Ethics in nursing: A systematic review of the framework of evidence perspective

2017 ◽  
Vol 26 (4) ◽  
pp. 1128-1148 ◽  
Author(s):  
Erman Yıldız
Keyword(s):  
Systematic Review ◽  
Professional Ethics ◽  
Ethics Education ◽  
Ethical Issues ◽  
Search Algorithm ◽  
Sufficient Information ◽  
Level Of Evidence ◽  
Ethical Approval ◽  
Research And Education ◽  
Meta Analyses

Aim: To determine the current state of knowledge on nursing and ethics and to assess the knowledge and experience based on the evidence in this regard. Background: Although ethics is at the center of the nursing profession and the ethical issues affecting nurses are given much importance, few studies have focused on professional ethics in nursing. In this respect, ethics has become a concept that contains controversial and ambiguous situations. Design: The Preferred Reporting Items for Systematic Reviews and Meta-analyses guide, a basic search algorithm, was taken. Data sources: Cochrane, PubMed, CINAHL Complete, PsycINFO, and ULAKBIM from 2012 to 2016. Review methods: Following a systematic search strategy, all papers were assessed in relation to inclusion criteria and type of study. When sufficient information was not available in the title and summary of the works, the necessary data were evaluated in full texts. Results: This review was completed with 27 articles meeting the research criteria. The evaluation identified six themes: (1) ethics and nursing, (2) ethical difficulties/ethical dilemmas and nursing, (3) ethical competence and nursing, (4) professional ethics and nursing, (5) ethics, education, and nursing, and (6) ethics in health research. Conclusion: As a result of the review, a synthesis of high evidence-level research relating to nursing ethics was obtained. The emphasis was on the importance of further research and education so that the ethical aspects of nursing can be better understood throughout the studies. Nursing researchers’ level of evidence on ethics and their orientation to high research design will shed light on uncertain and controversial aspects of the subject. Ethical consideration: Since this was a systematic review, no ethical approval was required. There is no conflict of interest in this literature review.

scholarly journals Indications and outcomes of enterovesical and colovesical fistulas: systematic review of the literature and meta-analysis of prevalence

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Stefano Granieri ◽  
Francesco Sessa ◽  
Alessandro Bonomi ◽  
Sissi Paleino ◽  
Federica Bruno ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Symptoms ◽  
Rare Complication ◽  
Meta Analysis ◽  
Treatment Options ◽  
Palliative Surgery ◽  
Review Of The Literature ◽  
Colovesical Fistula ◽  
Level Of Evidence ◽  
Meta Analyses

Abstract Background Entero-colovesical fistula is a rare complication of various benign and malignant diseases. The diagnosis is prominently based on clinical symptoms; imaging studies are necessary not only to confirm the presence of the fistula, but more importantly to demonstrate the extent and the nature of the fistula. There is still a lack of consensus regarding the if, when and how to repair the fistula. The aim of the study is to review the different surgical treatment options, focus on surgical indications, and explore cumulative recurrence, morbidity, and mortality rates of entero-vesical and colo-vesical fistula patients. Methods A systematic review of the literature was conducted according to PRISMA guidelines. Random effects meta-analyses of proportions were developed to assess primary and secondary endpoints. I2 statistic and Cochran’s Q test were computed to assess inter-studies’ heterogeneity. Results Twenty-two studies were included in the analysis with a total of 861 patients. Meta-analyses of proportions pointed out 5, 22.2, and 4.9% rates for recurrence, complications, and mortality respectively. A single-stage procedure was performed in 75.5% of the cases, whereas a multi-stage operation in 15.5% of patients. Palliative surgery was performed in 6.2% of the cases. In 2.3% of the cases, the surgical procedure was not specified. Simple and advanced repair of the bladder was performed in 84.3% and 15.6% of the cases respectively. Conclusions Although burdened by a non-negligible rate of complications, surgical repair of entero-colovesical fistula leads to excellent results in terms of primary healing. Our review offers opportunities for significant further research in this field. Level of Evidence Level III according to ELIS (SR/MA with up to two negative criteria).

scholarly journals Union rates and functional outcome of double plating of the femur: systematic review of the literature

2021 ◽  
Author(s):  
M. F. Lodde ◽  
M. J. Raschke ◽  
J. Stolberg-Stolberg ◽  
J. Everding ◽  
S. Rosslenbroich ◽  
...  
Keyword(s):  
Systematic Review ◽  
Fracture Healing ◽  
Functional Outcome ◽  
Femoral Fractures ◽  
Periprosthetic Fractures ◽  
Level Of Evidence ◽  
Distal Femoral Fractures ◽  
Femur Fractures ◽  
Meta Analyses ◽  
Double Plating

Abstract Background The optimal treatment strategy for the surgical management of femur fractures and non-unions remains unknown. The aim of this study is to assess union rates, complications and outcome after femoral double plating. Treatment of shaft, distal, periprosthetic fractures and pathological proximal femur fractures as well as femoral non-unions with double plating were evaluated. Methods A systematic review according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement was conducted. Published literature reporting on the treatment and clinical outcome of femoral fractures and non-unions with double plating was identified. In total, 24 studies with 436 cases of double plating, 64 cases of single plating, 84 cases of intramedullary nailing (IM), and 1 interfragmentary screw treatment met the inclusion criteria of this systematic review. The evaluated literature was published between 1991 and 2020. Results Double plating of femoral fractures achieved high healing rates and few complications were reported. It displayed significantly less intraoperative haemorrhage, shorter surgery time reduced risk of malunion in polytraumatised patients when compared to IM. Fracture healing rate of double-plating distal femoral fractures was 88.0%. However, there were no significant differences regarding fracture healing, complication or functional outcome when compared to single plating. Treatment of periprosthetic fractures with double plating displayed high healing rates (88.5%). Double plating of non-unions achieved excellent osseous union rates (98.5%). Conclusions The literature provides evidence for superior outcomes when using double plating in distal femoral fractures, periprosthetic fractures and femoral non-unions. Some evidence suggests that the use of double plating of femoral fractures in polytraumatised patients may be beneficial over other types of fracture fixation. Level of evidence IV.

Factors associated with neck pain in fighter aircrew: a systematic review and meta-analysis

2021 ◽  
pp. oemed-2020-107103
Author(s):  
James B Wallace ◽  
Phil M Newman ◽  
Aoife McGarvey ◽  
Peter G Osmotherly ◽  
Wayne Spratford ◽  
...  
Keyword(s):  
Systematic Review ◽  
Neck Pain ◽  
Data Availability ◽  
Computer Work ◽  
Current Evidence ◽  
Level Of Evidence ◽  
Operational Capability ◽  
Factors Associated ◽  
Common Complaint ◽  
Meta Analyses

Neck pain is a common complaint among fighter aircrew, impacting workforce health and operational capability. This systematic review aimed to identify, evaluate and synthesise the current evidence for factors associated with the occurrence of neck pain among fighter aircrew. Six electronic databases were searched in June 2019 and updated in June 2020 utilising the maximum date ranges. Included studies were appraised for methodological quality, ranked according to level of evidence and relevant data extracted. Where methods were homogeneous and data availability allowed, meta-analyses were performed. A total of 20 studies (16 cross sectional, one case–control, one retrospective cohort and two prospective cohort) were eligible for inclusion. Of the 44 factors investigated, consistent evidence was reported for greater occurrence of neck pain among aircrew operating more advanced aircraft and those exposed to more desk/computer work, while another 12 factors reported consistent evidence for no association. Of the 20 factors where meta-analyses could be performed, greater occurrence of neck pain was indicated for aircrew: flying more advanced aircraft, undertaking warm-up stretching and not placing their head against the seat under greater +Gz. Despite many studies investigating factors associated with neck pain among fighter aircrew, methodological limitations limited the ability to identify those factors that are most important to future preventive programmes. High-quality prospective studies with consistent use of definitions are required before we can implement efficient and effective programmes to reduce the prevalence and impact of neck pain in fighter aircrew. PROSPERO registration number: CRD42019128952.Neck pain is a common complaint among fighter aircrew, impacting workforce health and operational capability. This systematic review aimed to identify, evaluate and synthesise the current evidence for factors associated with the occurrence of neck pain among fighter aircrew.

scholarly journals Can physical testing be used to distinguish between migraine and cervicogenic headache sufferers? A protocol for a systematic review

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e031587 ◽  
Author(s):  
Ernesto Anarte ◽  
Gabriela Ferreira Carvalho ◽  
Annika Schwarz ◽  
Kerstin Luedtke ◽  
Deborah Falla
Keyword(s):  
Systematic Review ◽  
Differential Diagnosis ◽  
Diagnostic Accuracy ◽  
Meta Analysis ◽  
Cervicogenic Headache ◽  
Ethical Approval ◽  
Black Scale ◽  
Physical Tests ◽  
Meta Analyses ◽  
Asymptomatic Subjects

IntroductionDifferential diagnosis of migraine and cervicogenic headache (CGH) can be challenging given the large overlap of symptoms, commonly leading to misdiagnosis and ineffective treatment. In order to strengthen the differential diagnosis of headache, previous studies have evaluated the utility of physical tests to examine for musculoskeletal impairment, mainly in the cervical spine, which could be provoking or triggering headache. However, no systematic review has attempted to evaluate whether physical tests can differentiate CGH from migraine or both conditions from asymptomatic subjects.Methods/analysisA systematic review protocol has been designed and is reported in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P). A sensitive topic-based search strategy is planned which will include databases, hand searching of key journals and consultation of relevant leading authors in this field. Terms and keywords will be selected after discussion and agreement. Two independent reviewers will perform the search and select studies according to inclusion and exclusion criteria, including any cohort or observational studies evaluating the topic of this review; a third reviewer will confirm accuracy. A narrative synthesis will be developed for all included studies and, if possible, a meta-analysis will be conducted. The overall quality of the evidence will be assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) checklist for diagnostic accuracy studies and the Downs and Black scale for those studies where the QUADAS-2 checklist cannot be applied.Ethics and disseminationEthical approval is not required since no patient information will be collected. The results will provide a deeper understanding about the possibility of using physical tests to differentiate cervicogenic headache from migraine and from asymptomatic subjects, which has direct relevance for clinicians managing people with headache. The results will be published in a peer-reviewed journal and presented at scientific conferences.PROSPERO registration numberCRD42019135269.

Analgesic Efficacy of Nerve Blocks After Abdominoplasty: A Systematic Review

2019 ◽  
Vol 40 (11) ◽  
pp. 1208-1215 ◽  
Author(s):  
Peter M Vonu ◽  
Paul Campbell ◽  
Noah Prince ◽  
Bruce A Mast
Keyword(s):  
Systematic Review ◽  
Rectus Sheath ◽  
Analgesic Efficacy ◽  
Postoperative Pain Management ◽  
Opioid Consumption ◽  
Transversus Abdominis ◽  
Level Of Evidence ◽  
Nerve Blocks ◽  
Quadratus Lumborum ◽  
Meta Analyses

Abstract Background A variety of regional nerve blocks have been utilized in abdominoplasty procedures, including transversus abdominis plane (TAP), intercostal, rectus sheath (RS), pararectus + ilioinguinal/iliohypogastric, quadratus lumborum, and paravertebral blocks. No consensus exists regarding the most effective nerve block modality in optimizing postprocedural comfort levels. Objectives The purpose of this systematic review was to explore the efficacy of the various abdominal nerve blocks employed in abdominoplasty surgery and to draw attention to any modality that may be superior in regards to effectiveness and/or administration. Methods Utilizing Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic review was performed to identify studies that have employed regional nerve blocks in abdominoplasty procedures. Opioid consumption, pain scores, time to ambulation, time in the recovery room, and time to first analgesia request were extracted when available. Results A total of 191 articles were reviewed, of which 8 met inclusion criteria. The nerve blocks represented included TAP, RS, pararectus + ilioinguinal/iliohypogastric, intercostal, and quadratus lumborum. All modalities were effective in reducing opioid consumption except quadratus lumborum. Conclusions TAP, RS, pararectus + ilioinguinal/iliohypogastric, and intercostal regional nerve blocks have been shown to optimize postoperative pain management in abdominoplasty procedures. The existing literature suggests that when studied against one another, TAP is more efficacious than RS and pararectus + ilioinguinal/iliohypogastric. When ultrasound guidance is unavailable, consideration should be given to TAP employing the direct visualization approach. Level of Evidence: 2

The experience of conducting a Cochrane systematic review of the impact of clinical pathways on professional practice, patient outcomes, length of stay and hospital costs

2009 ◽  
Vol 13 (2) ◽  
pp. 62-66 ◽  
Author(s):  
Thomas Rotter ◽  
Leigh Kinsman ◽  
Erica James ◽  
Andreas Machotta ◽  
Holger Gothe ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Pathways ◽  
Hospital Costs ◽  
Evidence Base ◽  
Care Group ◽  
Level Of Evidence ◽  
Organisation Of Care ◽  
High Level ◽  
Meta Analyses ◽  
The Impact

Despite the high prevalence of clinical pathways (CPWs), the results from published studies are inconsistent and contradictory. The plethora of study designs, settings and lack of an agreed definition of a CPW make the relevance of individual studies difficult to apply to clinical settings. It was timely to catalogue and analyse the existing evidence base for CPWs via a rigorous systematic review. Systematic reviews and meta-analyses provide a high level of evidence for the effectiveness of interventions and are commonly employed reviewing strategies for addressing scientific questions in health-related research. This method is especially useful when research results are known to be inconsistent. Instead of conducting another primary evaluation, a detailed review is needed that reflects a summation of available research. This paper reports and discusses methodological and technical issues of a systematic review of the effectiveness of CPWs in hospitals, based on our experience with the Cochrane Effective Practice and Organisation of Care Group.

scholarly journals What is the level of evidence for the amnestic effects of sedatives in pediatric patients? A systematic review and meta-analyses

PLoS ONE ◽  
2017 ◽  
Vol 12 (7) ◽  
pp. e0180248 ◽  
Author(s):  
Karolline Alves Viana ◽  
Anelise Daher ◽  
Lucianne Cople Maia ◽  
Paulo Sucasas Costa ◽  
Carolina de Castro Martins ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pediatric Patients ◽  
Level Of Evidence ◽  
Meta Analyses

scholarly journals Iranian Physiotherapists’ Perceptions of the Ethical Issues in Everyday Practice

2020 ◽  
Vol 18 (2) ◽  
pp. 125-136
Author(s):  
Niloofar Souri ◽  
◽  
Afsun Nodehi Moghadam ◽  
Farahnaz Mohammadi Shahbolaghi ◽  
◽  
...  
Keyword(s):  
Professional Ethics ◽  
Ethics Education ◽  
Professional Competence ◽  
Ethical Issues ◽  
Daily Practice ◽  
Structured Interview ◽  
Medical Professional ◽  
Medical Community ◽  
Data Saturation ◽  
The Impact

Objectives: Considering the significant role of physiotherapists in the process of rehabilitation, their ethical commitment is essential to successful interaction and care provision. However, investigations on the medical professional ethics ​​in Iran are limited. Generally, research in this regard is rare in Asia. Thus, such studies could improve the moral knowledge of the Iranian physiotherapy community. Accordingly, this study aimed to explore professional ethics issues in physiotherapy to provide a platform concerning the challenges of professional ethics in physiotherapy in Iran. Methods: This qualitative study was conducted in 2016-2017 using the content analysis method. The study samples were recruited through purposive sampling approach until data saturation (12 physiotherapists). The required data were gathered by an in-depth semi-structured interview. All of the interviews were transcribed and analyzed, inductively. Results: Physiotherapists in Ahvaz and Tehran cities, Iran experienced challenges in 6 different categories during daily practice. These aspects included the following: therapists’ self-interest-craving, observing patients’ rights, maintaining professional competence, the effect of workplace on ethical conduct, personal ethical outlook, and insufficient professional ethics education. This study implicated the existence of a trend of kick-backs in the physiotherapy community; a problematic trend in the medical community, i.e. addressed by physicians in several articles. Additionally, the lack of receiving ethical education leads to ethical judgments based on personal values rather than ethical codes. According to the current research findings, it To increase the visibility of the article as well as to increase the citation of your article, we suggest that Latin keywords be based on the MeSH list. See: https://meshb.nlm.nih.gov/search was problematic for practitioners.  Discussion: Three subcategories of the incompetence of the healthcare system, the lack of supervision on ethical principles, and the impact of poor insurance system on patient admission are related to the endemic conditions of the health system of the country. These issues require serious interventions from executive powers.

scholarly journals Effect of oromotor exercises on feeding in children with cerebral palsy: systematic review

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Rania El Nagar ◽  
Alaa AL-Nemr ◽  
Faten Abdelazeim
Keyword(s):  
Systematic Review ◽  
Cerebral Palsy ◽  
Descriptive Analysis ◽  
Sensory Stimulation ◽  
Cochrane Library ◽  
Feeding Problems ◽  
Level Of Evidence ◽  
Weak Evidence ◽  
Children With Cerebral Palsy ◽  
Meta Analyses

Abstract Background Feeding problems are prevalent in children with cerebral palsy (CP). Oromotor exercises (OME) should be started as soon as possible to enhance chewing and drooling. Oromotor exercises consist of active exercises, passive exercises, and sensory stimulation. The purpose of this review is to evaluate the effectiveness of oromotor exercises on feeding, chewing, and drooling in children with CP. Body The American Academy for Cerebral Palsy and Developmental Medicine and Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology were used to conduct a systematic review. Four databases (PubMed, Cochrane Library, PEDro, and Google Scholar) were searched; this review includes seven articles, participants were 173 participants ranging in age from 18 months to 18 years. Articles were assessed according to their level of evidence and quality assessment was done by AACPDM, PEDro scale, and JBI scale. Due to the heterogeneity across included studies, descriptive analysis was performed on all of them. Primary outcomes were chewing and drooling. Results showed the effectiveness of OME in improving drooling, but with weak evidence while not effective in improving chewing. Conclusion High-quality studies are required to develop a firm judgment on the influence of oromotor exercises on feeding. The current level of evidence to support the effectiveness of oromotor exercises in children with CP is currently insufficient.

Wunder-women: Systematic review of causes, treatment and outcomes of Wunderlich syndrome during pregnancy

2018 ◽  
Vol 12 (2) ◽  
pp. 134-144
Author(s):  
Thomas Ahn ◽  
Matthew J Roberts ◽  
Anojan Navaratnam ◽  
Eric Chung ◽  
Simon T Wood
Keyword(s):  
Systematic Review ◽  
Pregnant Women ◽  
Case Reports ◽  
Contemporary Literature ◽  
Case Series ◽  
Artery Aneurysm ◽  
Well Being ◽  
Renal Neoplasm ◽  
Level Of Evidence ◽  
Meta Analyses

Objective: The objective of this article is to conduct a contemporary literature review on Wunderlich syndrome, or spontaneous renal haemorrhage (SRH), among pregnant women to describe contemporary aetiology, investigations and management patterns. Methods: A systematic review of MEDLINE and CENTRAL in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was performed. All articles, including case reports and case series on SRH published from 2000 to 2016, were included. Full-text manuscripts describing SRH among pregnant women were reviewed for clinical parameters, which were collated and analysed. Results: Twenty cases of SRH in pregnant women were identified. The median age and gestation were 32.1 years and 26.5 weeks, respectively, with SRH most commonly occurring in the third trimester (nine patients; 45%) and due to renal neoplasm, specifically angiomyolipoma (AML; 12 patients; 60%), followed by renal artery aneurysm (RAA; five patients; 25%). Surgical intervention (55%) was most commonly used for acute SRH. Foetal demise was not uncommon (15%). Conclusions: SRH in pregnant women is an uncommon but complex urological and obstetric emergency with potentially catastrophic consequences. A multidisciplinary approach is key to timely diagnosis and appropriate management considering the well-being both of mother and foetus. Pre-emptive diagnosis and intervention may reduce complications. Level of evidence: 4

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