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1.
Int J Qual Stud Health Well-being ; 19(1): 2419574, 2024 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-39460984

RESUMO

PURPOSE: Lifestyle advice for cardiac patients with overweight/obesity includes weight management, yet few achieve significant weight loss. People with heart disease may require different support to the general population. We synthesized evidence that reported cardiac patients' weight management experiences to identify barriers and facilitators to weight loss. METHODS: Our realist review identified five manuscripts reporting four studies of weight management experiences of people with heart disease. The capability, opportunity, motivation behaviour change model (COM-B) provided the framework for thematic synthesis. RESULTS: The studies included qualitative data from 117 participants and revealed factors favouring or impeding effective weight management during cardiac rehabilitation (CR) and in participants' daily lives. We identified four major themes illustrating participants' wish to change harmful health behaviours, adopting exercise and psychological strategies to facilitate change, social and professional support, and regaining control after a cardiac event. These themes broadly aligned with the COM-B categories of capability, opportunity, and motivation. CONCLUSIONS: Most cardiac patients with overweight/obesity express a desire to lose weight. Participants preferred personalized services that could adapt to meet their individual needs, but struggled to make sustainable changes for interconnecting psychological, social, cultural, and financial reasons. Consideration of these complexities when designing programmes may help to support successful weight management.


Assuntos
Cardiopatias , Motivação , Obesidade , Sobrepeso , Pesquisa Qualitativa , Redução de Peso , Humanos , Obesidade/terapia , Obesidade/psicologia , Sobrepeso/terapia , Sobrepeso/psicologia , Cardiopatias/psicologia , Exercício Físico , Comportamentos Relacionados com a Saúde , Apoio Social , Masculino , Feminino , Pessoa de Meia-Idade , Estilo de Vida
2.
Artigo em Inglês | MEDLINE | ID: mdl-39457297

RESUMO

As global populations continue to age, alcohol consumption rises, and we strive to age in place, it is important to have an up-to-date understanding of domiciliary carers' perspectives on older adults' alcohol use in their care. Therefore, a systematic review and thematic synthesis of qualitative studies of the unique challenges faced by domiciliary care workers in front line roles regarding older adults' alcohol use was conducted (PROSPERO registration number: CRD42024516660). Eight databases were searched on 22 February 2024 for qualitative studies focusing on older adults' (defined as aged 50 or over) alcohol consumption and domiciliary care. The Critical Appraisal Skills Programme checklist was utilised for quality appraisal. Twenty articles reporting 14 unique studies of mainly medium to low quality were included. Three overarching themes (and associated subthemes) were identified as follows: identification (alcohol problems are common, no assessment for alcohol problems, and additional overt signs of excessive alcohol use), management (to buy or not to buy that is the question, balancing rights and risks, monitor and report but do not intervene, maintaining the vicious circle, home as a barrier to accessing support and services, and more support needed from healthcare professionals), and training (lack of alcohol education). Domiciliary carers are well placed to make every contact count to target alcohol consumption but would benefit from support and resources for alcohol consumption identification and management. Clear guidance on how to manage alcohol consumption to harmoniously balance rights and risks is crucial, particularly when caring for older adults with cognitive difficulties.


Assuntos
Consumo de Bebidas Alcoólicas , Cuidadores , Pesquisa Qualitativa , Humanos , Cuidadores/psicologia , Consumo de Bebidas Alcoólicas/psicologia , Idoso , Serviços de Assistência Domiciliar , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais
3.
Health Expect ; 27(5): e70071, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-39445819

RESUMO

BACKGROUND: Despite increasing recognition of long COVID, the psychosocial impacts of the lived experience on individuals remain underexplored. This systematic review sought to fill this gap by identifying key themes that describe the psychosocial dimensions of long COVID. OBJECTIVE: The aim of this study is to identify key themes illustrating the psychosocial aspects of individuals' lived experience of long COVID. SEARCH STRATEGY: Searches were conducted in multiple databases and grey literature sources for qualitative studies published between November 2019 and June 2024. INCLUSION CRITERIA: Eligible studies involved adult participants self-reporting long COVID. The studies needed to provide qualitative data that could be synthesised thematically. DATA EXTRACTION AND SYNTHESIS: Data extraction and thematic synthesis were conducted by at least two independent reviewers at each stage. Quality appraisal was performed using the Critical Appraisal Skills Programme tool. RESULTS: The review included 34 studies. Thematic synthesis yielded five themes: 'Debilitation', 'Uncertainty', 'Sources of Support', 'Meaning Making: Adjusting to a New Normal' and 'Experiences with Healthcare Services'. Individuals with long COVID reported experiencing physical, economic, and social challenges. Uncertainty and scepticism from others caused anxiety. Support from healthcare services, friends and online groups played an important role. Acceptance and gratitude were found to be meaningful in adjusting to the new normal. Experiences with healthcare services varied. DISCUSSION AND CONCLUSIONS: This review provides valuable insights into the psychosocial impact of long COVID, highlighting the profound changes and challenges that individuals face. Healthcare services should adopt a holistic approach to integrate psychosocial support within their management strategies, to improve overall patient outcomes.


Assuntos
COVID-19 , Pesquisa Qualitativa , Humanos , COVID-19/psicologia , Apoio Social , Síndrome de COVID-19 Pós-Aguda , Adaptação Psicológica , SARS-CoV-2 , Incerteza
4.
Artigo em Inglês | MEDLINE | ID: mdl-39462992

RESUMO

Patient-initiated brief admission (PIBA) is an innovative psychiatric care intervention that gives patients the autonomy to initiate a short admission (approximately 1-3 days) to psychiatric inpatient care. This intervention is structured around a mutual agreement between the patient and their care provider that outlines the specific structure and content of their care. Unlike regular psychiatric admissions, healthcare professionals do not review the patient's decision for admission during PIBA. Similar interventions have been developed globally to reduce the need for long inpatient admissions and compulsory care by enhancing patient autonomy, promoting active participation in care, and empowering patients to recognise early signs of mental health deterioration. The objective of this systematic review was to explore the experiences of PIBA among individuals with mental health disorders. A systematic review was conducted using qualitative articles sourced from the PubMed, CINAHL, and PsycINFO databases. A total of thirteen original articles were included in the review, encompassing 186 patients. Research demonstrates that PIBA significantly impacts patients' care experiences in various ways. Access to PIBA gives patients the opportunity to take a break from daily stressors, which has proven significant in interrupting the cycle of worsening symptoms and negative thoughts. Furthermore, when the care environment is characterised by trust and respect, patients experience an increased sense of freedom, which contributes to a more effective recovery process. PIBA provides patients with a sense of safety and offers the possibility of a more functional daily life. Healthcare professionals'attitude and care provision also significantly influences patients' experiences. Central to a positive patient experience are a warm reception, attentiveness, and active listening. PIBA can not only change patients' perceptions of healthcare but, more importantly, fosters a transformative view of themselves as active participants in their own well-being. Knowledgeable healthcare professionals are crucial for the successful implementation of this intervention. By offering dignity and warmth alongside safety, PIBA addresses a critical gap in patient mental health care.

5.
J Adv Nurs ; 2024 Oct 18.
Artigo em Inglês | MEDLINE | ID: mdl-39420778

RESUMO

AIM: To systematically identify, appraise and synthesise qualitative research evidence which examined the impact of telehealth on the experiences and perceptions of patients living with advanced chronic obstructive pulmonary disease, to inform the development of patient-centred telehealth. DESIGN: Qualitative evidence synthesis. DATABASE SEARCHES: CINAHL, Cochrane, Embase, PUBMED, MEDLINE, EThOS, Web of Science, PsycINFO, Lenus, DART, RIAN and ProQuest were searched for primary qualitative studies undertaken between 2008 and 2023. METHODS: A thematic synthesis of studies was undertaken to identify descriptive themes relating to patient views. Methodological quality was assessed using the Critical Appraisal Skills Programme framework, and confidence in review findings was assessed using the GRADE-CERQual approach. FINDINGS: Nine studies met the inclusion criteria and were included in the final synthesis. Four analytical themes were generated (1) telehealth as a facilitator of independence, (2) the influence of patient and healthcare provider relationship on successful engagement with telehealth, (3) usability of telehealth to patients living with advanced chronic obstructive pulmonary disease and (4) trusting virtual health services and facilitating confidence in the patient/service user. Five descriptive themes emerged: (i) individualised telehealth chronic obstructive pulmonary disease care (ownership and control), (ii) managing chronic obstructive pulmonary disease exacerbations, (iii) being heard and feeling understood, (iv) telehealth as an education aid and (v) aging and virtual technology. CONCLUSION: Understanding the experiences of patients with chronic obstructive pulmonary disease and their engagement with telehealth is a necessary determinant of how best to utilise telehealth in this population and may serve to inform policymakers to further develop and implement telehealth into practice. Future research on patients and healthcare professionals' views on telehealth use in the palliative stage of this illness may also be valuable. IMPACT: Findings add value by providing healthcare providers with additional evidence to improve understanding of both telehealth complexity and human experiences and perceptions. It is anticipated that a deeper understanding of chronic obstructive pulmonary disease patients' experiences and perceptions will inform the development of strategies to maximise and enhance the application of patient-centred telehealth within the context of coping and living with a debilitating condition. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution was utilised in this study.

6.
Nurse Educ Pract ; 80: 104150, 2024 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-39357427

RESUMO

AIM: to report a thematic synthesis of students' narratives in free text comments from a national quality survey of Australian nursing degree students' clinical placements. BACKGROUND: Nursing student evaluation surveys are submitted to the Australian National Placement Evaluation Centre. Students in 36 Australian nursing programs are included. DESIGN: Thematic synthesis of nursing students' narrative comments. METHODS: Data were sourced from 10,226 surveys submitted between July and December 2023. From these, the 3640 free text comments were extracted and tabulated to form the sample for synthesis. Three authors conducted a thematic synthesis and all five authors agreed on the findings. FINDINGS: Student's comments generally portrayed a positive learning culture in clinical placement environments. One dominant theme 'Support' was interpreted as giving deeper meaning to students' perceptions of the help and encouragement of placement facility staff. Three subthemes 'Welcoming environment', 'Providing learning opportunities' and 'Teaching strategies' described students' ideas of what elements contribute to learning. Ten ways of teaching were revealed in students' narratives as education activities. Students commonly referred to staff supporters, illustrating that various staff worked to ensure students were supervised during clinical skills practice and that students' learning objectives were addressed. CONCLUSIONS: Staff-student relationships are paramount for students' learning and students' narratives revealed perceptions of a generally positive learning environment. The notion of support is implied as vital to nursing students' positive experience of clinical learning during placements. Curriculum designers, university course convenors and placement partners may use the findings identified in this study to ensure academic and placement facility staff are aware of how best to support students. In this way, institutions may narrow the gap between successful and less successful nursing student clinical placements.

7.
Clin Psychol Rev ; 114: 102489, 2024 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-39270558

RESUMO

INTRODUCTION: There is considerable research focusing on the negative outcomes of psychotherapy, however, there remains an overlooked population: those who appear to show no response after treatment. This qualitative evidence synthesis aimed to review the available literature exploring client and therapist experiences of psychotherapy nonresponse. METHOD: Seven databases were searched for studies using qualitative approaches to explore nonresponse. Twenty-four studies met inclusion criteria and were analysed using Thematic Synthesis. RESULTS: Six overarching client perspective themes and 18 subthemes were identified: Hopes and fears; A difficult task; A Disconnected relationship; Staying involved; Therapy was not worth the investment and, On a trajectory for improvement. Four overarching therapist perspective themes and 10 subthemes were identified: High expectations; Experiencing a disconnect; Feeling threatened and Holding onto hope. DISCUSSION: A model of psychotherapy nonresponse is proposed. The experience of nonresponse appears to involve both clients and therapists finding therapy difficult, experiencing problems connecting and not being open in the therapeutic relationship. Importantly, nonresponse appears not to be an absence of effects, but a range of experiences that are potentially harmful, particularly to clients. However, there were varied experiences of nonresponse, which indicates the importance of qualitative outcome measurement.

8.
J Med Internet Res ; 26: e58735, 2024 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-39190910

RESUMO

BACKGROUND: Dietary behaviors significantly influence health outcomes across populations. Unhealthy diets are linked to serious diseases and substantial economic burdens, contributing to approximately 11 million deaths and significant disability-adjusted life years annually. Digital dietary interventions offer accessible solutions to improve dietary behaviors. However, attrition, defined as participant dropout before intervention completion, is a major challenge, with rates as high as 75%-99%. High attrition compromises intervention validity and reliability and exacerbates health disparities, highlighting the need to understand and address its causes. OBJECTIVE: This study systematically reviews the literature on attrition in digital dietary interventions to identify the underlying causes, propose potential solutions, and integrate these findings with behavior theory concepts to develop a comprehensive theoretical framework. This framework aims to elucidate the behavioral mechanisms behind attrition and guide the design and implementation of more effective digital dietary interventions, ultimately reducing attrition rates and mitigating health inequalities. METHODS: We conducted a systematic review, meta-analysis, and thematic synthesis. A comprehensive search across 7 electronic databases (PubMed, MEDLINE, Embase, CENTRAL, Web of Science, CINAHL Plus, and Academic Search Complete) was performed for studies published between 2013 and 2023. Eligibility criteria included original research exploring attrition in digital dietary interventions. Data extraction focused on study characteristics, sample demographics, attrition rates, reasons for attrition, and potential solutions. We followed ENTREQ (Enhancing the Transparency in Reporting the Synthesis of Qualitative Research) and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and used RStudio (Posit) for meta-analysis and NVivo for thematic synthesis. RESULTS: Out of the 442 identified studies, 21 met the inclusion criteria. The meta-analysis showed mean attrition rates of 35% for control groups, 38% for intervention groups, and 40% for observational studies, with high heterogeneity (I²=94%-99%) indicating diverse influencing factors. Thematic synthesis identified 15 interconnected themes that align with behavior theory concepts. Based on these themes, the force-resource model was developed to explore the underlying causes of attrition and guide the design and implementation of future interventions from a behavior theory perspective. CONCLUSIONS: High attrition rates are a significant issue in digital dietary interventions. The developed framework conceptualizes attrition through the interaction between the driving force system and the supporting resource system, providing a nuanced understanding of participant attrition, summarized as insufficient motivation and inadequate or poorly matched resources. It underscores the critical necessity for digital dietary interventions to balance motivational components with available resources dynamically. Key recommendations include user-friendly design, behavior-factor activation, literacy training, force-resource matching, social support, personalized adaptation, and dynamic follow-up. Expanding these strategies to a population level can enhance digital health equity. Further empirical validation of the framework is necessary, alongside the development of behavior theory-guided guidelines for digital dietary interventions. TRIAL REGISTRATION: PROSPERO CRD42024512902; https://tinyurl.com/3rjt2df9.


Assuntos
Dietoterapia , Humanos , Pacientes Desistentes do Tratamento/estatística & dados numéricos , Dietoterapia/métodos , Dietoterapia/estatística & dados numéricos
9.
Int J Womens Health ; 16: 1229-1234, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39011397

RESUMO

Introduction: The number of women who present this perineal loss is high. Identifying the existing knowledge about the women's experiences and perceptions of pregnancy loss is essential to understand the impact of the phenomenon on women. This identification is also crucial to adapt and improve the healthcare provided. Subjects and Methods: A systematic literature review, meta-synthesis, of qualitative studies will be developed with the goal of obtaining a comprehensive understanding of mothers' perception of pregnancy loss and identifying their specific support needs. Inclusion Criteria: This review will consider qualitative investigations that study the perceptions or experiences of adult women who have suffered prenatal loss. All studies published in English, Spanish or Portuguese between January 1, 2012, and December 31, 2022 will be considered. This systematic review will follow the Joanna Briggs Institute statement for systematic reviews of qualitative design. The Psychology and Behavioral Sciences Collection, Scopus, CINAHL®, MEDLINE® and Cochrane Database of Systematic Reviews (CDRS) databases will be utilized for research. Data extraction will be performed in-peers by the researchers, using the Joanna Briggs Institute model. Finally, the available data will be analysed using a meta-aggregation approach. Conclusion: A better understanding of this phenomenon will be useful, identifying, on the one hand, the support needs of women who have suffered fetal loss and, on the other hand, also identifying the support and interventions that can be implemented by health professionals. Systematic Review Registration Number: PROSPERO® (CRD42023407314).

10.
Nurs Womens Health ; 2024 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-38823784

RESUMO

OBJECTIVE: To integrate the findings of qualitative research to describe the experiences of intimate partner violence (IPV) among mothers who use substances. DATA SOURCES: A systematic search of the literature was conducted using the databases of the American Psychological Association PsycINFO, CINAHL, and PubMed along with a manual search of Google Scholar. STUDY SELECTION: The Joanne Briggs Institute critical appraisal checklist for qualitative research criteria was used to assess the studies for selection. Inclusion criteria comprised (a) qualitative research, (b) available in English, (c) published in peer-reviewed journals, (d) inclusive of descriptions of IPV experienced by mothers who use substances, (e) conducted in the United States, and (f) published between January 2013 and October 2023. DATA EXTRACTION: The researchers highlighted and extracted data from studies that met the inclusion criteria. Data describing IPV among mothers who use substances were extracted. DATA SYNTHESIS: A thematic synthesis was used to integrate the findings using three stages and included (a) free line-by-line coding of the findings of the primary studies, (b) the development of the free codes into associated areas to construct descriptive subthemes, and (c) the development of overarching analytic themes. CONCLUSION: Findings from 11 qualitative studies were synthesized. Four descriptive subthemes emerged to delineate the experiences of IPV in mothers who use substances: Experience of Various Types of IPV, Lack of Structures to Identify and Address IPV, Coping With Violence by Taking Substances, and Substance Use Influences Behaviors of IPV. Nurses who work with mothers who use substances should be knowledgeable about local resources for IPV, complete ongoing educational training for IPV screening, and be familiar with recommended guidelines for the routine assessment of IPV.

11.
Front Rehabil Sci ; 5: 1376895, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38807900

RESUMO

Background: There has been an increasing interest in the concept of hope within the field of brain injury rehabilitation. Existing reviews have nevertheless focused on stroke, leaving out the broad population of people with acquired brain injury (ABI). Furthermore a majority of the included studies in those reviews excluded the subgroup of people with communication difficulties, thus primarily giving voice to a select group of people with ABI. Methods: A qualitative systematic review was conducted with the purpose of systematically reviewing and thematically synthesise findings about hope as experienced by adults with ABI in a rehabilitation or recovery process. The search strategy included peer-reviewed qualitative studies published after 2000 in English or Scandinavian languages. Searches of EBSCO databases incorporating CINAHL, MEDLINE, and PsycINFO were conducted together with SocINDEX, Social Work Abstracts, Eric and Web of Science. Ten qualitative studies were included, and the Critical Appraisal Skills Program (CASP) was used for assessing the quality and relevance of the ten studies. Qualitative findings were synthesized using Thomas and Harden's methodology. Results: Through a thematic synthesis eleven subthemes were identified relating to experiences of hope. These were grouped into four analytical themes: (1) hope a two folded phenomenon; (2) time and temporality; (3) progress, goals and visibility and (4) the alliance; a balancing act requiring good communication skills. Conclusion: This review has shown that even though hope has both a positive and negative side to it, it is necessary as a driving force for people with ABI in terms of supporting them to keep going and not give up. Rehabilitation professionals are advised to embrace the ambiguity of hope, customizing the support of hope to each person with ABI. Attention is needed on how to make progress visible for persons with ABI during their rehabilitation process just as rehabilitation professionals should acknowledge the alliance with the person with ABI as a core component of rehabilitation. This requires a focus on professionals' communication skills if hope promoting relationships between professionals and persons with ABI are to be achieved.

12.
JMIR Pediatr Parent ; 7: e56919, 2024 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-38809591

RESUMO

BACKGROUND: Social media have shown the potential to support type 1 diabetes self-management by providing informational, emotional, and peer-to-peer support. However, the perceptions of young people and health care professionals' (HCPs) toward the use of social media for type 1 diabetes self-management have not been systematically reviewed. OBJECTIVE: The aim of this study is to explore and summarize the experiences and views of young people with type 1 diabetes and their HCPs on using social media for self-management across qualitative findings. METHODS: We searched MEDLINE, Embase, PsycINFO, and CINAHL from 2012 to 2023 using Medical Subject Heading terms and text words related to type 1 diabetes and social media. We screened and selected the studies according to the inclusion and exclusion criteria. We quality appraised and characterized the included studies and conducted a thematic synthesis. RESULTS: We included 11 studies in our synthesis. A total of 9 of them were qualitative and 2 were mixed methods studies. Ten focused on young people with type 1 diabetes and 1 on HCPs. All used content analysis and were of moderate to high quality. Thirteen descriptive themes were yielded by our thematic synthesis, contributing to five analytic themes: (1) differences in how young people interact with social media, (2) characteristics of social media platforms that influence their use and uptake for type 1 diabetes self-management, (3) social media as a source of information, (4) impact on young people's coping and emotional well-being, and (5) impact on support from and relationships with HCPs and services. CONCLUSIONS: The synthesis suggests that we should consider leveraging social media's peer support capabilities to augment the traditional services for young people with type 1 diabetes. However, the patients may have privacy concerns about HCPs' involvement in their online activities. This warrants an update of existing guidelines to help young people use social media safely for self-managing their diabetes.

13.
Body Image ; 50: 101727, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-38797069

RESUMO

Body Dysmorphic Disorder (BDD) is a distressing psychological condition where an individual is preoccupied by a perceived issue with their appearance. Qualitative studies enable nuanced aspects of BDD phenomenology to be investigated. The current systematic review used thematic synthesis to integrate the findings from the extant qualitative studies. Searches were run on six databases to identify studies that had sought to describe the experience of individuals with BDD. PRISMA guidance was followed and ten articles were identified for inclusion. The quality of each article was appraised and thematic synthesis was conducted to generate novel and summative themes. Three superordinate themes were created: 'self-objectification and the view of self'; 'control and protecting the self'; and 'sociocultural influences and the impact of others in BDD'. Shame and self-disgust emerged as key experiential elements of BDD. The findings of the review suggest that self-objectification theory and possibly models of self-compassion are theoretically relevant to understanding the experience of individuals presenting with BDD. Current interventions may benefit from consideration of these theoretical models when seeking to improve efficacy.


Assuntos
Transtornos Dismórficos Corporais , Pesquisa Qualitativa , Autoimagem , Humanos , Transtornos Dismórficos Corporais/psicologia , Imagem Corporal/psicologia , Vergonha
14.
J Interprof Care ; 38(4): 739-758, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38678372

RESUMO

Clinical supervision typically occurs between clinicians who are trained in the same discipline, and this assumption is present across much of the relevant literature. However, the use of interprofessional supervision (IPS), wherein clinicians do not share the same discipline, has increased in recent years. As IPS increases in usage, it is key that the implications of this approach are explored. In order to map the existing evidence, a scoping review was conducted to explore what is known about the use of IPS across five allied health professions (psychology, speech and language therapy, occupational therapy, physiotherapy and social work). A systematic literature search of four electronic databases was conducted, with 27 articles meeting the inclusion criteria. The data were analyzed using thematic synthesis. Six key themes were identified relating to factors impacting the appropriateness of IPS, necessary steps in the IPS process, and impacts of IPS for clinicians. Limited application of standardized tools and theoretical frameworks within the existing research was highlighted. The findings identified within this review present a broad overview of the existing research relating to IPS, which can be used to inform future research in this area.


Assuntos
Pessoal Técnico de Saúde , Relações Interprofissionais , Humanos , Pessoal Técnico de Saúde/educação , Comportamento Cooperativo , Terapia Ocupacional
15.
J Clin Nurs ; 33(8): 3283-3293, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38661241

RESUMO

AIM: To synthesise the dietary expesriences of patients with inflammatory bowel disease by reviewing relevant qualitative studies. BACKGROUND: Diet plays a crucial role in the development and progression of inflammatory bowel disease (IBD). There is no specific diet that can be recommended for all patients. We conducted a synthesis of qualitative studies to gain a comprehensive understanding of the dietary management experience of patients with IBD, aiming to provide better dietary guidance in the future. DESIGN: A qualitative synthesis was conducted following the Thomas and Harden method and reported following the ENTREQ statement. METHODS: Qualitative studies were systematically searched in five electronic databases: PubMed, PsycINFO, Embase, CINAHL, and Web of Science. There was no time limit for publication, and all database searches were up to 10 May, 2023. The Joanna Briggs Institute Qualitative Assessment and Review Instrument was utilised to appraise the quality of the included studies. Data for inclusion in articles were extracted and analysed using a thematic synthesis method. RESULTS: Six studies involving 119 patients were eventually included. The studies were conducted in six different countries. Four major themes were identified: the diet of patients with IBD is completely different from the normal one; manage symptoms and live with the disease by modifying diet; psychological adjustment to eating (be frustrated; worried and afraid; feel ashamed; growth and resilience); barriers and challenges (barriers from perceived social support; conflicts between diet and nutrition; challenges from food hedonism and cravings). CONCLUSIONS: Patients with IBD highlighted the distinction between their diet and the normal diet. Dietary modifications were used as a way to manage symptoms and live with the disease. In addition to physical symptoms, patients experienced diet-related psychological changes. Dietary modifications in patients with IBD encounters difficulties and challenges, necessitating prompt guidance and intervention. (1) The implementation of dietary modifications in patients with IBD encounters numerous obstacles and complexities, necessitating prompt guidance and intervention. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution. REGISTRATION: The protocol was registered with PROSPERO (CRD42023391545).


Assuntos
Dieta , Doenças Inflamatórias Intestinais , Pesquisa Qualitativa , Humanos , Doenças Inflamatórias Intestinais/dietoterapia , Doenças Inflamatórias Intestinais/psicologia , Dieta/psicologia , Dieta/métodos , Adulto , Masculino , Feminino , Pessoa de Meia-Idade
16.
Nurs Ethics ; : 9697330241238343, 2024 Mar 16.
Artigo em Inglês | MEDLINE | ID: mdl-38491783

RESUMO

BACKGROUND: Previous research mainly focuses on how to support nursing students in caring for the patient and on educators' views of students' development as professional caring nurses. Against this background, it is important to further investigate nursing students' perspectives on what it means to become a professional caring nurse. RESEARCH AIM: This qualitative systematic review study aims to identify and synthesize nursing students' perceptions on the meaning of becoming a caring nurse. RESEARCH DESIGN AND DATA SOURCES: Systematic data searches were conducted by using the electronic databases MEDLINE (Ovid), CINAHL (EBSCO), Academic Search Premiere (EBSCO), and Philosopher`s Index. In total, 13 studies met the inclusion and quality criteria. The articles were analyzed by a systematic review and a thematic synthesis according to Thomas and Harden. ETHICAL CONSIDERATION: The study followed good ethical practice guidelines outlined in the Northern Nurses' Federation. FINDINGS: The analysis resulted in eight descriptive themes and finally in three analytical themes: Becoming is to get in touch with one's inner ethic or ethos, Becoming is a movement between courage, understanding, and being touched, and Becoming is strengthened through caring role models and a learning culture. CONCLUSIONS: Becoming a professional caring nurse is seen as an ongoing movement toward a deeper understanding of oneself and one's being and bearing. This movement is enabled when nursing students have a sense of self-awareness, courage to stand in their vulnerability, and reflect on their responsibility, caring attitude, and inner values and ethics. The force of becoming is that the attention is directed beyond self to care for and feel empathy for others in a caring manner. Becoming is released through a caring relationship, external confirmation, and good role models. A lack of external support in the movement can potentially prevent the students from becoming a professional caring nurse.

17.
JMIR Res Protoc ; 13: e52469, 2024 Mar 07.
Artigo em Inglês | MEDLINE | ID: mdl-38451694

RESUMO

BACKGROUND: Chronic pain is a highly prevalent condition that requires multidisciplinary treatment. However, in the United Kingdom, access to specialist pain clinics where patients can receive medical multidisciplinary treatment is limited, and provision varies between health boards. As such, self-management of chronic pain using digital tools has been gaining traction recently, but evidence of its effectiveness from clinical-based trials focuses mainly on quantitative outcomes. OBJECTIVE: This systematic review aims to identify, appraise, and synthesize qualitative evidence on patients' experiences with digital health interventions (DHIs) for the management of chronic pain. METHODS: This systematic review will consider qualitative and mixed methods studies that explore the experience of patients (aged 18 years and older) with chronic pain engaging in DHIs to manage their pain. MEDLINE Ovid, PubMed, Embase, CINAHL, PsycINFO, and Scopus databases will be searched for published studies. The systematic review will be conducted in accordance with the ENTREQ (Enhancing Transparency in Reporting the Synthesis of Qualitative Research) guidelines. Following the 3-step thematic synthesis methodology of Thomas and Harden, titles and abstracts will be screened by 2 independent reviewers (AM and HM), and a third reviewer (MI or FM) will resolve any conflict that arises before the full-text screening. The Critical Appraisal Skills Programme checklist tool will be used to critically appraise the included studies. The extracted data will be imported to NVivo (QSR International), where thematic synthesis will be used to derive analytical themes from the included studies. RESULTS: Themes that encapsulate the patient experience will be identified from qualitative evidence, and these themes will shed light on the perceived benefits and disadvantages, usability, acceptability, and the overall impact digital tools can have on the lives of those with chronic pain. CONCLUSIONS: This systematic review will identify, appraise, and synthesize the overall experience of patients engaging in DHI to manage a diverse range of chronic pain conditions. By elaborating the patient experience through qualitative analysis, the findings from this review will enhance our current understanding of the experiences of patients with chronic pain using digital tools for the self-management of their pain and highlight what person-centered elements are essential for future DHI development. TRIAL REGISTRATION: PROSPERO CRD42023445100; http://tinyurl.com/4z77khfs. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/52469.

18.
Health Econ Policy Law ; 19(2): 234-252, 2024 04.
Artigo em Inglês | MEDLINE | ID: mdl-38314528

RESUMO

The management implications of pricing healthcare services, especially hospitals, have received insufficient scholarly attention. Additionally, disciplinary overlaps have led to scattered academic efforts in this domain. This study performs a thematic synthesis of the literature and applies retrospective analysis to hospital service pricing articles to address these issues. The study's inputs were sourced from well-known online repositories, using a structured search string and PRISMA flow chart to select the pertinent documents. Our thematic analysis of pricing literature encompasses: (a) comprehension of hospital service pricing nature; (b) pricing objectives, strategies and practices differentiation; (c) presentation of factors impacting hospital service pricing. We observe that hospital pricing is an intricate and unclear matter. The terms 'pricing strategies' and 'pricing practices' are often used interchangeably in academic literature. Hospital service pricing is influenced by costs, demand and supply factors, market structure, pricing regulation and third-party reimbursements. The study's findings provide policy implications for service pricing in hospitals, in addition to suggesting avenues for future research on hospital pricing.


Assuntos
Custos e Análise de Custo , Humanos , Custos Hospitalares , Hospitais , Preços Hospitalares , Economia Hospitalar
19.
J Clin Psychol ; 80(5): 968-1002, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38328892

RESUMO

OBJECTIVE: This qualitative review sought to explore how young people (YP) conceptualize positive outcomes from cognitive-behavioral therapy (CBT) and what YP perceive to be the facilitators and barriers to positive outcomes. METHODS: A systematic literature search was conducted in June 2021 using six online databases. Studies were included if qualitative data were collected from participants who were aged up to 25, had internalizing mental health difficulties, and had received in-person CBT from trained practitioners. RESULTS: Nineteen studies were included. The Gough Weight of Evidence framework was used to assess methodological and topical quality and relevance. A thematic synthesis identified 34 conceptualizations of positive outcomes, 57 facilitators, and 49 barriers. Descriptive and analytical themes were identified. In line with the review's pragmatic perspective, the latter were worded as practice recommendations: acknowledge YP's perspectives on outcomes, teach tangible CBT techniques, balance autonomy and support, frame CBT as "upskilling," explore nuanced barriers to engagement, and consider the power of group dynamics. CONCLUSIONS: This review established the range of YP's views about positive outcomes from CBT, as well as facilitators and barriers to achieving these. Findings should prompt CBT practitioners to reflect and consider how their practice might be shaped through reports from YP as experts by experience.


Assuntos
Terapia Cognitivo-Comportamental , Humanos , Terapia Cognitivo-Comportamental/métodos , Adolescente , Adulto Jovem , Adulto , Pesquisa Qualitativa , Feminino , Masculino
20.
Psychol Sport Exerc ; 72: 102608, 2024 05.
Artigo em Inglês | MEDLINE | ID: mdl-38360079

RESUMO

To protect the integrity of sport, and the health of athletes, global anti-doping programmes seek to prevent doping, and elicit anti-doping and clean sport behaviours, through education, deterrence, detection, enforcement, and rules. To guide programme development, this meta-synthesis of qualitative research applied a behavioural science framework to identify barriers and enablers to doping, anti-doping, and clean sport. A systematic search of electronic databases up to May 2022, followed by critical appraisal, resulted in 73 included articles. Fifty-two articles reported the athlete perspective, thirteen included athletes, athlete support personnel (ASP), and other experts, and eight focused on ASP only. Rigorous methods of thematic synthesis were drawn upon to construct analytical themes in line with the theoretical domains framework (TDF) and the capability, opportunity, and motivation model of behaviour (COM-B). A wide range of barriers and enablers were identified which influenced capability, opportunity, and motivation to participate in a clean sport environment. The weight of evidence pointed to limitations in the current anti-doping education system in providing athletes and ASP with the knowledge and skills to protect against doping, as well as the significant influence of social and cultural norms in shaping doping and clean sport behaviours through a shared social identity, and risky contexts leading to moments of vulnerability to doping. We identified a need for anti-doping programmes to move beyond the current focus on athlete capability, and address the opportunity and motivation components of clean sport behaviours through a targeted and tailored focus on education, training, persuasion, modelling and environmental restructuring interventions.


Assuntos
Dopagem Esportivo , Esportes , Humanos , Dopagem Esportivo/prevenção & controle , Motivação , Pesquisa Qualitativa
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