Concept Analysis of Unintended Consequences

2018 ◽  
Vol 24 (2) ◽  
pp. 99-104
Author(s):  
Mykin Higbee

The concept of unintended consequences is widely discussed in the realms of politics or economics, but not as frequently as related to health care. Nursing professionals act with the intent to improve health outcomes for patients; however, with every action, there are risks and consequences that may or may not be anticipated. This article utilizes a modified version of Walker and Avant’s framework for concept analysis (2011) to identify the characteristics, defining attributes, and antecedents of the concept of unintended consequences, present a model case and empirical referents, and provide a practical and theoretical application to nursing. Opportunities for future research related to the concept of unintended consequences include a closer study of nurses’ choices that may affect their well-being or productivity, as well as educational opportunities to better inform nurses of the impact unintended consequences may have on them and the care they provide.

2020 ◽  
Vol 91 (8) ◽  
pp. 651-661
Author(s):  
Joshua T. Davis ◽  
Hilary A. Uyhelji

INTRODUCTION: Although the impact of microorganisms on their hosts has been investigated for decades, recent technological advances have permitted high-throughput studies of the collective microbial genomes colonizing a host or habitat, also known as the microbiome. This literature review presents an overview of microbiome research, with an emphasis on topics that have the potential for future applications to aviation safety. In humans, research is beginning to suggest relationships of the microbiome with physical disorders, including type 1 and type 2 diabetes mellitus, cardiovascular disease, and respiratory disease. The microbiome also has been associated with psychological health, including depression, anxiety, and the social complications that arise in autism spectrum disorders. Pharmaceuticals can alter microbiome diversity, and may lead to unintended consequences both short and long-term. As research strengthens understanding of the connections between the microbiota and human health, several potential applications for aerospace medicine and aviation safety emerge. For example, information derived from tests of the microbiota has potential future relevance for medical certification of pilots, accident investigation, and evaluation of fitness for duty in aerospace operations. Moreover, air travel may impact the microbiome of passengers and crew, including potential impacts on the spread of disease nationally and internationally. Construction, maintenance, and cleaning regimens that consider the potential for microbial colonization in airports and cabin environments may promote the health of travelers. Altogether, the mounting knowledge of microbiome effects on health presents several opportunities for future research into how and whether microbiome-based insights could be used to improve aviation safety.Davis JT, Uyhelji HA. Aviation and the microbiome. Aerosp Med Hum Perform. 2020; 91(8):651–661.


2021 ◽  
Vol 28 (1) ◽  
pp. 42-50
Author(s):  
Nicole M. Glenn ◽  
Lisa Allen Scott ◽  
Teree Hokanson ◽  
Karla Gustafson ◽  
Melissa A. Stoops ◽  
...  

Financial well-being describes when people feel able to meet their financial obligations, feel financially secure and are able to make choices that benefit their quality of life. Financial strain occurs when people are unable to pay their bills, feel stressed about money and experience negative impacts on their quality of life and health. In the face of the global economic repercussions of the COVID-19 pandemic, community-led approaches are required to address the setting-specific needs of residents and reduce the adverse impacts of widespread financial strain. To encourage evidence-informed best practices, a provincial health authority and community-engaged research centre collaborated to conduct a rapid review. We augmented the rapid review with an environmental scan and interviews. Our data focused on Western Canada and was collected prior to the pandemic (May–September 2019). We identified eight categories of community-led strategies to promote financial well-being: systems navigation and access; financial literacy and skills; emergency financial assistance; asset building; events and attractions; employment and educational support; transportation; and housing. We noted significant gaps in the evidence, including methodological limitations of the included studies (e.g. generalisability, small sample size), a lack of reporting on the mechanisms leading to the outcomes and evaluation of long-term impacts, sparse practice-based data on evaluation methods and outcomes, and limited intervention details in the published literature. Critically, few of the included interventions specifically targeted financial strain and/or well-being. We discuss the implications of these gaps in addition to possibilities and priorities for future research and practice. We also consider the results in relation to the COVID-19 pandemic and its economic consequences.


Author(s):  
Jonathan Plante ◽  
Karine Latulippe ◽  
Edeltraut Kröger ◽  
Dominique Giroux ◽  
Martine Marcotte ◽  
...  

Abstract Older persons experiencing a longer length of stay (LOS) or delayed discharge (DD) may see a decline in their health and well-being, generating significant costs. This review aimed to identify evidence on the impact of cognitive impairment (CI) on acute care hospital LOS/DD. A scoping review of studies examining the association between CI and LOS/DD was performed. We searched six databases; two reviewers independently screened references until November 2019. A narrative synthesis was used to answer the research question; 58 studies were included of which 33 found a positive association between CI and LOS or DD, 8 studies had mixed results, 3 found an inverse relationship, and 14 showed an indirect link between CI-related syndromes and LOS/DD. Thus, cognitive impairment seemed to be frequently associated with increased LOS/DD. Future research should consider CI together with other risks for LOS/DD and also focus on explaining the association between the two.


Author(s):  
Dhruva Pathak ◽  
Vijayakumar Bharathi S. ◽  
Padma Mala E.

The study investigated the impact of mandatory work from home due COVID-19 on personal and professional lives of people with different demographics. Statistical analysis of an online survey data (N=237) reveals that the impact on personal life dimensions—healthy lifestyle, family bonding, and physical stress—does not differ across people within different demographics. However, impact on emotional well-being is sensitive to gender and industry groups. Family size is also an important demographic factor impacted upon personal life dimensions. Professional dimensions related to work productivity and adopting new ways of working does not differ across demographics except for occupational role. Dimensions related to new skill development and change in professional attitude does differ across occupational roles. The study concludes by stating future research directions for mandatory work from home situation, and prescription to post-COVID-19 strategies for organizations.


Author(s):  
Allison Brown ◽  
Aliya Kassam ◽  
Mike Paget ◽  
Kenneth Blades ◽  
Megan Mercia ◽  
...  

Background: The evidence surrounding the impact of COVID-19 on medical learners remains anecdotal and highly speculative despite the anticipated impact and potential consequences of the current pandemic on medical training. The purpose of this study was to explore the extent that COVID-19 initially impacted medical learners around the world and examine global trends and patterns across geographic regions and levels of training. Methods: A cross-sectional survey of medical learners was conducted between March 25–June 14, 2020, shortly after the World Health Organization declared COVID-19 a pandemic. Results: 6492 learners completed the survey from 140 countries. Most medical schools removed learners from the clinical environment and adopted online learning, but students reported concerns about the quality of their learning, training progression, and milestone fulfillment. Residents reported they could be better utilized and expressed concerns about their career timeline. Trainees generally felt under-utilized and wanted to be engaged clinically in meaningful ways; however, some felt that contributing to healthcare during a pandemic was beyond the scope of a learner. Significant differences were detected between levels of training and geographic regions for satisfaction with organizational responses as well as the impact of COVID-19 learner wellness and state-trait anxiety. Conclusions: The disruption to the status quo of medical education is perceived by learners across all levels and geographic regions to have negatively affected their training and well-being, particularly amongst postgraduate trainees. These results provide initial empirical insights into the areas that warrant future research as well as consideration for current and future policy planning.


2021 ◽  
Vol 12 ◽  
Author(s):  
Brandon L. Boring ◽  
Kaitlyn T. Walsh ◽  
Namrata Nanavaty ◽  
Vani A. Mathur

The experience of pain is subjective, yet many people have their pain invalidated or not believed. Pain invalidation is associated with poor mental health, including depression and lower well-being. Qualitative investigations of invalidating experiences identify themes of depression, but also social withdrawal, self-criticism, and lower self-worth, all of which are core components of shame. Despite this, no studies have quantitatively assessed the interrelationship between pain invalidation, shame, and depression. To explore this relationship, participants recounted the frequency of experienced pain invalidation from family, friends, and medical professionals, as well as their feelings of internalized shame and depressive symptoms. As shame has been shown to be a precursor for depression, we further explored the role of shame as a mediator between pain invalidation and depressive symptoms. All sources of pain invalidation were positively associated with shame and depressive symptoms, and shame fully mediated the relationship between each source of pain invalidation and depression. Relative to other sources, pain invalidation from family was most closely tied to shame and depression. Overall, findings indicate that one mechanism by which pain invalidation may facilitate depression is via the experience of shame. Future research may explore shame as a potential upstream precursor to depression in the context of pain. Findings provide more insight into the harmful influence of pain invalidation on mental health and highlight the impact of interpersonal treatment on the experiences of people in pain.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Sophie Dennard ◽  
Derek K. Tracy ◽  
Aaron Beeney ◽  
Laura Craster ◽  
Fiona Bailey ◽  
...  

Purpose Prisons are uniquely challenging working environments. Staff are often exposed to direct and indirect trauma, impacting negatively on their mental well-being. Due to the limited research into prison staff experience, this paper aims to explore what staff find most challenging, how they cope, what support they would like and rewarding aspects of their work. Design/methodology/approach This service development project was facilitated through a staff well-being event. A qualitative approach was used and 74 staff members provided anonymised responses. An inductive and data-driven approach was used to analyse the data, and the trustworthiness of the analysis was considered using criteria established by Lincoln and Guba (1985). Findings Thematic analysis identified six themes, namely, the challenging nature of the work, interactions with prisoners, staff interactions, inadequate resources, staff support and development and coping strategies. Key findings include managing distress, self-harm and violence and limited resources presenting challenges. Role variety and opportunities to support prisoners were reported as positive. A variety of coping strategies were identified. Wider availability of supervision and reflective practice was suggested by staff. Practical implications Recommendations for increased staff support are made. Suggestions for future research investigating methods to increase rewarding aspects of work within prisons are given. Originality/value This analysis adds to the limited body of qualitative research investigating prison staff experiences; in particular, aspects of the work that they find rewarding such as the role variety and opportunities to make positive changes to prisoners’ lives. Novel coping strategies were identified, including cognitive reframing and behavioural strategies for managing stress, which could be encouraged to increase resilience.


Author(s):  
Branka Rodić Trmčić ◽  
Aleksandra Labus ◽  
Svetlana Mitrović ◽  
Vesna Buha ◽  
Gordana Stanojević

The main task of Internet of Things in eHealth solutions is to collect data, connect people, things and processes. This provides a wealth of information that can be useful in decision-making, improving health and well-being. The aim of this study is to identify framework of sensors and application health services to detect sources of stress and stressors and make them visible to users. Also, we aim at extracting relationship between event and sensor data in order to improve health behavior. Evaluation of the proposed framework model will be performed. Model is based on Internet of Things in eHealth and is going to aim to improve health behavior. Following the established pattern of behavior realized through wearable system users will be proposed a preventive actions model. Further, it will examine the impact of changing health behavior on habits, condition and attitudes in relation to well-being and prevention.


2019 ◽  
Vol 28 (1) ◽  
pp. 20-22

Purpose The purpose of this study is to summarize findings from research into knowledge sharing and to provide suggestions for further research. Design/methodology/approach A systematic literature review was carried out through three phases – review protocol, conducting the review and reporting the review. A thematic analysis was carried out on 61 peer reviewed studies. Findings The review looks at the impact of knowledge sharing in three categories – individual, team and organizational. The main factors studied were creativity, performance and learning. Knowledge sharing goes beyond work-related impacts and has a positive effect on team climate, job satisfaction and life satisfaction. Directions for future research were identified as adopting an interaction and process perspective, investigating negative, differential and psychological impacts and improving methodology through use of qualitative and longitudinal studies. Practical implications As knowledge sharing does have positive psychological effects including enhanced job and life satisfaction it would be beneficial to build it into the organization’s well-being program. Originality/value This paper has an original approach as it is the first systematic review to be carried out on research into knowledge sharing and suggests areas for further investigation.


2016 ◽  
Vol 25 (01) ◽  
pp. 13-29 ◽  
Author(s):  
J. Abraham ◽  
L. L. Novak ◽  
T. L. Reynolds ◽  
A. Gettinger ◽  
K. Zheng

SummaryObjective: To summarize recent research on unintended consequences associated with implementation and use of health information technology (health IT). Included in the review are original empirical investigations published in English between 2014 and 2015 that reported unintended effects introduced by adoption of digital interventions. Our analysis focuses on the trends of this steam of research, areas in which unintended consequences have continued to be reported, and common themes that emerge from the findings of these studies.Method: Most of the papers reviewed were retrieved by searching three literature databases: MEDLINE, Embase, and CINAHL. Two rounds of searches were performed: the first round used more restrictive search terms specific to unintended consequences; the second round lifted the restrictions to include more generic health IT evaluation studies. Each paper was independently screened by at least two authors; differences were resolved through consensus development.Results: The literature search identified 1,538 papers that were potentially relevant; 34 were deemed meeting our inclusion criteria after screening. Studies described in these 34 papers took place in a wide variety of care areas from emergency departments to ophthalmology clinics. Some papers reflected several previously unreported unintended consequences, such as staff attrition and patients’ withholding of information due to privacy and security concerns. A majority of these studies (71%) were quantitative investigations based on analysis of objectively recorded data. Several of them employed longitudinal or time series designs to distinguish between unintended consequences that had only transient impact, versus those that had persisting impact. Most of these unintended consequences resulted in adverse outcomes, even though instances of beneficial impact were also noted. While care areas covered were heterogeneous, over half of the studies were conducted at academic medical centers or teaching hospitals. Conclusion: Recent studies published in the past two years represent significant advancement of unintended consequences research by seeking to include more types of health IT applications and to quantify the impact using objectively recorded data and longitudinal or time series designs. However, more mixed-methods studies are needed to develop deeper insights into the observed unintended adverse outcomes, including their root causes and remedies. We also encourage future research to go beyond the paradigm of simply describing unintended consequences, and to develop and test solutions that can prevent or minimize their impact.


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