scholarly journals Etniske ulikheter i håndteringen av akutte smerter på akuttmottak eller postoperativ avdeling: en systematisk oversikt, med narrativ syntese

iNSPIRA ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. 1-19
Author(s):  
Thomas Samsonsen ◽  
Asgjerd Litleré Moi ◽  
Michael André Helnes Mortensen

Bakgrunn: Smerter er et hyppig fenomen i akuttavdelinger og kan ubehandlet føre til stress, søvnmangel og kroniske smertetilstander for pasientene. Sykepleieres smertehåndtering, inkludert observasjoner og tiltak, kompliseres av variasjonen i smerteuttrykk og reaksjoner på behandlingen hos pasientene. Med større etnisk mangfold i norske sykehus, kan kulturelle forskjeller være til hinder for adekvat smertelindring. Hensikt: Å oppsummere kunnskap om betydningen av etnisitet for smerteopplevelse og smertehåndteringen hos voksne akutt og/eller kritisk syke pasienter. Metode: Systematisk oversikt med narrativ syntese. Søket ble utført i Embase, Medline, Cochrane og Cinahl. Det ble søkt etter engelske eller norske/danske/svenske artikler publisert mellom 1980–2021 som omhandlet etnisitet og smertehåndtering i akutt-, postoperative- eller intensivavdelinger på sykehus. Det ble utført en blindet screening av artiklene i henhold til inklusjons- og eksklusjonskriterier. Critical Appraisal Skills Programme (CASP) ble brukt for å kvalitetsvurdere inkluderte studier. Resultater: Av i alt 1605 studier ble 22 studier inkludert. Studiene omhandlet pasientgrupper på akuttmottak eller postoperativ avdeling. Hyppigst forekom studier av etniske- og raseforskjeller av smerter etter benbrudd, etterfulgt av studier av etniske- og raseforskjeller ved forskjellige akutte smerter; dislokasjon av ledd, akutt koronarsyndrom, traume, magesmerter og postoperative smerter. De fleste studiene (16 av 22) rapporterte etniske forskjeller enten i smerteintensitet og/eller valg av analgetika, dose og/eller ventetid for analgetika. Konklusjon: Basert på funnene i denne systematiske oversikten har etnisitet stor betydning for smerteopplevelse og utført smertebehandling på akuttmottak og postoperative avdelinger. Åpenhet for ulike kulturelle smerteuttrykk, samt bevissthet rundt mulige fordommer, er viktig for god smertehåndtering i akuttavdelinger.

Author(s):  
Minna Anneli Sorsa ◽  
Jari Kylmä ◽  
Terese Elisabet Bondas

Perinatal psychological distress (PPD) may cause delays in help-seeking in the perinatal period, which is crucial for families with small children. Help-seeking theories focus on rational processes of behavior wherein ‘help-seeking’ is viewed as a decision-making process, in which action is preceded by recognizing a problem. We identified the phase prior to actual help-seeking actions as a life situation and a phenomenon through which to gain a deeper understanding from women’s own perspectives. The aim of this study was to integrate and synthesize knowledge of women’s experiences of contemplating seeking help for PPD. We chose interpretative meta-ethnography by Noblit and Hare (1988) and implemented eMERGe guidelines in reporting. The search was performed systematically, and the 14 included studies were evaluated with Critical Appraisal Skills Programme checklist (CASP). We identified seven themes and a metaphor in a lines-of-argument synthesis, showing that contemplating help-seeking is a multidimensional phenomenon. We did not observe a straightforward and linear process (as previous research suggests) but instead a complex process of contemplating help-seeking. A clinical implication is that service providers should work with outreach and develop their tools to connect with mothers with PPD. Another suggestion is to improve training in mental health literacy prior to or during pregnancy.


2014 ◽  
Vol 19 (1) ◽  
Author(s):  
Kenetsoe B. Seroalo ◽  
Emmerentia Du Plessis ◽  
Magdalena P. Koen ◽  
Vicki Koen

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.


Author(s):  
Saidy Eliana Arias Murcia ◽  
Lucero Lopez

Abstract Objective: to understand the experience of nurses in care delivery to culturally diverse families. Method: qualitative meta-synthesis. Exhaustive search in seven databases, three repositories and a manual search in references without time limit, in English, Spanish and Portuguese, resulting in 1609 potentially relevant studies. These were assessed based on the title, summary and full text, determining the final inclusion of 14 studies. Two independent reviewers used the Critical Appraisal Skills Programme (CASP) to assess the quality. The interpretative synthesis implied permanent contrast and consensus among the authors, revealing four categories and one meta-theme. Results: "taking care of a culturally diverse family, the experience of crossing a tightrope". Conclusion: the experience of nurses in care delivery to culturally diverse families is demanding and challenging because it imprints a constant tension among barriers, cultural manifestations and the ethical responsibility of care, incipiently revealing elements of cultural competency. The omission of information in the participants' reports in the studies represents a limitation. The findings offer a baseline for professionals and organizations to focus their intervention efforts on the continuing barriers in care delivery to culturally diverse families and strengthens the need for cultural competency training for nurses.


Author(s):  
Tahere Sharifi ◽  
Ehsan Shamsi-Gooshki ◽  
Ali Mohammad Mosadeghrad ◽  
Ebrahim Jaafaripooyan

Protection of patients' rights is critical in improving healthcare quality, and hence this study aimed at reviewing patient rights’ practices in healthcare organizations of Iran. Using systematic search, this review was conducted based on Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). Several keywords, including "patient rights", "patient bills of rights" and "patients rights’ charter" were searched bilingually in the databases of SID, Magiran, PubMed, Scopus, and Web of Science from 2010 to 2021, and then, following a three-tier screening using the Critical Appraisal Skills Program (CASP) checklists, 76 articles were extracted. The degree of compliance with the Patients' Rights Charter (PRC) in healthcare organizations was 60.88% on average. As to the observance of the PRC dimensions, respectively, the highest and lowest scores were related to the "right to privacy and confidentiality" (70.16%) and "right to access an efficient complaining system" (53.01 %). Respect for patients' rights in organizations was assessed at a moderate level, and some aspects of patients' rights should be attended to immediately. Therefore, discrepancies in the dimensions of patients' rights and their implementation by organizations should be on the agenda of healthcare managers and policymakers.


2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Aysha Nijamudeen ◽  
Tricia Tay

This is a summary of journal club-cum-teaching series organised by the Manchester Medical Journal to teach students critical appraisal skills.


2013 ◽  
Vol 5 (1) ◽  
pp. 32-37
Author(s):  
Anita Nordsteien ◽  
May-Elin Thengs Horntvedt ◽  
Nina Therese Holmen

This paper describes experiences from a collaborative project between the nursing educators at the Institute of Nursing Science and the health sciences librarians at Vestfold University College in Norway. The aim of the project was to develop a teaching model to improve the nursing students' information searching and critical appraisal skills.


2021 ◽  
Vol 3 (3) ◽  
pp. 120-123
Author(s):  
Adam Bedson

The College of Paramedics and the Royal Pharmaceutical Society are clear that they require advanced paramedics, as non-medical prescribers, to review and critically appraise the evidence base underpinning their prescribing practice. Evidence-based clinical guidance such as that published by the National Institute for Health and Care Excellence (NICE) is recommended as the primary source of evidence on which paramedics should base their prescribing decisions. NICE guidance reflects the best available evidence on which to base clinical decision-making. However, paramedics still need to critically appraise the evidence underpinning their prescribing, applying expertise and decision-making skills to inform their clinical reasoning. This is achieved by synthesising information from multiple sources to make appropriate, evidence-based judgments and diagnoses. This first article in the prescribing paramedic pharmacology series considers the importance of evidence-based paramedic prescribing, alongside a range of tools that can be used to develop and apply critical appraisal skills to support prescribing decision-making. These include critical appraisal check lists and research reporting tools


2020 ◽  
Author(s):  
Alexandros Stavros Hadjiantoni

Abstract Background: Anatomical misplacement of the Electrocardiogram (ECG) electrode(s) is common, with significant impact on clinical diagnosis. Reasons are multi-faceted, with this review examining the consequential effects of misplacement to ECG morphology, diagnosis, prognosis, patient outcomes, and potential impact to patient care pathway. Objectives: This review examined the significance of misplacement, its’ commonality and ensuing effect on patient safety, accurate ECG acquisition and diagnosis, with evaluation of reasons for such misplacement.Methodology: Review of available literature was conducted using electronic databases. In-line with the Preferred Reporting Items for Systematic reviews and Meta – analysis protocols (PRISMA) 2015 checklist, this review was conducted with search criteria, search terms, eligibility for inclusion/ exclusion criteria, extraction and data analysis predetermined by the authors. Keywords were arranged according to grouping of terms surrounding ECG, anatomical placement, and diagnosis. The search strategy was conducted during September/October 2019. Scoping searches were conducted alongside reference lists of included studies hand searched (Snowballing) for further relevant studies. The Critical Appraisal Skills Programme (CASP) was used to methodically appraise papers (CASP, 2019). Screening of titles and abstracts of identified citations was performed by a single reviewer. Eligible articles then full text screened independently by two reviewers. Disagreements were discussed and resolved by a third reviewer. In instances of unclear reporting, authors were contacted to provide further information and clarity. Assessment of relevant literature and critical appraisal of primary research, pertaining to the clinical diagnosis and effects of anatomical misplacement of ECG electrodes, formulate the thematic discussion drawn by this review. Results: This review identified a plethora of causes, ranging from: operator error; lack of anatomical awareness; inaccurate assessment of anatomical landmarks; obesity; differences in anatomy/gender; levels of undress and lack of appreciation of consequences of misplacement, both modifiable and non-modifiable attributable to electrode misplacement. Clinical diagnosis can be altered owing to erroneous placement of electrodes. ECG morphology is altered due to incorrect anatomical misplacement, culminating substandard practice, a missed diagnosis or misdiagnosis and potential harm. Conclusion: Correct anatomical placement of ECG electrodes is essential to diagnosis in the clinical setting. Peer-led educational intervention with mandatory training is essential to improve practice. PROSPERO Registration Number: CRD42019152461


2016 ◽  
Vol 29 (suppl 1) ◽  
pp. 124-127 ◽  
Author(s):  
José Máximo Costa PINTO ◽  
Marianna Gomes Cavalcanti Leite de LIMA ◽  
Ana Luiza Melo Cavalcanti de ALMEIDA ◽  
Marcelo Gonçalves SOUSA

ABSTRACT Introduction: It is estimated that there are nearly 40 million people with the human immunodeficiency virus (HIV) worldwide. Due to the advent of antiretroviral drugs, it has been observed increasing in obesity and metabolic rates among patients undergoing treatment. Thus, numerous surgical therapies for weight loss are proposed for continuous improvement in health of patients with HIV, being the vertical gastrectomy an option for intact intestinal transit. Objective: To evaluate the applicability of the vertical gastrectomy in patients with morbid obesity and HIV. Methods: Was conducted a systematic review of the literature, in the electronic databases Scopus, Pubmed, Cinahl, Scielo, Cochrane and Lilacs, from 1998 to 2015. MeSH headings used in data collection were "Gastrectomy" and "Morbid obesity" being combined with the descriptor "HIV". Were found 2148 articles in Scopus, 1234 in PubMed and 784 in Cinahl. The articles were analyzed by the Jadad Quality Scale, being reduced to 40 articles, subsequently reassessed using an elaborated form by the Critical Appraisal Skills Programme (CASP), reaching 12 articles in the end. Conclusion: It was found that vertical gastrectomy constitutes a safe and effective method, with low mortality and low rate of postoperative complications, being recommended as surgical technique in patients with obesity, HIV and comorbidities.


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