Behavioral pain indicators for adults with an intellectual disability: a scoping review protocol.

OBJECTIVE: This scoping review aims to identify and map the behavioral pain indicators observed when adults with an intellectual disability experience pain. INTRODUCTION: Adults with an intellectual disability have more health problems than the general population. The likelihood that this population will experience pain is high, but intellectual disability can obstruct the verbal expression of pain. Adults with an intellectual disability express pain via behavioral pain indicators; however, because no behavioral pain scale exists for this population, observers may misinterpret the pain experienced by adults with an intellectual disability. INCLUSION CRITERIA: The review will examine literature about behavioral pain indicators for adults with any type of intellectual disability who are suffering from any type of pain in any country or care setting. METHODS: The review will be conducted according to the JBI recommendations for scoping reviews. A preliminary search focusing on the concepts of intellectual disability and pain measurement was conducted for PubMed and CINAHL in March 2022. Once the protocol is validated, searches will also be carried out in Embase, JBI EBP Database, the Cochrane Database of Systematic Reviews, ProQuest Dissertations and Theses, PsycINFO, Web of Science Core Collection, ERIC, Google Scholar, MedNar, and the websites of relevant professional associations. Titles and abstracts, and then full-text studies, will be selected independently by 2 researchers and assessed against the inclusion criteria. Relevant information will be imported into a data chart. Any behavioral pain indicators identified will be classified into 14 behavioral categories. REVIEW REGISTRATION NUMBER: Open Science Framework osf.io/8xckf.

Interventions to improve patient experience in mammography: a scoping review protocol.

OBJECTIVE: The objective of this review is to map the global evidence on interventions aiming to enhance the patient experience during mammography examination. INTRODUCTION: Mammography is the examination of choice to detect breast cancer, which is the most common malignant condition among women globally. However, this examination can cause psychological distress, discomfort, and pain for patients. To limit these negative experiences, and to promote patient engagement in diagnostic and screening examinations, some interventions have been tested in clinical practice. Each intervention has key differing features that need to be explored in a scoping review. This mapping will help inform mammography professionals and researchers. INCLUSION CRITERIA: This review will consider studies that focus on women, men, transgender, nonbinary, or intersexual persons undergoing diagnostic or screening mammography. It will consider studies evaluating interventions and reporting data on the patient experience. These interventions may, for instance, be related to the information provided, breast compression, relaxation, medication, or physical environment. The review will also describe the outcomes related to patient experience (eg, anxiety, pain, discomfort). METHODS: The search strategy will aim to find published and unpublished studies and will be conducted in MEDLINE, Embase, CINAHL, PsycINFO, Cochrane Central Register of Controlled Trials, Web of Science, and ProQuest Dissertation and Theses. Furthermore, three registries will be searched for ongoing studies. This review will be conducted following JBI methodology, utilizing the three-step search strategy with two independent reviewers performing study selection and data extraction. The results, frequencies, and conceptual categories will be presented in a tabular and narrative summary. SCOPING REVIEW REGISTRATION: Open Science Framework ( https://osf.io/fn865/ ).

Factors influencing diabetes self-management in adults: an umbrella review of systematic reviews.

OBJECTIVE: The objective of this review was to identify and describe the factors influencing diabetes self-management in adults by summarizing the available evidence concerning their types, categories, and relative importance. INTRODUCTION: A wide range of factors, acting simultaneously, influence diabetes self-management and interfere with its actual application by patients. There is a variety of systematic reviews of these factors; however, a more thorough examination of their influences was lacking. INCLUSION CRITERIA: Systematic reviews of qualitative or quantitative literature focusing on factors influencing adult diabetes self-management in general or on individual behaviors (ie, management of oral antidiabetic medication and insulin injections, self-monitoring of blood glucose, foot care, healthy eating, regular exercise, and smoking cessation) will be included. METHODS: We performed an extensive search of 11 bibliographic databases, including gray literature, up to June 2019. Quantitative and qualitative findings were summarized separately and labeled according to their types (eg, facilitator/barrier, strength and direction of association), categories (eg, demographic, social), and frequency of occurrence. RESULTS: We identified 51 types of factors within 114 systematic reviews, which mostly addressed medication-taking behavior. Thirty-two (62.7%) factors were reported in both qualitative and quantitative literature. The predominant influences were psychological factors and behavioral attributes/skills factors. The most frequently reported facilitators of diabetes self-management were motivation to diabetes self-management, a favorable attitude to diabetes self-management, knowledge about the disease, medication and behaviors associated with diabetes self-management, skills, and self-efficacy/perceived behavioral control. The predominant barriers were the presence of depression, and polypharmacy or drug regimen complexity. The demographic factor of female sex was frequently reported for its negative influence on diabetes self-management, whereas older age was a positive factor. The social/cultural and physical environment were the least-studied categories. Other factors such as social support from family, friends, or networks; interventions led by health professionals; and a strong community environment with good social services favoring diabetes self-management were reported as major facilitators of diabetes self-management. CONCLUSIONS: Essential components of interventions to promote effective diabetes self-management should aim to help adults manage the effects of specific factors related to their psychological and practical self-management experience. Screening for depression, in particular, should become an integral part of the support for adult diabetes self-management, as depression is a particular obstacle to the effectiveness of diabetes self-management. Future studies should more deeply examine the influence of factors identified in the sociocultural and physical environment categories. Research should properly consider and invest efforts in strengthening social support and innovative community care approaches, including pharmacist- and nurse-led care models for encouraging and improving adult diabetes self-management. Finally, researchers should examine non-modifiable factors - age, sex, or socioeconomic status - in the light of factors from other categories in order to deepen understanding of their real-world patterns of action on adult diabetes self-management. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42018084665.

Patients' perspectives on interprofessional collaboration between health care professionals during hospitalization: a qualitative systematic review.

OBJECTIVE: The objective of this review was to gain a better understanding of the interprofessional collaboration between health care professionals from the patients' point of view during hospitalisation; the influence of interprofessional collaboration on patient care, safety, and well-being; and patients' perspectives of their role in the interprofessional collaboration process. INTRODUCTION: Interprofessional collaboration is a key factor in improving patient health care outcomes and safety through better communication between health care professionals, better teamwork, and better care coordination. However, implementing interprofessional collaboration in the clinical setting can prove complex. Patients are increasingly interested in becoming partners within the health care system. They have the potential to contribute to their own safety and to observe professionals during the care process, thus gaining a better understanding of the interprofessional collaboration process and facilitating changes in the behavior of health care professionals. INCLUSION CRITERIA: This review considered qualitative research and mixed-method studies. Participants were hospitalized patients. Studies were included when they explored i) patients' perceptions of interprofessional collaboration, ii) the influence of interprofessional collaboration on patients' care, safety, or well-being, or iii) patients' perceptions of their own role in interprofessional collaboration. Qualitative studies focusing only on the care process or families' points of view were excluded. METHODS: Searches of six databases including MEDLINE, CINAHL, Embase, Web of Science, PsycINFO, and Sociological Abstract, limited to English, French, and German were conducted from March 2017 to June 2018. Assessment of methodological quality of studies was performed using the JBI Qualitative Assessment and Review Instrument. Data were extracted using the standardized data extraction tool from JBI. Data synthesis following the JBI approach of meta-aggregation was performed. The level of confidence for each synthesized finding was established based on ConQual. RESULTS: A total of 22 studies were included, which resulted in 89 findings and 24 categories. Eight synthesized findings were generated: patients' perceptions of interprofessional collaboration based on personal experiences and observations; patients' experiences with effective or ineffective interprofessional communication; patients' experience with power imbalance and paternalistic attitudes; patients' perceptions of key factors for a confident relationship with the interprofessional health care team; patients' need for comprehension of discussions between health care professionals; patients' perceptions of their role in an interprofessional health care team; patients' perceptions of opportunities for empowerment in interprofessional health care teams; and patients' need for humanizing care from interprofessional health care teams. The level of confidence of synthesized findings varied from low to moderate according to ConQual. CONCLUSIONS: This systematic review synthesized the perspectives of hospitalized patients regarding interprofessional collaboration and their perceived role in collaborative practices. Hospitalized patients observe interprofessional collaboration, either directly or indirectly, and the way interprofessional collaboration is performed may impact both their care and their well-being. However, little evidence has been found regarding the impact of interprofessional collaboration on patient safety. Patients' perspectives on their perceived role is not unanimous; some patients want to play an active role in the collaborative process, whereas others prefer to trust the health care professionals' expertise. Health care professionals should consider patients' preferences and act accordingly regarding both the collaborative process and the inclusion of the patients in collaborative practices.

Patient perspectives on interprofessional collaboration between healthcare professionals during hospitalization: a qualitative systematic review protocol.

REVIEW QUESTION/OBJECTIVE: The objective of this qualitative systematic review is to examine the available evidence on interprofessional collaboration from the patients' perspectives, specifically on: i) interprofessional collaboration in adult or pediatric wards during hospitalization; ii) the influence of interprofessional collaboration on the patient's care, safety and well-being in adult or pediatric wards during hospitalization; and (iii) the patient's role in the interprofessional collaboration process in adult or pediatric wards during hospitalization.