issues in whole genome sequencing, biobanks or genome editing), a central methodological requirement is to involve a sufficiently representative subgroup of the general public. While the existing literature focusses on theoretical and normative aspects of 'representation', this study assesses empirically how such considerations are implemented in practice. It evaluates how PIA reports describe representation objectives, the recruitment process and levels of representation achieved. PIA reports were included from a systematic literature search if they directly reported a PIA conducted in a relevant discipline such as genomics, biobanks, biotechnology or others. PIA reports were analyzed with thematic text analysis. The text analysis was guided by an assessment matrix based on PIA-specific guidelines and frameworks. We included 46 relevant reports, most focusing on issues in genomics. 27 reports (59%) explicitly described representation objectives, though mostly without adjusting eligibility criteria and recruiting methods to the specific objective. 11 reports (24%) explicitly reported to have achieved the intended representation; the rest either reported failure or were silent on this issue. Representation of study samples in PIAs in biomedical research and innovation is currently not reported systematically. Improved reporting on representation would not only improve the validity and value of PIAs, but could also contribute to PIA results being used more often in relevant policy and decision-making processes. © 2016 S. Karger AG, Basel.

  6. Producing Cochrane systematic reviews-a qualitative study of current approaches and opportunities for innovation and improvement.

    Science.gov (United States)

    Turner, Tari; Green, Sally; Tovey, David; McDonald, Steve; Soares-Weiser, Karla; Pestridge, Charlotte; Elliott, Julian

    2017-08-01

    Producing high-quality, relevant systematic reviews and keeping them up to date is challenging. Cochrane is a leading provider of systematic reviews in health. For Cochrane to continue to contribute to improvements in heath, Cochrane Reviews must be rigorous, reliable and up to date. We aimed to explore existing models of Cochrane Review production and emerging opportunities to improve the efficiency and sustainability of these processes. To inform discussions about how to best achieve this, we conducted 26 interviews and an online survey with 106 respondents. Respondents highlighted the importance and challenge of creating reliable, timely systematic reviews. They described the challenges and opportunities presented by current production models, and they shared what they are doing to improve review production. They particularly highlighted significant challenges with increasing complexity of review methods; difficulty keeping authors on board and on track; and the length of time required to complete the process. Strong themes emerged about the roles of authors and Review Groups, the central actors in the review production process. The results suggest that improvements to Cochrane's systematic review production models could come from improving clarity of roles and expectations, ensuring continuity and consistency of input, enabling active management of the review process, centralising some review production steps; breaking reviews into smaller "chunks", and improving approaches to building capacity of and sharing information between authors and Review Groups. Respondents noted the important role new technologies have to play in enabling these improvements. The findings of this study will inform the development of new Cochrane Review production models and may provide valuable data for other systematic review producers as they consider how best to produce rigorous, reliable, up-to-date reviews.

  7. Patient-professional partnerships and chronic back pain self-management: a qualitative systematic review and synthesis.

    Science.gov (United States)

    Fu, Yu; McNichol, Elaine; Marczewski, Kathryn; Closs, S José

    2016-05-01

    Chronic back pain is common, and its self-management may be a lifelong task for many patients. While health professionals can provide a service or support for pain, only patients can actually experience it. It is likely that optimum self-management of chronic back pain may only be achieved when patients and professionals develop effective partnerships which integrate their complementary knowledge and skills. However, at present, there is no evidence to explain how such partnerships can influence patients' self-management ability. This review aimed to explore the influence of patient-professional partnerships on patients' ability to self-manage chronic back pain, and to identify key factors within these partnerships that may influence self-management. A systematic review was undertaken, aiming to retrieve relevant studies using any research method. Five databases were searched for papers published between 1980 and 2014, including Cochrane Library, CINAHL, Medline, EMBASE and PsycINFO. Eligible studies were those reporting on patients being supported by professionals to self-manage chronic back pain; patients being actively involved for self-managing chronic back pain; and the influence of patient-professional partnerships on self-management of chronic back pain. Included studies were critically appraised for quality, and findings were extracted and analysed thematically. A total of 738 studies were screened, producing 10 studies for inclusion, all of which happened to use qualitative methods. Seven themes were identified: communication, mutual understanding, roles of health professionals, information delivery, patients' involvement, individualised care and healthcare service. These themes were developed into a model suggesting how factors within patient-professional partnerships influence self-management. Review findings suggest that a partnership between patients and professionals supports patients' self-management ability, and effective communication is a

  8. The experiences of and meaning for women living and coping with type 2 diabetes: a systematic review of qualitative evidence.

    Science.gov (United States)

    Min, Li Jie; Drury, Vicki Blair; Taylor, Beverley Joan

    Effective management of diabetes not only relies on lifestyle modification and adherence to a treatment regime, but also the ability to cope with the impact of the disease on daily activities. Stress associated with the multi-caregiver role of women may affect the ability to manage the disease effectively. To explore the experience of women living and coping with type 2 diabetes. Adult women aged 18 years and above diagnosed with type 2 diabetes.The meaning of living and coping with type 2 diabetes.Qualitative studies, including designs such as phenomenology, grounded theory, ethnography, action research and feminist research. The search strategy used sought only to identify published English research papers from the year 1990 to 2010. A three-step search strategy was undertaken. The retrieved papers were assessed for methodological quality by two independent reviewers using the Joanna Briggs Institute Qualitative Assessment and Review Instrument. Data was extracted using the Joanna Briggs Institute Qualitative Assessment and Review data extraction tool. The data were synthesised using the Joanna Briggs Institute approach of meta-synthesis by meta-aggregation. Nine studies were included in the review. Forty-one findings were obtained and then grouped into 11 categories which were then aggregated into four synthesised findings: "Living with type 2 diabetes is emotionally and mentally challenging", "Support (of self, by others, spiritual) provides the ability to cope with diabetes", "Women see their personal responsibility in the management of diabetes and try to maintain their autonomy. Despite this, women place the needs of the family over their own needs thereby resulting in ineffective management" and "Effective management of diabetes is hindered by role duties of women as well as their attitudes and the attitudes of the healthcare providers". Women are challenged by their multi-caregiving roles and the complexities of managing their diabetes simultaneously

  9. Patients' experiences with routine outcome monitoring and clinical feedback systems: A systematic review and synthesis of qualitative empirical literature.

    Science.gov (United States)

    Solstad, Stig Magne; Castonguay, Louis Georges; Moltu, Christian

    2017-05-19

    Routine outcome monitoring (ROM) and clinical feedback (CF) systems have become important tools for psychological therapies, but there are challenges for their successful implementation. To overcome these challenges, a greater understanding is needed about how patients experience the use of ROM/CF. We conducted a systematic literature search of qualitative studies on patient experiences with the use of ROM/CF in mental health services. The findings from 16 studies were synthesized, resulting in four meta-themes: (1) Suspicion towards service providers, (2) Flexibility and support to capture complexity, (3) Empowering patients, and (4) Developing collaborative practice. We discuss the implications of these meta-themes for further development and implementation of ROM/CF into clinical practice, acknowledging the limitations of our review and suggesting avenues for further research. Clinical or methodological significance of this article: This article provides useful and actionable knowledge about the patient perspective on ROM/CF, an important discussion on the current state of research in this area, and useful and concrete suggestions for further avenues of research.

  10. Motivations, Challenges, and Attitudes to Self-management in Kidney Transplant Recipients: A Systematic Review of Qualitative Studies.

    Science.gov (United States)

    Jamieson, Nathan J; Hanson, Camilla S; Josephson, Michelle A; Gordon, Elisa J; Craig, Jonathan C; Halleck, Fabian; Budde, Klemens; Tong, Allison

    2016-03-01

    Kidney transplantation offers better outcomes compared to dialysis, but requires patients to adhere to an ongoing and complex self-management regimen. Medication nonadherence remains a leading cause of transplant loss, and inadequate self-management undermines transplantation and other health outcomes. We aimed to describe kidney transplant recipients' motivations, challenges, and attitudes toward self-management. Systematic review and thematic synthesis of qualitative studies. Kidney transplant recipients. MEDLINE, EMBASE, PsycINFO, and CINAHL were searched to October 2014. Thematic synthesis. 50 studies involving 1,238 recipients aged 18 to 82 years across 19 countries were included. We identified 5 themes: empowerment through autonomy (achieving mastery, tracking against tangible targets, developing bodily intuition, routinizing and problem solving, and adaptive coping), prevailing fear of consequences (inescapable rejection anxiety, aversion to dialysis, minimizing future morbidity, trivialization and denial, and defining acceptable risks), burdensome treatment and responsibilities (frustrating ambiguities, inadvertent forgetfulness, intrusive side effects, reversing ingrained behaviors, and financial hardship), overmedicalizing life (dominating focus, evading patienthood, and succumbing to burnout), and social accountability and motivation (demonstrating gratitude toward medical team, indebtedness to donor, and peer learning). Non-English articles were excluded. Self-efficacy and social accountability are motivators for self-management, although adherence can be mentally and physically taxing. Multicomponent interventions incorporating personalized care planning, education, psychosocial support, decision aids, and self-monitoring tools may foster self-management capacity and improve transplantation outcomes. Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  11. Online Peer-to-Peer Communities in the Daily Lives of People With Chronic Illness: A Qualitative Systematic Review.

    Science.gov (United States)

    Kingod, Natasja; Cleal, Bryan; Wahlberg, Ayo; Husted, Gitte R

    2017-01-01

    This qualitative systematic review investigated how individuals with chronic illness experience online peer-to-peer support and how their experiences influence daily life with illness. Selected studies were appraised by quality criteria focused upon research questions and study design, participant selection, methods of data collection, and methods of analysis. Four themes were identified: (a) illness-associated identity work, (b) social support and connectivity, (c) experiential knowledge sharing, and (d) collective voice and mobilization. Findings indicate that online peer-to-peer communities provide a supportive space for daily self-care related to chronic illness. Online communities provided a valued space to strengthen social ties and exchange knowledge that supported offline ties and patient-doctor relationships. Individuals used online communities to exchange experiential knowledge about everyday life with illness. This type of knowledge was perceived as extending far beyond medical care. Online communities were also used to mobilize and raise collective awareness about illness-specific concerns. © The Author(s) 2016.

  12. Children's experiences of congenital heart disease: a systematic review of qualitative studies.

    Science.gov (United States)

    Chong, Lauren S H; Fitzgerald, Dominic A; Craig, Jonathan C; Manera, Karine E; Hanson, Camilla S; Celermajer, David; Ayer, Julian; Kasparian, Nadine A; Tong, Allison

    2018-03-01

    We aimed to describe the experiences of children and adolescents with congenital heart disease (CHD). Electronic databases were searched until August 2016. Qualitative studies of children's perspectives on CHD were included. Data was extracted using thematic synthesis. From 44 studies from 12 countries involving 995 children, we identified 6 themes: disrupting normality (denying the diagnosis, oscillating between sickness and health, destabilizing the family dynamic), powerlessness in deteriorating health (preoccupation with impending mortality, vulnerability to catastrophic complications, exhaustion from medical testing), enduring medical ordeals (traumatized by invasive procedures, disappointed by treatment failure, displaced by transition, valuing empathy and continuity in care, overcoming uncertainty with information), warring with the body (losing stamina, distressing inability to participate in sport, distorted body image, testing the limits), hampering potential and goals (feeling disabled, unfair judgment and exclusion, difficulties with academic achievement, limiting attainment and maintenance of life milestones), and establishing one's own pace (demarcating disease from life, determination to survive, taking limitations in their stride, embracing the positives, finding personal enrichment, relying on social or spiritual support). Children with CHD feel vulnerable and burdened by debilitating physical symptoms, unpredictable complications, and discrimination. Clinicians may support patients by sharing recognition of these profound psychosocial consequences. What is Known: • CHD is associated with difficulties in learning and attention, school absenteeism, decreased endurance, poor body image, and peer socialization • What is lesser known is how young patients cope with the symptoms, prognostic uncertainty, and treatment burden What is New: • We found that children are challenged by lifestyle restrictions, fear of invasive procedures, impaired body

  13. Management of sleep bruxism in adults: a qualitative systematic literature review.

    Science.gov (United States)

    Manfredini, Daniele; Ahlberg, Jari; Winocur, Ephraim; Lobbezoo, Frank

    2015-11-01

    This paper updates the bruxism management review published by Lobbezoo et al. in 2008 (J Oral Rehabil 2008; 35: 509-23). The review focuses on the most recent literature on management of sleep bruxism (SB) in adults, as diagnosed with polysomnography (PSG) with audio-video (AV) recordings, or with any other approach measuring the sleep-time masticatory muscles' activity, viz., PSG without AV recordings or electromyography (EMG) recorded with portable devices. Fourteen (N = 14) papers were included in the review, of which 12 were randomised controlled trials (RCTs) and 2 were uncontrolled before-after studies. Structured reading of the included articles showed a high variability of topics, designs and findings. On average, the risk of bias for RCTs was low-to-unclear, whilst the before-after studies had several methodological limitations. The studies' results suggest that (i) almost every type of oral appliance (OA) (seven papers) is somehow effective to reduce SB activity, with a potentially higher decrease for devices providing large extent of mandibular advancement; (ii) all tested pharmacological approaches [i.e. botulinum toxin (two papers), clonazepam (one paper) and clonidine (one paper)] may reduce SB with respect to placebo; (iii) the potential benefit of biofeedback (BF) and cognitive-behavioural (CB) approaches to SB management is not fully supported (two papers); and (iv) the only investigation providing an electrical stimulus to the masseter muscle supports its effectiveness to reduce SB. It can be concluded that there is not enough evidence to define a standard of reference approach for SB treatment, except for the use of OA. Future studies on the indications for SB treatment are recommended. © 2015 John Wiley & Sons Ltd.

  14. Young adults' perspectives on living with kidney failure: a systematic review and thematic synthesis of qualitative studies.

    Science.gov (United States)

    Bailey, Phillippa K; Hamilton, Alexander J; Clissold, Rhian L; Inward, Carol D; Caskey, Fergus J; Ben-Shlomo, Yoav; Owen-Smith, Amanda

    2018-01-10

    Young adults fare worse than younger adolescents or older adults on a broad range of health indicators. Those with a chronic illness such as renal failure are a particularly vulnerable group, who experience poor outcomes compared with both children and older adults. Understanding how being in receipt of renal replacement therapy (RRT) affects the lives of young adults might help us to better prepare and support these individuals for and on RRT, and improve outcomes. This study aimed to synthesise research describing young adults' experiences of the psychosocial impact of kidney failure and RRT. A systematic literature review identified qualitative research reporting the perspectives of people aged 16-30 years receiving RRT on the psychosocial impact of renal failure. Electronic databases (including Medline/EMBASE/PsycINFO/ASSIA) were searched to November 2017 for full-text papers. The transparency of reporting of each study was assessed using the Consolidated Criteria for Reporting Qualitative Health Research (COREQ) framework. Quality was assessed using the Critical Appraisal Skills Programme qualitative checklist. An inductive thematic synthesis was undertaken. Seven studies from five different countries were included, comprising 123 young adults receiving RRT. Comprehensiveness of reporting was variable: studies reported 9-22 of the 32 COREQ-checklist items.Three global themes about the impact of kidney failure on young adults were identified: (1) difference desiring normality, (2) thwarted or moderated dreams and ambitions, and (3) uncertainty and liminality. These reflected five organising themes: (1) physical appearance and body image, (2) activity and participation, (3) educational disruption and underachievement, (4) career ambitions and employment difficulties, and (5) social isolation and intimate relationships. Across different countries and different healthcare settings, young adults on RRT experience difference and liminality, even after

  15. Limits to modern contraceptive use among young women in developing countries: a systematic review of qualitative research

    Directory of Open Access Journals (Sweden)

    Wight Daniel

    2009-02-01

    Full Text Available Abstract Background Improving the reproductive health of young women in developing countries requires access to safe and effective methods of fertility control, but most rely on traditional rather than modern contraceptives such as condoms or oral/injectable hormonal methods. We conducted a systematic review of qualitative research to examine the limits to modern contraceptive use identified by young women in developing countries. Focusing on qualitative research allows the assessment of complex processes often missed in quantitative analyses. Methods Literature searches of 23 databases, including Medline, Embase and POPLINE®, were conducted. Literature from 1970–2006 concerning the 11–24 years age group was included. Studies were critically appraised and meta-ethnography was used to synthesise the data. Results Of the 12 studies which met the inclusion criteria, seven met the quality criteria and are included in the synthesis (six from sub-Saharan Africa; one from South-East Asia. Sample sizes ranged from 16 to 149 young women (age range 13–19 years. Four of the studies were urban based, one was rural, one semi-rural, and one mixed (predominantly rural. Use of hormonal methods was limited by lack of knowledge, obstacles to access and concern over side effects, especially fear of infertility. Although often more accessible, and sometimes more attractive than hormonal methods, condom use was limited by association with disease and promiscuity, together with greater male control. As a result young women often relied on traditional methods or abortion. Although the review was limited to five countries and conditions are not homogenous for all young women in all developing countries, the overarching themes were common across different settings and contexts, supporting the potential transferability of interventions to improve reproductive health. Conclusion Increasing modern contraceptive method use requires community-wide, multifaceted

  16. A systematic review of qualitative findings on factors enabling and deterring uptake of HIV testing in Sub-Saharan Africa.

    Science.gov (United States)

    Musheke, Maurice; Ntalasha, Harriet; Gari, Sara; McKenzie, Oran; Bond, Virginia; Martin-Hilber, Adriane; Merten, Sonja

    2013-03-11

    Despite Sub-Saharan Africa (SSA) being the epicenter of the HIV epidemic, uptake of HIV testing is not optimal. While qualitative studies have been undertaken to investigate factors influencing uptake of HIV testing, systematic reviews to provide a more comprehensive understanding are lacking. Using Noblit and Hare's meta-ethnography method, we synthesised published qualitative research to understand factors enabling and deterring uptake of HIV testing in SSA. We identified 5,686 citations out of which 56 were selected for full text review and synthesised 42 papers from 13 countries using Malpass' notion of first-, second-, and third-order constructs. The predominant factors enabling uptake of HIV testing are deterioration of physical health and/or death of sexual partner or child. The roll-out of various HIV testing initiatives such as 'opt-out' provider-initiated HIV testing and mobile HIV testing has improved uptake of HIV testing by being conveniently available and attenuating fear of HIV-related stigma and financial costs. Other enabling factors are availability of treatment and social network influence and support. Major barriers to uptake of HIV testing comprise perceived low risk of HIV infection, perceived health workers' inability to maintain confidentiality and fear of HIV-related stigma. While the increasingly wider availability of life-saving treatment in SSA is an incentive to test, the perceived psychological burden of living with HIV inhibits uptake of HIV testing. Other barriers are direct and indirect financial costs of accessing HIV testing, and gender inequality which undermines women's decision making autonomy about HIV testing. Despite differences across SSA, the findings suggest comparable factors influencing HIV testing. Improving uptake of HIV testing requires addressing perception of low risk of HIV infection and perceived inability to live with HIV. There is also a need to continue addressing HIV-related stigma, which is intricately

  17. Systematic review

    DEFF Research Database (Denmark)

    Momsen, Anne-Mette Hedeager; Hald, Kathrine; Nielsen, Claus Vinther

    2017-01-01

    REVIEW OBJECTIVE/QUESTION: The objective of this review is to identify the effectiveness of expanded cardiac rehabilitation (CR) in patients diagnosed with coronary heart disease (CHD). Specifically, the review question is: What is the effectiveness of expanded CR compared to standard CR in adult...

  18. Facilitators and Barriers of Smokers’ Compliance with Smoking Bans in Public Places: A Systematic Review of Quantitative and Qualitative Literature

    Directory of Open Access Journals (Sweden)

    Li Zhou

    2016-12-01

    Full Text Available Background: Environmental tobacco smoke (ETS exposure is associated with an increased risk of many diseases. Many countries have ratified a national smoking ban in public places, but studies on factors related to smoking issues in public places post-ban are lacking. Aim: To identify facilitators and barriers that influenced smokers’ compliance with smoking bans in public places. Methods: Using PubMed, MEDLINE, and the Web of Science database, we conducted a systematic search of English articles published before June 2015 on factors of smokers’ compliance with the smoking bans in public places. Results: A total of 390 references were identified, among which seventeen articles (twelve quantitative studies, two qualitative studies, three mixed-method studies were included in this review. These studies focused on four types of public places including recreational venues (n = 7, hospital (n = 5, school (n = 4, and workplace (n = 1. Factors at the  individual-, interpersonal-, and organizational-level were identified: at the individual level, nicotine dependence, insufficiency of tobacco-related knowledge, and the negative attitudes towards smoking bans were the most commonly identified barriers; at the interpersonal level, the smoking behaviors of people around, close relatives, and friends’ approval were the main barriers; and at the organizational level, the main barriers were inefficient implementation of the bans and the inconvenience of the designative smoking areas. Conclusions: This synthesis of the literature provided evidence of the identified barriers and facilitators of smokers’ compliance with the smoking bans. It will be beneficial for the policy-maker to consider interventions on multiple levels of factors to overcome the barriers and enhance smokers’ compliance with the smoking bans in public places.

  19. Supporting someone with an eating disorder: a systematic review of caregiver experiences of eating disorder treatment and a qualitative exploration of burnout management within eating disorder services

    OpenAIRE

    Fowler, Emma

    2016-01-01

    Aims: Eating disorder recovery is often supported by caregivers and mental health professionals. This research portfolio focuses on the experiences of supporting someone with an eating disorder from the perspective of the caregivers and also mental health professionals. The aims of this research portfolio are: Firstly, to systematically review the published qualitative literature relating to the experiences of caregivers supporting someone during eating disorder treatment; and ...

  20. Barriers and facilitators to physical activity in people with hip or knee osteoarthritis: protocol for a systematic review of qualitative evidence.

    Science.gov (United States)

    Kanavaki, Archontissa M; Rushton, Alison; Klocke, Rainer; Abhishek, Abhishek; Duda, Joan L

    2016-11-03

    This protocol aims to describe the objective and methods to be followed in a systematic review of qualitative studies on barriers and facilitators to physical activity (PA) in people with hip or knee osteoarthritis (OA). MEDLINE, EMBASE, PhychINFO, Web of Science, CINAHL, SPORTDiscus, Scopus and grey literature sources will be electronically searched. Hand search of qualitative research-centred journals, reference screening of relevant reviews and inquiries to researchers active in the field will complement the search. Studies will be selected if they apply qualitative or mixed-methods designs to directly explore factors that correspond to engagement in PA/exercise or, the perceptions regarding PA/exercise in people with hip or knee OA. The Critical Appraisal Skills Programme Qualitative Checklist and the evaluative criteria of credibility, transferability, dependability and confirmability will be applied for the study appraisal. 2 independent reviewers will perform the search, study selection and study appraisal. Thematic synthesis will be used for synthesising the findings of the primary studies and the process and product of the synthesis will be checked by a second researcher. ConQual approach will be used for assessing the confidence in the qualitative findings. This systematic review will inform our understanding of the PA determinants and how to optimise behaviour change in people living with hip or knee OA. The review findings will be reported in a peer-reviewed journal and presented at national or international conferences. The study raises no ethical issues. CRD42016030024. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  1. Understanding the Relationship between Teachers' Pedagogical Beliefs and Technology Use in Education: A Systematic Review of Qualitative Evidence

    Science.gov (United States)

    Tondeur, Jo; van Braak, Johan; Ertmer, Peggy A.; Ottenbreit-Leftwich, Anne

    2017-01-01

    This review was designed to further our understanding of the link between teachers' pedagogical beliefs and their educational uses of technology. The synthesis of qualitative findings integrates the available evidence about this relationship with the ultimate goal being to facilitate the integration of technology in education. A meta-aggregative…

  2. Peer support for parents of children with chronic disabling conditions: a systematic review of quantitative and qualitative studies.

    Science.gov (United States)

    Shilling, Val; Morris, Christopher; Thompson-Coon, Jo; Ukoumunne, Obioha; Rogers, Morwenna; Logan, Stuart

    2013-07-01

    To review the qualitative and quantitative evidence of the benefits of peer support for parents of children with disabling conditions in the context of health, well-being, impact on family, and economic and service implications. We comprehensively searched multiple databases. Eligible studies evaluated parent-to-parent support and reported on the psychological health and experience of giving or receiving support. There were no limits on the child's condition, study design, language, date, or setting. We sought to aggregate quantitative data; findings of qualitative studies were combined using thematic analysis. Qualitative and quantitative data were brought together in a narrative synthesis. Seventeen papers were included: nine qualitative studies, seven quantitative studies, and one mixed-methods evaluation. Four themes were identified from qualitative studies: (1) shared social identity, (2) learning from the experiences of others, (3) personal growth, and (4) supporting others. Some quantitative studies reported a positive effect of peer support on psychological health and other outcomes; however, this was not consistently confirmed. It was not possible to aggregate data across studies. No costing data were identified. Qualitative studies strongly suggest that parents perceive benefit from peer support programmes, an effect seen across different types of support and conditions. However, quantitative studies provide inconsistent evidence of positive effects. Further research should explore whether this dissonance is substantive or an artefact of how outcomes have been measured. © The Authors. Developmental Medicine & Child Neurology © 2013 Mac Keith Press.

  3. Systematic review

    DEFF Research Database (Denmark)

    Borup, H; Kirkeskov, L; Hanskov, Dorte Jessing Agerby

    2017-01-01

    . Conclusions: This review suggests that COPD occurs more often among construction workers than among workers who are not exposed to construction dust. It is not possible to draw any conclusions on specific subgroups as most studies analysed construction workers as one united group. In addition, no potential...

  4. Systematic review

    DEFF Research Database (Denmark)

    Helgstrand, John Thomas; Berg, Kasper Drimer; Lippert, Solvej

    2016-01-01

    trials have challenged this dogma. The aim of this study was to evaluate how endocrine therapy (ET) affects survival in different clinical settings of PCa. Materials and methods A review of published phase II, III and IV studies evaluating the effect of ET on survival was performed. Results In localized...

  5. Process evaluations of task sharing interventions for perinatal depression in low and middle income countries (LMIC): a systematic review and qualitative meta-synthesis.

    Science.gov (United States)

    Munodawafa, Memory; Mall, Sumaya; Lund, Crick; Schneider, Marguerite

    2018-03-23

    Perinatal depression is common in low and middle income countries (LAMICs). Task sharing interventions have been implemented to treat perinatal depression in these settings, as a way of dealing with staff shortages. Task sharing allows lay health workers to provide services for less complex cases while being trained and supervised by specialists. Randomized controlled trials suggest that these interventions can be effective but there is limited qualitative information exploring barriers and facilitators to their implementation. This systematic review aims to systematically review current qualitative evidence of process evaluations of task sharing interventions for perinatal depression in LAMICs in relation to the United Kingdom (UK) Medical Research Council (MRC) framework for conducting process evaluations. We searched Medline/ PubMed, PsycINFO, Scopus, Cochrane Library and Web of science for studies from LAMICS using search terms under the broad categories of: (a) "maternal depression'" (b) "intervention" (c) "lay counsellor" OR "community health worker" OR "non-specialist" and (d) "LAMICs". Abstracts were independently reviewed for inclusion by two authors. Full text articles were screened and data for included articles were extracted using a standard data extraction sheet. Qualitative synthesis of qualitative evidence was conducted. 8420 articles were identified from initial searches. Of these, 26 full text articles were screened for eligibility with only three studies meeting the inclusion criteria. Main findings revealed that participants identified the following crucial factors: contextual factors included physical location, accessibility and cultural norms. Implementation factors included acceptability of the intervention and characteristics of the personnel. Mechanisms included counsellor factors such as motivating and facilitating trust; intervention factors such as use of stories and visual aids, and understandability of the content; and participant

  6. Effects of complex interventions in 'skin cancer prevention and treatment': protocol for a mixed-method systematic review with qualitative comparative analysis.

    Science.gov (United States)

    Beifus, Karolina; Breitbart, Eckhard; Köberlein-Neu, Juliane

    2017-09-05

    Occurring from ultraviolet radiation combined with impairing ozone levels, uncritical sun exposure and use of tanning beds an increasing number of people are affected by different types of skin cancer. But preventive interventions like skin cancer screening are still missing the evidence for effectiveness and therefore are criticised. Fundamental for an appropriate course of action is to approach the defined parameters as measures for effectiveness critically. A prerequisite should be the critical application of used parameter that are defined as measures for effectiveness. This research seeks to establish, through the available literature, the effects and conditions that prove the effectiveness of prevention strategies in skin cancer. A mixed-method approach is employed to combine quantitative to qualitative methods and answer what effects can display effectiveness considering time horizon, perspective and organisational level and what are essential and sufficient conditions to prove effectiveness and cost-effectiveness in skin cancer prevention strategies. A systematic review will be performed to spot studies from any design and assess the data quantitatively and qualitatively. Included studies from each key question will be summarised by characteristics like population, intervention, comparison, outcomes, study design, endpoints, effect estimator and so on. Beside statistical relevancies for a systematic review the qualitative method of qualitative comparative analysis (QCA) will be performed. The estimated outcomes from this review and QCA are the accomplishment and absence of effects that are appropriate for application in effectiveness assessments and further cost-effectiveness assessment. Formal ethical approval is not required as primary data will not be collected. International Prospective Register for Systematic Reviews number CRD42017053859. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights

  7. Facilitators and barriers to the delivery of school-based smoking prevention interventions for children and young people: a protocol for a systematic review of qualitative studies.

    Science.gov (United States)

    Dobbie, Fiona; Angus, Kathryn; Littlecott, Hannah; Allum, Karen; Wells, Valerie; Amos, Amanda; Haw, Sally; Bauld, Linda

    2018-04-06

    Despite a decline in child and adult smoking prevalence, young people who smoke (even occasionally) can rapidly become addicted to nicotine, with most adult smokers initiating smoking before they are 18. Schools have long been a popular setting to deliver youth smoking prevention interventions, but evidence of the effectiveness of school-based prevention programmes is mixed, and outcomes vary by the type of programme delivered. Existing systematic reviews that explore the factors contributing to the success or failure of school-based smoking prevention programmes often exclude qualitative studies, due to a focus on intervention effectiveness which qualitative research cannot answer. Instead, qualitative research is focussed on the experiences and perceptions of those involved in the programmes. This systematic review will address this gap by updating a 2009 review to examine qualitative studies. The aim is to generate deeper insight to help target resources which have the potential to save lives by preventing smoking initiation among children and young people. This systematic review will be searching the following databases: the Cochrane Library, MEDLINE, EMBASE, PsycINFO, HMIC, ERIC, ASSIA, Web of Science and CINAHL. In order to identify additional references, we will consult the reference lists of a sample of systematic reviews and search relevant organizational websites in order to identify appropriate grey literature. The search strategy will include key words and database-specific subject headings relating to smoking, children and young people, health promotion and school. Authors will independently screen, assess data quality and extract data for synthesis. Study findings will be synthesised thematically using 'best-fit framework syntheses'. This allows for an existing set of themes to be used as a starting point to map or code included studies. These themes are then adapted as coding takes place to accommodate new emerging themes. This review will focus on

  8. Experiences of early labour management from perspectives of women, labour companions and health professionals: A systematic review of qualitative evidence.

    Science.gov (United States)

    Beake Rm Ma Research Associate, Sarah; Chang Ba MPhil PhD Lecturer, Yan-Shing; Cheyne Rm Rgn MSc PhD Professor Of Midwifery, Helen; Spiby MPhil Rn Rm Professor Of Midwifery, Helen; Sandall Rm MSc PhD Professor Of Social Science And Women's Health, Jane; Bick, Debra

    2018-02-01

    to examine evidence of women's, labour companions' and health professionals' experiences of management of early labour to consider how this could be enhanced to better reflect women's needs. a systematic review of qualitative evidence. women in early labour with term, low risk singleton pregnancies, not booked for a planned caesarean birth or post-dates induction of labour, their labour companions, and health professionals responsible for early labour care (e.g. midwives, nurse-midwives, obstetricians, family doctors). Studies from high and middle income country settings were considered. 21 publications were included from the UK, Ireland, Scandinavia, USA, Italy and New Zealand. Key findings included the impact of communication with health professionals (most usually midwives) on women's decision making; women wanting to be listened to by sympathetic midwives who could reassure that symptoms and signs of early labour were 'normal' and offer clear advice on what to do. Antenatal preparation which included realistic information on what to expect when labour commenced was important and appreciated by women and labour companions. Views of the optimal place for women to remain and allow early labour to progress differed and the perceived benefit of support and help offered by labour companions varied. Some were supportive and helped women to relax, while others were anxious and encouraged women to seek early admission to the planned place of birth. Web-based sources of information are increasingly used by women, with mixed views of the value of information accessed. women, labour companions and health professionals find early labour difficult to manage well, with women unsure of how decisions about admission to their planned place of birth are taken. It is unclear why women are effectively left to manage this aspect of their labour with minimal guidance or support. Tailoring management to meet individual needs, with provision of effective communication could reassure

  9. Public perceptions of non-pharmaceutical interventions for reducing transmission of respiratory infection: systematic review and synthesis of qualitative studies.

    Science.gov (United States)

    Teasdale, Emma; Santer, Miriam; Geraghty, Adam W A; Little, Paul; Yardley, Lucy

    2014-06-11

    Non-pharmaceutical public health interventions may provide simple, low-cost, effective ways of minimising the transmission and impact of acute respiratory infections in pandemic and non-pandemic contexts. Understanding what influences the uptake of non-pharmaceutical interventions such as hand and respiratory hygiene, mask wearing and social distancing could help to inform the development of effective public health advice messages. The aim of this synthesis was to explore public perceptions of non-pharmaceutical interventions that aim to reduce the transmission of acute respiratory infections. Five online databases (MEDLINE, PsycINFO, CINAHL, EMBASE and Web of Science) were systematically searched. Reference lists of articles were also examined. We selected papers that used a qualitative research design to explore perceptions and beliefs about non-pharmaceutical interventions to reduce transmission of acute respiratory infections. We excluded papers that only explored how health professionals or children viewed non-pharmaceutical respiratory infection control. Three authors performed data extraction and assessment of study quality. Thematic analysis and components of meta-ethnography were adopted to synthesise findings. Seventeen articles from 16 studies in 9 countries were identified and reviewed. Seven key themes were identified: perceived benefits of non-pharmaceutical interventions, perceived disadvantages of non-pharmaceutical interventions, personal and cultural beliefs about infection transmission, diagnostic uncertainty in emerging respiratory infections, perceived vulnerability to infection, anxiety about emerging respiratory infections and communications about emerging respiratory infections. The synthesis showed that some aspects of non-pharmaceutical respiratory infection control (particularly hand and respiratory hygiene) were viewed as familiar and socially responsible actions to take. There was ambivalence about adopting isolation and personal

  10. Influences on Decision-Making Regarding Antipsychotic Prescribing in Nursing Home Residents With Dementia: A Systematic Review and Synthesis of Qualitative Evidence.

    Science.gov (United States)

    Walsh, Kieran A; Dennehy, Rebecca; Sinnott, Carol; Browne, John; Byrne, Stephen; McSharry, Jennifer; Coughlan, Eoin; Timmons, Suzanne

    2017-10-01

    Antipsychotic prescribing is prevalent in nursing homes for the management of behavioral and psychological symptoms of dementia (BPSD), despite the known risks and limited effectiveness. Many studies have attempted to understand this continuing phenomenon, using qualitative research methods, and have generated varied and sometimes conflicting findings. To date, the totality of this qualitative evidence has not been systematically collated and synthesized. To synthesize the findings from individual qualitative studies on decision-making and prescribing behaviors for antipsychotics in nursing home residents with dementia, with a view to informing intervention development and quality improvement in this field. A systematic review and synthesis of qualitative evidence was conducted (PROSPERO protocol registration CRD42015029141). Six electronic databases were searched systematically from inception through July 2016 and supplemented by citation, reference, and gray literature searching. Studies were included if they used qualitative methods for both data collection and analysis, and explored antipsychotic prescribing in nursing homes for the purpose of managing BPSD. The Critical Appraisal Skills Program assessment tool was used for quality appraisal. A meta-ethnography was conducted to synthesize included studies. The Confidence in the Evidence from Reviews of Qualitative research approach was used to assess the confidence in individual review findings. All stages were conducted by at least 2 independent reviewers. Of 1534 unique records identified, 18 met the inclusion criteria. Five key concepts emerged as influencing decision-making: organizational capacity; individual professional capability; communication and collaboration; attitudes; regulations and guidelines. A "line of argument" was synthesized and a conceptual model constructed, comparing this decision-making process to a dysfunctional negative feedback loop. Our synthesis indicates that when all stakeholders

  11. What does the literature tell us about health workers' experiences of task-shifting projects in sub-Saharan Africa? A systematic, qualitative review.

    Science.gov (United States)

    Mijovic, Hana; McKnight, Jacob; English, Mike

    2016-08-01

    To review systematically, qualitative literature covering the implementation of task shifting in sub-Saharan Africa to address the growing interest in interventions of this kind. This review aims to distil the key practical findings to both guide a specific project aiming to improve the quality of neonatal care in Kenya and to contribute to the broader literature. Task-shifting programmes aim to improve access to healthcare by delegating specific tasks from higher to lower skilled health workers. Evidence suggests that task-shifting programmes in sub-Saharan Africa may improve patient outcomes, but they have also been criticised for providing fragmented, unsustainable services. This systematic review of qualitative literature summarises factors affecting implementation of task shifting and how such interventions in sub-Saharan Africa may have affected health workers' feelings about their own positions and their ability to provide care. Following literature search, a modified Critical Appraisal Skills Program (CASP) framework was used to assess quality. Thereafter, analysis adopted a thematic synthesis approach. A systematic literature search identified qualitative studies examining task -shifting interventions in sub-Saharan Africa. Thematic synthesis was used to identify overarching themes arising from across the studies and infer how task-shifting interventions may impact on the health workers from whom tasks are being shifted. From the 230 studies screened, 13 met the inclusion criteria. Overarching themes identified showed that task shifting has been associated with jurisdictional debates linked to new cadres working beyond their scope of practice, and tension around compensation and career development for those taking on tasks that were being delegated. Based on the qualitative data available, it appears that task shifting may negatively impact the sense of agency and the ability to perform of health workers' from whom tasks are shifted. The potential

  12. Stigma-related barriers and facilitators to help seeking for mental health issues in the armed forces: a systematic review and thematic synthesis of qualitative literature.

    Science.gov (United States)

    Coleman, S J; Stevelink, S A M; Hatch, S L; Denny, J A; Greenberg, N

    2017-08-01

    A recent quantitative review in the area of stigma and help seeking in the armed forces has questioned the association between these factors (Sharp et al. 2015). To date, the contribution of qualitative literature in this area has largely been ignored, despite the value this research brings to the understanding of complex social constructs such as stigma. The aim of the current systematic review of qualitative studies was to identify appropriate literature, assess the quality and synthesize findings across studies regarding evidence of stigma-related barriers and facilitators to help seeking for mental health issues within the armed forces. A multi-database text word search incorporating searches of PsycINFO, MEDLINE, Social Policy and Practice, Social Work Abstracts, EMBASE, ERIC and EBM Review databases between 1980 and April 2015 was conducted. Literature was quality assessed using the Critical Appraisal Skills Programme tool. Thematic synthesis was conducted across the literature. The review identified eight studies with 1012 participants meeting the inclusion criteria. Five overarching themes were identified across the literature: (1) non-disclosure; (2) individual beliefs about mental health; (3) anticipated and personal experience of stigma; (4) career concerns; and (5) factors influencing stigma. The findings from the current systematic review found that unlike inconsistent findings in the quantitative literature, there was substantial evidence of a negative relationship between stigma and help seeking for mental health difficulties within the armed forces. The study advocates for refinement of measures to accurately capture the complexity of stigma and help seeking in future quantitative studies.

  13. The knowledge, attitudes and beliefs of patients and their healthcare professionals around oral dosage form modification: A systematic review of the qualitative literature.

    Science.gov (United States)

    Mc Gillicuddy, Aoife; Kelly, Maria; Crean, Abina M; Sahm, Laura J

    The objective of this systematic review was to synthesize the available qualitative evidence on the knowledge, attitudes and beliefs of adult patients, healthcare professionals and carers about oral dosage form modification. A systematic review and synthesis of qualitative studies was undertaken, utilising the thematic synthesis approach. The following databases were searched from inception to September 2015: PubMed, Medline (EBSCO), EMBASE, CINAHL, PsycINFO, Web of Science, ProQuest Databases, Scopus, Turning Research Into Practice (TRIP), Cochrane Central Register of Controlled Trials (CENTRAL) and the Cochrane Database of Systematic Reviews (CDSR). Citation tracking and searching the references lists of included studies was also undertaken. Grey literature was searched using the OpenGrey database, internet searching and personal knowledge. An updated search was undertaken in June 2016. Studies meeting the following criteria were eligible for inclusion; (i) used qualitative data collection and analysis methods; (ii) full-text was available in English; (iii) included adult patients who require oral dosage forms to be modified to meet their needs or; (iv) carers or healthcare professionals of patients who require oral dosage forms to be modified. Two reviewers independently appraised the quality of the included studies using the Critical Appraisal Skills Programme Checklist. A thematic synthesis was conducted and analytical themes were generated. Of 5455 records screened, seven studies were eligible for inclusion; three involved healthcare professionals and the remaining four studies involved patients. Four analytical themes emerged from the thematic synthesis: (i) patient-centred individuality and variability; (ii) communication; (iii) knowledge and uncertainty and; (iv) complexity. The variability of individual patient's requirements, poor communication practices and lack of knowledge about oral dosage form modification, when combined with the complex and multi

  14. Participant views and experiences of participating in HIV research in sub-Saharan Africa: a qualitative systematic review.

    Science.gov (United States)

    Nalubega, Sylivia; Evans, Catrin

    2015-06-12

    Human immunodeficiency virus clinical trials are increasingly being conducted in sub-Saharan Africa. There is a tension between the pressure to increase levels of research participation and the need to ensure informed consent and protection of participants' rights. Researchers need to be aware of the particular ethical issues that underpin Human immunodeficiency virus research conduct in low income settings. This necessitates hearing from those who have participated in research and who have direct experience of the research process. This review aimed to synthesize and present the best available evidence in relation to Human immunodeficiency virus research participation in sub-Saharan Africa, based on the views and experiences of research participants. The review included studies whose participants were current or former adult Human immunodeficiency virus research participants from sub-Saharan African countries. Views, experiences, attitudes, understandings, perceptions and perspectives of Human immunodeficiency virus research participants in sub-Saharan Africa. Types of studies: This review considered studies that focused on qualitative data, including, but not limited to, designs such as phenomenology, ethnography, grounded theory, action research and feminist research. A three-step search strategy was utilized. Seven databases (CINAHL, Ovid MEDLINE (R) 1946, ASSIA, PsychInfo, Web of Science, EMBASE, and African Index Medicus) were searched with no limitation to years of publication, followed by hand searching of reference lists. Only studies published in the English language were considered. Methodological quality was assessed using the Qualitative Assessment and Review Instrument developed by the Joanna Briggs Institute. Qualitative findings were extracted using the Joanna Briggs Institute Qualitative Assessment and Review Instrument. Qualitative research findings were pooled using a pragmatic meta-aggregative approach and the Joanna Briggs Institute Qualitative

  15. Effectiveness of rifampicin chemoprophylaxis in preventing leprosy in patient contacts: a systematic review of quantitative and qualitative evidence.

    Science.gov (United States)

    Ferreira, Silvana Margarida Benevides; Yonekura, Tatiana; Ignotti, Eliane; Oliveira, Larissa Bertacchini de; Takahashi, Juliana; Soares, Cassia Baldini

    2017-10-01

    Individuals in contact with patients who have leprosy have an increased risk of disease exposure, which reinforces the need for chemoprophylactic measures, such as the use of rifampicin. The objective of the review was to synthesize the best available evidence regarding the effectiveness of rifampicin chemoprophylaxis for contacts with patients with leprosy, and to synthesize the best available evidence on the experience and acceptability of rifampicin chemoprophylaxis as reported by the contacts and health professionals involved in the treatment of leprosy or Hansen's disease. In the quantitative component, individuals in contact with leprosy patients were included. In the qualitative component, in addition to contacts, health professionals who were in the practice of treating leprosy were included. The quantitative component considered as an intervention rifampicin at any dose, frequency and mode of administration, and rifampicin combination regimens.The qualitative component considered as phenomena of interest the experience and acceptability of rifampicin chemoprophylaxis. The quantitative component considered experimental and observational studies whereas the qualitative component considered studies that focused on qualitative data, including but not limited to, designs such as phenomenology, grounded theory, ethnography and action-research. The quantitative component considered studies that reported on outcomes such as the development of clinical leprosy in the contacts of patients who had leprosy, incidence rates, adverse effects and safety/harmful effects of the intervention. A three-step strategy for published and unpublished literature was used. The search for published studies included: PubMed, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, Scopus, Web of Science, National Institute for Health and Clinical Excellence, Latin American and Caribbean Health Sciences Literature; and Google Scholar and EVIPnet for unpublished

  16. The perceived effectiveness of traditional and faith healing in the treatment of mental illness: a systematic review of qualitative studies.

    Science.gov (United States)

    van der Watt, A S J; van de Water, T; Nortje, G; Oladeji, B D; Seedat, S; Gureje, O

    2018-04-25

    This work complements a quantitative review by Nortje et al. (Lancet Psychiatry 3(2):154-170, 2016) by exploring the qualitative literature in regard to the perceived effectiveness of traditional and faith healing of mental disorders. Qualitative studies focusing specifically on traditional and/or faith healing practices for mental illness were retrieved from eight databases. Data were extracted  into basic coding sheets to facilitate the assessment of the quality of eligible papers using the COREQ. Sixteen articles met the inclusion criteria. Despite methodological limitations, there was evidence from the papers that stakeholders perceived traditional and/or faith healing to be effective in treating mental illness, especially when used in combination with biomedical treatment. Patients will continue to seek treatment from traditional and/or faith healers for mental illness if they perceive it to be effective regardless of alternative biomedical evidence. This provides opportunities for collaboration to address resource scarcity in low to middle income countries.

  17. An exploration of adolescents' decisions to abstain or refrain from alcohol consumption in Australian social settings: a qualitative systematic review.

    Science.gov (United States)

    Sharrad, Sue; de, Charlotte; Aylward, Paul; Wiechula, Rick

    2015-10-01

    A significant number of Australian adolescents consume alcohol, with almost two thirds of them doing so at risky levels. This is continuing to increase despite recent National Health and Medical Research Council (NHMRC) guidelines stipulating that no alcohol is the safest option. Measures initiated to reduce and prevent alcohol consumption by adolescents have limited effectiveness. Consumption of alcohol by Australian adolescents is a national concern because of the deleterious effects of alcohol consumption on adolescents' social, physical and neurological development, as well as other short- and long-term health risks, and the negative impact of alcohol-related violence and injury on the community. Understanding adolescents' decisions to abstain or refrain from alcohol consumption may provide valuable insights to assist in dealing with this significant social and health issue, more particularly about the mechanisms used by adolescents or their ability to make decisions about resisting or abstaining from alcohol consumption when exposed to alcohol in their social setting(s). The review aimed to synthesize the best available qualitative evidence on the decisions made or mechanisms used by adolescents who abstain or refrain from consuming alcohol in any social setting where alcohol is available. Adolescents aged between 14 and 19 years who reside in Australia.The phenomenon of interest was abstinence from or resistance to alcohol consumption when exposed to alcohol in social situations.This review considered studies that focused on qualitative data, including, but not limited to,designs such as phenomenology, grounded theory, action research and exploratory studies. A three-step search strategy was used. An initial search to identify keywords only was undertaken in Medline and CINAHL. This was followed by an expanded search using all identified keywords and index terms specific to each included database. The reference lists of included papers were then searched for

  18. How do older adults experience and perceive socially assistive robots in aged care: a systematic review of qualitative evidence.

    Science.gov (United States)

    Vandemeulebroucke, Tijs; de Casterlé, Bernadette Dierckx; Gastmans, Chris

    2018-02-01

    The aim of this review was to gain a better understanding of how older adults experience, perceive, think, and feel about the use of socially assistive robots (SARs) in aged care settings. We conducted a literature search for studies that used a qualitative or a mixed-method approach having a significant qualitative element. Pubmed, Cinahl, Embase, Scopus, and Web of Science electronic databases were queried. Candidate articles published in journals and conference proceedings were considered for review. Two independent reviewers assessed the included studies for methodological quality using the Critical Appraisal Skills Program, after which data on subjects' self-reported opinions and perceptions were extracted and synthesized using thematic analyses. Seventeen studies producing 23 publications were included. Based on the opinions of older adults, four themes emerged in relation to the use of SARS: (1) roles of a SAR; (2) interaction between the older adult and the SAR, which could be further subdivided into (a) the technical aspect of the interaction and (b) the human aspect of the interaction; (3) appearance of the SAR; and (4) normative/ethical issues regarding the use of SARs in aged care. Older adults have clear positive and negative opinions about different aspects of SARs in aged care. Nonetheless, some opinions can be ambiguous and need more attention if SARs are to be considered for use in aged care. Understanding older adults' lived experiences with SARs creates the possibility of using an approach that embeds technological innovation into the care practice itself.

  19. A qualitative systematic review of internal and external influences on shared decision-making in all health care settings.

    Science.gov (United States)

    Truglio-Londrigan, Marie; Slyer, Jason T; Singleton, Joanne K; Worral, Priscilla

    noted. Additional research points to patient satisfaction and enhanced quality of life. There is some evidence to suggest that shared decision-making does facilitate positive health outcomes.In today's healthcare environment there is greater emphasis on patient-centered care that exemplifies patient engagement, participation, partnership, and shared decision-making. Given the shift from the more autocratic delivery of care to the shared approach there is a need to more fully understand the what of shared decision-making as well as how shared decision-making takes place along with what internal and external influences may encourage, support, and facilitate the shared decision-making process. These influences are intervening variables that may be of significance for the successful development of practice-based strategies that may foster shared decision-making in practice. The purpose of this qualitative systematic review is to identify internal and external influences on shared decision-making in all health care settings.A preliminary search of the Joanna Briggs Library of Systematic Reviews, MEDLINE, CINAHL, and PROSPERO did not identify any previously conducted qualitative systematic reviews on the meaningfulness of internal and external influences on shared decision-making.

  20. Challenges, coping strategies, and recommendations related to the HIV services field in the HAART era: a systematic literature review of qualitative studies from the United States and Canada.

    Science.gov (United States)

    Kerr, Zachary Y; Miller, Katye R; Galos, Dylan; Love, Randi; Poole, Charles

    2013-02-01

    Qualitative research methods have been utilized to study the nature of work in the HIV services field. Yet current literature lacks a Highly Active Anti-Retroviral Treatment (HAART) era compendium of qualitative research studying challenges and coping strategies in the field. This study systematically reviewed challenges and coping strategies that qualitative researchers observed in the HIV services field during the HAART era, and their recommendations to organizations. Four online databases were searched for peer-reviewed research that utilized qualitative methods, were published from January 1998 to February 2012, utilized samples of individuals in the HIV services field; occurred in the U.S. or Canada, and contained information related to challenges and/or coping strategies. Abstracts were identified (n=846) and independently read and coded for inclusion by at least two of the four first authors. Identified articles (n=26) were independently read by at least two of the four first authors who recorded the study methodology, participant demographics, challenges and coping strategies, and recommendations. A number of challenges affecting those in the HIV services field were noted, particularly interpersonal and organizational issues. Coping strategies were problem- and emotion-focused. Summarized research recommendations called for increased support, capacity-building, and structural changes. Future research on challenges and coping strategies must provide up-to-date information to the HIV services field while creating, implementing, and evaluating interventions to manage current challenges and reduce the risk of burnout.

  1. Barriers and facilitators to patient and public engagement and recruitment to digital health interventions: protocol of a systematic review of qualitative studies.

    Science.gov (United States)

    O'Connor, Siobhan; Hanlon, Peter; O'Donnell, Catherine A; Garcia, Sonia; Glanville, Julie; Mair, Frances S

    2016-09-02

    Patients and the public are beginning to use digital health tools to assist in managing chronic illness, support independent living and self-care, and remain connected to health and care providers. However, engaging with and enrolling in digital health interventions, such as telehealth systems, mobile health applications, patient portals and personal health records, in order to use them varies considerably. Many factors affect people's ability to engage with and sign up to digital health platforms. The primary aim is to identify the barriers and facilitators patients and the public experience to engagement and recruitment to digital health interventions. The secondary aim is to identify engagement and enrolment strategies, leading if possible to a taxonomy of such approaches, and a conceptual framework of digital health engagement and recruitment processes. A systematic review of qualitative studies will be conducted by searching six databases: MEDLINE, CINAHL, PubMed, EMBASE, Scopus and the ACM Digital Library for papers published between 2000 and 2015. Titles and abstracts along with full-text papers will be screened by two independent reviewers against predetermined inclusion and exclusion criteria. A data extraction form will be used to provide details of the included studies. Quality assessment will be conducted using the Consolidated Criteria for Reporting Qualitative Research checklist. Any disagreements will be resolved through discussion with an independent third reviewer. Analysis will be guided by framework synthesis and informed by normalization process theory and burden of treatment theory, to aid conceptualisation of digital health engagement and recruitment processes. This systematic review of qualitative studies will explore factors affecting engagement and enrolment in digital health interventions. It will advance our understanding of readiness for digital health by examining the complex factors that affect patients' and the public's ability to

  2. Systematic review automation technologies

    Science.gov (United States)

    2014-01-01

    Systematic reviews, a cornerstone of evidence-based medicine, are not produced quickly enough to support clinical practice. The cost of production, availability of the requisite expertise and timeliness are often quoted as major contributors for the delay. This detailed survey of the state of the art of information systems designed to support or automate individual tasks in the systematic review, and in particular systematic reviews of randomized controlled clinical trials, reveals trends that see the convergence of several parallel research projects. We surveyed literature describing informatics systems that support or automate the processes of systematic review or each of the tasks of the systematic review. Several projects focus on automating, simplifying and/or streamlining specific tasks of the systematic review. Some tasks are already fully automated while others are still largely manual. In this review, we describe each task and the effect that its automation would have on the entire systematic review process, summarize the existing information system support for each task, and highlight where further research is needed for realizing automation for the task. Integration of the systems that automate systematic review tasks may lead to a revised systematic review workflow. We envisage the optimized workflow will lead to system in which each systematic review is described as a computer program that automatically retrieves relevant trials, appraises them, extracts and synthesizes data, evaluates the risk of bias, performs meta-analysis calculations, and produces a report in real time. PMID:25005128

  3. Service user experiences of specialist mental health supported accommodation: A systematic review of qualitative studies and narrative synthesis.

    Science.gov (United States)

    Krotofil, Joanna; McPherson, Peter; Killaspy, Helen

    2018-04-02

    Specialist supported accommodation services have become a key component of most community-based mental healthcare systems. While mental health policies highlight the importance of service user involvement in service development and care planning, there are no comprehensive literature reviews synthesising services users' perspectives on, or experiences of, supported accommodation services. This systematic review was undertaken to fill this gap. We searched electronic databases (January 2015, updated June 2017), conducted hand searches and used forward-backward snowballing to identify 13,678 papers. We inspected the full-text of 110 papers and included 50 of these in the final review. Data extraction and quality assessments were conducted. We used narrative synthesis to develop a conceptual model of service users' experiences that included structural, process, relational and contextual factors, such as the characteristics of the service, relationships with staff and other service users, the intensity and nature of support, the physical environment, and social and community integration. The review highlights the complex interplay of individual, service-level and community factors in shaping the lived experience of service users and their impact on personal identity and recovery. Our approach addressed some of the widely reported limitations of the quantitative research in this field, providing a conceptual model relevant to service user experiences across supported accommodation service types, population groups and countries. © 2018 John Wiley & Sons Ltd.

  4. The Impact of Antenatal Psychological Group Interventions on Psychological Well-Being: A Systematic Review of the Qualitative and Quantitative Evidence

    Directory of Open Access Journals (Sweden)

    Franziska Wadephul

    2016-06-01

    Full Text Available Depression, anxiety and stress in the perinatal period can have serious, long-term consequences for women, their babies and their families. Over the last two decades, an increasing number of group interventions with a psychological approach have been developed to improve the psychological well-being of pregnant women. This systematic review examines interventions targeting women with elevated symptoms of, or at risk of developing, perinatal mental health problems, with the aim of understanding the successful and unsuccessful features of these interventions. We systematically searched online databases to retrieve qualitative and quantitative studies on psychological antenatal group interventions. A total number of 19 papers describing 15 studies were identified; these included interventions based on cognitive behavioural therapy, interpersonal therapy and mindfulness. Quantitative findings suggested beneficial effects in some studies, particularly for women with high baseline symptoms. However, overall there is insufficient quantitative evidence to make a general recommendation for antenatal group interventions. Qualitative findings suggest that women and their partners experience these interventions positively in terms of psychological wellbeing and providing reassurance of their ‘normality’. This review suggests that there are some benefits to attending group interventions, but further research is required to fully understand their successful and unsuccessful features.

  5. The Impact of Antenatal Psychological Group Interventions on Psychological Well-Being: A Systematic Review of the Qualitative and Quantitative Evidence.

    Science.gov (United States)

    Wadephul, Franziska; Jones, Catriona; Jomeen, Julie

    2016-06-08

    Depression, anxiety and stress in the perinatal period can have serious, long-term consequences for women, their babies and their families. Over the last two decades, an increasing number of group interventions with a psychological approach have been developed to improve the psychological well-being of pregnant women. This systematic review examines interventions targeting women with elevated symptoms of, or at risk of developing, perinatal mental health problems, with the aim of understanding the successful and unsuccessful features of these interventions. We systematically searched online databases to retrieve qualitative and quantitative studies on psychological antenatal group interventions. A total number of 19 papers describing 15 studies were identified; these included interventions based on cognitive behavioural therapy, interpersonal therapy and mindfulness. Quantitative findings suggested beneficial effects in some studies, particularly for women with high baseline symptoms. However, overall there is insufficient quantitative evidence to make a general recommendation for antenatal group interventions. Qualitative findings suggest that women and their partners experience these interventions positively in terms of psychological wellbeing and providing reassurance of their 'normality'. This review suggests that there are some benefits to attending group interventions, but further research is required to fully understand their successful and unsuccessful features.

  6. Patient, nursing and medical staff experiences and perceptions of the care of people with palliative esophagogastric cancer: a systematic review of the qualitative evidence.

    Science.gov (United States)

    Cowley, Alison; Evans, Catrin; Bath-Hextall, Fiona; Cooper, Joanne

    2016-10-01

    Esophagogastric cancer is the fifth most common malignancy and its incidence is increasing. The disease progresses quickly and five-year survival rates are poor. Treatment with palliative intent is provided for the majority of patients but there remains a lack of empirical evidence on the most effective service models to support esophagogastric cancer patients. The overall objective of this systematic review was to synthesize the best available evidence on the experiences and perceptions of patients and health professionals with regard to the care of people diagnosed with palliative esophagogastric cancer. The review considered studies that included patients diagnosed with palliative esophagogastric cancer and any health professionals involved in the delivery of palliative care to this patient group in a hospital, home or community setting. The review considered studies that investigated the experiences and perceptions of people diagnosed with palliative esophagogastric cancer and staff working with these people. Studies that were carried out in any setting, including in-patient and outpatient areas, specialist cancer and non-specialist palliative care services and those were any patient were in receipt or had experiences of palliative care services were considered. All types of health practitioners delivering palliative care to esophagogastric cancer patients were considered. Studies that focused on qualitative data, including, but not limited to, designs such as phenomenology, grounded theory, ethnography, action research, feminist research and narrative approaches were considered. Mixed methods studies were considered in the review only if qualitative findings were reported separately. A three-step search strategy was utilized. A total 11 databases were searched for studies from 2000 onward, followed by hand searching of reference lists. Methodological quality was assessed using the Joanna Briggs Institute Qualitative Assessment and Review Instrument critical

  7. Patient and healthcare provider barriers to hypertension awareness, treatment and follow up: a systematic review and meta-analysis of qualitative and quantitative studies.

    Directory of Open Access Journals (Sweden)

    Rasha Khatib

    Full Text Available BACKGROUND: Although the importance of detecting, treating, and controlling hypertension has been recognized for decades, the majority of patients with hypertension remain uncontrolled. The path from evidence to practice contains many potential barriers, but their role has not been reviewed systematically. This review aimed to synthesize and identify important barriers to hypertension control as reported by patients and healthcare providers. METHODS: Electronic databases MEDLINE, EMBASE and Global Health were searched systematically up to February 2013. Two reviewers independently selected eligible studies. Two reviewers categorized barriers based on a theoretical framework of behavior change. The theoretical framework suggests that a change in behavior requires a strong commitment to change [intention], the necessary skills and abilities to adopt the behavior [capability], and an absence of health system and support constraints. FINDINGS: Twenty-five qualitative studies and 44 quantitative studies met the inclusion criteria. In qualitative studies, health system barriers were most commonly discussed in studies of patients and health care providers. Quantitative studies identified disagreement with clinical recommendations as the most common barrier among health care providers. Quantitative studies of patients yielded different results: lack of knowledge was the most common barrier to hypertension awareness. Stress, anxiety and depression were most commonly reported as barriers that hindered or delayed adoption of a healthier lifestyle. In terms of hypertension treatment adherence, patients mostly reported forgetting to take their medication. Finally, priority setting barriers were most commonly reported by patients in terms of following up with their health care providers. CONCLUSIONS: This review identified a wide range of barriers facing patients and health care providers pursuing hypertension control, indicating the need for targeted multi

  8. F229. THE BIOLOGICAL UNDERPINNINGS OF TREATMENT RESPONSE IN DELUSIONAL DISORDER: A SYSTEMATIC REVIEW OF QUALITATIVE EVIDENCE-TO-DATE

    Science.gov (United States)

    González-Rodríguez, Alexandre; Estrada, Francesc; Montalvo, Itziar; Monreal, José Antonio; Palao, Diego; Labad, Javier

    2018-01-01

    Abstract Background The dopamine hypothesis of schizophrenia has been extensively proposed as a neurobiological mechanism that explains the relationship between schizophrenic symptoms and hyperdopaminergic states. This hypothesis is supported by direct and indirect evidence, and it mainly postulates that antipsychotics act blocking dopamine receptors. When focusing on delusional disorder patients, especially delusional disorder somatic type, a great effort towards the search for a biological basis of treatment response has been recently demonstrated. Thus, the main goal of this systematic review was to examine the evidence explaining the biological underpinnings of treatment response in delusional disorder. Methods A systematic review was performed using Pubmed, Scopus and PsycINFO databases (from 1990 to October 2017), according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The following search terms were used: [(‘treat*’ OR ‘therap*’ OR ‘biol*’) AND (‘delusional disorder’)]. This systematic computerized search was completed by additional studies hand-checked through reference lists from the included studies and review articles. Studies were only included if the met our inclusion criteria: (a) the International Classification of Diseases (ICD) or Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnosis for delusional disorder, (b) be published in peer-reviewed journals, (c) in English, German or Spanish, (d) and reporting a hypothesis for the biological basis of treatment response in delusional disorder, irrespective of method and study design. Exclusion criteria were: (a) studies including organic delusional disorder or (b) somatic delusions secondary to other psychiatric diagnoses. The literature search strategy, data extraction and synthesis was conducted independently by two authors (A.G.R, F.E.). When disagreement, it was solved by consensus. Results A total of 59 articles were

  9. Enhancing Public Health HIV Interventions: A Qualitative Meta-Synthesis and Systematic Review of Studies to Improve Linkage to Care, Adherence, and Retention

    Directory of Open Access Journals (Sweden)

    Joseph D. Tucker

    2017-03-01

    Full Text Available Although HIV services are expanding, few have reached the scale necessary to support universal viral suppression of individuals living with HIV. The purpose of this systematic review was to summarize the qualitative evidence evaluating public health HIV interventions to enhance linkage to care, antiretroviral drug (ARV adherence, and retention in care. We searched 19 databases without language restrictions. The review collated data from three separate qualitative evidence reviews addressing each of the three outcomes along the care continuum. 21,738 citations were identified and 24 studies were included in the evidence review. Among low and middle-income countries in Africa, men living with HIV had decreased engagement in interventions compared to women and this lack of engagement among men also influenced the willingness of their partners to engage in services. Four structural issues (poverty, unstable housing, food insecurity, lack of transportation mediated the feasibility and acceptability of public health HIV interventions. Individuals living with HIV identified unmet mental health needs that interfered with their ability to access HIV services. Persistent social and cultural factors contribute to disparities in HIV outcomes across the continuum of care, shaping the context of service delivery among important subpopulations.

  10. Qualitative Studies of Infant and Young Child Feeding in Lower-Income Countries: A Systematic Review and Synthesis of Dietary Patterns

    Directory of Open Access Journals (Sweden)

    Alessandra N. Bazzano

    2017-10-01

    Full Text Available Continued high rates of both under- and over-nutrition in low- and low-middle-income countries highlight the importance of understanding dietary practices such as early and exclusive breastfeeding, and dietary patterns such as timely, appropriate complementary feeding—these behaviors are rooted in complex cultural ecologies. A systematic review and synthesis of available qualitative research related to infant and young child dietary patterns and practices from the perspective of parents and families in low income settings is presented, with a focus on barriers and facilitators to achieving international recommendations. Data from both published and grey literature from 2006 to 2016 was included in the review. Quality assessment consisted of two phases (Critical Appraisal Skills Program (CASP guidelines and assessment using GRADE-CERQual, followed by synthesis of the studies identified, and subsequent thematic analysis and interpretation. The findings indicated several categories of both barriers and facilitators, spanning individual and system level factors. The review informs efforts aimed at improving child health and nutrition, and represents the first such comprehensive review of the qualitative literature, uniquely suited to understanding complex behaviors leading to infant and young child dietary patterns.

  11. Enhancing Public Health HIV Interventions: A Qualitative Meta-Synthesis and Systematic Review of Studies to Improve Linkage to Care, Adherence, and Retention.

    Science.gov (United States)

    Tucker, Joseph D; Tso, Lai Sze; Hall, Brian; Ma, Qingyan; Beanland, Rachel; Best, John; Li, Haochu; Lackey, Mellanye; Marley, Gifty; Rich, Zachary C; Sou, Ka-Lon; Doherty, Meg

    2017-03-01

    Although HIV services are expanding, few have reached the scale necessary to support universal viral suppression of individuals living with HIV. The purpose of this systematic review was to summarize the qualitative evidence evaluating public health HIV interventions to enhance linkage to care, antiretroviral drug (ARV) adherence, and retention in care. We searched 19 databases without language restrictions. The review collated data from three separate qualitative evidence reviews addressing each of the three outcomes along the care continuum. 21,738 citations were identified and 24 studies were included in the evidence review. Among low and middle-income countries in Africa, men living with HIV had decreased engagement in interventions compared to women and this lack of engagement among men also influenced the willingness of their partners to engage in services. Four structural issues (poverty, unstable housing, food insecurity, lack of transportation) mediated the feasibility and acceptability of public health HIV interventions. Individuals living with HIV identified unmet mental health needs that interfered with their ability to access HIV services. Persistent social and cultural factors contribute to disparities in HIV outcomes across the continuum of care, shaping the context of service delivery among important subpopulations. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  12. Culturally and linguistically diverse healthcare students' experiences of learning in a clinical environment: A systematic review of qualitative studies.

    Science.gov (United States)

    Mikkonen, Kristina; Elo, Satu; Kuivila, Heli-Maria; Tuomikoski, Anna-Maria; Kääriäinen, Maria

    2016-02-01

    Learning in the clinical environment of healthcare students plays a significant part in higher education. The greatest challenges for culturally and linguistically diverse healthcare students were found in clinical placements, where differences in language and culture have been shown to cause learning obstacles for students. There has been no systematic review conducted to examine culturally and linguistically diverse healthcare students' experiences of their learning in the clinical environment. This systematic review aims to identify culturally and linguistically diverse healthcare students' experiences of learning in a clinical environment. The search strategy followed the guidelines of the Centre of Reviews and Dissemination. The original studies were identified from seven databases (CINAHL, Medline Ovid, Scopus, Web of Science, Academic Search Premiere, Eric and Cochrane Library) for the period 2000-2014. Two researchers selected studies based on titles, abstracts and full texts using inclusion criteria and assessed the quality of studies independently. Twelve original studies were chosen for the review. The culturally and linguistically diverse healthcare students' learning experiences were divided into three influential aspects of learning in a clinical environment: experiences with implementation processes and provision; experiences with peers and mentors; and experiences with university support and instructions. The main findings indicate that culturally and linguistically diverse healthcare students embarking on clinical placements initially find integration stressful. Implementing the process of learning in a clinical environment requires additional time, well prepared pedagogical orientation, prior cultural and language education, and support for students and clinical staff. Barriers to learning by culturally and linguistically diverse healthcare students were not being recognized and individuals were not considered motivated; learners experienced the

  13. The meaningfulness of participating in support groups for informal caregivers of older adults with dementia: a qualitative systematic review

    DEFF Research Database (Denmark)

    Lauritzen, Jette; Pedersen, Preben Ulrich; Sørensen, Erik Elgaard

    Introduction: Support groups are considered an effective and economical way to relieve informal caregivers stress and burden. Research shows, that participating in support groups seems to be beneficial for the informal caregivers, but there are no significant improvements in feelings of stress...... and burden. It is unclear how support groups can produce a meaningful and optimal outcome for the informal caregivers. Aim: To identify the meaningfulness of participating in support groups for informal caregivers of older adults with dementia living in their own home. Method: A systematic literature review...... that through comparison and sharing positive and negative emotions, the members of the support group are able to take on and maintain the role as caregiver....

  14. Non-pharmacological interventions for attention-deficit/hyperactivity disorder (ADHD) delivered in school settings: systematic reviews of quantitative and qualitative research.

    Science.gov (United States)

    Richardson, Michelle; Moore, Darren A; Gwernan-Jones, Ruth; Thompson-Coon, Jo; Ukoumunne, Obioha; Rogers, Morwenna; Whear, Rebecca; Newlove-Delgado, Tamsin V; Logan, Stuart; Morris, Christopher; Taylor, Eric; Cooper, Paul; Stein, Ken; Garside, Ruth; Ford, Tamsin J

    2015-01-01

    BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterised by age-inappropriate levels of inattention, impulsivity and hyperactivity. School can be particularly challenging for children with ADHD. Few reviews have considered non-pharmacological interventions in school settings. OBJECTIVES To assess the effectiveness of non-pharmacological interventions delivered in school settings for pupils with, or at risk of, ADHD and to explore the factors that may enhance, or limit, their delivery. DATA SOURCES Twenty electronic databases (including PsycINFO, MEDLINE, EMBASE, Education Resources Information Centre, The Cochrane Library and Education Research Complete) were searched from 1980 to February-August 2013. Three separate searches were conducted for four systematic reviews; they were supplemented with forward and backwards citation chasing, website searching, author recommendations and hand-searches of key journals. REVIEW METHODS The systematic reviews focused on (1) the effectiveness of school-based interventions for children with or at risk of ADHD; (2) quantitative research that explores attitudes towards school-based non-pharmacological interventions for pupils with ADHD; (3) qualitative research investigating the attitudes and experiences of children, teachers, parents and others using ADHD interventions in school settings; and (4) qualitative research exploring the experience of ADHD in school among pupils, their parents and teachers more generally. Methods of synthesis included a random-effects meta-analysis, meta-regression and narrative synthesis for review 1, narrative synthesis for review 2 and meta-ethnography and thematic analysis for reviews 3 and 4. RESULTS For review 1, 54 controlled trials met the inclusion criteria. For the 36 meta-analysed randomised controlled trials, beneficial effects (p views about the impact of interventions, although it was clear that interventions both influence and are

  15. Barriers and facilitators to young children's physical activity and sedentary behaviour: a systematic review and synthesis of qualitative literature

    Science.gov (United States)

    Lakshman, R.; van Sluijs, E. M. F.

    2017-01-01

    Summary Positive activity behaviours (i.e. higher physical activity [PA]/lower sedentary behaviour [SB]) are beneficial from infancy, yet evidence suggests that young children (0‐ to 6‐year‐olds) are relatively inactive. To better understand the perceived influences on these behaviours and to aid intervention development, this paper systematically synthesizes the extensive qualitative literature regarding perceived barriers and facilitators to PA and SB in young children (0–6 years old). A search of eight electronic databases (July 2016) identified 43 papers for inclusion. Data extraction and evidence synthesis were conducted using thematic content analysis, underpinned by the socio‐ecological model (i.e. individual, interpersonal, community, organizational and policy levels). Parents, childcare providers and children perceived seven broad themes to be important for PA and SB, including the child; the home; out‐of‐home childcare; parent–childcare provider interactions; environmental factors; safety; and weather. Each theme mapped onto between one and five levels of the socio‐ecological model; barriers and facilitators at the interpersonal level (e.g. parents, care providers and family) were most frequently cited, reflecting the important (perceived) role adults/peers play in shaping young children's behaviours. We provide an overarching framework to explain PA and SB in early childhood. We also highlight where gaps in the current literature exist (e.g. from male carers; in developing countries; and barriers and facilitators in the environmental and policy domains) and where future quantitative work may focus to provide novel insights about children's activity behaviours (e.g. safety and weather). PMID:28589678

  16. The importance of service-users' perspectives: A systematic review of qualitative evidence reveals overlooked critical features of weight management programmes.

    Science.gov (United States)

    Sutcliffe, Katy; Melendez-Torres, G J; Burchett, Helen E D; Richardson, Michelle; Rees, Rebecca; Thomas, James

    2018-03-14

    Extensive research effort shows that weight management programmes (WMPs) targeting both diet and exercise are broadly effective. However, the critical features of WMPs remain unclear. To develop a deeper understanding of WMPs critical features, we undertook a systematic review of qualitative evidence. We sought to understand from a service-user perspective how programmes are experienced, and may be effective, on the ground. We identified qualitative studies from existing reviews and updated the searches of one review. We included UK studies capturing the views of adult WMP users. Thematic analysis was used inductively to code and synthesize the evidence. Service users were emphatic that supportive relationships, with service providers or WMP peers, are the most critical aspect of WMPs. Supportive relationships were described as providing an extrinsic motivator or "hook" which helped to overcome barriers such as scepticism about dietary advice or a lack confidence to engage in physical activity. The evidence revealed that service-users' understandings of the critical features of WMPs differ from the focus of health promotion guidance or descriptions of evaluated programmes which largely emphasize educational or goal setting aspects of WMPs. Existing programme guidance may not therefore fully address the needs of service users. The study illustrates that the perspectives of service users can reveal unanticipated intervention mechanisms or underemphasized critical features and underscores the value of a holistic understanding about "what happens" in complex psychosocial interventions such as WMPs. © 2017 The Authors Health Expectations published by John Wiley & Sons Ltd.

  17. Qualitative systematic review of barriers and facilitators to self-management of chronic obstructive pulmonary disease: views of patients and healthcare professionals.

    Science.gov (United States)

    Russell, Siân; Ogunbayo, Oladapo J; Newham, James J; Heslop-Marshall, Karen; Netts, Paul; Hanratty, Barbara; Beyer, Fiona; Kaner, Eileen

    2018-01-17

    Self-management interventions for chronic obstructive pulmonary disease (COPD) can improve quality of life, reduce hospital admissions, and improve symptoms. However, many factors impede engagement for patients and practitioners. Qualitative research, with its focus on subjective experience, can provide invaluable insights into such factors. Therefore, a systematic review and synthesis of qualitative evidence on COPD self-management from the perspective of patients, carers, and practitioners was conducted. Following a systematic search and screening, 31 studies were appraised and data extracted for analysis. This review found that patients can adapt to COPD; however, learning to self-manage is often a protracted process. Emotional needs are considerable; frustration, depression, and anxiety are common. In addition, patients can face an assortment of losses and limitations on their lifestyle and social interaction. Over time, COPD can consume their existence, reducing motivation. Support from family can prove vital, yet tinged with ambivalence and burden. Practitioners may not have sufficient time, resources, or appropriate skills or confidence to provide effective self-management support, particularly in regard to patients' psychosocial needs. This can compound patients' capability to engage in self-management. For COPD self-management to be effective, patients' psychosocial needs must be prioritised alongside medication and exacerbation management. In addition, patients' personal beliefs regarding COPD and its management should be reviewed periodically to avoid problematic behaviours and enhance positive adaptions to the disease. Patients with COPD are not a homogenous group and no one intervention will prove effective for all. Finally, practitioners require greater education, training, and support to successfully assist patients.

  18. The patient experience of patient-centered communication with nurses in the hospital setting: a qualitative systematic review protocol.

    Science.gov (United States)

    Newell, Stephanie; Jordan, Zoe

    2015-01-01

    The objective of this systematic review is to synthesize the eligible evidence of patients' experience of engaging and interacting with nurses, in the medical-surgical ward setting.This review will consider the following questions: Communication is a way in which humans make sense of the world around them. Communication takes place as an interactive two-way process or interaction, involving two or more people and can occur by nonverbal, verbal, face-to-face or non-face-to-face methods. Effective communication is described to occur when the sender of a message sends their message in a way that conveys the intent of their message and then is understood by the receiver of the message. As a result of the communication from both the sender and the receiver of the message a shared meaning is created between both parties.Communication can therefore be viewed as a reciprocal process. In the health care literature the terms communication and interaction are used interchangeably.Communication failures between clinicians are the most common primary cause of errors and adverse events in health care. Communication is a significant factor in patient satisfaction and complaints about care. Communication plays an integral role in service quality in all service professions including health care professions.Within healthcare, quality care has been defined by the Institute of Medicine as 'care that is safe, effective, timely, efficient, equitable and patient-centred'. Patient-centered care is defined as 'care that is respectful of and responsive to individual patient preferences, needs and values, and ensuring that patient's values guide all clinical decisions. Patient centered-care encompasses the 'individual experiences of a patient, the clinical service, the organizational and the regulatory levels of health care'. At the individual patient level, patient-centered care is care that is 'provided in a respectful manner, assures open and ongoing sharing of useful information in an

  19. Effectiveness of psychological interventions delivered by non-psychologists on low back pain and disability: a qualitative systematic review.

    Science.gov (United States)

    Bostick, Geoff P

    2017-11-01

    Psychological treatments delivered by non-psychologists have been proposed as a way to increase access to care to address important psychological barriers to recovery in people with low back pain (LBP). This review aimed to synthesize randomized controlled trials (RCTs) that assess the effectiveness of psychological interventions delivered by non-psychologists in reducing pain intensity and disability in adults with LBP, compared with usual care. A systematic review without meta-analysis was carried out. Randomized controlled trials including adult patients with all types of musculoskeletal LBP were eligible. Interventions included those based on psychological principles and delivered by non-psychologists. The primary outcomes of interest were self-reported pain intensity and disability. Information sources included Medline, EMBASE, and the Cochrane Central Registrar for Controlled Trials. The Cochrane Collaboration's tool for assessing risk of bias was used for the evaluation of internal validity. There were 1,101 records identified, 159 were assessed for eligibility, 16 were critically appraised, and 11 studies were included. Mild to moderate risk of bias was present in the included studies, with personnel and patient blinding, treatment fidelity, and attrition being the most common sources of bias. Considerable heterogeneity existed for patient population, intervention components, and comparison groups. Although most studies demonstrated statistical and clinical improvements in pain and disability, few were statistically superior to the comparison group. Consistent with the broader psychological literature, psychological interventions delivered by non-psychologists have modest effects on low back pain and disability. Additional high quality research is needed to understand what patients are likely to respond to psychological interventions, the appropriate dose to achieve the desired outcome, the amount of training required to implement psychological

  20. The Role of Physiotherapy Extended Scope Practitioners in Musculoskeletal care with Focus on Decision Making and Clinical Outcomes: A Systematic Review of Quantitative and Qualitative Research.

    Science.gov (United States)

    Thompson, Jonathan; Yoward, Samantha; Dawson, Pamela

    2017-06-01

    Physiotherapy extended scope practitioner (ESP) roles are widely utilized in the management of musculoskeletal conditions. The present article reviews the current literature, with particular emphasis on the decision-making process, patient/clinician interaction and clinical outcomes. A systematic review of musculoskeletal extended scope practice was carried out. The review focused on the outcome of interventions, and the interactions and decision-making processes between ESPs and their patients. A wide search strategy was employed, through multiple databases, grey literature and experts in the field. Qualitative and quantitative studies alike were included and a mixed-methods synthesis approach was undertaken in analysing the findings of included studies. A total of 476 articles were identified for inclusion, 25 of which (22 quantitative and three qualitative) meeting the criteria for full quality appraisal and synthesis. It was not possible to conduct a meta-analysis owing to data heterogeneity. The results showed high patient satisfaction with the ESP role, support for ESP staff listing patients for orthopaedic surgery, a high positive correlation of decision making between ESPs and orthopaedic surgeons and evidence of a positive impact on patient outcomes. Qualitative themes reflected the importance of ESP clinical decision making and interpersonal skills and their role in patient education. There is broad support for the physiotherapy ESP role and evidence of favourable outcomes from ESP intervention. Clinical decisions made by ESPs correlate well with those of medical colleagues, although there is a lack of detail explaining the ESP decision-making process itself and the influences and mechanisms by which this occurs. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  1. Stakeholders perspectives on the key components of community-based interventions coordinating care in dementia: a qualitative systematic review.

    Science.gov (United States)

    Backhouse, Amy; Richards, David A; McCabe, Rose; Watkins, Ross; Dickens, Chris

    2017-11-22

    Interventions aiming to coordinate services for the community-based dementia population vary in components, organisation and implementation. In this review we aimed to investigate the views of stakeholders on the key components of community-based interventions coordinating care in dementia. We searched four databases from inception to June 2015; Medline, The Cochrane Library, EMBASE and PsycINFO, this was aided by a search of four grey literature databases, and backward and forward citation tracking of included papers. Title and abstract screening was followed by a full text screen by two independent reviewers, and quality was assessed using the CASP appraisal tool. We then conducted thematic synthesis on extracted data. A total of seven papers from five independent studies were included in the review, and encompassed the views of over 100 participants from three countries. Through thematic synthesis we identified 32 initial codes that were grouped into 5 second-order themes: (1) case manager had four associated codes and described preferences for the case manager personal and professional attributes, including a sound knowledge in dementia and availability of local services; (2) communication had five associated codes and emphasized the importance stakeholders placed on multichannel communication with service users, as well as between multidisciplinary teams and across organisations; (3) intervention had 11 associated codes which focused primarily on the practicalities of implementation such as the contact type and frequency between case managers and service users, and the importance of case manager training and service evaluation; (4) resources had five associated codes which outlined stakeholder views on the required resources for coordinating interventions and potential overlap with existing resources, as well as arising issues when available resources do not meet those required for successful implementation; and (5) support had seven associated codes that

  2. Stakeholders perspectives on the key components of community-based interventions coordinating care in dementia: a qualitative systematic review

    Directory of Open Access Journals (Sweden)

    Amy Backhouse

    2017-11-01

    Full Text Available Abstract Background Interventions aiming to coordinate services for the community-based dementia population vary in components, organisation and implementation. In this review we aimed to investigate the views of stakeholders on the key components of community-based interventions coordinating care in dementia. Methods We searched four databases from inception to June 2015; Medline, The Cochrane Library, EMBASE and PsycINFO, this was aided by a search of four grey literature databases, and backward and forward citation tracking of included papers. Title and abstract screening was followed by a full text screen by two independent reviewers, and quality was assessed using the CASP appraisal tool. We then conducted thematic synthesis on extracted data. Results A total of seven papers from five independent studies were included in the review, and encompassed the views of over 100 participants from three countries. Through thematic synthesis we identified 32 initial codes that were grouped into 5 second-order themes: (1 case manager had four associated codes and described preferences for the case manager personal and professional attributes, including a sound knowledge in dementia and availability of local services; (2 communication had five associated codes and emphasized the importance stakeholders placed on multichannel communication with service users, as well as between multidisciplinary teams and across organisations; (3 intervention had 11 associated codes which focused primarily on the practicalities of implementation such as the contact type and frequency between case managers and service users, and the importance of case manager training and service evaluation; (4 resources had five associated codes which outlined stakeholder views on the required resources for coordinating interventions and potential overlap with existing resources, as well as arising issues when available resources do not meet those required for successful implementation

  3. Understanding of Factors that Enable Health Promoters in Implementing Health-Promoting Schools: A Systematic Review and Narrative Synthesis of Qualitative Evidence

    Science.gov (United States)

    Hung, Tommy Tsz Man; Chiang, Vico Chung Lim; Dawson, Angela; Lee, Regina Lai Tong

    2014-01-01

    Health-promoting schools have been regarded as an important initiative in promoting child and adolescent health in school settings using the whole-school approach. Quantitative research has proved its effectiveness in various school-based programmes. However, few qualitative studies have been conducted to investigate the strategies used by health promoters to implement such initiatives. In this study, the researchers conducted a systematic review and narrative synthesis of the qualitative literature to identify important enablers assisting the implementation of health-promoting schools from the perspectives of health promoters. Five enablers have been identified from the review: (a) Following a framework/guideline to implement health-promoting schools; (b) Obtaining committed support and contributions from the school staff, school board management, government authorities, health agencies and other stakeholders; (c) Adopting a multidisciplinary, collaborative approach to implementing HPS; (d) Establishing professional networks and relationships; and (e) Continuing training and education in school health promotion. This highlights the importance of developing school health policies that meet local health needs, and socio-cultural characteristics that can foster mutual understanding between the health and education sectors so as to foster health promotion in children and adolescents. PMID:25264789

  4. Generalist health professional's interactions with consumers who have a mental illness in nonmental health settings: A systematic review of the qualitative research.

    Science.gov (United States)

    Brunero, Scott; Ramjan, Lucie M; Salamonson, Yenna; Nicholls, Daniel

    2018-05-10

    Generalist health professionals (GHPs) or those healthcare professionals working in nonmental health facilities are increasingly being required to provide care to consumers with a mental illness. The review aimed to synthesize the qualitative research evidence on the meanings and interpretations made by GHPs (nonmental health professional) who interact with consumers with mental illness in nonmental health settings. A systematic review of the qualitative literature was undertaken for the years 1994-2016. The following electronic databases were searched: CINAHL, MEDLINE, PsycINFO, and Sociological Abstracts. Using narrative synthesis methods, the following themes were identified: mental health knowledge (the GHPs' knowledge level about mental illness and how this impacts their experiences and perceptions); GHPs perceive mental illness as a safety risk (GHPs concern over harm to the consumer and themselves); organizational support (the system response from the environmental design, and expert support and care); and emotional consequences of care (the feelings expressed by GHPs based on their experiences and perceptions of consumers). The results suggest that GHPs provide care in a setting which consists of multiple understandings of what care means. Efforts beyond educational initiatives such as organizational and system-level changes will need to be implemented if we are to progress care for this consumer group. © 2018 Australian College of Mental Health Nurses Inc.

  5. Characteristics and determinants of knowledge transfer policies at universities and public institutions in medical research--protocol for a systematic review of the qualitative research literature.

    Science.gov (United States)

    Jahn, Rosa; Müller, Olaf; Bozorgmehr, Kayvan

    2015-08-19

    Universities, public institutions, and the transfer of knowledge to the private sector play a major role in the development of medical technologies. The decisions of universities and public institutions regarding the transfer of knowledge impact the accessibility of the final product, making it easier or more difficult for consumers to access these products. In the case of medical research, these products are pharmaceuticals, diagnostics, or medical procedures. The ethical dimension of access to these potentially lifesaving products is apparent and distinguishes the transfer of medical knowledge from the transfer of knowledge in other areas. While the general field of technology transfer from academic and public to private actors is attracting an increasing amount of scholarly attention, the specifications of knowledge transfer in the medical field are not as well explored. This review seeks to provide a systematic overview and analysis of the qualitative literature on the characteristics and determinants of knowledge transfer in medical research and development. The review systematically searches the literature for qualitative studies that focus on knowledge transfer characteristics and determinants at medical academic and public research institutions. It aims at identifying and analyzing the literature on the content and context of knowledge transfer policies, decision-making processes, and actors at academic and public institutions. The search strategy includes the databases PubMed, Web of Science, ProQuest, and DiVa. These databases will be searched based on pre-specified search terms. The studies selected for inclusion in the review will be critically assessed for their quality utilizing the Qualitative Research Checklist developed by the Clinical Appraisal Skills Programme. Data extraction and synthesis will be based on the meta-ethnographic approach. This review seeks to further the understanding of the kinds of transfer pathways that exist in medical

  6. Effectiveness and acceptability of parental financial incentives and quasi-mandatory schemes for increasing uptake of vaccinations in preschool children: systematic review, qualitative study and discrete choice experiment.

    Science.gov (United States)

    Adams, Jean; Bateman, Belinda; Becker, Frauke; Cresswell, Tricia; Flynn, Darren; McNaughton, Rebekah; Oluboyede, Yemi; Robalino, Shannon; Ternent, Laura; Sood, Benjamin Gardner; Michie, Susan; Shucksmith, Janet; Sniehotta, Falko F; Wigham, Sarah

    2015-11-01

    Uptake of preschool vaccinations is less than optimal. Financial incentives and quasi-mandatory policies (restricting access to child care or educational settings to fully vaccinated children) have been used to increase uptake internationally, but not in the UK. To provide evidence on the effectiveness, acceptability and economic costs and consequences of parental financial incentives and quasi-mandatory schemes for increasing the uptake of preschool vaccinations. Systematic review, qualitative study and discrete choice experiment (DCE) with questionnaire. Community, health and education settings in England. Qualitative study - parents and carers of preschool children, health and educational professionals. DCE - parents and carers of preschool children identified as 'at high risk' and 'not at high risk' of incompletely vaccinating their children. Qualitative study - focus groups and individual interviews. DCE - online questionnaire. The review included studies exploring the effectiveness, acceptability or economic costs and consequences of interventions that offered contingent rewards or penalties with real material value for preschool vaccinations, or quasi-mandatory schemes that restricted access to 'universal' services, compared with usual care or no intervention. Electronic database, reference and citation searches were conducted. Systematic review - there was insufficient evidence to conclude that the interventions considered are effective. There was some evidence that the quasi-mandatory interventions were acceptable. There was insufficient evidence to draw conclusions on economic costs and consequences. Qualitative study - there was little appetite for parental financial incentives. Quasi-mandatory schemes were more acceptable. Optimising current services was consistently preferred to the interventions proposed. DCE and questionnaire - universal parental financial incentives were preferred to quasi-mandatory interventions, which were preferred to targeted

  7. US Health Care Clinicians' Knowledge, Attitudes, and Practices Regarding Human Papillomavirus Vaccination: A Qualitative Systematic Review.

    Science.gov (United States)

    Rosen, Brittany L; Shepard, Allie; Kahn, Jessica A

    2018-03-01

    Clinicians' recommendation for the human papillomavirus (HPV) vaccine appears to be an important driver of parental decisions about vaccination. Our aim was to synthesize the best available evidence exploring the perceptions and experiences regarding HPV vaccination, from the perspective of the US clinician. We conducted a comprehensive literature search of Academic Search Complete, CINAHL Plus, Communication & Mass Media Complete, Consumer Health Complete (EBSCOhost), ERIC, Health and Psychosocial Instruments, MEDLINE with full text, and PsycINFO databases. We identified 60 eligible articles: 48 quantitative and 12 qualitative. We extracted the following information: study purpose, use of theory, location, inclusion criteria, and health care provider classification. Results were organized into 5 categories: 1) clinicians' knowledge and beliefs about HPV and the HPV vaccine, 2) clinicians' attitudes and beliefs about recommending HPV vaccines, 3) clinicians' intention to recommend HPV vaccines, 4) clinicians' professional practices regarding HPV vaccination, and 5) patient HPV vaccination rates. Although clinicians were generally supportive of HPV vaccination, there was a discrepancy between clinicians' intentions, recommendation practices, and patient vaccination rates. Studies reported that clinicians tended not to provide strong, consistent recommendations, and were more likely to recommend HPV vaccines to girls versus boys and to older versus younger adolescents. Analyses revealed a number of facilitating factors and barriers to HPV vaccination at the clinician, parent/patient, and systems levels, including clinician knowledge, clinician beliefs, and office procedures that promote vaccination. This review provides an evidence base for multilevel interventions to improve clinician HPV vaccine recommendations and vaccination rates. Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  8. Are Electronic Cigarettes an Effective Aid to Smoking Cessation or Reduction Among Vulnerable Groups? A Systematic Review of Quantitative and Qualitative Evidence.

    Science.gov (United States)

    Gentry, Sarah; Forouhi, Nita; Notley, Caitlin

    2018-03-28

    Smoking prevalence remains high in some vulnerable groups, including those who misuse substances, have a mental illness, are homeless or are involved with the criminal justice system. E-cigarette use is increasing and may support smoking cessation/reduction. Systematic review of quantitative and qualitative data on the effectiveness of e-cigarettes for smoking cessation/reduction among vulnerable groups. Databases searched were MEDLINE, EMBASE, PsychINFO, CINAHL, ASSIA, ProQuest Dissertations and Theses and Open Grey. Narrative synthesis of quantitative data and thematic synthesis of qualitative data. 2628 records and 46 full texts were screened; 9 studies were identified for inclusion. Due to low quality of evidence, it is uncertain whether e-cigarettes are effective for smoking cessation in vulnerable populations. A moderate quality study suggested e-cigarettes were as effective as nicotine replacement therapy. Four studies suggested significant smoking reduction, however three were uncontrolled and had sample sizes below 30. A prospective cohort study found no differences between e-cigarette users and non-users. No significant adverse events and minimal side effects were identified. Qualitative thematic synthesis revealed barriers and facilitators associated with each component of the COM-B (capability, opportunity, motivation, behaviour) model, including practical barriers; perceptions of effectiveness for cessation/reduction; design features contributing to automatic and reflective motivation; smoking bans facilitating practical opportunity; and social connectedness increasing social opportunity. Further research is needed to identify the most appropriate device types for practicality and safety, level of support required in e-cigarette interventions, and to compare e-cigarettes with current best practice smoking cessation support among vulnerable groups. Smoking prevalence among people with mental illness, substance misuse, homelessness or criminal justice

  9. Barriers to, and facilitators of, the prevention of unintentional injury in children in the home: a systematic review and synthesis of qualitative research.

    Science.gov (United States)

    Smithson, Janet; Garside, Ruth; Pearson, Mark

    2011-04-01

    This review considers barriers to, and facilitators of, success for interventions to reduce unintentional injury to children in the home through supply and/or installation of home safety equipment, and looks at risk assessments. A systematic review of qualitative research. Bibliographic databases were searched for studies on interventions to reduce unintentional child injury in the home, or on related attitudes and behaviours. Studies were quality appraised, findings extracted, and a conceptual framework was developed to assess factors affecting the success of interventions. Nine peer-reviewed journal articles were included. Barriers and facilitators were highlighted at organisational, environmental and personal levels. Effective provision of safety equipment involves ongoing support with installation and maintenance. Take up and success of interventions depends on adjusting interventions according to practical limitations and parents' cultural expectations. A particular barrier was parents' inability to modify rented or shared accommodation. The review highlights ways in which health inequalities affect the take up and success of home safety interventions, and how health workers can use this knowledge to facilitate future interventions.

  10. The Relationship Between Vancomycin Trough Concentrations and AUC/MIC Ratios in Pediatric Patients: A Qualitative Systematic Review.

    Science.gov (United States)

    Tkachuk, Stacey; Collins, Kyle; Ensom, Mary H H

    2018-04-01

    In adults, the area under the concentration-time curve (AUC) divided by the minimum inhibitory concentration (MIC) is associated with better clinical and bacteriological response to vancomycin in patients with methicillin-resistant Staphylococcus aureus who achieve target AUC/MIC ≥ 400. This target is often extrapolated to pediatric patients despite the lack of similar evidence. The impracticalities of calculating the AUC in practice means vancomycin trough concentrations are used to predict the AUC/MIC. This review aimed to determine the relationship between vancomycin trough concentrations and AUC/MIC in pediatric patients. We searched the MEDLINE and Embase databases, the Cochrane Database of Systematic Reviews, and the Cochrane Central Register of Controlled Trials using the medical subject heading (MeSH) terms vancomycin and AUC and pediatric* or paediatric*. Articles were included if they were published in English and reported a relationship between vancomycin trough concentrations and AUC/MIC. Of 122 articles retrieved, 11 met the inclusion criteria. One trial reported a relationship between vancomycin trough concentrations, AUC/MIC, and clinical outcomes but was likely underpowered. Five studies found troughs 6-10 mg/l were sufficient to attain an AUC/MIC > 400 in most general hospitalized pediatric patients. One study in patients undergoing cardiothoracic surgery found a trough of 18.4 mg/l achieved an AUC/MIC > 400. Two oncology studies reported troughs ≥ 15 mg/l likely attained an AUC/MIC ≥ 400. In critical care patients: one study found a trough of 9 mg/l did not attain the AUC/MIC target; another found 7 mg/l corresponded to an AUC/MIC of 400. Potential vancomycin targets varied based on the population studied but, for general hospitalized pediatric patients, troughs of 6-10 mg/l are likely sufficient to achieve AUC/MIC ≥ 400. For MIC ≥ 2 mg/l, higher troughs are likely necessary to achieve an AUC/MIC ≥ 400. More

  11. The role of schools in children and young people's self-harm and suicide: systematic review and meta-ethnography of qualitative research.

    Science.gov (United States)

    Evans, Rhiannon; Hurrell, Chloe

    2016-05-14

    Evidence reports that schools influence children and young people's health behaviours across a range of outcomes. However there remains limited understanding of the mechanisms through which institutional features may structure self-harm and suicide. This paper reports on a systematic review and meta-ethnography of qualitative research exploring how schools influence self-harm and suicide in students. Systematic searches were conducted of nineteen databases from inception to June 2015. English language, primary research studies, utilising any qualitative research design to report on the influence of primary or secondary educational settings (or international equivalents) on children and young people's self-harm and suicide were included. Two reviewers independently appraised studies against the inclusion criteria, assessed quality, and abstracted data. Data synthesis was conducted in adherence with Noblit and Hare's meta-ethnographic approach. Of 6744 unique articles identified, six articles reporting on five studies were included in the meta-ethnography. Five meta-themes emerged from the studies. First, self-harm is often rendered invisible within educational settings, meaning it is not prioritised within the curriculum despite students' expressed need. Second, where self-harm transgresses institutional rules it may be treated as 'bad behaviour', meaning adequate support is denied. Third, schools' informal management strategy of escalating incidents of self-harm to external 'experts' serves to contribute to non-help seeking behaviour amongst students who desire confidential support from teachers. Fourth, anxiety and stress associated with school performance may escalate self-harm and suicide. Fifth, bullying within the school context can contribute to self-harm, whilst some young people may engage in these practices as initiation into a social group. Schools may influence children and young people's self-harm, although evidence of their impact on suicide remains

  12. The role of schools in children and young people’s self-harm and suicide: systematic review and meta-ethnography of qualitative research

    Directory of Open Access Journals (Sweden)

    Rhiannon Evans

    2016-05-01

    Full Text Available Abstract Background Evidence reports that schools influence children and young people’s health behaviours across a range of outcomes. However there remains limited understanding of the mechanisms through which institutional features may structure self-harm and suicide. This paper reports on a systematic review and meta-ethnography of qualitative research exploring how schools influence self-harm and suicide in students. Methods Systematic searches were conducted of nineteen databases from inception to June 2015. English language, primary research studies, utilising any qualitative research design to report on the influence of primary or secondary educational settings (or international equivalents on children and young people’s self-harm and suicide were included. Two reviewers independently appraised studies against the inclusion criteria, assessed quality, and abstracted data. Data synthesis was conducted in adherence with Noblit and Hare’s meta-ethnographic approach. Of 6744 unique articles identified, six articles reporting on five studies were included in the meta-ethnography. Results Five meta-themes emerged from the studies. First, self-harm is often rendered invisible within educational settings, meaning it is not prioritised within the curriculum despite students’ expressed need. Second, where self-harm transgresses institutional rules it may be treated as ‘bad behaviour’, meaning adequate support is denied. Third, schools’ informal management strategy of escalating incidents of self-harm to external ‘experts’ serves to contribute to non-help seeking behaviour amongst students who desire confidential support from teachers. Fourth, anxiety and stress associated with school performance may escalate self-harm and suicide. Fifth, bullying within the school context can contribute to self-harm, whilst some young people may engage in these practices as initiation into a social group. Conclusions Schools may influence children

  13. A systematic review and qualitative analysis to inform the development of a new emergency department-based geriatric case management model.

    Science.gov (United States)

    Sinha, Samir K; Bessman, Edward S; Flomenbaum, Neal; Leff, Bruce

    2011-06-01

    We inform the future development of a new geriatric emergency management practice model. We perform a systematic review of the existing evidence for emergency department (ED)-based case management models designed to improve the health, social, and health service utilization outcomes for noninstitutionalized older patients within the context of an index ED visit. This was a systematic review of English-language articles indexed in MEDLINE and CINAHL (1966 to 2010), describing ED-based case management models for older adults. Bibliographies of the retrieved articles were reviewed to identify additional references. A systematic qualitative case study analytic approach was used to identify the core operational components and outcome measures of the described clinical interventions. The authors of the included studies were also invited to verify our interpretations of their work. The determined patterns of component adherence were then used to postulate the relative importance and effect of the presence or absence of a particular component in influencing the overall effectiveness of their respective interventions. Eighteen of 352 studies (reported in 20 articles) met study criteria. Qualitative analyses identified 28 outcome measures and 8 distinct model characteristic components that included having an evidence-based practice model, nursing clinical involvement or leadership, high-risk screening processes, focused geriatric assessments, the initiation of care and disposition planning in the ED, interprofessional and capacity-building work practices, post-ED discharge follow-up with patients, and evaluation and monitoring processes. Of the 15 positive study results, 6 had all 8 characteristic components and 9 were found to be lacking at least 1 component. Two studies with positive results lacked 2 characteristic components and none lacked more than 2 components. Of the 3 studies with negative results demonstrating no positive effects based on any outcome tested, one

  14. Orthotic management of instability of the knee related to neuromuscular and central nervous system disorders: systematic review, qualitative study, survey and costing analysis.

    Science.gov (United States)

    O'Connor, Joanne; McCaughan, Dorothy; McDaid, Catriona; Booth, Alison; Fayter, Debra; Rodriguez-Lopez, Roccio; Bowers, Roy; Dyson, Lisa; Iglesias, Cynthia P; Lalor, Simon; O'Connor, Rory J; Phillips, Margaret; Ramdharry, Gita

    2016-07-01

    Patients who have knee instability that is associated with neuromuscular disease (NMD) and central nervous system (CNS) conditions can be treated using orthoses, such as knee-ankle-foot orthoses (KAFOs). To assess existing evidence on the effectiveness of orthoses; patient perspectives; types of orthotic devices prescribed in the UK NHS; and associated costs. Qualitative study of views of orthoses users - a qualitative in-depth interview study was undertaken. Data were analysed for thematic content. A coding scheme was developed and an inductive approach was used to identify themes. Systematic review - 18 databases were searched up to November 2014: MEDLINE, MEDLINE In-Process & Other Non-Indexed Citations, Cumulative Index to Nursing and Allied Health, EMBASE, PASCAL, Scopus, Science Citation Index, BIOSIS Previews, Physiotherapy Evidence Database, Recal Legacy, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, Health Technology Assessment database, Cochrane Central Register of Controlled Trials, Conference Proceedings Citation Index: Science, Health Management Consortium, ClinicalTrials.gov, International Clinical Trials Registry Platform and National Technical Information Service. Studies of adults using an orthosis for instability of the knee related to NMD or a CNS disorder were included. Data were extracted and quality was assessed by two researchers. Narrative synthesis was undertaken. Survey and costing analysis - a web survey of orthotists, physiotherapists and rehabilitation medicine physicians was undertaken. Telephone interviews with orthotists informed a costing analysis. Qualitative study - a total of 24 people participated. Potential for engagement in daily activities was of vital importance to patients; the extent to which their device enabled this was the yardstick by which it was measured. Patients' prime desired outcome was a reduction in pain, falls or trips, with improved balance and stability. Effectiveness

  15. Conceptualising quality of life outcomes for women participating in testing for sexually transmitted infections: A systematic review and meta-synthesis of qualitative research.

    Science.gov (United States)

    Jackson, Louise J; Roberts, Tracy E

    2015-10-01

    Many public health interventions have aims which are broader than health alone; this means that there are difficulties in using outcome measures that capture health effects only, such as Quality Adjusted Life Years (QALYs). Sexually Transmitted Infections (STIs) are a major public health concern both in the UK and globally, with Chlamydia trachomatis being the most common bacterial STI worldwide. There is scope for the wider use of qualitative syntheses in health-related research; in this study we highlight their potential value in informing outcome identification, particularly for public health interventions where a broad range of outcomes may need to be considered. This article presents a systematic review and meta-ethnography of qualitative studies that investigated women's experiences of thinking about and participating in testing for chlamydia. The meta-ethnography highlights issues relating to beliefs about STIs and testing, assessing risk and interpreting symptoms, emotional responses to testing, coping with diagnosis, relationship with sex partners(s), informal support, and interaction with health care services. The study findings suggest that women can experience a range of impacts on their health and quality of life. It is important that this range of effects is taken into account within evaluations, to ensure that decision makers are fully informed about the outcomes associated with screening interventions, and ultimately, to make sure that appropriate interventions are available to support women in maintaining good sexual health. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. What we talk about when we talk about recovery: a systematic review and best-fit framework synthesis of qualitative literature.

    Science.gov (United States)

    Stuart, Simon Robertson; Tansey, Louise; Quayle, Ethel

    2017-06-01

    The recovery approach is increasingly popular among mental-health services, but there is a lack of consensus about its applicability and it has been criticised for imposing professionalised ideas onto what was originally a service-user concept. To carry out a review and synthesis of qualitative research to answer the question: "What do we know about how service users with severe and enduring mental illness experience the process of recovery?" It was hoped that this would improve clarity and increase understanding. A systematic review identified 15 peer-reviewed articles examining experiences of recovery. Twelve of these were analysed using best-fit framework synthesis, with the CHIME model of recovery providing the exploratory framework. The optimistic themes of CHIME accounted for the majority of people's experiences, but more than 30% of data were not felt to be encapsulated. An expanded conceptualisation of recovery is proposed, in which difficulties are more prominently considered. An overly optimistic, professionally imposed view of recovery might homogenise or even blame individuals rather than empower them. Further understanding is needed of different experiences of recovery, and of people's struggles to recover.

  17. The experiences of family members in the year following the diagnosis of a child or adolescent with cancer: a qualitative systematic review.

    Science.gov (United States)

    Mu, Pei-Fan; Lee, Mei-Yin; Sheng, Ching-Ching; Tung, Pei-Chi; Huang, Ling-Ya; Chen, Yi-Wei

    2015-06-12

    Research shows that it is stressful for family members when a child or an adolescent within the family unit is diagnosed with cancer and this stress continues over the course of the year after the diagnosis. Qualitative studies have been conducted aimed at exploring parental, siblings' and other family members' experiences when facing health-illness transition-related stress during the first year after the child is diagnosed with cancer. This study integrates the research findings of relevant existing qualitative studies on this topic in order to provide empirical evidence-based suggestions for clinical care. This study intent is to obtain an understanding of the family members' experiences over the course of the following year after learning that a child or adolescent within their family unit has been diagnosed with cancer. The participants of interest are family members of a child or adolescent with cancer who verbally describe the whole experience and/or report on the impact of the diagnosis and disease on their lives. In this systematic review, there were no restrictions on the type, severity and prognosis of cancer. Studies investigating the experiences of the family of a child or adolescent with cancer that were reported verbally and the opinions of others external to the family (e.g. nurses) were excluded from the review. The phenomena of interest were the self-reported experiences over the course of the following year of family members of a child or adolescent with cancer and the impact on the whole family of the child or adolescent receiving a cancer diagnosis. The settings included acute care, home and community settings with any cultural context. Research on other phenomena, such as experiences related to social support intervention for the family, the long-term coping experience of the family, the bereavement experiences of children with cancer, the experiences of a child or adolescent with cancer and experiences more than one year after the diagnosis

  18. Public responses to the sharing and linkage of health data for research purposes: a systematic review and thematic synthesis of qualitative studies.

    Science.gov (United States)

    Aitken, Mhairi; de St Jorre, Jenna; Pagliari, Claudia; Jepson, Ruth; Cunningham-Burley, Sarah

    2016-11-10

    The past 10 years have witnessed a significant growth in sharing of health data for secondary uses. Alongside this there has been growing interest in the public acceptability of data sharing and data linkage practices. Public acceptance is recognised as crucial for ensuring the legitimacy of current practices and systems of governance. Given the growing international interest in this area this systematic review and thematic synthesis represents a timely review of current evidence. It highlights the key factors influencing public responses as well as important areas for further research. This paper reports a systematic review and thematic synthesis of qualitative studies examining public attitudes towards the sharing or linkage of health data for research purposes. Twenty-five studies were included in the review. The included studies were conducted primarily in the UK and North America, with one study set in Japan, another in Sweden and one in multiple countries. The included studies were conducted between 1999 and 2013 (eight studies selected for inclusion did not report data collection dates). The qualitative methods represented in the studies included focus groups, interviews, deliberative events, dialogue workshops and asynchronous online interviews. Key themes identified across the corpus of studies related to the conditions necessary for public support/acceptability, areas of public concern and implications for future research. The results identify a growing body of evidence pointing towards widespread general-though conditional-support for data linkage and data sharing for research purposes. Whilst a variety of concerns were raised (e.g. relating to confidentiality, individuals' control over their data, uses and abuses of data and potential harms arising) in cases where participants perceived there to be actual or potential public benefits from research and had trust in the individuals or organisations conducting and/or overseeing data linkage/sharing, they

  19. Clinical effectiveness and patient perspectives of different treatment strategies for tics in children and adolescents with Tourette syndrome: a systematic review and qualitative analysis.

    Science.gov (United States)

    Hollis, Chris; Pennant, Mary; Cuenca, José; Glazebrook, Cris; Kendall, Tim; Whittington, Craig; Stockton, Sarah; Larsson, Linnéa; Bunton, Penny; Dobson, Suzanne; Groom, Madeleine; Hedderly, Tammy; Heyman, Isobel; Jackson, Georgina M; Jackson, Stephen; Murphy, Tara; Rickards, Hugh; Robertson, Mary; Stern, Jeremy

    2016-01-01

    Tourette syndrome (TS) is a neurodevelopmental condition characterised by chronic motor and vocal tics affecting up to 1% of school-age children and young people and is associated with significant distress and psychosocial impairment. To conduct a systematic review of the benefits and risks of pharmacological, behavioural and physical interventions for tics in children and young people with TS (part 1) and to explore the experience of treatment and services from the perspective of young people with TS and their parents (part 2). For the systematic reviews (parts 1 and 2), mainstream bibliographic databases, The Cochrane Library, education, social care and grey literature databases were searched using subject headings and text words for tic* and Tourette* from database inception to January 2013. For part 1, randomised controlled trials and controlled before-and-after studies of pharmacological, behavioural or physical interventions in children or young people (aged tic disorder were included. Mixed studies and studies in adults were considered as supporting evidence. Risk of bias associated with each study was evaluated using the Cochrane tool. When there was sufficient data, random-effects meta-analysis was used to synthesize the evidence and the quality of evidence for each outcome was assessed using the Grading of Recommendations Assessment, Development and Evaluation approach. For part 2, qualitative studies and survey literature conducted in populations of children/young people with TS or their carers or in health professionals with experience of treating TS were included in the qualitative review. Results were synthesized narratively. In addition, a national parent/carer survey was conducted via the Tourettes Action website. Participants included parents of children and young people with TS aged under 18 years. Participants (young people with TS aged 10-17 years) for the in-depth interviews were recruited via a national survey and specialist Tourettes clinics

  20. Healthcare users' experiences of communicating with healthcare professionals about children who have life-limiting conditions: a qualitative systematic review protocol.

    Science.gov (United States)

    Ekberg, Stuart; Bradford, Natalie; Herbert, Anthony; Danby, Susan; Yates, Patsy

    2015-11-01

    -quality communication with and about children who have life-limiting conditions, this does not mean that these stakeholders necessarily share the same perspective of what constitutes high-quality communication and the best way of accomplishing this. Focusing on healthcare users' experiences of communication with healthcare professionals about children who have life-limiting conditions, the present review will explore the subjective impact of professionals' communication on the people for whom they provide care.It may be necessary to consider a range of contextual factors to understand healthcare users' experiences of communicating with healthcare professionals about children who have life-limiting conditions. For instance, age, developmental stage, cognitive capacity, emotional and social strengths, and family dynamics can influence a child's level of involvement in discussions about their condition and care. Although there are factors that appear more consistent across the range of pediatric palliative care users, such as parents' preferences for being treated by healthcare professionals as partners in making decisions about the care of their child, there is not always such consistency. Nor is it clear whether such findings can be generalized across different cultural contexts. In appraising existing research, this systematic review will therefore consider the relationship between the context of individual studies and their reported findings.The primary aim of this review is to identify, appraise and synthesize existing qualitative evidence of healthcare users' experiences of communicating with healthcare professionals about children who have life-limiting conditions. The review will consider relevant details of these findings, particularly whether factors like age are relevant for understanding particular experiences of communication. An outcome of this review will be the identification of best available qualitative evidence that can be used to inform professional practice, as well

  1. A comparison of working in small-scale and large-scale nursing homes: A systematic review of quantitative and qualitative evidence.

    Science.gov (United States)

    Vermeerbergen, Lander; Van Hootegem, Geert; Benders, Jos

    2017-02-01

    Ongoing shortages of care workers, together with an ageing population, make it of utmost importance to increase the quality of working life in nursing homes. Since the 1970s, normalised and small-scale nursing homes have been increasingly introduced to provide care in a family and homelike environment, potentially providing a richer work life for care workers as well as improved living conditions for residents. 'Normalised' refers to the opportunities given to residents to live in a manner as close as possible to the everyday life of persons not needing care. The study purpose is to provide a synthesis and overview of empirical research comparing the quality of working life - together with related work and health outcomes - of professional care workers in normalised small-scale nursing homes as compared to conventional large-scale ones. A systematic review of qualitative and quantitative studies. A systematic literature search (April 2015) was performed using the electronic databases Pubmed, Embase, PsycInfo, CINAHL and Web of Science. References and citations were tracked to identify additional, relevant studies. We identified 825 studies in the selected databases. After checking the inclusion and exclusion criteria, nine studies were selected for review. Two additional studies were selected after reference and citation tracking. Three studies were excluded after requesting more information on the research setting. The findings from the individual studies suggest that levels of job control and job demands (all but "time pressure") are higher in normalised small-scale homes than in conventional large-scale nursing homes. Additionally, some studies suggested that social support and work motivation are higher, while risks of burnout and mental strain are lower, in normalised small-scale nursing homes. Other studies found no differences or even opposing findings. The studies reviewed showed that these inconclusive findings can be attributed to care workers in some

  2. [Work accommodation at the time of Return-to-Work for workers on sick leave: a qualitative systematic review with recommendations for Return-to-work Guidance 2017].

    Science.gov (United States)

    Nogawa, Kazuhiro; Kojimahara, Noriko

    2018-03-12

    We conducted a systematic review to determine whether work accommodation at the time of return-to-work (RTW) following a period of sick leave would improve work-related outcomes. Using a Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach, we developed recommendations applicable to the field of occupational health in Japan. We approached our review question for "Evidence-based Return-to-work Guidance in Occupational Health 2017 (RTW 2017)" using a PICO framework (P: workers on sick leave; I: work accommodation; C: usual care; O: improvement of work-related outcomes, such as shortened sick leave period or lower rate of sick leave recurrence). To identify relevant intervention studies about work accommodation at the time of RTW, for example, modified work or partial RTW, we searched Cochrane Library, PubMed, and ICHUSHI Web using keywords/phrases such as workplace accommodation, partial RTW, rehabilitation, and modified work. Although we found no systematic reviews, we did identify 632 randomized controlled trials and cohort studies. Two researchers screened them independently using selection and exclusion criteria defined by the RTW guidance committee in the scope. For intervention studies, we extracted PICO and evaluated risk of bias using RevMan 5.3. For cohort studies, we applied the Newcastle-Ottawa scale for evaluation of risk of bias. We then evaluated the body of evidence based on risk of bias, indirectness, inconsistency, imprecision, and publication bias using GRADEPro GDT. Finally, we adopted Evidence to Decision from GRADE and developed recommendations based on anonymous panels' votes. We identified three relevant studies, which were one randomized controlled trial and two cohort studies, on Partial RTW or modified work for musculoskeletal disorders. Although we could not conduct a meta-analysis, our qualitative systematic review of these studies led us to conclude that partial RTW could shorten the period of sick leave and

  3. Longer-term needs of stroke survivors with communication difficulties living in the community: a systematic review and thematic synthesis of qualitative studies

    Science.gov (United States)

    Clarke, David

    2017-01-01

    Objective To review and synthesise qualitative literature relating to the longer-term needs of community dwelling stroke survivors with communication difficulties including aphasia, dysarthria and apraxia of speech. Design Systematic review and thematic synthesis. Method We included studies employing qualitative methodology which focused on the perceived or expressed needs, views or experiences of stroke survivors with communication difficulties in relation to the day-to-day management of their condition following hospital discharge. We searched MEDLINE, EMBASE, PsycINFO, CINAHL, The Cochrane Library, International Bibliography of the Social Sciences and AMED and undertook grey literature searches. Studies were assessed for methodological quality by two researchers independently and the findings were combined using thematic synthesis. Results Thirty-two studies were included in the thematic synthesis. The synthesis reveals the ongoing difficulties stroke survivors can experience in coming to terms with the loss of communication and in adapting to life with a communication difficulty. While some were able to adjust, others struggled to maintain their social networks and to participate in activities which were meaningful to them. The challenges experienced by stroke survivors with communication difficulties persisted for many years poststroke. Four themes relating to longer-term need were developed: managing communication outside of the home, creating a meaningful role, creating or maintaining a support network and taking control and actively moving forward with life. Conclusions Understanding the experiences of stroke survivors with communication difficulties is vital for ensuring that longer-term care is designed according to their needs. Wider psychosocial factors must be considered in the rehabilitation of people with poststroke communication difficulties. Self-management interventions may be appropriate to help this subgroup of stroke survivors manage their

  4. Barriers and Facilitators to the Implementation of Interventions to Prevent Youth Violence in Latin America: A Systematic Review and Qualitative Evidence Synthesis.

    Science.gov (United States)

    Atienzo, Erika E; Kaltenthaler, Eva; Baxter, Susan K

    2016-08-12

    Youth violence in Latin America is an important public health problem. However, the evidence from preventive programs within the region to address this problem is limited. Identifying context-specific factors that facilitate or hinder the success of interventions is necessary to guarantee the successful implementation of new preventive strategies. We present a systematic review and synthesis of qualitative studies to identify factors affecting the implementation of programs to prevent youth violence in Latin America. We searched 10 electronic databases and websites of international institutions. The quality of the studies was assessed using the critical appraisal skills program checklist, while the certainty of the findings of the synthesis was assessed using the certainty of the qualitative evidence approach. We included eight papers describing five programs in Argentina, Venezuela, Peru, El Salvador, and Mexico. Most of the factors affecting the implementation of programs were aspects related to features of the programs and social/political constraints. The synthesis suggests that future programs can benefit from having a multidisciplinary and/or multisectoral approach involving different key players. At the same time, potential strategies for avoiding problems related to such active engagement should be planned via promoting effective channels for communication and supervision. The review also suggests the importance of increasing awareness and motivation toward the problem of youth violence among relevant agencies and stakeholders. While the limited volume and quality of the literature impact on the ability to draw conclusions, the results could be useful for new programs being designed and the ones seeking to be adapted from other contexts. © The Author(s) 2016.

  5. Ethnicity-specific factors influencing childhood immunisation decisions among Black and Asian Minority Ethnic groups in the UK: a systematic review of qualitative research.

    Science.gov (United States)

    Forster, Alice S; Rockliffe, Lauren; Chorley, Amanda J; Marlow, Laura A V; Bedford, Helen; Smith, Samuel G; Waller, Jo

    2017-06-01

    Uptake of some childhood immunisations in the UK is lower among those from some Black and Asian Minority Ethnic (BAME) backgrounds. This systematic review of qualitative research sought to understand the factors that are associated with ethnicity that influence the immunisation decisions of parents from BAME backgrounds living in the UK. Databases were searched on 2 December 2014 for studies published at any time using the terms 'UK' and 'vaccination' and 'qualitative methods' (and variations of these). Included articles comprised participants who were parents from BAME backgrounds. Thematic synthesis methods were used to develop descriptive and higher order themes. Themes specific to ethnicity and associated factors are reported. Eight papers were included in the review. Most participants were from Black (n=62) or Asian (n=38) backgrounds. Two ethnicity-related factors affected immunisation decisions. First, factors that are related to ethnicity itself (namely religion, upbringing and migration, and language) affected parents' perceived importance of immunisations, whether immunisations were permitted or culturally acceptable and their understanding of immunisation/the immunisation schedule. Second, perceived biological differences affected decision-making and demand for information. Factors related to ethnicity must be considered when seeking to understand immunisation decisions among parents from BAME backgrounds. Where appropriate and feasible, vaccination information should be targeted to address beliefs about ethnic differences held by some individuals from some BAME backgrounds. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  6. A qualitative systematic review of published work on disclosure and help-seeking for domestic violence and abuse among women from ethnic minority populations in the UK.

    Science.gov (United States)

    Femi-Ajao, Omolade; Kendal, Sarah; Lovell, Karina

    2018-03-07

    Domestic violence and abuse has been recognised as an international public health problem. However, the pervasiveness of the problem is unknown due in part to underreporting, especially among women from ethnic minority populations. In relation to this group, this review seeks to explore: (1) the barriers to disclosure; (2) the facilitators of help-seeking; and (3) self-perceived impacts of domestic violence. We systematically identified published qualitative studies conducted among women from ethnic minority populations in the UK. Data analysis was completed using thematic analysis approach. 562 papers were identified and eight papers from four studies conducted among women from ethnic minority populations in the UK met the inclusion criteria and were reviewed. Barriers to disclosure include: Immigration status, community influences, problems with language and interpretation, and unsupportive attitudes of staff within mainstream services. Facilitators of help-seeking were: escalation of abuse and safety of children. Self-perceived impact of abuse includes: shame, denial, loss of identity and lack of choice. There is an on-going need for staff from domestic violence services to be aware of the complexities within which women from ethnic minority populations experience domestic violence and abuse.

  7. Supporting 'work-related goals' rather than 'return to work' after cancer? A systematic review and meta-synthesis of 25 qualitative studies.

    Science.gov (United States)

    Wells, Mary; Williams, Brian; Firnigl, Danielle; Lang, Heidi; Coyle, Joanne; Kroll, Thilo; MacGillivray, Steve

    2013-06-01

    This study aimed to systematically review and synthesise qualitative studies of employment and cancer. A rigorous systematic review and meta-synthesis process was followed. A total of 13,233 papers were retrieved from eight databases; 69 were deemed relevant following title and abstract appraisal. Four further publications were identified via contact with key authors. Screening of full texts resulted in the retention of 25 publications from six countries, which were included in the synthesis. Studies consistently indicate that for people with cancer, 'work' forms a central basis for self-identity and self-esteem, provides financial security, forms and maintains social relationships, and represents an individual's abilities, talents and health. Work is therefore more than paid employment. Its importance to individuals rests on the relative value survivors place on these constituent functions. The desirability, importance and subsequent interpretation of individuals' experience of 'return to work' appears to be influenced by the ways in which cancer affects these functions or goals of 'work'. Our synthesis draws these complex elements into a heuristic model to help illustrate and communicate these inter-relationships. The concept of 'return to work' may be overly simplistic, and as a result, misleading. The proposed benefits previously ascribed to 'return to work' may only be achieved through consideration of the specific meaning and role of work to the individual. Interventions to address work-related issues need to be person-centred, acknowledging the work-related outcomes that are important to the individual. A conceptual and operational shift towards supporting survivors to identify and achieve their 'work-related goals' may be more appropriate. Copyright © 2012 John Wiley & Sons, Ltd.

  8. Children's experiences of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME): a systematic review and meta-ethnography of qualitative studies.

    Science.gov (United States)

    Parslow, Roxanne M; Harris, Sarah; Broughton, Jessica; Alattas, Adla; Crawley, Esther; Haywood, Kirstie; Shaw, Alison

    2017-01-13

    To synthesis the qualitative studies of children's experiences of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME). Systematic review and meta-ethnography. CFS/ME is an important disabling illness, with uncertain cause and prognosis. As a result, children with CFS/ME can find themselves living with greater uncertainty and stigma, exacerbating the impact of the condition. There is a growing body of qualitative research in CFS/ME, yet there has been no attempt to systematically synthesis the studies involving children. Studies exploring the experiences of children diagnosed with CFS/ME, published or unpublished, using qualitative methods were eligible. MEDLINE, EMBASE, PsycINFO and CINAHL databases were searched as well as grey literature, reference lists and contacting authors. Quality assessment was done independently using the Critical Appraisal Skills Programme (CASP) checklist. Studies were synthesised using techniques of meta-ethnography. Ten studies involving 82 children with CFS/ME aged 8-18 were included. Our synthesis describes four third-order constructs within children's experiences: (1) disruption and loss: physical, social and the self; (2) barriers to coping: suspension in uncertainty, problems with diagnosis and disbelief; (3) facilitators to coping: reducing uncertainty, credible illness narratives, diagnosis and supportive relationships and (4) hope, personal growth and recovery. CFS/ME introduces profound biographical disruption through its effects on children's ability to socialise, perform school and therefore how they see their future. Unfamiliarity of the condition, problems with diagnosis and felt stigma prevent children from forming a new illness identity. Children adopt coping strategies such as building credible explanations for their illness. Physical, social, emotional and self-dimensions of life should be included when treating and measuring outcomes from healthcare in paediatric CFS/ME. There is a need for greater recognition

  9. Non-pharmacological interventions for attention-deficit/hyperactivity disorder (ADHD) delivered in school settings: systematic reviews of quantitative and qualitative research.

    Science.gov (United States)

    Richardson, Michelle; Moore, Darren A; Gwernan-Jones, Ruth; Thompson-Coon, Jo; Ukoumunne, Obioha; Rogers, Morwenna; Whear, Rebecca; Newlove-Delgado, Tamsin V; Logan, Stuart; Morris, Christopher; Taylor, Eric; Cooper, Paul; Stein, Ken; Garside, Ruth; Ford, Tamsin J

    2015-06-01

    Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterised by age-inappropriate levels of inattention, impulsivity and hyperactivity. School can be particularly challenging for children with ADHD. Few reviews have considered non-pharmacological interventions in school settings. To assess the effectiveness of non-pharmacological interventions delivered in school settings for pupils with, or at risk of, ADHD and to explore the factors that may enhance, or limit, their delivery. Twenty electronic databases (including PsycINFO, MEDLINE, EMBASE, Education Resources Information Centre, The Cochrane Library and Education Research Complete) were searched from 1980 to February-August 2013. Three separate searches were conducted for four systematic reviews; they were supplemented with forward and backwards citation chasing, website searching, author recommendations and hand-searches of key journals. The systematic reviews focused on (1) the effectiveness of school-based interventions for children with or at risk of ADHD; (2) quantitative research that explores attitudes towards school-based non-pharmacological interventions for pupils with ADHD; (3) qualitative research investigating the attitudes and experiences of children, teachers, parents and others using ADHD interventions in school settings; and (4) qualitative research exploring the experience of ADHD in school among pupils, their parents and teachers more generally. Methods of synthesis included a random-effects meta-analysis, meta-regression and narrative synthesis for review 1, narrative synthesis for review 2 and meta-ethnography and thematic analysis for reviews 3 and 4. For review 1, 54 controlled trials met the inclusion criteria. For the 36 meta-analysed randomised controlled trials, beneficial effects (p intervention features were linked with effectiveness. For review 2, 28 included studies revealed that educators' attitudes towards interventions ranged in positivity

  10. Patient Perspectives on Quality of Life With Uncontrolled Type 1 Diabetes Mellitus: A Systematic Review and Qualitative Meta-synthesis.

    Science.gov (United States)

    Vanstone, Meredith; Rewegan, Alex; Brundisini, Francesca; Dejean, Deirdre; Giacomini, Mita

    2015-01-01

    Patients with uncontrolled type 1 diabetes mellitus may be candidates for pancreatic islet cell transplantation. This report synthesizes qualitative research on how patients with uncontrolled type 1 diabetes perceive their quality of life. The objective of this analysis was to examine the perceptions of patients with uncontrolled type 1 diabetes on how it affects their lived experience and quality of life. This report synthesizes 31 primary qualitative studies to examine quality of life from the perspectives of adult patients with type 1 diabetes mellitus and their families or partners. We performed a qualitative meta-synthesis to integrate findings across primary research studies. Long- and short-term negative consequences of uncontrolled type 1 diabetes affect all aspects of patients' lives: physical, emotional, practical, and social. The effect on each domain is far-reaching, and effects interact across domains. Uncontrolled blood sugar levels lead to substantial psychological distress, negative moods, cognitive difficulties, irritable or aggressive behaviour, and closely associated problems with relationships, self-image, and confidence. Emotional distress is pervasive and under-addressed by health care providers. Patients live in fear of complications from diabetes over the long term. In the shorter term, they are anxious about the personal, social, and professional consequences of hypoglycemic episodes (e.g., injury, humiliation), and may curtail normal activities such as driving or socializing because they are worried about having an episode. The quality of life for patients' family members is also negatively impacted by uncontrolled type 1 diabetes. Uncontrolled type 1 diabetes has significant negative impacts on the quality of life of both people with the disease and their families.

  11. Systematic reviews of and integrated report on the quantitative, qualitative and economic evidence base for the management of obesity in men.

    Science.gov (United States)

    Robertson, Clare; Archibald, Daryll; Avenell, Alison; Douglas, Flora; Hoddinott, Pat; van Teijlingen, Edwin; Boyers, Dwayne; Stewart, Fiona; Boachie, Charles; Fioratou, Evie; Wilkins, David; Street, Tim; Carroll, Paula; Fowler, Colin

    2014-05-01

    Obesity increases the risk of many serious illnesses such as coronary heart disease, type 2 diabetes and osteoarthritis. More men than women are overweight or obese in the UK but men are less likely to perceive their weight as a problem and less likely to engage with weight-loss services. The aim of this study was to systematically review evidence-based management strategies for treating obesity in men and investigate how to engage men in obesity services by integrating the quantitative, qualitative and health economic evidence base. Electronic databases including MEDLINE, EMBASE, PsycINFO, the Cochrane Central Register of Controlled Trials, the Database of Abstracts of Reviews of Effects and the NHS Economic Evaluation Database were searched from inception to January 2012, with a limited update search in July 2012. Subject-specific websites, reference lists and professional health-care and commercial organisations were also consulted. Six systematic reviews were conducted to consider the clinical effectiveness, cost-effectiveness and qualitative evidence on interventions for treating obesity in men, and men in contrast to women, and the effectiveness of interventions to engage men in their weight reduction. Randomised controlled trials (RCTs) with follow-up data of at least 1 year, or any study design and length of follow-up for UK studies, were included. Qualitative and mixed-method studies linked to RCTs and non-randomised intervention studies, and UK-based, men-only qualitative studies not linked to interventions were included. One reviewer extracted data from the included studies and a second reviewer checked data for omissions or inaccuracies. Two reviewers carried out quality assessment. We undertook meta-analysis of quantitative data and a realist approach to integrating the qualitative and quantitative evidence synthesis. From a total of 12,764 titles reviewed, 33 RCTs with 12 linked reports, 24 non-randomised reports, five economic evaluations with two

  12. Chronic disease patients' experiences with accessing health care in rural and remote areas: a systematic review and qualitative meta-synthesis.

    Science.gov (United States)

    Brundisini, F; Giacomini, M; DeJean, D; Vanstone, M; Winsor, S; Smith, A

    2013-01-01

    Rurality can contribute to the vulnerability of people with chronic diseases. Qualitative research can identify a wide range of health care access issues faced by patients living in a remote or rural setting. To systematically review and synthesize qualitative research on the advantages and disadvantages rural patients with chronic diseases face when accessing both rural and distant care. This report synthesizes 12 primary qualitative studies on the topic of access to health care for rural patients with chronic disease. Included studies were published between 2002 and 2012 and followed adult patients in North America, Europe, Australia, and New Zealand. Qualitative meta-synthesis was used to integrate findings across primary research studies. Three major themes were identified: geography, availability of health care professionals, and rural culture. First, geographic distance from services poses access barriers, worsened by transportation problems or weather conditions. Community supports and rurally located services can help overcome these challenges. Second, the limited availability of health care professionals (coupled with low education or lack of peer support) increases the feeling of vulnerability. When care is available locally, patients appreciate long-term relationships with individual clinicians and care personalized by familiarity with the patient as a person. Finally, patients may feel culturally marginalized in the urban health care context, especially if health literacy is low. A culture of self-reliance and community belonging in rural areas may incline patients to do without distant care and may mitigate feelings of vulnerability. Qualitative research findings are not intended to generalize directly to populations, although meta-synthesis across a number of qualitative studies builds an increasingly robust understanding that is more likely to be transferable. Selected studies focused on the vulnerability experiences of rural dwellers with chronic

  13. Choosing the best animal species to mimic clinical colon anastomotic leakage in humans: a qualitative systematic review

    DEFF Research Database (Denmark)

    Pommergaard, H C; Rosenberg, J; Schumacher-Petersen, Camilla

    2011-01-01

    Animal models are valuable for studying pathogenic factors and preventive measures for colon anastomotic leakage. The suitability of the species as models varies greatly; however, no consensus exists on which species to use. The aim of this review was to evaluate different experimental animals...... for the study of clinical colon anastomotic leakage....

  14. Choosing the best animal species to mimic clinical colon anastomotic leakage in humans: a qualitative systematic review

    DEFF Research Database (Denmark)

    Pommergaard, Hans-Christian; Rosenberg, J; Schumacher-Petersen, Camilla

    2011-01-01

    Animal models are valuable for studying pathogenic factors and preventive measures for colon anastomotic leakage. The suitability of the species as models varies greatly; however, no consensus exists on which species to use. The aim of this review was to evaluate different experimental animals fo...

  15. Pakistani women's use of mental health services and the role of social networks: a systematic review of quantitative and qualitative research.

    Science.gov (United States)

    Kapadia, Dharmi; Brooks, Helen Louise; Nazroo, James; Tranmer, Mark

    2017-07-01

    Pakistani women in the UK are an at-risk group with high levels of mental health problems, but low levels of mental health service use. However, the rates of service use for Pakistani women are unclear, partly because research with South Asian women has been incorrectly generalised to Pakistani women. Further, this research has been largely undertaken within an individualistic paradigm, with little consideration of patients' social networks, and how these may drive decisions to seek help. This systematic review aimed to clarify usage rates, and describe the nature of Pakistani women's social networks and how they may influence mental health service use. Ten journal databases (ASSIA, CINAHL Plus, EMBASE, HMIC, IBSS, MEDLINE, PsycINFO, Social Sciences Abstracts, Social Science Citation Index and Sociological Abstracts) and six sources of grey literature were searched for studies published between 1960 and the end of March 2014. Twenty-one studies met inclusion criteria. Ten studies (quantitative) reported on inpatient or outpatient service use between ethnic groups. Seven studies (four quantitative, three qualitative) investigated the nature of social networks, and four studies (qualitative) commented on how social networks were involved in accessing mental health services. Pakistani women were less likely than white (British) women to use most specialist mental health services. No difference was found between Pakistani and white women for the consultation of general practitioners for mental health problems. Pakistani women's networks displayed high levels of stigmatising attitudes towards mental health problems and mental health services, which acted as a deterrent to seeking help. No studies were found which compared stigma in networks between Pakistani women and women of other ethnic groups. Pakistani women are at a considerable disadvantage in gaining access to and using statutory mental health services, compared with white women; this, in part, is due to

  16. Qualitative elastography can replace thyroid nodule fine-needle aspiration in patients with soft thyroid nodules. A systematic review and meta-analysis

    Energy Technology Data Exchange (ETDEWEB)

    Nell, Sjoerd; Kist, Jakob W. [Department of Surgery, University Medical Center Utrecht (Netherlands); Debray, Thomas P.A. [Julius Center for Health Sciences and Primary Care Utrecht (Netherlands); Keizer, Bart de [Department of Radiology and Nuclear Medicine, University Medical Center Utrecht (Netherlands); Oostenbrugge, Timotheus J. van; Borel Rinkes, Inne H.M. [Department of Surgery, University Medical Center Utrecht (Netherlands); Valk, Gerlof D. [Department of Endocrinology, University Medical Center Utrecht (Netherlands); Vriens, Menno R., E-mail: mvriens@umcutrecht.nl [Department of Surgery, University Medical Center Utrecht (Netherlands)

    2015-04-15

    Context: Only a minority of thyroid nodules is malignant; nevertheless, many invasive diagnostic procedures are performed to distinguish between benign and malignant nodules. Qualitative ultrasound elastography is a non-invasive technique to evaluate thyroid nodules. Objective: To investigate the diagnostic value of qualitative elastography in distinguishing benign from malignant thyroid nodules in patients referred for fine-needle aspiration (FNA). Data sources: A systematic literature search (PubMed, Embase and Cochrane Library) was performed. Study selection: Included studies reported thyroid nodule elastography color scores and the related cytologic or histologic findings in patients with a thyroid nodule referred for FNA. Data extraction: Two independent reviewers extracted study data and assessed study quality. Pooled sensitivities and specificities of different populations were calculated using a bivariate Bayesian framework. Data Synthesis: Twenty studies including thyroid nodules were analyzed. Pooled results of elastography indicate a summary sensitivity of 85% (95% confidence interval [CI], 79–90%) and specificity of 80% (95% CI, 73–86%). The respective pooled negative predictive and positive predictive values were 97% (95% CI, 94–98%) and 40% (95% CI, 34–48%). The pretest probability of a benign nodule was 82%. Only 3.7% of the false-negative nodules was a follicular thyroid carcinoma. A pooled negative predictive value of 99% (95% CI, 97–100%) was found when only complete soft nodules (Asteria elastography 1) were classified as benign, which included 14% of the studied population. Conclusions: Elastography has a fair specificity and sensitivity for diagnostic accuracy. Its major strength entails the detection of benignity, especially when only completely soft nodules are qualified as benign. The outcomes of our analysis show that FNA could safely be omitted in patients referred for analysis of their thyroid nodule when elastography shows it

  17. Qualitative systematic review: the unique experiences of the nurse-family member when a loved one is admitted with a critical illness.

    Science.gov (United States)

    Giles, Tracey M; Hall, Karen L

    2014-07-01

    To interpret and synthesize nurse-family member experiences when a critically ill loved one is admitted to hospital. Having a family member hospitalized in a critical condition is an important stressor. When the family member is also a nurse, the provision of care is more complex, yet little research exists on this issue. Systematic review using Thomas and Harden's approach to thematic synthesis of qualitative research. Primary studies were located by searching CINAHL, Proquest, Journals@Ovid, SCOPUS, Cochrane Library and Google Scholar. No date restrictions were applied due to a lack of relevant literature. All studies that met inclusion criteria were retrieved (n = 1717) and seven met the review aim. Following critical appraisal, seven studies from 1999-2011 describing the nurse-family member's experience were reviewed and synthesized. Six characteristics of the nurse-family member experience were identified: specialized knowledge; dual-role conflicts; competing expectations; building relationships; being 'let in'; and healthcare setting. Nurse-family members experience important stressors that can negatively affect their psychological health and experience as a healthcare consumer. Nurse-family members want a different type of care than other healthcare consumers. Acknowledging nurse-family members' specialized knowledge and dual role, keeping them fully informed and allowing them to be with the patient and feel in control can reduce their fear and anxiety. Further research is needed to develop a deeper understanding of the unique experiences, challenges and needs of nurse-family members to provide them with an enhanced level of care. © 2013 John Wiley & Sons Ltd.

  18. The experience of adults who choose watchful waiting or active surveillance as an approach to medical treatment: a qualitative systematic review.

    Science.gov (United States)

    Rittenmeyer, Leslie; Huffman, Dolores; Alagna, Michael; Moore, Ellen

    2016-02-01

    "Watchful waiting" or "active surveillance" is an alternative approach in the medical management of certain diseases. Most often considered appropriate as an approach to treatment for low-risk prostate cancer, it is also found in the literature in breast cancer surveillance, urinary lithiasis, lymphocytic leukemia, depression and small renal tumors. This systematic review sought to:Identify and synthesize the best available international evidence on the experience of adults who choose watchful waiting or active surveillance as an approach to medical treatment. To this end the questions addressed in this review were:1. How do patients who have chosen watchful waiting or active surveillance describe the process of coming to the decision?2. What were the factors that influenced their decision to choose?3. How do patients who have chosen watchful waiting or active surveillance describe the experience? Male or female patients, 18 years or older, who experience the phenomenon of choosing or not choosing watchful waiting or active surveillance as a treatment approach.The phenomena of interest were accounts of the experiences of adult patients who choose watchful waiting or active surveillance as an approach to medical treatment.This review considered studies that focused on qualitative data including, but not limited to, designs such as phenomenology, grounded theory, ethnography, action research and critical theory. Mixed method studies with narrative description and patient voice were also considered. Grey literature such as research reports and dissertations were also included. The search strategy aimed to find both published and unpublished studies through electronic databases, reference lists, and the World Wide Web. Extensive searches were undertaken of relevant databases to include CINAHL, PubMed, SCOPUS and PsycINFO. A three-step search strategy was used in each component of the review. Studies were limited to English language papers. The search considered papers

  19. Experience of care for mental health problems in the antenatal or postnatal period for women in the UK: a systematic review and meta-synthesis of qualitative research.

    Science.gov (United States)

    Megnin-Viggars, Odette; Symington, Iona; Howard, Louise M; Pilling, Stephen

    2015-12-01

    Pregnancy and the first postnatal year can be a difficult and distressing period for women with mental health problems, particularly if they are not able to access appropriate and timely assessment and treatment. The aim of this systematic review was to synthesise qualitative evidence on experiences of care for women with (or at risk of developing) antenatal or postnatal mental health problems across a range of disorders (including non-psychotic mental disorders). Six electronic databases were searched for papers published from 2000 to April 2014. Thirty-nine studies were identified that met the inclusion criteria. Findings were synthesised using secondary framework and thematic analysis approaches. Seven key themes were identified across mental disorder groups: an unmet need for collaborative and integrated care; stigma and fears about loss of custody; healthcare professionals unable or unwilling to address psychological needs; focus on babies over mothers; importance of non-judgmental and compassionate support; an unmet need for information; importance of service user involvement in treatment decisions. Women's experience of accessing and engaging with care for mental health problems could be improved if given the opportunity to develop trusting relationships with healthcare professionals who acknowledge and reinforce the woman's role in caring for her baby in a non-judgmental and compassionate manner, and foster hope and optimism about treatment. Information for women, their families and healthcare professionals, and the provision of individualised care and treatment, are also crucial to enable full implementation of a person-centred programme of care.

  20. Combining paracetamol (acetaminophen) with nonsteroidal antiinflammatory drugs: a qualitative systematic review of analgesic efficacy for acute postoperative pain.

    Science.gov (United States)

    Ong, Cliff K S; Seymour, Robin A; Lirk, Phillip; Merry, Alan F

    2010-04-01

    There has been a trend over recent years for combining a nonsteroidal antiinflammatory drug (NSAID) with paracetamol (acetaminophen) for pain management. However, therapeutic superiority of the combination of paracetamol and an NSAID over either drug alone remains controversial. We evaluated the efficacy of the combination of paracetamol and an NSAID versus either drug alone in various acute pain models. A systematic literature search of Medline, Embase, Cumulative Index to Nursing and Allied Health Literature, and PubMed covering the period from January 1988 to June 2009 was performed to identify randomized controlled trials in humans that specifically compared combinations of paracetamol with various NSAIDs versus at least 1 of these constituent drugs. Identified studies were stratified into 2 groups: paracetamol/NSAID combinations versus paracetamol or NSAIDs. We analyzed pain intensity scores and supplemental analgesic requirements as primary outcome measures. In addition, each study was graded for quality using a validated scale. Twenty-one human studies enrolling 1909 patients were analyzed. The NSAIDs used were ibuprofen (n = 6), diclofenac (n = 8), ketoprofen (n = 3), ketorolac (n = 1), aspirin (n = 1), tenoxicam (n = 1), and rofecoxib (n = 1). The combination of paracetamol and NSAID was more effective than paracetamol or NSAID alone in 85% and 64% of relevant studies, respectively. The pain intensity and analgesic supplementation was 35.0% +/- 10.9% and 38.8% +/- 13.1% lesser, respectively, in the positive studies for the combination versus paracetamol group, and 37.7% +/- 26.6% and 31.3% +/- 13.4% lesser, respectively, in the positive studies for the combination versus the NSAID group. No statistical difference in median quality scores was found between experimental groups. Current evidence suggests that a combination of paracetamol and an NSAID may offer superior analgesia compared with either drug alone.

  1. Risk Perception and Anxiety Regarding Radiation after the 2011 Fukushima Nuclear Power Plant Accident: A Systematic Qualitative Review

    Science.gov (United States)

    Lyamzina, Yuliya; Suzuki, Yuriko; Murakami, Michio

    2017-01-01

    The purpose of this study was to provide a review of the publications of the risk perceptions or anxiety regarding radiation among people living in Japan after the 2011 Fukushima nuclear power plant accident. Two database (MEDLINE and PsycINFO) and hand-searched the references in identified publications were searched. For each identified publication, the measurements and time related-change of risk perception and anxiety regarding radiation were summarized. Twenty-four publications were identified. Quantitative measures of risk perception or anxiety were roughly divided into two types: single-item Likert scales that measure anxiety about radiation; and theoretical, or model-based measures. Rates of Fukushima residents with radiation-related anxiety decreased from 2012 to 2015. Factors governing risk perception or radiation-related anxiety were summarized by demographics, disaster-related stressors, trusted information, and radiation-related variables. The effects of risk perception or anxiety regarding radiation were summarized as severe distress, intention to leave employment or not to return home, or other dimensions. This review provides summary of current findings on risk perception or anxiety regarding radiation in Japan after the accident. Further researches are needed about detailed statistical analysis for time-related change and causality among variables. PMID:29077045

  2. Risk Perception and Anxiety Regarding Radiation after the 2011 Fukushima Nuclear Power Plant Accident: A Systematic Qualitative Review

    Directory of Open Access Journals (Sweden)

    Yoshitake Takebayashi

    2017-10-01

    Full Text Available The purpose of this study was to provide a review of the publications of the risk perceptions or anxiety regarding radiation among people living in Japan after the 2011 Fukushima nuclear power plant accident. Two database (MEDLINE and PsycINFO and hand-searched the references in identified publications were searched. For each identified publication, the measurements and time related-change of risk perception and anxiety regarding radiation were summarized. Twenty-four publications were identified. Quantitative measures of risk perception or anxiety were roughly divided into two types: single-item Likert scales that measure anxiety about radiation; and theoretical, or model-based measures. Rates of Fukushima residents with radiation-related anxiety decreased from 2012 to 2015. Factors governing risk perception or radiation-related anxiety were summarized by demographics, disaster-related stressors, trusted information, and radiation-related variables. The effects of risk perception or anxiety regarding radiation were summarized as severe distress, intention to leave employment or not to return home, or other dimensions. This review provides summary of current findings on risk perception or anxiety regarding radiation in Japan after the accident. Further researches are needed about detailed statistical analysis for time-related change and causality among variables.

  3. Risk Perception and Anxiety Regarding Radiation after the 2011 Fukushima Nuclear Power Plant Accident: A Systematic Qualitative Review.

    Science.gov (United States)

    Takebayashi, Yoshitake; Lyamzina, Yuliya; Suzuki, Yuriko; Murakami, Michio

    2017-10-27

    The purpose of this study was to provide a review of the publications of the risk perceptions or anxiety regarding radiation among people living in Japan after the 2011 Fukushima nuclear power plant accident. Two database (MEDLINE and PsycINFO) and hand-searched the references in identified publications were searched. For each identified publication, the measurements and time related-change of risk perception and anxiety regarding radiation were summarized. Twenty-four publications were identified. Quantitative measures of risk perception or anxiety were roughly divided into two types: single-item Likert scales that measure anxiety about radiation; and theoretical, or model-based measures. Rates of Fukushima residents with radiation-related anxiety decreased from 2012 to 2015. Factors governing risk perception or radiation-related anxiety were summarized by demographics, disaster-related stressors, trusted information, and radiation-related variables. The effects of risk perception or anxiety regarding radiation were summarized as severe distress, intention to leave employment or not to return home, or other dimensions. This review provides summary of current findings on risk perception or anxiety regarding radiation in Japan after the accident. Further researches are needed about detailed statistical analysis for time-related change and causality among variables.

  4. The experience of attempting to return to work following spinal cord injury: a systematic review of the qualitative literature.

    Science.gov (United States)

    Hilton, Gillean; Unsworth, Carolyn; Murphy, Gregory

    2018-07-01

    This review sought to answer the question "What are the barriers and facilitators influencing people's experience of return to work following spinal cord injury?" Studies that met the selection criteria were identified, presented and critically appraised using National Institute for Health and Care Excellence guidelines. Thematic synthesis was completed with studies possessing strong methodological rigor. Synthesis and interpretation involved three stages; coding of primary data; development of descriptive themes reflective of the primary data; and establishment of analytical themes to answer the review question. Data from nine papers were included in the thematic synthesis. Several descriptive themes and three analytical themes were drawn from the data to answer the research question. Analytical themes included: a matrix of personal and environmental factors exists requiring complex navigation in order to create possibilities and opportunities for postinjury employment; the process of seeking or gaining employment shares a reciprocal relationship with the temporal nature of adjustment to spinal cord injury; and there is an intrinsic need for occupational engagement through paid employment. Returning to or gaining employment after spinal cord injury is a fundamentally difficult experience for people. Multiple strategies are required to support the navigation of the process. There is, however, a need in people with spinal cord injury, to be a worker, and with that comes the inherent benefits of being employed. Implications for rehabilitation Returning to work should be a significant focus of spinal cord injury rehabilitation. Employment is both possible and health promoting following spinal cord injury. Multiple strategies are required to support people to navigate the return to work process. It is important to be cognizant of the individual motivations for being a worker and the complexity of the adjustment process. Spinal cord injury centers can provide a

  5. Swaddling: A Systematic Review

    NARCIS (Netherlands)

    van Sleuwen, Bregje E.; Engelberts, Adèle C.; Boere-Boonekamp, Magdalena M.; Kuis, Wietse; Schulpen, Tom W.J.

    2007-01-01

    Swaddling was an almost universal child-care practice before the 18th century. It is still tradition in certain parts of the Middle East and is gaining popularity in the United Kingdom, the United States, and the Netherlands to curb excessive crying. We have systematically reviewed all articles on

  6. Swaddling : A systematic review

    NARCIS (Netherlands)

    van Sleuwen, Bregje E.; Engelberts, Adele C.; Boere-Boonekamp, Magda M.; Kuis, Wietse; Schulpen, Tom W. J.; L'Hoir, Monique P.

    2007-01-01

    Swaddling was an almost universal child-care practice before the 18th century. It is still tradition in certain parts of the Middle East and is gaining popularity in the United Kingdom, the United States, and the Netherlands to curb excessive crying. We have systematically reviewed all articles on

  7. Longer-term needs of stroke survivors with communication difficulties living in the community: a systematic review and thematic synthesis of qualitative studies.

    Science.gov (United States)

    Wray, Faye; Clarke, David

    2017-10-06

    To review and synthesise qualitative literature relating to the longer-term needs of community dwelling stroke survivors with communication difficulties including aphasia, dysarthria and apraxia of speech. Systematic review and thematic synthesis. We included studies employing qualitative methodology which focused on the perceived or expressed needs, views or experiences of stroke survivors with communication difficulties in relation to the day-to-day management of their condition following hospital discharge. We searched MEDLINE, EMBASE, PsycINFO, CINAHL, The Cochrane Library, International Bibliography of the Social Sciences and AMED and undertook grey literature searches. Studies were assessed for methodological quality by two researchers independently and the findings were combined using thematic synthesis. Thirty-two studies were included in the thematic synthesis. The synthesis reveals the ongoing difficulties stroke survivors can experience in coming to terms with the loss of communication and in adapting to life with a communication difficulty. While some were able to adjust, others struggled to maintain their social networks and to participate in activities which were meaningful to them. The challenges experienced by stroke survivors with communication difficulties persisted for many years poststroke. Four themes relating to longer-term need were developed: managing communication outside of the home, creating a meaningful role, creating or maintaining a support network and taking control and actively moving forward with life. Understanding the experiences of stroke survivors with communication difficulties is vital for ensuring that longer-term care is designed according to their needs. Wider psychosocial factors must be considered in the rehabilitation of people with poststroke communication difficulties. Self-management interventions may be appropriate to help this subgroup of stroke survivors manage their condition in the longer-term; however, such

  8. Quality of systematic reviews in pediatric oncology - A systematic review

    NARCIS (Netherlands)

    Lundh, Andreas; Knijnenburg, Sebastiaan L.; Jørgensen, Anders W.; van Dalen, Elvira C.; Kremer, Leontien C. M.

    2009-01-01

    Background: To ensure evidence-based decision making in pediatric oncology systematic reviews are necessary. The objective of our study was to evaluate the methodological quality of all currently existing systematic reviews in pediatric oncology. Methods: We identified eligible systematic reviews

  9. Patient-centered early pregnancy care: a systematic review of quantitative and qualitative studies on the perspectives of women and their partners.

    Science.gov (United States)

    van den Berg, M M J; Dancet, E A F; Erlikh, T; van der Veen, F; Goddijn, M; Hajenius, P J

    2018-01-01

    Early pregnancy complications, defined as miscarriage, recurrent miscarriage or ectopic pregnancy, affect the physical and psychological well-being of intended parents. Research in this field so far has focused mainly on improving accuracy of diagnostic tests and safety and effectiveness of therapeutic management. An overview of aspects of care valued by women and/or their partners is missing. This systematic review aims to provide an overview of aspects of care valued by women and/or their partners faced with early pregnancy complications and to identify potential targets for improvement in early pregnancy healthcare. We searched five electronic databases for empirical quantitative or qualitative studies on patients' perspectives of early pregnancy care in July 2017. We first identified aspects of early pregnancy care valued by women and/or their partners based on qualitative and quantitative data and organized these aspects of care according to the eight dimensions of patient-centered care. Second, we extracted the assessment of service quality from women and/or their partners on each of these aspects of care based on quantitative data. Third, we combined the findings on patients' values with the findings of service quality assessment to identify potential targets for improvement in five groups according to how likely these targets are to require improvement. The search yielded 6240 publications, of which 27 studies were eligible for inclusion in this review. All included studies focused on miscarriage or recurrent miscarriage care. We identified 24 valued aspects of care, which all covered the eight dimensions of patient-centered care. The most frequently reported valued aspect was 'being treated as an individual person experiencing a significant life event rather than a common condition'. Assessment of service quality from women and/or their partners was available for 13 of the 24 identified aspects of care. Quantitative studies all documented service quality

  10. Integrating Evidence From Systematic Reviews, Qualitative Research, and Expert Knowledge Using Co-Design Techniques to Develop a Web-Based Intervention for People in the Retirement Transition.

    Science.gov (United States)

    O'Brien, Nicola; Heaven, Ben; Teal, Gemma; Evans, Elizabeth H; Cleland, Claire; Moffatt, Suzanne; Sniehotta, Falko F; White, Martin; Mathers, John C; Moynihan, Paula

    2016-08-03

    Integrating stakeholder involvement in complex health intervention design maximizes acceptability and potential effectiveness. However, there is little methodological guidance about how to integrate evidence systematically from various sources in this process. Scientific evidence derived from different approaches can be difficult to integrate and the problem is compounded when attempting to include diverse, subjective input from stakeholders. The intent of the study was to describe and appraise a systematic, sequential approach to integrate scientific evidence, expert knowledge and experience, and stakeholder involvement in the co-design and development of a complex health intervention. The development of a Web-based lifestyle intervention for people in retirement is used as an example. Evidence from three systematic reviews, qualitative research findings, and expert knowledge was compiled to produce evidence statements (stage 1). Face validity of these statements was assessed by key stakeholders in a co-design workshop resulting in a set of intervention principles (stage 2). These principles were assessed for face validity in a second workshop, resulting in core intervention concepts and hand-drawn prototypes (stage 3). The outputs from stages 1-3 were translated into a design brief and specification (stage 4), which guided the building of a functioning prototype, Web-based intervention (stage 5). This prototype was de-risked resulting in an optimized functioning prototype (stage 6), which was subject to iterative testing and optimization (stage 7), prior to formal pilot evaluation. The evidence statements (stage 1) highlighted the effectiveness of physical activity, dietary and social role interventions in retirement; the idiosyncratic nature of retirement and well-being; the value of using specific behavior change techniques including those derived from the Health Action Process Approach; and the need for signposting to local resources. The intervention

  11. Integrating Evidence From Systematic Reviews, Qualitative Research, and Expert Knowledge Using Co-Design Techniques to Develop a Web-Based Intervention for People in the Retirement Transition

    Science.gov (United States)

    O'Brien, Nicola; Heaven, Ben; Teal, Gemma; Evans, Elizabeth H; Cleland, Claire; Moffatt, Suzanne; Sniehotta, Falko F; White, Martin; Mathers, John C

    2016-01-01

    Background Integrating stakeholder involvement in complex health intervention design maximizes acceptability and potential effectiveness. However, there is little methodological guidance about how to integrate evidence systematically from various sources in this process. Scientific evidence derived from different approaches can be difficult to integrate and the problem is compounded when attempting to include diverse, subjective input from stakeholders. Objective The intent of the study was to describe and appraise a systematic, sequential approach to integrate scientific evidence, expert knowledge and experience, and stakeholder involvement in the co-design and development of a complex health intervention. The development of a Web-based lifestyle intervention for people in retirement is used as an example. Methods Evidence from three systematic reviews, qualitative research findings, and expert knowledge was compiled to produce evidence statements (stage 1). Face validity of these statements was assessed by key stakeholders in a co-design workshop resulting in a set of intervention principles (stage 2). These principles were assessed for face validity in a second workshop, resulting in core intervention concepts and hand-drawn prototypes (stage 3). The outputs from stages 1-3 were translated into a design brief and specification (stage 4), which guided the building of a functioning prototype, Web-based intervention (stage 5). This prototype was de-risked resulting in an optimized functioning prototype (stage 6), which was subject to iterative testing and optimization (stage 7), prior to formal pilot evaluation. Results The evidence statements (stage 1) highlighted the effectiveness of physical activity, dietary and social role interventions in retirement; the idiosyncratic nature of retirement and well-being; the value of using specific behavior change techniques including those derived from the Health Action Process Approach; and the need for signposting to local

  12. First-time fathers' needs and experiences of transition to fatherhood in relation to their mental health and wellbeing: a qualitative systematic review protocol.

    Science.gov (United States)

    Baldwin, Sharin; Bick, Debra

    2017-03-01

    This qualitative review seeks to identify first-time fathers' needs and experiences in relation to their mental health and wellbeing during their transition to fatherhood. This will include resident first-time fathers who are either the biological or non-biological father.The objectives are to explore first-time fathers' experiences in relation to.

  13. Staff experiences within the implementation of computer-based nursing records in residential aged care facilities: a systematic review and synthesis of qualitative research.

    Science.gov (United States)

    Meißner, Anne; Schnepp, Wilfried

    2014-06-20

    Since the introduction of electronic nursing documentation systems, its implementation in recent years has increased rapidly in Germany. The objectives of such systems are to save time, to improve information handling and to improve quality. To integrate IT in the daily working processes, the employee is the pivotal element. Therefore it is important to understand nurses' experience with IT implementation. At present the literature shows a lack of understanding exploring staff experiences within the implementation process. A systematic review and meta-ethnographic synthesis of primary studies using qualitative methods was conducted in PubMed, CINAHL, and Cochrane. It adheres to the principles of the PRISMA statement. The studies were original, peer-reviewed articles from 2000 to 2013, focusing on computer-based nursing documentation in Residential Aged Care Facilities. The use of IT requires a different form of information processing. Some experience this new form of information processing as a benefit while others do not. The latter find it more difficult to enter data and this result in poor clinical documentation. Improvement in the quality of residents' records leads to an overall improvement in the quality of care. However, if the quality of those records is poor, some residents do not receive the necessary care. Furthermore, the length of time necessary to complete the documentation is a prominent theme within that process. Those who are more efficient with the electronic documentation demonstrate improved time management. For those who are less efficient with electronic documentation the information processing is perceived as time consuming. Normally, it is possible to experience benefits when using IT, but this depends on either promoting or hindering factors, e.g. ease of use and ability to use it, equipment availability and technical functionality, as well as attitude. In summary, the findings showed that members of staff experience IT as a benefit when

  14. An overview of systematic review.

    Science.gov (United States)

    Baker, Kathy A; Weeks, Susan Mace

    2014-12-01

    Systematic review is an invaluable tool for the practicing clinician. A well-designed systematic review represents the latest and most complete information available on a particular topic or intervention. This article highlights the key elements of systematic review, what it is and is not, and provides an overview of several reputable organizations supporting the methodological development and conduct of systematic review. Important aspects for evaluating the quality of a systematic review are also included. Copyright © 2014 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

  15. Systematic literature review

    DEFF Research Database (Denmark)

    Barnard, K. D.; Lloyd, C. E.; Skinner, T. C.

    2007-01-01

    mixed results, with one study reporting quality of life benefits and one reporting no evidence of quality of life benefits. Conclusions: There is conflicting evidence reported in the various studies on the quality of life benefits of CSII in Type 1 diabetes. Existing research is flawed, making......Aim: To review systematically the published literature addressing whether continuous subcutaneous insulin infusion (CSII) provides any quality of life benefits to people with Type 1 diabetes. Methods: Electronic databases and published references were searched and a consultation with two...

  16. Telerheumatology: A Systematic Review.

    Science.gov (United States)

    McDougall, John A; Ferucci, Elizabeth D; Glover, Janis; Fraenkel, Liana

    2017-10-01

    To identify and summarize the published and gray literature on the use of telemedicine for the diagnosis and management of inflammatory and/or autoimmune rheumatic disease. We performed a registered systematic search (CRD42015025382) for studies using MEDLINE (1946 to July 2015), Embase (1974 to July 2015), Web of Science (1900 to July 2015), and Scopus (1946 to July 2015) databases. We included studies that demonstrated the use of telemedicine for diagnosis and/or management of inflammatory/autoimmune rheumatic disease. Following data extraction, we performed a descriptive analysis. Our literature search identified 1,468 potentially eligible studies. Of these studies, 20 were ultimately included in this review. Studies varied significantly in publication type, quality of evidence, and the reporting of methods. Most demonstrated a high risk of bias. Rheumatoid arthritis was the most commonly studied rheumatic disease (42% of patients). Studies demonstrated conflicting results regarding the effectiveness of telemedicine (18 found it effective, 1 found it effective but possibly harmful, and 1 found it ineffective). A limited number of studies included some component of a cost analysis (n = 6; 16% of patients); all of these found telemedicine to be cost-effective. Studies identified by this systematic review generally found telemedicine to be effective for the diagnosis and management of autoimmune/inflammatory rheumatic disease; however, there is limited evidence to support this conclusion. Further studies are needed to determine the best uses of telemedicine for the diagnosis and management of these conditions. © 2016, American College of Rheumatology.

  17. Experiences of the home-dwelling elderly in the use of telecare in home care services: a qualitative systematic review protocol.

    Science.gov (United States)

    Karlsen, Cecilie; Ludvigsen, Mette S; Moe, Carl E; Haraldstad, Kristin; Thygesen, Elin

    2017-05-01

    The objective of this systematic review is to identify and synthesize the best evidence on the home-dwelling elderly's experiences with the use of telecare in home care services. Furthermore, the study will identify experiences with telecare devices and examine what beliefs the home-dwelling elderly hold regarding the impact of telecare on the ability to age in place.Review question 1: How do the home-dwelling elderly experience the use of telecare in the context of home care services?Review question 2: How do the home-dwelling elderly experience telecare devices?Review question 3: What beliefs do the home-dwelling elderly hold regarding the impact of telecare on the ability to age in place?

  18. A systematic review and evidence synthesis of qualitative studies to identify primary care clinicians' barriers and enablers to the management of osteoarthritis.

    Science.gov (United States)

    Egerton, T; Diamond, L E; Buchbinder, R; Bennell, K L; Slade, S C

    2017-05-01

    Primary care management of osteoarthritis (OA) is variable and often inconsistent with clinical practice guidelines (CPGs). This study aimed to identify and synthesize available qualitative evidence on primary care clinicians' views on providing recommended management of OA. Eligibility criteria included full reports published in peer-reviewed journals, with data collected directly from primary care clinicians using qualitative methods for collection and analysis. Five electronic databases (MEDLINE, Cochrane Central Register, EMBASE, CINAHL and PsychInfo) were searched to August 2016. Two independent reviewers identified eligible reports, conducted critical appraisal (based on Critical Appraisal Skills Programme (CASP) criteria), and extracted data. Three reviewers independently, then collaboratively, synthesized and interpreted data through an inductive and iterative process to derive new themes. The Confidence in Evidence from Reviews of Qualitative research (CERQual) approach was used to determine a confidence profile for each finding. Eight studies involving approximately 83 general practitioners (GPs), 24 practice nurses, 12 pharmacists and 10 physical therapists, from Australia, France, United Kingdom, Germany and Mexico were included. Four barriers were identified as themes 1) OA is not that serious, 2) Clinicians are, or perceive they are, under-prepared, 3) Personal beliefs at odds with providing recommended practice, and 4) Dissonant patient expectations. No themes were enablers. Confidence ratings were moderate or low. Synthesising available data revealed barriers that collectively point towards a need to address clinician knowledge gaps, and enhance clinician communication and behaviour change skills to facilitate patient adherence, enable effective conversations and manage dissonant patient expectations. PROSPERO (http://www.crd.york.ac.uk/PROSPERO) [4/11/2015, CRD42015027543]. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

  19. Gynecomastia: A systematic review.

    Science.gov (United States)

    Fagerlund, Anders; Lewin, Richard; Rufolo, Guglielmo; Elander, Anna; Santanelli di Pompeo, Fabio; Selvaggi, Gennaro

    2015-01-01

    Gynecomastia is a common medical problem presenting in nearly a third of the male population. Treatment for gynecomastia can be either pharmacological or surgical. Patients with gynecomastia often experience affected quality-of-life. The aim of this systematic review was to analyze the quality of evidence of the current literature in relation to different treatment modalities and Quality-of-Life in patients with gynecomastia. A systematic search of the literature was performed in PubMed, Medline, Scopus, The Cochrane Library, and SveMed+ in accordance with the PRISMA statement. All searches were undertaken between September-November 2014. The PICOS (patients, intervention, comparator, outcomes, and study design) approach was used to specify inclusion criteria. Methodological quality was graded according to MINORS. Quality of evidence was rated according to GRADE. Data from the included studies were extracted based on study characteristics, participants specifics, type of intervention/treatment, and type of outcome measures into data extraction forms. A total of 134 abstracts were identified in the literature search. Seventeen studies met inclusion criteria, 14 concerning treatment and three concerning Quality-of-Life. All studies were non-randomised with a high risk of bias and very low quality of evidence according to GRADE. Several different surgical methods have been described with good results, minimal scars, and various levels of complications. Traditional surgical excision of glandular tissue combined with liposuction provides most consistent results and a low rate of complications. Pubertal gynecomastia may safely be managed by pharmacological anti-oestrogen treatment.

  20. Iridology: A systematic review.

    Science.gov (United States)

    Ernst, E

    1999-02-01

    Iridologists claim to be able to diagnose medical conditions through abnormalities of pigmentation in the iris. This technique is popular in many countries. Therefore it is relevant to ask whether it is valid. To systematically review all interpretable tests of the validity of iridology as a diagnostic tool. DATA SOURCE AND EXTRACTION: Three independent literature searches were performed to identify all blinded tests. Data were extracted in a predefined, standardized fashion. Four case control studies were found. The majority of these investigations suggests that iridology is not a valid diagnostic method. The validity of iridology as a diagnostic tool is not supported by scientific evaluations. Patients and therapists should be discouraged from using this method.

  1. Family Adjustment to Childhood Cancer: A Systematic Review

    Science.gov (United States)

    Long, Kristin A.; Marsland, Anna L.

    2011-01-01

    This systematic review integrates qualitative and quantitative research findings regarding family changes in the context of childhood cancer. Twenty-eight quantitative, 42 qualitative, and one mixed-method studies were reviewed. Included studies focused on family functioning, marital quality, and/or parenting in the context of pediatric cancer,…

  2. Systematic reviews of and integrated report on the quantitative, qualitative and economic evidence base for the management of obesity in men.

    OpenAIRE

    Robertson, C.; Archibald, D.; Avenell, A.; Douglas, F.; Hoddinott, P.; Van Teijlingen, Edwin; Boyers, D.; Stewart, F.; Boachie, C.; Fioratou, E.; Wilkins, D.; Street, T.; Carroll, P.; Fowler, C.

    2014-01-01

    Background\\ud Obesity increases the risk of many serious illnesses such as coronary heart disease, type 2 diabetes and osteoarthritis. More men than women are overweight or obese in the UK but men are less likely to perceive their weight as a problem and less likely to engage with weight-loss services.\\ud Objective\\ud The aim of this study was to systematically review evidence-based management strategies for treating obesity in men and investigate how to engage men in obesity services by inte...

  3. The views and experiences of nurses and midwives in the provision and management of provider-initiated HIV testing and counseling: a systematic review of qualitative evidence.

    Science.gov (United States)

    Evans, Catrin; Nalubega, Sylivia; McLuskey, John; Darlington, Nicola; Croston, Michelle; Bath-Hextall, Fiona

    2016-01-15

    Global progress towards HIV prevention and care is contingent upon increasing the number of those aware of their status through HIV testing. Provider-initiated HIV testing and counseling is recommended globally as a strategy to enhance uptake of HIV testing and is primarily conducted by nurses and midwives. Research shows that provider-initiated HIV testing and counseling implementation is sub-optimal. The reasons for this are unclear. The review aimed to explore nurses' and midwives' views and experiences of the provision and management of provider-initiated HIV testing and counseling. All cadres of nurses and midwives were considered, including those who undertake routine HIV testing as part of a diverse role and those who are specifically trained as HIV counselors. Types of phenomenon of interest: The review sought to understand the views and experiences of the provision and management of provider-initiated HIV testing and counseling (including perceptions, opinions, beliefs, practices and strategies related to HIV testing and its implementation in practice). The review included only provider-initiated HIV testing and counseling. It excluded all other models of HIV testing. The review included all countries and all healthcare settings. Types of studies: This review considered all forms of qualitative study design and methodology. Qualitative elements of a mixed method study were included if they were presented separately within the publication. A three-step search strategy was utilized. Eight databases were searched for papers published from 1996 to October 2014, followed by hand searching of reference lists. Only studies published in the English language were considered. Methodological quality was assessed using the Qualitative Assessment and Review Instrument developed by the Joanna Briggs Institute. Qualitative findings were extracted using the Joanna Briggs Institute Qualitative Assessment and Review Instrument. Qualitative research findings were pooled

  4. Systematic Reviews in Sports Medicine.

    Science.gov (United States)

    DiSilvestro, Kevin J; Tjoumakaris, Fotios P; Maltenfort, Mitchell G; Spindler, Kurt P; Freedman, Kevin B

    2016-02-01

    The number of systematic reviews published in the orthopaedic literature has increased, and these reviews can help guide clinical decision making. However, the quality of these reviews can affect the reader's ability to use the data to arrive at accurate conclusions and make clinical decisions. To evaluate the methodological and reporting quality of systematic reviews and meta-analyses in the sports medicine literature to determine whether such reviews should be used to guide treatment decisions. The hypothesis was that many systematic reviews in the orthopaedic sports medicine literature may not follow the appropriate reporting guidelines or methodological criteria recommended for systematic reviews. Systematic review. All clinical sports medicine systematic reviews and meta-analyses from 2009 to 2013 published in The American Journal of Sports Medicine (AJSM), The Journal of Bone and Joint Surgery (JBJS), Arthroscopy, Sports Health, and Knee Surgery, Sports Traumatology, Arthroscopy (KSSTA) were reviewed and evaluated for level of evidence according to the guidelines from the Oxford Centre for Evidence-Based Medicine, for reporting quality according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, and for methodological quality according to the Assessment of Multiple Systematic Reviews (AMSTAR) tool. Analysis was performed by year and journal of publication, and the levels of evidence included in the systematic reviews were also analyzed. A total of 200 systematic reviews and meta-analyses were identified over the study period. Of these, 53% included evidence levels 4 and 5 in their analyses, with just 32% including evidence levels 1 and 2 only. There were significant differences in the proportion of articles with high levels of evidence (P Systematic reviews and meta-analyses in orthopaedics sports medicine literature relied on evidence levels 4 and 5 in 53% of studies over the 5-year study period. Overall, PRISMA and

  5. The barriers and facilitators to smoking cessation experienced by women's partners during pregnancy and the post-partum period: a systematic review of qualitative research.

    Science.gov (United States)

    Flemming, Kate; Graham, Hilary; McCaughan, Dorothy; Angus, Kathryn; Bauld, Linda

    2015-09-03

    Smoking in pregnancy can cause substantial harm and, while many women quit, others continue to smoke throughout pregnancy. The role of partners is an important but relatively under-researched factor in relation to women's smoking in pregnancy; partner's smoking status and attitudes to smoking cessation are important influences in a pregnant women's attempt to quit. Further understanding of how partners perceive the barriers and facilitators to smoking cessation in pregnancy is needed, particularly from qualitative studies where participants describe these issues in their own words. A synthesis of qualitative research of partners' views of smoking in pregnancy and post-partum was conducted using meta-ethnography. Searches were undertaken from 1990 to January 2014 using terms for partner/household, pregnancy, post-partum, smoking, qualitative in seven electronic databases. The review was reported in accordance with the 'Enhancing transparency in reporting the synthesis of qualitative research' (ENTREQ) statement. Nine studies reported in 14 papers were included, detailing the experience of 158 partners; the majority were interviewed during the post-partum period. Partners were all male, with a single exception. Socioeconomic measures indicated that most participants were socially disadvantaged. The synthesis identified recurring smoking-related perceptions and experiences that hindered (barriers) and encouraged (facilitators) partners to consider quitting during the woman's pregnancy and into the post-partum period. These were represented in five lines of argument relating to: smoking being an integral part of everyday life; becoming and being a father; the couple's relationship; perceptions of the risks of smoking; and their harm reduction and quitting strategies. The cluster of identified barriers and facilitators to quitting offers pointers for policy and practice. The workplace emerges as an important space for and influence on partners' smoking habits

  6. Aromatherapy: a systematic review.

    Science.gov (United States)

    Cooke, B; Ernst, E

    2000-01-01

    Aromatherapy is becoming increasingly popular; however there are few clear indications for its use. To systematically review the literature on aromatherapy in order to discover whether any clinical indication may be recommended for its use, computerised literature searches were performed to retrieve all randomised controlled trials of aromatherapy from the following databases: MEDLINE, EMBASE, British Nursing Index, CISCOM, and AMED. The methodological quality of the trials was assessed using the Jadad score. All trials were evaluated independently by both authors and data were extracted in a pre-defined, standardised fashion. Twelve trials were located: six of them had no independent replication; six related to the relaxing effects of aromatherapy combined with massage. These studies suggest that aromatherapy massage has a mild, transient anxiolytic effect. Based on a critical assessment of the six studies relating to relaxation, the effects of aromatherapy are probably not strong enough for it to be considered for the treatment of anxiety. The hypothesis that it is effective for any other indication is not supported by the findings of rigorous clinical trials. PMID:10962794

  7. Smoking in Video Games: A Systematic Review

    OpenAIRE

    Forsyth, SR; Malone, RE

    2016-01-01

    INTRODUCTION: Video games are played by a majority of adolescents, yet little is known about whether and how video games are associated with smoking behavior and attitudes. This systematic review examines research on the relationship between video games and smoking. METHODS: We searched MEDLINE, psycINFO, and Web of Science through August 20, 2014. Twenty-four studies met inclusion criteria. Studies were synthesized qualitatively in four domains: the prevalence and incidence of smoking imager...

  8. Systematic text condensation: a strategy for qualitative analysis.

    Science.gov (United States)

    Malterud, Kirsti

    2012-12-01

    To present background, principles, and procedures for a strategy for qualitative analysis called systematic text condensation and discuss this approach compared with related strategies. Giorgi's psychological phenomenological analysis is the point of departure and inspiration for systematic text condensation. The basic elements of Giorgi's method and the elaboration of these in systematic text condensation are presented, followed by a detailed description of procedures for analysis according to systematic text condensation. Finally, similarities and differences compared with other frequently applied methods for qualitative analysis are identified, as the foundation of a discussion of strengths and limitations of systematic text condensation. Systematic text condensation is a descriptive and explorative method for thematic cross-case analysis of different types of qualitative data, such as interview studies, observational studies, and analysis of written texts. The method represents a pragmatic approach, although inspired by phenomenological ideas, and various theoretical frameworks can be applied. The procedure consists of the following steps: 1) total impression - from chaos to themes; 2) identifying and sorting meaning units - from themes to codes; 3) condensation - from code to meaning; 4) synthesizing - from condensation to descriptions and concepts. Similarities and differences comparing systematic text condensation with other frequently applied qualitative methods regarding thematic analysis, theoretical methodological framework, analysis procedures, and taxonomy are discussed. Systematic text condensation is a strategy for analysis developed from traditions shared by most of the methods for analysis of qualitative data. The method offers the novice researcher a process of intersubjectivity, reflexivity, and feasibility, while maintaining a responsible level of methodological rigour.

  9. Development of an explanatory model of sexual intimacy following treatment for localised prostate cancer: A systematic review and meta-synthesis of qualitative evidence.

    Science.gov (United States)

    Tucker, Samantha R; Speer, Susan A; Peters, Sarah

    2016-08-01

    Prostate cancer is a leading cause of cancer in men, affecting one in eight. An ageing population coupled with increased testing indicates that the incidence of early-stage prostate cancer is rising rapidly. Treatments are effective, but all can result in chronic sexual side effects and impact on the psychological, emotional and relational components of sexual functioning. Whilst the physical consequences of treatment are well documented, we lack a comprehensive picture of the effects of localised prostate cancer treatment on men's experience of sexual intimacy and how this may affect survivorship and recovery. This study synthesises the qualitative literature related to men's experience of sexual intimacy in the context of localised prostate cancer. A systematic search strategy identified 12 studies, which were assessed using a modified version of the Critical Appraisal Skills Programme. Using Noblit and Hare's (1988) approach, a meta-synthesis was conducted. Findings are organised within four inter-related themes that form the basis of a new conceptual explanatory model: (i) Loss and grief: Destroyed intimacy; (ii) Going through the motions: Artificial intimacy; (iii) Fear of failure: Avoiding intimacy and (iv) Breaking barriers: Constructing an alternative intimacy. The LMAC (Loss, Motions, Avoidance and Construction) model provides a new way of conceptualising sexual recovery following prostate cancer treatment and opportunities for health care professionals to support men and their partners. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Experiences and management of fatigue in everyday life among adult patients living with heart failure: a systematic review of qualitative evidence.

    Science.gov (United States)

    Schjoedt, Inge; Sommer, Irene; Bjerrum, Merete Bender

    2016-03-01

    Fatigue, a common and distressing symptom of heart failure, is a non-specific, invisible and subjective experience, which is difficult to describe and for which there are no effective interventions. Fatigue negatively impacts on patients' everyday life, prognosis and quality of life, therefore it is important that patients can manage, monitor and respond to changes in fatigue. To cope with fatigue patients may need or seek advice on self-management strategies. To synthesize the best available evidence on the experiences and management of fatigue in everyday life among adult patients with stable heart failure. Adults with confirmed and stable heart failure. Studies exploring the experiences and management of fatigue in everyday life among adults with heart failure. Qualitative studies focusing on qualitative data, including, but not limited to, designs within phenomenology, grounded theory or ethnography. A three-step search strategy was used to identify published and unpublished qualitative studies from 1995 to 2014. Studies that met the inclusion criteria were assessed by two independent reviewers for methodological validity using the standardized critical appraisal tools of the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI). Data was extracted from the five included studies using JBI-QARI. Findings were identified and arranged according to the three research questions: patients' experiences of fatigue, impact of fatigue on everyday life and how patients' managed fatigue and its consequences in everyday life. Findings were pooled using JBI-QARI. From the five included studies, 108 findings were derived and subsequently aggregated into 24 categories, which were finally meta-synthesized into five syntheses: "A pervasive and unignorable bodily experience" captured the patients' descriptions of fatigue experiences; "Limited performance of daily living and social activities" and "Loss of self-esteem, identity and intellectual function

  11. Therapeutic benefit of balneotherapy and hydrotherapy in the management of fibromyalgia syndrome: a qualitative systematic review and meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Naumann, Johannes; Sadaghiani, Catharina

    2014-07-07

    In the present systematic review and meta-analysis, we assessed the effectiveness of different forms of balneotherapy (BT) and hydrotherapy (HT) in the management of fibromyalgia syndrome (FMS). A systematic literature search was conducted through April 2013 (Medline via Pubmed, Cochrane Central Register of Controlled Trials, EMBASE, and CAMBASE). Standardized mean differences (SMDs) and 95% confidence intervals (CIs) were calculated using a random-effects model. Meta-analysis showed moderate-to-strong evidence for a small reduction in pain (SMD -0.42; 95% CI [-0.61, -0.24]; P < 0.00001; I2 = 0%) with regard to HT (8 studies, 462 participants; 3 low-risk studies, 223 participants), and moderate-to-strong evidence for a small improvement in health-related quality of life (HRQOL; 7 studies, 398 participants; 3 low-risk studies, 223 participants) at the end of treatment (SMD -0.40; 95% CI [-0.62, -0.18]; P = 0.0004; I2 = 15%). No effect was seen at the end of treatment for depressive symptoms and tender point count (TPC). High-quality studies with larger sample sizes are needed to confirm the therapeutic benefit of BT and HT, with focus on long-term results and maintenance of the beneficial effects.

  12. Systematic Review Workshop (August 2013)

    Science.gov (United States)

    The goal for this workshop is to receive scientific input regarding approaches for different steps within a systematic review, such as evaluating individual studies, synthesizing evidence within a particular discipline, etc.

  13. Adherence to a Mediterranean-style diet and effects on cognition in adults: A qualitative evaluation of the systematic review of longitudinal and prospective trials

    Directory of Open Access Journals (Sweden)

    Roy J Hardman

    2016-07-01

    Full Text Available The Mediterranean-style diet (MedDiet involves substantial intake of fruits, vegetables, and fish, and a lower consumption of dairy, red meat, and sugars. Over the past 15 years much empirical evidence supports the suggestion that a MedDiet may be beneficial with respect to reducing the incidence of cardiovascular disease, cancer, metabolic syndrome, and dementia. A number of cross-sectional studies that have examined the impact of MedDiet on cognition have yielded largely positive results. The objective of this review is to evaluate longitudinal and prospective trials to gain an understanding of how a MedDiet may impact cognitive processes over time. The included studies were aimed at improving cognition or minimizing of cognitive decline. Studies reviewed included assessments of dietary status using either a food frequency questionnaire or a food diary assessment. Eighteen articles meeting our inclusion criteria were subjected to systematic review. These revealed that higher adherence to a MedDiet is associated with slower rates of cognitive decline, reduced conversion to Alzheimer’s disease (AD and improvements in cognitive function. The specific cognitive domains that were found to benefit with improved Mediterranean Diet Score (MedDietS were memory (delayed recognition, long-term and working memory executive function, and visual constructs. The current review has also considered a number of methodological issues in making recommendations for future research. The utilisation of a dietary pattern such as the Mediterranean style diet will be essential as part of the armamentarium to maintain quality of life and reduce the potential social and economic burden of dementia. Key Words: Nutrition, cognition, Mediterranean diet, clinical trials

  14. Service users’ experiences and views of aggressive situations in mental health care: a systematic review and thematic synthesis of qualitative studies

    Directory of Open Access Journals (Sweden)

    Gudde CB

    2015-10-01

    Full Text Available Camilla Buch Gudde,1,2 Turid Møller Olsø,4 Richard Whittington,1,5,6 Solfrid Vatne,3 1Forensic Department Brøset, Centre for Research and Education in Forensic Psychiatry, St Olavs Hospital, 2Department of Social Work and Health Science, Faculty of Social Science and Technology Management, NTNU, Trondheim, 3Institute of Health and Social Sciences, Molde University College, Molde, 4Norwegian Resource Centre for Community Mental Health, NTNU Social Research AS, 5Department of Neuroscience, Norwegian University of Science and Technology, NTNU, Trondheim, Norway; 6Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK Background: Aggressive situations occurring within mental health services can harm service users, staff, and the therapeutic environment. There is a consensus that the aggression phenomenon is multidimensional, but the picture is still unclear concerning the complex interplay of causal variables and their respective impact. To date, only a small number of empirical studies include users’ views of relevant factors. The main objective of this review is to identify and synthesize evidence relating to service users’ experiences and views of aggressive situations in mental health settings. Methods: We included qualitative studies of any design reporting on service users’ own experiences of conditions contributing to aggressive situations in mental health care and their views on preventative strategies. Eligible articles were identified through an electronic database search (PsycINFO, PubMed, Ovid Nursing Database, Embase, and CINAHL, hand search, and cross-referencing. Extracted data were combined and interpreted using aspects of thematic synthesis. Results: We reviewed 5,566 records and included 13 studies (ten qualitative and three mixed methods. Service users recognized that both their own mental state and negative aspects of the treatment environment affected the development of aggressive situations

  15. What is the impact on health and wellbeing of interventions that foster respect and social inclusion in community-residing older adults? A systematic review of quantitative and qualitative studies.

    Science.gov (United States)

    Ronzi, S; Orton, L; Pope, D; Valtorta, N K; Bruce, N G

    2018-01-30

    Many interventions have been developed to promote respect and social inclusion among older people, but the evidence on their impacts on health has not been synthesised. This systematic review aims to appraise the state of the evidence across the quantitative and qualitative literature. Eligible studies published between 1990 and 2015 were identified by scanning seven bibliographic databases using a pre-piloted strategy, searching grey literature and contacting experts. Studies were included if they assessed the impact (quantitatively) and/or perceived impact (qualitatively) of an intervention promoting respect and social inclusion on the physical or mental health of community-residing people aged 60 years and older. Titles and abstracts were screened for eligibility by one reviewer. A second reviewer independently screened a 10% random sample. Full texts were screened for eligibility by one reviewer, with verification by another reviewer. Risk of bias was assessed using standardised tools. Findings were summarised using narrative synthesis, harvest plots and logic models to depict the potential pathways to health outcomes. Of the 27,354 records retrieved, 40 studies (23 quantitative, 6 qualitative, 11 mixed methods) were included. All studies were conducted in high and upper middle-income countries. Interventions involved mentoring, intergenerational and multi-activity programmes, dancing, music and singing, art and culture and information-communication technology. Most studies (n = 24) were at high or moderate risk of bias. Music and singing, intergenerational interventions, art and culture and multi-activity interventions were associated with an overall positive impact on health outcomes. This included depression (n = 3), wellbeing (n = 3), subjective health (n = 2), quality of life (n = 2), perceived stress and mental health (n = 2) and physical health (n = 2). Qualitative studies offered explanations for mediating factors (e

  16. Broadening Public Participation in Systematic Reviews: A Case Example Involving Young People in Two Configurative Reviews

    Science.gov (United States)

    Oliver, Kathryn; Rees, Rebecca; Brady, Louca-Mai; Kavanagh, Josephine; Oliver, Sandy; Thomas, James

    2015-01-01

    Background: Arguments supporting the involvement of users in research have even more weight when involving the public in systematic reviews of research. We aimed to explore the potential for public involvement in systematic reviews of observational and qualitative studies. Methods: Two consultative workshops were carried out with a group of young…

  17. The difficulties of systematic reviews.

    Science.gov (United States)

    Westgate, Martin J; Lindenmayer, David B

    2017-10-01

    The need for robust evidence to support conservation actions has driven the adoption of systematic approaches to research synthesis in ecology. However, applying systematic review to complex or open questions remains challenging, and this task is becoming more difficult as the quantity of scientific literature increases. We drew on the science of linguistics for guidance as to why the process of identifying and sorting information during systematic review remains so labor intensive, and to provide potential solutions. Several linguistic properties of peer-reviewed corpora-including nonrandom selection of review topics, small-world properties of semantic networks, and spatiotemporal variation in word meaning-greatly increase the effort needed to complete the systematic review process. Conversely, the resolution of these semantic complexities is a common motivation for narrative reviews, but this process is rarely enacted with the rigor applied during linguistic analysis. Therefore, linguistics provides a unifying framework for understanding some key challenges of systematic review and highlights 2 useful directions for future research. First, in cases where semantic complexity generates barriers to synthesis, ecologists should consider drawing on existing methods-such as natural language processing or the construction of research thesauri and ontologies-that provide tools for mapping and resolving that complexity. These tools could help individual researchers classify research material in a more robust manner and provide valuable guidance for future researchers on that topic. Second, a linguistic perspective highlights that scientific writing is a rich resource worthy of detailed study, an observation that can sometimes be lost during the search for data during systematic review or meta-analysis. For example, mapping semantic networks can reveal redundancy and complementarity among scientific concepts, leading to new insights and research questions. Consequently

  18. The NTI-tss device for the therapy of bruxism, temporomandibular disorders, and headache – Where do we stand? A qualitative systematic review of the literature

    Science.gov (United States)

    Stapelmann, Henrike; Türp, Jens C

    2008-01-01

    Background The NTI-tss device is an anterior bite stop, which, according to the manufacturer, is indicated for the prevention and treatment of bruxism, temporomandibular disorders (TMDs), tension-type headaches, and migraine. The aim of this systematic review was to appraise the currently available evidence regarding the efficacy and safety of the NTI-tss splint. Methods We performed a systematic search in nine electronic databases and in NTI-tss-associated websites (last update: December 31, 2007). The reference lists of all relevant articles were perused. Five levels of scientific quality were distinguished. Reporting quality of articles about randomized controlled trials (RCTs) was evaluated using the Jadad score. To identify adverse events, we searched in the identified publications and in the MAUDE database. Results Nine of 68 relevant publications reported about the results of five different RCTs. Two RCTs concentrated on electromyographic (EMG) investigations in patients with TMDs and concomitant bruxism (Baad-Hansen et al 2007, Jadad score: 4) or with bruxism alone (Kavaklı 2006, Jadad score: 2); in both studies, compared to an occlusal stabilization splint the NTI-tss device showed significant reduction of EMG activity. Two RCTs focused exclusively on TMD patients; in one trial (Magnusson et al 2004, Jadad score: 3), a stabilization appliance led to greater improvement than an NTI-tss device, while in the other study (Jokstad et al 2005, Jadad score: 5) no difference was found. In one RCT (Shankland 2002, Jadad score: 1), patients with tension-type headache or migraine responded more favorably to the NTI-tss splint than to a bleaching tray. NTI-tss-induced complications related predominantly to single teeth or to the occlusion. Conclusion Evidence from RCTs suggests that the NTI-tss device may be successfully used for the management of bruxism and TMDs. However, to avoid potential unwanted effects, it should be chosen only if certain a patient will be

  19. The NTI-tss device for the therapy of bruxism, temporomandibular disorders, and headache – Where do we stand? A qualitative systematic review of the literature

    Directory of Open Access Journals (Sweden)

    Türp Jens C

    2008-07-01

    Full Text Available Abstract Background The NTI-tss device is an anterior bite stop, which, according to the manufacturer, is indicated for the prevention and treatment of bruxism, temporomandibular disorders (TMDs, tension-type headaches, and migraine. The aim of this systematic review was to appraise the currently available evidence regarding the efficacy and safety of the NTI-tss splint. Methods We performed a systematic search in nine electronic databases and in NTI-tss-associated websites (last update: December 31, 2007. The reference lists of all relevant articles were perused. Five levels of scientific quality were distinguished. Reporting quality of articles about randomized controlled trials (RCTs was evaluated using the Jadad score. To identify adverse events, we searched in the identified publications and in the MAUDE database. Results Nine of 68 relevant publications reported about the results of five different RCTs. Two RCTs concentrated on electromyographic (EMG investigations in patients with TMDs and concomitant bruxism (Baad-Hansen et al 2007, Jadad score: 4 or with bruxism alone (Kavaklı 2006, Jadad score: 2; in both studies, compared to an occlusal stabilization splint the NTI-tss device showed significant reduction of EMG activity. Two RCTs focused exclusively on TMD patients; in one trial (Magnusson et al 2004, Jadad score: 3, a stabilization appliance led to greater improvement than an NTI-tss device, while in the other study (Jokstad et al 2005, Jadad score: 5 no difference was found. In one RCT (Shankland 2002, Jadad score: 1, patients with tension-type headache or migraine responded more favorably to the NTI-tss splint than to a bleaching tray. NTI-tss-induced complications related predominantly to single teeth or to the occlusion. Conclusion Evidence from RCTs suggests that the NTI-tss device may be successfully used for the management of bruxism and TMDs. However, to avoid potential unwanted effects, it should be chosen only if certain a

  20. The NTI-tss device for the therapy of bruxism, temporomandibular disorders, and headache - where do we stand? A qualitative systematic review of the literature.

    Science.gov (United States)

    Stapelmann, Henrike; Türp, Jens C

    2008-07-29

    The NTI-tss device is an anterior bite stop, which, according to the manufacturer, is indicated for the prevention and treatment of bruxism, temporomandibular disorders (TMDs), tension-type headaches, and migraine. The aim of this systematic review was to appraise the currently available evidence regarding the efficacy and safety of the NTI-tss splint. We performed a systematic search in nine electronic databases and in NTI-tss-associated websites (last update: December 31, 2007). The reference lists of all relevant articles were perused. Five levels of scientific quality were distinguished. Reporting quality of articles about randomized controlled trials (RCTs) was evaluated using the Jadad score. To identify adverse events, we searched in the identified publications and in the MAUDE database. Nine of 68 relevant publications reported about the results of five different RCTs. Two RCTs concentrated on electromyographic (EMG) investigations in patients with TMDs and concomitant bruxism (Baad-Hansen et al 2007, Jadad score: 4) or with bruxism alone (Kavakli 2006, Jadad score: 2); in both studies, compared to an occlusal stabilization splint the NTI-tss device showed significant reduction of EMG activity. Two RCTs focused exclusively on TMD patients; in one trial (Magnusson et al 2004, Jadad score: 3), a stabilization appliance led to greater improvement than an NTI-tss device, while in the other study (Jokstad et al 2005, Jadad score: 5) no difference was found. In one RCT (Shankland 2002, Jadad score: 1), patients with tension-type headache or migraine responded more favorably to the NTI-tss splint than to a bleaching tray. NTI-tss-induced complications related predominantly to single teeth or to the occlusion. Evidence from RCTs suggests that the NTI-tss device may be successfully used for the management of bruxism and TMDs. However, to avoid potential unwanted effects, it should be chosen only if certain a patient will be compliant with follow-up appointments. The

  1. [Iridology: a systematic review].

    Science.gov (United States)

    Salles, Léia Fortes; Silva, Maria Júlia Paes

    2008-09-01

    This study is a literature review about Iridology/Irisdiagnose in the period from 1970 to 2005. The objective was to identify the worldwide scientific publications (articles) in this field and the opinions about the method. Twenty-five articles were found, four of them from Brazilian authors. About the category, 1 was literature review, 12 research studies and 12 updates, historical reviews or editorials. The countries that have contributed more with the studies were Brazil and Russia. Fifteen of those are in favor of the method and 10 are against it. In conclusion, it is necessary to develop more studies inside the methodological rigor, once Iridology brings hope to preventive medicine.

  2. Qualitative reasoning for biological network inference from systematic perturbation experiments.

    Science.gov (United States)

    Badaloni, Silvana; Di Camillo, Barbara; Sambo, Francesco

    2012-01-01

    The systematic perturbation of the components of a biological system has been proven among the most informative experimental setups for the identification of causal relations between the components. In this paper, we present Systematic Perturbation-Qualitative Reasoning (SPQR), a novel Qualitative Reasoning approach to automate the interpretation of the results of systematic perturbation experiments. Our method is based on a qualitative abstraction of the experimental data: for each perturbation experiment, measured values of the observed variables are modeled as lower, equal or higher than the measurements in the wild type condition, when no perturbation is applied. The algorithm exploits a set of IF-THEN rules to infer causal relations between the variables, analyzing the patterns of propagation of the perturbation signals through the biological network, and is specifically designed to minimize the rate of false positives among the inferred relations. Tested on both simulated and real perturbation data, SPQR indeed exhibits a significantly higher precision than the state of the art.

  3. Barriers to access and minority ethnic carers' satisfaction with social care services in the community: a systematic review of qualitative and quantitative literature

    Science.gov (United States)

    Greenwood, Nan; Habibi, Ruth; Smith, Raymond; Manthorpe, Jill

    2015-01-01

    As populations age, the numbers of carers overall and numbers of carers from minority ethnic groups in particular are rising. Evidence suggests that carers from all sections of the community and particularly carers from minority groups often fail to access care services. This may relate to barriers in accessing services and service dissatisfaction. The aim of this systematic review was to identify and summarise minority ethnic carers' perceptions of barriers to accessing community social care services and their satisfaction with these services if accessed. The following databases were searched from their start until July 2013: Social Care Online, Social Policy and Research, Scopus, PsychINFO, HMIC, ASSIA, MEDLINE, Embase, CINAHL Plus and AMED. Thirteen studies met the inclusion criteria. Most investigated either barriers to access or satisfaction levels, although three explored both. Only 4 studies investigated minority ethnic carers' satisfaction with social care, although 12 studies reported perceived barriers to accessing services. Few studies compared minority ethnic carers' perceptions with majority ethnic groups, making it difficult to identify issues specific to minority groups. Most barriers described were potentially relevant to all carers, irrespective of ethnic group. They included attitudinal barriers such as not wanting to involve outsiders or not seeing the need for services and practical barriers such as low awareness of services and service availability. Issues specific to minority ethnic groups included language barriers and concerns about services' cultural or religious appropriateness. Studies investigating satisfaction with services reported a mixture of satisfaction and dissatisfaction. Barriers common to all groups should not be underestimated and a better understanding of the relationship between perceived barriers to accessing services and dissatisfaction with services is needed before the experiences of all carers can be improved. PMID

  4. A qualitative systematic review of the evidence base for non-cross-resistance between steroidal and non-steroidal aromatase inhibitors in metastatic breast cancer.

    Science.gov (United States)

    Beresford, M; Tumur, I; Chakrabarti, J; Barden, J; Rao, N; Makris, A

    2011-04-01

    The most effective sequence of tamoxifen and both steroidal (SAIs) and non-steroidal aromatase inhibitors (NSAIs) has been extensively studied in the adjuvant setting. However, treatments for women who have failed initial aromatase inhibitor therapy in the metastatic setting have received relatively little attention. A systematic review was undertaken to assess the use of SAIs and NSAIs in metastatic breast cancer. Medline, Embase and the Cochrane library were searched using free text and MeSH terms. Studies assessing the cross-resistance, efficacy and safety of SAIs and NSAIs for postmenopausal women with advanced metastatic breast cancer confirmed by histology/cytology were included. Patients had progressed/relapsed from previous adjuvant, first- or second-line aromatase inhibitor treatment and had undergone treatment with at least two regimens consisting of aminoglutethimide, anastrozole, letrozole and/or exemestane. Nine studies reported results for patients treated with an SAI after treatment failure with an NSAI. For SAI after NSAI, clinical benefit was the most frequently reported outcome. The clinical benefit for exemestane (SAI) after any NSAI failure or before treatment ranged from 12% (complete response not recorded, partial response 2%, stable disease 10%) to 55% (complete response 6%, partial response 13%, stable disease 35%) Survival outcomes were infrequently reported; four studies reported disease progression. The time to progression ranged from 3.7 to 5.2 months. Only one study reported a median overall survival with exemestane at 15.2 months. Only one study reported information for an NSAI after SAI and an NSAI followed by another NSAI. This review suggests that switching from an NSAI to an SAI is a reasonable option. This would be particularly important for patients who would probably respond to further endocrine manoeuvres; strongly oestrogen receptor-positive disease, non-visceral disease, a good prior response or a long duration of response

  5. Using Multiple Types of Studies in Systematic Reviews of Health Care Interventions – A Systematic Review

    Science.gov (United States)

    Peinemann, Frank; Tushabe, Doreen Allen; Kleijnen, Jos

    2013-01-01

    Background A systematic review may evaluate different aspects of a health care intervention. To accommodate the evaluation of various research questions, the inclusion of more than one study design may be necessary. One aim of this study is to find and describe articles on methodological issues concerning the incorporation of multiple types of study designs in systematic reviews on health care interventions. Another aim is to evaluate methods studies that have assessed whether reported effects differ by study types. Methods and Findings We searched PubMed, the Cochrane Database of Systematic Reviews, and the Cochrane Methodology Register on 31 March 2012 and identified 42 articles that reported on the integration of single or multiple study designs in systematic reviews. We summarized the contents of the articles qualitatively and assessed theoretical and empirical evidence. We found that many examples of reviews incorporating multiple types of studies exist and that every study design can serve a specific purpose. The clinical questions of a systematic review determine the types of design that are necessary or sufficient to provide the best possible answers. In a second independent search, we identified 49 studies, 31 systematic reviews and 18 trials that compared the effect sizes between randomized and nonrandomized controlled trials, which were statistically different in 35%, and not different in 53%. Twelve percent of studies reported both, different and non-different effect sizes. Conclusions Different study designs addressing the same question yielded varying results, with differences in about half of all examples. The risk of presenting uncertain results without knowing for sure the direction and magnitude of the effect holds true for both nonrandomized and randomized controlled trials. The integration of multiple study designs in systematic reviews is required if patients should be informed on the many facets of patient relevant issues of health care

  6. Assessment and management of adult cancer pain: a systematic review and synthesis of recent qualitative studies aimed at developing insights for managing barriers and optimizing facilitators within a comprehensive framework of patient care.

    Science.gov (United States)

    Luckett, Tim; Davidson, Patricia M; Green, Anna; Boyle, Frances; Stubbs, John; Lovell, Melanie

    2013-08-01

    Cancer pain is a common, burdensome problem, which is not well managed despite evidence-based guidelines. To develop insights for managing barriers and optimizing facilitators to adult cancer pain assessment and management within a comprehensive framework of patient care. We undertook a systematic review and synthesis of qualitative studies. Medline, PsycINFO, Embase, AMED, CINAHL, and Sociological Abstracts were searched from May 20 to 26, 2011. To be included, the articles had to be published in a peer-reviewed journal since 2000; written in English; and report original qualitative studies on the perspectives of patients, their significant others, or health care providers. Article quality was rated using the checklist of Kitto et al. Thematic synthesis followed a three-stage approach using Evidence for Policy and Practice Information and Co-ordinating Centre-Reviewer 4 software: 1) free line-by-line coding of "Results," 2) organization into "descriptive" themes, and 3) development of "analytical" themes informative to our objective. At Stage 3, a conceptual framework was selected from the peer-reviewed literature according to prima facie "fit" for descriptive themes. Of 659 articles screened, 70 met the criteria, reporting 65 studies with 48 patient, 19 caregiver, and 21 health care provider samples. Authors rarely reported reflexivity or negative cases. Mead and Bower's model of patient-centered care accommodated 85% of the descriptive themes; 12% more related to the caregiver and service/system factors. Three themes could not be accommodated. Findings highlight the need to integrate patient/family education within improved communication, individualize care, use more nonpharmacological strategies, empower patients/families to self-manage pain, and reorganize multidisciplinary roles around patient-centered care and outcomes. These conclusions require validation via consensus and intervention trials. Copyright © 2013 U.S. Cancer Pain Relief Committee. Published

  7. What are the experiences of seeking, receiving and providing FGM-related healthcare? Perspectives of health professionals and women/girls who have undergone FGM: protocol for a systematic review of qualitative evidence.

    Science.gov (United States)

    Evans, Catrin; Tweheyo, Ritah; McGarry, Julie; Eldridge, Jeanette; McCormick, Carol; Nkoyo, Valentine; Higginbottom, Gina Marie Awoko

    2017-12-14

    Female genital mutilation (FGM) is an issue of global concern. High levels of migration mean that healthcare systems in higher-income western countries are increasingly being challenged to respond to the care needs of affected communities. Research has identified significant challenges in the provision of, and access to, FGM-related healthcare. There is a lack of confidence and competence among health professionals in providing appropriate care, suggesting an urgent need for evidence-based service development in this area. This study will involve two systematic reviews of qualitative evidence to explore the experiences, needs, barriers and facilitators to seeking and providing FGM-related healthcare in high-income (Organisation for Economic Cooperation and Development) countries, from the perspectives of: (1) women and girls who have undergone FGM and (2) health professionals. Twelve databases including MEDLINE, EMBASE, PsycINFO, ASSIA, Web of Science, ERIC, CINAHL, and POPLINE will be searched with no limits on publication year. Relevant grey literature will be identified from digital sources and professional networks.Two reviewers will independently screen, select and critically appraise the studies. Study quality will be assessed using the Joanna Briggs Institute Qualitative Assessment and Review Instrument appraisal tool. Findings will be extracted into NVivo software. Synthesis will involve inductive thematic analysis, including in-depth reading, line by line coding of the findings, development of descriptive themes and re-coding to higher level analytical themes. Confidence in the review findings will be assessed using the CERQual approach. Findings will be integrated into a comprehensive set of recommendations for research, policy and practice. The syntheses will be reported as per the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) statement. Two reviews will be published in peer-reviewed journals and an integrated report

  8. Orthotic management of instability of the knee related to neuromuscular and central nervous system disorders: systematic review, qualitative study, survey and costing analysis.

    OpenAIRE

    O'Connor, Joanne; McCaughan, Dorothy; McDaid, Catriona; Booth, Alison; Fayter, Debra; Rodriguez-Lopez, Roccio; Bowers, Roy; Dyson, Lisa; Iglesias, Cynthia P; Lalor, Simon; O'Connor, Rory J; Phillips, Margaret; Ramdharry, Gita

    2016-01-01

    BACKGROUND: \\ud \\ud Patients who have knee instability that is associated with neuromuscular disease (NMD) and central nervous system (CNS) conditions can be treated using orthoses, such as knee-ankle-foot orthoses (KAFOs).\\ud \\ud OBJECTIVES: \\ud \\ud To assess existing evidence on the effectiveness of orthoses; patient perspectives; types of orthotic devices prescribed in the UK NHS; and associated costs.\\ud \\ud METHODS: \\ud \\ud Qualitative study of views of orthoses users - a qualitative in-...

  9. Quality of systematic reviews in pediatric oncology--a systematic review.

    Science.gov (United States)

    Lundh, Andreas; Knijnenburg, Sebastiaan L; Jørgensen, Anders W; van Dalen, Elvira C; Kremer, Leontien C M

    2009-12-01

    To ensure evidence-based decision making in pediatric oncology systematic reviews are necessary. The objective of our study was to evaluate the methodological quality of all currently existing systematic reviews in pediatric oncology. We identified eligible systematic reviews through a systematic search of the literature. Data on clinical and methodological characteristics of the included systematic reviews were extracted. The methodological quality of the included systematic reviews was assessed using the overview quality assessment questionnaire, a validated 10-item quality assessment tool. We compared the methodological quality of systematic reviews published in regular journals with that of Cochrane systematic reviews. We included 117 systematic reviews, 99 systematic reviews published in regular journals and 18 Cochrane systematic reviews. The average methodological quality of systematic reviews was low for all ten items, but the quality of Cochrane systematic reviews was significantly higher than systematic reviews published in regular journals. On a 1-7 scale, the median overall quality score for all systematic reviews was 2 (range 1-7), with a score of 1 (range 1-7) for systematic reviews in regular journals compared to 6 (range 3-7) in Cochrane systematic reviews (pmethodological flaws leading to a high risk of bias. While Cochrane systematic reviews were of higher methodological quality than systematic reviews in regular journals, some of them also had methodological problems. Therefore, the methodology of each individual systematic review should be scrutinized before accepting its results.

  10. Methodology of a systematic review.

    Science.gov (United States)

    Linares-Espinós, E; Hernández, V; Domínguez-Escrig, J L; Fernández-Pello, S; Hevia, V; Mayor, J; Padilla-Fernández, B; Ribal, M J

    2018-05-03

    The objective of evidence-based medicine is to employ the best scientific information available to apply to clinical practice. Understanding and interpreting the scientific evidence involves understanding the available levels of evidence, where systematic reviews and meta-analyses of clinical trials are at the top of the levels-of-evidence pyramid. The review process should be well developed and planned to reduce biases and eliminate irrelevant and low-quality studies. The steps for implementing a systematic review include (i) correctly formulating the clinical question to answer (PICO), (ii) developing a protocol (inclusion and exclusion criteria), (iii) performing a detailed and broad literature search and (iv) screening the abstracts of the studies identified in the search and subsequently of the selected complete texts (PRISMA). Once the studies have been selected, we need to (v) extract the necessary data into a form designed in the protocol to summarise the included studies, (vi) assess the biases of each study, identifying the quality of the available evidence, and (vii) develop tables and text that synthesise the evidence. A systematic review involves a critical and reproducible summary of the results of the available publications on a particular topic or clinical question. To improve scientific writing, the methodology is shown in a structured manner to implement a systematic review. Copyright © 2018 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  11. A systematic review of peri-operative melatonin

    DEFF Research Database (Denmark)

    Andersen, L P H; Werner, M U; Rosenberg, J

    2014-01-01

    We systematically reviewed randomised controlled trials of peri-operative melatonin. We included 24 studies of 1794 participants that reported eight peri-operative outcomes: anxiety; analgesia; sleep quality; oxidative stress; emergence behaviour; anaesthetic requirements; steal induction......%, respectively. Qualitative reviews suggested the melatonin improved sleep quality and emergence behaviour, and might be capable of reducing oxidative stress and anaesthetic requirements....

  12. Key stakeholders' experiences of respite services for people with dementia and their perspectives on respite service development: a qualitative systematic review.

    Science.gov (United States)

    Shea, Emma O'; Timmons, Suzanne; Shea, Eamon O'; Fox, Siobhan; Irving, Kate

    2017-12-07

    Respite services provide a break in the caregiving relationship for people with dementia and their carers, however they are often under-used and service acceptability can be low. This study aims to understand key stakeholders' experiences of respite services for people with dementia, with a view to informing respite service development. A systematic search was conducted of the Pubmed/MedLine, Embase, Cinahl, PsychInfo, Scopus, Web of Science, and Cochrane databases (1980-2016, English) with fixed search terms relating to 'respite' and 'dementia', following PRISMA guidelines. Noblit and Hare's approach to meta-ethnography was employed. Key concepts were identified across the papers and reciprocal and refutational translation techniques were applied to primary studies; findings were synthesized into third order interpretations and finally, a 'line-of-argument' was developed. In total 23 papers were reviewed, which described 20 independent samples across 12 countries. The views of 889 participants were synthesized (13 people with dementia, 690 carers, 44 'service providers', 52 frontline staff, 70 managers, 12 volunteers, six academic/policy-makers, and two independent consultants). Five key concepts were identified and outlined i.e. 1) the transition to service use 2) expanding organizational capacity 3) dementia care quality 4) building a collaborative care partnership and 5) dyad restoration. There was broad agreement around the key areas for service development across the range of stakeholders (flexible and responsive person-centred care, meaningful activity for people with dementia, enhanced client-service communication and informational support). However, there was clear divergence in stakeholder perspectives around the barriers to implementation of such developments. Organizational tension was evident between frontline staff and management in respite services, hindering the cultural change necessary to facilitate service development in line with dyad's needs

  13. Achalasia: a systematic review.

    Science.gov (United States)

    Pandolfino, John E; Gawron, Andrew J

    2015-05-12

    Achalasia significantly affects patients' quality of life and can be difficult to diagnose and treat. To review the diagnosis and management of achalasia, with a focus on phenotypic classification pertinent to therapeutic outcomes. Literature review and MEDLINE search of articles from January 2004 to February 2015. A total of 93 articles were included in the final literature review addressing facets of achalasia epidemiology, pathophysiology, diagnosis, treatment, and outcomes. Nine randomized controlled trials focusing on endoscopic or surgical therapy for achalasia were included (734 total patients). A diagnosis of achalasia should be considered when patients present with dysphagia, chest pain, and refractory reflux symptoms after an endoscopy does not reveal a mechanical obstruction or an inflammatory cause of esophageal symptoms. Manometry should be performed if achalasia is suspected. Randomized controlled trials support treatments focused on disrupting the lower esophageal sphincter with pneumatic dilation (70%-90% effective) or laparoscopic myotomy (88%-95% effective). Patients with achalasia have a variable prognosis after endoscopic or surgical myotomy based on subtypes, with type II (absent peristalsis with abnormal pan-esophageal high-pressure patterns) having a very favorable outcome (96%) and type I (absent peristalsis without abnormal pressure) having an intermediate prognosis (81%) that is inversely associated with the degree of esophageal dilatation. In contrast, type III (absent peristalsis with distal esophageal spastic contractions) is a spastic variant with less favorable outcomes (66%) after treatment of the lower esophageal sphincter. Achalasia should be considered when dysphagia is present and not explained by an obstruction or inflammatory process. Responses to treatment vary based on which achalasia subtype is present.

  14. Papillomaviruses: a systematic review

    Directory of Open Access Journals (Sweden)

    Rodrigo Pinheiro Araldi

    Full Text Available Abstract In the last decades, a group of viruses has received great attention due to its relationship with cancer development and its wide distribution throughout the vertebrates: the papillomaviruses. In this article, we aim to review some of the most relevant reports concerning the use of bovines as an experimental model for studies related to papillomaviruses. Moreover, the obtained data contributes to the development of strategies against the clinical consequences of bovine papillomaviruses (BPV that have led to drastic hazards to the herds. To overcome the problem, the vaccines that we have been developing involve recombinant DNA technology, aiming at prophylactic and therapeutic procedures. It is important to point out that these strategies can be used as models for innovative procedures against HPV, as this virus is the main causal agent of cervical cancer, the second most fatal cancer in women.

  15. The experiences of persons living with HIV who participate in mind-body and energy therapies: a systematic review protocol of qualitative evidence.

    Science.gov (United States)

    Bremner, Marie; Blake, Barbara; Stiles, Cheryl

    2015-10-01

    The purpose of this systematic review is to explore the experiences and perceptions of persons living with HIV who participate in mind-body and energy therapies. The review will focus on the use of mind-body medicine and energy therapies that include meditation, prayer, mental healing, Tai Chi, yoga, art therapy, music therapy, dance therapy, Qigong, reiki, therapeutic touch, healing touch and electromagnetic therapy. These mind-body and energy therapies are selected categories because they do not involve options that might be contraindicated to an individual's current treatment regime. More specifically, the review questions are: Complementary and alternative medicine (CAM) is a popular adjunct to conventional medicine across global populations. Complementary generally refers to a non-mainstream approach together with conventional medicine whereas alternative refers to a non-mainstream approach in place of conventional medicine. Most people use non-mainstream approaches along with conventional treatments. The World Health Organization [WHO] defines CAM as distinct health-care practices that have not been assimilated into a country's mainstream health care system.The USA's National Center for Complementary and Integrative Health (NCCIH), formerly National Center for Complementary and Alternative Medicine (NCCAM), organizes CAM into five medical system categories: whole medical systems, mind-body medicine, biologically based practices, manipulative and body-based practices, and energy therapies. Whole medical systems include homeopathy, naturopathy, traditional Chinese medicine and Ayurveda. Mind-body medicine includes meditation, prayer, mental healing, Tai Chi, yoga, art therapy, music therapy and dance therapy. Biologically based practices include dietary supplements, herbal supplements and a few scientifically unproven therapies. Manipulative and body-based practices include massage and spinal manipulation such as chiropractic and osteopathic. Energy therapies

  16. Understanding careseeking for child illness in sub-Saharan Africa: a systematic review and conceptual framework based on qualitative research of household recognition and response to child diarrhoea, pneumonia and malaria.

    Science.gov (United States)

    Colvin, Christopher J; Smith, Helen J; Swartz, Alison; Ahs, Jill W; de Heer, Jodie; Opiyo, Newton; Kim, Julia C; Marraccini, Toni; George, Asha

    2013-06-01

    Diarrhoea, pneumonia and malaria are the largest contributors to childhood mortality in sub-Saharan Africa. While supply side efforts to deliver effective and affordable interventions are being scaled up, ensuring timely and appropriate use by caregivers remains a challenge. This systematic review synthesises qualitative evidence on the factors that underpin household recognition and response to child diarrhoea, pneumonia and malaria in sub-Saharan Africa. For this review, we searched six electronic databases, hand searched 12 journals from 1980 to 2010 using key search terms, and solicited expert review. We identified 5104 possible studies and included 112. Study quality was appraised using the Critical Appraisal Skills Program (CASP) tool. We followed a meta-ethnographic approach to synthesise findings according to three main themes: how households understand these illnesses, how social relationships affect recognition and response, and how households act to prevent and treat these illnesses. We synthesise these findings into a conceptual model for understanding household pathways to care and decision making. Factors that influence household careseeking include: cultural beliefs and illness perceptions; perceived illness severity and efficacy of treatment; rural location, gender, household income and cost of treatment. Several studies also emphasise the importance of experimentation, previous experience with health services and habit in shaping household choices. Moving beyond well-known barriers to careseeking and linear models of pathways to care, the review suggests that treatment decision making is a dynamic process characterised by uncertainty and debate, experimentation with multiple and simultaneous treatments, and shifting interpretations of the illness and treatment options, with household decision making hinging on social negotiations with a broad variety of actors and influenced by control over financial resources. The review concludes with research

  17. Twelve recommendations for integrating existing systematic reviews into new reviews: EPC guidance.

    Science.gov (United States)

    Robinson, Karen A; Chou, Roger; Berkman, Nancy D; Newberry, Sydne J; Fu, Rongwei; Hartling, Lisa; Dryden, Donna; Butler, Mary; Foisy, Michelle; Anderson, Johanna; Motu'apuaka, Makalapua; Relevo, Rose; Guise, Jeanne-Marie; Chang, Stephanie

    2016-02-01

    As time and cost constraints in the conduct of systematic reviews increase, the need to consider the use of existing systematic reviews also increases. We developed guidance on the integration of systematic reviews into new reviews. A workgroup of methodologists from Evidence-based Practice Centers developed consensus-based recommendations. Discussions were informed by a literature scan and by interviews with organizations that conduct systematic reviews. Twelve recommendations were developed addressing selecting reviews, assessing risk of bias, qualitative and quantitative synthesis, and summarizing and assessing body of evidence. We provide preliminary guidance for an efficient and unbiased approach to integrating existing systematic reviews with primary studies in a new review. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. A systematic review of systematic reviews of homeopathy

    Science.gov (United States)

    Ernst, E

    2002-01-01

    Homeopathy remains one of the most controversial subjects in therapeutics. This article is an attempt to clarify its effectiveness based on recent systematic reviews. Electronic databases were searched for systematic reviews/meta-analysis on the subject. Seventeen articles fulfilled the inclusion/exclusion criteria. Six of them related to re-analyses of one landmark meta-analysis. Collectively they implied that the overall positive result of this meta-analysis is not supported by a critical analysis of the data. Eleven independent systematic reviews were located. Collectively they failed to provide strong evidence in favour of homeopathy. In particular, there was no condition which responds convincingly better to homeopathic treatment than to placebo or other control interventions. Similarly, there was no homeopathic remedy that was demonstrated to yield clinical effects that are convincingly different from placebo. It is concluded that the best clinical evidence for homeopathy available to date does not warrant positive recommendations for its use in clinical practice. PMID:12492603

  19. What do parents perceive are the barriers and facilitators to accessing psychological treatment for mental health problems in children and adolescents? A systematic review of qualitative and quantitative studies.

    Science.gov (United States)

    Reardon, Tessa; Harvey, Kate; Baranowska, Magdalena; O'Brien, Doireann; Smith, Lydia; Creswell, Cathy

    2017-06-01

    A minority of children and adolescents with mental health problems access treatment. The reasons for poor rates of treatment access are not well understood. As parents are a key gatekeeper to treatment access, it is important to establish parents' views of barriers/facilitators to accessing treatment. The aims of this study are to synthesise findings from qualitative and quantitative studies that report parents' perceptions of barriers/facilitators to accessing treatment for mental health problems in children/adolescents. A systematic review and narrative synthesis were conducted. Forty-four studies were included in the review and were assessed in detail. Parental perceived barriers/facilitators relating to (1) systemic/structural issues; (2) views and attitudes towards services and treatment; (3) knowledge and understanding of mental health problems and the help-seeking process; and (4) family circumstances were identified. Findings highlight avenues for improving access to child mental health services, including increased provision that is free to service users and flexible to their needs, with opportunities to develop trusting, supportive relationships with professionals. Furthermore, interventions are required to improve parents' identification of mental health problems, reduce stigma for parents, and increase awareness of how to access services.

  20. Quality of systematic reviews in pediatric oncology--a systematic review

    DEFF Research Database (Denmark)

    Lundh, Andreas; Knijnenburg, Sebastiaan L; Jørgensen, Anders W

    2009-01-01

    BACKGROUND: To ensure evidence-based decision making in pediatric oncology systematic reviews are necessary. The objective of our study was to evaluate the methodological quality of all currently existing systematic reviews in pediatric oncology. METHODS: We identified eligible systematic reviews...... through a systematic search of the literature. Data on clinical and methodological characteristics of the included systematic reviews were extracted. The methodological quality of the included systematic reviews was assessed using the overview quality assessment questionnaire, a validated 10-item quality...... assessment tool. We compared the methodological quality of systematic reviews published in regular journals with that of Cochrane systematic reviews. RESULTS: We included 117 systematic reviews, 99 systematic reviews published in regular journals and 18 Cochrane systematic reviews. The average methodological...

  1. Uterine transplantation: a systematic review

    Directory of Open Access Journals (Sweden)

    Dani Ejzenberg

    Full Text Available Up to 15% of the reproductive population is infertile, and 3 to 5% of these cases are caused by uterine dysfunction. This abnormality generally leads women to consider surrogacy or adoption. Uterine transplantation, although still experimental, may be an option in these cases. This systematic review will outline the recommendations, surgical aspects, immunosuppressive drugs and reproductive aspects related to experimental uterine transplantation in women.

  2. Systematic reviews in context: highlighting systematic reviews relevant to Africa in the Pan African Medical Journal.

    Science.gov (United States)

    Wiysonge, Charles Shey; Kamadjeu, Raoul; Tsague, Landry

    2016-01-01

    Health research serves to answer questions concerning health and to accumulate facts (evidence) required to guide healthcare policy and practice. However, research designs vary and different types of healthcare questions are best answered by different study designs. For example, qualitative studies are best suited for answering questions about experiences and meaning; cross-sectional studies for questions concerning prevalence; cohort studies for questions regarding incidence and prognosis; and randomised controlled trials for questions on prevention and treatment. In each case, one study would rarely yield sufficient evidence on which to reliably base a healthcare decision. An unbiased and transparent summary of all existing studies on a given question (i.e. a systematic review) tells a better story than any one of the included studies taken separately. A systematic review enables producers and users of research to gauge what a new study has contributed to knowledge by setting the study's findings in the context of all previous studies investigating the same question. It is therefore inappropriate to initiate a new study without first conducting a systematic review to find out what can be learnt from existing studies. There is nothing new in taking account of earlier studies in either the design or interpretation of new studies. For example, in the 18th century James Lind conducted a clinical trial followed by a systematic review of contemporary treatments for scurvy; which showed fruits to be an effective treatment for the disease. However, surveys of the peer-reviewed literature continue to provide empirical evidence that systematic reviews are seldom used in the design and interpretation of the findings of new studies. Such indifference to systematic reviews as a research function is unethical, unscientific, and uneconomical. Without systematic reviews, limited resources are very likely to be squandered on ill-conceived research and policies. In order to

  3. Community health workers' experiences of mobile device-enabled clinical decision support systems for maternal, newborn and child health in developing countries: a qualitative systematic review protocol.

    Science.gov (United States)

    Dzabeng, Francis; Enuameh, Yeetey; Adjei, George; Manu, Grace; Asante, Kwaku Poku; Owusu-Agyei, Seth

    2016-09-01

    The objective of this review is to synthesize evidence on the experiences of community health workers (CHWs) of mobile device-enabled clinical decision support systems (CDSSs) interventions designed to support maternal newborn and child health (MNCH) in low-and middle-income countries.Specific objectives.

  4. Biceps Autograft Augmentation for Rotator Cuff Repair : A Systematic Review

    NARCIS (Netherlands)

    Veen, Egbert J D; Stevens, Martin; Diercks, Ronald L

    Purpose: To improve surgical outcomes in patients with massive cuff defects, different techniques and augmentations are proposed. The biceps tendon is easily available as an autograft. Our aim was to conduct a qualitative systematic review of various methods and surgical techniques that use a biceps

  5. Intervention Now to Eliminate Repeat Unintended Pregnancy in Teenagers (INTERUPT): a systematic review of intervention effectiveness and cost-effectiveness, and qualitative and realist synthesis of implementation factors and user engagement.

    Science.gov (United States)

    Aslam, Rabeea'h W; Hendry, Maggie; Booth, Andrew; Carter, Ben; Charles, Joanna M; Craine, Noel; Edwards, Rhiannon Tudor; Noyes, Jane; Ntambwe, Lupetu Ives; Pasterfield, Diana; Rycroft-Malone, Jo; Williams, Nefyn; Whitaker, Rhiannon

    2017-08-15

    Unintended repeat conceptions can result in emotional, psychological and educational harm to young women, often with enduring implications for their life chances. This study aimed to identify which young women are at the greatest risk of repeat unintended pregnancies; which interventions are effective and cost-effective; and what are the barriers to and facilitators for the uptake of these interventions. We conducted a mixed-methods systematic review which included meta-analysis, framework synthesis and application of realist principles, with stakeholder input and service user feedback to address this. We searched 20 electronic databases, including MEDLINE, Excerpta Medica database, Applied Social Sciences Index and Abstracts and Research Papers in Economics, to cover a broad range of health, social science, health economics and grey literature sources. Searches were conducted between May 2013 and June 2014 and updated in August 2015. Twelve randomised controlled trials (RCTs), two quasi-RCTs, 10 qualitative studies and 53 other quantitative studies were identified. The RCTs evaluated psychosocial interventions and an emergency contraception programme. The primary outcome was repeat conception rate: the event rate was 132 of 308 (43%) in the intervention group versus 140 of 289 (48%) for the control group, with a non-significant risk ratio (RR) of 0.92 [95% confidence interval (CI) 0.78-1.08]. Four studies reported subsequent birth rates: 29 of 237 (12%) events for the intervention arm versus 46 out of 224 (21%) for the control arm, with an RR of 0.60 (95% CI 0.39-0.93). Many repeat conceptions occurred in the context of poverty, low expectations and aspirations and negligible opportunities. Qualitative and realist evidence highlighted the importance of context, motivation, future planning and giving young women a central and active role in the development of new interventions. Little or no evidence for the effectiveness or cost-effectiveness of any of the

  6. Primary neural leprosy: systematic review

    Directory of Open Access Journals (Sweden)

    Jose Antonio Garbino

    2013-06-01

    Full Text Available The authors proposed a systematic review on the current concepts of primary neural leprosy by consulting the following online databases: MEDLINE, Lilacs/SciELO, and Embase. Selected studies were classified based on the degree of recommendation and levels of scientific evidence according to the “Oxford Centre for Evidence-based Medicine”. The following aspects were reviewed: cutaneous clinical and laboratorial investigations, i.e. skin clinical exam, smears, and biopsy, and Mitsuda's reaction; neurological investigation (anamnesis, electromyography and nerve biopsy; serological investigation and molecular testing, i.e. serological testing for the detection of the phenolic glycolipid 1 (PGL-I and the polymerase chain reaction (PCR; and treatment (classification criteria for the definition of specific treatment, steroid treatment, and cure criteria.

  7. Religion and Suicide Risk: A Systematic Review.

    Science.gov (United States)

    Lawrence, Ryan E; Oquendo, Maria A; Stanley, Barbara

    2016-01-01

    Although religion is reported to be protective against suicide, the empirical evidence is inconsistent. Research is complicated by the fact that there are many dimensions to religion (affiliation, participation, doctrine) and suicide (ideation, attempt, completion). We systematically reviewed the literature on religion and suicide over the last 10 years (89 articles) with a goal of identifying what specific dimensions of religion are associated with specific aspects of suicide. We found that religious affiliation does not necessarily protect against suicidal ideation, but does protect against suicide attempts. Whether religious affiliation protects against suicide attempts may depend on the culture-specific implications of affiliating with a particular religion, since minority religious groups can feel socially isolated. After adjusting for social support measures, religious service attendance is not especially protective against suicidal ideation, but does protect against suicide attempts, and possibly protects against suicide. Future qualitative studies might further clarify these associations.

  8. Review Essay: Does Qualitative Network Analysis Exist?

    Directory of Open Access Journals (Sweden)

    Rainer Diaz-Bone

    2007-01-01

    Full Text Available Social network analysis was formed and established in the 1970s as a way of analyzing systems of social relations. In this review the theoretical-methodological standpoint of social network analysis ("structural analysis" is introduced and the different forms of social network analysis are presented. Structural analysis argues that social actors and social relations are embedded in social networks, meaning that action and perception of actors as well as the performance of social relations are influenced by the network structure. Since the 1990s structural analysis has integrated concepts such as agency, discourse and symbolic orientation and in this way structural analysis has opened itself. Since then there has been increasing use of qualitative methods in network analysis. They are used to include the perspective of the analyzed actors, to explore networks, and to understand network dynamics. In the reviewed book, edited by Betina HOLLSTEIN and Florian STRAUS, the twenty predominantly empirically orientated contributions demonstrate the possibilities of combining quantitative and qualitative methods in network analyses in different research fields. In this review we examine how the contributions succeed in applying and developing the structural analysis perspective, and the self-positioning of "qualitative network analysis" is evaluated. URN: urn:nbn:de:0114-fqs0701287

  9. Systematic Review Methodology in Higher Education

    Science.gov (United States)

    Bearman, Margaret; Smith, Calvin D.; Carbone, Angela; Slade, Susan; Baik, Chi; Hughes-Warrington, Marnie; Neumann, David L.

    2012-01-01

    Systematic review methodology can be distinguished from narrative reviews of the literature through its emphasis on transparent, structured and comprehensive approaches to searching the literature and its requirement for formal synthesis of research findings. There appears to be relatively little use of the systematic review methodology within the…

  10. Intervention Now to Eliminate Repeat Unintended Pregnancy in Teenagers (INTERUPT): a systematic review of intervention effectiveness and cost-effectiveness, and qualitative and realist synthesis of implementation factors and user engagement.

    Science.gov (United States)

    Whitaker, Rhiannon; Hendry, Maggie; Aslam, Rabeea'h; Booth, Andrew; Carter, Ben; Charles, Joanna M; Craine, Noel; Tudor Edwards, Rhiannon; Noyes, Jane; Ives Ntambwe, Lupetu; Pasterfield, Diana; Rycroft-Malone, Jo; Williams, Nefyn

    2016-02-01

    The UK has one of the highest rates of teenage pregnancies in Western Europe. One-fifth of these are repeat pregnancies. Unintended conceptions can cause substantial emotional, psychological and educational harm to teenagers, often with enduring implications for life chances. Babies of teenage mothers have increased mortality and are at a significantly increased risk of poverty, educational underachievement and unemployment later in life, with associated costs to society. It is important to identify effective, cost-effective and acceptable interventions. To identify who is at the greatest risk of repeat unintended pregnancies; which interventions are effective and cost-effective; and what the barriers to and facilitators of the uptake of these interventions are. We conducted a multistreamed, mixed-methods systematic review informed by service user and provider consultation to examine worldwide peer-reviewed evidence and UK-generated grey literature to find and evaluate interventions to reduce repeat unintended teenage pregnancies. We searched the following electronic databases: MEDLINE and MEDLINE In-Process & Other Non-Indexed Citations, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, The Cochrane Library (Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects and the Health Technology Assessment Database), EMBASE (Excerpta Medica database), British Nursing Index, Educational Resources Information Center, Sociological Abstracts, Applied Social Sciences Index and Abstracts, BiblioMap (the Evidence for Policy and Practice Information and Co-ordinating Centre register of health promotion and public health research), Social Sciences Citation Index (supported by Web of Knowledge), Research Papers in Economics, EconLit (American Economic Association's electronic bibliography), OpenGrey, Scopus, Scirus, Social Care Online, National Research Register, National Institute for Health Research Clinical Research Network

  11. A mixed-methods approach to systematic reviews.

    Science.gov (United States)

    Pearson, Alan; White, Heath; Bath-Hextall, Fiona; Salmond, Susan; Apostolo, Joao; Kirkpatrick, Pamela

    2015-09-01

    There are an increasing number of published single-method systematic reviews that focus on different types of evidence related to a particular topic. As policy makers and practitioners seek clear directions for decision-making from systematic reviews, it is likely that it will be increasingly difficult for them to identify 'what to do' if they are required to find and understand a plethora of syntheses related to a particular topic.Mixed-methods systematic reviews are designed to address this issue and have the potential to produce systematic reviews of direct relevance to policy makers and practitioners.On the basis of the recommendations of the Joanna Briggs Institute International Mixed Methods Reviews Methodology Group in 2012, the Institute adopted a segregated approach to mixed-methods synthesis as described by Sandelowski et al., which consists of separate syntheses of each component method of the review. Joanna Briggs Institute's mixed-methods synthesis of the findings of the separate syntheses uses a Bayesian approach to translate the findings of the initial quantitative synthesis into qualitative themes and pooling these with the findings of the initial qualitative synthesis.

  12. Improving the uptake of systematic reviews: a systematic review of intervention effectiveness and relevance.

    LENUS (Irish Health Repository)

    Wallace, John

    2014-01-01

    Little is known about the barriers, facilitators and interventions that impact on systematic review uptake. The objective of this study was to identify how uptake of systematic reviews can be improved.

  13. [Recovery: systematic review of a concept].

    Science.gov (United States)

    Baccari, Ivana Oliveira Preto; Campos, Rosana Teresa Onocko; Stefanello, Sabrina

    2015-01-01

    The concept of recovery has been described in papers as a state of psychic, physical and social recuperation of day-to-day functions. The scope of this article is to analyze the concepts of the term in different research methodologies and the paradigmatic evolution of the recovery concept. Systematic bibliographical research was conducted in the Pubmed database using the words "recovery + schizophrenia" limited to freely available full papers published in the previous two years. Nineteen papers were analyzed. The majority of the papers sought associations between characteristic data and recovery; few papers discussed the concept in a way to distinguish it from other words like cure or rehabilitation. Recovery as a state in which people with severe mental illness can feel like the creators of their own itinerary tend to be found in qualitative studies and in bibliographic reviews in which the meaning of recovery is not related to the lack of symptoms and tends to prioritize how participative the life of an individual can be despite the disease. Some quantitative studies detect this conceptual difference. In qualitative research there is an increase in the concept of recovery and in ways of promoting it.

  14. Videogames for Emotion Regulation: A Systematic Review.

    Science.gov (United States)

    Villani, Daniela; Carissoli, Claudia; Triberti, Stefano; Marchetti, Antonella; Gilli, Gabriella; Riva, Giuseppe

    2018-04-01

    Emotion regulation (ER) supports multiple individual functions and promotes mental health and wellbeing. Among the tools that may be used to help people in managing their affective states, videogames are reaching attention and are showing positive effects. Yet, little is known about their effectiveness. This study aims to assess the amount and quality of studies investigating the effects and modalities of the use of videogames for ER. A systematic literature search according to PRISMA guidelines was performed. Subsequently, according to expert advice other few studies have been added. Twenty-three studies met the inclusion criteria and were included in the review; they can be categorized into three groups, namely (1) cross-sectional and qualitative studies, (2) experimental studies investigating the effects of videogame experience on ER and (3) ER intervention with serious games. Discussion of the reviewed studies highlights that frequent gaming with commercial games offers more opportunities for ER improvement (related to gameplay and enjoyment of fictional properties) than limited-time experiences, such as those supported by bespoke serious games. This research area is still in its infancy and findings need to be interpreted with caution; furthermore, future reviews are encouraged to include clinical populations. Videogames offer several opportunities for ER and a challenge for educational and psychological interventions.

  15. Mixed methods systematic review exploring mentorship outcomes in nursing academia.

    Science.gov (United States)

    Nowell, Lorelli; Norris, Jill M; Mrklas, Kelly; White, Deborah E

    2017-03-01

    The aim of this study was to report on a mixed methods systematic review that critically examines the evidence for mentorship in nursing academia. Nursing education institutions globally have issued calls for mentorship. There is emerging evidence to support the value of mentorship in other disciplines, but the extant state of the evidence in nursing academia is not known. A comprehensive review of the evidence is required. A mixed methods systematic review. Five databases (MEDLINE, CINAHL, EMBASE, ERIC, PsycINFO) were searched using an a priori search strategy from inception to 2 November 2015 to identify quantitative, qualitative and mixed methods studies. Grey literature searches were also conducted in electronic databases (ProQuest Dissertations and Theses, Index to Theses) and mentorship conference proceedings and by hand searching the reference lists of eligible studies. Study quality was assessed prior to inclusion using standardized critical appraisal instruments from the Joanna Briggs Institute. A convergent qualitative synthesis design was used where results from qualitative, quantitative and mixed methods studies were transformed into qualitative findings. Mentorship outcomes were mapped to a theory-informed framework. Thirty-four studies were included in this review, from the 3001 records initially retrieved. In general, mentorship had a positive impact on behavioural, career, attitudinal, relational and motivational outcomes; however, the methodological quality of studies was weak. This review can inform the objectives of mentorship interventions and contribute to a more rigorous approach to studies that assess mentorship outcomes. © 2016 John Wiley & Sons Ltd.

  16. How to write a systematic review.

    Science.gov (United States)

    Harris, Joshua D; Quatman, Carmen E; Manring, M M; Siston, Robert A; Flanigan, David C

    2014-11-01

    The role of evidence-based medicine in sports medicine and orthopaedic surgery is rapidly growing. Systematic reviews and meta-analyses are also proliferating in the medical literature. To provide the outline necessary for a practitioner to properly understand and/or conduct a systematic review for publication in a sports medicine journal. Review. The steps of a successful systematic review include the following: identification of an unanswered answerable question; explicit definitions of the investigation's participant(s), intervention(s), comparison(s), and outcome(s); utilization of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines and PROSPERO registration; thorough systematic data extraction; and appropriate grading of the evidence and strength of the recommendations. An outline to understand and conduct a systematic review is provided, and the difference between meta-analyses and systematic reviews is described. The steps necessary to perform a systematic review are fully explained, including the study purpose, search methodology, data extraction, reporting of results, identification of bias, and reporting of the study's main findings. Systematic reviews or meta-analyses critically appraise and formally synthesize the best existing evidence to provide a statement of conclusion that answers specific clinical questions. Readers and reviewers, however, must recognize that the quality and strength of recommendations in a review are only as strong as the quality of studies that it analyzes. Thus, great care must be used in the interpretation of bias and extrapolation of the review's findings to translation to clinical practice. Without advanced education on the topic, the reader may follow the steps discussed herein to perform a systematic review. © 2013 The Author(s).

  17. Systematic review of catatonia treatment

    Directory of Open Access Journals (Sweden)

    Pelzer ACM

    2018-01-01

    Full Text Available Anne CM Pelzer,1 Frank MMA van der Heijden,2 Erik den Boer3 1Department of Psychiatry, Reinier van Arkel, ‘s-Hertogenbosch, 2Department of Psychiatry, Vincent van Gogh Institute for Psychiatry, Venlo, 3Department of Psychiatry, GGzE, Eindhoven, the Netherlands Objective: To investigate the evidence-based treatment of catatonia in adults. The secondary aim is to develop a treatment protocol. Materials and methods: A systematic review of published treatment articles (case series, cohort or randomized controlled studies which examined the effects of particular interventions for catatonia and/or catatonic symptoms in adult populations and used valid outcome measures was performed. The articles for this review were selected by searching the electronic databases of the Cochrane Library, MEDLINE, EMBASE and PSYCHINFO. Results: Thirty-one articles met the inclusion criteria. Lorazepam and electroconvulsive therapy (ECT proved to be the most investigated treatment interventions. The response percentages in Western studies varied between 66% and 100% for studies with lorazepam, while in Asian and Indian studies, they were 0% and 100%. For ECT, the response percentages are 59%–100%. There does not seem to be evidence for the use of antipsychotics in catatonic patients without any underlying psychotic disorder. Conclusion: Lorazepam and ECT are effective treatments for which clinical evidence is found in the literature. It is not possible to develop a treatment protocol because the evidence for catatonia management on the basis of the articles reviewed is limited. Stringent treatment studies on catatonia are warranted. Keywords: review, catatonia, therapeutics, electroconvulsive therapy, benzodiazepines, lorazepam, ECT

  18. Compliance in oxygen saturation targeting in preterm infants : a systematic review

    NARCIS (Netherlands)

    van Zanten, Henriëtte A; Tan, Ratna N G B; van den Hoogen, Agnes; Lopriore, Enrico; te Pas, Arjan B

    2015-01-01

    UNLABELLED: During oxygen therapy in preterm infants, targeting oxygen saturation is important for avoiding hypoxaemia and hyperoxaemia, but this can be very difficult and challenging for neonatal nurses. We systematically reviewed the qualitative and quantitative studies investigating the

  19. Dissemination bias in systematic reviews of animal research: a systematic review.

    Directory of Open Access Journals (Sweden)

    Katharina F Mueller

    Full Text Available Systematic reviews of preclinical studies, in vivo animal experiments in particular, can influence clinical research and thus even clinical care. Dissemination bias, selective dissemination of positive or significant results, is one of the major threats to validity in systematic reviews also in the realm of animal studies. We conducted a systematic review to determine the number of published systematic reviews of animal studies until present, to investigate their methodological features especially with respect to assessment of dissemination bias, and to investigate the citation of preclinical systematic reviews on clinical research.Eligible studies for this systematic review constitute systematic reviews that summarize in vivo animal experiments whose results could be interpreted as applicable to clinical care. We systematically searched Ovid Medline, Embase, ToxNet, and ScienceDirect from 1st January 2009 to 9th January 2013 for eligible systematic reviews without language restrictions. Furthermore we included articles from two previous systematic reviews by Peters et al. and Korevaar et al.The literature search and screening process resulted in 512 included full text articles. We found an increasing number of published preclinical systematic reviews over time. The methodological quality of preclinical systematic reviews was low. The majority of preclinical systematic reviews did not assess methodological quality of the included studies (71%, nor did they assess heterogeneity (81% or dissemination bias (87%. Statistics quantifying the importance of clinical research citing systematic reviews of animal studies showed that clinical studies referred to the preclinical research mainly to justify their study or a future study (76%.Preclinical systematic reviews may have an influence on clinical research but their methodological quality frequently remains low. Therefore, systematic reviews of animal research should be critically appraised before

  20. Childhood depression: a systematic review

    Directory of Open Access Journals (Sweden)

    Lima NNR

    2013-09-01

    Full Text Available Nádia Nara Rolim Lima,1 Vânia Barbosa do Nascimento,1 Sionara Melo Figueiredo de Carvalho,1 Luiz Carlos de Abreu,1,3 Modesto Leite Rolim Neto,2 Aline Quental Brasil,2 Francisco Telésforo Celestino Junior,2 Gislene Farias de Oliveira,2 Alberto Olavo Advíncula Reis3 1Programa de Pós-graduação em Ciências da Saúde, Faculdade de Medicina do ABC, Santo André, São Paulo, Brazil; 2Departamento de Medicina. Universidade Federal do Ceará, UFC, Barbalha, Ceará, Brazil; 3Departamento de Saúde Materno Infantil, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil Abstract: As an important public health issue, childhood depression deserves special attention, considering the serious and lasting consequences of the disease to child development. Taking this into consideration, the present study was based on the following question: what practical contributions to clinicians and researchers does the current literature on childhood depression have to offer? The objective of the present study was to conduct a systematic review of articles regarding childhood depression. To accomplish this purpose, a systematic review of articles on childhood depression, published from January 1, 2010 to November 24, 2012, on MEDLINE and SciELO databases was carried out. Search terms were “depression” (medical subject headings [MeSH], “child” (MeSH, and "childhood depression" (keyword. Of the 180 retrieved studies, 25 met the eligibility criteria. Retrieved studies covered a wide range of aspects regarding childhood depression, such as diagnosis, treatment, prevention and prognosis. Recent scientific literature regarding childhood depression converge to, directly or indirectly, highlight the negative impacts of depressive disorders to the children's quality of life. Unfortunately, the retrieved studies show that childhood depression commonly grows in a background of vulnerability and poverty, where individual and familiar needs

  1. Abortion Stigma: A Systematic Review.

    Science.gov (United States)

    Hanschmidt, Franz; Linde, Katja; Hilbert, Anja; Riedel-Heller, Steffi G; Kersting, Anette

    2016-12-01

    Although stigma has been identified as a potential risk factor for the well-being of women who have had abortions, little attention has been paid to the study of abortion-related stigma. A systematic search of the databases Medline, PsycArticles, PsycInfo, PubMed and Web of Science was conducted; the search terms were "(abortion OR pregnancy termination) AND stigma * ." Articles were eligible for inclusion if the main research question addressed experiences of individuals subjected to abortion stigma, public attitudes that stigmatize women who have had abortions or interventions aimed at managing abortion stigma. To provide a comprehensive overview of this issue, any study published by February 2015 was considered. The search was restricted to English- and German-language studies. Seven quantitative and seven qualitative studies were eligible for inclusion. All but two dated from 2009 or later; the earliest was from 1984. Studies were based mainly on U.S. samples; some included participants from Ghana, Great Britain, Mexico, Nigeria, Pakistan, Peru and Zambia. The majority of studies showed that women who have had abortions experience fear of social judgment, self-judgment and a need for secrecy. Secrecy was associated with increased psychological distress and social isolation. Some studies found stigmatizing attitudes in the public. Stigma appeared to be salient in abortion providers' lives. Evidence of interventions to reduce abortion stigma was scarce. Most studies had limitations regarding generalizability and validity. More research, using validated measures, is needed to enhance understanding of abortion stigma and thereby reduce its impact on affected individuals. Copyright © 2016 by the Guttmacher Institute.

  2. Summarizing systematic reviews: methodological development, conduct and reporting of an umbrella review approach.

    Science.gov (United States)

    Aromataris, Edoardo; Fernandez, Ritin; Godfrey, Christina M; Holly, Cheryl; Khalil, Hanan; Tungpunkom, Patraporn

    2015-09-01

    With the increase in the number of systematic reviews available, a logical next step to provide decision makers in healthcare with the evidence they require has been the conduct of reviews of existing systematic reviews. Syntheses of existing systematic reviews are referred to by many different names, one of which is an umbrella review. An umbrella review allows the findings of reviews relevant to a review question to be compared and contrasted. An umbrella review's most characteristic feature is that this type of evidence synthesis only considers for inclusion the highest level of evidence, namely other systematic reviews and meta-analyses. A methodology working group was formed by the Joanna Briggs Institute to develop methodological guidance for the conduct of an umbrella review, including diverse types of evidence, both quantitative and qualitative. The aim of this study is to describe the development and guidance for the conduct of an umbrella review. Discussion and testing of the elements of methods for the conduct of an umbrella review were held over a 6-month period by members of a methodology working group. The working group comprised six participants who corresponded via teleconference, e-mail and face-to-face meeting during this development period. In October 2013, the methodology was presented in a workshop at the Joanna Briggs Institute Convention. Workshop participants, review authors and methodologists provided further testing, critique and feedback on the proposed methodology. This study describes the methodology and methods developed for the conduct of an umbrella review that includes published systematic reviews and meta-analyses as the analytical unit of the review. Details are provided regarding the essential elements of an umbrella review, including presentation of the review question in a Population, Intervention, Comparator, Outcome format, nuances of the inclusion criteria and search strategy. A critical appraisal tool with 10 questions to

  3. Dhat syndrome: a systematic review.

    Science.gov (United States)

    Udina, Marc; Foulon, Hubert; Valdés, Manuel; Bhattacharyya, Sagnik; Martín-Santos, Rocío

    2013-01-01

    Dhat syndrome is a widely recognized clinical condition often seen on the Indian subcontinent that is characterized by a preoccupation with semen loss in urine and other symptoms such as fatigue or depressed mood. Although it has been considered to be a culture-bound syndrome, it may also be regarded as a distinct manifestation of depression or another medical illness. The purpose of this paper was to carry out a systematic review on Dhat syndrome. A review of the literature published up until February 2012 was conducted using the key words [Dhat syndrome] or [semen-loss anxiety] or [semen-loss syndrome]. We included only original studies. The majority of studies reported patients from the Indian subcontinent. There was a high degree of heterogeneity among the studies. Dhat was a common condition in young people from certain cultures and origins. Depressive and anxiety symptoms were common, including fatigue, sleepiness, and sexual dysfunction. Good clinical engagement, social support, and sexual education were useful in some cases. Given the high rate of comorbid depressive symptoms, antidepressant has been used. In an increasingly globalized world, clinicians must be able to properly diagnose and treat patients from other cultures, who may report symptoms that are influenced by their beliefs, culture, or place of origin. Dhat may be a common manifestation of a depressive or anxiety disorder in certain cultures. Further research is needed to improve our understanding of this condition, to clarify its nosologic status, and to offer appropriate treatment to affected individuals. Copyright © 2013 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

  4. Smoking in Video Games: A Systematic Review.

    Science.gov (United States)

    Forsyth, Susan R; Malone, Ruth E

    2016-06-01

    Video games are played by a majority of adolescents, yet little is known about whether and how video games are associated with smoking behavior and attitudes. This systematic review examines research on the relationship between video games and smoking. We searched MEDLINE, psycINFO, and Web of Science through August 20, 2014. Twenty-four studies met inclusion criteria. Studies were synthesized qualitatively in four domains: the prevalence and incidence of smoking imagery in video games (n = 6), video game playing and smoking behavior (n = 11), video game addiction and tobacco addiction (n = 5) and genre-specific game playing and smoking behavior (n = 3). Tobacco content was present in a subset of video games. The literature is inconclusive as to whether exposure to video games as a single construct is associated with smoking behavior. Four of five studies found an association between video game addiction and smoking. For genre-specific game playing, studies suggest that the type of game played affected association with smoking behavior. Research on how playing video games influences adolescents' perceptions of smoking and smoking behaviors is still in its nascence. Further research is needed to understand how adolescents respond to viewing and manipulating tobacco imagery, and whether engaging in game smoking translates into changes in real-world attitudes or behavior. Smoking imagery in video games may contribute to normalizing adolescent smoking. A large body of research has shown that smoking imagery in a variety of media types contributes to adolescent smoking uptake and the normalization of smoking behavior, and almost 90% of adolescents play video games, yet there has never been a published systematic review of the literature on this important topic. This is the first systematic review to examine the research on tobacco and video games.We found that tobacco imagery is indeed present in video games, the relationship between video game playing and smoking

  5. Occupational skin cancer: Systematic review

    Directory of Open Access Journals (Sweden)

    Jéssica Suellen Sena

    2016-06-01

    Full Text Available SUMMARY Objective: To analyze the epidemiological profile, risk factors in the workplace environment and prevention methods for professionals at risk of skin cancer. Method: A systematic review of articles on occupational skin cancer, published in the Lilacs, Scielo, Medline and Cochrane Library from January 1st, 2008, to December 31st, 2013, was performed. The search included the following terms: “neoplasias cutâneas” (DeCS, “exposição ocupacional” (DeCS, “epidemiologia” (DeCS as well as the keyword “prevenção”, and their equivalents in English. Results: After analyzing the titles and summaries of articles, the search strategy resulted in 83 references, of which 22 articles met the eligibility criteria. Discussion: We found that sun exposure is the main occupational risk factor for skin cancer, causing outdoor workers to be the most vulnerable to developing occupational skin cancer. Professionals with low levels of education and European descent are at increased risk of developing this cancer. Conclusion: Outdoor workers are more vulnerable to developing occupational skin cancer, estimating that professionals with low level of education and European descent are at increased risk of developing this cancer. Therefore, companies need to invest more in the health of workers by providing protective equipment and thus preventing occupational skin cancer.

  6. Optimizing literature search in systematic reviews

    DEFF Research Database (Denmark)

    Aagaard, Thomas; Lund, Hans; Juhl, Carsten Bogh

    2016-01-01

    BACKGROUND: When conducting systematic reviews, it is essential to perform a comprehensive literature search to identify all published studies relevant to the specific research question. The Cochrane Collaborations Methodological Expectations of Cochrane Intervention Reviews (MECIR) guidelines...... of musculoskeletal disorders. METHODS: Data sources were systematic reviews published by the Cochrane Musculoskeletal Review Group, including at least five RCTs, reporting a search history, searching MEDLINE, EMBASE, CENTRAL, and adding reference- and hand-searching. Additional databases were deemed eligible...... if they indexed RCTs, were in English and used in more than three of the systematic reviews. Relative recall was calculated as the number of studies identified by the literature search divided by the number of eligible studies i.e. included studies in the individual systematic reviews. Finally, cumulative median...

  7. Mental Pain and Suicide: A Systematic Review of the Literature

    OpenAIRE

    Verrocchio, Maria Cristina; Carrozzino, Danilo; Marchetti, Daniela; Andreasson, Kate; Fulcheri, Mario; Bech, Per

    2016-01-01

    Background Mental pain, defined as a subjective experience characterized by perception of strong negative feelings and changes in the self and its function, is no less real than other types of grief. Mental pain has been considered to be a distinct entity from depression. We have performed a systematic review analyzing the relationship between mental pain and suicide by providing a qualitative data synthesis of the studies. Methods We have conducted, in accordance with PRISMA guide...

  8. Physical activity in spondyloarthritis: a systematic review

    LENUS (Irish Health Repository)

    O’Dwyer, Tom

    2014-10-01

    Physical activity (PA) is associated with numerous health-related benefits among adults with chronic diseases and the general population. As the benefits are dose-dependent, this review aims to establish the PA levels of adults with spondyloarthritis and to compare these to the general population. Electronic databases (Cochrane Central Register of Controlled Trials, EMBASE, MEDLINE\\/PubMed, PEDro, AMED, CINAHL) were systematically searched from inception to May 2014 using medical subject headings and keywords. This was supplemented by searching conference abstracts and hand-searching reference lists of included studies. Eligible studies were randomized controlled trials and observational studies of adults with SpA in which free-living PA or energy expenditure levels were measured. Subjects less than 18 years or with juvenile-onset SpA were excluded. Outcomes included objective and self-report measurements. Two reviewers independently screened studies for inclusion and assessed methodological quality using the Cochrane risk of bias tool and the RTI item bank. From the 2,431 records reviewed, nine studies involving 2,972 participants were included. This review focused on qualitative synthesis. Meta-analyses were not undertaken due to differences in study design, measurement tools, and participant characteristics. This heterogeneity, coupled with the risk of bias inherent in the included observational studies, limits the generalizability of findings. Objective measurements suggest PA levels may be lower among adults with spondyloarthritis than in healthy population controls. Self-reported PA and self-reported rates of adherence to PA recommendations varied largely across studies; higher disease activity was associated with lower self-reported PA levels. Physical activity levels may be lower in adults with axial spondyloarthritis, with higher disease activity associated with lower PA levels.

  9. Improving environmental change research with systematic techniques for qualitative scenarios

    International Nuclear Information System (INIS)

    Schweizer, Vanessa Jine; Kriegler, Elmar

    2012-01-01

    Scenarios are key tools in analyses of global environmental change. Often they consist of quantitative and qualitative components, where the qualitative aspects are expressed in narrative, or storyline, form. Fundamental challenges in scenario development and use include identifying a small set of compelling storylines that span a broad range of policy-relevant futures, documenting that the assumptions embodied in the storylines are internally consistent, and ensuring that the selected storylines are sufficiently comprehensive, that is, that descriptions of important kinds of future developments are not left out. The dominant approach to scenario design for environmental change research has been criticized for lacking sufficient means of ensuring that storylines are internally consistent. A consequence of this shortcoming could be an artificial constraint on the range of plausible futures considered. We demonstrate the application of a more systematic technique for the development of storylines called the cross-impact balance (CIB) method. We perform a case study on the scenarios published in the IPCC Special Report on Emissions Scenarios (SRES), which are widely used. CIB analysis scores scenarios in terms of internal consistency. It can also construct a very large number of scenarios consisting of combinations of assumptions about individual scenario elements and rank these combinations in terms of internal consistency. Using this method, we find that the four principal storylines employed in the SRES scenarios vary widely in internal consistency. One type of storyline involving highly carbon-intensive development is underrepresented in the SRES scenario set. We conclude that systematic techniques like CIB analysis hold promise for improving scenario development in global change research. (letter)

  10. The Emergence of Systematic Review in Toxicology.

    Science.gov (United States)

    Stephens, Martin L; Betts, Kellyn; Beck, Nancy B; Cogliano, Vincent; Dickersin, Kay; Fitzpatrick, Suzanne; Freeman, James; Gray, George; Hartung, Thomas; McPartland, Jennifer; Rooney, Andrew A; Scherer, Roberta W; Verloo, Didier; Hoffmann, Sebastian

    2016-07-01

    The Evidence-based Toxicology Collaboration hosted a workshop on "The Emergence of Systematic Review and Related Evidence-based Approaches in Toxicology," on November 21, 2014 in Baltimore, Maryland. The workshop featured speakers from agencies and organizations applying systematic review approaches to questions in toxicology, speakers with experience in conducting systematic reviews in medicine and healthcare, and stakeholders in industry, government, academia, and non-governmental organizations. Based on the workshop presentations and discussion, here we address the state of systematic review methods in toxicology, historical antecedents in both medicine and toxicology, challenges to the translation of systematic review from medicine to toxicology, and thoughts on the way forward. We conclude with a recommendation that as various agencies and organizations adapt systematic review methods, they continue to work together to ensure that there is a harmonized process for how the basic elements of systematic review methods are applied in toxicology. © The Author 2016. Published by Oxford University Press on behalf of the Society of Toxicology.

  11. Comparison of search strategies in systematic reviews of adverse effects to other systematic reviews.

    Science.gov (United States)

    Golder, Su; Loke, Yoon K; Zorzela, Liliane

    2014-06-01

    Research indicates that the methods used to identify data for systematic reviews of adverse effects may need to differ from other systematic reviews. To compare search methods in systematic reviews of adverse effects with other reviews. The search methodologies in 849 systematic reviews of adverse effects were compared with other reviews. Poor reporting of search strategies is apparent in both systematic reviews of adverse effects and other types of systematic reviews. Systematic reviews of adverse effects are less likely to restrict their searches to MEDLINE or include only randomised controlled trials (RCTs). The use of other databases is largely dependent on the topic area and the year the review was conducted, with more databases searched in more recent reviews. Adverse effects search terms are used by 72% of reviews and despite recommendations only two reviews report using floating subheadings. The poor reporting of search strategies in systematic reviews is universal, as is the dominance of searching MEDLINE. However, reviews of adverse effects are more likely to include a range of study designs (not just RCTs) and search beyond MEDLINE. © 2014 Crown Copyright.

  12. Career choice in academic medicine: systematic review.

    Science.gov (United States)

    Straus, Sharon E; Straus, Christine; Tzanetos, Katina

    2006-12-01

    To review systematically the evidence about what factors influence the decision to choose or not choose a career in academic medicine. A systematic review of relevant literature from 1990 to May 2005. Searches of The Cochrane Library, Medline (using Ovid and PubMed) from 1990 to May 2005, and EMBASE from 1990 to May 2005 were completed to identify relevant studies that explored the influential factors. Additional articles were identified from searching the bibliographies of retrieved articles. We attempted to identify studies that included residents, fellows, or staff physicians. No restrictions were placed on the study methodologies identified and all articles presenting empirical evidence were retrieved. For cohort, case-control, and cross-sectional studies, minimum inclusion criteria were the presence of defined groups, and the ability to extract relevant data. For surveys that involved case series, minimum inclusion criteria were a description of the population, and the availability of extractable data. Minimum inclusion criteria for qualitative studies were descriptions of the sampling strategy and methods. The search identified 251 abstracts; 25 articles were included in this review. Completion of an MD with a graduate degree or fellowship program is associated with a career in academic medicine. Of the articles identified in this review, this finding is supported by the highest quality of evidence. Similarly, the completion of research and publication of this research in medical school and residency are associated with a career in academic medicine. The desire to teach, conduct research, and the intellectual stimulation and challenge provided in academia may also persuade people to choose this career path. The influence of a role model or a mentor was reported by physicians to impact their decision making. Trainees' interest in academic medicine wanes as they progress through their residency. In order to revitalize academic medicine, we must engage trainees

  13. Advancing Systematic Review Workshop (December 2015)

    Science.gov (United States)

    EPA hosted an event to examine the systematic review process for development and applications of methods for different types of evidence (epidemiology, animal toxicology, and mechanistic). The presentations are also available.

  14. Systematic reviews in the field of nutrition

    Science.gov (United States)

    Systematic reviews are valuable tools for staying abreast of evolving nutrition and aging -related topics, formulating dietary guidelines, establishing nutrient reference intakes, formulating clinical practice guidance, evaluating health claims, and setting research agendas. Basic steps of conductin...

  15. Building Research Capacity for Systematic Reviews | IDRC ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    ... is addressing this gap, summarizing the best available primary research on digital ... Systematic reviews are used to appraise relevant research and synthesize ... The health sciences field uses them widely to inform studies and evaluate ...

  16. Systematic reviews in pain research: methodology refined

    National Research Council Canada - National Science Library

    McQuay, H. J; Kalso, Eija; Moore, R. Andrew

    2008-01-01

    "Presents invited papers from the 6th IASP Research Symposium, Systematic Reviews and Meta-Analyses in Pain, held in Spain in September 2006, organized by the International Collaboration on Evidence...

  17. Side effects are incompletely reported among systematic reviews in gastroenterology.

    Science.gov (United States)

    Mahady, Suzanne E; Schlub, Timothy; Bero, Lisa; Moher, David; Tovey, David; George, Jacob; Craig, Jonathan C

    2015-02-01

    Systematic reviews are an integral component of evidence-based health care. However, little is known on how well they report the potential harms of interventions. We assessed the reporting of harms in recently published systematic reviews of interventions relevant to clinical gastroenterology. We identified all systematic reviews of randomized trials of gastroenterology interventions published from 2008 to 2012 in highly cited gastroenterology and general medical journals. We adapted the Consolidated Standards of Reporting Trials guidelines for harms and assessed qualitative and quantitative parameters of harms reporting. Regression analyses determined predictors of more comprehensive harms reporting. In total, 78 systematic reviews were identified, with 72 published in gastroenterology journals and six in general medical journals. Overall, one in three systematic reviews (26/78, 33%) did not refer to harms of the intervention anywhere in the article. Less than half of the studies included adverse events as an outcome measure, and data on absolute rates of adverse events were only provided in 28%. Most (65%) did not include any figures or tables on adverse event; however, all included these on efficacy outcomes (mean, 3 and range, 1-7). Regression analyses indicated that the use of reporting guidelines was significantly associated with better harms reporting (P = 0.04). The reporting of harms in gastroenterology systematic reviews is largely inadequate and highly asymmetrical compared with the reporting of benefits. We suggest that review authors routinely assess both efficacy and harms outcomes of an intervention and that reporting guidelines specifically targeting harms reporting be developed. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.

  18. Treatment effects for dysphagia in Parkinson's disease: a systematic review.

    Science.gov (United States)

    van Hooren, M R A; Baijens, L W J; Voskuilen, S; Oosterloo, M; Kremer, B

    2014-08-01

    Dysphagia remains a common problem in Parkinson's disease (PD). Previous systematic reviews on therapy effects for oropharyngeal dysphagia in PD have shown a lack of evidence. In the past 5 years several placebo or sham-controlled trials with varying results have been published. The aim of this systematic literature review is to summarize and qualitatively analyze the published studies on this matter. Studies published up to December 2013 were found via a systematic comprehensive electronic database search using PubMed, Embase, and The Cochrane Library. Two reviewers independently assessed the studies using strict inclusion criteria. Twelve studies were included and qualitatively analyzed using critical appraisal items. The review includes rehabilitative (exercises, electrical stimulation, bolus modification etc.) and pharmacologic treatment. Some well-designed controlled trials were included. However, none of the included studies fulfilled all criteria for external and internal validity. A meta-analysis was not carried out as most of the studies were not of sufficient quality to warrant doing so. Expiratory Muscle Strength Training (EMST) and Video-Assisted Swallowing Therapy (VAST) may be effective dysphagia treatments solely or in addition to dopaminergic therapy for PD. However, these preliminary results warrant further investigation concerning their clinical applicability, and further research should be based on randomized sham-controlled trials to determine the effectiveness and long-term effects of different therapies for dysphagia in PD. Copyright © 2014 Elsevier Ltd. All rights reserved.

  19. Assessing harmful effects in systematic Reviews

    Directory of Open Access Journals (Sweden)

    Woolacott Nerys F

    2004-07-01

    Full Text Available Abstract Background Balanced decisions about health care interventions require reliable evidence on harms as well as benefits. Most systematic reviews focus on efficacy and randomised trials, for which the methodology is well established. Methods to systematically review harmful effects are less well developed and there are few sources of guidance for researchers. We present our own recent experience of conducting systematic reviews of harmful effects and make suggestions for future practice and further research. Methods We described and compared the methods used in three systematic reviews. Our evaluation focused on the review question, study designs and quality assessment. Results One review question focused on providing information on specific harmful effects to furnish an economic model, the other two addressed much broader questions. All three reviews included randomised and observational data, although each defined the inclusion criteria differently. Standard methods were used to assess study quality. Various practical problems were encountered in applying the study design inclusion criteria and assessing quality, mainly because of poor study design, inadequate reporting and the limitations of existing tools. All three reviews generated a large volume of work that did not yield much useful information for health care decision makers. The key areas for improvement we identified were focusing the review question and developing methods for quality assessment of studies of harmful effects. Conclusions Systematic reviews of harmful effects are more likely to yield information pertinent to clinical decision-making if they address a focused question. This will enable clear decisions to be made about the type of research to include in the review. The methodology for assessing the quality of harmful effects data in systematic reviews requires further development.

  20. A primer on systematic reviews in toxicology.

    Science.gov (United States)

    Hoffmann, Sebastian; de Vries, Rob B M; Stephens, Martin L; Beck, Nancy B; Dirven, Hubert A A M; Fowle, John R; Goodman, Julie E; Hartung, Thomas; Kimber, Ian; Lalu, Manoj M; Thayer, Kristina; Whaley, Paul; Wikoff, Daniele; Tsaioun, Katya

    2017-07-01

    Systematic reviews, pioneered in the clinical field, provide a transparent, methodologically rigorous and reproducible means of summarizing the available evidence on a precisely framed research question. Having matured to a well-established approach in many research fields, systematic reviews are receiving increasing attention as a potential tool for answering toxicological questions. In the larger framework of evidence-based toxicology, the advantages and obstacles of, as well as the approaches for, adapting and adopting systematic reviews to toxicology are still being explored. To provide the toxicology community with a starting point for conducting or understanding systematic reviews, we herein summarized available guidance documents from various fields of application. We have elaborated on the systematic review process by breaking it down into ten steps, starting with planning the project, framing the question, and writing and publishing the protocol, and concluding with interpretation and reporting. In addition, we have identified the specific methodological challenges of toxicological questions and have summarized how these can be addressed. Ultimately, this primer is intended to stimulate scientific discussions of the identified issues to fuel the development of toxicology-specific methodology and to encourage the application of systematic review methodology to toxicological issues.

  1. Strategically Reviewing the Research Literature in Qualitative Research

    Science.gov (United States)

    Chenail, Ronald J.; Cooper, Robin; Desir, Charlene

    2010-01-01

    Reviewing literature in qualitative research can be challenging in terms of why, when, where, and how we should access third-party sources in our work, especially for novice qualitative researchers. As a pragmatic solution, we suggest qualitative researchers utilize research literature in four functional ways: (a) define the phenomenon in…

  2. A Systematic Method for Search Term Selection in Systematic Reviews

    Science.gov (United States)

    Thompson, Jenna; Davis, Jacqueline; Mazerolle, Lorraine

    2014-01-01

    The wide variety of readily available electronic media grants anyone the freedom to retrieve published references from almost any area of research around the world. Despite this privilege, keeping up with primary research evidence is almost impossible because of the increase in professional publishing across disciplines. Systematic reviews are a…

  3. SYSTEMATIC REVIEW SEBAGAI METODE PENELITIAN UNTUK MENSINTESIS HASIL-HASIL PENELITIAN (SEBUAH PENGANTAR

    Directory of Open Access Journals (Sweden)

    Siswanto Siswanto

    2012-12-01

    Full Text Available Individual research is not enough to provide inputs for policy improvement. In order that research results can be used for policy inputs, a synthesis from a number research results and packaging them into actionable messages are important methodologies that have to be mastered by researchers. By conducting synthesis of research results with the use of systematic review and packaging it in the form of actionable messages (policy brief and policy paper, a more comprehensive and balanced fact can be presented for policy makers. Systematic review comprises quantitative technique (meta-analysis and qualitative technique (meta-synthesis. However, systematic review should be distinguished with a review that is not systematic (traditional review. Both quantitative and qualitative review possess a systematic and sequential step as that of general research methodology. Quantitative approach is identified as meta-analysis, whereas qualitative approach is identified as meta-synthesis. Within meta-synthesis, there are at least two approaches, i.e. meta-ethnography and meta-aggregation. Within the perspective of research translation, meta-aggregation is an important method in comprehending a number of qualitative research results, for providing more comprehensive and balanced facts to policy makers. Key words: systematic review, meta-analysis, meta-synthesis, meta-ethnography, meta-aggregation

  4. Qualitative "trial-sibling" studies and "unrelated" qualitative studies contributed to complex intervention reviews.

    Science.gov (United States)

    Noyes, Jane; Hendry, Margaret; Lewin, Simon; Glenton, Claire; Chandler, Jackie; Rashidian, Arash

    2016-06-01

    To compare the contribution of "trial-sibling" and "unrelated" qualitative studies in complex intervention reviews. Researchers are using qualitative "trial-sibling" studies undertaken alongside trials to provide explanations to understand complex interventions. In the absence of qualitative "trial-sibling" studies, it is not known if qualitative studies "unrelated" to trials are helpful. Trials, "trial-sibling," and "unrelated" qualitative studies looking at three health system interventions were identified. We looked for similarities and differences between the two types of qualitative studies, such as participants, intervention delivery, context, study quality and reporting, and contribution to understanding trial results. Reporting was generally poor in both qualitative study types. We detected no substantial differences in participant characteristics. Interventions in qualitative "trial-sibling" studies were delivered using standardized protocols, whereas interventions in "unrelated" qualitative studies were delivered in routine care. Qualitative "trial-sibling" studies alone provided insufficient data to develop meaningful transferrable explanations beyond the trial context, and their limited focus on immediate implementation did not address all phenomena of interest. Together, "trial-sibling" and "unrelated" qualitative studies provided larger, richer data sets across contexts to better understand the phenomena of interest. Findings support inclusion of "trial-sibling" and "unrelated" qualitative studies to explore complexity in complex intervention reviews. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Cochrane Qualitative and Implementation Methods Group guidance series-paper 5: methods for integrating qualitative and implementation evidence within intervention effectiveness reviews.

    Science.gov (United States)

    Harden, Angela; Thomas, James; Cargo, Margaret; Harris, Janet; Pantoja, Tomas; Flemming, Kate; Booth, Andrew; Garside, Ruth; Hannes, Karin; Noyes, Jane

    2018-05-01

    The Cochrane Qualitative and Implementation Methods Group develops and publishes guidance on the synthesis of qualitative and mixed-method evidence from process evaluations. Despite a proliferation of methods for the synthesis of qualitative research, less attention has focused on how to integrate these syntheses within intervention effectiveness reviews. In this article, we report updated guidance from the group on approaches, methods, and tools, which can be used to integrate the findings from quantitative studies evaluating intervention effectiveness with those from qualitative studies and process evaluations. We draw on conceptual analyses of mixed methods systematic review designs and the range of methods and tools that have been used in published reviews that have successfully integrated different types of evidence. We outline five key methods and tools as devices for integration which vary in terms of the levels at which integration takes place; the specialist skills and expertise required within the review team; and their appropriateness in the context of limited evidence. In situations where the requirement is the integration of qualitative and process evidence within intervention effectiveness reviews, we recommend the use of a sequential approach. Here, evidence from each tradition is synthesized separately using methods consistent with each tradition before integration takes place using a common framework. Reviews which integrate qualitative and process evaluation evidence alongside quantitative evidence on intervention effectiveness in a systematic way are rare. This guidance aims to support review teams to achieve integration and we encourage further development through reflection and formal testing. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. "Assessing the methodological quality of systematic reviews in radiation oncology: A systematic review".

    Science.gov (United States)

    Hasan, Haroon; Muhammed, Taaha; Yu, Jennifer; Taguchi, Kelsi; Samargandi, Osama A; Howard, A Fuchsia; Lo, Andrea C; Olson, Robert; Goddard, Karen

    2017-10-01

    The objective of our study was to evaluate the methodological quality of systematic reviews and meta-analyses in Radiation Oncology. A systematic literature search was conducted for all eligible systematic reviews and meta-analyses in Radiation Oncology from 1966 to 2015. Methodological characteristics were abstracted from all works that satisfied the inclusion criteria and quality was assessed using the critical appraisal tool, AMSTAR. Regression analyses were performed to determine factors associated with a higher score of quality. Following exclusion based on a priori criteria, 410 studies (157 systematic reviews and 253 meta-analyses) satisfied the inclusion criteria. Meta-analyses were found to be of fair to good quality while systematic reviews were found to be of less than fair quality. Factors associated with higher scores of quality in the multivariable analysis were including primary studies consisting of randomized control trials, performing a meta-analysis, and applying a recommended guideline related to establishing a systematic review protocol and/or reporting. Systematic reviews and meta-analyses may introduce a high risk of bias if applied to inform decision-making based on AMSTAR. We recommend that decision-makers in Radiation Oncology scrutinize the methodological quality of systematic reviews and meta-analyses prior to assessing their utility to inform evidence-based medicine and researchers adhere to methodological standards outlined in validated guidelines when embarking on a systematic review. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Communicating Qualitative Research Study Designs to Research Ethics Review Boards

    Science.gov (United States)

    Ells, Carolyn

    2011-01-01

    Researchers using qualitative methodologies appear to be particularly prone to having their study designs called into question by research ethics or funding agency review committees. In this paper, the author considers the issue of communicating qualitative research study designs in the context of institutional research ethics review and offers…

  8. The nature of qualitative construction partnering research : literature review

    NARCIS (Netherlands)

    Marieke Venselaar; Hans Warmelink

    2017-01-01

    from the publisher's site: "The purpose of this paper is to investigate the nature of qualitative construction partnering research. Design/methodology/approach. In total, 20 qualitative peer-reviewed papers about construction partnering research are reviewed. Findings: The results show four

  9. Contribution of systematic reviews to management decisions.

    Science.gov (United States)

    Cook, Carly N; Possingham, Hugh P; Fuller, Richard A

    2013-10-01

    Systematic reviews comprehensively summarize evidence about the effectiveness of conservation interventions. We investigated the contribution to management decisions made by this growing body of literature. We identified 43 systematic reviews of conservation evidence, 23 of which drew some concrete conclusions relevant to management. Most reviews addressed conservation interventions relevant to policy decisions; only 35% considered practical on-the-ground management interventions. The majority of reviews covered only a small fraction of the geographic and taxonomic breadth they aimed to address (median = 13% of relevant countries and 16% of relevant taxa). The likelihood that reviews contained at least some implications for management tended to increase as geographic coverage increased and to decline as taxonomic breadth increased. These results suggest the breadth of a systematic review requires careful consideration. Reviews identified a mean of 312 relevant primary studies but excluded 88% of these because of deficiencies in design or a failure to meet other inclusion criteria. Reviews summarized on average 284 data sets and 112 years of research activity, yet the likelihood that their results had at least some implications for management did not increase as the amount of primary research summarized increased. In some cases, conclusions were elusive despite the inclusion of hundreds of data sets and years of cumulative research activity. Systematic reviews are an important part of the conservation decision making tool kit, although we believe the benefits of systematic reviews could be significantly enhanced by increasing the number of reviews focused on questions of direct relevance to on-the-ground managers; defining a more focused geographic and taxonomic breadth that better reflects available data; including a broader range of evidence types; and appraising the cost-effectiveness of interventions. © 2013 The Authors. Conservation Biology published by Wiley

  10. Help Options in CALL: A Systematic Review

    Science.gov (United States)

    Cardenas-Claros, Monica S.; Gruba, Paul A.

    2009-01-01

    This paper is a systematic review of research investigating help options in the different language skills in computer-assisted language learning (CALL). In this review, emerging themes along with is-sues affecting help option research are identified and discussed. We argue that help options in CALL are application resources that do not only seem…

  11. Systematic reviews of diagnostic test accuracy

    DEFF Research Database (Denmark)

    Leeflang, Mariska M G; Deeks, Jonathan J; Gatsonis, Constantine

    2008-01-01

    More and more systematic reviews of diagnostic test accuracy studies are being published, but they can be methodologically challenging. In this paper, the authors present some of the recent developments in the methodology for conducting systematic reviews of diagnostic test accuracy studies....... Restrictive electronic search filters are discouraged, as is the use of summary quality scores. Methods for meta-analysis should take into account the paired nature of the estimates and their dependence on threshold. Authors of these reviews are advised to use the hierarchical summary receiver...

  12. A Critical Review of Search Strategies Used in Recent Systematic Reviews Published in Selected Prosthodontic and Implant-Related Journals: Are Systematic Reviews Actually Systematic?

    Science.gov (United States)

    Layton, Danielle

    The aim of this study was to outline how search strategies can be systematic, to examine how the searches in recent systematic reviews in prosthodontic and implant-related journals were structured, and to determine whether the search strategies used in those articles were systematic. A total of 103 articles published as systematic reviews and indexed in Medline between January 2013 and May 2016 were identified from eight prosthodontic and implant journals and reviewed. The search strategies were considered systematic when they met the following criteria: (1) more than one electronic database was searched, (2) more than one searcher was clearly involved, (3) both text words and indexing terms were clearly included in the search strategy, (4) a hand search of selected journals or reference lists was undertaken, (5) gray research was specifically sought, and (6) the articles were published in English and at least one other language. The data were tallied and qualitatively assessed. The majority of articles reported on implants (54%), followed by tooth-supported fixed prosthodontics (13%). A total of 23 different electronic resources were consulted, including Medline (by 100% of articles), the Cochrane Library (52%), and Embase (37%). The majority consulted more than one electronic resource (71%), clearly included more than one searcher (73%), and employed a hand search of either selected journals or reference lists (86%). Less than half used both text words and indexing terms to identify articles (42%), while 15% actively sought gray research. Articles published in languages other than English were considered in 63 reviews, but only 14 had no language restrictions. Of the 103 articles, 5 completed search strategies that met all 6 criteria, and a further 12 met 5 criteria. Two articles did not fulfill any of the criteria. More than 95% of recent prosthodontic and implant review articles published in the selected journals failed to use search strategies that were

  13. Conversation therapy for aphasia: a qualitative review of the literature.

    Science.gov (United States)

    Simmons-Mackie, Nina; Savage, Meghan C; Worrall, Linda

    2014-01-01

    A diverse literature addresses elements of conversation therapy in aphasia including intervention rooted in conversation analysis, partner training, group therapy and behavioural intervention. Currently there is no resource for clinicians or researchers that defines and organizes this information into a coherent synopsis describing various conversation therapy practices. To organize information from varied sources into a descriptive overview of conversation therapy for aphasia. Academic search engines were employed to identify research articles published between 1950 and September 2013 reporting on conversation therapy for aphasia. Thirty articles met criteria for review and were identified as primary sources for the qualitative review. Using qualitative methodology, relevant data were extracted from articles and categories were identified to create a descriptive taxonomy of conversation therapy for aphasia. Conversation interventions were divided into descriptive categories including: treatment participants (person with aphasia, partner, dyad), primary guiding orientation (conversation analysis, social model, behavioural, relationship centred), service delivery (individual, group), focus of intervention (generic/individualized; problem/solution oriented; compensatory), training methods (explicit/implicit; external/embedded), activities or tasks, and outcomes measured. Finally, articles were categorized by research design. There was marked variation in conversation therapy approaches and outcome measures reported and a notable gap in information about one-on-one conversation therapy for individuals with aphasia. This review provides a description of various conversation therapy approaches and identified gaps in the existing literature. Valid measures of natural conversation, research on one-on-one conversation approaches for individuals with aphasia, and a systematic body of evidence consisting of high quality research are needed. © 2014 Royal College of Speech

  14. Barreras y facilitadores de acceso a la atención de salud: una revisión sistemática cualitativa Health care access barriers and facilitators: a qualitative systematic review

    Directory of Open Access Journals (Sweden)

    Macarena Hirmas Adauy

    2013-03-01

    salud para ser reducidas o eliminadas.OBJECTIVE: To determine whether health care access barriers and facilitators cut across different populations, countries, and pathologies, and if so, at which stages of health care access they occur most frequently. METHODS: A qualitative systematic review of literature published between 2000 and 2010 was undertaken drawing on six international sources: Fuente Académica, MEDLINE (full-text, Academic Search Complete (a full-text multidisciplinary academic database, PubMed, SciELO, and LILACS. Scientific appraisal guidelines from the Critical Appraisal Skills Programme Español (CASPe and Strengthening the Reporting of Observational Studies in Epidemiology (STROBE were applied. Gray literature was also reviewed. RESULTS: From the review of scientific literature, 19 of 1 160 articles and 8 of 12 gray literature documents were selected. A total of 230 barriers and 35 facilitators were identified in countries with different contexts and degrees of development. The 230 barriers were classified according to the Tanahashi framework: 25 corresponded to availability, 67 to access, 87 to acceptability, and 51 to contact. Most of the barriers were related to acceptability and access. The facilitating elements that were identified had to do with personal factors, the provider-client relationship, social support, knowledge about diseases, and adaptation of the services to patients. CONCLUSIONS: The barriers and facilitators were seen mostly in people who initiated contact with the health systems, and they occurred at all stages of health care access. Only a few of the studies looked at people who did not initiate contact with the health services. The barriers and facilitators identified were socially determined and largely a reflection of existing social inequities in the countries. To reduce or eliminate them, joint action with other non-health sectors will be necessary.

  15. Usefulness of systematic review search strategies in finding child health systematic reviews in MEDLINE

    NARCIS (Netherlands)

    Boluyt, Nicole; Tjosvold, Lisa; Lefebvre, Carol; Klassen, Terry P.; Offringa, Martin

    2008-01-01

    OBJECTIVE: To determine the sensitivity and precision of existing search strategies for retrieving child health systematic reviews in MEDLINE using PubMed. DESIGN: Filter (diagnostic) accuracy study. We identified existing search strategies for systematic reviews, combined them with a filter that

  16. Systematic review of reviews of risk factors for intracranial aneurysms

    International Nuclear Information System (INIS)

    Clarke, Mike

    2008-01-01

    Systematic reviews of systematic reviews identify good quality reviews of earlier studies of medical conditions. This article describes a systematic review of systematic reviews performed to investigate factors that might influence the risk of rupture of an intracranial aneurysm. It exemplifies the technique of this type of research and reports the finding of a specific study. The annual incidence of subarachnoid haemorrhage resulting from the rupture of intracranial aneurysms is estimated to be nine per 100,000. A large proportion of people who have this bleed, will die or remain dependent on the care of others for some time. Reliable knowledge about the risks of subarachnoid haemorrhage in different populations will help in planning, screening and prevention strategies and in predicting the prognosis of individual patients. If the necessary data were available in the identified reviews, an estimate for the numerical relationship between a particular characteristic and the risk of subarachnoid haemorrhage was included in this report. The identification of eligible systematic reviews relied mainly on the two major bibliographic databases of the biomedical literature: PubMed and EMBASE. These were searched in 2006, using specially designed search strategies. Approximately 2,000 records were retrieved and each of these was checked carefully against the eligibility criteria for this systematic review. These criteria required that the report be a systematic review of studies assessing the risk of subarachnoid haemorrhage in patients known to have an unruptured intracranial aneurysm or of studies that had investigated the characteristics of people who experienced a subarachnoid haemorrhage without previously being known to have an unruptured aneurysm. Reports which included more than one systematic review were eligible and each of these reviews was potentially eligible. The quality of each systematic review was assessed. In this review, 16 separate reports were

  17. Using text mining for study identification in systematic reviews: a systematic review of current approaches

    OpenAIRE

    O?Mara-Eves, Alison; Thomas, James; McNaught, John; Miwa, Makoto; Ananiadou, Sophia

    2015-01-01

    Background The large and growing number of published studies, and their increasing rate of publication, makes the task of identifying relevant studies in an unbiased way for inclusion in systematic reviews both complex and time consuming. Text mining has been offered as a potential solution: through automating some of the screening process, reviewer time can be saved. The evidence base around the use of text mining for screening has not yet been pulled together systematically; this systematic...

  18. Pharmacological interventions to treat phlebitis: systematic review.

    Science.gov (United States)

    dos Reis, Paula Elaine Diniz; Silveira, Renata Cristina de Campos Pereira; Vasques, Christiane Inocêncio; de Carvalho, Emilia Campos

    2009-01-01

    This study presents a systematic review for evaluating effective pharmacological actions for the treatment of phlebitis stemming from infusion therapy. The studies reviewed were categorized according to the type of therapeutic approach proposed by the author and by the level of evidence presented. The review found that topical nitroglycerin and notoginseny were more effective in the reduction of the inflammatory process when compared with other proposed alternatives. Nevertheless, the development of research related to possible alternatives for the treatment of phlebitis is important.

  19. The quality of systematic reviews about interventions for refractive error can be improved: a review of systematic reviews.

    Science.gov (United States)

    Mayo-Wilson, Evan; Ng, Sueko Matsumura; Chuck, Roy S; Li, Tianjing

    2017-09-05

    Systematic reviews should inform American Academy of Ophthalmology (AAO) Preferred Practice Pattern® (PPP) guidelines. The quality of systematic reviews related to the forthcoming Preferred Practice Pattern® guideline (PPP) Refractive Errors & Refractive Surgery is unknown. We sought to identify reliable systematic reviews to assist the AAO Refractive Errors & Refractive Surgery PPP. Systematic reviews were eligible if they evaluated the effectiveness or safety of interventions included in the 2012 PPP Refractive Errors & Refractive Surgery. To identify potentially eligible systematic reviews, we searched the Cochrane Eyes and Vision United States Satellite database of systematic reviews. Two authors identified eligible reviews and abstracted information about the characteristics and quality of the reviews independently using the Systematic Review Data Repository. We classified systematic reviews as "reliable" when they (1) defined criteria for the selection of studies, (2) conducted comprehensive literature searches for eligible studies, (3) assessed the methodological quality (risk of bias) of the included studies, (4) used appropriate methods for meta-analyses (which we assessed only when meta-analyses were reported), (5) presented conclusions that were supported by the evidence provided in the review. We identified 124 systematic reviews related to refractive error; 39 met our eligibility criteria, of which we classified 11 to be reliable. Systematic reviews classified as unreliable did not define the criteria for selecting studies (5; 13%), did not assess methodological rigor (10; 26%), did not conduct comprehensive searches (17; 44%), or used inappropriate quantitative methods (3; 8%). The 11 reliable reviews were published between 2002 and 2016. They included 0 to 23 studies (median = 9) and analyzed 0 to 4696 participants (median = 666). Seven reliable reviews (64%) assessed surgical interventions. Most systematic reviews of interventions for

  20. Roles for librarians in systematic reviews: a scoping review

    Science.gov (United States)

    Spencer, Angela J.; Eldredge, Jonathan D.

    2018-01-01

    Objective What roles do librarians and information professionals play in conducting systematic reviews? Librarians are increasingly called upon to be involved in systematic reviews, but no study has considered all the roles librarians can perform. This inventory of existing and emerging roles aids in defining librarians’ systematic reviews services. Methods For this scoping review, the authors conducted controlled vocabulary and text-word searches in the PubMed; Library, Information Science & Technology Abstracts; and CINAHL databases. We separately searched for articles published in the Journal of the European Association for Health Information and Libraries, Evidence Based Library and Information Practice, the Journal of the Canadian Heath Libraries Association, and Hypothesis. We also text-word searched Medical Library Association annual meeting poster and paper abstracts. Results We identified 18 different roles filled by librarians and other information professionals in conducting systematic reviews from 310 different articles, book chapters, and presented papers and posters. Some roles were well known such as searching, source selection, and teaching. Other less documented roles included planning, question formulation, and peer review. We summarize these different roles and provide an accompanying bibliography of references for in-depth descriptions of these roles. Conclusion Librarians play central roles in systematic review teams, including roles that go beyond searching. This scoping review should encourage librarians who are fulfilling roles that are not captured here to document their roles in journal articles and poster and paper presentations. PMID:29339933

  1. Health professionals’ perceptions of the barriers and facilitators to providing smoking cessation advice to women in pregnancy and during the post-partum period: a systematic review of qualitative research

    Directory of Open Access Journals (Sweden)

    Kate Flemming

    2016-03-01

    Full Text Available Abstract Background Reducing smoking in pregnancy is a policy priority in many countries and as a result there has been a rise in the development of services to help pregnant women to quit. A wide range of professionals are involved in providing these services, with midwives playing a particularly pivotal role. Understanding professionals’ experiences of providing smoking cessation support in pregnancy can help to inform the design of interventions as well as to improve routine care. Methods A synthesis of qualitative research of health professionals’ perceptions of the barriers and facilitators to providing smoking cessation advice to women in pregnancy and the post-partum period was conducted using meta-ethnography. Searches were undertaken from 1990 to January 2015 using terms for maternity health professionals and smoking cessation advisors, pregnancy, post-partum, smoking, and qualitative in seven electronic databases. The review was reported in accordance with the ‘Enhancing transparency in reporting the synthesis of qualitative research’ (ENTREQ statement. Results Eight studies reported in nine papers were included, reporting on the views of 190 health professionals/key informants, including 85 midwives and health visitors. The synthesis identified that both the professional role of participants and the organisational context in which they worked could act as either barriers or facilitators to an individual’s ability to provide smoking cessation support to pregnant or post-partum women. Underpinning these factors was an acknowledgment that the association