scholarly journals Emotional distress, anxiety and depression in South Asians with long-term conditions: a qualitative systematic review

2021 ◽  
pp. BJGP.2021.0345
Author(s):  
Hassan Awan ◽  
Faraz Mughal ◽  
Tom Kingstone ◽  
Carolyn A Chew-Graham ◽  
Nadia Corp
Keyword(s):  
Systematic Review ◽  
Heart Disease ◽  
Emotional Distress ◽  
Help Seeking ◽  
South Asians ◽  
Qualitative Studies ◽  
Long Term Conditions ◽  
Help Seeking Behaviour

People with physical-mental comorbidity have a poorer quality of life, worse clinical outcomes and increased mortality compared to people with physical conditions alone. South Asians (SAs) are the largest minority group in the UK and are more likely to have long-term conditions (LTCs) such as diabetes and heart disease. SAs are less likely to recognise symptoms which may represent mental health problems. To explore how people of SA origin with LTCs understand, experience and seek help for emotional distress, depression and anxiety. Systematic review of qualitative studies exploring emotional distress in SAs with diabetes or coronary heart disease, within primary and community care settings worldwide. Comprehensive searches of eight electronic databases from inception to 1st September 2021. Data extracted included study characteristics, and understanding, experience and help-seeking behaviour for emotional distress. Thematic synthesis was undertaken. The CASP checklist for qualitative studies was used to assess quality of papers, and GRADE-CERQual used to determine the overall strength of evidence. Twenty one studies from 3,165 unique citations were included. Three main themes were identified. Understanding of emotional distress: non-medical terminology used, such as ‘tension,’ and a complex relationship between emotional and physical illness. Experiences of emotional distress: multiple forms of inequality, distress at diagnosis of their LTC, cultural factors, and gender differences. Help-seeking behaviour: self-management, seeking help from family, friends, and faith, and inadequate clinical support. This review provides a greater understanding of SAs’ conceptualisation of emotional distress in the context of LTCs, to support improvement in its recognition and management.

scholarly journals Psychosocial influences on help-seeking behaviour for cancer in low-income and lower middle-income countries: a mixed-methods systematic review

2021 ◽  
Vol 6 (2) ◽  
pp. e004213
Author(s):  
Grace McCutchan ◽  
Bahr Weiss ◽  
Harriet Quinn-Scoggins ◽  
Anh Dao ◽  
Tom Downs ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mixed Methods ◽  
Cancer Treatment ◽  
Help Seeking ◽  
Middle Income ◽  
Cancer Symptoms ◽  
Middle Income Countries ◽  
Help Seeking Behaviour ◽  
Psychosocial Influences

IntroductionStarting cancer treatment early can improve outcomes. Psychosocial factors influencing patients’ medical help-seeking decisions may be particularly important in low and lower middle-income countries (LMIC) where cancer outcomes are poor. Comprehensive review evidence is needed to understand the psychosocial influences on medical help-seeking for cancer symptoms, attendance for diagnosis and starting cancer treatment.MethodsMixed-methods systematic review registered on PROSPERO (CRD42018099057). Peer-reviewed databases were searched until April 2020 for studies assessing patient-related barriers and facilitators to medical help-seeking for cancer symptoms, diagnosis and treatment in adults (18+ years) living in LMICs. Quality of included studies was assessed using the Critical Appraisal Skills Programme tool. Data were synthesised using meta-analytic techniques, meta-ethnography or narrative synthesis as appropriate.ResultsOf 3963 studies identified, 64 were included. In quantitative studies, use of traditional, complementary and alternative medicine (TCAM) was associated with 3.60 higher odds of prolonged medical help-seeking (95% CI 2.06 to 5.14). Qualitative studies suggested that use of TCAM was a key barrier to medical help-seeking in LMICs, and was influenced by causal beliefs, cultural norms and a preference to avoid biomedical treatment. Women face particular barriers, such as needing family permission for help-seeking, and higher stigma for cancer treatment. Additional psychosocial barriers included: shame and stigma associated with cancer such as fear of social rejection (eg, divorce/disownment); limited knowledge of cancer and associated symptoms; and financial and access barriers associated with travel and appointments.ConclusionDue to variable quality of studies, future evaluations would benefit from using validated measures and robust study designs. The use of TCAM and gender influences appear to be important barriers to help-seeking in LMIC. Cancer awareness campaigns developed with LMIC communities need to address cultural influences on medical help-seeking behaviour.

The effect of telehealth versus usual care for home-care patients with long-term conditions: A systematic review, meta-analysis and qualitative synthesis

2019 ◽  
pp. 1357633X1986295 ◽  
Author(s):  
Sophie McFarland ◽  
Anne Coufopolous ◽  
Deborah Lycett
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Home Care ◽  
Psychological Wellbeing ◽  
Long Term Conditions ◽  
Peace Of Mind ◽  
Term Condition ◽  
Bed Days

Introduction Approximately 26 million people in the United Kingdom are living with one long-term condition and 10 million are living with two or more; these figures are projected to continue increasing (NHS England 2018). People with long-term conditions are two to three times more likely to have poor psychological wellbeing and utilise 50% of GP appointments, 64% of outpatient appointments and over 70 of inpatient bed days. Research in this population could help with increasing constraints on healthcare budgets and resources. Technology-enabled healthcare in the community might help improve quality of life and reduce healthcare costs of managing chronic disease but the overall impact is unclear, we therefore conducted a systematic review. Methods Keywords and MeSH terms were used to search MEDLINE and CINAHL. We included qualitative and quantitative studies that reported on adult home-care patients diagnosed with at least one long-term condition, comparing telehealth to usual home care. Meta-analyses and sensitivity analyses were conducted using RevMan 5. Qualitative findings were thematically synthesised and reported narratively. Results In total, 2568 studies were identified and nine (2611 participants) were included. Telehealth was not statistically significantly different versus standard home care for quality of life, psychological wellbeing, physical function, anxiety, depression, disease specific outcomes or bed days of care at 3, 6, 9 and 12 months. Qualitative findings showed patients found telehealth was beneficial for providing peace of mind and legitimising access to healthcare. Conclusion Telehealth may offer reassurance to those living in the community with long-term conditions; however, a lack of high-quality studies and heterogeneity between interventions makes conclusions difficult.

Interactive remote patient monitoring devices for managing chronic health conditions: systematic review and meta-analysis (Preprint)

2021 ◽  
Author(s):  
Donato Giuseppe Leo ◽  
Benjamin J.R. Buckley ◽  
Mahin Chowdhury ◽  
Stephanie L. Harrison ◽  
Masoud Isanejad ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Usual Care ◽  
Current Evidence ◽  
Long Term Conditions ◽  
Increased Risk ◽  
Patient Reported ◽  
Meta Analyses

BACKGROUND Telemedicine is an expanding and feasible approach to improve medical care for patients with long-term conditions. However, there is a poor understanding of patients’ acceptability of this intervention and their rate of uptake. OBJECTIVE To systematically review the current evidence on telehealth in the management of patients with long-term conditions, and to evaluate the patients’ uptake and acceptability of this technology. METHODS MEDLINE, SCOPUS, and CENTRAL were searched from date of inception to 5 February 2021, with no language restrictions. Studies were eligible for inclusion if they reported any of the following outcomes: (i) intervention uptake and adherence; (ii) study retention; (iii) patient acceptability, satisfaction and experience using intervention: (iv) changes in physiological values; (v) all-cause and cardiovascular related hospitalization; (vi) all-cause and disease specific mortality; (vii) patient-reported outcome measures; (viii) quality of life. Two reviewers independently assessed articles for eligibility. This systematic review was registered on PROSPERO (CRD42021236291). RESULTS Ninety-six studies were included and fifty-eight were pooled for meta-analyses. Meta-analyses showed reduction in mortality (RR= 0.71, 95% CI 0.56 to 0.89, P=0.003, I2=0%); and improvements in BP (MD -3.85 mmHg, 95% CI -7.03 to -0.68, P<.02, I2= 100%) and HbA1c (MD -0.33, 95% CI -0.57 to -0.09, P=.008, I2= 99%); but no significant improvements in quality of life (MD 1.45, 95% CI -0.10 to 3, P=.07, I2=80%); and increased risk of hospitalization (RR 1.02, 95% CI 0.85 to 1.23, P=.81, I2=79%) with telehealth compared to usual care. CONCLUSIONS Telehealth is a valid alternative to usual care, reducing mortality and improving self-management of the disease, with patients reporting good satisfaction and adherence. Further studies are required to address some potential concerns regarding higher hospitalisation rates and a lack of a positive impact on patients’ quality of life.

scholarly journals Barriers and facilitators to implementation of shared medical appointments in primary care for the management of long-term conditions: a systematic review and synthesis of qualitative studies

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e046842
Author(s):  
Fiona Graham ◽  
Mei Yee Tang ◽  
Katherine Jackson ◽  
Helen Martin ◽  
Amy O'Donnell ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Best Practice ◽  
Medical Condition ◽  
Patient Characteristics ◽  
Qualitative Studies ◽  
Long Term Conditions ◽  
Shared Medical Appointments ◽  
Critical Appraisal Skills

ObjectiveTo synthesise the published literature on practitioner, patient and carer views and experiences of shared medical appointments (SMAs) for the management of long-term conditions in primary care.DesignSystematic review of qualitative primary studies.MethodsA systematic search was conducted using MEDLINE (Ovid), PsycINFO (Ovid), CINAHL (EBSCOhost), Web of Science, Social Science Premium Collection (Proquest) and Scopus (SciVerse) from database starting dates to June 2019. Practitioner, patient and carer perspectives were coded separately. Deductive coding using a framework approach was followed by thematic analysis and narrative synthesis. Quality assessment was conducted using the Critical Appraisal Skills Programme for qualitative studies.ResultsWe identified 18 unique studies that reported practitioner (n=11), patient (n=14) and/or carer perspectivs(n=3). Practitioners reported benefits of SMAs including scope for comprehensive patient-led care, peer support, less repetition and improved efficiency compared with 1:1 care. Barriers included administrative challenges and resistance from patients and colleagues, largely due to uncertainties and unclear expectations. Skilled facilitators, tailoring of SMAs to patient groups, leadership support and teamwork were reported to be important for successful delivery. Patients’ reported experiences were largely positive with the SMAs considered a supportive environment in which to share and learn about self-care, though the need for good facilitation was recognised. Reports of carer experience were limited but included improved communication between carer and patient.ConclusionThere is insufficient evidence to indicate whether views and experiences vary between staff, medical condition and/or patient characteristics. Participant experiences may be subject to reporting bias. Policies and guidance regarding best practice need to be developed with consideration given to resource requirements. Further research is needed to capture views about wider and co-occurring conditions, to hear from those without SMA experience and to understand which groups of patients and practitioners should be brought together in an SMA for best effect.PROSPERO registration numberCRD42019141893.

scholarly journals The Effectiveness of Personalisation on Health Outcomes of Older People: A Systematic Review

2021 ◽  
pp. 104973152110516
Author(s):  
Clara T. Fatoye ◽  
Tadesse Gebrye ◽  
Francis Fatoye
Keyword(s):  
Systematic Review ◽  
Older People ◽  
Health Outcomes ◽  
Long Term Conditions ◽  
Health And Social Care ◽  
Newcastle Ottawa Scale ◽  
Meta Analyses ◽  
And Control

Purpose As people get older, they tend to have long-term conditions requiring health and social care intervention such as personalisation. Personalisation is person centred ensuring independence and control. To date, no systematic review has examined the effectiveness of personalisation. This review examined the effectiveness of personalisation in older people. Methods A systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was undertaken. Databases searched included: Science Direct and Medline (PubMed) NHSEED and CINAHL. Inclusion criteria were older people living in their own homes receiving personalisation. Excluded were studies carried out in nursing homes. Newcastle-Ottawa Scale was used for quality of assessment. Results Search yielded 151 published studies with titles and abstracts; 143 studies were excluded and eight included. Studies included showed health outcomes of older people receiving personalisation improved significantly. Conclusions Review found evidence of improvement in quality of life and mobility in older people.

Sign in / Sign up

Export Citation Format

Share Document