School reintegration following hospitalisation for children with medical complexity and chronic disease diagnoses: a scoping review protocol

IntroductionSchools play a significant role in children’s social, emotional and intellectual well-being. For children with medical complexity (CMC) and chronic disease diagnoses (CDD), an absence from school due to prolonged hospitalisation places them at risk for greater social exclusion and poorer academic outcomes than their healthy counterparts. Processes that support the school reintegration of children with complex and chronic medical conditions currently lack consistency and identified evidence-based practices. This scoping review aims to integrate the relevant literature on current reintegration procedures as well as assess stakeholders’ perceived challenges related to children with CMC and CDD’s return to school following hospitalisation. Finally, information will be synthesised regarding parental and child involvement in reintegration strategies.Methods and analysisThe current scoping review follows the five-stage framework proposed by Arksey and O’Malley (2005). The search syntax will be applied in Medline, Web of Science, PsycInfo, Education Resource, ERIC, CINAHL and SocIndex. Peer-reviewed journal articles will be included without the restriction of publication year or language. However, only children and adolescents aged 4–18 with CMC and CDD, who have been out of school for 2 weeks or more and reintegrated into a non-hospital school setting will be included. Articles will be screened by two authors based on the outlined eligibility criteria. Data will be summarised qualitatively and where applicable, visualisation techniques such as tables, graphs and figures will be implemented to address approaches, strategies and outcomes related to reintegration to school following hospitalisation.Ethics and disseminationThe current study comprises available publications and does not collect primary data. For this reason, ethics approval is not necessary. The results of this scoping review will be prepared and submitted for publication in a peer-reviewed journal and presented at future conferences to key stakeholders focusing on educational accessibility and inclusion.

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What do you mean by engagement? – evaluating the use of community engagement in the design and implementation of chronic disease-based interventions for Indigenous populations – scoping review

International Journal for Equity in Health ◽

10.1186/s12939-020-01346-6 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Sahr Wali ◽

Stefan Superina ◽

Angela Mashford-Pringle ◽

Heather Ross ◽

Joseph A. Cafazzo

Keyword(s):

Chronic Disease ◽

Health Outcomes ◽

Community Engagement ◽

Participatory Research ◽

Scoping Review ◽

Indigenous Health ◽

Well Being ◽

Indigenous Populations ◽

Local Context ◽

Engagement Strategies

Abstract Background Indigenous populations have remained strong and resilient in maintaining their unique culture and values, despite centuries of colonial oppression. Unfortunately, a consequential result of facing years of adversity has led Indigenous populations to experience a disproportionate level of poorer health outcomes compared to non-Indigenous populations. Specifically, the rate of Indigenous chronic disease prevalence has significantly increased in the last decade. Many of the unique issues Indigenous populations experience are deeply rooted in their colonial history and the intergenerational traumas that has subsequently impacted their physical, mental, emotional and spiritual well-being. With this, to better improve Indigenous health outcomes, understanding the local context of their challenges is key. Studies have begun to use modes of community engagement to initiate Indigenous partnerships and design chronic disease-based interventions. However, with the lack of a methodological guideline regarding the appropriate level of community engagement to be used, there is concern that many interventions will continue to fall short in meeting community needs. Objective The objective of this study was to investigate the how various community engagement strategies have been used to design and/or implement interventions for Indigenous populations with chronic disease. Methods A scoping review guided by the methods outlined by Arksey and O’Malley was conducted. A comprehensive search was completed by two reviewers in five electronic databases using keywords related to community engagement, Indigenous health and chronic disease. Studies were reviewed using a descriptive-analytical narrative method and data was categorized into thematic groups reflective of the main findings. Results We identified 23 articles that met the criteria for this scoping review. The majority of the studies included the use a participatory research model and the procurement of study approval. However, despite the claimed use of participatory research methods, only 6 studies had involved community members to identify the area of priority and only five had utilized Indigenous interview styles to promote meaningful feedback. Adapting for the local cultural context and the inclusion of community outreach were identified as the key themes from this review. Conclusion Many studies have begun to adopt community engagement strategies to better meet the needs of Indigenous Peoples. With the lack of a clear guideline to approach Indigenous-based participatory research, we recommend that researchers focus on 1) building partnerships, 2) obtaining study approval and 3) adapting interventions to the local context.

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Scoping review of mental health in prisons through the COVID-19 pandemic

BMJ Open ◽

10.1136/bmjopen-2020-046547 ◽

2021 ◽

Vol 11 (5) ◽

pp. e046547

Author(s):

Luke Johnson ◽

Kerry Gutridge ◽

Julie Parkes ◽

Anjana Roy ◽

Emma Plugge

Keyword(s):

Mental Health ◽

Scoping Review ◽

Grey Literature ◽

Well Being ◽

Health Impact ◽

Poor Quality ◽

Eligibility Criteria ◽

Prison Staff ◽

The Impact

ObjectiveTo examine the extent, nature and quality of literature on the impact of the COVID-19 pandemic on the mental health of imprisoned people and prison staff.DesignScoping review.Data sourcesPubMed, Embase, CINAHL, Global Health, Cochrane, PsycINFO, PsychExtra, Web of Science and Scopus were searched for any paper from 2019 onwards that focused on the mental health impact of COVID-19 on imprisoned people and prison staff. A grey literature search focused on international and government sources and professional bodies representing healthcare, public health and prison staff was also performed. We also performed hand searching of the reference lists of included studies.Eligibility criteria for selection of studiesAll papers, regardless of study design, were included if they examined the mental health of imprisoned people or prison staff specifically during the COVID-19 pandemic. Imprisoned people could be of any age and from any countries. All languages were included. Two independent reviewers quality assessed appropriate papers.ResultsOf 647 articles found, 83 were eligible for inclusion, the majority (58%) of which were opinion pieces. The articles focused on the challenges to prisoner mental health. Fear of COVID-19, the impact of isolation, discontinuation of prison visits and reduced mental health services were all likely to have an adverse effect on the mental well-being of imprisoned people. The limited research and poor quality of articles included mean that the findings are not conclusive. However, they suggest a significant adverse impact on the mental health and well-being of those who live and work in prisons.ConclusionsIt is key to address the mental health impacts of the pandemic on people who live and work in prisons. These findings are discussed in terms of implications for getting the balance between infection control imperatives and the fundamental human rights of prison populations.

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Outcomes research on children with medical complexity: A scoping review of gaps and opportunities

Child Care Health and Development ◽

10.1111/cch.12725 ◽

2019 ◽

Vol 46 (1) ◽

pp. 121-131 ◽

Cited By ~ 1

Author(s):

Wendy S. Looman ◽

Young Shin Park ◽

Tiffany T. Gallagher ◽

Elizabeth V. Weinfurter

Keyword(s):

Scoping Review ◽

Outcomes Research ◽

Children With Medical Complexity ◽

Medical Complexity

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Restricted visitation policies in acute care settings during the COVID-19 pandemic: a scoping review

Critical Care ◽

10.1186/s13054-021-03763-7 ◽

2021 ◽

Vol 25 (1) ◽

Author(s):

Stephana J. Moss ◽

Karla D. Krewulak ◽

Henry T. Stelfox ◽

Sofia B. Ahmed ◽

Melanie C. Anglin ◽

...

Keyword(s):

Acute Care ◽

Scoping Review ◽

Healthcare Professionals ◽

Case Series ◽

Well Being ◽

Primary Data ◽

Cochrane Central Register ◽

Negative Consequences ◽

Primary Research ◽

Acute Care Settings

Abstract Background Restricted visitation policies in acute care settings because of the COVID-19 pandemic have negative consequences. The objective of this scoping review is to identify impacts of restricted visitation policies in acute care settings, and describe perspectives and mitigation approaches among patients, families, and healthcare professionals. Methods We searched Medline, Embase, PsycINFO, Healthstar, CINAHL, Cochrane Central Register of Controlled Trials on January 01/2021, unrestricted, for published primary research records reporting any study design. We included secondary (e.g., reviews) and non-research records (e.g., commentaries), and performed manual searches in web-based resources. We excluded records that did not report primary data. Two reviewers independently abstracted data in duplicate. Results Of 7810 citations, we included 155 records. Sixty-six records (43%) were primary research; 29 (44%) case reports or case series, and 26 (39%) cohort studies; 21 (14%) were literature reviews and 8 (5%) were expert recommendations; 54 (35%) were commentary, editorial, or opinion pieces. Restricted visitation policies impacted coping and daily function (n = 31, 20%) and mental health outcomes (n = 29, 19%) of patients, families, and healthcare professionals. Participants described a need for coping and support (n = 107, 69%), connection and communication (n = 107, 69%), and awareness of state of well-being (n = 101, 65%). Eighty-seven approaches to mitigate impact of restricted visitation were identified, targeting families (n = 61, 70%), patients (n = 51, 59%), and healthcare professionals (n = 40, 46%). Conclusions Patients, families, and healthcare professionals were impacted by restricted visitation polices in acute care settings during COVID-19. The consequences of this approach on patients and families are understudied and warrant evaluation of approaches to mitigate their impact. Future pandemic policy development should include the perspectives of patients, families, and healthcare professionals. Trial registration: The review was registered on PROSPERO (CRD42020221662) and a protocol peer-reviewed prior to data extraction.

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Reporting standards, outcomes and costs of quality improvement studies in Ireland: a scoping review

BMJ Open Quality ◽

10.1136/bmjoq-2020-001319 ◽

2021 ◽

Vol 10 (3) ◽

pp. e001319

Author(s):

Siobhán Eithne McCarthy ◽

Samira Barbara Jabakhanji ◽

Jennifer Martin ◽

Maureen Alice Flynn ◽

Jan Sørensen

Keyword(s):

Quality Improvement ◽

Health Economics ◽

Scoping Review ◽

Quality Criteria ◽

Well Being ◽

Reporting Standards ◽

Eligibility Criteria ◽

Equity Issues ◽

Stakeholder Workshop ◽

The Cost

ObjectivesTo profile the aims and characteristics of quality improvement (QI) initiatives conducted in Ireland, to review the quality of their reporting and to assess outcomes and costs.DesignScoping review.Data sourcesSystematic searches were conducted in PubMed, Web of Science, Embase, Google Scholar, Lenus and rian.ie. Two researchers independently screened abstracts (n=379) and separately reviewed 43 studies identified for inclusion using a 70-item critique tool. The tool was based on the Quality Improvement Minimum Quality Criteria Set (QI-MQCS), an appraisal instrument for QI intervention publications, and health economics reporting criteria. After reaching consensus, the final dataset was analysed using descriptive statistics. To support interpretations, findings were presented at a national stakeholder workshop.Eligibility criteriaQI studies implemented and evaluated in Ireland and published between January 2015 and April 2020.ResultsThe 43 studies represented various QI interventions. Most studies were peer-reviewed publications (n=37), conducted in hospitals (n=38). Studies mainly aimed to improve the ‘effectiveness’ (65%), ‘efficiency’ (53%), ‘timeliness’ (47%) and ‘safety’ (44%) of care. Fewer aimed to improve ‘patient-centredness’ (30%), ‘value for money’ (23%) or ‘staff well-being’ (9%). No study aimed to increase ‘equity’. Seventy per cent of studies described 14 of 16 QI-MQCS dimensions. Least often studies reported the ‘penetration/reach’ of an initiative and only 35% reported health outcomes. While 53% of studies expressed awareness of costs, only eight provided at least one quantifiable figure for costs or savings. No studies assessed the cost-effectiveness of the QI.ConclusionIrish QI studies included in our review demonstrate varied aims and high reporting standards. Strategies are needed to support greater stimulation and dissemination of QI beyond the hospital sector and awareness of equity issues as QI work. Systematic measurement and reporting of costs and outcomes can be facilitated by integrating principles of health economics in QI education and guidelines.

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Homes of children with medical complexity as a complex work system: outcomes associated with interactions in the physical environment

Proceedings of the Human Factors and Ergonomics Society Annual Meeting ◽

10.1177/1071181319631484 ◽

2019 ◽

Vol 63 (1) ◽

pp. 753-757

Author(s):

Nadejda Doutcheva ◽

Hannah Thomas ◽

Reid Parks ◽

Ryan Coller ◽

Nicole Werner

Keyword(s):

Patient Safety ◽

Systems Engineering ◽

Physical Environment ◽

Well Being ◽

Home Environments ◽

Children With Medical Complexity ◽

Work System ◽

Systems Research ◽

Physical Environments ◽

Medical Complexity

Family caregivers provide critical care for children with medical complexity (CMC) at home, yet homes are still a poorly understood healthcare setting. Home environments include diverse physical environments, technologies, tools, tasks, and people, and are therefore complex work systems. Research suggests that home environments can contribute positively and negatively to both individuals’ well-being and the quality of care that families can provide. Our objective for this study was to determine how the physical environment of the home interacts within a work system to affect outcomes related to in-home care of CMC. We used contextual inquiry to interview 30 caregivers in their homes and analyzed our data using the Systems Engineering Initiative for Patient Safety (SEIPS) 2.0 model. We focused on identifying physical environments’ interactions with other work system components and the resulting CMC outcomes. We identified six categories of outcomes that are influenced by work system interactions within the physical environment: 1) Safe or Unsafe delivery of care; 2) Prepared for or Inability to Respond to Care Crisis; 3) Home Mobility or Inaccessibility; 4) Efficient and Inefficient Care; 5) Inclusion and Isolation from Family; and 6) Socioemotional Comfort and Stress. The physical environment influences a range of outcomes from patient safety to families’ emotional well-being. Our results point to the need for adaptation of SEIPS 2.0 to the home environment by incorporating consideration for family and home-based outcomes into the model.

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Associations between contextual and compositional characteristics of early childcare facilities with health, health behaviours and well-being among young children aged 06 years: protocol for a scoping review

BMJ Open ◽

10.1136/bmjopen-2020-037038 ◽

2020 ◽

Vol 10 (9) ◽

pp. e037038

Author(s):

Jennifer Hilger-Kolb ◽

Sven Schneider ◽

Raphael Herr ◽

Nina Osenbruegge ◽

Stephanie Hoffmann ◽

...

Keyword(s):

Young Children ◽

Scoping Review ◽

Selection Process ◽

Life Stage ◽

Well Being ◽

Primary Data ◽

Cochrane Library ◽

Key Characteristics ◽

Scoping Reviews ◽

Early Childcare

IntroductionEarly childhood is an important life stage which is crucial for determining health and health inequalities in later life. At the meso-level (institutional-level), early childcare facilities (eg, kindergartens, preschools) are the most important agent of socialisation next to families in young children aged 06 years. In recent years, an increasing amount of studies has focused on contextual and compositional characteristics of early childcare facilities and their association with health (eg, self-rated health), health behaviour (eg, physical activity) and well-being (eg, emotional well-being) in this age group. However, as currently no overview of the available literature on this topic exists, we will conduct a scoping review including various study designs (eg, cross-sectional studies, prospective studies, qualitative studies).Methods and analysisWe will follow the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. A systematic search of the following scientific databases will be conducted: PubMed/Medline, PsycInfo, Sociological Abstracts, Education Resources Information Center and The Cochrane Library. During the selection process, we will follow a two-step process. First, two reviewers will independently screen titles/abstracts of all potentially eligible articles by applying a set of previously defined inclusion and exclusion criteria. After the completion of the title/abstract screening, full texts of the remaining articles will be screened following the same procedure. To determine inter-rater agreement between reviewers, we will calculate Cohen’s Kappa after both steps. Key characteristics (eg, country of origin, sample size, study design) of included articles will be extracted. We will map the evidence available by providing a summary table on the key characteristics extracted and by presenting the associations using various types of illustrations.Ethics and disseminationSince no primary data will be collected for this review, ethical approval is not required. Our findings will be published in an international peer-reviewed journal and presented at national and international conferences.

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Are People with Aphasia (PWA) Involved in the Creation of Quality of Life and Aphasia Impact-Related Questionnaires? A Scoping Review

Brain Sciences ◽

10.3390/brainsci10100688 ◽

2020 ◽

Vol 10 (10) ◽

pp. 688

Author(s):

Marina Charalambous ◽

Maria Kambanaros ◽

Jean-Marie Annoni

Keyword(s):

Quality Of Life ◽

Scoping Review ◽

Best Practice ◽

Well Being ◽

Eligibility Criteria ◽

Direct Involvement ◽

Scoping Reviews ◽

The Creation ◽

The Impact

Background: Quality of Life (QoL) questionnaires are used to describe the impact of aphasia on stroke survivors’ life. People with aphasia (PWA) are traditionally excluded from research, potentially leading to a mismatch between the factors chosen in the tools and the realistic needs of PWA. The purpose of this review was to determine the direct involvement of PWA in the creation of QoL and aphasia impact-related questionnaires (AIR-Qs). Methods: A scoping review methodology was conducted by an expert librarian and two independent reviewers on health sciences based on the Preferred Reporting Items for Systematic Reviews and Metanalyses extension for Scoping Reviews (PRISMA-ScR) protocol, through a literature search in five databases: Medline Complete, PubMed, PsychINFO, Scopus, and Google Scholar. Search terms included ‘stroke’, ‘people with aphasia’, ‘communication’, ‘well-being’, and ‘quality of life’. Results: Of 952 results, 20 studies met the eligibility criteria. Of these, only four AIR-Qs studies (20%) were found reporting the direct involvement of PWA, while no QoL tools did so. Evidence showed involvement in the creation phase of AIR-Q, mainly in a consultation role. Conclusions: There is an absence of a framework for conducting and reporting the involvement of PWA in qualitative participatory research studies, which limits effectiveness to promote equitable best practice in aphasia rehabilitation.

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The Role of Occupational Therapy in Pulmonary Rehabilitation Programs: Scoping Review Protocol (Preprint)

10.2196/preprints.30244 ◽

2021 ◽

Author(s):

Natalie Snyder ◽

Ria Wilson ◽

Lian Finch ◽

Brooklyn Gallant ◽

Chris Landa ◽

...

Keyword(s):

Occupational Therapy ◽

Scoping Review ◽

Pulmonary Rehabilitation ◽

Clinical Decision Making ◽

Relevant Literature ◽

Occupational Therapists ◽

Well Being ◽

Current Guideline ◽

Scoping Reviews

BACKGROUND Background: Chronic respiratory diseases are highly prevalent and compromise an individual’s ability to perform activities of daily living (ADLs) and participate in meaningful life roles. Pulmonary rehabilitation (PR) is a well-established intervention aiming at restoring an individual’s exercise capacity and improving their ability to complete their ADLs. Occupational therapists help individuals engage in meaningful ‘occupations’, improving their health and well-being. Given the concordance in the aims of PR and the occupational therapy (OT) scope of practice, occupational therapists appear to be well-suited as key players in PR programs. However, the benefits of adding OT to PR programs have been sparsely reported in the literature and the role of OT in PR has never been synthesized or reported in national and international guidelines. OBJECTIVE Objective: To explore the role of OT in PR programs, the current guideline recommendations for the inclusion of OT in PR programs, the estimated prevalence of OT in PR programs and the reported or anticipated effects of OT interventions in PR programs. METHODS Methods: The review will be conducted following Joanna Briggs Institute (JBI) methodology for scoping reviews. A comprehensive search will be undertaken in the Cochrane Database of Systematic Reviews, EMBASE, MEDLINE, and CINAHL to identify and retrieve relevant literature, published in English, French or Portuguese. Gray literature will also be searched from international OT association websites for position statements and guidelines relevant to PR programs. All literature published since the establishment of the effectiveness of PR for chronic respiratory disease in 1994, that explores OT in PR programs for these patients will be included. Search results will be exported to Covidence for title, abstract, and full text screening, by two independent reviewers. Data will be extracted by two independent reviewers using a pilot-tested template including: the number of PR programs including OT (specifically from surveys), the purpose of the study, the study design, patient characteristics, respiratory conditions included, PR components, OT role, outcomes, and results. Findings will be presented using a narrative summary, supplemented by figures and/or tables. Key themes will be displayed in an infographic or schematic. RESULTS Results: The study was initiated in January 2021 and registered with the Open Science Framework (OSF) in February 2021, prior to title and abstract screening. Data collection, analysis and drafting of the manuscript will occur throughout 2021, with expected publication in 2022. CONCLUSIONS Conclusion: The results of this scoping review will help healthcare professionals improve patient care by broadening their understanding and awareness of the role of OT in PR programs. This role clarification may help to inform program development, clinical decision making and will serve to optimize the delivery of multidisciplinary care for patients in PR programs, ultimately improving patient outcomes. CLINICALTRIAL International Registered Report Identifier (IRRID): OSF Registration Identifier: DOI: 10.17605/OSF.IO/ZH63W

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The potential of CYP2D6 phenotyping to improve opioid dosing strategies

10.1101/2021.10.07.21264057 ◽

2021 ◽

Author(s):

Ridley Cassidy ◽

Ewan Main

Keyword(s):

Narrative Analysis ◽

Relevant Literature ◽

Cost Effective ◽

Health Concern ◽

Primary Data ◽

Screening Methods ◽

Pharmacokinetic Studies ◽

Global Public Health ◽

Eligibility Criteria ◽

Dosing Strategies

Background: Prescription opioids account for more than 40% of opioid induced mortalities. With the trend towards increased opioid prescribing set to continue rising, opioid-based adverse drug reactions, (ADRs) and their associated human and financial cost present a major global public health concern. The review examined the relationship between CYP2D6 phenotypes and opioid metabolising. The aim was to establish whether screening for CYP2D6 phenotypes would improve existing opioid dosing strategies and reduce ADRs. Method: A systematic review was conducted using the online Web of Science database. Selected key words and Boolean operator combinations were used to search the relevant literature. Identified studies were screened against pre-defined inclusion/exclusion criteria. Eligible studies were subject to full review and quality assessment. A narrative analysis was performed to synthesise data from the studies included in the final review. Results: The review yielded five studies that met the eligibility criteria and were subject to full review. Four of the five studies reported significant effects of CYP2D6 phenotypes on opioid metabolising or opioid based ADRs. Three studies focused exclusively on pharmacokinetics, two studies focused exclusively on ADRs, and one study considered pharmacokinetics and ADRs. All pharmacokinetic studies reported a significant association between CYP2D6 phenotypes and opioid metabolising. Only one of the studies reported a significant association between CYP2D6 phenotypes and ADRs. Conclusion: The majority of evidence considered in the review supports the role of CYP2D6 in the metabolising of opioids and opioid based ADRs. Consequently, CYP2D6 screening should be considered as a potential mechanism for improving existing opioid dosing strategies and reducing ADRs. There is a need for further higher quality primary data studies focusing specifically on CYP2D6 phenotyping in the context of dosage strategies and exploring impact in longitudinal designs. Future studies should also seek to develop cost effective CYP2D6 screening methods to help support the clinical significance of CYP2D6 phenotyping.

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