scholarly journals Tri-Response Police, Ambulance, Mental Health Crisis Models in Reducing Involuntary Detentions of Mentally Ill People: Protocol for a Systematic Review

2021 ◽  
Vol 18 (15) ◽  
pp. 8230
Author(s):  
Julia Heffernan ◽  
Ewan McDonald ◽  
Elizabeth Hughes ◽  
Richard Gray
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Assessment Tool ◽  
Public Health Practice ◽  
Grey Literature ◽  
Risk Of Bias ◽  
Future Research ◽  
Mental Health Crisis ◽  
Health Crisis ◽  
Response Models

Police, ambulance and mental health tri-response services are a relatively new model of responding to people experiencing mental health crisis in the community, but limited evidence exists examining their efficacy. To date there have been no systematic reviews that have examined the association between the tri-response model and rates of involuntary detentions. A systematic review examining co-response models demonstrated possible reduction in involuntary detention, however, recommended further research. The aim of this protocol is to describe how we will systematically review the evidence base around the relationship of the police, ambulance mental health tri-response models in reducing involuntary detentions. We will search health, policing and grey literature databases and include clinical evaluations of any design. Risk of bias will be determined using the Effective Public Health Practice Project Quality Assessment Tool and a narrative synthesis will be undertaken to synthesis key themes. Risk of bias and extracted data will be summarized in tables and results synthesis tabulated to identify patterns within the included studies. The findings will inform future research into the effectiveness of tri-response police, ambulance, and mental health models in reducing involuntary detentions.

scholarly journals Nocturnal digital surveillance in aged populations and its effects on health, welfare and social care provision: a systematic review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Matt X. Richardson ◽  
Maria Ehn ◽  
Sara Landerdahl Stridsberg ◽  
Ken Redekop ◽  
Sarah Wamala-Andersson
Keyword(s):  
Systematic Review ◽  
Standard Care ◽  
Social Care ◽  
Grey Literature ◽  
Care Quality ◽  
Risk Of Bias ◽  
Future Research ◽  
Care Provision ◽  
Digital Surveillance

Abstract Background Nocturnal digital surveillance technologies are being widely implemented as interventions for remotely monitoring elderly populations, and often replace person-based surveillance. Such interventions are often placed in care institutions or in the home, and monitored by qualified personnel or relatives, enabling more rapid and/or frequent assessment of the individual’s need for assistance than through on-location visits. This systematic review summarized the effects of these surveillance technologies on health, welfare and social care provision outcomes in populations ≥ 50 years, compared to standard care. Method Primary studies published 2005–2020 that assessed these technologies were identified in 11 databases of peer-reviewed literature and numerous grey literature sources. Initial screening, full-text screening, and citation searching steps yielded the studies included in the review. The Risk of Bias and ROBINS-I tools were used for quality assessment of the included studies. Result Five studies out of 744 identified records met inclusion criteria. Health-related outcomes (e.g. accidents, 2 studies) and social care outcomes (e.g. staff burden, 4 studies) did not differ between interventions and standard care. Quality of life and affect showed improvement (1 study each), as did economic outcomes (1 study). The quality of studies was low however, with all studies possessing a high to critical risk of bias. Conclusions We found little evidence for the benefit of nocturnal digital surveillance interventions as compared to standard care in several key outcomes. Higher quality intervention studies should be prioritized in future research to provide more reliable evidence.

The effects of non-clinician guidance on effectiveness and process outcomes of digital mental health interventions: A systematic review and meta-analysis. (Preprint)

2021 ◽  
Author(s):  
Calista Leung ◽  
Julia Pei ◽  
Kristen Hudec ◽  
Farhud Shams ◽  
Richard Munthali ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Psychosocial Support ◽  
Meta Analysis ◽  
Grey Literature ◽  
Risk Of Bias ◽  
Health Interventions ◽  
Cochrane Central Register ◽  
Process Outcomes ◽  
Mental Health Interventions

BACKGROUND Digital mental health interventions are increasingly prevalent in the current context of rapidly evolving technology, and research indicates that they yield effectiveness outcomes comparable to in-person treatment. Integrating professionals (i.e. psychologists, physicians) into digital mental health interventions has been common, and the inclusion of guidance within programs can increase adherence to interventions. However, employing professionals to enhance mental health programs may undermine the scalability of digital interventions. Therefore, delegating guidance tasks to paraprofessionals (peer supporters, technicians, lay counsellors, or other non-clinicians) can help reduce costs and increase accessibility. OBJECTIVE This systematic review and meta-analysis evaluates the effectiveness, adherence, and other process outcomes of non-clinician guided digital mental health interventions. METHODS Four databases (MEDLINE, EMBASE, CINAHL, and PSYCInfo) were searched for randomized controlled trials published between 2010 and 2020 examining digital mental health interventions. Three journals focused on digital intervention were also hand searched and grey literature was searched using ProQuest and the Cochrane Central Register of Control Trials (CENTRAL). Two researchers independently assessed risk of bias using the Cochrane Risk of Bias Tool 2. Data were collected on effectiveness, adherence, and other process outcomes, and meta-analyses were conducted for effectiveness and adherence outcomes. Non-clinician guided interventions were compared with treatment as usual, clinician-guided interventions, and unguided interventions. RESULTS Thirteen studies qualified for inclusion. Results indicate that non-clinician guided interventions yielded higher post-treatment effectiveness outcomes when compared to conditions involving control programs (e.g. online psychoeducation, monitored attention control) or waitlist controls (k=7, Hedges g=-0.73 (95% CI -1.08 to -0.38)). There are significant differences between non-clinician guided interventions and unguided interventions as well (k=6, Hedges g=-0.17 (95% CI -0.23 to -0.11)). In addition, non-clinician guided interventions did not differ in effectiveness from clinician-guided interventions (k=3, Hedges g=0.08 (95% CI -0.01 to 0.17)). These results suggest that guided digital mental health interventions are helpful to improve mental health outcomes regardless of the qualification, and that the presence of a non-clinician guide improves effectiveness outcomes more than no guidance. Non-clinician guided interventions did not yield significantly different effects on adherence outcomes when compared with unguided interventions (k=3, OR 1.58 (95% CI 0.51 to 4.92)), although a general trend of improved adherence was observed within non-clinician guided interventions. CONCLUSIONS Integrating paraprofessionals and non-clinicians appear to improve outcomes of digital mental health interventions, and may also enhance adherence outcomes (though the trend was nonsignificant). Further research should focus on the specific types of tasks these paraprofessionals can successfully provide (i.e. psychosocial support, therapeutic alliance, technical augmentation) and their associated outcomes. CLINICALTRIAL The protocol is preregistered on PROSPERO (CRD42020191226).

Nursing interventions for adults following a mental health crisis: A systematic review guided by trauma‐informed principles

2020 ◽  
Vol 29 (3) ◽  
pp. 348-363
Author(s):  
Nafsin Nizum ◽  
Rosanra Yoon ◽  
Laura Ferreira‐Legere ◽  
Nancy Poole ◽  
Zainab Lulat
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Nursing Interventions ◽  
Mental Health Crisis ◽  
Health Crisis ◽  
Trauma Informed

scholarly journals Psychometric properties of the Jefferson Scale of Empathy: a COSMIN systematic review protocol

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Brett Williams ◽  
Bronwyn Beovich
Keyword(s):  
Systematic Review ◽  
Psychometric Properties ◽  
Methodological Quality ◽  
Grey Literature ◽  
Risk Of Bias ◽  
Measurement Properties ◽  
Future Research ◽  
Health Measurement ◽  
Jefferson Scale Of Empathy

Abstract Background Empathy is an important characteristic to possess for healthcare professionals. It has been found to improve communication between professionals and patients and to improve clinical health outcomes. The Jefferson Scale of Empathy (JSE) was developed to measure this quality and has been used extensively, and psychometrically appraised, with a variety of cohorts and in different cultural environments. However, no study has been undertaken to systematically examine the methodological quality of studies which have assessed psychometric factors of the JSE. This systematic review will examine the quality of published papers that have reported on psychometric factors of the JSE. Methods A systematic review of studies which report on the psychometric properties of the JSE will be conducted. We will use a predefined search strategy to identify studies meeting the following eligibility criteria: original data is reported on for at least one of the psychometric measurement properties described in the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) Risk of Bias checklist, examines the JSE in a healthcare cohort (using the student, physician or health profession versions of the JSE), and is published from January 2001 and in the English language. Conference abstracts, editorials and grey literature will be excluded. Six electronic databases (Medline, EMBASE, PsychInfo, PubMed, Web of Science and CINAHL) will be systematically searched for articles meeting these criteria and studies will be assessed for eligibility by two review authors. The methodological quality of included papers will be examined using the COSMIN Risk of Bias checklist. Discussion A narrative description of the findings will be presented along with summary tables. Recommendations for use of the JSE with various cohorts and circumstances will be offered which may inform future research in this field. Systematic review registration PROSPERO CRD42018111412

scholarly journals Impact of Covid-19 Pandemic on Mental Health of Healthcare Workers in India: A Questionnaire Based Study

2020 ◽  
Vol 7 ◽  
Author(s):  
Ayaskant Sahoo ◽  
Swikruti Behera
Keyword(s):  
Mental Health ◽  
Healthcare Workers ◽  
Healthcare Professionals ◽  
Assessment Tool ◽  
Personal Data ◽  
Working Hours ◽  
Mental Wellbeing ◽  
Mental Health Crisis ◽  
Health Crisis ◽  
Self Reporting Questionnaire

Introduction: Healthcare workers across the globe are working tirelessly to keep the severity under control. The long working hours wearing PPE, the self-quarantine periods, staying away from family, and various other factors does influence the mental wellbeing of an individual. In a country like India mental health is still a poorly recognised issue even among healthcare professionals. Objectives: To assess the stress, anxiety and depression among healthcare professionals at the time of Coronavirus pandemic and estimating the same in Anaesthesiology Cohort.Material & Methods: The study was conducted using a self-reporting questionnaire. The questionnaire was made using Google forms and the link for participation was sent using various digital mediums e.g., email, WhatsApp, Facebook. The questionnaire was sent to a total of 886 doctors and there was a total of 256 responses were received. The questionnaire was submitted anonymously and no personal data was collected. The respondents were allowed to submit only once to prevent duplicity of response. We used the DASS 21 scale as the assessment tool. Data was collected using google forms and the collected data was transferred to a Microsoft Excel sheet for analysis.Results: Our study on 256 doctors 40.75% doctors were found to be suffering from Depression, 38.29% from anxiety & 32.4% from stress in the current pandemic situation. Anaesthesiologists were found to have 30.29% depression; Anxiety was found among 42.56% and stress was found among 37.24%.Conclusion: Stressors, like gruelling shifts, risk of infections, non-availability of protective kits, health risk to family and friends etc, are many and respite seems to be far. We need to address and acknowledge the mental health of healthcare workers and people working in critical care into consideration and find solutions to the underlying causes so that the current and future of the healthcare can be saved from mental health crisis.

scholarly journals A systematic review of the effectiveness of palliative interventions to treat rectal tenesmus in cancer

2017 ◽  
Vol 31 (10) ◽  
pp. 975-981 ◽  
Author(s):  
Áine Ní Laoire ◽  
Lucy Fettes ◽  
Fliss EM Murtagh
Keyword(s):  
Systematic Review ◽  
Advanced Cancer ◽  
Assessment Tool ◽  
Treatment Options ◽  
Grey Literature ◽  
Case Series ◽  
Clinical Excellence ◽  
Cochrane Library ◽  
Future Research ◽  
Systematic Review Methodology

Background: Rectal tenesmus is a distressing symptom in patients with advanced cancer and challenging to treat. There is lack of consensus on the appropriate management of tenesmus in this patient population. Aim: To identify and examine the effectiveness of interventions to palliate rectal tenesmus caused by advanced cancer when surgery, radiotherapy or chemotherapy are no longer treatment options. Design: A systematic review of the literature following standard systematic review methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance. Data sources: A comprehensive search of the electronic databases MEDLINE, EMBASE and the Cochrane Library was conducted from date of inception to April 2016. PubMed ‘related articles’ search, grey literature search and hand-searches of the bibliographies of relevant papers and textbooks were also performed. Non-cancer patients were excluded. Any studies involving surgery or radiotherapy to treat tenesmus were excluded. Studies involving interventions to treat pelvic pain syndromes without specific outcome measures on severity of tenesmus were excluded. The quality of the studies was assessed using a National Institute for Health and Clinical Excellence–recommended quality assessment tool. Results: From 861 studies, 9 met full criteria and were selected. All were case series investigating the use of pharmacological interventions (diltiazem, nifedipine, methadone, mexiletine hydrochloride, lidocaine and bupivacaine), anaesthetic interventions (lumbar sympathectomy, neurolytic superior hypogastric plexus block), and endoscopic laser interventions. The included studies showed substantial heterogeneity, and therefore, a meta-analysis was not feasible. Conclusion: From this review, we identified a significant gap in research into the palliation of rectal tenesmus. A multimodal approach may be necessary due to the complexity of the pathophysiology of tenesmus. Future research should focus on randomised controlled trials of drug therapies whose potential effectiveness is suggested by case series.

scholarly journals P122: Ready for the story? A mixed methods systematic review of factors that influence handovers between prehospital personnel and emergency department nurses receiving patients arriving by ambulance

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S100-S100
Author(s):  
G. Reay ◽  
J. Norris ◽  
L. Nowell ◽  
J. Abraham ◽  
A. Hayden ◽  
...  
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
Mixed Methods ◽  
Adverse Events ◽  
Assessment Tool ◽  
Public Health Practice ◽  
Grey Literature ◽  
Learning Program ◽  
Emergency Nurses ◽  
Emergency Department Nurses

Introduction: Safe and efficient handovers between emergency medical services (EMS) practitioners and emergency nurses are vital as poor transitions may lead to loss of information and place patients at risk for adverse events. We conducted a mixed methods systematic review to a) examine factors that disrupt or improve handovers from EMS practitioners to emergency department nurses, and b) investigate the effectiveness of interventional strategies that lead to improvements in communication and fewer adverse events. Methods: We searched electronic databases (DARE, MEDLINE, EMBASE, Cochrane, CINAHL, Joanna Briggs Institute EBP; Communication Abstracts); grey literature (grey literature databases, organization websites, querying experts in emergency medicine); and reference lists of the included studies. Citation tracking was conducted for the included studies. Two reviewers independently screened titles/abstracts and full-texts for inclusion and methodological quality using the Effective Public Health Practice Project Quality Assessment Tool for quantitative studies and the Joanna Briggs Institute Critic Appraisal Checklist for Qualitative Research. Narrative and thematic synthesis were conducted to integrate and explore relationships within the data. Results: Twenty-two studies were included in this review from the 6150 records initially retrieved. Our analysis suggests that qualitative, quantitative, and mixed methods research approaches have been utilized to explore handovers. Studies (n=11) have predominantly explored existing patterns of handovers focusing on barriers and facilitators. Interventions (e.g. multimedia transmission of pre-hospital information, tailored e-learning program) were investigated in five studies. Results suggest that lack of formal handover training, workflow interruptions, workload, and strained working relationships between EMS and nursing are perceived threats to optimal handovers. Conclusion: The findings from this review can inform the development of handover interventions and contribute to a more rigorous approach to researching handovers between EMS practitioners and emergency nurses. Furthermore, there is a need for studies in which specific interventions to optimize handovers are examined.

scholarly journals Improving outcomes for people in mental health crisis: a rapid synthesis of the evidence for available models of care

2016 ◽  
Vol 20 (3) ◽  
pp. 1-162 ◽  
Author(s):  
Fiona Paton ◽  
Kath Wright ◽  
Nigel Ayre ◽  
Ceri Dare ◽  
Sonia Johnson ◽  
...  
Keyword(s):  
Mental Health ◽  
Cost Effectiveness ◽  
Systematic Reviews ◽  
Assessment Tool ◽  
Care Pathway ◽  
Clinical Effectiveness ◽  
Models Of Care ◽  
Mental Health Crisis ◽  
Health Crisis ◽  
Crisis Care

BackgroundCrisis Concordat was established to improve outcomes for people experiencing a mental health crisis. The Crisis Concordat sets out four stages of the crisis care pathway: (1) access to support before crisis point; (2) urgent and emergency access to crisis care; (3) quality treatment and care in crisis; and (4) promoting recovery.ObjectivesTo evaluate the clinical effectiveness and cost-effectiveness of the models of care for improving outcomes at each stage of the care pathway.Data sourcesElectronic databases were searched for guidelines, reviews and, where necessary, primary studies. The searches were performed on 25 and 26 June 2014 for NHS Evidence, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, NHS Economic Evaluation Database, and the Health Technology Assessment (HTA) and PROSPERO databases, and on 11 November 2014 for MEDLINE, PsycINFO and the Criminal Justice Abstracts databases. Relevant reports and reference lists of retrieved articles were scanned to identify additional studies.Study selectionWhen guidelines covered a topic comprehensively, further literature was not assessed; however, where there were gaps, systematic reviews and then primary studies were assessed in order of priority.Study appraisal and synthesis methodsSystematic reviews were critically appraised using the Risk Of Bias In Systematic reviews assessment tool, trials were assessed using the Cochrane risk-of-bias tool, studies without a control group were assessed using the National Institute for Health and Care Excellence (NICE) prognostic studies tool and qualitative studies were assessed using the Critical Appraisal Skills Programme quality assessment tool. A narrative synthesis was conducted for each stage of the care pathway structured according to the type of care model assessed. The type and range of evidence identified precluded the use of meta-analysis.Results and limitationsOne review of reviews, six systematic reviews, nine guidelines and 15 primary studies were included. There was very limited evidence for access to support before crisis point. There was evidence of benefits for liaison psychiatry teams in improving service-related outcomes in emergency departments, but this was often limited by potential confounding in most studies. There was limited evidence regarding models to improve urgent and emergency access to crisis care to guide police officers in their Mental Health Act responsibilities. There was positive evidence on clinical effectiveness and cost-effectiveness of crisis resolution teams but variability in implementation. Current work from the Crisis resolution team Optimisation and RElapse prevention study aims to improve fidelity in delivering these models. Crisis houses and acute day hospital care are also currently recommended by NICE. There was a large evidence base on promoting recovery with a range of interventions recommended by NICE likely to be important in helping people stay well.Conclusions and implicationsMost evidence was rated as low or very low quality, but this partly reflects the difficulty of conducting research into complex interventions for people in a mental health crisis and does not imply that all research was poorly conducted. However, there are currently important gaps in research for a number of stages of the crisis care pathway. Particular gaps in research on access to support before crisis point and urgent and emergency access to crisis care were found. In addition, more high-quality research is needed on the clinical effectiveness and cost-effectiveness of mental health crisis care, including effective components of inpatient care, post-discharge transitional care and Community Mental Health Teams/intensive case management teams.Study registrationThis study is registered as PROSPERO CRD42014013279.FundingThe National Institute for Health Research HTA programme.

scholarly journals Impact of multimorbidity on healthcare costs and utilisation: a systematic review of the UK literature

2020 ◽  
Vol 71 (702) ◽  
pp. e39-e46
Author(s):  
Marina Soley-Bori ◽  
Mark Ashworth ◽  
Alessandra Bisquera ◽  
Hiten Dodhia ◽  
Rebecca Lynch ◽  
...  
Keyword(s):  
Systematic Review ◽  
Dental Care ◽  
Healthcare Costs ◽  
Assessment Tool ◽  
Meta Analysis ◽  
Grey Literature ◽  
Healthcare Utilisation ◽  
Future Research ◽  
Healthcare Provision ◽  
The Uk

BackgroundManaging multimorbidity is complex for both patients and healthcare systems. Patients with multimorbidity often use a variety of primary and secondary care services. Country-specific research exploring the healthcare utilisation and cost consequences of multimorbidity may inform future interventions and payment schemes in the UK.AimTo assess the relationship between multimorbidity, healthcare costs, and healthcare utilisation; and to determine how this relationship varies by disease combinations and healthcare components.Design and settingA systematic review.MethodThis systematic review followed the bidirectional citation searching to completion method. MEDLINE and grey literature were searched for UK studies since 2004. An iterative review of references and citations was completed. Authors from all articles selected were contacted and asked to check for completeness of UK evidence. The National Institutes of Health National Heart, Lung, and Blood Institute quality assessment tool was used to assess risk of bias. Data were extracted, findings synthesised, and study heterogeneity assessed; meta-analysis was conducted when possible.ResultsSeventeen studies were identified: seven predicting healthcare costs and 10 healthcare utilisation. Multimorbidity was found to be associated with increased total costs, hospital costs, care transition costs, primary care use, dental care use, emergency department use, and hospitalisations. Several studies demonstrated the high cost of depression and of hospitalisation associated with multimorbidity.ConclusionIn the UK, multimorbidity increases healthcare utilisation and costs of primary, secondary, and dental care. Future research is needed to examine whether integrated care schemes offer efficiencies in healthcare provision for multimorbidity.

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