The Effectiveness of Self-Management Interventions for Individuals with Low Health Literacy and/or Low Income: A Descriptive Systematic Review.

BACKGROUND: With the burden of chronic illness increasing globally, self-management is a crucial strategy in reducing healthcare costs and increasing patient quality of life. Low income and low health literacy are both associated with poorer health outcomes and higher rates of chronic disease. Thus, self-management represents an important healthcare strategy for these populations. The purpose of this study is to review self-management interventions in populations with low income or low health literacy and synthesize the efficacy of these interventions. METHODS: A systematic review of trials evaluating the efficacy of self-management interventions in populations with low income or low health literacy diagnosed with a chronic illness was conducted. Electronic databases were primarily searched to identify eligible studies. Data were extracted and efficacy summarized by self-management skills, outcomes, and content tailoring. RESULTS: 23 studies were reviewed, with ten reporting an overall positive effect on at least one primary outcome. Effective interventions most often included problem-solving as well as taking action and/or resource utilization. A wide range of health-related outcomes were considered, were efficacious empowerment and disease-specific quality of life were found to be significant. The efficacy of interventions did not seem to vary by duration, format, or mode of delivery or whether these included individuals with low health literacy and/or low income. Tailoring did not seem to impact on efficacy. DISCUSSION: Findings suggest that self-management interventions in populations with low income or low health literacy are most effective when three to four self-management skills are utilized, particularly when problem-solving is targeted. Healthcare providers and researchers can use these findings to develop education strategies and tools for populations with low income or low health literacy to improve chronic illness self-management.

A Descriptive Systematic Review of Physical Activity Interventions for Caregivers: Effects on Caregivers' and Care Recipients' Psychosocial Outcomes, Physical Activity Levels, and Physical Health.

BACKGROUND: Caregiving can adversely impact individuals' psychosocial and physical well-being. An important task in health research is to find effective ways to enhance caregivers' health and functioning. PURPOSE: To provide a systematic review of the efficacy of physical activity (PA) interventions for caregivers on their and the care recipients' psychosocial outcomes, PA levels, and physical health. METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist, a descriptive systematic review of studies examining the effects of PA interventions for caregivers on their outcomes and those of the care recipients was conducted. Studies were primarily identified through searching electronic databases. RESULTS: Fourteen studies were reviewed. PA interventions significantly decreased caregivers' distress and increased their well-being, quality of life, sleep quality, PA levels, self-efficacy for caregiving or exercise, and readiness for exercise. Most PA interventions targeted the caregiver alone. Two studies examined the impact of the intervention on the care recipient and found no significant effect. CONCLUSIONS: PA interventions hold promise in improving caregivers' outcomes. However, more high quality trials are needed before definitive conclusions can be drawn.

Post-traumatic growth following a first episode of psychosis: a scoping review.

AIM: A first-episode psychosis (FEP) is a traumatic experience that can often result in great suffering. However, in addition to suffering, persons affected by FEP may also experience post-traumatic growth (PTG) or the perception that good has followed psychosis. Although much is known concerning the negative outcomes following FEP, little attention has been given to the state of scientific knowledge on PTG following FEP. The aim of this study is to determine the state of knowledge concerning PTG following FEP to help set the stage for a full systematic review. METHODS: A scoping review was conducted following six steps: identifying the research question and relevant studies, selecting studies, charting the data, coding and summarizing results and consulting with relevant stakeholders regarding the findings. RESULTS: Post-traumatic growth following FEP was described mostly as following the process of recovery and primarily, in qualitative articles. Themes related to PTG included developing positive character traits, making positive lifestyle changes, developing stronger connections with others, integrating the FEP with the self, experiencing greater religiosity and appreciating life more. CONCLUSIONS: In addition to the negative aftermath of FEP, PTG may also occur. Evidence of PTG following FEP will be examined in a systematic review focused on the recovery and qualitative literature.

Protocol for a mixed studies systematic review on the implementation of the recovery approach in adult mental health services.

INTRODUCTION: Recovery is integral to mental health planning in G-8 countries including Canada. A recovery-oriented approach to care aims to promote personal empowerment, illness self-management and a life beyond services for people with serious mental illness (SMI), while reducing the financial burden associated with mental illness. Although there is a growing body of literature on recovery, no synthesis of research on the implementation of recovery into mental health services exists. OBJECTIVES: The objective is to conduct a mixed studies systematic review on the operationalisation of recovery into mental health services for adults with SMI. It will inform the transformation of Canadian services to a recovery orientation, but may be applicable to other countries. METHODS AND ANALYSIS: Seven databases including PubMed, Ovid Medline, Ovid Embase, Ovid PsycInfo, CINAHL, the Cochrane Library and Scopus will be searched for peer-reviewed empirical studies published from 1998 to December 2016. Systematic reviews and studies using quantitative, qualitative and mixed methodologies will be included. Secondary searches will be conducted in reference lists of all selected full text articles. Handsearches will also be performed in the tables of contents of three recovery-focused journals for the last 5 years. International experts in the field will be contacted for comments and advice. Data extraction will include identification and methodological synthesis of each study; definition of recovery; information on recovery implementation; facilitators and barriers and study outcomes. A quality assessment will be conducted on each study. The data will be synthesised and a stepwise thematic analysis performed. ETHICS AND DISSEMINATION: Ethics approval is not required for this knowledge synthesis. Findings will be disseminated through knowledge translation activities including: (1) a 1-day symposium; (2) presentations in national and international conferences and to local stakeholders; (3) publications in peer-reviewed journals; (4) posts on the organisational websites.

A systematic review of stress in dental students.

The aim of this study was to systematically review the available literature on the levels, causes, and impact of stress among dental students. The investigators searched eight electronic databases: Medline, Medline in process, Psychinfo, ERIC, Embase, Cochrane Library, Web of Science, and SCOPUS. Two independent reviewers conducted the selection, data extraction, and quality appraisal for included studies. The investigators then coded both quantitative and qualitative studies using similar codes and pooled results from studies that used the Dental Environment Stress questionnaire to demonstrate dental students' stress levels. The search initially identified 4,720 studies, of which 124 studies were included in the final qualitative synthesis and twenty-one were included in the meta-analysis. Evidence from this research showed that dental students experience considerable amounts of stress during their training. This stress is mainly due to the demanding nature of the training. In addition, studies suggest adverse effects of elevated stress on students' health and well-being. Most of the available literature is based on cross-sectional studies; thus, future longitudinal studies are needed to follow students throughout their curriculum. In addition, further research needs to explore and test stress management interventions.