scholarly journals The association between caregiver education on adult T2DM and patient’s outcomes in community: A systematic review

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 804-805
Author(s):  
Aluem Tark ◽  
Jiyoun Song ◽  
Jeong-Yeon Kim ◽  
So Yeon Park ◽  
Kyungmi Woo
Keyword(s):  
Diabetes Care ◽  
Risk Of Bias ◽  
Future Research ◽  
Bias Analysis ◽  
Adult Type ◽  
Caregiver Education ◽  
Study Results ◽  
Care Outcomes ◽  
Caregiver Involvement

Abstract Introduction: Adult type 2 diabetes (T2DM) threatens public health and most patients manage their diabetic condition while in the community. As it is challenging for patients to properly manage diabetes alone, caregiver involvement in T2DM patient care is encouraged. This study aimed to examine the association between caregiver involvement in T2DM education within a community and the patients’ diabetes care outcomes (e.g., glycated hemoglobin (HbA1c) level, behavior, or hospitalization). Methods: The available scientific literature in PubMed, Cochrane, EMBASE, and CINAHL was searched. The methodological quality of bias was assessed using the Cochrane risk of bias tool. Results: A total of 13 out of 741 published studies were synthesized in this review. There is evidence that caregiver involvement in T2DM education is effective in the reduction of HbA1C and BMI, but not necessarily effective in reducing lipids. Study results indicate that caregiver related interventions can significantly improve patient diabetes knowledge, physical activity, and self-efficacy, but results were more mixed regarding medication adherence. Risk of bias analysis classified the majority of studies (77%) to be moderate or high quality. Conclusion: This review aimed to explore the association between caregiver involvement in adult T2DM education in the community and patients’ diabetes care outcomes. The findings show an improvement in biological and behavioral self-management outcomes with caregivers involved in T2DM education, though no studies examined the direct association between complications or hospital readmission. Future research focused on tailored interventions and longer follow-up of patient outcomes are recommended.

scholarly journals Nocturnal digital surveillance in aged populations and its effects on health, welfare and social care provision: a systematic review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Matt X. Richardson ◽  
Maria Ehn ◽  
Sara Landerdahl Stridsberg ◽  
Ken Redekop ◽  
Sarah Wamala-Andersson
Keyword(s):  
Systematic Review ◽  
Standard Care ◽  
Social Care ◽  
Grey Literature ◽  
Care Quality ◽  
Risk Of Bias ◽  
Future Research ◽  
Care Provision ◽  
Digital Surveillance

Abstract Background Nocturnal digital surveillance technologies are being widely implemented as interventions for remotely monitoring elderly populations, and often replace person-based surveillance. Such interventions are often placed in care institutions or in the home, and monitored by qualified personnel or relatives, enabling more rapid and/or frequent assessment of the individual’s need for assistance than through on-location visits. This systematic review summarized the effects of these surveillance technologies on health, welfare and social care provision outcomes in populations ≥ 50 years, compared to standard care. Method Primary studies published 2005–2020 that assessed these technologies were identified in 11 databases of peer-reviewed literature and numerous grey literature sources. Initial screening, full-text screening, and citation searching steps yielded the studies included in the review. The Risk of Bias and ROBINS-I tools were used for quality assessment of the included studies. Result Five studies out of 744 identified records met inclusion criteria. Health-related outcomes (e.g. accidents, 2 studies) and social care outcomes (e.g. staff burden, 4 studies) did not differ between interventions and standard care. Quality of life and affect showed improvement (1 study each), as did economic outcomes (1 study). The quality of studies was low however, with all studies possessing a high to critical risk of bias. Conclusions We found little evidence for the benefit of nocturnal digital surveillance interventions as compared to standard care in several key outcomes. Higher quality intervention studies should be prioritized in future research to provide more reliable evidence.

scholarly journals LO29: Interventions at triage to improve emergency department throughput: a systematic review

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S17-S17
Author(s):  
K. Grant ◽  
C. Bayley ◽  
E. Lang ◽  
G. Innes
Keyword(s):  
Emergency Department ◽  
Assessment Tool ◽  
Care Quality ◽  
Risk Of Bias ◽  
Future Research ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Meaningful Improvement ◽  
Study Results ◽  
Statistical Heterogeneity

Introduction: Emergency Department (ED) crowding is the primary threat to emergency care quality. Input and outflow factors are important factors, but EDs must optimize throughput efficiency by improving internal processes from triage to disposition, and triage is the first throughput phase. Triage throughput interventions exclude strategies that direct patients away from the ED (these modify input rather than throughput). Previous research has described physicians in triage, team triage, telemedical triage, and nurse practitioner (NP) or physician assistant (PA) led triage, but their impact has never been systematically evaluated. Methods: We conducted systematic database searches in Medline, Embase, CINAHL, and the Cochrane Central Register of Controlled Trials without the use of filters or language restrictions of all triage interventions that effected ED throughput (PROSPERO:CRD42019125651). Two independent reviewers screened studies. Study quality was assessed using the Cochrane Risk of Bias tool (version 2) for randomized controlled trials, and the National Heart, Lung, and Blood Institute quality assessment tool for other designs. Results: 18 studies met inclusion criteria (Cohen's k = 0.69). Study results were not pooled due to high statistical heterogeneity as assessed by chi-squared and I-squared statistics. Studies were grouped into physician led, NP or PA led, and team triage interventions. Six physician in triage interventions reported LOS changes between -82 and + 18 minutes. Five NP/PA led triage interventions resulted in LOS changes of -106 to + 19 minutes. Five team triage interventions reported LOS reductions of 4 to 34 minutes. One telemedicine triage study reported a non-significant 8 minute increase in LOS. Six physician at triage interventions yielded significant LWBS rate improvement (relative risk {RR}= 0.29-0.82). Team triage interventions generated LWBS rate changes ranging from meaningful improvement (RR = 0.58) to substantial deterioration (RR = 1.68). Five studies have low risk of bias, 11 studies have some risk of bias, and 2 studies have high risk of bias (Cohen's kappa = 0.58). Conclusion: Fourteen of 18 triage interventions reduced EDLOS and/or LWBS rate. Physician, NP and PA led triage were the most effective triage interventions. To aid widespread adoption, future research should focus on interrupted time series or RCT designs, and more comprehensive descriptions of the contextual factors affecting implementation of these interventions.

scholarly journals Psychometric properties of the Jefferson Scale of Empathy: a COSMIN systematic review protocol

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Brett Williams ◽  
Bronwyn Beovich
Keyword(s):  
Systematic Review ◽  
Psychometric Properties ◽  
Methodological Quality ◽  
Grey Literature ◽  
Risk Of Bias ◽  
Measurement Properties ◽  
Future Research ◽  
Health Measurement ◽  
Jefferson Scale Of Empathy

Abstract Background Empathy is an important characteristic to possess for healthcare professionals. It has been found to improve communication between professionals and patients and to improve clinical health outcomes. The Jefferson Scale of Empathy (JSE) was developed to measure this quality and has been used extensively, and psychometrically appraised, with a variety of cohorts and in different cultural environments. However, no study has been undertaken to systematically examine the methodological quality of studies which have assessed psychometric factors of the JSE. This systematic review will examine the quality of published papers that have reported on psychometric factors of the JSE. Methods A systematic review of studies which report on the psychometric properties of the JSE will be conducted. We will use a predefined search strategy to identify studies meeting the following eligibility criteria: original data is reported on for at least one of the psychometric measurement properties described in the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) Risk of Bias checklist, examines the JSE in a healthcare cohort (using the student, physician or health profession versions of the JSE), and is published from January 2001 and in the English language. Conference abstracts, editorials and grey literature will be excluded. Six electronic databases (Medline, EMBASE, PsychInfo, PubMed, Web of Science and CINAHL) will be systematically searched for articles meeting these criteria and studies will be assessed for eligibility by two review authors. The methodological quality of included papers will be examined using the COSMIN Risk of Bias checklist. Discussion A narrative description of the findings will be presented along with summary tables. Recommendations for use of the JSE with various cohorts and circumstances will be offered which may inform future research in this field. Systematic review registration PROSPERO CRD42018111412

Safety Culture, Patient Safety, and Quality of Care Outcomes: A Literature Review

2017 ◽  
Vol 41 (2) ◽  
pp. 279-304 ◽  
Author(s):  
Seung Eun Lee ◽  
Linda D. Scott ◽  
V. Susan Dahinten ◽  
Catherine Vincent ◽  
Karen Dunn Lopez ◽  
...  
Keyword(s):  
Patient Safety ◽  
Quality Of Care ◽  
Literature Review ◽  
Safety Culture ◽  
Theoretical Framework ◽  
Future Research ◽  
Units Of Analysis ◽  
Care Outcomes ◽  
Collection Methods

This integrative literature review was conducted to examine the relationships between safety culture and patient safety and quality of care outcomes in hospital settings and to identify directions for future research. Using a search of six electronic databases, 17 studies that met the study criteria were selected for review. This review revealed semantic inconsistencies, infrequent use of a theory or theoretical framework, limited discussions of validity of instruments used, and significant methodological variations. Most notably, this review identified a large array of nonsignificant and inconsistent relationships between safety culture and patient safety and quality of care outcomes. To improve understanding of the relationships, investigators should consider using a theoretical framework and valid measures of the key concepts. Researchers should also give more attention to selecting appropriate sampling and data collection methods, units of analysis, levels of data measurement and aggregation, and statistical analyses.

scholarly journals Brief Engagement and Acceptance Coaching for Hospice Settings (the BEACHeS study): results from a Phase I study of acceptability and initial effectiveness in people with non-curative cancer

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Nicholas J. Hulbert-Williams ◽  
Sabrina F. Norwood ◽  
David Gillanders ◽  
Anne M. Finucane ◽  
Juliet Spiller ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Focus Groups ◽  
Advanced Cancer ◽  
Psychological Intervention ◽  
Qualitative Interviews ◽  
Future Research ◽  
Study Results ◽  
Palliative Care Setting

Abstract Objectives Transitioning into palliative care is psychologically demanding for people with advanced cancer, and there is a need for acceptable and effective interventions to support this. We aimed to develop and pilot test a brief Acceptance and Commitment Therapy (ACT) based intervention to improve quality of life and distress. Methods Our mixed-method design included: (i) quantitative effectiveness testing using Single Case Experimental Design (SCED), (ii) qualitative interviews with participants, and (iii) focus groups with hospice staff. The five-session, in-person intervention was delivered to 10 participants; five completed at least 80%. Results At baseline, participants reported poor quality of life but low distress. Most experienced substantial physical health deterioration during the study. SCED analysis methods did not show conclusively significant effects, but there was some indication that outcome improvement followed changes in expected intervention processes variables. Quantitative and qualitative data together demonstrates acceptability, perceived effectiveness and safety of the intervention. Qualitative interviews and focus groups were also used to gain feedback on intervention content and to make design recommendations to maximise success of later feasibility trials. Conclusions This study adds to the growing evidence base for ACT in people with advanced cancer. A number of potential intervention mechanisms, for example a distress-buffering hypothesis, are raised by our data and these should be addressed in future research using randomised controlled trial designs. Our methodological recommendations—including recruiting non-cancer diagnoses, and earlier in the treatment trajectory—likely apply more broadly to the delivery of psychological intervention in the palliative care setting. This study was pre-registered on the Open Science Framework (Ref: 46,033) and retrospectively registered on the ISRCTN registry (Ref: ISRCTN12084782).

Student Participation Behaviour outside the Classroom

2016 ◽  
Vol 7 (1) ◽  
pp. 27-41 ◽  
Author(s):  
Tamer H. Elsharnouby
Keyword(s):  
Structural Equation ◽  
Student Participation ◽  
Equation Modeling ◽  
Future Research ◽  
Gulf Region ◽  
Study Results ◽  
Managerial Implications ◽  
University Services ◽  
University Brand

Drawing on literature pertaining to services marketing, branding and higher education, this study empirically identifies the antecedents of student attitude towards university brand and examines the influence of brand attitude on student participation behaviour in the university services provision. With data collected from 379 students from a leading university in the Gulf region and using structural equation modeling, the study identifies three key antecedents of students' attitude — namely, perceived faculty competency, quality of interactions among students and quality of student–administrative/IT staff interaction. The study results also suggest that a favourable evaluation of university brand in students' minds will enhance their propensity to participate actively in university services provision. The paper concludes by discussing the managerial implications of the findings, and some directions for future research are suggested.

scholarly journals Assessment of quality of life in people living with HIV in Georgia

2016 ◽  
Vol 28 (7) ◽  
pp. 672-678 ◽  
Author(s):  
Ekaterine Karkashadze ◽  
Margaret A. Gates ◽  
Nikoloz Chkhartishvili ◽  
Jack DeHovitz ◽  
Tengiz Tsertsvadze
Keyword(s):  
Quality Of Life ◽  
Prevalence Ratio ◽  
Educational Interventions ◽  
Cross Sectional Study ◽  
Education Level ◽  
Future Research ◽  
People Living With Hiv ◽  
Cross Sectional ◽  
Study Results

The purpose of our study was to assess quality of life (QoL) among Georgian HIV-infected individuals and to examine factors associated with QoL. Our cross-sectional study sample consisted of 201 HIV-infected adult outpatients recruited at the National AIDS Center in Tbilisi, Georgia. WHOQOL-HIV-BREF was used to measure QoL. Data about other variables of interest were obtained from medical records. Modified Poisson regression with robust variance estimates was performed to create a predictive model of factors that influenced QoL. The study results showed the following factors as predictors of good general QoL: antiretroviral (ARV) treatment (prevalence ratio (PR)=2.87 (95% CI: 1.45, 5.67)); higher education level (PR = 1.51 (95% CI: 1.05, 2.17)); CD4 cells ≥200 cells/mm3 (PR = 1.83 (95% CI: 1.13, 2.94)); and age ≥40 years (PR = 1.60 (95% CI: 1.09, 2.36)). However, all factors examined were associated with at least one QoL domain. Our study suggests that HIV-infected individuals younger than 40 years and those with lower education level are more likely to have poorer QoL, while those receiving ARV treatment tend to have better QoL. This highlights the importance of educational interventions and ARV treatment in HIV patients. Future research should seek to implement additional evidence-based actions to improve QoL in this population.

scholarly journals Alternatives to mental health admissions for children and adolescents experiencing mental health crises: A systematic review of the literature

2021 ◽  
pp. 135910452110447
Author(s):  
Denisa A Clisu ◽  
Imogen Layther ◽  
Deborah Dover ◽  
Russell M Viner ◽  
Tina Read ◽  
...  
Keyword(s):  
Mental Health ◽  
Web Of Science ◽  
Multisystemic Therapy ◽  
Risk Of Bias ◽  
Future Research ◽  
Inpatient Setting ◽  
Review Of The Literature ◽  
Children And Young People ◽  
Randomised Controlled

Background: Many children and young people (CYP) presenting with mental health crises are admitted to hospital due to concerns around illness severity and risk. Whilst inpatient admissions have an important role for such children, there are a number of burdens associated with them, and safe avoidance of admissions is favourable. We systematically reviewed the literature for studies of interventions reported as alternatives to a hospital admission in CYP presenting with mental health crises, in any inpatient setting. Methods: Three databases (PsychInfo, PubMed and Web of Science) were searched for peer-reviewed papers in October 2020, with an updated search in May 2021. Results: We identified 19 papers of interventions delivered in the emergency department, the home, outside of home but outside of clinics and in hospital clinics. The quality of most included studies was low, with less than half being randomised controlled trials and only half of these at low risk of bias. The best quality studies and greatest evidence for efficacy came from in-home interventions, in particular multisystemic therapy, which improved psychological outcomes, and though a large number of CYP still ended up being admitted, there appeared to be decreased length of stay. Conclusions: Overall, we could not recommend a particular intervention as an alternative to inpatient admission; however, our review describes benefits across a range of types of interventions that might be considered in multi-modal treatments. We also provide recommendations for future research, in particular the evaluation of new interventions as they emerge.

Analysis of Amount and Style of Oral Interaction Related to Language Outcomes in Children With Hearing Loss: A Systematic Review (2006–2016)

2019 ◽  
Vol 62 (9) ◽  
pp. 3470-3492 ◽  
Author(s):  
Nuzhat Sultana ◽  
Lena L. N. Wong ◽  
Suzanne C. Purdy
Keyword(s):  
Systematic Review ◽  
Hearing Loss ◽  
Oral Language ◽  
Full Text ◽  
Future Research ◽  
Language Outcomes ◽  
Input Language ◽  
Study Results ◽  
Language Input

Purpose This systematic review summarizes the evidence for differences in the amount of language input between children with and without hearing loss (HL). Of interest to this review is evaluating the associations between language input and language outcomes (receptive and expressive) in children with HL in order to enhance insight regarding what oral language input is associated with good communication outcomes. Method A systematic review was conducted using keywords in 3 electronic databases: Scopus, PubMed, and Google Scholar. Keywords were related to language input, language outcomes, and HL. Titles and abstracts were screened independently, and full-text manuscripts meeting inclusion criteria were extracted. An appraisal checklist was used to evaluate the methodological quality of studies as poor, good, or excellent. Results After removing duplicates, 1,545 study results were extracted, with 27 eligible for full-text review. After the appraisal, 8 studies were included in this systematic review. Differences in the amount of language input between children with and without HL were noted. Conversational exchanges, open-ended questions, expansions, recast, and parallel talk were positively associated with stronger receptive and expressive language scores. The quality of evidence was not assessed as excellent for any of the included studies. Conclusions This systematic review reveals low-level evidence from 8 studies that specific language inputs (amount and style) are optimal for oral language outcomes in children with HL. Limitations were identified as sample selection bias, lack of information on control of confounders and assessment protocols, and limited duration of observation/recordings. Future research should address these limitations.

scholarly journals Pilot study on the effectiveness of telemedicine in improving the quality of diabetes care of the rural Nepal

2015 ◽  
Vol 03 (01) ◽  
pp. 052-055
Author(s):  
Jyoti Bhattarai ◽  
Samjhana Shakya ◽  
Niraj Shrestha
Keyword(s):  
Diabetes Care ◽  
Intervention Group ◽  
Control Group ◽  
Telemedicine Service ◽  
Local Doctor ◽  
Study Results ◽  
Quality Of Diabetes Care ◽  
Rural Nepal ◽  
Interventional Group

AbstractThe use of telecommunication in the field of medicine is very limited in Nepal. Despite huge potential of improving access of the sub-urban and rural communities with the urban-based health care professionals for expert consultation, the use of the telecommunication technology remains largely unexplored. In light of the facts, a comparative study was conducted at a rural community in Makwanpur. In total 40 patients (20 in each group) were selected for the study with an objective to test the feasibility and effectiveness of telemedicine in improving the quality of diabetes care in an experimental group and control group in Makwanpur district. In the intervention group, diabetes care was provided with tele-consultation for diabetes care mediated via local doctor. The outcome was compared with a control group based in an urban community with treatment as usual in their community. The study results showed that the use of telemedicine is a feasible alternative to provide diabetes care in rural Nepal. Overall fasting blood sugar was better controlled in the control group whereas there was significant improvements in micro albumin were observed in the interventional group. Similarly, the knowledge of the respondents on various aspects of the disease was also found to be better in the interventional group than in the control group. Majority of the respondents (90%) felt telemedicine service is less expensive than the service they had taken before.

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