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Journal of Nursing Scholarship : An... Mar 2023Emergency healthcare professionals (EHPs) face significant occupational stressors requiring the skilled use of adaptive coping strategies. Some EHP resort to maladaptive...
BACKGROUND
Emergency healthcare professionals (EHPs) face significant occupational stressors requiring the skilled use of adaptive coping strategies. Some EHP resort to maladaptive coping (MC) strategies that negatively impact their mental health, yet MC strategies are not clearly defined in the literature. Examining factors that predispose EHP to MC can support interventions to improve coping and well-being.
OBJECTIVE
This systematic review examined MC among EHP working in pre-hospital and hospital-based settings. The primary aim was to identify factors associated with MC strategies used by EHP.
METHODS
Embase, Ovid, CINAHL Plus, PsychInfo, and the Cochrane Library were systematically searched for quantitative studies measuring MC use among EHP. Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) 2020 checklist was used to guide the review. Studies were included if they: (a) targeted licensed healthcare professionals providing patient care, (b) occurred in emergency department or pre-hospital emergency setting, and (c) examined provider coping. Studies were excluded if they: (a) did not include EHPs, (b) did not differentiate results in mixed samples, (c) did not clearly measure coping strategies, (d) failed to include MC strategies in the results, or (e) were not available in full text. Risk of bias and study quality was appraised using Joanna Briggs Institute (JBI) Critical Appraisal Checklist. Bandura's Social Cognitive Theory (SCT) guided the final synthesis, drawing conclusions from the evidence to identify factors associated with MC in EHP.
RESULTS
A total of 14 cross-sectional studies, published between 2003 and 2021, were included in the review. Included studies were conducted in either pre-hospital, hospital, or a combination of both settings. Most studies included mixed samples or emergency physicians. A variety of coping strategies were significantly correlated with poor mental health outcomes including venting, denial, disengagement, self-blame, and substance use. Among personal factors, EHPs who were female, older than 50, living alone, with personal trauma history were significantly more likely to use MC strategies. Additionally, EHP with children, work experience, higher life satisfaction, and resilience were negatively associated with MC. Environmental factors positively associated with MC included work stress, workload, and poor benefits. Trauma exposure had a positive, but non-significant relationship.
CONCLUSIONS
Emergency healthcare professionals use a variety of coping strategies, many of which are maladaptive and significantly related to poor mental health outcomes. Several personal and environmental factors contribute to behavior that reflect the use of MC strategies, but findings are sparse. Researchers should consider current limitations and challenges, particularly mental health stigma, when designing future studies.
CLINICAL RELEVANCE
The evidence in this review suggests that certain factors predispose EHP for use of MC strategies. This review highlights an important research gap necessitating more robust studies to identify MC risk factors among EHP in chronically high-stress environments.
Topics: Child; Humans; Female; Male; Cross-Sectional Studies; Adaptation, Psychological; Health Personnel; Occupational Stress; Delivery of Health Care
PubMed: 36419400
DOI: 10.1111/jnu.12848 -
International Psychogeriatrics Feb 2020To identify barriers and facilitators to help seeking for a dementia diagnosis from the perspective of carers and people with dementia.
OBJECTIVE
To identify barriers and facilitators to help seeking for a dementia diagnosis from the perspective of carers and people with dementia.
DESIGN
A systematic review of the literature was conducted according to the PRISMA guidelines (PROSPERO protocol registration CRD42018092524). Nine electronic databases were searched for qualitative, quantitative, and mixed methods primary research studies. Two independent reviewers screened titles and abstracts, full texts of eligible studies, and conducted quality appraisal of included articles. A convergent qualitative synthesis approach was used.
RESULTS
From 7496 articles, 35 papers representing 32 studies from 1986 to 2017 were included. Studies originated from 13 countries across 4 continents. Barriers and facilitators were reported predominantly by carers. A small number of studies included people with dementia. Barriers included denial, stigma and fear, lack of knowledge, normalization of symptoms, preserving autonomy, lack of perceived need, unaware of changes, lack of informal network support, carer difficulties, and problems accessing help. Facilitators included recognition of symptoms as a problem, prior knowledge and contacts, and support from informal network.
CONCLUSIONS
Studies from a 30-year period demonstrated that barriers to help seeking persist globally, despite increasing numbers of national dementia policies. Barriers and facilitators rarely existed independently demonstrating the complexity of help seeking for a diagnosis of dementia. Multiple barriers compounded the decision-making process and more than one facilitator was often required to overcome them. Multi-faceted interventions to reduce barriers are needed, one approach would be a focus on the development of dementia friendly communities to reduce stigma and empower people with dementia and carers.
PubMed: 32024558
DOI: 10.1017/S1041610219002229 -
The International Journal of Eating... Feb 2023Treatment-seeking rates among eating disorder (ED) populations are relatively low, with only one in four individuals seeking help. Previous research has identified many... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
Treatment-seeking rates among eating disorder (ED) populations are relatively low, with only one in four individuals seeking help. Previous research has identified many factors that might be associated with help-seeking in EDs, but to date no review has investigated the quantitative association between these factors and actual help-seeking behavior. The aim of the current review was to synthesize the relevant quantitative literature on factors (i.e., perceived barriers, characteristics associated with treatment seeking, demographic variables) associated with help-seeking using meta-analytic strategies, as well as provide recommendations on future early intervention research strategies to promote early help-seeking.
METHOD
Overall, 19 studies were included, identifying 141 perceived barriers (e.g., stigma) or individual characteristics (e.g., BMI, duration of illness) and 56 demographic variables (e.g., ethnicity), which were synthesized into 24 unique variables.
RESULTS
Less help-seeking was predicted by higher levels of denial and less perceived ability of others to provide help.
DISCUSSION
Given the small number of studies these results should be considered preliminary. Future studies should consider barriers to help-seeking when creating early intervention approaches. To improve help-seeking rates we suggest the use of targeted psychoeducational materials and co-design with people with lived experience when developing new strategies.
PUBLIC SIGNIFICANCE
The present study addresses a significant gap in the literature by synthesizing factors associated with help-seeking, with the aim of informing early intervention strategies to promote early help-seeking in eating disorder populations. Denial of illness and perceived inability of others to provide help were associated with lower help-seeking. Future studies should consider barriers to help-seeking and co-design with people with lived experience when creating new early intervention strategies.
Topics: Humans; Patient Acceptance of Health Care; Feeding and Eating Disorders; Social Stigma; Early Intervention, Educational; Ethnicity
PubMed: 36346008
DOI: 10.1002/eat.23845 -
Family Medicine and Community Health Jul 2023General practice receptionists provide an essential function in the healthcare system but routinely encounter acts of incivility and aggression from patients, including...
OBJECTIVE
General practice receptionists provide an essential function in the healthcare system but routinely encounter acts of incivility and aggression from patients, including hostility, abuse and violence. This study was conducted to summarise what is known about patient-initiated aggression towards general practice receptionists, including impacts on reception staff and existing mitigation strategies.
DESIGN
Systematic review with convergent integrated synthesis.
ELIGIBILITY CRITERIA
Studies published at any time in English that examine patient aggression experiences of reception staff in primary care settings.
INFORMATION SOURCES
Searches of five major databases were performed (CINAHL Complete, Scopus, PubMed, Healthcare Administration Database and Google Scholar) to August 2022.
RESULTS
Twenty studies of various designs were included, ranging from the late 1970s to 2022 and originating from five OECD countries. Twelve were assessed as high quality using a validated checklist. Reviewed articles represented 4107 participants; 21.5% were general practice receptionists. All studies reported that displays of aggression towards receptionists by patients were a frequent and routine occurrence in general practice, particularly verbal abuse such as shouting, cursing, accusations of malicious behaviour and use of racist, ablest and sexist insults. Although infrequent, physical violence was widely reported. Inefficient appointment scheduling systems, delayed access to doctors and prescription denial appeared common precipitators. Receptionists adapted their behaviour and demeanour to placate and please patients to avoid escalation of patient frustrations at the cost of their own well-being and clinic productivity. Training in patient aggression management increased receptionist confidence and appeared to decrease negative sequalae. Coordinated support for general practice reception staff who had experienced patient aggression was generally lacking, with a small proportion receiving professional counselling.
CONCLUSIONS
Patient aggression towards reception staff is a serious workplace safety concern for general practices and negatively affects healthcare sector function more broadly. Receptionists in general practice deserve evidence-based measures to improve their working conditions and well-being for their own benefit and that of the community.
REGISTRATION
Pre-registered in Open Science Framework (osf.io/42p85).
Topics: Humans; Aggression; Family Practice; General Practice; Violence; Physicians
PubMed: 37414572
DOI: 10.1136/fmch-2023-002171 -
Nursing Open Feb 2023The aim of this meta-synthesis was to identify and synthesize qualitative research evaluating the real feelings, inner needs and emotional experience of women undergoing... (Meta-Analysis)
Meta-Analysis
AIM
The aim of this meta-synthesis was to identify and synthesize qualitative research evaluating the real feelings, inner needs and emotional experience of women undergoing hysterectomy.
DESIGN
Meta-synthesis.
METHODS
The PubMed, Web of Science, Cochrane Library, CINAHL, Embase, Ovid Medline and Sino Med were systematically searched until November 2021 and updated until June 2022. Two reviewers independently extracted data into a Microsoft Excel sheet. Qualitative meta-synthesis was performed by coding relevant citations, organizing codes into descriptive themes and developing analytical themes.
RESULTS
Qualitative meta-synthesis yielded three themes and nine sub-themes: comprehensive consideration before hysterectomy (a. disease factors; b. fertility factors; c. opinions of others); emotions and experience after hysterectomy (a. postoperative physical condition; b. psychological resilience to the loss of the uterus; c. changes in the couple's relationship); coping strategies (a. self-denial and avoidance; b. change of perception and self-adjustment; c. seek help from others).
Topics: Female; Humans; Adaptation, Psychological; Hysterectomy; Qualitative Research; Resilience, Psychological
PubMed: 36071582
DOI: 10.1002/nop2.1348 -
Sensors (Basel, Switzerland) May 2023Software-defined networking (SDN) is a revolutionary innovation in network technology with many desirable features, including flexibility and manageability. Despite... (Review)
Review
Software-defined networking (SDN) is a revolutionary innovation in network technology with many desirable features, including flexibility and manageability. Despite those advantages, SDN is vulnerable to distributed denial of service (DDoS), which constitutes a significant threat due to its impact on the SDN network. Despite many security approaches to detect DDoS attacks, it remains an open research challenge. Therefore, this study presents a systematic literature review (SLR) to systematically investigate and critically analyze the existing DDoS attack approaches based on machine learning (ML), deep learning (DL), or hybrid approaches published between 2014 and 2022. We followed a predefined SLR protocol in two stages on eight online databases to comprehensively cover relevant studies. The two stages involve automatic and manual searching, resulting in 70 studies being identified as definitive primary studies. The trend indicates that the number of studies on SDN DDoS attacks has increased dramatically in the last few years. The analysis showed that the existing detection approaches primarily utilize ensemble, hybrid, and single ML-DL. Private synthetic datasets, followed by unrealistic datasets, are the most frequently used to evaluate those approaches. In addition, the review argues that the limited literature studies demand additional focus on resolving the remaining challenges and open issues stated in this SLR.
PubMed: 37177643
DOI: 10.3390/s23094441 -
Health & Place Mar 2021In this narrative review we explored existing evidence about people living with dementia accessing and using their garden in both the domestic home and care home... (Review)
Review
In this narrative review we explored existing evidence about people living with dementia accessing and using their garden in both the domestic home and care home settings. The review revealed that gardens enabled people living with dementia to maintain a sense of continuity and identity by connecting to nature, people, and to the moment, whilst managing everyday risks. However, the review also revealed a number of areas where attention and study is urgently required, including: increasing the visibility and presence of people living with dementia in the literature; developing more participatory, creative and co-research designs; and exploring the person living with dementia's denial of access to garden spaces.
Topics: Dementia; Fathers; Gardening; Gardens; Humans; Male; Narration
PubMed: 33610889
DOI: 10.1016/j.healthplace.2021.102516 -
Palliative Medicine Sep 2019Preparing children for the death of a parent is challenging. Parents are often uncertain if and how to communicate and support their children. Many parents feel it is...
BACKGROUND
Preparing children for the death of a parent is challenging. Parents are often uncertain if and how to communicate and support their children. Many parents feel it is protecting their children by not telling them about the prognosis. Children less prepared for parental death from a terminal illness are more susceptive to later adversities. To facilitate coping and moderate for such adversities, there is a need to gain insight and understand the experience and challenges confronted by families.
AIM
This review synthesised evidence on the experiences of parents and children when a parent is at end of life to discern their challenges, support needs and factors that facilitated good practice.
DESIGN
Mixed-methods systematic review.
DATA SOURCES
Four electronic databases (CINAHL, PubMed, PsycINFO and Ovid MEDLINE) using MeSH terms and word searches in October 2018. Studies were not limited by year of publication, language or country. Grey literature searches were also completed on Google Scholar and OpenGrey.
RESULTS
In all, 7829 records were identified; 27 qualitative and 0 quantitative studies met the inclusion criteria. Eight descriptive themes were identified, further categorised into two broad themes: (1) barriers and facilitators in sharing the news that a parent is dying and (2) strategies to manage the changing situation.
CONCLUSION
Lack of understanding in relation to the parent's prognosis, denial and feeling ill-equipped were suggested as barriers for parents to share the news with their children. Engagement with social networks, including extended family relatives and peers, and maintaining routines such as attending school were suggested supportive by parents and children. Findings are limited primarily to White, middle-class two-parent families. A number of areas for future research are identified.
Topics: Adolescent; Adult; Child; Child of Impaired Parents; Female; Humans; Male; Middle Aged; Neoplasms; Parent-Child Relations; Parents; Psychosocial Support Systems; Terminal Care; Young Adult
PubMed: 31244381
DOI: 10.1177/0269216319857622 -
Health & Social Care in the Community Mar 2021Living with a chronic or mental health condition can be challenging and requires considerable adjustment. As ways of coping are culturally influenced, it is important to... (Review)
Review
How people of African Caribbean or Irish ethnicity cope with long-term health conditions in UK community settings: A systematic review of qualitative, quantitative and mixed method studies.
Living with a chronic or mental health condition can be challenging and requires considerable adjustment. As ways of coping are culturally influenced, it is important to understand how minority ethnic populations cope, to inform appropriate services. This review aimed to explore the coping strategies used by UK residents from an African Caribbean or Irish background between 1960 and 2020. A systematic literature search on strategies used to cope with chronic health conditions in both populations living in the United Kingdom identified 26 relevant studies. Data were extracted, quality of papers was appraised and critical interpretive synthesis was applied. Two major foci of the studies were coping strategies and barriers to coping. The main coping strategies were denial/scepticism, self-management, spirituality and religion. Within each population, there was variation in ways of coping. The review highlights the complex role of religion in influencing coping strategies. It demonstrates how personal and minority ethnic populations' experiences of service use are connected with stigma, fear and mistrust, which also act as barriers to seeking help and to coping. Coping with a chronic or mental health condition in the Irish and African Caribbean populations is under-researched. Stigma, fear and mistrust in services act as key barriers to help-seeking and religion is a prominent coping strategy. However, few detailed examples were given on how it was used to assist individuals when managing a chronic or mental health condition. Also due to a lack of research, firm conclusions cannot be drawn for the Irish population.
Topics: Adaptation, Psychological; Black People; Caribbean Region; Ethnicity; Humans; United Kingdom
PubMed: 33025714
DOI: 10.1111/hsc.13181 -
Harvard Review of Psychiatry 2019Systematic reviews about treatment attitudes of patients influencing adherence in bipolar disorder (BD) are rare.
BACKGROUND
Systematic reviews about treatment attitudes of patients influencing adherence in bipolar disorder (BD) are rare.
METHODS
A systematic review was conducted according to the PRISMA guidelines and principles of thematic synthesis. Selectively identified quantitative and qualitative studies were used to examine the attitude-adherence relationship in BD, the types and correlates of treatment attitudes, and the impact of psychosocial interventions on attitudes.
RESULTS
The final list of 163 articles included 114 observational reports (incorporating 21 psychosocial intervention trials), 45 qualitative/descriptive studies, and 4 patient surveys. A positive association between treatment attitudes and adherence was found in most quantitative and qualitative studies, though the strength of the relationship was unclear. Thematic analysis of qualitative studies suggested that patient attitudes influencing adherence were based on perceived advantages and disadvantages of treatment. The principal correlates of patients' attitudes were family attitudes, the clinician-patient alliance, social support, and patients' knowledge of BD. Though negative attitudes such as denial, concerns about adverse treatment consequences, and stigmatizing effects of treatment were common, many patients believed treatment to be beneficial and necessary. The limited data on the effect of psychosocial interventions indicated that treatments selectively targeting attitudes enhanced adherence.
LIMITATIONS
The studies were heterogeneous in design; the quality was uneven (fair to poor); and the risk of bias moderate to high.
CONCLUSIONS
Despite these flaws, awareness of the existing evidence on the attitude-adherence association and other aspects of treatment attitudes in BD can help in efforts to address nonadherence in BD.
Topics: Bipolar Disorder; Health Behavior; Health Knowledge, Attitudes, Practice; Humans; Patient Compliance; Patient Satisfaction
PubMed: 31385812
DOI: 10.1097/HRP.0000000000000228