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Journal of Cancer Survivorship :... Dec 2023Breast lymphoedema is a possible side effect of breast conserving surgery, but it is poorly understood. This is due, in part, to difficulty assessing the breast. This... (Review)
Review
PURPOSE
Breast lymphoedema is a possible side effect of breast conserving surgery, but it is poorly understood. This is due, in part, to difficulty assessing the breast. This systematic review described outcome measures that quantify breast lymphoedema signs and symptoms and evaluated the measurement properties for these outcome measures.
METHOD
Seven databases were searched using terms in four categories: breast cancer, lymphoedema and oedema, clinician reported (ClinROM) and patient reported outcome measures (PROM) and psychometric and measurement properties. Two reviewers independently reviewed studies and completed quality assessments. The Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) methodology was used for studies including measurement property evidence.
RESULTS
Fifty-six papers were included with thirteen questionnaires, eight patient-reported rating scales, seven physical measures, seven clinician-rating scales and four imaging techniques used to quantify breast lymphoedema. Based on COSMIN methodology, one ClinROM had sufficient reliability, ultrasound measuring dermal thickness. Tissue dielectric constant (TDC) measuring local tissue water had promising reliability. Four questionnaires had sufficient content validity (BLYSS, BLSQ, BrEQ and LYMQOL-Breast).
CONCLUSIONS
Ultrasound is recommended to reliably assess breast lymphoedema signs. No PROM can be recommended with confidence, but BLYSS, BLSQ, BrEQ and LYMQOL-Breast are promising. Further research is recommended to improve evidence of measurement properties for outcome measures.
IMPLICATIONS FOR CANCER SURVIVORS
There are many approaches to assess breast lymphoedema, but currently, only ultrasound can be recommended for use, with others, such as TDC and questionnaires, showing promise. Further research is required for all approaches to improve evidence of measurement properties.
Topics: Humans; Female; Breast Neoplasms; Reproducibility of Results; Patient Reported Outcome Measures; Cancer Survivors; Lymphedema; Psychometrics
PubMed: 36301407
DOI: 10.1007/s11764-022-01278-w -
Rheumatology International Aug 2023General Joint Hypermobility (GJH) is a common condition found in 2-57% of the population. Of those with GJH, 10% suffer from accompanying physical and/or psychological...
General Joint Hypermobility (GJH) is a common condition found in 2-57% of the population. Of those with GJH, 10% suffer from accompanying physical and/or psychological symptoms. While the understanding of GJH in the general population is unfolding, its implication in a cohort of children, adolescents and young adults are not yet understood. This systematic review explored GJH's prevalence, tools to measure it, its physical and psychosocial symptoms, with a special interest in aesthetic sports. The CINHAL, MEDLINE, PsycINFO, SPORTDiscus and Scopus databases were searched for relevant studies. Inclusion criteria were (1) Age range of 5-24; (2) Participants had GJH; (3) A measurement for GJH; (4) Studies written in English language. Study screening for title, abstract and full text (when needed) and quality assessment were performed by two independent individuals. 107 studies were included in this review and were thematically grouped into six clusters expressing different foci: (1) GJH's Core Characteristics; (2) Orthopedic; (3) Physical Other; (4) Psychosocial; (5) Treatment and (6) Aesthetic Sports. The review revealed a growing interest in GJH in this cohort in the last decade, especially regarding non-musculoskeletal physical implications and psychosocial aspects. Prevalence varied between different ethnic groups and as a parameter of age, gender and measurement. The most widespread tool to measure GJH was the Beighton scale, with a cut-off varying between 4 and 7. Children show fewer, but similar GJH implication to those in the general population, however, more research on the topic is warranted, especially regarding psychosocial aspects and treatment.
Topics: Child; Young Adult; Humans; Adolescent; Adult; Prevalence; Cross-Sectional Studies; Physical Examination; Joint Instability
PubMed: 37149553
DOI: 10.1007/s00296-023-05338-x -
Physiotherapy Sep 2023To synthesise exercise therapy intervention data investigating patient rating outcomes for the management of tendinopathy. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To synthesise exercise therapy intervention data investigating patient rating outcomes for the management of tendinopathy.
DESIGN
A systematic review and meta-analysis of randomized controlled trials investigating exercise therapy interventions and reporting patient rating outcomes.
SETTING
Any setting in any country listed as very high on the human development index.
PARTICIPANTS
People with a diagnosis of any tendinopathy of any severity or duration.
INTERVENTIONS
Exercise therapy for the management of tendinopathy comprising five different therapy classes: 1) resistance; 2) plyometric; 3) vibration; 4) flexibility, and 5) movement pattern retraining modalities, were considered for inclusion.
MAIN OUTCOME MEASURES
Outcomes measuring patient rating of condition, including patient satisfaction and Global Rating of Change (GROC).
RESULTS
From a total of 124 exercise therapy studies, 34 (Achilles: 41%, rotator cuff: 32%, patellar: 15%, elbow: 9% and gluteal: 3%) provided sufficient information to be meta-analysed. The data were obtained across 48 treatment arms and 1246 participants. The pooled estimate for proportion of satisfaction was 0.63 [95%CrI: 0.53-0.73], and the pooled estimate for percentage of maximum GROC was 53 [95%CrI: 38-69%]. The proportion of patients reporting positive satisfaction and perception of change increased with longer follow-up periods from treatment onset.
CONCLUSION
Patient satisfaction and GROC appear similar and are ranked moderately high demonstrating that patients generally perceive exercise therapies positively. Further research including greater consistency in measurement tools is required to explore and where possible, identify patient- and exercise-related moderating factors that can be used to improve person-centred care.
SYSTEMATIC REVIEW REGISTRATION NUMBER
PROSPERO ID=CRD42020168187 CONTRIBUTION OF PAPER.
Topics: Humans; Tendinopathy; Exercise Therapy; Physical Therapy Modalities; Rotator Cuff; Patient Satisfaction
PubMed: 37406460
DOI: 10.1016/j.physio.2023.05.002 -
Clinical Child and Family Psychology... May 2024Anxiety disorders are common, emerge during childhood, and pose a significant burden to society and individuals. Research evaluating the impact of anxiety on functional... (Review)
Review
Anxiety disorders are common, emerge during childhood, and pose a significant burden to society and individuals. Research evaluating the impact of anxiety on functional impairment and quality of life (QoL) is increasing; however, there is yet to be a systematic review and meta-analysis of these relationships in pediatric samples. This systematic review and meta-analysis were conducted to determine the extent of impairments in functioning and QoL that young people with anxiety disorders experience relative to their healthy peers, as well as sociodemographic and clinical moderators of these relationships. Studies were included when they compared young people (mean age range within studies 7-17 years) with a primary clinical anxiety disorder to a healthy comparison group and measured impairment and/or QoL via a validated instrument. A total of 12 studies met criteria for this review (N = 3,129 participants). A majority of studies (K = 9) assessed impairment as an outcome measure, and three assessed QoL outcomes. Meta-analysis of nine studies (N = 1,457 children) showed large relationships between clinical anxiety and life impairment (g = 3.23) with the strongest effects seen for clinician report (g = 5.00), followed by caregiver (g = 2.15) and child (g = 1.58) report. The small number of studies and diversity in methodology prevented quantitative investigation of moderating factors. In the systematic review of QoL outcomes, all three studies reported significantly poorer QoL for youth with anxiety disorders relative to unaffected peers. Findings support the importance of measuring functioning and QoL as outcomes in clinical research and practice among anxious young people.This study is registered with PROSPERO under the identification number CRD42023439040.
PubMed: 38782783
DOI: 10.1007/s10567-024-00484-5 -
JMIR Medical Education Mar 2024Digital competence is listed as one of the key competences for lifelong learning and is increasing in importance not only in private life but also in professional life.... (Review)
Review
BACKGROUND
Digital competence is listed as one of the key competences for lifelong learning and is increasing in importance not only in private life but also in professional life. There is consensus within the health care sector that digital competence (or digital literacy) is needed in various professional fields. However, it is still unclear what exactly the digital competence of health professionals should include and how it can be measured.
OBJECTIVE
This scoping review aims to provide an overview of the common definitions of digital literacy in scientific literature in the field of health care and the existing measurement instruments.
METHODS
Peer-reviewed scientific papers from the last 10 years (2013-2023) in English or German that deal with the digital competence of health care workers in both outpatient and inpatient care were included. The databases ScienceDirect, Scopus, PubMed, EBSCOhost, MEDLINE, OpenAIRE, ERIC, OAIster, Cochrane Library, CAMbase, APA PsycNet, and Psyndex were searched for literature. The review follows the JBI methodology for scoping reviews, and the description of the results is based on the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist.
RESULTS
The initial search identified 1682 papers, of which 46 (2.73%) were included in the synthesis. The review results show that there is a strong focus on technical skills and knowledge with regard to both the definitions of digital competence and the measurement tools. A wide range of competences were identified within the analyzed works and integrated into a validated competence model in the areas of technical, methodological, social, and personal competences. The measurement instruments mainly used self-assessment of skills and knowledge as an indicator of competence and differed greatly in their statistical quality.
CONCLUSIONS
The identified multitude of subcompetences illustrates the complexity of digital competence in health care, and existing measuring instruments are not yet able to reflect this complexity.
Topics: Humans; Health Personnel; Checklist; Consensus; Databases, Factual; Education, Continuing
PubMed: 38551628
DOI: 10.2196/55737 -
Accident; Analysis and Prevention Nov 2023Driver workload (DWL) is an important factor that needs to be considered in the study of traffic safety. The research focus on DWL has undergone certain shifts with the...
Driver workload (DWL) is an important factor that needs to be considered in the study of traffic safety. The research focus on DWL has undergone certain shifts with the rapid development of scientific and technological advancements in the field of transportation in recent years. This study aims to grasp the state of research on DWL by both bibliometric analysis and individual critical literature review. The knowledge structure and development trend are described using bibliometric analysis. The knowledge mapping method is applied to mine the available literature in depth. It is discovered that one of the current research focus on DWL has shifted towards investigating its application in the field of autonomous driving. Subjective questionnaires and experimental tests (including both simulation technology and field study) are the main approaches to analyze DWL. An individual critical literature review of the influencing factors, measurement, and performance of DWL is provided. Research findings have shown that DWL was highly impacted by both intrinsic (e.g., age, temperament, driving experience) and external factors (e.g., vehicles, roads, tasks, environments). Scholars are actively exploring the combined effects of various factors and the level of vehicle automation on DWL. In addition to assess DWL by using subjective measures or physiological parameter measures separately, studies have started to improve classification accuracy by combining multiple measurement methods. Safety thresholds of DWL are not sufficiently studied due to the various interference items corresponding to different scenarios, but it is expected to quantify the DWL and find the threshold by establishing assessment models considering these intrinsic and external multiple-factors simultaneously. Driver or vehicle performance indicators are controversial to measure DWL directly, but they were suitable to reflect the impact of DWL in different driving conditions.
Topics: Humans; Workload; Accidents, Traffic; Automation; Bibliometrics; Computer Simulation
PubMed: 37696063
DOI: 10.1016/j.aap.2023.107289 -
BMJ Open Sep 2023The COVID-19 pandemic has tested global healthcare resilience. Many countries previously considered 'resilient' have performed poorly. Available organisational and...
OBJECTIVES
The COVID-19 pandemic has tested global healthcare resilience. Many countries previously considered 'resilient' have performed poorly. Available organisational and system frameworks tend to be context-dependent and focus heavily on physical capacities. This study aims to explore and synthesise evidence about healthcare resilience and present a unified framework for future resilience-building.
DESIGN
Systematic review and synthesis of reviews using a meta-narrative approach.
SETTING
Healthcare organisations and systems.
PRIMARY AND SECONDARY OUTCOME MEASURES
Definitions, concepts and measures of healthcare resilience. We used thematic analysis across included reviews to summarise evidence on healthcare resilience.
RESULTS
The main paradigms within healthcare resilience include global health, disaster risk reduction, emergency management, patient safety and public health. Definitions of healthcare resilience recognise various hierarchical levels: individual (micro), facility or organisation (meso), health system (macro) and planetary or international (meta). There has been a shift from a focus on mainly disasters and crises, to an 'all-hazards' approach to resilience. Attempts to measure resilience have met with limited success. We analysed key concepts to build a framework for healthcare resilience containing pre-event, intra-event, post-event and trans-event domains. Alongside, we synthesise a definition which dovetails with our framework.
CONCLUSION
Resilience increasingly takes an all-hazards approach and a process-oriented perspective. There is increasing recognition of the relational aspects of resilience. Few frameworks incorporate these, and they are difficult to capture within measurement systems. We need to understand how resilience works across hierarchical levels, and how competing priorities may affect overall resilience. Understanding these will underpin interdisciplinary, cross-sectoral and multi-level approaches to healthcare resilience for the future.
PROSPERO REGISTRATION NUMBER
CRD42022314729.
Topics: Humans; COVID-19; Pandemics; Health Facilities; Patient Safety; Disasters
PubMed: 37730383
DOI: 10.1136/bmjopen-2023-072136 -
Implementation Science : IS Sep 2023Evidence-based practice (EBP) is well known to most healthcare professionals. Implementing EBP in clinical practice is a complex process that can be challenging and... (Review)
Review
BACKGROUND
Evidence-based practice (EBP) is well known to most healthcare professionals. Implementing EBP in clinical practice is a complex process that can be challenging and slow. Lack of EBP knowledge, skills, attitudes, self-efficacy, and behavior can be essential barriers that should be measured using valid and reliable instruments for the population in question. Results from previous systematic reviews show that information regarding high-quality instruments that measure EBP attitudes, behavior, and self-efficacy in various healthcare disciplines need to be improved. This systematic review aimed to summarize the measurement properties of existing instruments that measure healthcare professionals' EBP attitudes, behaviors, and self-efficacy.
METHODS
We included studies that reported measurement properties of instruments that measure healthcare professionals' EBP attitudes, behaviors, and self-efficacy. Medline, Embase, PsycINFO, HaPI, AMED via Ovid, and Cinahl via Ebscohost were searched in October 2020. The search was updated in December 2022. The measurement properties extracted included data on the item development process, content validity, structural validity, internal consistency, reliability, and measurement error. The quality assessment, rating of measurement properties, synthesis, and modified grading of the evidence were conducted in accordance with the COSMIN methodology for systematic reviews.
RESULTS
Thirty-four instruments that measure healthcare professionals' EBP attitudes, behaviors or self-efficacy were identified. Seventeen of the 34 were validated in two or more healthcare disciplines. Nurses were most frequently represented (n = 53). Despite the varying quality of instrument development and content validity studies, most instruments received sufficient ( +) ratings on content validity, with the quality of evidence graded as "very low" in most cases. Structural validity and internal consistency were the measurement properties most often assessed, and reliability and measurement error were most rarely assessed. The quality assessment results and overall rating of these measurement properties varied, but the quality of evidence was generally graded higher for these properties than for content validity.
CONCLUSIONS
Based on the summarized results, the constructs, and the population of interest, several instruments can be recommended for use in various healthcare disciplines. However, future studies should strive to use qualitative methods to further develop existing EBP instruments and involve the target population.
TRIAL REGISTRATION
This review is registered in PROSPERO. CRD42020196009. Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020196009.
Topics: Humans; Attitude of Health Personnel; Evidence-Based Practice; Reproducibility of Results; Self Efficacy; Systematic Reviews as Topic
PubMed: 37705031
DOI: 10.1186/s13012-023-01301-3 -
Journal of Sex Research Aug 2023Sexual self-concept and sexual self-schema are multidimensional constructs critical to developing a more holistic theoretical understanding of the sexual self. With an...
Sexual self-concept and sexual self-schema are multidimensional constructs critical to developing a more holistic theoretical understanding of the sexual self. With an increased amount of research exploring these constructs over the past few decades, a systematic review was warranted to highlight next steps for future research in this area. Therefore, utilizing a staged systematic review, we aimed to explore how these parallel concepts are measured and among which populations they are used. The evaluation of 236 unique manuscripts published 1990-2020 revealed the use of 38 established or constructed measures of sexual self-concept, and 16 established or constructed measures of sexual self-schema. Three distinct measures were used in more than one-fifth of the studies reviewed, although the use of full-form measures vs. subscales differed across studies. Although there was diversity in the samples used in the studies reviewed, these studies were conducted most commonly with samples consisting of individuals who were primarily, if not solely, cisgender, women, heterosexual, White, non-college attending, U.S. residents, and/or had no unique characteristics identified (e.g., cancer patient/survivor, pregnant). The largest proportion of studies reviewed examined sexual self-concept during emerging adulthood, followed by early adulthood and middle adulthood. Suggested directions for future research in this area include (a) reexamining and testing how current measures are capturing these constructs and among whom; (b) expanding samples to include and/or target specifically gender, sexual, and racial/ethnic minoritized groups as well as individuals with unique characteristics that would affect sexual well-being; and (c) utilizing samples in childhood, adolescence, and late adulthood.
PubMed: 37594457
DOI: 10.1080/00224499.2023.2244937 -
JPRAS Open Dec 2023The prominent ear is a type of congenital ear deformity that can be corrected by a variety of nonsurgical treatments, such as splinting and the taping method. However,... (Review)
Review
BACKGROUND
The prominent ear is a type of congenital ear deformity that can be corrected by a variety of nonsurgical treatments, such as splinting and the taping method. However, there is no objective evaluation method that is universally accepted. The aim of this review is to evaluate objective measurement methods that are used in the available literature to analyze nonsurgical treatment of prominent ears.
METHODS
A systematic review was performed in the MEDLINE and Embase databases in December 2022 and updated on April 2023 according to Preferred Reporting Items for Systematics and Meta-Analyses (PRISMA) guideline. Any study using objective measurements (continuous variables such as distance and angle) to evaluate the effect of nonsurgical treatment of prominent ears was included. The Joanna Briggs Institute (JBI) critical appraisal for case series was used for quality assessment.
RESULTS
A total of 286 studies were screened for eligibility, of which five articles were eligible for inclusion. All of the included studies were case series. The helix mastoid distance (HMD) is the most commonly used parameter to measure treatment outcome. Pinna and cartilage stiffness, length, and width were also used, but without clear statistical relevance. HMD was classified into grading groups (i.e. good, moderate, and poor) to evaluate the treatment's effect.
CONCLUSION
Based on the included studies, objective measurements are rarely used, and when used, they are largely heterogeneous. Although HMD was the most frequent measurement used, all studies used different definitions for the measurement and grouped subsequent outcomes differently. Automated algorithms, based on three-dimensional imaging, could be used for object measurements in the nonsurgical treatment of prominent ears.
PubMed: 37694192
DOI: 10.1016/j.jpra.2023.07.002