scholarly journals Navigating complexity of child abuse through intuition and evidence-based guidelines: a mix-methods study among child and youth healthcare practitioners

2020 ◽  
Author(s):  
Jetske Charlotte Erisman ◽  
Kevin de Sabbata ◽  
Teun Zuiderent-Jerak ◽  
Elena V Syurina
Keyword(s):  
Child Abuse ◽  
Well Being ◽  
Care Practice ◽  
Evidence Based ◽  
Structured Interviews ◽  
Daily Work ◽  
Tunnel Vision ◽  
Dutch Child ◽  
Secondary Information ◽  
Evidence Based Guidelines

Abstract Background: Dutch child and youth health care (CYHC) practitioners monitor and assess the well-being of children. One of their main concerns is identifying cases of child abuse, which is an arduous and sensitive task. In these contexts, CYHC-practitioners use both evidence-based guidelines aimed at increasing the quality of care through rationalised decision-making, and intuition. These two practices are seen as being at odds with each other, yet empirical research has shown that both are necessary in healthcare. This study aims to unravel how intuition is perceived and used by Dutch CYHC-practitioners when identifying and working with cases of child abuse, and how this relates to their evidence-based guidelines.Methods: A sequential exploratory mixed-methods design: in-depth semi-structured interviews with CYHC-physicians focused on perceptions on intuition, which were followed by a survey amongst CYHC-practitioners on the recognition and use of the concept.Results: The majority of CYHC-practitioners recognise and use intuition in their daily work, stating that it is necessary in their profession. CYHC-practitioners use intuition to 1) sense that something is ‘off’, 2) differentiate between ‘normal’ and ‘abnormal’, 3) assess risks, 4) weigh secondary information and 5) communicate with parents. At the same time, they warn of its dangers, as it may lead to ‘tunnel vision’ and false accusations. Conclusion: Intuition is experienced as an integral part of the work of CYHC-practitioners. It is understood as particularly useful in cases of child abuse, which are inherently complex, as signs and evidence of abuse are often hidden, subtle and unique in each case. CYHC-practitioners use intuition to manage and navigate this complexity. There is an opportunity for guidelines to support reflection and intuition as a ‘good care’ practice.

scholarly journals Navigating complexity through intuition and evidence-based guidelines: a mix-methods study among child and youth healthcare professionals

2020 ◽  
Author(s):  
Jetske Charlotte Erisman ◽  
Kevin de Sabbata ◽  
Teun Zuiderent-Jerak ◽  
Elena V Syurina
Keyword(s):  
Child Abuse ◽  
Well Being ◽  
Care Practice ◽  
Evidence Based ◽  
Structured Interviews ◽  
Daily Work ◽  
Tunnel Vision ◽  
Dutch Child ◽  
Secondary Information ◽  
Evidence Based Guidelines

Abstract Background: Dutch child and youth health care (CYHC) professionals monitor and assess the well-being of children. One of their main concerns is identifying cases of child abuse, which is an arduous and sensitive task. In these contexts, CYHC-professionals use both evidence-based guidelines aimed at increasing the quality of care through rationalised decision-making, and intuition. These two practices are seen as being at odds with each other, yet empirical research has shown that both are needed in healthcare. This study aims to unravel how intuition is perceived and used by Dutch CYHC-professionals when identifying and working with cases of child abuse, and how this relates to their evidence-based guidelines.Methods: A sequential exploratory mixed-methods design: in-depth semi-structured interviews with CYHC-practitioners focused on perceptions on intuition, which were followed by a survey amongst CYHC-professionals on the recognition and use of the concept.Results: The majority of CYHC-professionals recognise and use intuition in their daily work, stating that it is necessary in their profession. CYHC-professionals use intuition to: 1) sense that something is off, 2) differentiate between ‘normal’ and ‘abnormal’, 3) assess risks, 4) weigh secondary information and 5) communicate with parents. At the same time, they warn for its dangers as it may lead to ‘tunnel vision’ and false accusations. Conclusion: Intuition is experienced as an integral part of the work of CYHC-professionals. It is stated to be particularly useful in the case of child abuse, which is inherently complex as signs and evidence of abuse are hidden, subtle and unique in each case. CYHC- professionals use intuition to manage and navigate this complexity. There is an opportunity for guidelines to support reflection and intuition as a ‘good care’ practice.

scholarly journals Navigating complexity of child abuse through intuition and evidence-based guidelines: a mix-methods study among child and youth healthcare practitioners

2020 ◽  
Author(s):  
Jetske Charlotte Erisman ◽  
Kevin de Sabbata ◽  
Teun Zuiderent-Jerak ◽  
Elena V Syurina
Keyword(s):  
Child Abuse ◽  
Well Being ◽  
Care Practice ◽  
Evidence Based ◽  
Structured Interviews ◽  
Daily Work ◽  
Tunnel Vision ◽  
Dutch Child ◽  
Secondary Information ◽  
Evidence Based Guidelines

Abstract Background: Dutch child and youth health care (CYHC) practitioners monitor and assess the well-being of children. One of their main concerns is identifying cases of child abuse, which is an arduous and sensitive task. In these contexts, CYHC-practitioners use both evidence-based guidelines aimed at increasing the quality of care through rationalised decision-making, and intuition. These two practices are seen as being at odds with each other, yet empirical research has shown that both are necessary in healthcare. This study aims to unravel how intuition is perceived and used by Dutch CYHC-practitioners when identifying and working with cases of child abuse, and how this relates to their evidence-based guidelines. Methods: A sequential exploratory mixed-methods design: in-depth semi-structured interviews with CYHC-physicians focused on perceptions on intuition, which were followed by a survey amongst CYHC-practitioners on the recognition and use of the concept. Results: The majority of CYHC-practitioners recognise and use intuition in their daily work, stating that it is necessary in their profession. CYHC-practitioners use intuition to 1) sense that something is ‘off’, 2) differentiate between ‘normal’ and ‘abnormal’, 3) assess risks, 4) weigh secondary information and 5) communicate with parents. At the same time, they warn of its dangers, as it may lead to ‘tunnel vision’ and false accusations. Conclusion: Intuition is experienced as an integral part of the work of CYHC-practitioners. It is understood as particularly useful in cases of child abuse, which are inherently complex, as signs and evidence of abuse are often hidden, subtle and unique in each case. CYHC-practitioners use intuition to manage and navigate this complexity. There is an opportunity for guidelines to support reflection and intuition as a ‘good care’ practice.

scholarly journals Navigating complexity through intuition and evidence-based guidelines: a mix-methods study among child and youth healthcare practitioners

2019 ◽  
Author(s):  
Jetske Charlotte Erisman ◽  
Kevin de Sabbata ◽  
Teun Zuiderent-Jerak ◽  
Elena V Syurina
Keyword(s):  
Child Abuse ◽  
Well Being ◽  
Evidence Based ◽  
Structured Interviews ◽  
Daily Work ◽  
Tunnel Vision ◽  
Dutch Child ◽  
Secondary Information ◽  
Evidence Based Guidelines ◽  
Based Medicine

Abstract Background Dutch child and youth health care (CYHC) practitioners monitor and assess the well-being of all children. One of their main concerns is identifying cases of child abuse, which is an arduous and sensitive task. They use both evidence-based guidelines aimed at increasing the quality of care through rationalised decision-making and intuition. These two practices are seen as being at odds with each other, yet empirical research has shown that both are needed in healthcare. This study aims to understand how Dutch CYHC-practitioners perceive the role of intuition in their work and in relation to evidence-based medicine, in the case of child abuse.Methods A sequential exploratory mixed-methods design. In-depth semi-structured interviews with CYHC-practitioners focused on perceptions on intuition, which was followed by a survey amongst CYHC-professionals on the recognition and use of the concept.Results The majority of CYHC-practitioners and professionals recognise and use intuition in their daily work, stating that it is necessary in their profession. CYHC-practitioners use intuition: 1) to sense that something is off, 2) to differentiate between ‘normal’ and ‘abnormal’, 3) to assess risks, 4) to weigh secondary information and 5) to communicate with parents. At the same time, they warn for its dangers as it may lead to tunnel vision and false accusations. Their ways of working with intuition show parallels to the practices that evidence-based guidelines try to support.Conclusion Intuition is experienced as an integral part of the work of CYHC-practitioners. It is stated to be particularly useful in the case of child abuse, which is inherently complex as signs and evidence of abuse are hidden, subtle and unique in each case. CYHC-practitioners use intuition to manage and navigate this complexity. As there is a lack of guidance on how to practice intuition, there is a need for support through guidelines.

scholarly journals Navigating complexity through intuition and evidence-based guidelines: a mix-methods study among child and youth healthcare practitioners

2020 ◽  
Author(s):  
Jetske Charlotte Erisman ◽  
Kevin de Sabbata ◽  
Teun Zuiderent-Jerak ◽  
Elena V Syurina
Keyword(s):  
Child Abuse ◽  
Well Being ◽  
Evidence Based ◽  
Structured Interviews ◽  
Daily Work ◽  
Tunnel Vision ◽  
Dutch Child ◽  
Secondary Information ◽  
Evidence Based Guidelines ◽  
Based Medicine

Abstract Background Dutch child and youth health care (CYHC) practitioners monitor and assess the well-being of all children. One of their main concerns is identifying cases of child abuse, which is an arduous and sensitive task. They use both evidence-based guidelines aimed at increasing the quality of care through rationalised decision-making, and intuition. These two practices are seen as being at odds with each other, yet empirical research has shown that both are needed in healthcare. This study aims to understand how Dutch CYHC-practitioners perceive the role of intuition in their work and in relation to evidence-based medicine, in the case of child abuse. Methods A sequential exploratory mixed-methods design: in-depth semi-structured interviews with CYHC-practitioners focused on perceptions on intuition, which were followed by a survey amongst CYHC-professionals on the recognition and use of the concept. Results The majority of CYHC-practitioners and professionals recognise and use intuition in their daily work, stating that it is necessary in their profession. CYHC-practitioners use intuition: 1) to sense that something is off, 2) to differentiate between ‘normal’ and ‘abnormal’, 3) to assess risks, 4) to weigh secondary information and 5) to communicate with parents. At the same time, they warn for its dangers as it may lead to tunnel vision and false accusations. Their ways of working with intuition show parallels to the practices that evidence-based guidelines try to support. Conclusion Intuition is experienced as an integral part of the work of CYHC-practitioners. It is stated to be particularly useful in the case of child abuse, which is inherently complex as signs and evidence of abuse are hidden, subtle and unique in each case. CYHC-practitioners use intuition to manage and navigate this complexity. As there is a lack of guidance on how to practice intuition, there is a need for support through guidelines.

scholarly journals Navigating complexity through intuition and evidence-based guidelines: a mix-methods study among child and youth healthcare practitioners

2019 ◽  
Author(s):  
Jetske Charlotte Erisman ◽  
Kevin de Sabbata ◽  
Teun Zuiderent-Jerak ◽  
Elena V Syurina
Keyword(s):  
Child Abuse ◽  
Well Being ◽  
Evidence Based ◽  
Structured Interviews ◽  
Daily Work ◽  
Tunnel Vision ◽  
Dutch Child ◽  
Secondary Information ◽  
Evidence Based Guidelines ◽  
Based Medicine

Abstract Background: Dutch child and youth health care (CYHC) practitioners monitor and assess the well-being of all children. One of their main concerns is identifying cases of child abuse, which is an arduous and sensitive task. They use both evidence-based guidelines aimed at increasing the quality of care through rationalised decision-making and intuition. These two practices are seen as being at odds with each other, yet empirical research has shown that both are needed in healthcare. This study aims to understand how Dutch CYHC-practitioners perceive the role of intuition in their work and in relation to evidence-based medicine, in the case of child abuse.Methods: A sequential exploratory mixed-methods design. In-depth semi-structured interviews with CYHC-practitioners focused on perceptions on intuition, which was followed by a survey amongst CYHC-professionals on the recognition and use of the concept.Results: The majority of CYHC-practitioners and professionals recognise and use intuition in their daily work, stating that it is necessary in their profession. CYHC-practitioners use intuition: 1) to sense that something is off, 2) to differentiate between ‘normal’ and ‘abnormal’, 3) to assess risks, 4) to weigh secondary information and 5) to communicate with parents. At the same time, they warn for its dangers as it may lead to tunnel vision and false accusations. Their ways of working with intuition show parallels to the practices that evidence-based guidelines try to support.Conclusion: Intuition is experienced as an integral part of the work of CYHC-practitioners. It is stated to be particularly useful in the case of child abuse, which is inherently complex as signs and evidence of abuse are hidden, subtle and unique in each case. CYHC-practitioners use intuition to manage and navigate this complexity. As there is a lack of guidance on how to practice intuition, there is a need for support through guidelines.

scholarly journals Implementation—The Missing Link in the Research Translation Pipeline: Is It Any Wonder No One Ever Implements Evidence-Based Practice?

2018 ◽  
Vol 32 (9) ◽  
pp. 751-761 ◽  
Author(s):  
Elizabeth A. Lynch ◽  
Brigit M. Chesworth ◽  
Louise A. Connell
Keyword(s):  
Clinical Practice ◽  
Stroke Rehabilitation ◽  
Evaluation Research ◽  
Well Being ◽  
Professional Associations ◽  
Evidence Base ◽  
Care Practice ◽  
Research Translation ◽  
Evidence Based ◽  
Rehabilitation Research

Despite the exponential growth in the evidence base for stroke rehabilitation, there is still a paucity of knowledge about how to consistently and sustainably deliver evidence-based stroke rehabilitation therapies in clinical practice. This means that people with stroke will not consistently benefit from research breakthroughs, simply because clinicians do not always have the skills, authority, knowledge or resources to be able to translate the findings from a research trial and apply these in clinical practice. This “point of view” article by an interdisciplinary, international team illustrates the lack of available evidence to guide the translation of evidence to practice in rehabilitation, by presenting a comprehensive and systematic content analysis of articles that were published in 2016 in leading clinical stroke rehabilitation journals commonly read by clinicians. Our review confirms that only a small fraction (2.5%) of published stroke rehabilitation research in these journals evaluate the implementation of evidence-based interventions into health care practice. We argue that in order for stroke rehabilitation research to contribute to enhanced health and well-being of people with stroke, journals, funders, policy makers, researchers, clinicians, and professional associations alike need to actively support and promote (through funding, conducting, or disseminating) implementation and evaluation research.

scholarly journals I Don’t Want to See It End: A Faith Community Nurse Intervention for Older Adults and Caregivers

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 151-151
Author(s):  
Loralee Sessanna ◽  
Sherry Pomeroy ◽  
Yvonne Askew
Keyword(s):  
Adult Population ◽  
Health Assessment ◽  
Well Being ◽  
Population Based ◽  
Faith Community ◽  
Care Practice ◽  
Community Nurse ◽  
Structured Interviews ◽  
Older Adult Population ◽  
The Impact

Abstract The Faith Community Nurse (FCN) provides population-based and other nonclinical services in community settings that are not commonly available to the older adult population. The purpose of the FCN Connections (FCNC) study was to test the impact of the FCNC intervention on the health and well-being of clients (C) age 60 and older with chronic diseases and caregiver (CG) dyads (CCGD) by embedding a FCN in a primary care practice (PCP). A mixed method design was used with two cohorts over 18 months (N = 13 CCGD). Experienced FCNs led the components of the intervention in the CCGD home, including client health assessment, education and support while identifying their caregiver’s perceived needs, providing education and spiritual/emotional support, linking to resources, and connecting the CCGD with the PCP. The CCGD completed measurements at baseline, 6 and 12 weeks. CG knowledge, preparedness, self-efficacy with caregiving activities, and spirituality were measured with statistically significant CG improvement for handling emergencies, making caregiving activities pleasant, and taking care of emotional needs of the client. Spirituality, self-esteem, function, depression, and healthy living domains were measured for clients. At 12 weeks, semi-structured interviews with the CCGD were conducted and transcribed. An experiential/phenomenological framework and Reflexive Thematic Analysis were used to analyze data which generated one overarching theme, ‘I don’t want to see it [study] end’ and key themes, Theme 1 [client]: ‘She was always there to help’ and Theme 2 [caregiver]: ‘It’s like you took the pressure off me for a while’ describing the CCGD’s FCNC experience.

scholarly journals Towards a new model for producing evidence-based guidelines: a qualitative study of current approaches and opportunities for innovation among Australian guideline developers

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 956
Author(s):  
Steve McDonald ◽  
Julian H. Elliott ◽  
Sally Green ◽  
Tari Turner
Keyword(s):  
Systematic Reviews ◽  
New Technologies ◽  
Research Output ◽  
Guideline Development ◽  
Evidence Based ◽  
Structured Interviews ◽  
Australian Guideline ◽  
Horizon Scanning ◽  
New Guidelines ◽  
Evidence Based Guidelines

Background: Many organisations in Australia undertake systematic reviews to inform development of evidence-based guidelines or would like to do so. However, the substantial resources required to produce systematic reviews limit the feasibility of evidence-based approaches to guideline development. We are working with Australian guideline developers to design, build and test systems that make creating evidence-based guidelines easier and more efficient. Methods: To understand the evidence needs of guideline developers and to inform the development of potential tools and services, we conducted 16 semi-structured interviews with Australian guideline developers. Developers were involved in different types of guidelines, represented both new and established guideline groups, and had access to widely different levels of resources. Results: All guideline developers recognised the importance of having access to timely evidence to support their processes, but were frequently overwhelmed by the scale of this task. Groups developing new guidelines often underestimated the time, expertise and work involved in completing searching and screening. Many were grappling with the challenge of updating and were keen to explore alternatives to the blanket updating of the full guideline. Horizon-scanning and evidence signalling were seen as providing more pragmatic approaches to updating, although some were wary of challenges posed by receiving evidence on a too-frequent basis. Respondents were aware that new technologies, such as machine learning, offered potentially large time and resource savings. Conclusions: As well as the constant challenge of managing financial constraints, Australian guideline developers seeking to develop clinical guidelines face several critical challenges. These include acquiring appropriate methodological expertise, investing in information technology, coping with the proliferation of research output, feasible publication and dissemination options, and keeping guidance up to date.

scholarly journals Characteristics of sleep-conducive music: A narrative evidence review

2020 ◽  
Vol 7 (3) ◽  
pp. 430-437
Author(s):  
Yuluan Wang ◽  
Annette Rivard ◽  
Christine Guptill ◽  
Carol Boliek ◽  
Cary Brown
Keyword(s):  
Sleep Disturbances ◽  
Meta Analysis ◽  
Sleep Onset ◽  
Well Being ◽  
Future Research ◽  
Evidence Based ◽  
Negative Consequences ◽  
Evidence Review ◽  
Evidence Based Guidelines ◽  
The Impact

Objectives: Sleep deficiency (SD) is a prevalent problem and has serious negative consequences for physical, cognitive, and psychological well-being. The use of music as a non-pharmacological sleep intervention has been proposed in several studies. A 2014 meta-analysis of 10 randomized trials evaluating the impact of music on sleep concluded that it can decrease sleep onset delay (latency) and sleep disturbances, increases sleep duration, and improves daytime dysfunction.  It appears that, to-date, evidence-based guidelines for the selection and/or production of sleep-promoting music do not exist.  This review addresses that gap and synthesizes available literature towards the goal of developing guidelines grounded in the evidence-based characteristics of sleep conducive music. Design and Results: A narrative review of research papers relevant to the topic identified evidence-based characteristics of sleep-conducive music related to tempo, rhythm, pitch, volume, and duration. Conclusion: This identification and compilation of evidence-based characteristics of sleep-conducive music can underpin future research that targets development and testing of specific music to promote sleep.  

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