-
Trauma, Violence & Abuse Dec 2023Intimate partner violence (IPV) is a public health problem that has devastating physical, psychological, and economic consequences. The emergency department (ED) is an... (Review)
Review
Intimate partner violence (IPV) is a public health problem that has devastating physical, psychological, and economic consequences. The emergency department (ED) is an important point of contact for individuals experiencing IPV. However, there are few studies synthesizing interactions between patients experiencing IPV and providers. We aimed to summarize the existing evidence regarding (1) ED care experiences of patients with a history of IPV and (2) experiences of ED providers interacting with them. The secondary aim of this review was to evaluate high-quality care barriers and facilitators and to elucidate common causes of care avoidance. A literature search of peer-reviewed electronic databases was undertaken. Inclusion criteria consisted of studies detailing IPV-related patient or provider experiences surrounding ED visits. Articles published before 2000 or unavailable in English/French were excluded. A total of 772 studies were screened, yielding a final number of 41 studies. Negative patient experiences arose from individual-, institutional-, and system-level issues, commonly including adverse provider behavior. Negative provider experiences stemmed from individual-, institutional-, and system-level issues, such as a lack of knowledge and lack of infrastructure. Facilitators to positive patient experiences included interacting with empathetic providers, having privacy, and receiving timely specialized care. Facilitators to positive provider experiences included feeling well-equipped to manage IPV and having policies leading to appropriate care. Negative ED care experiences reveal inadequate care quality, ultimately leading to secondary victimization of individuals experiencing IPV. This review also uncovered important literature gaps regarding experiences of those who identify as equity-deserving.
Topics: Humans; Intimate Partner Violence; Emergency Service, Hospital
PubMed: 35997064
DOI: 10.1177/15248380221118962 -
Drug and Alcohol Dependence Oct 2022There has been a lack of systematic exploration of remotely delivered intervention content and their effectiveness for behaviour change outcomes. This review provides a... (Review)
Review
BACKGROUND
There has been a lack of systematic exploration of remotely delivered intervention content and their effectiveness for behaviour change outcomes. This review provides a synthesis of the behaviour change techniques (BCT) contained in remotely delivered alcohol and/or substance misuse approaches and their association with intervention promise.
METHODS
Searches in MEDLINE, Scopus, PsycINFO (ProQuest), and the Cochrane Library, included studies reporting remote interventions focusing on alcohol and/or substance misuse among adults, with a primary behaviour change outcome (e.g., alcohol levels consumed). Assessment of risk of bias, study promise, and BCT coding was conducted. Synthesis focussed on the association of BCTs with intervention effectiveness using promise ratios.
RESULTS
Studies targeted alcohol misuse (52 studies) or substance misuse (10 studies), with predominantly randomised controlled trial designs and asynchronous digital approaches. For alcohol misuse studies, 16 were very promising, 17 were quite promising, and 13 were not promising. Of the 36 eligible BCTs, 28 showed potential promise, with seven of these only appearing in very or quite promising studies. Particularly promising BCTs were 'Avoidance/reducing exposure to cues for behaviour', 'Pros and cons' and 'Self-monitoring of behaviour'. For substance misuse studies, three were very promising and six were quite promising, with all 12 BCTs showing potential promise.
CONCLUSIONS
This review showed remotely delivered alcohol and substance misuse interventions can be effective and highlighted a range of BCTs that showed promise for improving services. However, concerns with risk of bias and the potential of promise ratios to inflate effectiveness warrant caution in interpreting the evidence.
Topics: Adult; Alcoholism; Behavior Therapy; Humans
PubMed: 35963209
DOI: 10.1016/j.drugalcdep.2022.109597 -
Annals of Surgery Nov 2022Randomized controlled trials (RCTs) yield the highest level of evidence but are notoriously difficult to perform in surgery. Surgical RCTs may be hampered by slow...
INTRODUCTION
Randomized controlled trials (RCTs) yield the highest level of evidence but are notoriously difficult to perform in surgery. Surgical RCTs may be hampered by slow accrual, the surgical learning curve, and lack of financial support. Alternative RCT designs such as stepped-wedge randomized controlled trials (SW-RCTs), registry-based randomized controlled trials (RB-RCTs), and trials-within-cohorts (TwiCs) may overcome several of these difficulties. This review provides an overview of alternative RCT designs used in surgical research.
METHODS
We systematically searched PubMed, EMBASE, and Cochrane Central for surgical SW-RCTs, RB-RCTs, and TwiCs. A surgical RCT was defined as a randomized trial that studied interventions in patients undergoing general surgery, regardless of the affiliation of the corresponding author. Exponential regression analysis was performed to assess time trends.
RESULTS
Overall, 41 surgical RCTs using alternative designs were identified, including 17 published final RCT reports and 24 published protocols of ongoing RCTs. These included 25 SW-RCTs (61%), 13 RB-RCTs (32%), and 3 TwiCs (7%). Most of these RCTs were performed in Europe (63%) and within gastrointestinal/oncological surgery (41%). The total number of RCTs using alternative designs exponentially increased over the last 7 years ( P <0.01), with 95% (n=39/41) of the total number published within this time frame. The most reported reasons for using alternative RCT designs were avoidance of contamination for SW-RCTs and generalizability of the trial population for RB-RCTs and TwiCs.
CONCLUSIONS
Alternative RCT designs are increasingly used in surgical research, mostly in Europe and within gastrointestinal/oncological surgery. When adequately used, these alternative designs may overcome several difficulties associated with surgical RCTs.
Topics: Europe; Humans; Randomized Controlled Trials as Topic
PubMed: 35866665
DOI: 10.1097/SLA.0000000000005620 -
Arthroscopy, Sports Medicine, and... Jun 2022To investigate whether psychological factors, such as avoidance behavior, fear, pain catastrophization, kinesiophobia, anxiety, depression, optimism, and expectation are... (Review)
Review
PURPOSE
To investigate whether psychological factors, such as avoidance behavior, fear, pain catastrophization, kinesiophobia, anxiety, depression, optimism, and expectation are associated with different subjective and functional baseline scores in patients with frozen shoulder contracture syndrome (FSCS).
METHODS
Searches were conducted in MEDLINE, Cochrane Library (CENTRAL Database), PEDro, Pubpsych, and PsychNET.APA without restrictions applied to language, date, or status of publication. Two authors reviewed study titles, abstract, and full text based on the following inclusion criteria: adult population (≥ 30 < 70 years old) with FSCS.
RESULTS
Seven hundred and seventy-six records were included by the search strategies. After title final screening, 6 studies were included for the qualitative synthesis. Psychological features investigated were anxiety, depression, pain-related fear, pain catastrophizing, and pain self-efficacy; reported outcomes included pain, function, disability, quality of life, and range of motion. Data suggest that anxiety and depression impact self-assessed function, pain, and quality of life. There is no consensus on the correlation between psychological variables and range of motion. Associations were suggested between pain-related fear, pain-related beliefs, and pain-related behavior and perceived arm function; pain-related conditions showed no significant correlation with range of motion and with perceived stiffness at baseline.
CONCLUSION
Scores traditionally thought to assess physical dimensions like shoulder pain, disability, and function seem to be influenced by psychological variables. In FSCS patients, depression and anxiety were associated with increased pain perception and decreased function and quality of life at baseline. Moreover, pain-related fear and catastrophizing seem to be associated with perceived arm function.
PubMed: 35747628
DOI: 10.1016/j.asmr.2022.04.001 -
Brain Sciences May 2022There exist extensive animal research and lesion studies in humans demonstrating a tight association between the hypothalamus and socioemotional behavior. However, human... (Review)
Review
There exist extensive animal research and lesion studies in humans demonstrating a tight association between the hypothalamus and socioemotional behavior. However, human neuroimaging literature in this direction is still rather limited. In order to reexamine the functional role of this region in regulating human social behavior, we here provided a synthesis of neuroimaging studies showing hypothalamic activation during affiliative, cooperative interactions, and in relation to ticklish laughter and humor. In addition, studies reporting involvement of the hypothalamus during aggressive and antisocial interactions were also considered. Our systematic review revealed a growing number of investigations demonstrating that the evolutionary conserved hypothalamic neural circuity is involved in multiple and diverse aspects of human socioemotional behavior. On the basis of the observed heterogeneity of hypothalamus-mediated socioemotional responses, we concluded that the hypothalamus might play an extended functional role for species survival and preservation, ranging from exploratory and approaching behaviors promoting social interactions to aggressive and avoidance responses protecting and defending the established social bonds.
PubMed: 35741594
DOI: 10.3390/brainsci12060707 -
The British Journal of Surgery Sep 2022Minimally invasive surgical (MIS) techniques are considered the gold standard of surgical interventions, but they have a high environmental cost. With global...
BACKGROUND
Minimally invasive surgical (MIS) techniques are considered the gold standard of surgical interventions, but they have a high environmental cost. With global temperatures rising and unmet surgical needs persisting, this review investigates the carbon and material footprint of MIS and summarizes strategies to make MIS greener.
METHODS
The MEDLINE, Embase, and Web of Science databases were interrogated between 1974 and July 2021. The search strategy encompassed surgical setting, waste, carbon footprint, environmental sustainability, and MIS. Two investigators independently performed abstract/full-text reviews. An analysis of disability-adjusted life years (DALYs) averted per ton of carbon dioxide equivalents (CO2e) or waste produced was generated.
RESULTS
From the 2456 abstracts identified, 16 studies were selected reporting on 5203 MIS procedures. Greenhouse gas (GHG) emissions ranged from 6 kg to 814 kg CO2e per case. Carbon footprint hotspots included production of disposables and anaesthetics. The material footprint of MIS ranged from 0.25 kg to 14.3 kg per case. Waste-reduction strategies included repackaging disposables, limiting open and unused instruments, and educational interventions. Robotic procedures result in 43.5 per cent higher GHG emissions, 24 per cent higher waste production, fewer DALYs averted per ton of CO2, and less waste than laparoscopic alternatives.
CONCLUSION
The increased environmental impact of robotic surgery may not sufficiently offset the clinical benefit. Utilizing alternative surgical approaches, reusable equipment, repackaging, surgeon preference cards, and increasing staff awareness on open and unused equipment and desflurane avoidance can reduce GHG emissions and waste.
Topics: Carbon Dioxide; Carbon Footprint; Greenhouse Gases; Humans; Laparoscopy; Robotic Surgical Procedures
PubMed: 35726503
DOI: 10.1093/bjs/znac191 -
Omega May 2022This systematic review aimed to summarize the evidence regarding death anxiety (DA) and related factors among nurses. Scopus, PubMed, Web of Science, Iranmedex, and...
This systematic review aimed to summarize the evidence regarding death anxiety (DA) and related factors among nurses. Scopus, PubMed, Web of Science, Iranmedex, and Scientific Information Database (SID) databases were extensively searched using purpose-related keywords from the earliest to October 5, 2021. A total of 6819 nurses were included in 31 studies. The DA of nurses based on the Templer's Death Anxiety Scale was moderate. Factors such as personal anxiety, frequency and severity of job stress, burnout, dying patient avoidance behavior, euthanasia, sex, mental health status, social desirability, attitude toward the elderly, humor, social maturity, psychological hardiness, quality of life, lack of social activity, self-efficacy, coping with death, and life satisfaction were associated with nurses' DA. Therefore, nursing policymakers can promote nurses' health to improve the quality of nursing care by considering these related factors.
PubMed: 35500143
DOI: 10.1177/00302228221095710 -
BMJ Supportive & Palliative Care Apr 2022To explore the emotional experience of physicians in acute settings when encountering end-of-life conversations and decision making.
OBJECTIVE
To explore the emotional experience of physicians in acute settings when encountering end-of-life conversations and decision making.
METHOD
Thematic synthesis of qualitative studies. Medline, PsychInfo, PubMed, BNI and CIAHL were searched from 1985 to 2021 for studies published in English. Data extraction was informed by a framework created for assessing methodological quality by Polanin, Pigott, Espelage and Grotpeter (2019) and adapted by Draper (2019).
RESULTS
Of 8429 papers identified, 17 were selected for review. Two themes containing 10 subthemes described the emotional and psychological factors impacting the experience of end-of-life care, namely: a tension between desire and ability to communicate end-of-life news, and a conflict of hiding versus revealing self across several practical and emotional contexts.
CONCLUSION
Medical training is only a small factor in how well a person copes with end-of-life care and may sometimes feed negative appraisals . Lack of support from senior colleagues, fear of criticism and a sense of perceived failure were linked to lower self-efficacy in end-of-life care. Beyond learning practical skills, physicians benefit from understanding the psychological factors impacting their experience and in building self-efficacy, and observing senior colleagues effectively process strong and difficult emotions.
PRACTICAL IMPLICATIONS
Promoting personal reflection and sharing of the experiences encountered in end-of-life care, especially modelled from senior colleagues, may contribute to improvements in competence and reduce the impact of heroism, feelings of failure and avoidance in practice.
PubMed: 35414630
DOI: 10.1136/bmjspcare-2021-003446 -
Psychological interventions for reducing fear avoidance beliefs among people with chronic back pain.Rehabilitation Psychology Nov 2021Chronic back pain (CBP) is responsible for considerable suffering across the world and is frequently associated with decreased functional capacity, quality of life, and...
OBJECTIVE
Chronic back pain (CBP) is responsible for considerable suffering across the world and is frequently associated with decreased functional capacity, quality of life, and substantial health care costs. Fear avoidance beliefs (FAB) comprise cognitions and fears about the potential for physical activities to produce pain and harm and are common among people with CBP. Collectively, research shows that FAB are frequently associated with low levels of physical activity, poorer work outcomes, and disability. Therefore, the purpose of this systematic review is to systematically locate and synthesize the current evidence regarding the effectiveness of psychological interventions on fear avoidance beliefs and fear avoidance behavior in patients with CBP.
DESIGN
A systematic literature search was conducted based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and included the databases Web of Science, PubMed, Cochrane, CINAHL, Medline, and PsycINFO.
RESULTS
A total of 5,052 records were identified resulting in 2,448 documents after duplicates were removed. We screened 147 studies full text. Twenty-two studies were included in the qualitative synthesis. FAB were assessed by the Fear Avoidance Beliefs Questionnaire, the Tampa Scale of Kinesiophobia and the Avoidance Exercise Questionnaire. Interventions included cognitive behavior therapy (CBT), psychoeducation (PE), and other psychological approaches like motivational interviewing. Twelve of 22 studies demonstrated significant improvements in FAB for people with CBP who underwent a PE or CBT intervention or a different psychological approach.
CONCLUSION
CBT and PE interventions are mainly used to address FAB among people with CBP. However, there is still inconsistent evidence as to which psychological interventions are most effective to treat FAB among people with CBP. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Topics: Back Pain; Chronic Pain; Fear; Humans; Low Back Pain; Psychosocial Intervention; Quality of Life; Surveys and Questionnaires
PubMed: 34591524
DOI: 10.1037/rep0000394 -
American Journal of Clinical Dermatology Nov 2021Patients with vitiligo experience reduced quality of life.
BACKGROUND
Patients with vitiligo experience reduced quality of life.
OBJECTIVE
To comprehensively describe the available evidence for psychosocial burden in vitiligo.
METHODS
A systematic review of observational studies and clinical trials identified using PubMed, EMBASE, Scopus, and the Cochrane databases was performed through 1 March, 2021, to assess psychosocial comorbidities in vitiligo. Two independent reviewers performed an assessment of articles and extracted data for qualitative synthesis.
RESULTS
Included studies (N = 168) were published between 1979 and 1 March, 2021; 72.6% were published since 2010. Disorders including or related to depression (41 studies, 0.1-62.3%) and anxiety (20 studies, 1.9-67.9%) were the most commonly reported. The most prevalent psychosocial comorbidities were feelings of stigmatization (eight studies, 17.3-100%), adjustment disorders (12 studies, 4-93.9%), sleep disturbance (seven studies, 4.6-89.0%), relationship difficulties including sexual dysfunction (ten studies, 2.0-81.8%), and avoidance or restriction behavior (12.5-76%). The prevalence of most psychosocial comorbidities was significantly higher vs healthy individuals. Factors associated with a significantly higher burden included female sex, visible or genital lesions, age < 30 years (particularly adolescents), and greater body surface area involvement, among others. The most commonly reported patient coping strategy was lesion concealment.
LIMITATIONS
Available studies were heterogeneous and often had limited details; additionally, publication bias is possible.
CONCLUSIONS
The results of this systematic review show that vitiligo greatly affects psychosocial well-being. The extent of psychosocial comorbidities supports the use of multidisciplinary treatment strategies and education to address the vitiligo-associated burden of disease.
PROTOCOL REGISTRATION
PROSPERO (CRD42020162223).
Topics: Adaptation, Psychological; Adjustment Disorders; Age Factors; Body Surface Area; Clinical Trials as Topic; Comorbidity; Female; Humans; Male; Observational Studies as Topic; Personality Disorders; Prevalence; Quality of Life; Risk Factors; Severity of Illness Index; Social Stigma; Vitiligo
PubMed: 34554406
DOI: 10.1007/s40257-021-00631-6