Self-care interventions for adults with heart failure: A systematic review and meta-analysis protocol.

AIM: To synthesize and compare outcomes from controlled trials of interventions to improve heart failure self-care among adults. BACKGROUND: Heart failure self-care interventions are recommended for preventing and detecting exacerbations, improving symptom management and preventing hospitalizations. Little is known about the overall effectiveness of heart failure self-care programmes and which types of interventions show the greatest improvement in outcomes. DESIGN: Systematic review and meta-analysis, including moderator analyses. METHODS: Multiple databases (including MEDLINE/PubMed, CINAHL, PsycINFO, Scopus and Cochrane Central Register of Controlled Trials) will be searched from inception through 2018 along with grey literature searches to identify trials testing interventions to improve self-care outcomes of adults with heart failure. Data will be extracted from eligible studies on sample, methodological and intervention characteristics and data to calculate effect sizes. Data will be analysed using random-effects models. Moderator variables will be analysed with meta-regression and sub-group analyses. Risk for bias will be assessed using the Cochrane Risk for Bias tool and by examining potential sources of bias as moderator variables. Funding for this project began in July 2017. DISCUSSION: We will analyse self-care behaviour outcomes and clinical outcomes including hospitalizations, mortality, disease severity and quality of life. This will be the most extensive meta-analysis of heart failure self-care interventions to date. IMPACT: Comparative effectiveness of existing self-care interventions is not yet known. This research will identify the most promising self-care intervention components for designing better interventions and guide targeting of interventions to specific sub-populations. PROSPERO Registration Number: CRD42017075831.

Abused South asian women in westernized countries and their experiences seeking help.

The aims of this qualitative systematic review were to better understand domestic abuse among South Asian (SA) women in westernized locales and to make evidence-based inferences related to helping services. Thirty English-language research reports met the inclusion criteria. Findings were extracted, assessed for quality, and analyzed using an iterative approach. Based on the results, domestic abuse appears to be grounded in the context of SA mores and the experience of immigration. Situational circumstances and language barriers make it difficult for SA women to reach and utilize helping services. Nurses are urged to consider these barriers as they assist SA immigrant women to enhance their well-being.

Literature search strategies for conducting knowledge-building and theory-generating qualitative systematic reviews.

AIM: To report literature search strategies for the purpose of conducting knowledge-building and theory-generating qualitative systematic reviews. BACKGROUND: Qualitative systematic reviews lie on a continuum from knowledge-building and theory-generating to aggregating and summarizing. Different types of literature searches are needed to optimally support these dissimilar reviews. DATA SOURCES: Articles published between 1989-Autumn 2011. These documents were identified using a hermeneutic approach and multiple literature search strategies. DISCUSSION: Redundancy is not the sole measure of validity when conducting knowledge-building and theory-generating systematic reviews. When conducting these types of reviews, literature searches should be consistent with the goal of fully explicating concepts and the interrelationships among them. To accomplish this objective, a 'berry picking' approach is recommended along with strategies for overcoming barriers to finding qualitative research reports. IMPLICATIONS: To enhance integrity of knowledge-building and theory-generating systematic reviews, reviewers are urged to make literature search processes as transparent as possible, despite their complexity. This includes fully explaining and rationalizing what databases were used and how they were searched. It also means describing how literature tracking was conducted and grey literature was searched. In the end, the decision to cease searching also needs to be fully explained and rationalized. CONCLUSION: Predetermined linear search strategies are unlikely to generate search results that are adequate for purposes of conducting knowledge-building and theory-generating qualitative systematic reviews. Instead, it is recommended that iterative search strategies take shape as reviews evolve.

Perceived competency and resolution of homelessness among women with substance abuse problems.

Using a metasynthesis approach, our aim was to articulate new insights relating to the most efficient and effective means of helping homeless women with substance abuse problems to enhance their well-being and become more stably housed. Distorted perceptions of competency, which are shaped by dysfunctional relationships and mental health problems, make it challenging for women with substance abuse problems to resolve homelessness. Women with particularly low or high levels of perceived competency tend to grapple with challenges related to structure and control, trust, and hopelessness. Therapeutic strategies for approaching these women include careful assessment, caring, personalized structure and control, development of interpersonal trust, instillation of hope, and the targeted use of psychotherapeutic agents and counseling. Framing care for homeless women within the context of perceived competency offers a new way of understanding their plight and shaping interventions to more expeditiously move them toward healthy and stable lives.

Substance abuse treatment for women who are under correctional supervision in the community: a systematic review of qualitative findings.

This systematic review was conducted to more fully analyze qualitative research findings relating to community-based court-supervised substance abuse treatment for women and to make recommendations regarding treatment enhancement. Five reports of qualitative research met the inclusion criteria. Findings from these reports were extracted and analyzed using constant comparative methods. Women who are referred to court-sanctioned substance abuse treatment programs may initially be reluctant to participate. Once engaged, however, they advocate for a full complement of well-financed comprehensive services. To optimize treatment effectiveness, women recommend gender-specific programs in which ambivalence is diminished, hope is instilled, and care is individualized.

Therapeutic substance abuse treatment for incarcerated women.

The purpose of this qualitative systematic review was to explicate attributes of optimal therapeutic strategies for treating incarcerated women who have a history of substance abuse. An expansive search of electronic databases for qualitative research reports relating to substance abuse treatment for incarcerated women was conducted. Nine qualitative research reports comprised the sample for this review. Findings from these reports were extracted, placed into a data analysis matrix, coded, and categorized. Memos were written and strategies for treating incarcerated women with alcohol problems were identified. Therapeutic effects of treatment programs for incarcerated women with substance abuse problems appear to be enhanced when trust-based relationships are established, individualized and just care is provided, and treatment facilities are separate from the general prison environment.

Design and evaluation of a personal digital assistant- based alerting service for clinicians.

PURPOSE: This study describes the system architecture and user acceptance of a suite of programs that deliver information about newly updated library resources to clinicians' personal digital assistants (PDAs). DESCRIPTION: Participants received headlines delivered to their PDAs alerting them to new books, National Guideline Clearinghouse guidelines, Cochrane Reviews, and National Institutes of Health (NIH) Clinical Alerts, as well as updated content in UpToDate, Harrison's Online, Scientific American Medicine, and Clinical Evidence. Participants could request additional information for any of the headlines, and the information was delivered via e-mail during their next synchronization. Participants completed a survey at the conclusion of the study to gauge their opinions about the service. RESULTS/OUTCOME: Of the 816 headlines delivered to the 16 study participants' PDAs during the project, Scientific American Medicine generated the highest proportion of headline requests at 35%. Most users of the PDA Alerts software reported that they learned about new medical developments sooner than they otherwise would have, and half reported that they learned about developments that they would not have heard about at all. While some users liked the PDA platform for receiving headlines, it seemed that a Web database that allowed tailored searches and alerts could be configured to satisfy both PDA-oriented and e-mail-oriented users.

The Region 4 collaborative virtual reference project.

In May 2002, the Denison Memorial Library at the University of Colorado Health Sciences Center and the J. Otto Lottes Health Sciences Library at the University of Missouri-Columbia, with funding from the National Network of Libraries of Medicine-Midcontinental Region, embarked on a collaborative, real-time reference project using the 24/7 Reference, Inc., software package. This paper describes how the project was conceived, and includes details on the service hours, staffing, training, marketing, lessons learned, and future plans for the service.

When A. Rose is not A. Rose: the vagaries of author searching.

Creation of a faculty database is a challenging but worthwhile project. In 2002, librarians at the University of Missouri-Columbia were approached by the School of Medicine to create a database of faculty publications. This article outlines the project and gives special emphasis to the problems of author searching. Discussion items include author searching syntax and providing ideas for how to determine if a publication was written by a particular author.