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Child Abuse & Neglect Jun 2020Effects of treatment for child sexual abuse (CSA) victims have important implications. Assessing Risk of Bias (RoB) is a vital step to inform interpretations of...
BACKGROUND
Effects of treatment for child sexual abuse (CSA) victims have important implications. Assessing Risk of Bias (RoB) is a vital step to inform interpretations of treatment effects for these victims. The AMSTAR-2 (A MeaSurement Tool to Assess systematic Reviews) offers a comprehensive critical appraisal, allowing users to distinguish high quality reviews.
OBJECTIVE
The aim of this article is two-fold: 1) to provide an up-to-date systematic review of treatment program meta-analytical reviews on interventions for CSA victims; and 2) to evaluate the quality of meta-analytical reviews using the AMSTAR-2. This is the first systematic review to examine the quality of meta-analyses on the effectiveness of CSA interventions using the AMSTAR-2.
METHOD
Eight electronic databases were searched for articles published up to April 2019. Meta-analytical reviews that assessed the effectiveness of any treatment modality for sexually abused children and adolescents up to 18 years old were considered. Outcome measures included physical and mental symptoms, and disorders, measured through validated instruments. Of 2794 articles, nine meta-analyses met the eligibility criteria. There was a variety of interventions, including: trauma-focused cognitive-behavioral therapy CBT, psychodrama, play therapy, and eclectic interventions. The most common outcomes measured were post-traumatic stress disorder/trauma, externalizing, internalizing, and sexualized behaviors.
RESULTS
Although effect sizes were moderately significant, with treatment having a positive effect, all meta-analyses showed a high RoB.
CONCLUSIONS
To use the best available evidence in clinical decision-making for CSA victims, reviewers should conduct meta-analyses that employ RoB tools.
Topics: Adolescent; Bias; Child; Child Abuse, Sexual; Epidemiologic Methods; Humans; Meta-Analysis as Topic; Quality Control; Risk Assessment
PubMed: 32240874
DOI: 10.1016/j.chiabu.2020.104463 -
JBI Database of Systematic Reviews and... Jun 2019The objective of this review is to evaluate the effectiveness of high fidelity simulation (HFS) versus low fidelity simulation (LFS) on practical/clinical skill...
Effectiveness of high fidelity simulation versus low fidelity simulation on practical/clinical skill development in pre-registration physiotherapy students: a systematic review.
OBJECTIVE
The objective of this review is to evaluate the effectiveness of high fidelity simulation (HFS) versus low fidelity simulation (LFS) on practical/clinical skill development in pre-registration physiotherapy students.
INTRODUCTION
Evidence suggests that improved skill development in university can reduce anxiety in practice, improving performance of skills and overall learning at clinical placement for health professions students. However, evidence indicates that the clinical environment is most effective for learning. As a result, there has been increased interest in the use of HFS where students can test knowledge and skills in an increasingly self-directed way. No previous reviews on the effectiveness of HFS on skill development in physiotherapy students were identified.
INCLUSION CRITERIA
Experimental and quasi-experimental studies comparing HFS (simulated person, manikin, virtual simulation, video case-studies) to LFS (peer role-play, paper-based case-studies) in pre-registration physiotherapy education were included. Primary outcomes were objective measures of skills performance; secondary outcomes were students' perceptions of the impact of simulation on learning measured using quantitative outcomes.
METHODS
A three-step search strategy was employed. Following an initial search of MEDLINE and CINAHL and analysis of text words, MEDLINE, CINAHL, ERIC, AMED, EThOS and Google Scholar were searched in November 2017. Reference lists of studies included at critical appraisal stage were hand-searched. Studies published in English from 1978 onwards were included. Title/abstract screening, critical appraisal and data extraction were conducted by two independent reviewers; conflicts were resolved by discussion.
RESULTS
Meta-analysis was not possible due to heterogeneity; therefore, results were presented in narrative form. Three randomized controlled trials (RCT) and three quasi-experimental studies (310 participants) were included. They were conducted in the USA and Australia, and evaluated standardized patients (people who take on the role of a real patient), near-peers, computerized manikins and virtual simulation in pre-registration Bachelor of Science (Honors), Master of Science and Doctor of Physiotherapy students. One RCT was considered high quality, with the remainder moderate quality. The findings related to five main areas: i) In terms of motor skills performance, an increased number of safety fails were found with HFS (HFS = 13.5% safety fails, HFS plus video feedback = 15.4% safety fails, control [LFS] = 8.1% safety fails); ii) In terms of clinical performance, the Assessment of Physiotherapy Practice (APP) tool indicated no significant improvement in mean APP scores at week 6 of clinical placement (HFS mean APP score = 60.7 [9.1], control mean APP score = 58.7 [8.4]; P = 0.35); iii) In terms of self-efficacy, only one of two studies showed a statistically significant difference with HFS, as measured by the Acute Care Confidence Survey (P = 0.001); however, became non-significant once students were on clinical placement (P = 0.328); iv) Students did not perceive a significant difference in their communication skills with HFS, as measured on a visual analogue scale (simulation = 9.05 [1.27]; control 8.75 [1.2]; P = 0.482); and v) In terms of general perceptions, students were significantly more positive about HFS for increasing awareness of safety issues (P = 0.002), patients' emotional status (P = 0.002), handling skills (P < 0.0001) and ability to provide instructions to patients (P < 0.0001).
CONCLUSIONS
Currently, there is no high quality evidence that HFS improves motor skill performance in pre-registration physiotherapy students. There is a small amount of moderate-quality evidence it may improve students' perception of their self-efficacy but no evidence that it improves communication skills. However, a lack of studies and variation in outcome measures meant that meta-analysis was not possible. At present, no recommendations can be made regarding the use of HFS to improve skill performance in this population.
Topics: Clinical Competence; Education, Medical, Undergraduate; High Fidelity Simulation Training; Humans; Learning; Models, Educational; Physical Therapy Modalities; Role Playing; Students, Health Occupations
PubMed: 30964770
DOI: 10.11124/JBISRIR-2017-003931 -
PloS One 2019Psychodrama is an experiential psychotherapy in which guided role-play is used to gain insights and work on personal and interpersonal problems and possible solutions....
BACKGROUND
Psychodrama is an experiential psychotherapy in which guided role-play is used to gain insights and work on personal and interpersonal problems and possible solutions. Despite the wealth of literature describing clinical work, psychodrama intervention research is relatively scarce compared to other psychotherapies and psychological interventions.
OBJECTIVE
For this reason we implemented the integrative approach to systematic review that authorizes the combination of publications with diverse methodologies and all types of participants, interventions, comparisons, and outcomes. Our aim was to produce a comprehensive summary of psychodrama intervention research in the last decade that critically evaluates methodological issues to inform future studies.
METHODS
We searched four major electronic databases (PsycINFO, PubMEd, Scopus by Elsevier, and Web of Science) for peer-reviewed articles on psychodrama interventions published in English between 1 January 2007 and 31 December 2017. The quality of qualitative and mixed methods studies was assessed on the basis of pre-established guidelines, and the risk of bias was assessed for all quantitative randomized control studies, consistent with the PRISMA protocol.
FINDINGS
The database search and a hand search resulted in 31 psychodrama intervention publications. Overall, these studies examined the effects of psychodrama on more than 20 different outcomes and most studies had adult clients. The next largest group was adolescents, whereas only two studies involved children. Thus psychodrama intervention research in the last decade suggests there are promising results in all methodologies, and highlights the need to enhance methodological as well as reporting quality and to theorize and examine modality-specific mechanisms that lead to therapeutic change. Recommendations to improve methodology, transparency, and specificity in reporting future psychodrama and other psychotherapy research are discussed.
Topics: Bias; Crisis Intervention; Humans; Psychodrama; Qualitative Research; Treatment Outcome
PubMed: 30779787
DOI: 10.1371/journal.pone.0212575 -
Frontiers in Psychology 2018The original theory of psychodrama proposed by Moreno in 1921 has been adjusted and re-interpreted by several authors over the last three decades. This resulted in the...
The original theory of psychodrama proposed by Moreno in 1921 has been adjusted and re-interpreted by several authors over the last three decades. This resulted in the proliferation of techniques whose definitions and contexts of application are unclear and poorly documented in the literature. The purpose of this review was three-fold: (1) to identify the psychodramatic techniques currently used for research and clinical purposes, (2) to extract and create a list of core techniques which are consensually used by psychodramatists, and which reflect the main principles of the Morenian theory of psychodrama, and (3) to propose an operationalised definition of the core psychodramatic techniques identified. To achieve this, a systematic review was conducted, according to the PRISMA guidelines (Moher et al., 2009). The search was conducted between June and September of 2012 in the main electronic databases (e.g., PubMed, Embase, PsychINFO) and using the following keywords: "psychodrama," "group psychotherapy," "experiential psychotherapy," "Moreno," "intervention," and "techniques." Fifty-six techniques were extracted from the 21 papers selected for review. Of these, a preliminary list of 30 techniques was selected, which was reduced to a total of 11 core techniques: soliloquy, double, mirror, role reversal, resistance interpolation, sculpture, social atom, intermediate objects, games, sociometry, role training. The credibility of this final core list was first checked with an expert in Morenian psychodrama, and later discussed with a network of 22 European psychodramatists to ensure full consensus. Overall, this review provides a contemporary framework for psychodramatists that reconciles the current approaches to psychodrama with the core techniques proposed by Moreno, and updates the definitions of these techniques, by merging the interpretations of different experts in the field. To have a list of core techniques which is consensually accepted from an international point of view is paramount not only for future research, but also for training purposes. The implications of this review for clinical practice are also discussed.
PubMed: 30087638
DOI: 10.3389/fpsyg.2018.01263 -
Trauma, Violence & Abuse Jan 2020There is an immediate need to advance knowledge around the effective prevention of intimate partner violence (IPV), which is responsible for significant negative health...
There is an immediate need to advance knowledge around the effective prevention of intimate partner violence (IPV), which is responsible for significant negative health and well-being outcomes for women around the world. Creative approaches are being explored internationally-this systematic review provides a timely synthesis of applied theater interventions addressing primary, secondary, and tertiary IPV prevention. Six hundred and ten articles were identified through a comprehensive search of five cross-disciplinary databases. Eleven studies discussed in 15 quantitative and qualitative peer-reviewed articles and one book chapter met the inclusion criteria and were included in the review. Articles were appraised using a standardized quality assessment tool and were analyzed within the context of IPV prevention. Of the reviewed studies, five were classified as primary prevention, four secondary, and two focused on tertiary prevention. Specific strategies used by each of the studies included healthy relationship training, rising awareness and community advocacy, service provider training, bystander training, and working with survivors. While the paucity and quality of current literature make it difficult to determine overall efficacy, this review points to the potential of applied theater as a useful prevention strategy, particularly when interactive, participatory methods are incorporated. Further, applied theater could be an effective tool for working in culturally diverse settings as well as with minority groups. Future applied theater program planning needs to include comprehensive evaluation. More rigorous investigation, involving mixed-method research approaches, is required to fully understand the potential of applied theater as a tool in the context of IPV prevention.
Topics: Female; Humans; Intimate Partner Violence; Male; Psychodrama; Qualitative Research
PubMed: 29334014
DOI: 10.1177/1524838017750157 -
Augmentative and Alternative... 2015The purpose of this study was to conduct a systematic review and meta-analysis of the augmentative and alternative communication (AAC) partner instruction intervention... (Meta-Analysis)
Meta-Analysis Review
The purpose of this study was to conduct a systematic review and meta-analysis of the augmentative and alternative communication (AAC) partner instruction intervention literature to determine (a) the overall effects of partner interventions on the communication of individuals using AAC, and (b) any possible moderating variables relating to participant, intervention, or outcome characteristics. Seventeen single-case experimental design studies (53 participants) met the inclusion criteria and were advanced to the full coding and analysis phase of the investigation. Descriptive analyses and effect size estimations using the Improvement Rate Difference (IRD) metric were conducted. Overall, communication partner interventions were found to be highly effective across a range of participants using AAC, intervention approaches, and outcome measure characteristics, with more evidence available for participants less than 12 years of age, most of whom had a diagnosis of autism spectrum disorder or intellectual/developmental disability. Aided AAC modeling, expectant delay, and open-ended question asking were the most frequently targeted communication partner interaction skills. Providing a descriptive overview, instructor modeling, guided practice, and role plays were the most frequently incorporated communication partner intervention activities within the included studies.
Topics: Autism Spectrum Disorder; Communication; Communication Aids for Disabled; Developmental Disabilities; Humans; Intellectual Disability; Interpersonal Relations; Role Playing
PubMed: 26059542
DOI: 10.3109/07434618.2015.1052153 -
International Journal of Nursing... Jan 2014Interprofessional simulation can provide health profession program educators with an effective means to prepare future practitioners to engage in meaningful... (Review)
Review
Interprofessional simulation can provide health profession program educators with an effective means to prepare future practitioners to engage in meaningful collaboration. This systematic review was conducted to identify best practice recommendations to enhance collaborative healthcare using interprofessional simulation education innovations for learners in pre-licensure nursing programs. Using a systematic review methodology, 375 articles were reviewed and 17 studies met the inclusion criteria. Based on the methodological strength of the research and the impact of the simulation innovations, the following simulation techniques were recommended: high-fidelity human patient simulators, role play, and didactic lecture and audience response didactic lecture, both followed by role play with a standardized patient. Instructor modeling was related to achievement of interprofessional competencies when compared to no modeling. Future research is needed to identify optimal timing for implementing interprofessional education innovations, for development of appropriate evaluation tools, and to determine the effects of collaborative practice on patient care.
Topics: Attitude of Health Personnel; Benchmarking; Clinical Competence; Cooperative Behavior; Curriculum; Education, Nursing, Baccalaureate; Evidence-Based Nursing; Feedback, Psychological; Humans; Interdisciplinary Communication; Nursing Education Research; Patient Simulation; Role Playing; Students, Nursing; Surveys and Questionnaires
PubMed: 24402885
DOI: 10.1515/ijnes-2013-0027 -
The Cochrane Database of Systematic... Feb 2011Studies have also shown that non-ulcer dyspepsia (NUD) patients have higher scores of anxiety, depression, neurotism, chronic tension, hostility, hypochondriasis and... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Studies have also shown that non-ulcer dyspepsia (NUD) patients have higher scores of anxiety, depression, neurotism, chronic tension, hostility, hypochondriasis and tendency to be more pessimistic when compared with the community controls. However, the role of psychological interventions in NUD remains uncertain.
OBJECTIVES
This review aims to determine the effectiveness of psychological interventions including psychotherapy, psychodrama, cognitive behavioural therapy, relaxation therapy and hypnosis in the improvement of either individual or global dyspepsia symptom scores and quality of life scores in patients with NUD.
SEARCH STRATEGY
Trials were identified by searching the Cochrane Controlled Trials Register (Issue 3-1999), MEDLINE (1966-99), EMBASE (1988-99), PsycLIT (1987-1999) and CINAHL (1982-99). Bibliographies of retrieved articles were also searched and experts in the field were contacted. Searches were updated on 10 December 2002 and 21 January 2004. The searches were re-run on 24 January 2005 and 9 January 2006 and no new trials were found
SELECTION CRITERIA
All randomised controlled trials (RCTs) or quasi-randomised studies assessing the effectiveness of psychological interventions (including psychotherapy, psychodrama, cognitive behavioural therapy, relaxation therapy and hypnosis) for non-ulcer dyspepsia (NUD) were identified.
DATA COLLECTION AND ANALYSIS
Data collected included both individual and global dyspepsia symptom scores and quality of life (QoL) scores.
MAIN RESULTS
We identified only four trials each using different psychological interventions; three presented results in a manner that did not allow synthesis of the data to form a meta-analysis. All trials suggested that psychological interventions benefit dyspepsia symptoms and this effect persists for one year. However, all trials used statistical techniques that adjusted for baseline differences between groups. This should not be necessary for a randomised trial that is adequately powered suggesting that the sample size was too small. Unadjusted data was not statistically significant. The other problems of psychological intervention included low recruitment and high drop out rate, which has been shown to be greater in patients receiving group therapy.
AUTHORS' CONCLUSIONS
There is insufficient evidence from this review to confirm the efficacy of psychological intervention in NUD.
Topics: Cognitive Behavioral Therapy; Dyspepsia; Humans; Psychotherapy; Randomized Controlled Trials as Topic
PubMed: 21328255
DOI: 10.1002/14651858.CD002301.pub5 -
Annals of Oncology : Official Journal... May 2011Group training in communication skills [communication skills training (CST)] has become partly mandatory for oncology staff. However, so far, a comprehensive... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
Group training in communication skills [communication skills training (CST)] has become partly mandatory for oncology staff. However, so far, a comprehensive meta-analysis on the efficacy is lacking.
DESIGN
Included studies either compare the efficacy of a specific training with a control group or look at the additional effect of booster sessions on communication behaviour, attitudes or patient outcomes.
METHODS
Four electronic databases were searched up to July 2008 without language restriction, and reference lists of earlier reviews were screened. Effect sizes (ESs) were extracted and pooled in random effects meta-analyses.
RESULTS
We included 13 trials (three non-randomised), 10 with no specific intervention in the control group. Meta-analysis showed a moderate effect of CST on communication behaviour ES = 0.54. Three trials compared basic training courses with more extensive training courses and showed a small additional effect on communication skills ES = 0.37. Trials investigating participants' attitudes ES = 0.35 and patient outcomes ES = 0.13 (trend) confirmed this effect.
CONCLUSIONS
Training health professionals by CST is a promising approach to change communication behaviour and attitudes. Patients might also benefit from specifically trained health professionals but strong studies are lacking. However, feasibility and economic aspects have to be kept in mind when considering providing a training of optimal length.
Topics: Communication; Confidence Intervals; Education, Medical, Continuing; Education, Nursing; Empathy; Humans; Medical Oncology; Patient Satisfaction; Randomized Controlled Trials as Topic; Role Playing; Stress, Psychological
PubMed: 20974653
DOI: 10.1093/annonc/mdq441 -
BMC Geriatrics Apr 2010To systematically review the medical literature to assess the effect of geriatric educational games on the satisfaction, knowledge, beliefs, attitudes and behaviors of... (Review)
Review
OBJECTIVE
To systematically review the medical literature to assess the effect of geriatric educational games on the satisfaction, knowledge, beliefs, attitudes and behaviors of health care professionals.
METHODS
We conducted a systematic review following the Cochrane Collaboration methodology including an electronic search of 10 electronic databases. We included randomized controlled trials (RCT) and controlled clinical trials (CCT) and excluded single arm studies. Population of interests included members (practitioners or students) of the health care professions. Outcomes of interests were participants' satisfaction, knowledge, beliefs, attitude, and behaviors.
RESULTS
We included 8 studies evaluating 5 geriatric role playing games, all conducted in United States. All studies suffered from one or more methodological limitations but the overall quality of evidence was acceptable. None of the studies assessed the effects of the games on beliefs or behaviors. None of the 8 studies reported a statistically significant difference between the 2 groups in terms of change in attitude. One study assessed the impact on knowledge and found non-statistically significant difference between the 2 groups. Two studies found levels of satisfaction among participants to be high. We did not conduct a planned meta-analysis because the included studies either reported no statistical data or reported different summary statistics.
CONCLUSION
The available evidence does not support the use of role playing interventions in geriatric medical education with the aim of improving the attitudes towards the elderly.
Topics: Attitude of Health Personnel; Clinical Competence; Controlled Clinical Trials as Topic; Education, Medical; Games, Experimental; Geriatrics; Humans; Randomized Controlled Trials as Topic; Role Playing
PubMed: 20416055
DOI: 10.1186/1471-2318-10-19