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The International Journal of Eating... Jan 2017To systematically review the literature on perceived barriers and facilitators of help-seeking for eating disorders. (Review)
Review
OBJECTIVE
To systematically review the literature on perceived barriers and facilitators of help-seeking for eating disorders.
METHOD
Three databases (PubMed, PsychInfo, Cochrane) were searched using keywords and Medical Subject Headings (MeSH) terms. Retrieved abstracts (N = 3493) were double screened and relevant papers (n = 13) were double coded. Qualitative and quantitative studies were included if they reported perceived barriers and facilitators towards seeking help for eating disorders. Barriers and facilitators were extracted from the included papers and coded under themes. The most prominent barriers and facilitators were determined by the number of studies reporting each theme.
RESULTS
Eight qualitative, three quantitative, and two mixed-methods studies met the inclusion criteria for the current review. The most prominent perceived barriers to help-seeking were stigma and shame, denial of and failure to perceive the severity of the illness, practical barriers (e.g., cost of treatment), low motivation to change, negative attitudes towards seeking help, lack of encouragement from others to seek help and lack of knowledge about help resources. Facilitators of help-seeking were reported in six studies, with the most prominent themes identified as the presence of other mental health problems or emotional distress, and concerns about health.
DISCUSSION
Programs targeting prevention and early intervention for eating disorders should focus on reducing stigma and shame, educating individuals about the severity of eating disorders, and increasing knowledge around help-seeking pathways for eating disorders. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2017; 50:9-21).
Topics: Denial, Psychological; Feeding and Eating Disorders; Female; Health Education; Humans; Patient Acceptance of Health Care; Shame; Social Stigma
PubMed: 27526643
DOI: 10.1002/eat.22598 -
Journal of Oral Rehabilitation Nov 2013The objective of this systematic review was to find sufficient evidence to deny or accept the association between the head and cervical posture and temporomandibular... (Review)
Review
The objective of this systematic review was to find sufficient evidence to deny or accept the association between the head and cervical posture and temporomandibular disorders (TMDs), and thus assist health professionals in the evaluation and treatment of patients with TMDs. A search was conducted through all publications written in English about this topic using the databases from Medline, ISI Web of Science, EMBASE, PubMed and Lilacs. The abstracts that fulfilled the initial guideline were retrieved and evaluated to ensure they met the inclusion criteria. To assess the methodological quality of the studies, we developed a questionnaire considering the following criteria: participant's eligibility, control group, diagnosis of TMDs, posture diagnosis and randomisation. Twenty-two studies were selected as potential studies based on their abstracts. Only seventeen studies actually fulfilled the inclusion criteria. The search provided information about the methodological quality of the studies, in which several methodological defects were found. The evidence presented in this systematic review shows that the relation between TMDs and the head and neck posture is still controversial and unclear. The insufficient number of articles considered of excellent methodological quality is a factor that hinders the acceptance or denial of this association.
Topics: Cervical Vertebrae; Head; Humans; Neck; Posture; Randomized Controlled Trials as Topic; Temporomandibular Joint Dysfunction Syndrome
PubMed: 24118029
DOI: 10.1111/joor.12104 -
American Journal of Kidney Diseases :... Mar 2016Kidney transplantation offers better outcomes compared to dialysis, but requires patients to adhere to an ongoing and complex self-management regimen. Medication... (Review)
Review
BACKGROUND
Kidney transplantation offers better outcomes compared to dialysis, but requires patients to adhere to an ongoing and complex self-management regimen. Medication nonadherence remains a leading cause of transplant loss, and inadequate self-management undermines transplantation and other health outcomes. We aimed to describe kidney transplant recipients' motivations, challenges, and attitudes toward self-management.
STUDY DESIGN
Systematic review and thematic synthesis of qualitative studies.
SETTING & POPULATION
Kidney transplant recipients.
SEARCH STRATEGY & SOURCES
MEDLINE, EMBASE, PsycINFO, and CINAHL were searched to October 2014.
ANALYTICAL APPROACH
Thematic synthesis.
RESULTS
50 studies involving 1,238 recipients aged 18 to 82 years across 19 countries were included. We identified 5 themes: empowerment through autonomy (achieving mastery, tracking against tangible targets, developing bodily intuition, routinizing and problem solving, and adaptive coping), prevailing fear of consequences (inescapable rejection anxiety, aversion to dialysis, minimizing future morbidity, trivialization and denial, and defining acceptable risks), burdensome treatment and responsibilities (frustrating ambiguities, inadvertent forgetfulness, intrusive side effects, reversing ingrained behaviors, and financial hardship), overmedicalizing life (dominating focus, evading patienthood, and succumbing to burnout), and social accountability and motivation (demonstrating gratitude toward medical team, indebtedness to donor, and peer learning).
LIMITATIONS
Non-English articles were excluded.
CONCLUSIONS
Self-efficacy and social accountability are motivators for self-management, although adherence can be mentally and physically taxing. Multicomponent interventions incorporating personalized care planning, education, psychosocial support, decision aids, and self-monitoring tools may foster self-management capacity and improve transplantation outcomes.
Topics: Adaptation, Psychological; Attitude to Health; Graft Rejection; Graft Survival; Humans; Kidney Failure, Chronic; Kidney Transplantation; Medication Adherence; Motivation; Qualitative Research; Self Care
PubMed: 26372087
DOI: 10.1053/j.ajkd.2015.07.030 -
BMJ Clinical Evidence Mar 2009Anorexia nervosa is characterised by a low body mass index (BMI), fear of gaining weight, denial of current low weight and its impact on health, and amenorrhoea.... (Review)
Review
INTRODUCTION
Anorexia nervosa is characterised by a low body mass index (BMI), fear of gaining weight, denial of current low weight and its impact on health, and amenorrhoea. Estimated prevalence is highest in teenage girls, and up to 0.7% of this age group may be affected. While most people with anorexia nervosa recover completely or partially, about 5% die of the condition, and 20% develop a chronic eating disorder. Young women with anorexia nervosa are at increased risk of bone fractures later in life.
METHODS AND OUTCOMES
We conducted a systematic review which aimed to answer the following clinical questions: What are the effects of treatments for anorexia nervosa? What are the effects of interventions to prevent or treat complications of anorexia nervosa? We searched: Medline, Embase, The Cochrane Library, and other important databases up to August 2007 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
RESULTS
We found 40 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
CONCLUSIONS
In this systematic review we present information relating to the effectiveness and safety of the following interventions: anxiolytic drugs, cyproheptadine, inpatient/outpatient treatment setting, oestrogen treatment, psychotherapy, refeeding, selective serotonin reuptake inhibitors (SSRIs), and tricyclic antidepressants.
Topics: Anorexia Nervosa; Feeding and Eating Disorders; Humans; Prevalence; Psychotherapy
PubMed: 19445758
DOI: No ID Found -
International Journal of Epidemiology Dec 2009Chronic Fatigue Syndrome (CFS) is characterized by unexplained fatigue that lasts for at least 6 months alongside a constellation of other symptoms. CFS was historically... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Chronic Fatigue Syndrome (CFS) is characterized by unexplained fatigue that lasts for at least 6 months alongside a constellation of other symptoms. CFS was historically thought to be most common among White women of higher socio-economic status. However, some recent studies in the USA suggest that the prevalence is actually higher in some minority ethnic groups. If there are convincing differences in prevalence and risk factors across all or some ethnic groups, investigating the causes of these can help unravel the pathophysiology of CFS.
METHODS
A systematic review was conducted to explore the relationship between fatigue, chronic fatigue (CF--fatigue lasting for 6 months), CFS and ethnicity. Studies were population-based and health service-based. Meta-analysis was also conducted to examine the population prevalence of CF and CFS across ethnic groups.
RESULTS
Meta-analysis showed that compared with the White American majority, African Americans and Native Americans have a higher risk of CFS [Odds Ratio (OR) 2.95, 95% confidence interval (CI): 0.69-10.4; OR = 11.5, CI: 1.1-56.4, respectively] and CF (OR = 1.56, CI: 1.03-2.24; OR = 3.28, CI: 1.63-5.88, respectively). Minority ethnic groups with CF and CFS experience more severe symptoms and may be more likely to use religion, denial and behavioural disengagement to cope with their condition compared with the White majority.
CONCLUSIONS
Although available studies and data are limited, it does appear that some ethnic minority groups are more likely to suffer from CF and CFS compared with White people. Ethnic minority status alone is insufficient to explain ethnic variation of prevalence. Psychosocial risk factors found in high-risk groups and ethnicity warrant further investigation to improve our understanding of aetiology and the management of this complex condition.
Topics: Adaptation, Psychological; Black or African American; Attitude to Health; Comorbidity; Denial, Psychological; Fatigue Syndrome, Chronic; Female; Health Behavior; Humans; Indians, North American; Male; Minority Groups; Prevalence; Risk Factors; Severity of Illness Index; Socioeconomic Factors; White People
PubMed: 19349479
DOI: 10.1093/ije/dyp147 -
Drug and Alcohol Dependence Mar 2023The prevalence of drug use in Muslim communities is difficult to estimate due to religious, social, and cultural prohibition toward drug use. With Islam affecting all... (Review)
Review
Barriers and facilitators to accessing inpatient and community substance use treatment and harm reduction services for people who use drugs in the Muslim communities: A systematic narrative review of studies on the experiences of people who receive services and service providers.
BACKGROUND
The prevalence of drug use in Muslim communities is difficult to estimate due to religious, social, and cultural prohibition toward drug use. With Islam affecting all aspects of life in the Muslim world, people who use drugs do it clandestinely to avoid stigma and exclusion from the community, leading to a low number of them seeking treatment for their drug use. This review explored the barriers and facilitators to accessing inpatient and community substance use treatment and harm reduction services for people who use drugs in Muslim communities.
METHODS
This review was in accordance with PRISMA. Seven databases were systematically searched for qualitative, quantitative, and mixed methods studies conducted in countries where at least 70% of the population were Muslim or where data were presented separately for Muslim communities in other countries. Eligible articles were reviewed, and key qualitative themes were abstracted and compared across studies and settings.
RESULTS
Twenty-four studies were included from Iran, Bangladesh, Afghanistan, Tajikistan, Kazakhstan, Kyrgyzstan, Egypt, Lebanon, and UAE. Two themes were identified: a psychosocial theme included denial of the problem severity, lack of trust in the treatment system, fear of breach in confidentiality and privacy, the need for community support, religion and women who use drugs. Additionally, an organizational theme included affordability, treatment Service characteristics, lack of Awareness, service providers' Attitudes, drug use registration and fear of legal consequences of drug use. Stigma was also identified as an over-arching theme. The Mixed Methods Appraisal Tool (MMAT) was used to assess the quality of the included studies with where 12 of the studies met all 5 the quality criteria. No studies were excluded for having lower quality scores.
CONCLUSION
This review reflected how diverse the Muslim world is in drug use. It is important to use mosques to raise awareness on people who use drugs and reduce stigma. Providing holistic services for people who use drugs specially women will improve their access to treatment and harm reduction services in the Muslim world.
Topics: Humans; Female; Islam; Harm Reduction; Inpatients; Substance-Related Disorders; Social Stigma; Qualitative Research
PubMed: 36805826
DOI: 10.1016/j.drugalcdep.2023.109790 -
BMJ Open Dec 2023Patients with breast cancer and endocrine therapy-related symptoms often experience pain, self-denial, anxiety, fear of recurrence and despair, which can be extremely...
INTRODUCTION
Patients with breast cancer and endocrine therapy-related symptoms often experience pain, self-denial, anxiety, fear of recurrence and despair, which can be extremely physically and psychologically traumatising for the patients. Failure to receive effective support and management reduces adherence to medications, leading to a higher risk of relapse and mortality. Clearly, it is paramount to identify what support these patients may need and how to meet their symptom management needs. This paper outlines a protocol to synthesise qualitative evidence on endocrine therapy symptom experiences, management expectations and preferences of patients with breast cancer.
METHODS AND ANALYSIS
The following databases were searched in November 2023 with no date restriction applied: The Cochrane Library, PubMed, Embase, Web of Science, Scopus, CINAHL and OpenGrey. Published studies on qualitative or mixed-method on symptom experiences and management needs during endocrine therapy in patients with breast cancer will be retrieved. We will also search for reference lists and perform a forward citation search. Before inclusion in this review, two reviewers will independently apply the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Qualitative Research to ensure methodological validity. Any disagreements regarding the evaluation of the articles will be resolved through discussion with or by a third reviewer. Data will be extracted using the standardised data extraction tool EndNote20 for unified management, assessment, and review of information. The common sense model of self-regulation will guide data extraction and synthesis. The final synthesised findings will be graded according to the GRADE-CERQual approach to establish confidence.
ETHICS AND DISSEMINATION
This systematic review addressed previously published studies without personally identifiable participant information. Ethical approval from the research committee was not required. The findings of this systematic review will be disseminated to various key stakeholders and published in peer-reviewed journals.
PROSPERO REGISTRATION NUMBER
CRD42023406987.
Topics: Female; Humans; Breast Neoplasms; Mental Processes; Neoplasm Recurrence, Local; Palliative Care; Qualitative Research
PubMed: 38149416
DOI: 10.1136/bmjopen-2023-073915 -
BMC Public Health Apr 2014South Asian children with asthma are less likely to receive prescriptions and more likely to suffer uncontrolled symptoms and acute asthma admissions compared with White... (Review)
Review
BACKGROUND
South Asian children with asthma are less likely to receive prescriptions and more likely to suffer uncontrolled symptoms and acute asthma admissions compared with White British children. Understanding barriers are therefore vital in addressing health inequalities. We undertook a systematic review identifying explanatory factors for barriers and facilitators to asthma management in South Asian children. South Asians were defined as individuals of Indian, Pakistani or Bangladeshi descent.
METHODS
Data Sources - Medline, HMIC, EMBASE, ASSIA, Web of Science, BNI, CINAHL, PsycINFO, OpenSIGLE, CRD, Scopus, NHS Evidence, Cochrane Library, Campbell Collaboration, RCPCH, ATS, ERS, Asthma UK, Google Scholar & Asthma Guidelines (BTS, GINA, ATS, Monash, NAEPP, Singapore & New Zealand) to August 2013.Inclusion Criteria - Qualitative, quantitative or mixed methods research with primary focus on identifying explanations for barriers and/or facilitators to asthma management in South Asian children aged 0-18 years with diagnosed/suspected asthma and/or carers and/or healthcare professionals.Data Extraction - Three authors independently reviewed, selected & extracted eligible articles with disagreements resolved by research team discussion.
RESULTS
15 studies encompassing 25,755 children, 18,483 parents/carers and 239 healthcare professionals were included. Barriers and explanatory factors identified were:1. Lack of asthma knowledge in families and healthcare professionals.2. Under-use of preventer medications.3. Non-acceptance/denial of asthma.4. Over-reliance on Emergency Department management.5. Communication problems.6. Non-adherence to medication.7. Use of complementary therapies.Little facilitators regarding asthma management were identified.
CONCLUSIONS
Several key issues were identified as likely to be ethnic-specific to South Asian families, rather than a reflection of minority status: impact of parental and professional knowledge and beliefs, health service utilisation pattern explanations and the impact of prejudice and stigmatisation. Other explanations such as language barriers are not strictly ethnic specific but instead reflect a minority position.Further research is required to identify why barriers exist, the mechanisms by which they impact on asthma management and how they can be overcome. Furthermore, understanding the difference between barriers and explanations that are ethnic-specific and those that are related to being a minority will enable the application of generic system-wide interventions where ethnicity is not the issue and ethnically-tailored interventions where needed.
Topics: Adolescent; Asthma; Bangladesh; Child; Child Welfare; Child, Preschool; Communication Barriers; Female; Health Knowledge, Attitudes, Practice; Healthcare Disparities; Humans; India; Infant; Infant, Newborn; Male; Pakistan; Patient Education as Topic
PubMed: 24767303
DOI: 10.1186/1471-2458-14-403 -
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 -
Trauma, Violence & Abuse Jul 2024Intimate partner abuse (IPA) is widespread, and denial, minimization, justifying, and blaming (DMJB) are common among people who have committed IPA. Views on the... (Review)
Review
Intimate partner abuse (IPA) is widespread, and denial, minimization, justifying, and blaming (DMJB) are common among people who have committed IPA. Views on the function of DMJB in IPA are mixed, often based on the theoretical standpoint of the authors. This systematic review brings together the knowledge of how distorted accounts operate in IPA committed by men. A systematic review of primary research related to DMJB in heterosexual men who have committed to IPA was conducted. In all, 31 papers were found to meet the inclusion criteria (adult, male-to-female abuse, in western culture, peer reviewed and published in English) and were quality appraised. Data were extracted and analyzed using narrative synthesis. The findings indicate the way DMJB operates in this group is complex. It can represent facilitators of abusive behavior, a way to protect the individual's identity and self-esteem, and a tool men use instrumentally to achieve goals. Themes were present within and between studies highlighting the complex function of DMJB. A model representing the hypothesized intertwined function of DMJB for IPA is proposed. The limitations of the review are discussed and implications and recommendations for policy, practice, and future research are proposed.
Topics: Humans; Male; Intimate Partner Violence; Denial, Psychological; Female; Self Concept; Adult; Interpersonal Relations
PubMed: 37702188
DOI: 10.1177/15248380231196108