scholarly journals Beliefs and challenges held by medical staff about providing emergency care to migrants: an international systematic review and translation of findings to the UK context

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e028748
Author(s):  
Hooi-Ling Harrison ◽  
Gavin Daker-White
Keyword(s):  
Systematic Review ◽  
Emergency Care ◽  
Care Delivery ◽  
Qualitative Studies ◽  
Undocumented Migrants ◽  
Care Providers ◽  
Policy And Practice ◽  
Eligibility Criteria ◽  
Potential Health ◽  
The Uk

ObjectiveMigration has increased globally. Emergency departments (EDs) may be the first and only contact some migrants have with healthcare. Emergency care providers’ (ECPs) views concerning migrant patients were examined to identify potential health disparities and enable recommendations for ED policy and practice.DesignSystematic review and meta-synthesis of published findings from qualitative studies.Data sourcesElectronic databases (Ovid Medline, Embase (via Ovid), PsycINFO (via OVID), CINAHL, Web of Science and PubMed), specialist websites and journals were searched.Eligibility criteriaStudies employing qualitative methods published in English.SettingsEDs in high-income countries.ParticipantsECPs included doctors, nurses and paramedics.Topic of enquiryStaff views on migrant care in ED settings.Data extraction and synthesisData that fit the overarching themes of ‘beliefs’ and ‘challenges’ were extracted and coded into an evolving framework. Lines of argument were drawn from the main themes identified in order to infer implications for UK policy and practice.ResultsEleven qualitative studies from Europe and the USA were included. Three analytical themes were found: challenges in cultural competence; weak system organisation that did not sufficiently support emergency care delivery; and ethical dilemmas over decisions on the rationing of healthcare and reporting of undocumented migrants.ConclusionECPs made cultural and organisational adjustments for migrant patients, however, willingness was dependent on the individual’s clinical autonomy. ECPs did not allow legal status to obstruct delivery of emergency care to migrant patients. Reported decisions to inform the authorities were mixed; potentially leading to uncertainty of outcome for undocumented migrants and deterring those in need of healthcare from seeking treatment. If a charging policy for emergency care in the UK was introduced, it is possible that ECPs would resist this through fears of widening healthcare disparities. Further recommendations for service delivery involve training and organisational support.

Systematic review of barriers and enablers to the delivery of palliative care by primary care practitioners

2019 ◽  
Vol 33 (9) ◽  
pp. 1131-1145 ◽  
Author(s):  
Mariko L Carey ◽  
Alison C Zucca ◽  
Megan AG Freund ◽  
Jamie Bryant ◽  
Anne Herrmann ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Palliative Care ◽  
Care Delivery ◽  
Primary Care Providers ◽  
Healthcare Services ◽  
Care Providers ◽  
Eligibility Criteria ◽  
Barriers And Enablers ◽  
Primary Care Practitioners

Background: There is increasing demand for primary care practitioners to play a key role in palliative care delivery. Given this, it is important to understand their perceptions of the barriers and enablers to optimal palliative care, and how commonly these are experienced. Aim: To explore the type and prevalence of barriers and enablers to palliative care provision reported by primary care practitioners. Design: A systematic review of quantitative data-based articles was conducted. Data sources: Medline, Embase and PsychINFO databases were searched for articles published between January 2007 and March 2019. Data synthesis: Abstracts were assessed against the eligibility criteria by one reviewer and a random sample of 80 articles were blind coded by a second author. Data were extracted from eligible full-texts by one author and checked by a second. Given the heterogeneity in the included studies’ methods and outcomes, a narrative synthesis was undertaken. Results: Twenty-one studies met the inclusion criteria. The most common barriers related to bureaucratic procedures, communication between healthcare professionals, primary care practitioners’ personal commitments, and their skills or confidence. The most common enablers related to education, nurses and trained respite staff to assist with care delivery, better communication between professionals, and templates to facilitate referral to out-of-hours services. Conclusion: A holistic approach addressing the range of barriers reported in this review is needed to support primary care providers to deliver palliative care. This includes better training and addressing barriers related to the interface between healthcare services.

scholarly journals The lived experience of people with obesity: study protocol for a systematic review and synthesis of qualitative studies

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Emma Farrell ◽  
Marta Bustillo ◽  
Carel W. le Roux ◽  
Joe Nadglowski ◽  
Eva Hollmann ◽  
...  
Keyword(s):  
Systematic Review ◽  
Lived Experience ◽  
Health Care Providers ◽  
Evidence Synthesis ◽  
Qualitative Studies ◽  
Qualitative Evidence Synthesis ◽  
Care Providers ◽  
Critical Appraisal Skills ◽  
Health Complications

Abstract Background Obesity is a prevalent, complex, progressive and relapsing chronic disease characterised by abnormal or excessive body fat that impairs health and quality of life. It affects more than 650 million adults worldwide and is associated with a range of health complications. Qualitative research plays a key role in understanding patient experiences and the factors that facilitate or hinder the effectiveness of health interventions. This review aims to systematically locate, assess and synthesise qualitative studies in order to develop a more comprehensive understanding of the lived experience of people with obesity. Methods This is a protocol for a qualitative evidence synthesis of the lived experience of people with obesity. A defined search strategy will be employed in conducting a comprehensive literature search of the following databases: PubMed, Embase, PsycInfo, PsycArticles and Dimensions (from 2011 onwards). Qualitative studies focusing on the lived experience of adults with obesity (BMI >30) will be included. Two reviewers will independently screen all citations, abstracts and full-text articles and abstract data. The quality of included studies will be appraised using the critical appraisal skills programme (CASP) criteria. Thematic synthesis will be conducted on all of the included studies. Confidence in the review findings will be assessed using GRADE CERQual. Discussion The findings from this synthesis will be used to inform the EU Innovative Medicines Initiative (IMI)-funded SOPHIA (Stratification of Obesity Phenotypes to Optimize Future Obesity Therapy) study. The objective of SOPHIA is to optimise future obesity treatment and stimulate a new narrative, understanding and vocabulary around obesity as a set of complex and chronic diseases. The findings will also be useful to health care providers and policy makers who seek to understand the experience of those with obesity. Systematic review registration PROSPERO CRD42020214560.

Challenges of Providing Health Care in Complex Emergencies: A Systematic Review

2021 ◽  
pp. 1-5
Author(s):  
Hesam Seyedin ◽  
Morteza Rostamian ◽  
Fahimeh Barghi Shirazi ◽  
Haleh Adibi Larijani
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Health Services ◽  
Health Care Providers ◽  
Health Care Delivery ◽  
Qualitative Content Analysis ◽  
Care Delivery ◽  
Information Access ◽  
Care Providers ◽  
Complex Emergencies

Abstract Providing health care in times of complex emergencies (CEs) is one of the most vital needs of people. CEs are situations in which a large part of the population is affected by social unrest, wars, and food shortages. This systematic review study was conducted to identify the challenges of health-care delivery in CEs. We searched terms related to health-care delivery and CEs in PubMed, Web of Sciences, Science Direct, and Google scholar databases, as well as Persian databases SID and Magiran. The searching keywords included: “Health Care, Complex Crises, War, Humanitarian, Refugees, Displaced Persons, Health Services, and Challenges.” Of 409 records, we selected 6 articles based on the Preferred Reporting Items for Systematic Reviews (PRISMA) checklist. Studies were analyzed through qualitative content analysis. The results show that CEs affect health-care delivery in 4 primary areas: the workforce, infrastructure, information access, and organization of health services. These areas can pose potential threats for health-care providers and planners at times of emergencies. Thus, they should be informed about these challenges to strengthen the health-care system.

Barriers in Case Managers’ Roles: A Qualitative Systematic Review

2017 ◽  
Vol 40 (10) ◽  
pp. 1522-1542 ◽  
Author(s):  
Jee Young Joo ◽  
Diane L. Huber
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Case Management ◽  
Health Care Providers ◽  
Management Practices ◽  
Case Managers ◽  
Qualitative Studies ◽  
Complex Case ◽  
Bibliographic Databases ◽  
Care Providers

The challenges faced by case managers when implementing case management have received little focus. Several qualitative studies have been published that may be able to shed light on those challenges. This study is a systematic review of qualitative literature to identify barriers case managers have when implementing case management. Five electronic bibliographic databases were systematically searched, and 10 qualitative studies were identified for inclusion in the review which were published from 2007 to 2016. Through thematic synthesis of findings, five themes were identified as barriers to case management implementation: unclear scope of practice, diverse and complex case management activities, insufficient training, poor collaboration with other health-care providers, and client relationship challenges. This review study suggested that standardized evidence-based practical protocols and certification programs may help overcome case managers’ barriers and improve case management practices. Health policymakers, case management associations, and health-care management researchers should develop educational and practical supports for case managers.

scholarly journals ‘They do not care how much you know until they know how much you care’: a qualitative meta-synthesis of patient experience in the emergency department

2019 ◽  
Vol 36 (6) ◽  
pp. 355-363 ◽  
Author(s):  
Blair Graham ◽  
Ruth Endacott ◽  
Jason E Smith ◽  
Jos M Latour
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
Lived Experience ◽  
Conceptual Model ◽  
Patient Experience ◽  
Meta Analysis ◽  
Clinical Effectiveness ◽  
Qualitative Studies ◽  
Care Providers ◽  
Qualitative Approaches

BackgroundPatient experience is positively associated with both clinical effectiveness and patient safety and should be a priority for emergency care providers. While both quantitative and qualitative approaches can be used to evaluate patient experience in the emergency department (ED), the latter is well aligned to develop a detailed understanding of features influencing the lived experience of ED patients. This study aimed to systematically review the literature of qualitative studies to identify determinants of adult patient experience in the ED.MethodsA Preferred Reporting Items for Systematic review and Meta-Analysis compliant systematic review was conducted using PubMed, CINAHL, EMBASE, BNI and bibliography searches to identify qualitative studies exploring patient experiences in ED published in English between 1997 and 2018. Quality assessment was conducted using the Critical Appraisal Skills Programme checklist. Descriptive text and quotations relating to patient experience were extracted from included studies and a meta-synthesis conducted using thematic analysis.ResultsA total of 625 records were screened from which 40 studies underwent full review and 22 were included. Results were coded by two researchers (BG and JML). Meta-synthesis identified 198 discrete units of analysis which were clustered around five analytical themes. These were based on the perceived ‘needs’ of patients visiting the ED and were defined as communication, emotional, competent care, physical/environmental and waiting needs. Findings were translated into a conceptual model for optimising patient experience in the ED.ConclusionThis meta-synthesis provides a framework for understanding the determinants of patient experience in the ED. The resulting conceptual model and recommendations may have the potential to directly inform practice and improve the patient experience.

scholarly journals Barriers to and facilitators of implementation of the integration of oncology and palliative care in daily practice: a systematic review

2021 ◽  
Author(s):  
Yu Uneno ◽  
Yoshiki Horie ◽  
Yuki Kataoka ◽  
Masanori Mori ◽  
Mami Hirakawa ◽  
...  
Keyword(s):  
Systematic Review ◽  
Palliative Care ◽  
Care Delivery ◽  
Daily Practice ◽  
Individual Characteristics ◽  
Educational Opportunities ◽  
Eligibility Criteria ◽  
Ovid Medline ◽  
Care Delivery Model ◽  
The Government

Abstract Background: Palliative care (PC) is widely recognized as an essential part of oncology care, and multiple academic societies have developed strong recommendations regarding the implementation of the integration of oncology and PC (IOP) in daily practice. However, IOP implementation is a slow- evolving process, and its barriers and facilitators have not yet been comprehensively identified. This systematic review aimed to clarify the barriers to and facilitators of IOP in the context of treating patients with advanced cancer.Methods: We searched Ovid MEDLINE, Embase, and Cumulative Index of Nursing and Allied Health Literature until June 3, 2017. We included original articles, narrative and systematic reviews, guidelines, editorials, commentaries, and letters. After title and abstract screening by two of five independent reviewers, we analyzed the data qualitatively using inductive content analysis and a consolidated framework for implementation research. Results: We obtained 3,304 articles, of which 60 met the predefined eligibility criteria. The numbers and proportions of original and review articles, guidelines, and other article types were 21 (35%), 30 (50%), 3 (5%), and 7 (12%), respectively. Five categories emerged regarding both the barriers to and facilitators of IOP: intervention characteristics, outer settings, inner settings, individual characteristics, and process. The representative barriers were limited availability of and access to PC services, limited educational opportunities for PC providers, insufficient reimbursement and research funding toward PC services, focus on cure rather than care (patients and their caregivers), and insufficient communication between oncology and PC staff (n = 26, 16, 14, 13, and 7, respectively). The representative facilitators were improvement of the availability of and access to PC services, development of an optimal integrated care model, enrichment of educational opportunities regarding PC (healthcare professionals), and initiatives by government and academic societies (n = 24, 18, 25, and 7, respectively).Conclusions: This study clarified the multi-level barriers to and facilitators of the implementation of IOP. Educational and financial support from the government and academic societies appears essential, and further effort to develop and investigate the implementable care delivery model is warranted.Registration: PROSPERO:CRD42018069212

scholarly journals Nursing students’ experiences with faculty incivility in the clinical education context: a qualitative systematic review and meta-synthesis

BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e024383 ◽  
Author(s):  
Zheng Zhu ◽  
Weijie Xing ◽  
Lucylynn Lizarondo ◽  
Mengdi Guo ◽  
Yan Hu
Keyword(s):  
Systematic Review ◽  
Nursing Students ◽  
Clinical Education ◽  
Data Extraction ◽  
Included Study ◽  
Qualitative Studies ◽  
Contributing Factors ◽  
Open Communication ◽  
Eligibility Criteria ◽  
Deep Blue

ObjectiveThe aim of this study is to synthesise evidence for the experiences and perceptions of incivility during clinical education of nursing students.DesignWe used a meta-aggregation approach to conduct a systematic review of qualitative studies.Data sourcesPublished and unpublished papers from 1990 until 13 January 2018 were searched using electronic databases, including CINAHL, PubMed (MEDLINE), ProQuest Central, ProQuest Education Journals, ProQuest XML-Dissertations and Theses, Web of Science, Embase, EBSCO Discovery Service and PsycINFO. The search for unpublished studies included the Open Grey collection, conference proceedings and the Deep Blue Library.Eligibility criteriaWe included qualitative studies that focused on nursing students' perceptions and experiences of incivility from faculty during their clinical education.Data extraction and synthesisTwo reviewers independently appraised the methodological quality and extracted relevant data from each included study. Meta-aggregation was used to synthesise the data.ResultsA total of 3397 studies was returned from the search strategies. Eighteen studies fulfilled the inclusion criteria and were included in the meta-synthesis. Six synthesised findings were identified, covering features of incivility, manifestations of incivility, contributing factors, impacts on students, coping strategies and suggestions.ConclusionsThe results showed experiences of incivility during clinical education. However, the confidence was low for all synthesised findings. We suggest that nursing students should try to cope positively with incivility. Nurse managers and clinical preceptors should be aware of the prevalence and impact of incivility and implement policies and strategies to reduce incivility towards nursing students. Hospitals and universities should have an immediate response person or system to help nursing students confronting incivility and create an open communication environment.

scholarly journals Managing behavioural and psychological symptoms in community dwelling older people with dementia: 2. A systematic review of qualitative studies

Dementia ◽  
2018 ◽  
Vol 18 (7-8) ◽  
pp. 2950-2970 ◽  
Author(s):  
Andreas Braun ◽  
Daksha P Trivedi ◽  
Angela Dickinson ◽  
Laura Hamilton ◽  
Claire Goodman ◽  
...  
Keyword(s):  
Systematic Review ◽  
Psychological Symptoms ◽  
Community Dwelling ◽  
Qualitative Studies ◽  
Future Research ◽  
Care Providers ◽  
Family Carers ◽  
People With Dementia ◽  
Behavioural And Psychological Symptoms ◽  
At Home

Background People living with dementia often develop distressing behavioural and psychological symptoms (BPSD) that can affect their quality of life and the capacity of family carers and staff providing support at home. This systematic review of qualitative studies considers the views and experiences of people living with dementia and care providers about these symptoms and what helps to reduce their impact. Methods The two-stage review involved (a) An initial mapping of the literature to understand the range of BPSD, and how it is operationalised by different groups, to develop a search strategy; (b) A search of electronic databases from January 2000 to March 2015, updated in October 2016. Included studies focused on people living in their own homes. Data extraction and thematic analysis were structured to provide a narrative synthesis of the evidence. Results We retrieved 17, 871 records and included relevant qualitative papers (n = 58) targeting community-dwelling people with dementia and family carers around the management of BPSD. Five key themes were identified: (1) Helpful interventions/support for BPSD management, (2) Barriers to support services for BPSD management, (3) Challenges around recognition/diagnosis of BPSD, (4) Difficulties in responding to aggression and other BPSD, and (5) Impact of BPSD on family carers and people living with dementia. Conclusions Family carers sometimes feel that their experiences of BPSD may not be evident to professionals until a crisis point is reached. Some helpful services exist but access to support, lack of knowledge and skills, and limited information are consistently identified as barriers to their uptake. The lack of common terminology to identify and monitor the range of BPSD that people with dementia living at home may experience means that closer attention should be paid to family carer accounts. Future research should include qualitative studies to evaluate the relevance of interventions.

Aged Care Residents’ Perspectives on Quality of Care in Care Homes: A Systematic Review of Qualitative Evidence

2021 ◽  
pp. 016402752198907
Author(s):  
Andrew S. Gilbert ◽  
Stephanie M. Garratt ◽  
Leona Kosowicz ◽  
Joan Ostaszkiewicz ◽  
Briony Dow
Keyword(s):  
Systematic Review ◽  
Quality Of Care ◽  
Quality Care ◽  
Care Home ◽  
Aged Care ◽  
Care Homes ◽  
Care Providers ◽  
Eligibility Criteria ◽  
Qualitative Evidence

There is increasing interest in harnessing aged care residents’ perspectives to drive quality improvement in aged care homes. We conducted a systematic review of qualitative evidence including literature examining residents’ descriptions of “quality of care” in aged care homes, using database searches and screening records according to eligibility criteria. Three independent reviewers conducted quality assessment of forty-six eligible articles and performed thematic synthesis of articles’ findings. We distinguish nine key themes describing factors influencing quality care: staffing levels, staff attitude, continuity, routine, environment, decision-making and choice, dignity of risk, activities, and culture and spirituality. While many themes were consistent across studies, residents’ prioritization of them varied. Aged care home residents have differing conceptions of quality care as well as heterogeneous and dynamic needs and preferences. Care providers are best able to facilitate quality care when intentional efforts are made to recognize this and tailor delivery of services the individual residents.

Sign in / Sign up

Export Citation Format

Share Document