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1.
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1535343

RESUMO

Introducción: La esclerosis lateral amiotrófica (ELA) es la forma más común de enfermedad degenerativa de motoneurona en la edad adulta y es considerada una enfermedad terminal. Por lo mismo, el accionar del fonoaudiólogo debe considerar el respeto a los principios bioéticos básicos para garantizar una asistencia adecuada. Objetivo: Conocer aquellas consideraciones bioéticas relacionadas al manejo y estudio de personas con ELA para luego brindar una aproximación hacia el quehacer fonoaudiológico. Método: Se efectuó una búsqueda bibliográfica en las bases de datos PubMed, Scopus y SciELO. Se filtraron artículos publicados desde 2000 hasta junio de 2023 y fueron seleccionados aquellos que abordaban algún componente bioético en población con ELA. Resultados: Aspectos relacionados al uso del consentimiento informado y a la toma de decisiones compartidas destacaron como elementos esenciales para apoyar la autonomía de las personas. Conclusión: Una correcta comunicación y una toma de decisiones compartida son claves para respetar la autonomía de las personas. A su vez, la estandarización de procedimientos mediante la investigación clínica permitirá aportar al cumplimiento de los principios bioéticos de beneficencia y no maleficencia, indispensables para la práctica profesional.


Introduction: Amyotrophic lateral sclerosis (ALS) is the most common form of degenerative motor neuron disease in adulthood and is considered a terminal disease. For this reason, the actions of the speech therapist must consider respect for basic bioethical principles to guarantee adequate assistance. Objective: To know those bioethical considerations related to the management and study of people with ALS to then provide an approach to speech therapy. Methodology: A bibliographic search was carried out in the PubMed, Scopus, and SciELO databases. Articles published from 2000 to June 2023 were filtered and those that addressed a bioethical component in the population with ALS were selected. Results: Aspects related to the use of informed consent and shared decision-making stood out as essential elements to support people's autonomy. Conclusion: Proper communication and shared decision-making are key to respecting people's autonomy. In turn, the standardization of procedures through clinical research will contribute to compliance with the bioethical principles of beneficence and non-maleficence, essential for professional practice.

2.
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1535347

RESUMO

In a context where different protocols for recommended practices in clinical voice assessment exist, while there are gaps in the literature regarding the evidence base supporting assessment procedures and measures, clinicians from regions where a strong community holding expertise in clinical and scientific voice practices lack can struggle to confidently develop their voice assessment practices. In an effort to improve voice assessment practices and strengthen professional identity among speech-language pathologists in Quebec, Canada, a community of practice (CoP) was established, with the aim of promoting knowledge sharing, implementing change in clinical practice, and improving professional identity. Thirty-nine participants took part in the CoP activities conducted over a four-month period, including virtual meetings and in-person workshops. Participants had a high rate of attendance (> 74% participation rate in virtual meetings), and were highly satisfied with their participation and intended to remain involved after the project's end. Statistically significant changes in voice assessment practices were observed post-CoP, regarding probability of performing assessments (p < .001), and perceived importance of assessment for evaluative purposes (p <.001), as well as improvements in assessment specific confidence, specifically for procedure of auditory-perceptual assessment (p < .001) and purpose of aerodynamic assessment (p = .05). Moreover, there was an increase in professional identity post-CoP (p < .001) and participants felt they made significant learnings. The present study highlighted the need to involve SLPs in future research to identify assessments that are relevant to the specific evaluative objectives of SLPs working with voice, and suggests CoPs are an efficient tool for that purpose.


En un contexto en el que existen diferentes protocolos para las prácticas recomendadas en la evaluación vocal clínica, y en el que se presentan vacíos en la literatura respecto a la base de evidencia que respalda los procedimientos y medidas de evaluación, los profesionales de regiones donde no hay una comunidad sólida con experiencia en prácticas vocales clínicas y científicas pueden enfrentar dificultades para desarrollar con confianza sus prácticas de evaluación vocal. Con el propósito de mejorar las prácticas de evaluación vocal y fortalecer la identidad profesional entre los logopedas de Quebec, Canadá, se estableció una comunidad de práctica (CdP). Esta tenía como objetivo fomentar el intercambio de conocimientos, implementar cambios en la práctica clínica y mejorar la identidad profesional. Un total de treinta y nueve participantes se involucraron en las actividades de la CdP, llevadas a cabo durante un período de cuatro meses, que incluyeron reuniones virtuales y talleres presenciales. Los participantes tuvieron una alta tasa de asistencia (> 74% de participación en las reuniones virtuales) y expresaron un alto grado de satisfacción con su participación, manifestando su intención de continuar involucrados después de la finalización del proyecto. Se observaron cambios estadísticamente significativos en las prácticas de evaluación vocal posterior a la CdP, en lo que respecta a la probabilidad de llevar a cabo evaluaciones (p < .001) y la percepción de la importancia de la evaluación con fines evaluativos (p < .001), así como mejoras en la confianza específica en la evaluación, particularmente en el procedimiento de evaluación auditivo-perceptual (p < .001) y el propósito de la evaluación aerodinámica (p = .05). Además, se registró un aumento en la identidad profesional posterior a la CdP (p < .001) y los participantes sintieron que obtuvieron aprendizajes significativos. El presente estudio destacó la necesidad de involucrar a los logopedas en investigaciones futuras, para identificar evaluaciones pertinentes a los objetivos evaluativos específicos de los logopedas que trabajan con la voz, y sugiere que las CdP son una herramienta eficiente con ese propósito.

3.
BMC Nurs ; 23(1): 333, 2024 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-38760751

RESUMO

The practice of routine gastric residual aspiration in preterm infants remains controversial, with conflicting evidence regarding its impact on necrotizing enterocolitis (NEC). As front-line caregivers, nurses play a vital role in gastric aspiration procedures and must be informed by evidence. This quasi-experimental nursing study aimed to assess whether gastric aspiration is clinically relevant in reducing the risk of NEC in preterm infants.A total of 250 preterm infants from two NICUs in Egypt were allocated to the gastric aspiration (n = 125) and non-aspiration (n = 125) groups. Feeding practices, gastric residuals, and incidence/severity of NEC were compared between groups according to modified Bell's criteria. Risk factors were analyzed using multivariate regression. There were no significant baseline differences between the groups. The gastric residual attributes and feeding outcomes did not differ substantially from aspiration. The overall incidence of NEC was 14-15%, with no significant differences in the odds of onset or progression of NEC by stage between the groups. Lower gestational age and birth weight emerged as stronger predictors of NEC. Routine gastric aspiration does not appear to directly prevent or reduce the severity of NEC in this population. Although gastric residuals retain clinical importance, study findings question assumptions that aspiration protects against NEC and informs nursing practice. Evidence-based feeding protocols must continually evolve through ongoing research on modifiable risk factors for this devastating intestinal disease in preterm infants.

4.
Circulation ; 2024 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-38766861

RESUMO

Obesity is a recognized public health epidemic with a prevalence that continues to increase dramatically in nearly all populations, impeding progress in reducing incidence rates of cardiovascular disease. Over the past decade, obesity science has evolved to improve knowledge of its multifactorial causes, identifying important biological causes and sociological determinants of obesity. Treatments for obesity have also continued to develop, with more evidence-based programs for lifestyle modification, new pharmacotherapies, and robust data to support bariatric surgery. Despite these advancements, there continues to be a substantial gap between the scientific evidence and the implementation of research into clinical practice for effective obesity management. Addressing barriers to obesity science implementation requires adopting feasible methodologies and targeting multiple levels (eg, clinician, community, system, policy) to facilitate the delivery of obesity-targeted therapies and maximize the effectiveness of guideline-driven care to at-need patient populations. This scientific statement (1) describes strategies shown to be effective or promising for enhancing translation and clinical application of obesity-based research; (2) identifies key gaps in the implementation of obesity science into clinical practice; and (3) provides guidance and resources for health care professionals, health care systems, and other stakeholders to promote broader implementation and uptake of obesity science for improved population-level obesity management. In addition, advances in implementation science that hold promise to bridge the know-do gap in obesity prevention and treatment are discussed. Last, this scientific statement highlights implications for health research policy and future research to improve patient care models and optimize the delivery and sustainability of equitable obesity-related care.

5.
Gastroenterology ; 2024 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-38777133

RESUMO

BACKGROUND AND AIMS: Some brain-gut behavioral treatments (BGBTs) are beneficial for global symptoms in irritable bowel syndrome (IBS). US management guidelines suggest their use in patients with persistent abdominal pain but their specific effect on this symptom has not been assessed systematically. METHODS: We searched the literature through 16th December 2023 for randomized controlled trials (RCTs) assessing efficacy of BGBTs for adults with IBS, compared with each other, or a control intervention. Trials provided an assessment of abdominal pain resolution or improvement at treatment completion. We extracted data as intention-to-treat analyses, assuming dropouts to be treatment failures and reporting pooled relative risks (RRs) of abdominal pain not improving with 95% confidence intervals (CIs), ranking therapies according to P-score. RESULTS: We identified 42 eligible RCTs, containing 5220 participants. After treatment completion, the BGBTs with the largest numbers of trials, and patients recruited, demonstrating efficacy for abdominal pain, specifically, included self-guided/minimal contact cognitive behavioral therapy (CBT) (RR = 0.71; 95% CI 0.54-0.95, P-score 0.58), face-to-face multicomponent behavioral therapy (RR = 0.72; 95% CI 0.54-0.97, P score 0.56), and face-to-face gut-directed hypnotherapy (RR = 0.77; 95% CI 0.61-0.96, P-score 0.49). Among trials recruiting only patients with refractory global IBS symptoms, group CBT was more efficacious than routine care for abdominal pain, but no other significant differences were detected. No trials were low risk of bias across all domains and there was evidence of funnel plot asymmetry. CONCLUSIONS: Several BGBTs, including self-guided/minimal contact CBT, face-to-face multicomponent behavioral therapy, and face-to-face gut-directed hypnotherapy may be efficacious for abdominal pain in IBS, although none were superior to another.

6.
Cureus ; 16(4): e58251, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38745790

RESUMO

Background Evidence-based practice (EBP) is essential for physiotherapy as an integral part of the multidisciplinary rehabilitation team. Randomized controlled trials (RCTs), systematic reviews, and meta-analyses are the gold standard in the hierarchy of evidence. However, the extent of knowledge, attitudes, and professional use of RCTs and meta-analyses among physiotherapists in Nigeria remains unclear. Therefore, this study aimed to describe and explore the predictors of Nigerian physiotherapists' knowledge, attitudes, and professional behaviors toward RCTs, systematic reviews, and meta-analyses. Methods In this observational study, an electronic version of an adapted questionnaire assessing the knowledge, attitudes, and professional use of RCTs and meta-analyses was shared across electronic platforms of Nigerian physiotherapy professional organizations. Results We found good overall knowledge (76 {80.8%}) and attitude (83 {88.3%}) toward the use of RCTs, systematic reviews, and meta-analyses for evaluating health interventions. Exposure to meta-analysis during graduate and postgraduate training (odds ratio {OR}, 7.102; 95% CI, 1.680-30.021; p = 0.008) and the presence of a medical library at the workplace (OR, 0.264; 95% CI, 0.070-0.997; p = 0.049) were significant predictors of good knowledge of RCTs, systematic reviews, and meta-analyses. Self-rated (OR, 56.476; 95% CI, 1.356-2357.430; p = 0.034) and overall levels of knowledge (OR, 0.013; 95% CI, 0.000-0.371; p = 0.011) predicted the good use of RCTs, systematic reviews, and meta-analyses among respondents. Discussion To equip physiotherapy practitioners with the requisite skill in using RCTs, systematic reviews, and meta-analyses, graduate and postgraduate trainings should prioritize education on the use of RCTs, systematic reviews, and meta-analyses to inform clinical decisions and practice, while capable workplaces may set up medical libraries to ease access and enhance the use of RCTs, systematic reviews, and meta-analyses.

7.
SAGE Open Nurs ; 10: 23779608241250207, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38746076

RESUMO

Introduction: Healthcare professionals have development needs related to their consumption, use, and practice of clinical research. Little is known about these issues in mental health services specifically. Objectives: A survey of healthcare staff working in an NHS Mental Health and Disability Trust in England was conducted to describe research capacity and culture compared with previously reported samples, and to examine subgroup differences. Methods: An online questionnaire was utilized. The main measure was the Research Capacity and Culture tool comprising measures of individual's perceived research skills and of team and organizational research culture. Previous studies using the same measure were systematically identified, and pooled results, weighted by sample size, were calculated. Analyses were descriptive (current sample versus previous results) and inferential (comparisons between demographic and professional groups within the current sample). Results: N = 293 people completed the survey. The median item scores were poorer than those of pooled samples from studies reporting median item scores on 39/51 (76.5%) occasions and poorer than those pooled samples of studies reporting mean item scores on 51/51 (100.0%) occasions. Individual capability for research was in the 'less than adequate' range more than in previous samples (71.4% vs. 42.9%). For team culture items, the proportions were 84.2% vs. 78.9%, while most responses about organizational culture were in the 'adequate' range (55.6% vs. 66.7%). Staff >20 years employment had poorer perceptions of team and organizational culture. Conclusion: Perceptions of individual research capacity and team and organizational culture were poor compared with previous studies, most of which were conducted in non-mental health settings. There is need for development of research capacity and culture in mental health services including opportunities to develop basic research skills through to strategic developments to promote clinical academic careers. There is considerable room for improvement in the way organizations support research and signpost opportunities.

8.
Int J Nurs Stud Adv ; 6: 100176, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38746823

RESUMO

Background: In 2018 a Nursing Research Internship program was started within a major referral and tertiary teaching centre in Australia. Aim: We aimed to evaluate the first 12 months of the program using an implementation science framework. Methods: This was a qualitative study. Following ethical approval n = 20 semi -structured interviews were recorded and transcribed verbatim. Participants included nurses with clinical, research and management roles who had engaged in or supported a Nursing Research Internship program. The Framework Method was conducted to analyse the findings. Results: Key themes identified included 'What is the impact of a Nursing Research Internship program?'; 'Why do a Nursing Research Internship program?'; 'How do we do a Nursing Research Internship program?'; 'How do we sustain a Nursing Research Internship program?'. Positive impacts were identified for clinical nurses and their teams, for the hospital and health service, and for patients and families. Identified key components included protected research time, specialist support (including library, statistics, health economist, implementation scientist), regulatory support (ethics and governance procedures) and access to a computer and IT resources. The Nursing Research Internship program required support from nurse clinicians, nurse managers and nurse academics. Conclusion: A structured Nursing Research Internship program supports clinical nurses to answer research questions identified directly from clinical practice.

9.
Nurse Educ Today ; 139: 106239, 2024 May 08.
Artigo em Inglês | MEDLINE | ID: mdl-38749339

RESUMO

BACKGROUND: Evidence-based practice has been the desirable healthcare standard for decades. To ensure evidence-based healthcare in the future, nursing education curricula must include strategies for teaching evidence-based practice to nursing students. Learning outcomes about evidence-based practice might be incorporated into courses like the bachelor's thesis. AIM: This study investigates whether writing a bachelor's thesis influences nursing students' practice, skills, and attitudes towards evidence-based practice, and explores whether there are differences between students writing the thesis as a literature study and students conducting empirical studies. DESIGN: This Nationwide Prospective Cohort Study collects data on students' practice, skills, and attitudes towards evidence-based practice through the Student Evidence-Based Practice Questionnaire and two questions from the Norwegian version of the Evidence-Based Practice profile questionnaire. PARTICIPANTS: The sample consists of 314 nursing students writing their bachelor's thesis in the last term of their nursing education. The responding students represent all institutions of higher education in Norway. METHODS: Paired t-tests were used to examine changes in the subscales practice, retrieving/reviewing, sharing/applying, attitudes and total scale for the Student Evidence-Based Practice Questionnaire from before they started to submission of the bachelor's thesis. Linear multiple regression analyses were conducted to explore differences between students writing a literature study and students conducting empirical studies. RESULTS: The analysis showed that the nursing students significantly increased in the three subscales practice, retrieving/reviewing, and sharing/applying, in addition to the total scale for the questionnaire, while writing the bachelor's thesis. Further, the analysis showed no difference on the scales between the groups of students writing a literature study or conducting an empirical study. CONCLUSIONS: The results indicate that writing the bachelor's thesis leads to increased learning about evidence-based practice and does not depend on the kind of thesis the students write.

10.
Health Serv Res ; 2024 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-38750652

RESUMO

OBJECTIVE: To describe a structured, iterative, data-driven approach for modifying implementation strategies for a complex evidence-based practice during a nationwide scale-up initiative. DATA SOURCES AND STUDY SETTING: We scaled-up implementation of Critical Time Intervention (CTI)-an evidence-based case management model-across 32 diverse community-based Veterans Affairs (VA) "Grant and Per Diem" case management (GPD-CM) agencies that serve homeless-experienced Veterans transitioning to independent living. Primary data were collected using qualitative methods. STUDY DESIGN: We embarked on a scale-up initiative while conducting a pragmatic randomized evaluation using a roll-out design, comparing two versions of a CTI implementation package tailored to VA's GPD-CM program. We iteratively assessed contextual factors and implementation outcomes (e.g., acceptability); findings informed package modifications that were characterized using the Framework for Reporting Adaptations and Modifications to Evidence-based Implementation Strategies. DATA COLLECTION METHODS: We conducted semi-structured interviews with Veterans, GPD-CM staff, and liaising VA clinicians; periodic reflections with liaising VA clinicians and implementation team members; and drew upon detailed meeting notes. We used rapid qualitative methods and content analysis to integrate data and characterize modifications. PRINCIPAL FINDINGS: After each scale-up wave-in response to variations in agency-level characteristics- we made iterative modifications to the implementation package to increase CTI adoption and fidelity across the diverse contexts of our scale-up sites. Modifications included adding, deleting, integrating, and altering the package; core package components were preserved. CONCLUSIONS: Implementation packages for complex evidence-based practices undergoing scale-up in diverse contexts may benefit from iterative modifications to optimize practice adoption with fidelity. We offer a structured, pragmatic approach for iteratively identifying data-driven, midstream implementation package adjustments, for use in both VA and non-VA scale-up initiatives. Our project demonstrates the importance of assessing for and making modifications in a scale-up initiative, as well as the trade-offs of projects having simultaneous formative and summative evaluation aims.

11.
Nutr Health ; : 2601060241254563, 2024 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-38751085

RESUMO

Background: Health professionals, including dietitians, should adapt their clinical daily practice to evidence-based practice (EBP), but this does not happen often in daily practice. The aim of this study was to investigate the current status and barriers to evidence-based practice among dietitians. Methods: This was a mixed-method, cross-sectional, national study (questionnaire and focus group) performed on working and registered dietitians, both self-employed and employed by public hospitals. The main outcomes were EBP knowledge, frequency of use, and proficiency scores. Barriers to EBP implementation were also collected, as well as qualitative information from the focus group. Results: Forty-three dietitians were enrolled from August to November 2021 in Italy. Overall, EBP knowledge was moderate/good. Younger dietitians (< 50 years old) obtained better results than their older colleagues. A similar trend was observed in terms of seniority. There was a discrepancy between EBP knowledge and perception of EBP implementation: the worst scores were obtained by participants who claimed an already complete integration of EBP. The average frequency of EBP use was moderate, with higher scores in dietitians ≥ 50 years old and with seniority ≥ 20 years. EBP proficiency instead was poor. The focus group revealed a lack of time and resistance to change as the main barriers. Conclusion: The importance of EBP is well-acknowledged, but it is not correctly implemented yet, because of identified barriers that need to be fixed. These barriers include a lack of dedicated time, inadequate EBP training, and resistance to change, especially in hierarchical environments.

12.
Artigo em Inglês | MEDLINE | ID: mdl-38791851

RESUMO

This systematic review and meta-analysis examined the impact of evidence-based practice (EBP) education programs on undergraduate nursing students, focusing on enhancing EBP competency, critical thinking, and problem-solving ability. METHODS: The search, conducted through PubMed, Cochrane Library, EMBASE, CINAHL, and Web of Science up to December 2023, included studies published in English and Korean and adhered to PRISMA guidelines. Qualitative appraisal of the studies was conducted using the revised ROB II for randomized trials and the ROBINS-I for non-randomized trials. For the meta-analysis, the effect size of the intervention was calculated as a standardized mean difference. RESULTS: In our study, 11 studies met our inclusion criteria, and 8 studies of those were included in the meta-analysis. The effect sizes for EBP competency, critical thinking, and problem-solving ability were 1.55, 1.29, and 0.65, respectively. The meta-regression analysis indicated that tailored education programs of 4-7 weeks and being in the 4th grade significantly enhanced EBP competency. CONCLUSION: These findings support the development of a customizable and applied EBP education actively for students, preparing nursing students to effectively implement EBP in clinical settings after graduation. Despite the significant effect size of the outcome variables, the high heterogeneity suggests the need for further investigation to validate the EBP educational outcomes for nursing students.


Assuntos
Prática Clínica Baseada em Evidências , Estudantes de Enfermagem , Humanos , Prática Clínica Baseada em Evidências/educação , Pensamento , Bacharelado em Enfermagem
13.
BMC Nurs ; 23(1): 320, 2024 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-38734605

RESUMO

BACKGROUND: Chemotherapy, whilst treating tumours, can also lead to numerous adverse reactions such as nausea and vomiting, fatigue and kidney toxicity, threatening the physical and mental health of patients. Simultaneously, misuse of chemotherapeutic drugs can seriously endanger patients' lives. Therefore, to maintain the safety of chemotherapy for cancer patients and to reduce the incidence of adverse reactions to chemotherapy, many guidelines state that a comprehensive assessment of the cancer patient should be conducted and documented before chemotherapy. This recommended procedure, however, has yet to be extensively embraced in Chinese hospitals. As such, this study aimed to standardise the content of pre-chemotherapy assessment for cancer patients in hospitals and to improve nurses' adherence to pre-chemotherapy assessment of cancer patients by conducting a national multi-site evidence implementation in China, hence protecting the safety of cancer patients undergoing chemotherapy and reducing the incidence of adverse reactions to chemotherapy in patients. METHODS: The national multi-site evidence implementation project was launched by a JBI Centre of Excellence in China and conducted using the JBI approach to evidence implementation. A pre- and post-audit approach was used to evaluate the effectiveness of the project. This project had seven phases: training, planning, baseline audit, evidence implementation, two rounds of follow-up audits (3 and 9 months after evidence implementation, respectively) and sustainability assessment. A live online broadcast allowed all participating hospitals to come together to provide a summary and feedback on the implementation of the project. RESULTS: Seventy-four hospitals from 32 cities in China participated in the project, four withdrew during the project's implementation, and 70 hospitals completed the project. The pre-and post-audit showed a significant improvement in the compliance rate of nurses performing pre-chemotherapy assessments for cancer patients. Patient satisfaction and chemotherapy safety were also improved through the project's implementation, and the participating nurses' enthusiasm and belief in implementing evidence into practice was increased. CONCLUSION: The study demonstrated the feasibility of academic centres working with hospitals to promote the dissemination of evidence in clinical practice to accelerate knowledge translation. Further research is needed on the effectiveness of cross-regional and cross-organisational collaborations to facilitate evidence dissemination.

14.
Nurs Rep ; 14(2): 1089-1118, 2024 Apr 27.
Artigo em Inglês | MEDLINE | ID: mdl-38804416

RESUMO

The integration of arts-based methods into nursing education is a topic of growing interest in nursing practice. While there is an emerging body of research on this subject, evidence on competence development remains vague, largely due to methodological weaknesses. The purpose of this review is to evaluate the effectiveness of arts-based pedagogy in nursing, specifically in terms of students' changes in knowledge, skills, and attitudes. It explores which arts-based approaches to nursing education qualify as evidence-based practice in terms of nursing competence. A systematic critical review of research on arts-based pedagogy in nursing was conducted, identifying 43 relevant studies. These studies were assessed for methodological quality based on the CEC Standards for evidence-based practice, and 13 high-quality comparative studies representing a variety of arts-based approaches were selected. Creative drama was identified as the only evidence-based practice in the field, positively affecting empathy. The findings highlight a research gap in nursing education and emphasize the need for measurement and appraisal tools suitable for the peculiarities of arts-based pedagogy.

15.
Artigo em Inglês | MEDLINE | ID: mdl-38804913

RESUMO

BACKGROUND: Urinary retention is a healthcare complication putting patients at risk of unnecessary suffering and harm. Orthopaedic patients are known to face an increased such risk, calling for evidence-based preoperative assessment and corresponding measures to prevent bladder problems. The aim of this study was to evaluate healthcare professionals' adherence to risk assessment guidelines for urinary retention in hip surgery patients. METHODS: This was an observational study from January 2021 to April 2021 with a descriptive and comparative design, triangulating three data sources. 1) Medical records for 1382 hip surgery patients across 17 hospitals in Sweden were reviewed for preoperative risk assessments for urinary retention and voiding-related variables at discharge. 2) The patients completed a survey regarding postoperative lower urinary tract symptoms, and 3) data was extracted from a national quality registry regarding type of surgery, preoperative physical status, and perioperative urinary complications. Group differences were analysed with Chi-square/ Fisher's exact test, t-test, Wilcoxon rank sum test, or Mann-Whitney U-test. Logistic regression was used to analyse variables associated with completed risk assessments for urinary retention. RESULTS: Of all study participants, 23.4% (n =323) had a preoperative documented risk assessment of urinary retention. Whether a risk assessment was performed was significantly associated with acute surgery (OR 3.56, 95% CI 2.48-5.12) and undergoing surgery at an academic hospital (OR 4.59, 95% CI 2.68-7.85). Acute patients were more often affected by urinary retention and had bladder issues and/or an indwelling catheter at discharge. More than every tenth patient (11. 9 %, n =53) completing the survey experienced intensified bladder problems after their hip surgery. CONCLUSION: The study shows a lack of adherence to risk assessment for urinary retention according to evidence-based guidelines, which negatively affects quality of care and patient safety.

16.
Inquiry ; 61: 469580241248130, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38785261

RESUMO

Social care practitioners are often under-represented in research activity and output. Evidence-based practice enables social care practitioners to develop/engage the skills to evaluate evidence and be more actively involved in research. REalist Synthesis Of non-pharmacologicaL interVEntions for antipsychotic-induced weight gain (RESOLVE) is a NIHR-funded study where realist synthesis is used to understand and explain how, why, for whom, and in what contexts non-pharmacological interventions help service users, with severe mental illness, to manage antipsychotic-induced weight gain. Social care practitioners are a key part of the team providing care for people living with severe mental illness and therefore supporting antipsychotic-induced weight gain. The current study, RESOLVE 2, uses realist evaluation and RESOLVE as an illustrative example to help understand why and how social care practitioners engage (or not) with research. Semi-structured, audio-recorded interviews will be undertaken with a purposive sample of approximately 20 social care practitioners working with people who have severe mental illness, are treated with antipsychotics, and have experienced weight gain. Participants will be recruited from NHS Trusts and recruitment avenues such as social media and personal networks. Topics discussed during interviews will include barriers and facilitators to engagement in research, current, and past engagement as well as recommendations for researchers and other practitioners. Interview recordings will be transcribed verbatim and analyzed using realist evaluation which will allow in-depth causal explanations for research engagement. Better understanding of research engagement by social care practitioners will allow for evidence-based practice and better patient outcomes within these settings.


Assuntos
Antipsicóticos , Transtornos Mentais , Humanos , Transtornos Mentais/tratamento farmacológico , Transtornos Mentais/terapia , Antipsicóticos/uso terapêutico , Pesquisa sobre Serviços de Saúde , Aumento de Peso , Entrevistas como Assunto , Prática Clínica Baseada em Evidências , Serviço Social
17.
Eval Health Prof ; 47(2): 178-191, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38790111

RESUMO

Recent implementation science frameworks highlight the role of training and technical assistance (TTA) in building workforce capacity to implement evidence-based practices (EBPs). However, evaluation of TTA is limited. We describe three case examples that highlight TTA by three regional centers in the national Mental Health Technology Transfer Center (MHTTC) network. Each MHTTC formed Learning Communities (LCs) to facilitate connections among behavioral health professionals with the goals of sharing implementation strategies, discussing best-practices, and developing problem solving techniques. Data on outcomes were collected through a combination of self-report surveys and qualitative interviews. LC participants reported strong connectedness, gains in knowledge and skills, improvements in implementation capacity, and intentions to advocate for organizational and systems-level change. Furthermore, across the case examples, we identified LC characteristics that are associated with participant perceptions of outcomes, including tailoring LC content to workforce needs, providing culturally relevant information, engaging leaders, forming connections among participants and trainers, and challenging participants' current workplace practices. These findings are interpreted through the lens of the Interactive Systems Framework, which focuses on how TTA, such as LCs, can facilitate connections between the theoretical and empirical foundations of interventions and the practices of implementing interventions in real-world settings to advance workforce capacity.


Assuntos
Prática Clínica Baseada em Evidências , Humanos , Prática Clínica Baseada em Evidências/organização & administração , Feminino , Masculino , Pessoal de Saúde/educação , Fortalecimento Institucional/organização & administração , Ciência da Implementação , Adulto , Pesquisa Qualitativa , Aprendizagem , Internet , Educação a Distância/organização & administração
18.
J Multimorb Comorb ; 14: 26335565241258353, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38779357

RESUMO

Background: Managing multimorbidity poses significant challenges for individuals, their families, and society due to issues with health information comprehension, communication with healthcare providers, and navigating the healthcare system. These challenges emphasise the critical need to prioritize individual and organisational health literacy. Multimorbidity is associated with a lack of social support for health; however, social networks and community dynamics can enhance health literacy. The "Co-designing municipal rehabilitation" (CURIA) project targets enhancing individual and organisational health literacy, and social networks for individuals with multimorbidity, with the overall aim of addressing health inequity through a collaborative local co-design process involving stakeholders. Methods: The CURIA study employs a mixed-method approach that initially explores the health literacy experiences of individuals with multimorbidity participating in rehabilitation programs in selected Danish municipalities and the practices of professionals overseeing these programs. The subsequent co-design process will comprise individuals with multimorbidity, their relatives, municipalities, general practitioners, civil society, and knowledge institutions working together. This iterative and collaborative process involves tailoring and aligning health literacy needs with responsiveness within the context of local healthcare systems and developing supportive social networks. Discussion: Given the increasing burden of multimorbidity, there is an urgent need to develop evidence-based practice for multimorbidity rehabilitation practices, developed in collaboration with municipalities and civil society. Emphasising self-care support for individuals, managing complex rehabilitation needs, and involving individuals in intervention prioritisation and customisation are crucial aspects addressed by CURIA to enhance health literacy and align municipal rehabilitation with identified needs.

19.
Artigo em Inglês | MEDLINE | ID: mdl-38780831

RESUMO

INTRODUCTION: Several observational studies have been conducted to assess the prevalence of cardiovascular risk factors in hypertensive patients; however, none has yet investigated prevalence, clustering, and current management of cardiovascular risk factors upon first referral to hypertension specialists, which is the aim of the present study. METHODS: Consecutive adult outpatients with essential/secondary hypertension were included at the time of their first referral to hypertension specialists at 13 Italian centers in the period April 2022-2023 if they had at least one additional major cardiovascular risk factor among LDL-hypercholesterolemia, type 2 diabetes, and cigarette smoking. Prevalence, degree of control, and current management strategies of cardiovascular risk factors were assessed. RESULTS: A total of 255 individuals were included, 40.2% women and 98.4% Caucasian. Mean age was 60.3±13.3 years and mean blood pressure [BP] was 140.3±17.9/84.8±12.3 mmHg). Most participants were smokers (55.3%), had a sedentary lifestyle (75.7%), suffered from overweight/obesity (51%) or high LDL-cholesterol (41.6%), had never adopted strategies to lose weight (55.7%), and were not on a low-salt diet (57.4%). Only a minority of patients reported receiving specialist counseling, and 27.9% had never received recommendations to correct unhealthy lifestyle habits. Nearly 90% of individuals with an estimated high/very high cardiovascular risk profile did not achieve recommended LDL-cholesterol targets. CONCLUSIONS: In patients with hypertension, both pharmacological and lifestyle therapeutic advice are yet to improve before referral to hypertension specialists. This should be considered in the primary care setting in order to optimize cardiovascular risk management strategies.

20.
Cureus ; 16(4): e58521, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38765454

RESUMO

Background It is essential to provide evidence-based practice (EBP) courses for undergraduate nursing students. For this reason, students' beliefs and intentions to implement EBP should be measured to ensure that EBP courses are effective. Aim The aim of this study is to evaluate Saudi nursing students' EBP beliefs (EBPB) and implementation before they enroll in an EBP course. Methods A descriptive cross-sectional study was conducted. Two scales were used: the EBPB scale and the EBP implementation (EBPI) scale. The questionnaire was available for completion a single time before the second-year nursing students were introduced to the EBP course. Results The study revealed that the mean age for students is 20 ± 0.83. Nearly two-thirds (61.54%) of students are female. It can be noted that 71.5% have not attended any EBP programs. Additionally, 65.38% of students understand the concept of EBP, and 68.46% are willing to apply EBP nursing care. Therefore, there is a positive correlation between the EBPB scale variable and the EBPI scale. Conclusion This study highlights the positive attitude of undergraduate nursing students toward EBP. Nursing education programs must place more emphasis on integrating EBP curricula into their teaching strategies, with a focus on developing students' knowledge, skills, and values in EBP.

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