The need for a standardized conceptual term to describe invalidation of patient symptoms

2021 ◽  
pp. 135910532110247
Author(s):  
Allyson C Bontempo
Keyword(s):  
Health Outcomes ◽  
Patient Experience ◽  
Healthcare Providers ◽  
Narrative Review ◽  
Future Research ◽  
Research Reporting

In this paper, I comment on a growing literature documenting that many patients perceive their symptoms have been dismissed, ignored, not taken seriously, not believed, etc. (i.e. invalidated) by healthcare providers. I provide a narrative review of research reporting on this patient-provider phenomenon, invalidation of patient symptoms, in various illness contexts in order to highlight the variability concerning how scholars have been referring to the seemingly same phenomenon. Next, I discuss the challenges this variability poses for scholarship, including how it precludes the ability to build on our understanding of how it contributes to the patient experience and related health outcomes. I conclude with recommendations for future research.

scholarly journals Effect on nurse and patient experience: overnight use of blue-depleted illumination

2019 ◽  
Vol 8 (3) ◽  
pp. e000692 ◽  
Author(s):  
Lorenzo Albala ◽  
Timothy Bober ◽  
Graham Hale ◽  
Benjamin Warfield ◽  
Micaela Langille Collins ◽  
...  
Keyword(s):  
Health Outcomes ◽  
Patient Experience ◽  
Financial Incentives ◽  
Healthcare Providers ◽  
Depression Scale ◽  
Poor Sleep ◽  
Patient Anxiety ◽  
Night Time ◽  
Task Lighting ◽  
The Impact

BackgroundTypical hospital lighting is rich in blue-wavelength emission, which can create unwanted circadian disruption in patients when exposed at night. Despite a growing body of evidence regarding the effects of poor sleep on health outcomes, physiologically neutral technologies have not been widely implemented in the US healthcare system.ObjectiveThe authors sought to determine if rechargeable, proximity-sensing, blue-depleted lighting pods that provide wireless task lighting can make overnight hospital care more efficient for providers and less disruptive to patients.DesignNon-randomised, controlled interventional trial in an intermediate-acuity unit at a large urban medical centre.MethodsNight-time healthcare providers abstained from turning on overhead patient room lighting in favour of a physiologically neutral lighting device. 33 nurses caring for patients on that unit were surveyed after each shift. 21 patients were evaluated after two nights with standard-of-care light and after two nights with lighting intervention.ResultsProviders reported a satisfaction score of 8 out of 10, with 82% responding that the lighting pods provided adequate lighting for overnight care tasks. Among patients, a median 2-point improvement on the Hospital Anxiety and Depression Scale was reported.Conclusion and relevanceThe authors noted improved caregiver satisfaction and decreased patient anxiety by using a blue-depleted automated task-lighting alternative to overhead room lights. Larger studies are needed to determine the impact of these lighting devices on sleep measures and patient health outcomes like delirium. With the shift to patient-centred financial incentives and emphasis on patient experience, this study points to the feasibility of a physiologically targeted solution for overnight task lighting in healthcare environments.

The application of virtual reality in health professions� digital education: a narrative review (Preprint)

2018 ◽  
Author(s):  
Lorraine Tudor Car ◽  
Bhone Myint Kyaw ◽  
Josip Car
Keyword(s):  
Virtual Reality ◽  
Professional Education ◽  
Health Professions ◽  
Health Professions Education ◽  
Narrative Review ◽  
Current Evidence ◽  
Future Research ◽  
Educational Content ◽  
Potential Applications

BACKGROUND Digital technology called Virtual Reality (VR) is increasingly employed in health professions’ education. Yet, based on the current evidence, its use is narrowed around a few most applications and disciplines. There is a lack of an overview that would capture the diversity of different VR applications in health professions’ education and inform its use and research. OBJECTIVE This narrative review aims to explore different potential applications of VR in health professions’ education. METHODS The narrative synthesis approach to literature review was used to analyse the existing evidence. RESULTS We outline the role of VR features such as immersion, interactivity and feedback and explain the role of VR devices. Based on the type and scope of educational content VR can represent space, individuals, objects, structures or their combination. Application of VR in medical education encompasses environmental, organ and micro level. Environmental VR focuses on training in relation to health professionals’ environment and human interactions. Organ VR educational content targets primarily human body anatomy; and micro VR microscopic structures at the level of cells, molecules and atoms. We examine how different VR features and health professional education areas match these three VR types. CONCLUSIONS We conclude by highlighting the gaps in the literature and providing suggestions for future research.

Habit and Routine Interventions with Emerging Adults with Diabetes: An Integrative Review

2021 ◽  
pp. 019394592110322
Author(s):  
Kathleen M. Hanna ◽  
Jed R. Hansen ◽  
Kim A. Harp ◽  
Kelly J. Betts ◽  
Diane Brage Hudson ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Health Outcomes ◽  
Emerging Adults ◽  
Text Messaging ◽  
Integrative Review ◽  
Self Management ◽  
Future Research ◽  
Medical Librarian

Although theoretical and empirical writings on habits and routines are a promising body of science to guide interventions, little is known about such interventions among emerging adults with type 1 diabetes. Thus, an integrative review was conducted to describe interventions in relation to habits and routines, their influence on outcomes, and users’ perspectives. A medical librarian conducted a search. Teams screened titles, abstracts, and articles based upon predefined criteria. Evidence from the final 11 articles was synthesized. A minority of investigators explicitly articulated habits and routines theoretical underpinnings as part of the interventions. However, text messaging or feedback via technology used in other interventions could be implicitly linked to habits and routines. For the most part, these interventions positively influenced diabetes self-management-related behaviors and health outcomes. In general, the interventions were perceived positively by users. Future research is advocated using habit and routine theoretical underpinnings to guide interventions.

scholarly journals Inter-society consensus for the use of inhaled corticosteroids in infants, children and adolescents with airway diseases

2021 ◽  
Vol 47 (1) ◽  
Author(s):  
Marzia Duse ◽  
Francesca Santamaria ◽  
Maria Carmen Verga ◽  
Marcello Bergamini ◽  
Giovanni Simeone ◽  
...  
Keyword(s):  
Inhaled Corticosteroids ◽  
Healthcare Providers ◽  
Future Research ◽  
Secondary Sources ◽  
Care Services ◽  
Consensus Document ◽  
Airway Diseases ◽  
Primary Care Services ◽  
Non Allergic Rhinitis ◽  
Evidence Based Guidelines

Abstract Background In 2019, a multidisciplinary panel of experts from eight Italian scientific paediatric societies developed a consensus document for the use of inhaled corticosteroids in the management and prevention of the most common paediatric airways disorders. The aim is to provide healthcare providers with a multidisciplinary document including indications useful in the clinical practice. The consensus document was intended to be addressed to paediatricians who work in the Paediatric Divisions, the Primary Care Services and the Emergency Departments, as well as to Residents or PhD students, paediatric nurses and specialists or consultants in paediatric pulmonology, allergy, infectious diseases, and ear, nose, and throat medicine. Methods Clinical questions identifying Population, Intervention(s), Comparison and Outcome(s) were addressed by methodologists and a general agreement on the topics and the strength of the recommendations (according to the GRADE system) was obtained following the Delphi method. The literature selection included secondary sources such as evidence-based guidelines and systematic reviews and was integrated with primary studies subsequently published. Results The expert panel provided a number of recommendations on the use of inhaled corticosteroids in preschool wheezing, bronchial asthma, allergic and non-allergic rhinitis, acute and chronic rhinosinusitis, adenoid hypertrophy, laryngitis and laryngospasm. Conclusions We provided a multidisciplinary update on the current recommendations for the management and prevention of the most common paediatric airways disorders requiring inhaled corticosteroids, in order to share useful indications, identify gaps in knowledge and drive future research.

scholarly journals Assessing the indirect effects of COVID-19 on healthcare delivery, utilization and health outcomes: a scoping review

2021 ◽  
Author(s):  
Charlotte M Roy ◽  
E Brennan Bollman ◽  
Laura M Carson ◽  
Alexander J Northrop ◽  
Elizabeth F Jackson ◽  
...  
Keyword(s):  
Health Outcomes ◽  
Health Effects ◽  
Scoping Review ◽  
Cardiovascular Health ◽  
Healthcare Delivery ◽  
Final Analysis ◽  
High Income ◽  
Future Research ◽  
Published Data ◽  
Local Health

Abstract Background The COVID-19 pandemic and global efforts to contain its spread, such as stay-at-home orders and transportation shutdowns, have created new barriers to accessing healthcare, resulting in changes in service delivery and utilization globally. The purpose of this study is to provide an overview of the literature published thus far on the indirect health effects of COVID-19 and to explore the data sources and methodologies being used to assess indirect health effects. Methods A scoping review of peer-reviewed literature using three search engines was performed. Results One hundred and seventy studies were included in the final analysis. Nearly half (46.5%) of included studies focused on cardiovascular health outcomes. The main methodologies used were observational analytic and surveys. Data were drawn from individual health facilities, multicentre networks, regional registries, and national health information systems. Most studies were conducted in high-income countries with only 35.4% of studies representing low- and middle-income countries (LMICs). Conclusion Healthcare utilization for non-COVID-19 conditions has decreased almost universally, across both high- and lower-income countries. The pandemic’s impact on non-COVID-19 health outcomes, particularly for chronic diseases, may take years to fully manifest and should be a topic of ongoing study. Future research should be tied to system improvement and the promotion of health equity, with researchers identifying potentially actionable findings for national, regional and local health leadership. Public health professionals must also seek to address the disparity in published data from LMICs as compared with high-income countries.

scholarly journals Duration of Bisphosphonate Drug Holidays in Osteoporosis Patients: A Narrative Review of the Evidence and Considerations for Decision-Making

2021 ◽  
Vol 10 (5) ◽  
pp. 1140
Author(s):  
Kaleen N. Hayes ◽  
Elizabeth M. Winter ◽  
Suzanne M. Cadarette ◽  
Andrea M. Burden
Keyword(s):  
Surrogate Marker ◽  
Femoral Fractures ◽  
Osteonecrosis Of The Jaw ◽  
Bisphosphonate Therapy ◽  
Narrative Review ◽  
Drug Holiday ◽  
Future Research ◽  
Mineral Density ◽  
First Line Therapy

Bisphosphonates are first-line therapy for osteoporosis, with alendronate, risedronate, and zoledronate as the main treatments used globally. After one year of therapy, bisphosphonates are retained in bone for extended periods with extended anti-fracture effects after discontinuation. Due to this continued fracture protection and the potential for rare adverse events associated with long-term use (atypical femoral fractures and osteonecrosis of the jaw), a drug holiday of two to three years is recommended for most patients after long-term bisphosphonate therapy. The recommendation for a drug holiday up to three years is derived primarily from extensions of pivotal trials with alendronate and zoledronate and select surrogate marker studies. However, certain factors may modify the duration of bisphosphonate effects on a drug holiday and warrant consideration when determining an appropriate time off-therapy. In this narrative review, we recall what is currently known about drug holidays and discuss what we believe to be the primary considerations and areas for future research regarding drug holiday duration: total bisphosphonate exposure, type of bisphosphonate used, bone mineral density and falls risk, and patient sex and body weight.

A Systematic Review of Multi-Component Comprehensive School Physical Activity Program (CSPAP) Interventions

2021 ◽  
pp. 089011712110132
Author(s):  
Ann Pulling Kuhn ◽  
Peter Stoepker ◽  
Brian Dauenhauer ◽  
Russell L. Carson
Keyword(s):  
Physical Activity ◽  
Physical Education ◽  
Health Outcomes ◽  
Academic Outcomes ◽  
English Language ◽  
Comprehensive School ◽  
Physical Activity Program ◽  
School Level ◽  
Future Research ◽  
Activity Program

Objective: To identify, review, and describe multicomponent physical activity (PA) interventions in terms of: (a) number and combination of Comprehensive School Physical Activity Program (CSPAP) components, (b) study characteristics, and (c) primary outcomes. Data Source: Five electronic databases (i.e., PubMed, PsychInfo, Physical Education Index, Sport Discus, and ERIC). Study Inclusion and Exclusion Criteria: Included articles were peer-reviewed, written in English language, published since 1987, and included multicomponent school-based interventions. Data Extraction: Data items extracted were: school level, setting, CSPAP component description, health outcomes, academic outcomes, main conclusion, and reference. Data Synthesis: Included articles were synthesized by: (1) CSPAP components utilized, and (2) research outcome measured (i.e., health or academic). Results: Across 32 studies, 11 included physical education plus 1 additional CSPAP component (PE + 1); 10 included PE + 2 additional CSPAP components; 8 included PE + 3 additional CSPAP components; and 1 included all 5 CSPAP components. Two other studies included 2 or 3 CSPAP components without PE. Most interventions targeted health outcomes (94%) rather than academic outcomes (6%). Conclusions: Multicomponent approaches aligned with CSPAPs are effective in promoting PA and other positive outcomes for youth in schools. Future research should seek to understand effects of CSPAP components on a variety of outcomes and settings.

scholarly journals Local Anesthetics and Recurrence after Cancer Surgery-What’s New? A Narrative Review

2021 ◽  
Vol 10 (4) ◽  
pp. 719
Author(s):  
Sarah D. Müller ◽  
Jonathan S. H. Ziegler ◽  
Tobias Piegeler
Keyword(s):  
Tumor Cells ◽  
Circulating Tumor Cells ◽  
Local Anesthetics ◽  
Experimental Studies ◽  
Perioperative Period ◽  
Cancer Surgery ◽  
Narrative Review ◽  
Future Research ◽  
Inflammatory Stress ◽  
Research Activities

The perioperative use of regional anesthesia and local anesthetics is part of almost every anesthesiologist’s daily clinical practice. Retrospective analyses and results from experimental studies pointed towards a potential beneficial effect of the local anesthetics regarding outcome—i.e., overall and/or recurrence-free survival—in patients undergoing cancer surgery. The perioperative period, where the anesthesiologist is responsible for the patients, might be crucial for the further course of the disease, as circulating tumor cells (shed from the primary tumor into the patient’s bloodstream) might form new micro-metastases independent of complete tumor removal. Due to their strong anti-inflammatory properties, local anesthetics might have a certain impact on these circulating tumor cells, either via direct or indirect measures, for example via blunting the inflammatory stress response as induced by the surgical stimulus. This narrative review highlights the foundation of these principles, features recent experimental and clinical data and provides an outlook regarding current and potential future research activities.

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