scholarly journals Elaborating Models of eHealth Governance: Qualitative Systematic Review (Preprint)

2019 ◽  
Author(s):  
Anne Granstrom Ekeland ◽  
Line Helen Linstad
Keyword(s):  
Systematic Review ◽  
Health Policy ◽  
Full Text ◽  
Large Scale ◽  
Unintended Consequences ◽  
Qualitative Studies ◽  
The Internet ◽  
Policy Goals ◽  
Qualitative Systematic Review ◽  
Pubmed Database

BACKGROUND Large-scale national eHealth policy programs have gained attention not only for benefits but also for several unintended consequences and failed expectations. Given the complex and mixed accounts of the results, questions have been raised on how large-scale digitalization programs are governed to reach health policy goals of quality improvement and equal access along with necessary digital transformations. In this qualitative systematic review, we investigate the following question: How is governance implemented and considered in the studies included in the qualitative review? OBJECTIVE The aim of this study is to arrive at informed and recognizable conceptualizations and considerations of models of governance connected to eHealth, as presented and discussed in the scientific literature. In turn, we hope our results will help inform the discussion of how to govern such processes to obtain collectively negotiated objectives. METHODS A qualitative systematic review is a method for integrating or comparing with the findings from qualitative studies. It looks for “themes” or “constructs” that lie in or across individual qualitative studies. This type of review produces a narrative synthesis with thematic analysis and includes interpretive conceptual models. The goal is an interpretation and broadens the understanding of a particular phenomenon. We searched the PubMed database using predefined search terms and selected papers published in 2010. We specified the criteria for selection and quality assessment. RESULTS The search returned 220 papers. We selected 44 abstracts for full-text reading, and 11 papers were included for full-text synthesis. On the basis of the 11 papers, we constructed four governance models to categorize and conceptualize the findings. The models are political governance, normally depicting top-down processes; medical governance, which normally depicts bottom-up processes; the internet and global model, emphasizing international business strategies coupled with the internet; self-governance, which builds upon the development of the internet and Internet of Things, which has paved the way for personal governance and communication of one’s own health data. CONCLUSIONS Collective negotiations between the nation-state and global policy actors, medical and self-governance actors, and global business and industry actors are essential. Technological affordances represent both positive and negative opportunities concerning the realization of health policy goals, and future studies should scrutinize this dynamic.

scholarly journals Elaborating Models of eHealth Governance: Qualitative Systematic Review

10.2196/17214 ◽  
2020 ◽  
Vol 22 (10) ◽  
pp. e17214
Author(s):  
Anne Granstrom Ekeland ◽  
Line Helen Linstad
Keyword(s):  
Systematic Review ◽  
Health Policy ◽  
Full Text ◽  
Large Scale ◽  
Unintended Consequences ◽  
Qualitative Studies ◽  
The Internet ◽  
Policy Goals ◽  
Qualitative Systematic Review ◽  
Pubmed Database

Background Large-scale national eHealth policy programs have gained attention not only for benefits but also for several unintended consequences and failed expectations. Given the complex and mixed accounts of the results, questions have been raised on how large-scale digitalization programs are governed to reach health policy goals of quality improvement and equal access along with necessary digital transformations. In this qualitative systematic review, we investigate the following question: How is governance implemented and considered in the studies included in the qualitative review? Objective The aim of this study is to arrive at informed and recognizable conceptualizations and considerations of models of governance connected to eHealth, as presented and discussed in the scientific literature. In turn, we hope our results will help inform the discussion of how to govern such processes to obtain collectively negotiated objectives. Methods A qualitative systematic review is a method for integrating or comparing with the findings from qualitative studies. It looks for “themes” or “constructs” that lie in or across individual qualitative studies. This type of review produces a narrative synthesis with thematic analysis and includes interpretive conceptual models. The goal is an interpretation and broadens the understanding of a particular phenomenon. We searched the PubMed database using predefined search terms and selected papers published from 2010 onwards. We specified the criteria for selection and quality assessment. Results The search returned 220 papers. We selected 44 abstracts for full-text reading, and 11 papers were included for full-text synthesis. On the basis of the 11 papers, we constructed four governance models to categorize and conceptualize the findings. The models are political governance, normally depicting top-down processes; medical governance, which normally depicts bottom-up processes; the internet and global model, emphasizing international business strategies coupled with the internet; self-governance, which builds upon the development of the internet and Internet of Things, which has paved the way for personal governance and communication of one’s own health data. Conclusions Collective negotiations between the nation-state and global policy actors, medical and self-governance actors, and global business and industry actors are essential. Technological affordances represent both positive and negative opportunities concerning the realization of health policy goals, and future studies should scrutinize this dynamic.

scholarly journals Correction: Elaborating Models of eHealth Governance: Qualitative Systematic Review (Preprint)

2020 ◽  
Author(s):  
Anne Granstrom Ekeland ◽  
Line Helen Linstad
Keyword(s):  
Systematic Review ◽  
Quality Improvement ◽  
Health Policy ◽  
Large Scale ◽  
Unintended Consequences ◽  
Equal Access ◽  
Qualitative Review ◽  
Policy Goals ◽  
Qualitative Systematic Review

UNSTRUCTURED Large-scale national eHealth policy programs have gained attention not only for benefits but also for several unintended consequences and failed expectations. Given the complex and mixed accounts of the results, questions have been raised on how large-scale digitalization programs are governed to reach health policy goals of quality improvement and equal access along with necessary digital transformations. In this qualitative systematic review, we investigate the following question: How is governance implemented and considered in the studies included in the qualitative review?

scholarly journals More Than Two Decades of Research on Selective Traditions in Environmental and Sustainability Education—Seven Functions of the Concept

2021 ◽  
Vol 13 (12) ◽  
pp. 6524
Author(s):  
Per J. Sund ◽  
Niklas Gericke
Keyword(s):  
Systematic Review ◽  
Teacher Education ◽  
Sustainability Education ◽  
Qualitative Studies ◽  
The Other ◽  
Research Practice ◽  
Selective Tradition ◽  
Qualitative Systematic Review ◽  
Selective Traditions

This study investigates functions of the concept of selective traditions by means of a qualitative systematic review synthesis of earlier research. The study is based on a review method for integrating qualitative studies and looks for “themes” in or across them. In this case, it is about how the identified publications (twenty-four in total) use the concept of selective traditions. All but two studies stem from the Swedish context. The selective traditions relate to teachers’ approaches to the content, methods and purposes of environmental and sustainability education (ESE). Teachers mainly work within one specific selective tradition. Seven different functions were found in the publications of which five are claimed to be valuable for the development of ESE teaching, while the other two functions are useful in monitoring changes and development in ESE teaching. The results are discussed in terms of the consequences for research, practice and teacher education aiming at offering suggestions on how to develop future (transformative) ESE teaching.

scholarly journals SAT0643-HPR NURSE-LED CARE FROM THE PERSPECTIVE OF PEOPLE WITH EARLY RHEUMATOID ARTHRITIS: A QUALITATIVE SYSTEMATIC REVIEW

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1280.2-1281
Author(s):  
A. M. T. Sweeney ◽  
C. Mccabe ◽  
C. Flurey ◽  
J. Robson ◽  
A. Berry ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Systematic Review ◽  
Systematic Reviews ◽  
Qualitative Studies ◽  
Easy Access ◽  
Nurse Specialist ◽  
Care Needs ◽  
Thematic Synthesis ◽  
Early Ra ◽  
Qualitative Systematic Review

Background:Nurse-led care has been shown to be clinically effective and cost effective in rheumatoid arthritis (RA) but the role of the nurse in early RA is not well defined. Evidence for processes of care in RA is limited and it is not known how well rheumatology nurse-led clinics meet care needs of people with early RA.Objectives:The aim of this study was to develop an understanding of rheumatology nurse-led care from the perspective of people with early RA.Methods:A qualitative systematic review was conducted. The review protocol is published in the International prospective register of systematic reviews.In March 2019, the following databases were searched: MEDLINE, EMBASE, CINAHL, PsycINFO and OpenGrey. Due to lack of studies in early RA this review included adults with early and established inflammatory arthritis, qualitative studies with data on patients’ perspectives of nurse-led care, published in peer-reviewed journals in English between 2010 and 2019. Two reviewers screened titles, abstracts and full texts. Data were extracted and managed in tables. Joanna Briggs Institute Critical Appraisal Checklist was used for quality assessment of the included studies. A thematic synthesis was undertaken using the framework of Thomas and Harden.1Results:The search identified 1034 records. After screening and assessing for eligibility, 8 qualitative studies were included in the review (133 patients), 2 studies included people with early RA. Three main themes were identified (Figure 1).Figure 1.Themes of nurse-led care from the perspective of people with RAProviding knowledge and skill. This theme delineated rheumatology nursing as providing professional expertise in the planning and delivery of care. The rheumatology nurse-led service included easy access via telephone helpline, consultations with the clinical nurse specialist for assessment of disease activity and care needs, planning of care, disease information and education, supporting self-management, and referral to rheumatologist and the multi-disciplinary team. People with RA highly valued the nurse expertise and specialist knowledge provided at nurse-led clinics.‘She was very good at informing me, so I have only praise for this ... because I have never had it like this before’. (Person with early RA).Using a person-centred approach.This theme showed nurse-led care using a person-centred approach combined with empathy and good communication skills, which created a good therapeutic environment. People with RA appreciated the person-centeredness, empathy and involvement of the nurse. ‘She is very sensitive. She can see if I am feeling bad and comes straight to me and asks: “How are you today?” ...You are treated and taken seriously’. (Person with early RA).Meeting patients‘ care needs. This theme presented nurse-led care as creating a sense of being empowered and psychologically supported in the management of RA and its impact. Nurse-led care made people with RA feel cared for, secure and confident. It added value to rheumatology care and made care complete.‘The thought of sticking a needle into my own stomach... it felt a bit like I would never manage to do that. However, they have been absolutely wonderful here ... and now I can do it myself’. (Person with early RA).Conclusion:Nurse-led care for people with RA is characterised by provision of rheumatology expertise using a person-centred approach, and patients‘ holistic care needs are being met. This study found a dearth of literature on perceptions of nurse-led care in people with early RA, which highlights the need for further research in this population.References:[1]Thomas J, Harden A. Methods for the thematic synthesis of qualitative research in systematic reviews.BMC Med Res Methodol2008; 8: 45.Disclosure of Interests:Anne-Marie Tetsche Sweeney: None declared, Candy McCabe: None declared, Caroline Flurey: None declared, Joanna Robson: None declared, Alice Berry: None declared, Pamela Richards: None declared, Mwidimi Ndosi Grant/research support from: Bristol Myers Squibb, Consultant of: Janssen, Pfizer

Experience of Culturally-Tailored Diabetes Interventions for Ethnic Minorities: A Qualitative Systematic Review

2019 ◽  
pp. 105477381988595
Author(s):  
Jee Young Joo ◽  
Megan F. Liu
Keyword(s):  
Systematic Review ◽  
Ethnic Minorities ◽  
Diabetes Care ◽  
Healthy Lifestyle ◽  
The United States ◽  
Qualitative Studies ◽  
Qualitative Synthesis ◽  
Culturally Tailored ◽  
Qualitative Systematic Review ◽  
Diabetes Interventions

This qualitative systematic review synthesizes recent qualitative studies of culturally tailored interventions to better understand the experiences that individuals who are members of ethnic minorities have when undergoing type 2 diabetes treatment in the United States. Such interventions have been shown to be effective among ethnic minority populations; however, no qualitative synthesis has reported on recent findings from studies of these interventions. This systematic review identified seven relevant qualitative studies from five electronic databases—CINAHL, PsycINFO, PubMed, Ovid, and Web of Science—published from 2009 to 2019, and used a thematic synthesis review methodology. Methodological rigor was assessed for an appraisal of study quality. Five themes were identified as experiences of culturally tailored diabetes interventions: culturally appropriate healthy lifestyle behaviors, knowledge about diabetes care, emotional supports, access to the healthcare system, and family involvement. The findings of this review can be utilized as resources for improving diabetes care for ethnic minorities.

scholarly journals Factors Determining the Success and Failure of eHealth Interventions: Systematic Review of the Literature (Preprint)

2018 ◽  
Author(s):  
Conceição Granja ◽  
Wouter Janssen ◽  
Monika Alise Johansen
Keyword(s):  
Systematic Review ◽  
Quality Of Care ◽  
Qualitative Analysis ◽  
Full Text ◽  
Positive Impact ◽  
Future Research ◽  
Inclusion Criteria ◽  
Significant Discrepancy ◽  
Pubmed Database

BACKGROUND eHealth has an enormous potential to improve healthcare cost, effectiveness, and quality of care. However, there seems to be a gap between the foreseen benefits of research and clinical reality. OBJECTIVE Our objective was to systematically review the factors influencing the outcome of eHealth interventions in terms of success and failure. METHODS We searched the PubMed database for original peer-reviewed studies on implemented eHealth tools that reported on the factors for the success or failure, or both, of the intervention. We conducted the systematic review by following the patient, intervention, comparison, and outcome framework, with 2 of the authors independently reviewing the abstract and full text of the articles. We collected data using standardized forms that reflected the categorization model used in the qualitative analysis of the outcomes reported in the included articles. RESULTS Among the 903 identified articles, a total of 221 studies complied with the inclusion criteria. The studies were heterogeneous by country, type of eHealth intervention, method of implementation, and reporting perspectives. The article frequency analysis did not show a significant discrepancy between the number of reports on failure (392/844, 46.5%) and on success (452/844, 53.6%). The qualitative analysis identified 27 categories that represented the factors for success or failure of eHealth interventions. A quantitative analysis of the results revealed the category quality of healthcare (n=55) as the most mentioned as contributing to the success of eHealth interventions, and the category costs (n=42) as the most mentioned as contributing to failure. For the category with the highest unique article frequency, workflow (n=51), we conducted a full-text review. The analysis of the 23 articles that met the inclusion criteria identified 6 barriers related to workflow: workload (n=12), role definition (n=7), undermining of face-to-face communication (n=6), workflow disruption (n=6), alignment with clinical processes (n=2), and staff turnover (n=1). CONCLUSIONS The reviewed literature suggested that, to increase the likelihood of success of eHealth interventions, future research must ensure a positive impact in the quality of care, with particular attention given to improved diagnosis, clinical management, and patient-centered care. There is a critical need to perform in-depth studies of the workflow(s) that the intervention will support and to perceive the clinical processes involved.

Evaluation of text mining to reduce screening workload for injury-focused systematic reviews

2019 ◽  
Vol 26 (1) ◽  
pp. 55-60 ◽  
Author(s):  
Melita J Giummarra ◽  
Georgina Lau ◽  
Belinda J Gabbe
Keyword(s):  
Systematic Review ◽  
Text Mining ◽  
Systematic Reviews ◽  
Full Text ◽  
Large Scale ◽  
High Specificity ◽  
Work Related ◽  
Registration Number ◽  
Low Sensitivity ◽  
Injury Research

IntroductionText mining to support screening in large-scale systematic reviews has been recommended; however, their suitability for reviews in injury research is not known. We examined the performance of text mining in supporting the second reviewer in a systematic review examining associations between fault attribution and health and work-related outcomes after transport injury.MethodsCitations were independently screened in Abstrackr in full (reviewer 1; 10 559 citations), and until no more citations were predicted to be relevant (reviewer 2; 1809 citations, 17.1%). All potentially relevant full-text articles were assessed by reviewer 1 (555 articles). Reviewer 2 used text mining (Wordstat, QDA Miner) to reduce assessment to full-text articles containing ≥1 fault-related exposure term (367 articles, 66.1%).ResultsAbstrackr offered excellent workload savings: 82.7% of citations did not require screening by reviewer 2, and total screening time was reduced by 36.6% compared with traditional dual screening of all citations. Abstrackr predictions had high specificity (83.7%), and low false negatives (0.3%), but overestimated citation relevance, probably due to the complexity of the review with multiple outcomes and high imbalance of relevant to irrelevant records, giving low sensitivity (29.7%) and precision (14.5%). Text mining of full-text articles reduced the number needing to be screened by 33.9%, and reduced total full-text screening time by 38.7% compared with traditional dual screening.ConclusionsOverall, text mining offered important benefits to systematic review workflow, but should not replace full screening by one reviewer, especially for complex reviews examining multiple health or injury outcomes.Trial registration numberCRD42018084123.

scholarly journals Experience of being a frequent user of primary care and emergency department services: a qualitative systematic review and thematic synthesis

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e033351
Author(s):  
Magaly Brodeur ◽  
Eva Margo-Dermer ◽  
Maud-Christine Chouinard ◽  
Catherine Hudon
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Emergency Department ◽  
Full Text ◽  
Healthcare Delivery ◽  
Self Management ◽  
Frequent Users ◽  
Thematic Synthesis ◽  
Qualitative Systematic Review ◽  
Healthcare Experience

BackgroundFrequent users of healthcare services are often categorised as ‘heavy-cost patients’. In the recent years, many jurisdictions have attempted to implement different public policies to optimise the use of health services by frequent users. However, throughout this process, little attention has been paid to their experience as patients.ObjectiveTo thematically synthesise qualitative studies that explore the experience of frequent users of primary care and emergency department services.DesignQualitative systematic review and thematic synthesis.SettingPrimary care and emergency department.ParticipantsFrequent users of primary care and emergency department services.MethodsA qualitative systematic review was conducted using three online databases (MEDLINE with full text, CINAHL with full text and PsycINFO). This search was combined to an extensive manual search of reference lists and related citations. A thematic synthesis was performed to develop descriptive themes and analytical constructs.Study selectionTwelve studies were included. All included studies met the following inclusion criteria: qualitative design; published in English; discussed frequent users’ experiences from their own perspectives and users’ experiences occurred in primary care and/or emergency departments.ResultsThe predominant aspects of frequent users’ experiences were: (1) the experience of being ill and (2) the healthcare experience. The experience of being ill encompassed four central themes: physical limitations, mental suffering, impact on relationships and the role of self-management. The healthcare experience embraced the experience of accessing healthcare and the global experience of receiving care.ConclusionThis synthesis sheds light on potential changes to healthcare delivery in order to improve frequent users’ experiences: individualised care plans or case management interventions to support self-management of symptoms and reduce psychological distress; and giving greater importance on the patient–providers relationship as a central facet of healthcare delivery. This synthesis also highlights future research directions that would benefit frequent users.

scholarly journals The impact of new forms of large-scale general practice provider collaborations on England’s NHS: a systematic review

2018 ◽  
Vol 68 (668) ◽  
pp. e168-e177 ◽  
Author(s):  
Luisa M Pettigrew ◽  
Stephanie Kumpunen ◽  
Nicholas Mays ◽  
Rebecca Rosen ◽  
Rachel Posaner
Keyword(s):  
Systematic Review ◽  
General Practice ◽  
Large Scale ◽  
Health Management ◽  
Scaling Up ◽  
Unintended Consequences ◽  
Local Network ◽  
Financial Investment ◽  
General Practices ◽  
The Impact

BackgroundOver the past decade, collaboration between general practices in England to form new provider networks and large-scale organisations has been driven largely by grassroots action among GPs. However, it is now being increasingly advocated for by national policymakers. Expectations of what scaling up general practice in England will achieve are significant.AimTo review the evidence of the impact of new forms of large-scale general practice provider collaborations in England.Design and settingSystematic review.MethodEmbase, MEDLINE, Health Management Information Consortium, and Social Sciences Citation Index were searched for studies reporting the impact on clinical processes and outcomes, patient experience, workforce satisfaction, or costs of new forms of provider collaborations between general practices in England.ResultsA total of 1782 publications were screened. Five studies met the inclusion criteria and four examined the same general practice networks, limiting generalisability. Substantial financial investment was required to establish the networks and the associated interventions that were targeted at four clinical areas. Quality improvements were achieved through standardised processes, incentives at network level, information technology-enabled performance dashboards, and local network management. The fifth study of a large-scale multisite general practice organisation showed that it may be better placed to implement safety and quality processes than conventional practices. However, unintended consequences may arise, such as perceptions of disenfranchisement among staff and reductions in continuity of care.ConclusionGood-quality evidence of the impacts of scaling up general practice provider organisations in England is scarce. As more general practice collaborations emerge, evaluation of their impacts will be important to understand which work, in which settings, how, and why.

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