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1.
Recurso de Internet en Inglés | LIS - Localizador de Información en Salud | ID: lis-LISBR1.1-47074

RESUMEN

In response to the current crisis, we are maintaining an up-to-date map of the current evidence that we partition into broad domains for easy exploration. We are open to feedback on how we maintain and categorise this evidence base, so do get in touch if you have suggestions.


Asunto(s)
Brotes de Enfermedades , Práctica Clínica Basada en la Evidencia , Mapas , Coronavirus
3.
BMJ ; 368: m807, 2020 03 09.
Artículo en Inglés | MEDLINE | ID: mdl-32151997
6.
J Nurs Adm ; 50(3): 128-134, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32049700

RESUMEN

Nurses need training and mentoring to lead evidence-based practice (EBP) improvements. An array of roles have been reported to have a positive impact on EBP adoption. A training program was created to assist point-of-care nurses and nurse leader partners in operationalizing the EBP Change Champion role to address priority quality indicators. The program, a case exemplar, and lessons learned are described with implications for leaders responsible for promoting EBP to improve quality care.


Asunto(s)
Práctica Clínica Basada en la Evidencia/educación , Liderazgo , Personal de Enfermería en Hospital/educación , Calidad de la Atención de Salud/normas , Conocimientos, Actitudes y Práctica en Salud , Humanos , Evaluación de Programas y Proyectos de Salud
7.
Adv Exp Med Biol ; 1191: 415-449, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32002940

RESUMEN

Complementary and alternative medicine (CAM) encompasses a wide range of different nonmainstream therapies that have been increasingly used for treatment or adjunctive treatment of various ailments with anxiety/anxiety disorders being one of the commonly CAM (self)-medicated conditions. Thousands of published papers refer to use of CAM in various psychiatric disorders or in healthy or medically ill patients with mood or anxiety difficulties. In this chapter we focus specifically on clinically diagnosed (in line with the standard criteria) anxiety disorders and overview evidence of efficacy/safety of a range of CAM modalities: biologically based therapies (typically herbal preparations and less so nutraceuticals); manipulative and body-based therapies (acupuncture, aerobic exercise, massage, therapeutic touch, repetitive transcranial magnetic stimulation, balneotherapy, and others); mind-body therapies (yoga, Morita therapy, Tai Chi, reiki, Chinese cognitive therapy, religious and spiritual interventions, relaxation, mediation, and mindfulness-based interventions); and alternative medical systems (Ayurveda, homeopathy). We focus exclusively on randomized controlled trials and attempt to evaluate the existing body of evidence in the same manner that is applied to mainstream treatments.


Asunto(s)
Trastornos de Ansiedad/terapia , Terapias Complementarias , Práctica Clínica Basada en la Evidencia , Terapia por Acupuntura , Ejercicio , Humanos , Masaje , Ensayos Clínicos Controlados Aleatorios como Asunto , Tai Ji , Yoga
8.
Am J Occup Ther ; 74(1): 7401185030p1-7401185030p18, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32078508

RESUMEN

IMPORTANCE: Low vision affects many older adults and is expected to significantly increase over the next several decades. It has a significant impact on all aspects of daily life, including the reading required for participation in occupations. OBJECTIVE: To determine the effectiveness of interventions within the scope of occupational therapy to improve reading required for the performance of occupations by older adults with low vision. DATA SOURCES: We conducted a systematic review of literature published in the Cochrane Database of Systematic Reviews, MEDLINE, PsycINFO, CINAHL, and OTseeker databases from 2010 through 2016. The references of retrieved articles were also hand searched. STUDY SELECTION AND DATA COLLECTION: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to abstract and assess data quality and validity. This review followed the established methodology of the American Occupational Therapy Association Evidence-Based Practice Project. FINDINGS: Sixteen articles met the inclusion criteria and were categorized into three themes: (1) technology, (2) visual skills training, and (3) multicomponent interventions. Moderate evidence supports stand-based electronic magnification and eccentric viewing training to improve reading outcomes. Strong evidence supports multicomponent interventions. CONCLUSIONS AND RELEVANCE: Occupational therapy practitioners working with older adults with low vision are strongly encouraged to integrate stand-based electronic magnification, eccentric viewing training, and comprehensive low vision services into routine care. Further research with larger sample sizes and functional reading outcome measures is needed. WHAT THIS ARTICLE ADDS: This review provides additional support for the use of select occupational therapy interventions (stand-based electronic magnification, eccentric viewing training, and comprehensive low vision services) to support the reading required for occupational performance for older adults with low vision. The findings provide guidance to occupational therapy practitioners for selection and implementation of evidence-based interventions for reading.


Asunto(s)
Terapia Ocupacional , Baja Visión , Anciano , Práctica Clínica Basada en la Evidencia , Humanos , Lectura
9.
Am J Occup Ther ; 74(1): 7401205050p1-7401205050p14, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32078516

RESUMEN

IMPORTANCE: Despite advancements in stroke rehabilitation research, occupational therapy practitioners still face challenges with implementing research into routine practice. Although the development of evidence-based practices (EBPs) is one critical step along the knowledge translation continuum for the population of people with stroke, research is also needed to identify the most effective strategies for implementing EBPs with stroke survivors who are receiving occupational therapy services. OBJECTIVE: To synthesize research related to occupational therapy practitioners' implementation of EBPs in adult stroke rehabilitation. DATA SOURCES: We searched four electronic databases-CINAHL, MEDLINE, PubMed, and Academic Search Complete-and the peer-reviewed journal Implementation Science to identify relevant research studies. STUDY SELECTION AND DATA COLLECTION: Studies that met the following inclusion criteria were included in the scoping review: published between January 2003 and January 2018, addressed the adult stroke population, and examined the implementation of occupational therapy interventions. Data were abstracted on the basis of recommendations from the seminal review framework established by Arksey and O'Malley (2005). Thematic analysis identified themes that emerged from the included studies. FINDINGS: Twenty-five articles satisfied our inclusion parameters. Our analyses yielded three overarching themes: barriers to implementation, facilitators of implementation, and implementation strategies. Implementation strategies often consisted of multimodal knowledge translation training programs. CONCLUSION AND RELEVANCE: Although the stroke rehabilitation literature appears to have established the barriers to and facilitators of EBP implementation, greater attention to the identification of effective implementation strategies that promote the uptake of EBPs by occupational therapy practitioners is needed. WHAT THIS ARTICLE ADDS: This article summarizes the contextual factors and effective strategies that may influence practitioners' implementation of stroke research findings in real-world practice.


Asunto(s)
Terapia Ocupacional , Rehabilitación de Accidente Cerebrovascular , Accidente Cerebrovascular , Adulto , Práctica Clínica Basada en la Evidencia , Humanos , Accidente Cerebrovascular/fisiopatología , Investigación en Medicina Traslacional
10.
Am J Occup Ther ; 74(1): 7401390010p1-7401390010p5, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32078523

RESUMEN

Evidence Connection articles provide clinical application of systematic reviews developed in conjunction with the American Occupational Therapy Association's (AOTA's) Evidence-Based Practice Project. In this Evidence Connection article, we describe a case report of an older adult who was referred to outpatient occupational therapy services due to chronic back pain from herniated discs. Findings from the systematic review of occupational therapy for community-dwelling older adults were published in the July/August 2018 issue of the American Journal of Occupational Therapy (Berger et al., 2018; Elliott & Leland, 2018; Hunter & Kearney, 2018; Liu et al., 2018; Smallfield & Lucas Molitor, 2018a, 2018b) and in the American Occupational Therapy Association's Occupational Therapy Practice Guidelines for Productive Aging for Community-Dwelling Older Adults. Each article in the Evidence Connection series summarizes the evidence from the published reviews on a given topic and presents an application of the evidence to a related clinical case. These articles illustrate how the research evidence from the reviews can be used to inform and guide clinical decision making.


Asunto(s)
Terapia Ocupacional , Anciano , Envejecimiento , Eficiencia , Práctica Clínica Basada en la Evidencia , Humanos , Vida Independiente , Terapia Ocupacional/métodos
12.
Nursing ; 50(2): 41-44, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31904618

RESUMEN

This article discusses an evidence- and consensus-based support-surface algorithm designed to help clinicians choose the most appropriate support surface for preventing or treating pressure injuries based on patient, nurse, and institutional considerations.


Asunto(s)
Algoritmos , Lechos , Toma de Decisiones Clínicas/métodos , Enfermeras Clínicas/psicología , Úlcera por Presión/enfermería , Consenso , Práctica Clínica Basada en la Evidencia , Humanos , Factores de Riesgo
13.
Oncology ; 98(1): 1-9, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31514196

RESUMEN

Cytoreductive nephrectomy (CN) followed by systemic therapy had been considered the standard of care for metastatic renal cell carcinoma (mRCC) patients since two clinical trials established its role during the cytokines era. With introduction of new and effective drugs, such as vascular endothelial growth factor-targeted therapies, the role of CN started to be challenged. Retrospective studies conducted during the targeted therapy era pointed to better outcomes when CN was associated with systemic treatment, although certain patients with poor risk features did not seem to benefit. Therefore, prospective clinical trials supporting CN were needed. Recently, with the publication of two randomized trials evaluating CN in the targeted therapy era, it has been made clear that patient selection and multidisciplinary discussion are of paramount importance in order to achieve the best outcomes. We reviewed the available literature on the role of CN among mRCC patients, commenting on how to apply the new evidence into clinical practice and providing future perspectives.


Asunto(s)
Carcinoma de Células Renales/patología , Carcinoma de Células Renales/cirugía , Procedimientos Quirúrgicos de Citorreducción , Neoplasias Renales/patología , Neoplasias Renales/cirugía , Nefrectomía , Biomarcadores , Carcinoma de Células Renales/metabolismo , Carcinoma de Células Renales/mortalidad , Citocinas/metabolismo , Procedimientos Quirúrgicos de Citorreducción/efectos adversos , Procedimientos Quirúrgicos de Citorreducción/métodos , Práctica Clínica Basada en la Evidencia , Humanos , Neoplasias Renales/metabolismo , Neoplasias Renales/mortalidad , Metástasis de la Neoplasia , Estadificación de Neoplasias , Nefrectomía/efectos adversos , Nefrectomía/métodos , Pronóstico , Resultado del Tratamiento
14.
Support Care Cancer ; 28(1): 23-33, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31396746

RESUMEN

PURPOSE: The Palliative Care Study Group of the Multinational Association for Supportive Care in Cancer formed a subgroup to develop evidence-based recommendations on the management of constipation in patients with advanced cancer. METHODS: These recommendations were developed in accordance with the MASCC Guidelines Policy. A search strategy for Medline was developed, and the Cochrane Database of Systematic Reviews and the Cochrane Central Register of Controlled Trials were explored for relevant reviews/trials respectively. The recommendations were categorised by the level of evidence and a "category of guideline" based on the level of evidence (i.e. "recommendation", "suggestion", or "no guideline possible"). RESULTS: The group produced 15 recommendations, with varying levels of evidence and so varying categories of guideline. The recommendations relate to the assessment, the treatment, and the re-assessment of constipation. CONCLUSIONS: These recommendations provide a framework for the management of constipation in advanced cancer, although every patient needs individualised management.


Asunto(s)
Estreñimiento/terapia , Neoplasias/terapia , Cuidados Paliativos/métodos , Cuidados Paliativos/normas , Estreñimiento/diagnóstico , Estreñimiento/epidemiología , Estreñimiento/etiología , Progresión de la Enfermedad , Práctica Clínica Basada en la Evidencia/normas , Humanos , Oncología Médica/métodos , Oncología Médica/normas , Neoplasias/epidemiología , Neoplasias/patología , Sociedades Médicas/normas
15.
Nurs Educ Perspect ; 41(1): 39-40, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31860485

RESUMEN

Prelicensure nursing student exposure to undergraduate research education may have a significant effect on their research skills and use of evidence-based practice. There are potential benefits to introducing Q methodology to prelicensure nursing research students. Utilizing Q methodology principles and techniques, a class on Q methodology was integrated into a prelicensure nursing research and evidence-based practice course. The interactive classroom format and active student engagement in the step-by-step mock study were positive aspects of the class.


Asunto(s)
Bachillerato en Enfermería , Investigación en Enfermería , Estudiantes de Enfermería , Práctica Clínica Basada en la Evidencia , Humanos , Enseñanza
17.
Rev Lat Am Enfermagem ; 27: e3215, 2019.
Artículo en Inglés, Portugués, Español | MEDLINE | ID: mdl-31826158

RESUMEN

OBJECTIVE: compare ventilatory time between patients with the application of a disconnection protocol, managed in a coordinated way between doctor and nurse, with patients managed exclusively by the doctor. METHOD: experimental pilot study before and after. Twenty-five patients requiring invasive mechanical ventilation for 24 hours or more were included, and the protocol-guided group was compared with the protocol-free group managed according to usual practice. RESULTS: by means of the multidisciplinary protocol, the time of invasive mechanical ventilation was reduced (141.94 ± 114.50 vs 113.18 ± 55.14; overall decrease of almost 29 hours), the time spent on weaning (24 hours vs 7.40 hours) and the numbers of reintubation (13% vs 0%) in comparison with the group in which the nurse did not participate. The time to weaning was shorter in the retrospective cohort (2 days vs. 5 days), as was the hospital stay (7 days vs. 9 days). CONCLUSION: the use of a multidisciplinary protocol reduces the duration of weaning, the total time of invasive mechanical ventilation and reintubations. The more active role of the nurse is a fundamental tool to obtain better results.


Asunto(s)
Respiración Artificial/normas , Desconexión del Ventilador/normas , Anciano , Protocolos Clínicos , Práctica Clínica Basada en la Evidencia , Femenino , Humanos , Masculino , Rol de la Enfermera , Relaciones Médico-Enfermero , Proyectos Piloto , Estudios Retrospectivos
18.
Zhongguo Zhen Jiu ; 39(12): 1343-6, 2019 Dec 12.
Artículo en Chino | MEDLINE | ID: mdl-31820613

RESUMEN

Evidence-based Clinical Practice Guideline of Acupuncture and Moxibustion for Primary Dysmenorrhea (Guideline) is clarified from three aspects: the development method, contents and clinical application, which could provide clinical practical strategies suitable for most patients for clinicians. Based on comprehensive literature search and summary of acupuncture practice, the best clinical research evidence is obtained according to the evidence-based method, the evidence-quality evaluation and recommendation grading are introduced. With ancient literature, famous experts' experience and expert consensus, the recommendations of acupuncture-moxibustion for primary dysmenorrhea are developed, which are safe, effective and applicable for clinical treatment. The Guideline could standardize the acupuncture treatment plan for primary dysmenorrhea.


Asunto(s)
Terapia por Acupuntura , Dismenorrea/terapia , Moxibustión , Ensayos Clínicos como Asunto , Práctica Clínica Basada en la Evidencia , Femenino , Humanos
19.
Chiropr Man Therap ; 27: 68, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31857892

RESUMEN

Background: Recent clinical practice guidelines for the management of non-specific low back pain (LBP) recommend using stratified care approaches. To date, no study has assessed barriers and facilitators for health professionals in using stratified care approaches for managing non-specific LBP in the Canadian primary care setting. This study aimed to identify and contrast barriers and facilitators to using the stratified care approaches for non-specific LBP among Canadian physiotherapists and chiropractors. Methods: Individual telephone interviews, underpinned by the Theoretical Domains Framework (TDF), explored beliefs and attitudes about, and identified barriers and facilitators to the use of stratified care approaches for managing non-specific LBP in a purposive sample of 13 chiropractors and 14 physiotherapists between September 2015 and June 2016. Interviews were digitally recorded, transcribed verbatim and analysed by two independent assessors using directed content analysis. Results: Three and seven TDF domains were identified as likely relevant for physiotherapists and chiropractors, respectively. Shared key beliefs (and relevant domains of the TDF) for both physiotherapists and chiropractors included: lack of time, cost, and expertise (Environmental Context and Resources); and consulting more experienced colleagues and chronic patients with important psychological overlay (Social Influences). Unique key domains were identified among physiotherapists: incompatibility with achieving other objectives (Goals), and chiropractors: confidence in using stratified care approaches (Beliefs about Capabilities); intention to use stratified care approaches (Intentions); awareness and agreement with stratified care approaches (Knowledge); assessment of readiness for change and intentional planning behaviour (Behavioural Regulation); and improving the management of non-specific LBP patients and the uptake of evidence-based practice (Beliefs about Consequences). Conclusions: Several shared and unique barriers and facilitators to using the stratified care approaches for non-specific LBP among Canadian physiotherapists and chiropractors were identified. Findings may help inform the design of tailored theory-based knowledge translation interventions to increase the uptake of stratified care approaches in clinical practice.


Asunto(s)
Quiropráctica , Personal de Salud/psicología , Dolor de la Región Lumbar/terapia , Fisioterapeutas , Adulto , Actitud del Personal de Salud , Canadá , Práctica Clínica Basada en la Evidencia , Humanos , Dolor de la Región Lumbar/psicología , Masculino , Persona de Mediana Edad , Fisioterapeutas/psicología , Investigación Cualitativa
20.
Rev. Esc. Enferm. USP ; 53: e03518, Jan.-Dez. 2019. tab
Artículo en Inglés, Portugués | LILACS, BDENF - Enfermería | ID: biblio-1020379

RESUMEN

RESUMO Objetivo Verificar o conhecimento de estudantes sobre o plano individual de parto e conhecer sua opinião a respeito da utilização dessa estratégia de ensino-aprendizagem e das boas práticas obstétricas. Método Estudo descritivo, com alunos de Obstetrícia que cursavam estágios na atenção básica. A coleta dos dados realizada de 01/2017 a 05/2017, por meio digital, na Plataforma Google Formulários®. A análise foi realizada por estatística descritiva de categorização de enunciados. O estudo seguiu os padrões éticos exigidos. Resultados O formulário foi enviado a 97 discentes e respondido por 40% deles. Todos os respondentes informaram conhecer o plano de parto, e 87% aplicaram-no durante o atendimento de pré-natal. Os apontamentos mais frequentes (45%) acerca do plano de parto foram os que promoviam empoderamento e autonomia à mulher. As sugestões metodológicas mais citadas para a sua aplicação foram focar o conteúdo (76%) e aumentar o número de encontros (50%). O plano individual de parto foi reconhecido por 79% dos participantes como importante estratégia de ensino. Conclusão Além de conhecerem o plano de parto e aplicá-lo, os estudantes o consideram muito relevante para o ensino e a aprendizagem das boas práticas obstétricas.


RESUMEN Objetivo Verificar el conocimiento de estudiantes acerca del plan individual de parto y conocer su comprensión respecto de la utilización de dicha estrategia de enseñanza aprendizaje y de las buenas prácticas obstétricas. Método Estudio descriptivo, con alumnos de Obstetricia que cursaban pasantías en la atención básica. La recolección de datos fue realizada de 01/2017 a 05/2017, por medio electrónico, en la Plataforma Google Formularios®. El análisis fue llevado a cabo por estadística descriptiva de categorización de enunciados. El estudio siguió los estándares éticos exigidos. Resultados El formulario fue enviado a 97 discentes y respondido por el 40% de ellos. Todos los respondedores informaron conocer el plan de parto, y el 87% lo aplicaron durante la atención de prenatal. Los planteamientos más frecuentes (45%) acerca del plan de parto fueron los que promovían empoderamiento y autonomía a la mujer. Las sugerencias metodológicas más citadas para su aplicación fueron enfocar el contenido (76%) y aumentar el número de encuentros (50%). El plan individual de parto fue reconocido por el 79% de los participantes como importante estrategia de enseñanza. Conclusión Además de conocer el plan de parto y aplicarlo, los estudiantes lo consideran muy relevante para la enseñanza y el aprendizaje y de las buenas prácticas obstétricas.


ABSTRACT Objective To verify students' knowledge about individual birth planning and learn their opinion about the use of this teaching-learning strategy for good obstetric practices. Method This is a descriptive study conducted with midwifery students who made primary health care internships. Data collection was performed digitally from 01/2017 to 05/2017 through the Google Forms®Platform. The analysis was performed by descriptive categorization statistics of statements. The study followed the required ethical standards. Results The form was sent to 97 students and answered by 40% of them. All respondents reported knowing the birth planning, and 87% applied it during prenatal care. The most frequent (45%) points about the birth plan were those that promoted women's empowerment and autonomy. The most cited methodological suggestions for its application were to focus on content (76%) and increase the number of meetings (50%). Individual birth planning was recognized by 79% of the participants as an important teaching strategy. Conclusion In addition to knowing birth planning and applying it, the students consider it very relevant for teaching and learning good obstetrical practices.


Asunto(s)
Humanos , Estudiantes , Educación Superior , Parto Humanizado , Práctica Clínica Basada en la Evidencia , Aprendizaje , Obstetricia
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