ABSTRACT
We aimed to examine the nature and extent of theory application in studies of built environment attributes and impact on adults in healthcare facilities. Many varied theories are described when providing the rationale for research into built environments in healthcare. Uncertainty exists around the right theory to frame a research question, alignment with measurement tools, and whether healthcare setting makes a difference. This poses challenges to researchers seeking to build the evidence base for built environment design that benefits patients and staff. Our multidisciplinary review team scoped the literature to determine how theories are used to inform research investigating the impact of the built environment of healthcare on adults. When researchers recorded theory at development of the study question, in data collection, and in data analysis/interpretation, we called this explicitly theory-based application. Synthesis occurred using a narrative approach. Overall, we found 17 diverse theories named in studies. Explicitly theory-based use occurred with eight theories, comprising 47% of all theories used. Five theories were named more frequently in studies out of all theories identified. In 20% of studies, theory was not used explicitly during the research inquiry. We argue that researchers must continue to strive toward explicit use of theories, similar to development of other health interventions that employ multifactorial components.
Subject(s)
Built Environment , Facility Design and Construction/methods , Research Design , Adult , Humans , Models, TheoreticalABSTRACT
The aim of the present study was to monitor the health-related quality of life (HRQOL) of patients with head and neck cancer or haematological malignancies during a period from before to after medical treatment, and to investigate the relationships between patient experiences of oral symptoms and HRQOL. The sample consisted of 41 consecutive patients. At the start, during and end of radiotherapy or the second/third cycle of chemotherapy, patients rated their experiences of oral symptoms on a 100-mm visual analogue scale and completed the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ) C30 and the EORTC QLQ H&N35 (head and neck patients). At the end of treatment, an interview was done regarding the perceived influence of oral status on HRQOL. Among patients receiving radiotherapy, HRQOL tended to decrease over time, and oral symptoms increased. Patients who reported that their oral symptoms had influenced their everyday life (56%) reported more severe oral symptoms and lower HRQOL scores at the end of treatment when the oral symptoms were most intense. The findings from correlational analyses support the patients' reports from the interviews. For patients receiving chemotherapy for haematological malignancies, the quality of life did not change during the chemotherapy cycle. They reported very few oral symptoms, and very few reported that oral symptoms had any influence on their HRQOL. However, the correlational data indicate a relation between oral symptoms and HRQOL. Patients who reported more severe oral symptoms also reported lower HRQOL scores. The results demonstrate that oral status is related to HRQOL in these patient groups.
Subject(s)
Head and Neck Neoplasms/complications , Head and Neck Neoplasms/psychology , Hematologic Neoplasms/complications , Hematologic Neoplasms/psychology , Mouth Diseases/etiology , Mouth Diseases/psychology , Oral Health , Quality of Life , Adult , Aged , Analysis of Variance , Female , Head and Neck Neoplasms/therapy , Health Status Indicators , Hematologic Neoplasms/therapy , Humans , Male , Middle Aged , Prospective StudiesABSTRACT
Earlier studies have shown that patients are dissatisfied with the information they receive from doctors and nurses. The purpose of this study was to analyze satisfaction with information and quality of life in patients with cancer undergoing chemotherapy, considering the patient's information preference. Data were collected during interviews with 30 consecutive patients undergoing chemotherapy for cancer. The subject of the interviews was the satisfaction of patients with the information they received, and additional measures used were the Miller Behavioral Styles Scale and EORTC-QLQ-30. The results showed that 21 of 30 patients were satisfied with the information they received from health care. Married patients or cohabitants were satisfied more often than single patients. No significant differences in quality of life could be found between satisfied and dissatisfied patients. Regarding information preferences, the dissatisfied patients reported more information-avoiding behavior than those who were satisfied. The results must be interpreted cautiously because of the study's limitations, but one clinical implication can be stated: There is value in being aware of patients' information-seeking/avoiding behavior before starting to inform them.