Implementation Strategies to Support Evidence-Informed Symptom Management Among Outpatient Oncology Nurses: A Scoping Review Protocol

Author(s):  
Kylie Teggart ◽  
Denise Bryant-Lukosius ◽  
Sarah E. Neil-Sztramko ◽  
Rebecca Ganann

Abstract Introduction: Despite the availability of clinical practice guidelines for cancer symptom management, cancer care providers do not consistently utilize them in practice. Oncology nurses in outpatient settings are well-positioned to use established guidelines to inform symptom assessment and management; however, issues concerning inconsistent implementation persist. This scoping review aims to identify and describe the components of implementation strategies that have been used to enhance the adoption, implementation, and sustainability of symptom management guidelines among specialized and advanced oncology nurses in cancer-specific outpatient settings. Factors influencing guideline implementation will also be identified. Methods and analysis: This scoping review will follow Joanna Briggs Institute methodology. Electronic databases CINAHL, Embase, Emcare, MEDLINE(R), and grey literature sources will be searched for studies published in English since the year 2000. Primary studies and grey literature reports of any design that include specialized or advanced oncology nurses practicing in cancer-specific outpatient settings will be eligible. Sources describing implementation strategies to enhance the adoption, implementation, and sustainability of cancer symptom management guidelines and/or factors influencing implementation will be included. Two reviewers will independently screen for eligibility and extract data. Data extraction will be guided by the Consolidated Framework for Implementation Research (CFIR). Data will be analyzed descriptively and synthesized according to CFIR constructs. Results will be presented through tabular/diagrammatic formats and narrative summary. Ethics and dissemination: Ethics approval is not required for this scoping review. Planned knowledge translation activities include a national conference presentation, peer-reviewed publication, academic social media channels, and dissemination within local oncology nursing and patient networks.

2019 ◽  
Vol 10 (1) ◽  
pp. 91-104 ◽  
Author(s):  
Colleen Pawliuk ◽  
Kim Widger ◽  
Tammie Dewan ◽  
Gina Brander ◽  
Helen L Brown ◽  
...  

BackgroundQ3 conditions are progressive, metabolic, neurological or chromosomal childhood conditions without a cure. Children with these conditions face an unknown lifespan as well as unstable and uncomfortable symptoms. Clinicians and other healthcare professionals are challenged by a lack of evidence for symptom management for these conditions.AimsIn this scoping review, we systematically identified and mapped the existing literature on symptom management for children with Q3 conditions. We focused on the most common and distressing symptoms, namely alertness, behavioural problems, bowel incontinence, breathing difficulties, constipation, feeding difficulties, sleep disturbance, temperature regulation, tone and motor problems and urinary incontinence. For children with complex health conditions, good symptom management is pertinent to ensure the highest possible quality of life.MethodsScoping review. Electronic database searches in Ovid MEDLINE, Embase and CINAHL and a comprehensive grey literature search.ResultsWe included 292 studies in our final synthesis. The most commonly reported conditions in the studies were Rett syndrome (n=69), followed by Cornelia de Lange syndrome (n=25) and tuberous sclerosis (n=16). Tone and motor problems were the most commonly investigated symptom (n=141), followed by behavioural problems (n=82) and sleep disturbance (n=62).ConclusionThe evidence for symptom management in Q3 conditions is concentrated around a few conditions, and these studies may not be applicable to other conditions. The evidence is dispersed in the literature and difficult to access, which further challenges healthcare providers. More research needs to be done in these conditions to provide high-quality evidence for the care of these children.


2019 ◽  
Vol 20 (4) ◽  
pp. 162-178
Author(s):  
Aoife Mahon ◽  
Elizabeth Tilley ◽  
Gurch Randhawa ◽  
Yannis Pappas ◽  
Jitka Vseteckova

Purpose Individuals with intellectual disability(ies) are living longer contributing to an overall increase in the average age of caregivers. The purpose of this paper is to review the literature on the physical, social and psychological needs of ageing carers of individuals with intellectual disability(ies) in the UK. Design/methodology/approach A scoping review framework was used to identify literature from eleven databases, the grey literature and the references lists of relevant studies. Only primary research studies that discussed the needs of non-professional carers, aged 65+ years old, of individuals with intellectual disability(ies) in the UK were included. No date restrictions were applied. Thematic analysis was used to narratively synthesise findings. Findings Six studies were included. Five key themes were identified: Living with fear, lack of information, rebuilding trust, proactive professional involvement and being ignored. Housing and support information is not communicated well to carers. Professionals require more training on carer needs and trust must be rebuilt between carers and professionals. Proactive approaches would help identify carer needs, reduce marginalisation, help carers feel heard and reduce the risk of care crisis. Greater recognition of mutual caring relationships is needed. Originality/value This review highlighted the needs of older caregivers for individuals with intellectual disability(ies) as well as the need for more high-quality research in this field. The information presented in this review may be considered by primary care providers and funding bodies when planning future support for this growing population of carers.


2020 ◽  
Author(s):  
Jef Vanhamel ◽  
Anke Rotsaert ◽  
Thijs Reyniers ◽  
Christiana Nöstlinger ◽  
Marie Laga ◽  
...  

Abstract Background: Strengthening HIV combination prevention is imperative given the continued high HIV incidence worldwide. The introduction of oral PrEP as a new biomedical HIV prevention tool can be a potential gamechanger because of its high clinical efficacy and the feasibility of making it available for different key populations.Experiences with different PrEP delivery models in a variety of settings and HIV epidemics will inform howits uptake and usage can be maximised.Methods: We conducted a scoping review using the five-step framework for conducting scoping studies provided by Arksey and O’Malley. We systematically searched the existing peer-reviewed international and grey literature describing four components of a PrEP service delivery model in real-world: the target population of PrEP services, the setting where PrEP was delivered, PrEP providers’ professionalisation and PrEP delivery channels. We restricted our search to English language articles. No geographical or time restrictions were set.Results: Following exclusion of ineligible records and removal of duplicates, 33 articles were retained for charting and analysing of the results. The target population of PrEP services was often described in terms of PrEP eligibility without targeting specific subgroups. If a specific target group was mentioned, PrEP was mainly offered to men who have sex with men (MSM). PrEP was often delivered centralisedin specialist clinics providing HIV, sexual health or STI care. Yet examples of de-centralised and community-based PrEP delivery have been reported. Health care providers delivering PrEP were mainly medical professionals, with task-shifting to non-traditional health professionals and lay providers identified in a minority of the studies. PrEP was mainly delivered through classic in-person visits. More innovative options using mHealth and telemedicine approaches to deliver specific parts of PrEP services are currently being applied.Conclusions: Within our scope for PrEP service delivery models, a range of possibilities was found for all components of such models. This reflects differentiation of care according to different contextual settings. More research is needed on how integration of services in these contexts could respond to the needs of different profiles of PrEPuserswithin a combination prevention approach.


BMJ Open ◽  
2018 ◽  
Vol 8 (9) ◽  
pp. e022733 ◽  
Author(s):  
Mohamed A Osman ◽  
Kara Schick-Makaroff ◽  
Stephanie Thompson ◽  
Robin Featherstone ◽  
Liza Bialy ◽  
...  

IntroductionElectronic consultations (eConsult), asynchronous exchanges of patient health information at a distance, are increasingly used as an option to facilitate patient care and collaboration between primary care providers and specialists. Although eConsult has demonstrated success in increasing efficiency in the referral process and enhancing access to care, little is known about the factors influencing its wider adoption and implementation by end users. In this paper, we describe a protocol to conduct a scoping review of the literature on the barriers and facilitators to a wider adoption and implementation of eConsult service.Methods and analysisThis scoping review will be based on the framework pioneered by Arksey and O’Malley and later developed by Levacet al. We will use the guidance for scoping reviews developed by the Joanna Briggs Institute to report our findings. In addition to several electronic databases (Medline, Embase, Cochrane Library, CINAHL, EBSCOhost and PsycINFO) studies will be identified by including relevant grey literature. Two reviewers will independently screen titles and full texts for inclusion. Studies reporting on barriers and/or facilitators in settings similar to eConsult will be included. Data on study characteristics and key barriers and facilitators will be extracted. Data will be analysed thematically and classified using the Quadruple Aim framework.Ethics and disseminationApproval by research ethics board is not required since the review will only include published and publicly accessible data. Review findings will be used to inform future studies and the development of practice tools to support the wider adoption and success of eConsult implementation. We plan to publish our findings in a peer-reviewed journal and develop a useful and accessible summary of the results.


2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Choolwe Jacobs ◽  
Adnan A. Hyder

Abstract Background Skilled birth attendance (SBA) during delivery has been associated with improved maternal health outcome. However, low utilisation of SBA during childbirth has continued in many developing countries including Zambia. The proposed scoping review aims to map literature on beliefs and values and how mothers are influenced by relational normative motivations in utilisation of SBAs in health facilities. Methods We designed and registered a study protocol for a scoping review. Literature searches will be conducted in multiple electronic databases (from January 2000 onwards), including PubMed, EMBASE, Scopus and Web of Science. Grey literature will be identified through searching dissertation databases, Google Scholar, EBSCOhost and ResearchGate. Keyword searches will be used to identify articles. Only articles published in English, related on beliefs and values surrounding childbirth, and on perceptions towards facility delivery or skilled health care providers will be considered eligible for inclusion. Two reviewers will independently screen eligible titles, abstracts and full articles with a third reviewer to help resolve any disputes. The study methodological quality (or bias) will be appraised using the Mixed Method Appraisal Tool. A narrative summary of findings will be conducted. We will employ NVIVO version 10 software package to extract the relevant outcomes from the included articles using content thematic analysis. This protocol is registered with the Open Science Framework (osf.io/9gn76). Discussion Understanding how individual mother’s health seeking behaviours for SBA and those close to them are influenced by their beliefs and values is critical to informing health systems on the possible ‘hidden’ barriers and facilitators to utilisation of SBA in public health facilities. The review will complement evidence base on normative beliefs and values shaping care-seeking behaviours for skilled birth attendance by mothers in Africa.


2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Jane Parry ◽  
Meredith Vanstone ◽  
Michel Grignon ◽  
James R. Dunn

Abstract Background It is broadly accepted that poverty is associated with poor health, and the health impact of poverty has been explored in numerous high-income country settings. There is a large and growing body of evidence of the role that primary care practitioners can play in identifying poverty as a health determinant, and in interventions to address it. Purpose of study This study maps the published peer-reviewed and grey literature on primary care setting interventions to address poverty in high-income countries in order to identify key concepts and gaps in the research. This scoping review seeks to map the tools in use to identify and address patients’ economic needs; describe the key types of primary care-based interventions; and examine barriers and facilitators to successful implementation. Methods Using a scoping review methodology, we searched five databases, the grey literature and the reference lists of relevant studies to identify studies on interventions to address the economic needs-related social determinants of health that occur in primary health care delivery settings, in high-income countries. Findings were synthesized narratively, and examined using thematic analysis, according to iteratively identified themes. Results Two hundred and fourteen papers were included in the review and fell into two broad categories of description and evaluation: screening tools, and economic needs-specific interventions. Primary care-based interventions that aim to address patients’ financial needs operate at all levels, from passive sociodemographic data collection upon patient registration, through referral to external services, to direct intervention in addressing patients’ income needs. Conclusion Tools and processes to identify and address patients’ economic social needs range from those tailored to individual health practices, or addressing one specific dimension of need, to wide-ranging protocols. Primary care-based interventions to address income needs operate at all levels, from passive sociodemographic data collection, through referral to external services, to direct intervention. Measuring success has proven challenging. The decision to undertake this work requires courage on the part of health care providers because it can be difficult, time-consuming and complex. However, it is often appreciated by patients, even when the scope of action available to health care providers is quite narrow.


BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e031328
Author(s):  
Mary V Kinney ◽  
David Roger Walugembe ◽  
Phillip Wanduru ◽  
Peter Waiswa ◽  
Asha S George

IntroductionMaternal and perinatal death surveillance and response (MPDSR), or any related form of audit, is a systematic process used to prevent future maternal and perinatal deaths. While the existence of MPDSR policies is routinely measured, measurement and understanding of policy implementation has lagged behind. In this paper, we present a theory-based conceptual framework for understanding MPDSR implementation as well as a scoping review protocol to understand factors influencing MPDSR implementation in low/ middle-income countries (LMIC).Methods and analysisThe Consolidated Framework for Implementation Research will inform the development of a theory-based conceptual framework for MPDSR implementation. The methodology for the scoping review will be guided by an adapted Arksey and O’Malley approach. Documents will include published and grey literature sourced from electronic databases (PubMed, CINAHL, SCOPUS, Web of Science, JSTOR, LILACS), the WHO Library, Maternal Death Surveillance and Response Action Network, Google, the reference lists of key studies and key experts. Two reviewers will independently screen titles, abstracts and full studies for inclusion. All discrepancies will be resolved by an independent third party. We will include studies published in English from 2004 to July 2018 that present results on factors influencing implementation of MPDSR, or any related form. Qualitative content and thematic analysis will be applied to extracted data according to the theory-based conceptual framework. Stakeholders will be consulted at various stages of the process.Ethics and disseminationThe scoping review will synthesise implementation factors relating to MPDSR in LMIC as described in the literature. This review will contribute to the work of the Countdown to 2030 Drivers Group, which seeks to explore key contextual drivers for equitable and effective coverage of maternal and child health interventions. Ethics approval is not required. The results will be disseminated through various channels, including a peer-reviewed publication.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Makoto Kaneko ◽  
Ryuichi Ohta ◽  
Evelyn Vingilis ◽  
Maria Mathews ◽  
Thomas Robert Freeman

Abstract Background Rural-urban health care disparities are an important topic in health services research. Hence, developing valid and reliable tools to measure rurality is needed to support high quality research. However, Japan, has no index to measure rurality for health care research. In this study, we conducted a systematic scoping review to identify the important factors and methodological approaches to consider in a rurality index to inform the development of a rurality index for Japan. Methods For our review, we searched six bibliographic databases (MEDLINE, PubMed, CINAHIL, ERIC, Web of Science and the Grey Literature Report) and official websites of national governments such as Government and Legislative Libraries Online Publications Portal (GALLOP), from 1 January 1989 to 31 December 2018. We extracted relevant variables used in the development of rurality indices, the formulas used to calculate indices, and any measures for reliability and validity of these indices. Results We identified 17 rurality indices from 7 countries. These indices were primarily developed to assess access to health care or to determine eligibility for incentives for health care providers. Frequently used factors in these indices included population size/density and travel distance/time to emergency care or referral centre. Many indices did not report reliability or validity measures. Conclusions While the concept of rurality and concerns about barriers to access to care for rural residents is shared by many countries, the operationalization of rurality is highly context-specific, with few universal measures or approaches to constructing a rurality index. The results will be helpful in the development of a rurality index in Japan and in other countries.


2020 ◽  
Vol 20 (S4) ◽  
Author(s):  
Meike Schleiff ◽  
Adetoun Olateju ◽  
Ellie Decker ◽  
Abigail H. Neel ◽  
Rasheedat Oke ◽  
...  

Abstract Background Previous initiatives have aimed to document the history and legacy of the Smallpox Eradication Program (SEP) and the Global Polio Eradication Initiative (GPEI). In this multi-pronged scoping review, we explored the evolution and learning from SEP and GPEI implementation over time at global and country levels to inform other global health programs. Methods Three related reviews of literature were conducted; we searched for documents on 1) the SEP and 2) GPEI via online database searches and also conducted global and national-level grey literature searches for documents related to the GPEI in seven purposively selected countries under the Synthesis and Translation of Research and Innovations from Polio Eradication (STRIPE) project. We included documents relevant to GPEI implementation. We conducted full text data analysis and captured data on Expert Recommendations for Implementing Change (ERIC) implementation strategies and principles, tools, outcomes, target audiences, and relevance to global health knowledge areas. Results 200 articles were included in the SEP scoping review, 1885 articles in the GPEI scoping review, and 963 documents in the grey literature review. M&E and engagement strategies were consistently translated from the SEP to GPEI; these evolved into newer approaches under the GPEI. Management strategies including setting up robust record systems also carried forward from SEP to GPEI; however, lessons around the need for operational flexibility in applying these strategies at national and sub-national levels did not. Similarly, strategies and lessons around conducting health systems readiness assessments prior to implementation were not carried forward from SEP to GPEI. Differences in the planning and communication strategies between the two programs included fidelity to implementation blueprints appeared to be higher under SEP, and independent monitoring boards and communication and media strategies were more prominent under GPEI. Conclusions Linear learning did not always occur between SEP and GPEI; several lessons were lost and had to be re-learned. Implementation and adaptation of strategies in global health programs should be well codified, including information on the contextual, time and stakeholders’ issues that elicit adaptations. Such description can improve the systematic translation of knowledge, and gains in efficiency and effectiveness of future global health programs.


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