Title: Barriers and facilitators experienced by osteopaths in implementing a biopsychosocial (BPS) framework of care when managing people with musculoskeletal pain – A mixed methods systematic review

2021 ◽  
Author(s):  
Kesava Kovanur Sampath¹ ◽  
Ben Darlow² ◽  
Steve Tumilty³ ◽  
Warwick Shillito ◽  
Melissa Hanses ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Mixed Methods ◽  
Critical Appraisal ◽  
Current Practice ◽  
Barriers And Facilitators ◽  
Biomedical Model ◽  
Model Of Care ◽  
Review Finding ◽  
Critical Appraisal Skills ◽  
Appraisal Tool

Abstract Background: Clinical practice guidelines commonly recommend adopting a biopsychosocial (BPS) framework by practitioners managing musculoskeletal (MSK) pain. However, it remains unclear how osteopaths implement a BPS framework in the management of MSK pain. Hence, the objective of this review was to systematically appraise the literature on the current practices, barriers and facilitators experienced by osteopaths in implementing a BPS framework of care when managing people with MSK pain.Methods: The following electronic databases from January 2005 to August 2020 were searched: PubMed, CINAHL, Science Direct, Google Scholar, ProQuest Central and SCOPUS. Two independent reviewers reviewed the articles retrieved from the databases to assess for eligibility. Any studies (quantitative, qualitative and mixed methods) that investigated the use or application of the BPS approach in osteopathic practice were included in the review. The critical appraisal skills program (CASP) checklist was used to appraise the qualitative studies and the Mixed Methods Appraisal Tool (MMAT) was used to appraise quantitative or mixed methods studies. Advanced convergent meta-integration was used to synthesise data from quantitative, qualitative and mixed methods studies.Results: a total of 6 articles (two quantitative, three qualitative and one mixed methods) were included in the final review. While two key concepts (current practice and embracing a BPS approach) were generated using advanced meta-integration synthesis, two concepts (barriers and enablers) were informed from qualitative only data.Discussion: Our review finding showed that current osteopathic practice occurs within in the biomedical model of care. Although, osteopaths are aware of the theoretical underpinnings of the BPS model and identified the need to embrace the BPS model, various barriers exist that stop osteopaths BPS model use in osteopathic clinical practice. Ongoing education and/or workshops may be necessary to enable osteopaths to implement a BPS approach.

scholarly journals Barriers and facilitators experienced by osteopaths in implementing a biopsychosocial (BPS) framework of care when managing people with musculoskeletal pain – a mixed methods systematic review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kesava Kovanur Sampath ◽  
Ben Darlow ◽  
Steve Tumilty ◽  
Warwick Shillito ◽  
Melissa Hanses ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Mixed Methods ◽  
Musculoskeletal Pain ◽  
Critical Appraisal ◽  
Current Practice ◽  
Barriers And Facilitators ◽  
Model Of Care ◽  
Review Finding ◽  
Critical Appraisal Skills ◽  
Appraisal Tool

Abstract Background Clinical practice guidelines commonly recommend adopting a biopsychosocial (BPS) framework by practitioners managing musculoskeletal pain. However, it remains unclear how osteopaths implement a BPS framework in the management of musculoskeletal pain. Hence, the objective of this review was to systematically appraise the literature on the current practices, barriers and facilitators experienced by osteopaths in implementing a BPS framework of care when managing people with musculoskeletal pain. Methods The following electronic databases from January 2005 to August 2020 were searched: PubMed, CINAHL, Science Direct, Google Scholar, ProQuest Central and SCOPUS. Two independent reviewers reviewed the articles retrieved from the databases to assess for eligibility. Any studies (quantitative, qualitative and mixed methods) that investigated the use or application of the BPS approach in osteopathic practice were included in the review. The critical appraisal skills program (CASP) checklist was used to appraise the qualitative studies and the Mixed Methods Appraisal Tool (MMAT) was used to appraise quantitative or mixed methods studies. Advanced convergent meta-integration was used to synthesise data from quantitative, qualitative and mixed methods studies. Results A total of 6 studies (two quantitative, three qualitative and one mixed methods) were included in the final review. While two key concepts (current practice and embracing a BPS approach) were generated using advanced meta-integration synthesis, two concepts (barriers and enablers) were informed from qualitative only data. Discussion Our review finding showed that current osteopathic practice occurs within in the biomedical model of care. Although, osteopaths are aware of the theoretical underpinnings of the BPS model and identified the need to embrace it, various barriers exist that may prevent osteopaths from implementing the BPS model in clinical practice. Ongoing education and/or workshops may be necessary to enable osteopaths to implement a BPS approach.

scholarly journals A critical synthesis of interventions to reduce stigma attached to mental illness

2014 ◽  
Vol 19 (1) ◽  
Author(s):  
Kenetsoe B. Seroalo ◽  
Emmerentia Du Plessis ◽  
Magdalena P. Koen ◽  
Vicki Koen
Keyword(s):  
Mental Illness ◽  
Critical Appraisal ◽  
Research Evidence ◽  
Research Question ◽  
Practice Research ◽  
Evidence Based ◽  
Evidence Analysis ◽  
Critical Appraisal Skills ◽  
Nutrition And Dietetics ◽  
Appraisal Tool

Background: Interventions have been developed and implemented to reduce the stigma attached to mental illness. However, mental healthcare users are still stigmatised.Objective: The objective of this study was to critically synthesise the best available evidence regarding interventions to reduce stigma attached to mental illness.Method: An exploratory and descriptive research design was followed to identify primary studies; systematic review identifid primary studies answering this research question: What best evidence is available regarding interventions to reduce the stigma attached to mental illness? A search was done on selected electronic databases. Seventeen studies (n = 17) were identifid as providing evidence that answered the research question. The following instruments were used: Critical Appraisal Skills Programme, John Hopkins Nursing Evidence-Based Practice research evidence appraisal tool and the Academy of Nutrition and Dietetics Evidence Analysis Manual. The study was submitted to the Post-graduate Education and Research Committee of the School of Nursing Science at Potchefstroom Campus of North-West University for approval.Results: Results indicated some interventions that reduce the stigma attached to mental illness, such as web-based approaches, printed educational materials, documentary and antistigma fims, as well as live and video performances.Conclusions: Humanising interventions seems to have a positive effect on reducing stigma attached to mental illness. From the results and conclusions recommendations were formulated for nursing practice, nursing education and research.Agtergrond: Ingrypings is ontwikkel en geïmplementeer om die stigma verbonde aan geestesongesteldhede te verminder. Die persone wat aan geestesongesteldhede ly, ondervind egter steeds dat daar 'n stigma aan hulle kleef.Doelstellings: Die doel van die studie was om die beste beskikbare voorbeelde van intervensies om stigmatisering van geestesongesteldhede te verminder, krities saam te vat.Metode: ’n Verkennende en beskrywende navorsingsontwerp is gevolg om primêre studies te identifieer. ’n Sistematiese oorsig is gekies as metode om primêre studies te identifieer om die volgende navorsingsvraag te beantwoord: Wat is die beste beskikbare voorbeelde vaningrypings om die stigma verbonde aan geestesongesteldhede te verminder? ’n Ondersoek is gedoen op ’n uitgesoekte elektroniese databasis.Resultate: Tydens die keuring van studies is 17 studies geïdentifieer (n = 17) as bewyslewering en wat die navorsingsvraag beantwoord. Die volgende instrumente is gebruik: ‘Critical Appraisal Skills Programme’, ‘John Hopkins Nursing Evidence-Based Practice’, ‘Research Evidence Appraisal Tool and Evidence Analysis Manual’, en ‘Academy of Nutrition and Dietetics’.Gevolgtrekking: Die studie is aan die Nagraadse Onderrig- en Navorsingskomitee van die Skool van Verpleegkunde van die Potchefstroomkampus, Noordwes-Universiteit, voorgelê vir goedkeuring. Aanbevelings is geformuleer vir die verpleegpraktyk, verpleegonderrig ennavorsing.

Research in anaesthesia

2017 ◽  
Author(s):  
Gary Minto ◽  
J. Robert Sneyd
Keyword(s):  
Clinical Practice ◽  
Clinical Research ◽  
Basic Science ◽  
Critical Appraisal ◽  
Perioperative Medicine ◽  
Limited Information ◽  
Priority Areas ◽  
Number Of Patients ◽  
Critical Appraisal Skills

Clinicians need critical appraisal skills to weigh up the quality of the literature and to decide whether it has implications for their practice. Every belief in medicine is a construct created from the limited information available and carries a degree of uncertainty. A centralized approach to research identifies the highest priority areas of uncertainty so as to bring about the most improvement for the largest number of patients. This patient-centred model classifies studies into basic science, translational, and clinical research. Adequately powered mega-trials are required to bridge the translational gap between efficacy (does a treatment work?) and effectiveness (does a treatment work when applied in ordinary clinical practice?). There is a paucity of these in perioperative medicine.

scholarly journals Clinicians’ attitudes to oncology clinical practice guidelines and the barriers and facilitators to adherence: a mixed methods study protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. e035448 ◽  
Author(s):  
Mia Bierbaum ◽  
Jeffrey Braithwaite ◽  
Gaston Arnolda ◽  
Geoffrey P Delaney ◽  
Winston Liauw ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Mixed Methods ◽  
Cancer Treatment ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Clinical Sample ◽  
Phase 1 ◽  
Implementation Strategies ◽  
Mixed Methods Study ◽  
Barriers And Facilitators

IntroductionClinical practice guidelines (CPGs) are designed to reduce inappropriate clinical variation and improve the quality of care. Barriers to CPGs include a lack of awareness of CPGs, access to them, time pressures and concerns regarding the evidence underpinning CPG development, implementation and dissemination. The objectives of this study are to assess clinicians’ attitudes to CPGs for cancer treatment and the perceived barriers to and facilitators of CPG adherence in order to inform the implementation of cancer treatment CPGs.Methods and analysisA mixed methods study will be conducted using a three-phase, sequential design, with each phase informing the next. In phase 1, a qualitative study using recorded interviews will investigate clinicians’ attitudes to CPGs for cancer treatment and perceptions of barriers and facilitators to CPG adherence (n=30); interview transcripts will be analysed thematically. In phase 2, a survey will quantify the frequency of attitudes, barriers and facilitators identified in phase 1, in a broader clinical sample (n=200). In phase 3, a workshop forum will be held to facilitate discussions examining the implications of phase 1 and 2 findings for cancer CPG implementation strategies (n=40) leading to recommendations for improvements to practice. The workshop discussion will be recorded, and the transcript will be analysed thematically.Ethics and disseminationThis study has received ethics approval in New South Wales, Australia (2019/ETH11722, #52019568810127). Study findings will be published in peer-reviewed journals and will form part of a doctoral thesis and be presented at national and international conferences.

scholarly journals Potencial teórico, social y metodológico en los trabajos finales de graduación de la maestría de Enfermería Ginecológica, Obstétrica y Perinatal

2015 ◽  
Author(s):  
Ligia Rojas Valenciano ◽  
Laura López Quirós ◽  
Ana Ibis Campos González
Keyword(s):  
Clinical Practice ◽  
Critical Appraisal ◽  
Evidence Based ◽  
Critical Appraisal Skills

Introducción. El objetivo de este artículo es presentar los resultados del proyecto de investigación No. 421-B2-A19  en cuanto al potencial teórico, social y metodológico en los trabajos finales de graduación realizados en la maestría de Enfermería Ginecológica, Obstétrica y Perinatal. El componente de investigación en un área del quehacer de la Enfermería, cuya meta es preparar a los profesionales en enfermería clínica  acerca de utilizar diligentemente la investigación. Método. Se aplicó la investigación documental como una variante de la investigación científica cuyo objetivo fundamental es el análisis de diferentes fenómenos utilizando técnicas muy precisas de la documentación existente que, directa o indirectamente, aporte la información. Se incluyó 37 trabajos de investigación aplicada, 22 sustentados en el enfoque cualitativo y 15 en el cuantitativo, desde el año 2003 al 2011. A cada trabajo se le aplicó un análisis crítico utilizando una matriz construida a partir de elementos recomendados por CASpe para valorar documentos científicos cuantitativos (Critical Appraisal Skills Programme Español). Para el análisis crítico de los trabajos finales de investigación de corte cualitativo también se construyó una matriz que incluye aspectos del CAT (Critically Appraised Topic): EBCP (Evidence-Based Clinical Practice).Resultado. Los trabajos finales de graduación no demostraron ser significativos en el cambio o mejoramiento de la práctica profesional en términos de mejorar la calidad de atención a las personas. Solo han sido relevantes para que se gradúe un grupo grande de estudiantes. Existe poca claridad –en general- de los aspectos metodológicos de los enfoques investigativos cualitativo y cuantitativo.Conclusión. La investigación en la maestría Ginecológica, Obstétrica y Perinatal no  aporta un conocimiento enfermero sustantivo, lo cual provoca poco desarrollo disciplinar. Los trabajos finales de graduación aparentan ser solo requisito de graduación, por tanto, no contribuyen al mejoramiento de las prácticas ginecológicas, obstétricas y perinatales.

VP26 A Critical Appraisal Tool For Systematic Mixed Studies Reviews

2018 ◽  
Vol 34 (S1) ◽  
pp. 166-166 ◽  
Author(s):  
Quan Nha Hong ◽  
Pierre Pluye ◽  
Sergi Fàbregues ◽  
Gillian Bartlett ◽  
Felicity Boardman ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Delphi Study ◽  
Critical Appraisal ◽  
Included Study ◽  
The Core ◽  
Critical Appraisal Tool ◽  
Study Designs ◽  
Clinical Problems ◽  
Appraisal Tool

Introduction:Systematic mixed studies reviews are a type of systematic review that combine qualitative, quantitative and mixed methods studies. They are gaining in popularity due to their potential for providing in-depth answers to complex clinical problems and practical concerns. However, several challenges are encountered in systematic mixed studies reviews because of the heterogeneity of included study designs. One of these challenges is related to the quality appraisal of included studies. To address this challenge, a critical appraisal tool for assessing the quality of quantitative, qualitative and mixed methods studies was developed in 2007: the Mixed Methods Appraisal Tool (MMAT). The aim of this project was to strengthen the content validity of the MMAT.Methods:A new version of the MMAT was developed using the results from a literature review on critical appraisal tools and a modified e-Delphi study with methodological experts (n = 73) to identify the core relevant criteria to include in the MMAT.Results:The results of this project and the new version of the MMAT will be presented. The MMAT has three main characteristics. First, it can be used for different study designs since it includes criteria for qualitative, quantitative and mixed methods studies. Second, the MMAT focuses on the core relevant methodological criteria and has five criteria per category of study. Third, it includes specific criteria for assessing mixed methods studies.Conclusions:Currently, there exists over 500 critical appraisal tools, making the task of selecting the proper tools for use in systematic mixed studies reviews more difficult. The MMAT offers an alternative solution by proposing a unique tool that can appraise the quality of different study designs. Also, by limiting to core criteria, the MMAT can provide a more time efficient assessment.

scholarly journals How to read an ethics paper

2018 ◽  
Vol 44 (12) ◽  
pp. 810-813 ◽  
Author(s):  
Melanie Jansen ◽  
Peter Ellerton
Keyword(s):  
Clinical Practice ◽  
Medical Ethics ◽  
Critical Appraisal ◽  
Critical Reasoning ◽  
Ethical Decisions ◽  
Journal Clubs ◽  
Scientific Papers ◽  
Critical Appraisal Skills ◽  
Based Medicine ◽  
Work Done

In recent decades, evidence-based medicine has become one of the foundations of clinical practice, making it necessary that healthcare practitioners develop keen critical appraisal skills for scientific papers. Worksheets to guide clinicians through this critical appraisal are often used in journal clubs, a key part of continuing medical education. A similar need is arising for health professionals to develop skills in the critical appraisal of medical ethics papers. Medicine is increasingly ethically complex, and there is a growing medical ethics literature that modern practitioners need to be able to use in their practice. In addition, clinical ethics services are commonplace in healthcare institutions, and the lion’s share of the work done by these services is done by clinicians in addition to their usual roles. Education to support this work is important. In this paper, we present a worksheet designed to help busy healthcare practitioners critically appraise ethics papers relevant to clinical practice. In the first section, we explain what is different about ethics papers. We then describe how to work through the steps in our critical appraisal worksheet: identifying the point at issue; scrutinising definitions; dissecting the arguments presented; considering counterarguments; and finally deciding on relevance. Working through this reflective worksheet will help healthcare practitioners to use the ethics literature effectively in clinical practice. We also intend it to be a shared evaluative tool that can form the basis of professional discussion such as at ethics journal clubs. Practising these critical reasoning skills will also increase practitioners’ capacity to think through difficult ethical decisions in daily clinical practice.

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