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British Journal of Pain Jun 2024Breakthrough pain is common in life-limiting conditions and at end-of-life. Despite over 30 years of study, there is little consensus regarding the definition and...
BACKGROUND
Breakthrough pain is common in life-limiting conditions and at end-of-life. Despite over 30 years of study, there is little consensus regarding the definition and characteristics of breakthrough pain.
OBJECTIVE
This study aims to update and expand a 2010 systematic review by Haugen and colleagues to identify (1) all definitions of breakthrough pain and (2) all descriptions and classifications of breakthrough pain reported by patients, caregivers, clinicians, and experts.
DESIGN
This rapid systematic review followed the Cochrane Rapid Review Methods Group guidelines. A protocol is published on PROSPERO (CRD42019155583).
DATA SOURCES
CINAHL, MEDLINE, PsycINFO, and the Web of Science were searched for breakthrough pain terms from the inception dates of each database to 26th August 2022.
RESULTS
We identified 65 studies that included data on breakthrough pain definitions, descriptions, or classifications from patients ( = 30), clinicians ( = 6), and experts ( = 29), but none with data from caregivers. Most experts proposed that breakthrough pain was a sudden, severe, brief pain occurring in patients with adequately controlled mild-moderate background pain. However, definitions varied and there was no consensus. Pain characteristics were broadly similar across studies though temporal factors varied widely. Experts classified breakthrough pain into nociceptive, neuropathic, visceral, somatic, or mixed types. Patients with breakthrough pain commonly experienced depression, anxiety, and interference with daily life.
CONCLUSIONS
Despite ongoing efforts, there is still no consensus on the definition of breakthrough pain. A compromise is needed on breakthrough pain nomenclature to collect reliable incidence and prevalence data and to inform further refinement of the construct.
PubMed: 38751563
DOI: 10.1177/20494637231208093 -
International Journal of Nursing... Dec 2023Negative symptoms, frequently experienced by people with schizophrenia, can impair functional outcomes and quality of life. Negative symptoms typically affect... (Review)
Review
BACKGROUND
Negative symptoms, frequently experienced by people with schizophrenia, can impair functional outcomes and quality of life. Negative symptoms typically affect motivation, communication, and the ability to live independently and are difficult to treat. Several meta-analyses suggest that cognitive behavioural therapy results in a modest reduction in negative symptoms. It is unclear if similar effects can be achieved using behavioural activation. Behavioural activation is a derivative of cognitive behavioural therapy that helps to improve social and emotional functioning by encouraging patients to engage in activities that they value whilst modifying the avoidance responses. Behavioural activation can be a standalone treatment for depressive symptoms that is equally as efficacious as cognitive behavioural therapy.
OBJECTIVE
This systematic review aimed to identify and summarise the evidence about the efficacy of behavioural activation in treating negative symptoms.
DESIGN
Systematic review.
SETTING/PARTICIPANTS
Two published studies conducted in South Korea and the United Kingdom recruited 55 patients.
METHOD
We searched five databases and four trial registries for clinical treatment trials of behavioural activation involving adults diagnosed with negative symptoms of schizophrenia. Studies were screened according to the inclusion criteria and assessed for quality.
RESULTS
We identified 5023 published studies. After removing duplicates and conducting screening, two studies were included in this review. One study used a parallel non-randomised trial design whilst the other adopted a single group test-re-test design. Fifty-five participants were recruited from hospital and community settings. Both studies delivered 10 face-to-face sessions of behavioural activation; these were individual in one study and group sessions in the other. One study involved behavioural activation as the treatment whilst the other delivered behavioural activation with motivational interviewing. Neither study reported harms or adverse events.
CONCLUSIONS
Based on the included studies, there is low-quality evidence that behavioural activation may be helpful in the treatment of negative symptoms. Key limitations of the studies include small sample sizes and overall low study quality.
STUDY REGISTRATION
The protocol covering this review was registered with Open Science on 18 February 2022 (Registration DOI 10.17605/OSF.IO/57QSW; Weblink: https://osf.io/57qsw).
TWEETABLE ABSTRACT
Behavioural activation holds promise in supporting patients experiencing negative symptoms of schizophrenia.
PubMed: 38746587
DOI: 10.1016/j.ijnsa.2023.100132 -
International Journal of Nursing... Dec 2023Intensive care units deliver care to a heterogeneous group of patients with pre-existing co-morbid disease. Focus has shifted to improving health related quality of life... (Review)
Review
Patients' experiences and perspectives of post-hospital follow-up care to improve physical recovery for intensive care survivors: A systematic review of qualitative research.
BACKGROUND
Intensive care units deliver care to a heterogeneous group of patients with pre-existing co-morbid disease. Focus has shifted to improving health related quality of life with more patients surviving beyond hospital discharge. Randomised controlled trials evaluating follow-up interventions, to improve physical recovery, have not demonstrated a health-related quality of life benefit. Qualitative research may provide the context to understand the experiences of intensive care survivors during follow-up care addressing physical limitations.
OBJECTIVE
To synthesise qualitative studies and explore Intensive Care survivors' experiences and perspectives of physical symptoms in the context of follow-up care.
SETTINGS
A systematic search of electronic databases (MEDLINE, Cumulative Index of Nursing and Allied Health Literature, Web of Science, Applied Social Sciences Index and Abstracts, Ovid Nursing and Ovid Emcare) was conducted to identify peer-reviewed primary qualitative studies. No date parameters were applied. Inclusion/exclusion criteria guided the screening process.
PARTICIPANTS
The data from eligible primary research studies was extracted into NVivo (v12).
METHODS
Critical appraisal was completed using the Joanna Briggs Critical Appraisal Tool. Thematic analysis, guided by Braun and Clarke (2022), informed the data synthesis.
RESULTS
From 2457 studies, ten relevant studies were included. Two main themes were identified: 1. Recovery as uncertain; which outlines the uncertainty experienced by intensive care unit survivors during recovery. This theme pertained to system-level factors (role of healthcare professional and information provision) which provides the context for delivering follow-up care. 2. Self-determination of recovery; outlines individual characteristics in determining recovery which is conceptualised by patient-level factors (motivation, support network and perception of health).
CONCLUSIONS
For intensive care survivors, the recovery trajectory is uncertain with a gap in information provision during the acute phase following hospital discharge. Patients' self-determination of recovery is an important consideration to ensure follow-up care addresses the needs of individual patients. The impact of pre-existing co-morbid disease and subgroups of patients deriving benefit from follow-up care remains uncertain.
REGISTRATION
PROSPERO Registration no. CRD42022355711.
TWEETABLE ABSTRACT
Patients' experiences of post-hospital follow-up care to improve physical recovery for intensive care survivors: A Systematic Review of Qualitative Research.
PubMed: 38746570
DOI: 10.1016/j.ijnsa.2023.100168 -
Research Involvement and Engagement May 2024There is increasing interest in using patient and public involvement (PPI) in research to improve the quality of healthcare. Ordinarily, traditional methods have been... (Review)
Review
What are the strengths and limitations to utilising creative methods in public and patient involvement in health and social care research? A qualitative systematic review.
BACKGROUND
There is increasing interest in using patient and public involvement (PPI) in research to improve the quality of healthcare. Ordinarily, traditional methods have been used such as interviews or focus groups. However, these methods tend to engage a similar demographic of people. Thus, creative methods are being developed to involve patients for whom traditional methods are inaccessible or non-engaging.
OBJECTIVE
To determine the strengths and limitations to using creative PPI methods in health and social care research.
METHOD
Electronic searches were conducted over five databases on 14th April 2023 (Web of Science, PubMed, ASSIA, CINAHL, Cochrane Library). Studies that involved traditional, non-creative PPI methods were excluded. Creative PPI methods were used to engage with people as research advisors, rather than study participants. Only primary data published in English from 2009 were accepted. Title, abstract and full text screening was undertaken by two independent reviewers before inductive thematic analysis was used to generate themes.
RESULTS
Twelve papers met the inclusion criteria. The creative methods used included songs, poems, drawings, photograph elicitation, drama performance, visualisations, social media, photography, prototype development, cultural animation, card sorting and persona development. Analysis identified four limitations and five strengths to the creative approaches. Limitations included the time and resource intensive nature of creative PPI, the lack of generalisation to wider populations and ethical issues. External factors, such as the lack of infrastructure to support creative PPI, also affected their implementation. Strengths included the disruption of power hierarchies and the creation of a safe space for people to express mundane or "taboo" topics. Creative methods are also engaging, inclusive of people who struggle to participate in traditional PPI and can also be cost and time efficient.
CONCLUSION
'Creative PPI' is an umbrella term encapsulating many different methods of engagement and there are strengths and limitations to each. The choice of which should be determined by the aims and requirements of the research, as well as the characteristics of the PPI group and practical limitations. Creative PPI can be advantageous over more traditional methods, however a hybrid approach could be considered to reap the benefits of both. Creative PPI methods are not widely used; however, this could change over time as PPI becomes embedded even more into research.
PubMed: 38741156
DOI: 10.1186/s40900-024-00580-4 -
Nutrients Apr 2024Childhood cancer survivors (CCSs) face an increased risk of cardiovascular disease (CVD). This systematic review aims to provide the first synthesis of observational and... (Review)
Review
BACKGROUND
Childhood cancer survivors (CCSs) face an increased risk of cardiovascular disease (CVD). This systematic review aims to provide the first synthesis of observational and interventional studies on the relationship between diet and cardiovascular health in CCSs.
METHODS
A comprehensive search was conducted for studies published between 1990 and July 2023 in PubMed, MEDLINE, CINAHL, Child Development & Adolescent Studies, and Cochrane Library. Eligible studies included observational and interventional studies examining the associations or effects of dietary factors on CVD incidence, cardiac dysfunction, or CVD risk factors in CCSs diagnosed before age 25 years.
RESULTS
Ten studies met the inclusion criteria (nine observational and one interventional). Collectively, they comprised 3485 CCSs (male, 1734; female, 1751). The outcomes examined across observational studies included characteristics of obesity, diabetes biomarkers, hypertension indicators, dyslipidaemia biomarkers, and metabolic syndrome. The evidence suggested that greater adherence to healthy diets was associated with lower body mass index, blood pressure, glucose, and triglycerides and higher high-density lipoprotein cholesterol. The 12-week lifestyle intervention study in childhood leukaemia survivors found no impact on obesity indicators.
CONCLUSION
The review results indicate the potentially protective effects of healthy diets. However, the available research remains preliminary and limited, underscoring the need for more rigorous, adequately powered studies.
Topics: Humans; Cancer Survivors; Cardiovascular Diseases; Child; Female; Male; Adolescent; Diet, Healthy; Diet; Risk Factors; Neoplasms; Adult; Young Adult
PubMed: 38732563
DOI: 10.3390/nu16091315 -
World Psychiatry : Official Journal of... Jun 2024Psychotherapies are first-line treatments for most mental disorders, but their absolute outcomes (i.e., response and remission rates) are not well studied, despite the...
Psychotherapies are first-line treatments for most mental disorders, but their absolute outcomes (i.e., response and remission rates) are not well studied, despite the relevance of such information for health care users, providers and policy makers. We aimed to examine absolute and relative outcomes of psychotherapies across eight mental disorders: major depressive disorder (MDD), social anxiety disorder, panic disorder, generalized anxiety disorder (GAD), specific phobia, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), and borderline personality disorder (BPD). We used a series of living systematic reviews included in the Metapsy initiative (www.metapsy.org), with a common strategy for literature search, inclusion of studies and extraction of data, and a common format for the analyses. Literature search was conducted in major bibliographical databases (PubMed, PsycINFO, Embase, and the Cochrane Register of Controlled Trials) up to January 1, 2023. We included randomized controlled trials comparing psychotherapies for any of the eight mental disorders, established by a diagnostic interview, with a control group (waitlist, care-as-usual, or pill placebo). We conducted random-effects model pairwise meta-analyses. The main outcome was the absolute rate of response (at least 50% symptom reduction between baseline and post-test) in the treatment and control conditions. Secondary outcomes included the relative risk (RR) of response, and the number needed to treat (NNT). Random-effects meta-analyses of the included 441 trials (33,881 patients) indicated modest response rates for psychotherapies: 0.42 (95% CI: 0.39-0.45) for MDD; 0.38 (95% CI: 0.33-0.43) for PTSD; 0.38 (95% CI: 0.30-0.47) for OCD; 0.38 (95% CI: 0.33-0.43) for panic disorder; 0.36 (95% CI: 0.30-0.42) for GAD; 0.32 (95% CI: 0.29-0.37) for social anxiety disorder; 0.32 (95% CI: 0.23-0.42) for specific phobia; and 0.24 (95% CI: 0.15-0.36) for BPD. Most sensitivity analyses broadly supported these findings. The RRs were significant for all disorders, except BPD. Our conclusion is that most psychotherapies for the eight mental disorders are effective compared with control conditions, but absolute response rates are modest. More effective treatments and interventions for those not responding to a first-line treatment are needed.
PubMed: 38727072
DOI: 10.1002/wps.21203 -
Food Science & Nutrition May 2024Consumption of plum does not yet clearly affect the lipid profile. To ascertain the advantages of plum consumption on adult lipid profiles, we conducted a systematic... (Review)
Review
Consumption of plum does not yet clearly affect the lipid profile. To ascertain the advantages of plum consumption on adult lipid profiles, we conducted a systematic review and meta-analysis. We used pertinent keywords to search the databases of PubMed, Scopus, and ISI Web of Science up to November 10th, 2022, in order to find trials that were eligible. According to the analyses, eating plum significantly lowers LDL levels compared to controls (WMD: -12.50 mg/dL, 95% CI: -22.06, -2.94, = .010). Although plum consumption did not result in significant changes in TG (WMD: 0.56 mg/dL, 95% CI: -6.02, 7.15, = .866), TC (WMD: -12.35 mg/dL, 95% CI: -25.05, 0.37, = .057), and HDL concentrations (WMD: -0.39 mg/dL, 95% CI: -4.69, 3.89, = .855) compared to the control group. Intake of plums, particularly the intervention type of dried plums, significantly decreased TC levels in unhealthy subjects, according to subgroup analysis. The consumption of plums had a notably statistically significant effect on LDL levels when the intervention type was dried plum and unhealthy subjects were enrolled. Due to the very low to moderate quality of meta-evidence, to show how eating plum improves lipid profile, further high-quality research are still essential.
PubMed: 38726435
DOI: 10.1002/fsn3.4000 -
Frontiers in Psychology 2024Ethnic-racial identity (ERI) development refers to how individuals' experiences, beliefs, and attitudes influence understanding of ethnic-racial group membership....
BACKGROUND
Ethnic-racial identity (ERI) development refers to how individuals' experiences, beliefs, and attitudes influence understanding of ethnic-racial group membership. Messages about race, from multiple ecosystems, influence identity development and how individuals come to form their ERI. There has been a shift in ERI research to focus on Multiracial populations, however, most of the research focus is on Black/white biracial and general, non-specified Multiracial populations. The ERI development process and experience for persons of other Multiracial backgrounds (e.g., AfroLatinx or AsianBlack) is not as extensively studied. This systematic literature review aims to elucidate the existing conceptualization of Multiracial ERI development for non-Black/white biracial and general Multiracial populations in the United States.
METHODS
A comprehensive search strategy was employed across multiple academic databases to identify relevant studies based on explicit inclusion criteria. The initial search resulted in 1,846 articles, but when only Black/white biracial and non-specified general Multiracial studies were eliminated from this review, only 18 articles met the criteria for inclusion.
RESULTS
Common themes emerged from the reviewed literature, including the importance of spaces, conflicting social messages directed at Multiracial individuals, and coping responses used by Multiracial individuals when faced with challenges by family members and peers regarding their multiracial identity.
DISCUSSION
The findings underscore the need for a more nuanced exploration of ERI development among diverse Multiracial populations. Understanding the unique strengths, experiences, and challenges of different Multiracial populations beyond the Black-white biracial paradigm is essential for understanding ERI development across and between different Multiracial populations in today's world.
PubMed: 38725948
DOI: 10.3389/fpsyg.2024.1307624 -
Health Promotion International Jun 2024The health promotion literature that considers how scientific evidence can be effectively communicated tends to focus on evaluating the effectiveness of communication... (Review)
Review
The health promotion literature that considers how scientific evidence can be effectively communicated tends to focus on evaluating the effectiveness of communication materials. This has resulted in a knowledge gap regarding effective knowledge translation processes. This study explores the process, reasoning and practices for developing books for children that incorporate evidence-based information to aid understanding of scientific evidence about health and environmental or natural disasters. This study is informed by a systematic review of the literature combined with responses to an email interview with authors of books for children. Nine published studies were included in the systematic review. Twenty-two authors responded to the email survey (25% response rate, following 86 invitations). We report seven key findings to guide the development of health-promoting books for children: (i) understand the needs and expectations of the audience, (ii) articulate the topic and research evidence, (iii) assemble a team with a mix of content knowledge and creative expertise, (iv) format should be chosen to suit the user group and guided by the creative team, (v) early testing with children and their support system is crucial, (vi) develop a dissemination strategy to reach the user group and (vii) engage in reflexivity through evaluation of effectiveness of messaging. The current investigation can guide the process, reasoning and practice of developing books for children that incorporate evidence about health and environmental disasters.
Topics: Humans; Child; Books; Health Promotion; Research Personnel; Translational Research, Biomedical
PubMed: 38722020
DOI: 10.1093/heapro/daae035 -
Frontiers in Psychology 2024Poor mental wellbeing is a challenge for societies across the world, as is the increasing threat of climate change, and emerging evidence suggests these challenges are...
BACKGROUND
Poor mental wellbeing is a challenge for societies across the world, as is the increasing threat of climate change, and emerging evidence suggests these challenges are interrelated. Green and social prescribing of non-clinical interventions hold promise as a cost-effective and widely accessible way to improve wellbeing, and interest is growing in whether pro-ecological communal activities have mutual benefits for both people and the planet.
OBJECTIVES
Communal pro-ecological activities are growing in popularity, and research is gathering pace into whether participation influences mental wellbeing. The present systematic review scopes the existing evidence base to explore what is being done, what is being found, and what additional research is required.
METHODS
Electronic databases (PsychNET, PubMed, Scopus, and Web of Science) were searched for studies that involved groups of people undertaking pro-ecological activities, where components of mental wellbeing were assessed. Eligibility criteria were purposely broad, including all study designs and participants across the lifespan.
RESULTS
Thirty-seven eligible studies were identified. Nearly half of the studies used mixed-method designs, and most studies used surveys or interviews to evaluate outcomes. Most pro-ecological activities involved planting vegetation, and habitat creation, maintenance, or restoration. Methodological quality varied considerably. Among the perceived therapeutic mechanisms reported, the social elements of the interventions were prominent.
DISCUSSION
Coherent synthesis of the current evidence base is challenging given the heterogeneous range of methods, samples, and interventions within the studies. However, the results here demonstrate promise that with future research and better methodological rigor, pro-ecological group-based interventions hold the potential to improve mental wellbeing and influence sustainable behavior.
SYSTEMATIC REVIEW REGISTRATION
https://osf.io/vmpr6/.
PubMed: 38721323
DOI: 10.3389/fpsyg.2024.1288791