scholarly journals Analysis of Nurses’ and Physicians’ Attitudes, Knowledge, and Perceptions toward Fever in Children: A Systematic Review with Meta-Analysis

2021 ◽  
Vol 18 (23) ◽  
pp. 12444
Author(s):  
Francisco Vicens Blanes ◽  
Rosa Miró Bonet ◽  
Jesús Molina Mula
Keyword(s):  
Systematic Review ◽  
Clinical Practice ◽  
Health Professionals ◽  
Meta Analysis ◽  
Educational Programs ◽  
International Standards ◽  
Perceptions And Attitudes ◽  
Nurses And Physicians ◽  
Fever Management ◽  
Nurses Knowledge

Context: Fever is a common symptom in children that nurses and pediatricians treat. Although it is a common sign in clinical practice, fever instills irrational fears in parents that health professionals share. Objective: To investigate whether doctors’ and nurses’ knowledge, perceptions, and attitudes toward fever influence how this sign is managed. Furthermore, it intends to evaluate whether educational programs increase knowledge and change attitudes and/or perceptions of nurses about children’s fever. Data Sources: A systematic review with meta-analysis was conducted with PRISMA international standards and the Cochrane recommendations. Study selection: Articles examining health professionals’ (doctors and/or nurses) knowledge, perceptions, and/or attitudes toward fever in children and the use of antipyretics were selected for the study. Data extraction: The qualitative analysis was carried out by classifying the articles according to the applied educational programs for nurses related to fever care for children that evaluated different outcomes to determine their efficacies. Results: For the qualitative synthesis, 41 articles were included, and 5 of these were taken in meta-analysis, which measured the effectiveness of educational programs for fever management in nurses. Limitations: All of the included studies generally had a high risk of bias. Conclusion: According to the evidence reviewed, nurses’ and physicians’ perceptions and attitudes regarding fever management in children indicate an overtreatment of this sign. We can give a recommendation grade of D on the use of educational programs to modify attitudes, perceptions, and knowledge about fever in children and improve clinical practice in nurses.

scholarly journals Virtual Reality for Health Professions Education: Systematic Review and Meta-Analysis by the Digital Health Education Collaboration (Preprint)

2018 ◽  
Author(s):  
Bhone Myint Kyaw ◽  
Nakul Saxena ◽  
Pawel Posadzki ◽  
Jitka Vseteckova ◽  
Charoula Konstantia Nikolaou ◽  
...  
Keyword(s):  
Systematic Review ◽  
Virtual Reality ◽  
Clinical Practice ◽  
Health Professionals ◽  
Cognitive Skills ◽  
Meta Analysis ◽  
Health Professions ◽  
Risk Of Bias ◽  
Traditional Learning ◽  
Digital Education

BACKGROUND Virtual reality (VR) is a technology that allows the user to explore and manipulate computer-generated real or artificial three-dimensional multimedia sensory environments in real time to gain practical knowledge that can be used in clinical practice. OBJECTIVE The aim of this systematic review was to evaluate the effectiveness of VR for educating health professionals and improving their knowledge, cognitive skills, attitudes, and satisfaction. METHODS We performed a systematic review of the effectiveness of VR in pre- and postregistration health professions education following the gold standard Cochrane methodology. We searched 7 databases from the year 1990 to August 2017. No language restrictions were applied. We included randomized controlled trials and cluster-randomized trials. We independently selected studies, extracted data, and assessed risk of bias, and then, we compared the information in pairs. We contacted authors of the studies for additional information if necessary. All pooled analyses were based on random-effects models. We used the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach to rate the quality of the body of evidence. RESULTS A total of 31 studies (2407 participants) were included. Meta-analysis of 8 studies found that VR slightly improves postintervention knowledge scores when compared with traditional learning (standardized mean difference [SMD]=0.44; 95% CI 0.18-0.69; I2=49%; 603 participants; moderate certainty evidence) or other types of digital education such as online or offline digital education (SMD=0.43; 95% CI 0.07-0.79; I2=78%; 608 participants [8 studies]; low certainty evidence). Another meta-analysis of 4 studies found that VR improves health professionals’ cognitive skills when compared with traditional learning (SMD=1.12; 95% CI 0.81-1.43; I2=0%; 235 participants; large effect size; moderate certainty evidence). Two studies compared the effect of VR with other forms of digital education on skills, favoring the VR group (SMD=0.5; 95% CI 0.32-0.69; I2=0%; 467 participants; moderate effect size; low certainty evidence). The findings for attitudes and satisfaction were mixed and inconclusive. None of the studies reported any patient-related outcomes, behavior change, as well as unintended or adverse effects of VR. Overall, the certainty of evidence according to the GRADE criteria ranged from low to moderate. We downgraded our certainty of evidence primarily because of the risk of bias and/or inconsistency. CONCLUSIONS We found evidence suggesting that VR improves postintervention knowledge and skills outcomes of health professionals when compared with traditional education or other types of digital education such as online or offline digital education. The findings on other outcomes are limited. Future research should evaluate the effectiveness of immersive and interactive forms of VR and evaluate other outcomes such as attitude, satisfaction, cost-effectiveness, and clinical practice or behavior change.

Therapies for Onychomycosis

2015 ◽  
Vol 105 (4) ◽  
pp. 357-366 ◽  
Author(s):  
Aditya K. Gupta ◽  
Deanne Daigle ◽  
Maryse Paquet
Keyword(s):  
Systematic Review ◽  
Clinical Practice ◽  
Treatment Efficacy ◽  
Meta Analysis ◽  
Pulse Therapy ◽  
Controlled Trials ◽  
Review Of The Literature ◽  
Mycological Cure ◽  
Randomized Controlled ◽  
Topical Treatments

New therapies for onychomycosis continue to be developed, yet treatments are seldom directly compared in randomized controlled trials. The objective of this study was to compare the rates of mycological cure for oral and topical onychomycosis treatments using network meta-analysis. A systematic review of the literature on onychomycosis treatments published before March 25, 2013, was performed, and data were analyzed using network meta-analysis. Terbinafine, 250 mg, therapy was significantly superior to all treatments except itraconazole, 400 mg, pulse therapy; itraconazole, 200 mg, therapy was significantly superior to fluconazole and the topical treatments; and fluconazole, efinaconazole, ciclopirox, terbinafine nail solution, and amorolfine treatments were significantly superior to only placebo. These results support the superiority of 12-week continuous terbinafine, 250 mg, therapy and itraconazole, 400 mg, pulse therapy (1 week per month for 3 months) while suggesting the equivalence of topical therapies. These results reflect findings from the literature and treatment efficacy observed in clinical practice.

scholarly journals The prevalence of sleep disturbances among physicians and nurses facing the COVID-19 patients: a systematic review and meta-analysis

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Nader Salari ◽  
Habibolah Khazaie ◽  
Amin Hosseinian-Far ◽  
Hooman Ghasemi ◽  
Masoud Mohammadi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Sample Size ◽  
Medical Staff ◽  
Sleep Disturbances ◽  
Meta Analysis ◽  
Workplace Stress ◽  
Cross Sectional ◽  
Significance Level ◽  
Nurses And Physicians ◽  
As Stress

Abstract Background In all epidemics, healthcare staff are at the centre of risks and damages caused by pathogens. Today, nurses and physicians are faced with unprecedented work pressures in the face of the COVID-19 pandemic, resulting in several psychological disorders such as stress, anxiety and sleep disturbances. The aim of this study is to investigate the prevalence of sleep disturbances in hospital nurses and physicians facing the COVID-19 patients. Method A systematic review and metanalysis was conducted in accordance with the PRISMA criteria. The PubMed, Scopus, Science direct, Web of science, CINHAL, Medline, and Google Scholar databases were searched with no lower time-limt and until 24 June 2020. The heterogeneity of the studies was measured using I2 test and the publication bias was assessed by the Egger’s test at the significance level of 0.05. Results The I2 test was used to evaluate the heterogeneity of the selected studies, based on the results of I2 test, the prevalence of sleep disturbances in nurses and physicians is I2: 97.4% and I2: 97.3% respectively. After following the systematic review processes, 7 cross-sectional studies were selected for meta-analysis. Six studies with the sample size of 3745 nurses were examined in and the prevalence of sleep disturbances was approximated to be 34.8% (95% CI: 24.8-46.4%). The prevalence of sleep disturbances in physicians was also measured in 5 studies with the sample size of 2123 physicians. According to the results, the prevalence of sleep disturbances in physicians caring for the COVID-19 patients was reported to be 41.6% (95% CI: 27.7-57%). Conclusion Healthcare workers, as the front line of the fight against COVID-19, are more vulnerable to the harmful effects of this disease than other groups in society. Increasing workplace stress increases sleep disturbances in the medical staff, especially nurses and physicians. In other words, increased stress due to the exposure to COVID-19 increases the prevalence of sleep disturbances in nurses and physicians. Therefore, it is important for health policymakers to provide solutions and interventions to reduce the workplace stress and pressures on medical staff.

Systematic review and meta-analysis of the placebo effect in panic disorder: Implications for research and clinical practice

2022 ◽  
pp. 000486742110687
Author(s):  
Masoud Ahmadzad-Asl ◽  
Farnoush Davoudi ◽  
Safoura Mohamadi ◽  
Fatemeh Hadi ◽  
Seyed Aria Nejadghaderi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Practice ◽  
Panic Disorder ◽  
Placebo Effect ◽  
Effect Size ◽  
Rating Scales ◽  
Data Extraction ◽  
Meta Analysis ◽  
Placebo Response ◽  
Patient Reports

Objective: This review aimed to measure the degree of placebo response in panic disorder. Data Sources: We searched major databases up to 31 January 2021, for randomized pharmacotherapy trials published in English. Study Selection: A total of 43 studies met inclusion criteria to be in the analysis (with 174 separate outcome measurements). Data Extraction: Changes in outcome measures from baseline in the placebo group were used to estimate modified Cohen’s d effect size. Results: A total of 43 trials (2392 subjects, 174 outcomes using 27 rating scales) were included in the meta-analysis. Overall placebo effect size was 0.57 (95% confidence interval = [0.50, 0.64]), heterogeneity ( I2: 96.3%). Higher placebo effect size was observed among clinician-rated scales compared to patient reports (0.75 vs 0.35) and among general symptom and anxiety scales compared to panic symptoms and depression scales (0.92 and 0.64 vs 0.56 and 0.54, respectively). There was an upward trend in effect size over the publication period ( r = 0.02, p = 0.002) that was only significant among clinician-rated scales ( r = 0.02, p = 0.011). There was no significant publication bias, Egger’s test ( p = 0.08). Conclusion: We observed a substantial placebo effect size in panic disorder. This effect was more prominent for some aspects of panic disorder psychopathology than for others and was correlated with the source of the assessment and publication year. This finding has implications both for research design, to address the heterogeneity and diversity in placebo responses, and for clinical practice to ensure optimal quality of care. Systematic review registration number: PROSPERO, CRD42019125979.

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