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Pediatric Critical Care Medicine : a... Jun 2024
Topics: Humans; Biomedical Research; Child; Outcome Assessment, Health Care; Intensive Care Units, Pediatric
PubMed: 38836712
DOI: 10.1097/PCC.0000000000003482 -
Regional Anesthesia and Pain Medicine May 2024
Topics: Humans; Anesthesia, Conduction; Acute Pain; Awards and Prizes; Outcome Assessment, Health Care; Pain Management
PubMed: 38395462
DOI: 10.1136/rapm-2024-105286 -
Investigacion Y Educacion En Enfermeria Nov 2023The aim of this review was to identify reported nursing-sensitive outcomes in the Emergency Department to date. (Review)
Review
OBJECTIVE
The aim of this review was to identify reported nursing-sensitive outcomes in the Emergency Department to date.
METHODS
An Umbrella review was conducted. Four databases, CINAHL, Pubmed, Web of Science and Scopus, were searched from inception until October 2022. MeSH terms were: "nursing", "sensitivity and specificity", "emergency service, hospital", "nursing care". Two reviewers independently screened studies against the inclusion criteria for eligibility, extracted data and assessed study quality with the SIGN tool. Results of the included studies were summarized and described in themes for narrative analysis. The study was enrolled in the PROSPERO registry (CRD42022376941) and PRISMA guidelines were followed.
RESULTS
The search strategy yielded 2289 records. After duplicate removal, title, abstract and full-text eligibility screening, nine systematic reviews were included in the review. A total of 35 nursing-sensitive outcomes were reported. The most described outcomes were waiting times, patient satisfaction and time to treatment. The less measured were mortality, left without being seen and physical function. Synthesizing nursing-sensitive outcomes in themes for reporting, the most measured outcomes were within the safety domain (n=20), followed by the clinical (n=9), perceptual (n=5) and the least explored functional domain (n=1).
CONCLUSION
Nursing sensitive outcomes research in emergency nursing practice is a conceptual challenge still in its early stage. Several nursing-sensitive outcomes were identified in this review that can evaluate the contribution of emergency department nursing care to patient outcomes. Further research is required to explore patient outcomes sensitive to emergency nursing care.
Topics: Humans; Emergency Service, Hospital; Emergency Medical Services; Outcome Assessment, Health Care; Hospitals; Patient Satisfaction
PubMed: 38589303
DOI: 10.17533/udea.iee.v41n3e03 -
Expert Review of Pharmacoeconomics &... 2023Strong primary care has positive impact on patients' and population health, and high continuity of care is one of its hallmarks. Insight into the underlying mechanisms... (Review)
Review
INTRODUCTION
Strong primary care has positive impact on patients' and population health, and high continuity of care is one of its hallmarks. Insight into the underlying mechanisms is limited and research on this topic requires measures of primary care outputs, which are states that mediate between processes and outcomes of primary care.
AREAS COVERED
Nine potential outputs of high continuity of care were specified to examine 45 validated patient questionnaires, which were identified in a systematic review. Eighteen questionnaires covered one or more primary care outputs, yet at variable and mostly limited extent.
EXPERT OPINION
Measures of primary care outputs can strengthen clinical and health services research, but such measures have yet to be developed and validated for most primary care outputs. The use of these measures in outcome evaluations of interventions in healthcare would enhance the interpretation of intervention effects. Validated measures are also needed to tap the full potential of advanced methods of data-analysis in clinical and health services research. Better understanding of the primary care outputs may also help to mitigate broader challenges in healthcare systems.
Topics: Humans; Delivery of Health Care; Health Services Research; Outcome Assessment, Health Care; Primary Health Care; Surveys and Questionnaires
PubMed: 37306502
DOI: 10.1080/14737167.2023.2224566 -
Clinical Psychology & Psychotherapy 2023Treatment of schizotypal personality disorder is complex. Currently, there are no clear evidence-based recommendations for use of psychotherapy for individuals suffering... (Review)
Review
BACKGROUND
Treatment of schizotypal personality disorder is complex. Currently, there are no clear evidence-based recommendations for use of psychotherapy for individuals suffering from this mental illness, and studies are sparse. Our aim in this review is to map and describe the existing research and to answer the research question: What do we know about the use of psychotherapy for people with schizotypal personality disorder?
METHODS
We conducted a scoping review using systematic searches in the Embase, MEDLINE and PsycINFO databases. Two reviewers screened possible studies and extracted data on subject samples, type of psychotherapy, outcomes and suggested mechanisms of change. The review is based on the PRISMA checklist for scoping reviews.
RESULTS
Twenty-three papers were included, and we found a wide variety of study types, psychotherapeutic orientations and outcomes. Few studies emerged that focused solely on schizotypal personality disorder.
CONCLUSION
Psychotherapy as a treatment for schizotypal personality disorder is understudied compared with diagnoses such as schizophrenia and borderline personality disorder. Our results included two randomized controlled studies, as well as mainly smaller studies with different approaches to diagnostic criteria, psychotherapeutic orientation and outcome measures. The findings are too sparse and too diverse to make any evidence-based recommendations. We found some indications that psychotherapy may support and assist individuals with schizotypal personality disorder.
Topics: Humans; Schizotypal Personality Disorder; Psychotherapy; Borderline Personality Disorder; Schizophrenia; Outcome Assessment, Health Care
PubMed: 37675964
DOI: 10.1002/cpp.2901 -
British Journal of Anaesthesia Jul 2024Heterogeneity of reported outcomes can impact the certainty of evidence for prehabilitation. The objective of this scoping review was to systematically map outcomes and... (Review)
Review
BACKGROUND
Heterogeneity of reported outcomes can impact the certainty of evidence for prehabilitation. The objective of this scoping review was to systematically map outcomes and assessment tools used in trials of surgical prehabilitation.
METHODS
MEDLINE, EMBASE, PsychInfo, Web of Science, CINAHL, and Cochrane were searched in February 2023. Randomised controlled trials of unimodal or multimodal prehabilitation interventions (nutrition, exercise, psychological support) lasting at least 7 days in adults undergoing elective surgery were included. Reported outcomes were classified according to the International Society for Pharmacoeconomics and Outcomes Research framework.
RESULTS
We included 76 trials, mostly focused on abdominal or orthopaedic surgeries. A total of 50 different outcomes were identified, measured using 184 outcome assessment tools. Observer-reported outcomes were collected in 86% of trials (n=65), with hospital length of stay being most common. Performance outcomes were reported in 80% of trials (n=61), most commonly as exercise capacity assessed by cardiopulmonary exercise testing. Clinician-reported outcomes were included in 78% (n=59) of trials and most frequently included postoperative complications with Clavien-Dindo classification. Patient-reported outcomes were reported in 76% (n=58) of trials, with health-related quality of life using the 36- or 12-Item Short Form Survey being most prevalent. Biomarker outcomes were reported in 16% of trials (n=12) most commonly using inflammatory markers assessed with C-reactive protein.
CONCLUSIONS
There is substantial heterogeneity in the reporting of outcomes and assessment tools across surgical prehabilitation trials. Identification of meaningful outcomes, and agreement on appropriate assessment tools, could inform the development of a prehabilitation core outcomes set to harmonise outcome reporting and facilitate meta-analyses.
Topics: Humans; Randomized Controlled Trials as Topic; Preoperative Exercise; Postoperative Complications; Patient Reported Outcome Measures; Preoperative Care; Outcome Assessment, Health Care
PubMed: 38570300
DOI: 10.1016/j.bja.2024.01.046 -
Journal of Cancer Education : the... Oct 2023The Project ECHO model of telementoring has been used for the past 10 years to expand access to specialized cancer care. This scoping review identifies evidence for the... (Review)
Review
The Project ECHO model of telementoring has been used for the past 10 years to expand access to specialized cancer care. This scoping review identifies evidence for the model's ability to improve provider outcomes, synthesizing findings from existing studies within Moore et al.'s (2009) framework for continuing medical education outcomes. We search two large research databases and a collection maintained by Project ECHO staff for articles that focus on cancer ECHO programs, involve primary data collection, and were published between December 1, 2016, and November 30, 2021. We identified 25 articles for inclusion in our scoping review. Most articles reported results for outcomes related to program participation: attendance, satisfaction, and learning. Yet, just under half reported changes in provider practices. Results demonstrate widespread participation and improved learning resulting from ECHO programs focused on cancer care. There is also evidence of improved practices related to HCV vaccination and palliative care. We highlight examples of best practices as well as opportunities to improve provider outcome evaluations for cancer ECHO programs.
Topics: Humans; Outcome Assessment, Health Care; Education, Medical, Continuing; Data Collection; Neoplasms
PubMed: 37002507
DOI: 10.1007/s13187-023-02292-x -
The Journal of Allergy and Clinical... Sep 2023
Topics: Humans; Outcome Assessment, Health Care
PubMed: 37684077
DOI: 10.1016/j.jaip.2023.05.018 -
Administration and Policy in Mental... May 2024At the centre of POR is the concept of collaboration between patients, therapists, agencies, and third-party payers. For this commentary, I review the articles of the...
At the centre of POR is the concept of collaboration between patients, therapists, agencies, and third-party payers. For this commentary, I review the articles of the special issue with attention to both the opportunities and challenges offered by practice-oriented research (POR). I also reviewed some previous research on practice-research networks and how that research might inform POR. The use of routine outcome monitoring (ROM), artificial intelligence (AI), and program evaluation (PE) models show promise for advancing POR. However, each comes with its challenges. The use of ROM to improve patient outcomes has research support. However, researchers have identified problems with implementing ROM because of low uptake by clinicians and because clinicians may see ROM as a potential intrusion. AI shows promise to improve patient outcomes by potentially providing therapists with immediate and nuanced data to inform interventions and interpersonal stances specific to each patient. However, the scaling up of AI runs the risk of dehumanizing psychological interventions. PE may provide a context for allowing therapists to engage in POR to address real-world processes and outcomes of mental health interventions. However, like ROM PE faces the challenge of trust among clinicians and patients who may be reluctant to participate. Despite these challenges, and because of efforts to nurture and maintain respectful collaborations, articles in this special issue highlight how POR can play a pivotal role in bridging the gap between theory and practice.
Topics: Humans; Artificial Intelligence; Health Services Research; Outcome Assessment, Health Care; Program Evaluation
PubMed: 38598077
DOI: 10.1007/s10488-024-01370-6 -
The Journal of Evidence-based Dental... Sep 2023With evidence-based dentistry (EBD) having a far-reaching influence on oral healthcare, dental educators worldwide have made joint efforts to integrate EBD-related... (Review)
Review
OBJECTIVE
With evidence-based dentistry (EBD) having a far-reaching influence on oral healthcare, dental educators worldwide have made joint efforts to integrate EBD-related knowledge and skills into dental education. The present scoping review aims to identify and summarize the existing teaching contents, teaching methods, and assessment strategies of EBD education.
METHODS
Electronic (PubMed and Embase) and manual searches were performed to identify articles related to both "dental education" and "evidence-based practice." Based on predetermined eligibility criteria, articles were selected by 2 reviewers, independently and in duplicate. Data synthesis was conducted based on teaching contents, teaching strategies, and teaching assessment.
RESULTS
Of the 1758 articles found in the literature searches, 74 were deemed eligible and included in this review. A total of 4 basic skills (problem formulation, literature searching, critical appraisal, and research methodology), 5 teaching methods, and 6 assessment strategies were identified. In most of the articles, 2, or more skills were taught, and a combination of traditional strategies for teaching and its assessment (eg, courses and questionnaire survey) was involved. Other teaching methods, such as journal clubs and workshops, were seldom used, and validated assessment tools accounted for a relatively small proportion of the assessment strategies involved.
CONCLUSIONS
The contents, methods and assessment of EBD education have been widely studied and discussed. However, the current literature focuses mainly on teaching of critical appraisal skills, traditional teaching methods, and short-term outcome assessments. Future research in this area can be aimed at integrating all EBD-related skills into educational models, studying multifaceted teaching approaches, and developing comprehensive teaching outcome assessment methods based on validated tools and dental patient-reported outcomes.
Topics: Humans; Evidence-Based Dentistry; Research Design; Health Facilities; Outcome Assessment, Health Care; Patient Reported Outcome Measures
PubMed: 37689454
DOI: 10.1016/j.jebdp.2023.101895