Strategies for research capacity building by family physicians in primary healthcare: a scoping review protocol

INTRODUCTION

The qualities of primary healthcare (PHC) make it a very relevant environment for research; however, there is still work to be done to enhance the research capabilities of family physicians in healthcare units. Considering there is no ongoing review that specifically addresses this objective, the proposed goal of this scoping review is to determine the depth of the literature on the current strategies that support research capacity building among family physicians in the context of PHC.

METHODS AND ANALYSIS

The scoping review will include studies from PubMed, Scopus, Web of Science, Cochrane Library and grey literature, published from 2008 to 2023, that address strategies to promote research capacity building among family physicians in the context of PHC. Only studies published in English, Portuguese or Spanish will be considered. All study designs, including quantitative, qualitative and mixed-methods studies, will be eligible for inclusion. The literature search will be performed from January to March of 2024 and data charting will employ a descriptive-analytical method, systematically summarising study objectives, methodologies, findings and implications. This protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols and the review will employ the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews.

ETHICS AND DISSEMINATION

This review does not need ethical approval. Peer-reviewed publications, policy summaries, presentations at conferences and involvement with pertinent stakeholders are all part of our outreach approach.

A Formação sobre Cuidados de Reabilitação na Enfermagem de 1881 a 1966 – Enquadramento Legislativo

Introdução: O início da formação sobre assistência de reabilitação na Enfermagem foi complexo, sendo que a especialidade apenas se associou à disciplina em 1965 com o surgimento do primeiro curso pós-graduado. O objetivo deste estudo é descrever a formação acerca da assistência de reabilitação na enfermagem entre 1881 e 1966, tendo em conta o seu enquadramento legislativo. Metodologia: Recurso ao método histórico com análise documental e interpretação hermenêutica das fontes com referência à formação em enfermagem sobre assistência de reabilitação na enfermagem publicadas entre 1881 e 1966 após recolha documental no Diário do Governo. Resultados: Foram analisados 41 documentos entre Portarias e Decretos-Lei publicados com referência à formação em enfermagem e que contemplassem aspetos inerentes ao processo de recuperação e reabilitação incluindo planos de estudo. Discussão: Foi notória, numa fase inicial, a inclusão da assistência de reabilitação na formação em enfermagem em Portugal, principalmente no curso de enfermagem da cruzada das mulheres. Contudo, verificou-se alguma estagnação até à altura da Guerra Colonial, tendo sido a partir de 1961 aprovadas pelo Governo um conjunto de medidas que vieram preparar o caminho para a programação do primeiro curso pós-graduado de especialização em 1965. Conclusão: A formação acerca da assistência de reabilitação na enfermagem desenvolveu-se com avanços e recuos sobre influência de uma panóplia de alterações políticas e sociodemográficas. A Guerra Colonial em Portugal veio enfatizar necessidades que já eram sentidas anteriormente, criando as condições para a sua inclusão de forma muito específica na enfermagem a partir de 1965.

Burnout and Nursing Care: A Concept Paper

Burnout comprises a series of undetermined physical and psychosocial symptoms caused by an excessive energy requirement at work-it is a crisis in relationships with work itself and not necessarily a concern with underlying clinical disorders related to workers. Professions involving human interactions commonly involve emotional engagement, especially when the cared-for person needs assistance and support, as is the primary concern in the nursing profession. To some extent, the acknowledgment of the phenomena of burnout and how it affects people is sometimes addressed from a biomedical perspective. This concept paper aims to describe the burnout concept and reflect on the impact on nurses. Our intention with this reflection, considering the burnout impact on nurses, is to support a paradigm change in the prevention and management of burnout in healthcare contexts, promoting and fostering the well-being of nurses.

Hemostasis of the radial artery after coronary angiography: a scoping review

Funding Acknowledgements

Type of funding sources: None.

Background/Introduction

Nowadays, most interventional cardiology procedures are made via radial artery. There is significant variability of haemostasis methods, devices, and protocols. All of them try to avoid radial artery occlusion while maintaining patent haemostasis. Summarizing the available evidence about haemostasis of the radial artery after coronary angiography will allow us to challenge our current practice.

Purpose

The focus of this scoping review is to map the literature on haemostasis of the radial artery after coronary angiography. To date, no previous reviews addressing this purpose have been found.

Methods

This review follows the Joanna Briggs Institute methodology for scoping reviews. Two reviewers will independently perform the study selection regarding their eligibility. Data extraction will be accomplished using a researcher's developed tool to address the objectives and reviews questions. Any disagreements arisen between the reviewers will be resolved by discussion or consulting a third reviewer. Data synthesis will be presented in tabular form and a narrative summary that align with the review's objective. Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension to scoping reviews guidelines will be used to report the results. A set of relevant electronic databases and grey literature will be searched.

Results

Twenty-four studies were included, of various types: randomized clinical trials, case-reports, case series, narrative reviews. Three methods were described: compression devices, compression band and haemostatic patch. Sometimes more than one method is used, and there are various protocols that vary according to the institutional practice.

Conclusion

There are multiple radial artery haemostasis methods and protocols currently in use after a coronary angiography with no method overwhelmingly predominant. Few were associated with clearly defined haemostasis protocols, even though these protocols exist, often associated with compression devices. The institutional practice plays a decisive role on the use and modification of these protocols, with no clear evidence to support it. Such variability in protocols might have a detrimental effect in having a standardized one that can be used across various institutions/countries, facilitating broader multicentric studies.

Physical Rehabilitation Programs for Bedridden Patients with Prolonged Immobility: A Scoping Review

Bedridden patients usually stay in bed for long periods, presenting several problems caused by immobility, leading to a long recovery process. Thus, identifying physical rehabilitation programs for bedridden patients with prolonged immobility requires urgent research. Therefore, this scoping review aimed to map existing physical rehabilitation programs for bedridden patients with prolonged immobility, the rehabilitation domains, the devices used, the parameters accessed, and the context in which these programs were performed. This scoping review, guided by the Joanna Briggs Institute’s (JBI) methodology and conducted in different databases (including grey literature), identified 475 articles, of which 27 were included in this review. The observed contexts included research institutes, hospitals, rehabilitation units, nursing homes, long-term units, and palliative care units. Most of the programs were directed to the musculoskeletal domain, predominantly toward the lower limbs. The devices used included lower limb mobilization, electrical stimulation, inclined planes, and cycle ergometers. Most of the evaluated parameters were musculoskeletal, cardiorespiratory, or vital signs. The variability of the programs, domains, devices and parameters found in this scoping review revealed no uniformity, a consequence of the personalization and individualization of care, which makes the development of a standard intervention program challenging.

Monitoring and Management of the Palliative Care Patient Symptoms: A Best Practice Implementation Project

Background: In palliative care, symptoms are multiple and combined, evolving and changing, with a multidimensional character and multifactorial causes, and a high prevalence, negatively influencing the patient’s and family’s quality of life. Nurses who provide palliative care need to recognize and respond effectively to their patients’ symptoms. Methods: A project will be applied to implement the best practice in monitoring and managing palliative care patients’ symptoms. The Joanna Briggs Institute Practical Application of Clinical Evidence System (JBI PACES) and Getting Research into Practice (GRiP) audit and feedback tool will be used. The JBI PACES and GRiP framework for promoting evidence-based healthcare involves three phases of activity. First, a baseline audit. In a second phase, feedback will be given to the project team after the conclusion of the baseline audit report. Then, a third phase will be conducted as a follow-up audit. Conclusions: This project will improve the practice of the nursing team in monitoring and managing the symptoms of palliative care patients, positively influencing the quality of life of the patient and his family. The implementation and dissemination of this project could boost its replication in other centres.

Randomized trial of individual reminiscence therapy for older adults with cognitive impairment: a 3-month responder analysis

INTRODUCTION

Non-pharmacological intervention options, including individual reminiscence therapy (iRT), have been effective in improving cognitive functioning, mood, and quality of life (QoL) in persons with neurocognitive disorders (NCD).

OBJECTIVES

A 13-week randomized trial intervention utilizing iRT was conducted on older adults with NCD. We explored predictors of participants with positive and non-positive intervention responses using responder analysis, an analytic strategy that focuses on contributors to intervention response.

PATIENTS AND METHODS

Re-analysis of a published single-blind, multicentre, randomised controlled trial on 251 older adult residents with NCD from residential facilities across Portugal. Participants received 13 weeks of biweekly iRT (26 sessions) or treatment/programming as usual. Outcomes included global cognition (Minimental State Examination), memory (MAT), executive functioning (FAB), depressive symptoms (GDS-15), and QoL (QoL-AD).

RESULTS

There were more responders in the intervention than the control group on all five criteria, with significant differences for cognition (p = 0.001; f = 0.202; NNT = 5) and memory (p = 0.004; f = 0.184; NNT = 6). At baseline, intervention responders vs non-responders had: higher QoL-AD scores (30.23 vs 25.57; p < 0.001; d = -0.774) for cognition; lower FAB scores (1.41 vs -2.12; p < 0.001; d = 0.928) for executive functioning; higher GDS-15 scores for the depressive symptoms (7.57 vs 4.91; p < 0.001; d = -0.845), and for QoL (6.81 vs 5.33; p = 0.013; d = -0.443).

CONCLUSIONS

The iRT intervention showed high response rates for cognition and memory. Those with worse executive dysfunction, mood, and QoL, benefitted most from the intervention for those respective outcomes. Therefore, the presented iRT has beneficial effects for people with NCD, with mood and QoL as important influential factors.

Rehabilitation Programs for Bedridden Patients with Prolonged Immobility: A Scoping Review Protocol

Bedridden patients usually stay in bed for long periods, presenting several motor problems caused by immobility, such as reductions in muscle mass, bone mineral density and physical impairment, resulting in a long recovery process. Thus, identifying physical rehabilitation programs for bedridden patients with prolonged immobility is a matter of urgent research for a solution that will help health professionals and stakeholders to develop more adjusted programs and identify possible gaps. To date, no previous scoping reviews addressing this purpose have been found. This scoping review will be guided by the Joanna Briggs Institute (JBI) methodology, will focus on physical rehabilitation programs for bedridden patients with prolonged immobility and aims to map the programs, the devices used, and the parameters assessed. A relevant set of electronic databases and grey literature will be searched. Data extraction will be conducted using a tool developed by the research team that will address the review objectives and questions. Data synthesis will be presented in tabular form and a narrative summary aligned with the review's objective. This scoping review will contribute to the improvement of clinical practice, identifying key challenges that might justify the need to develop new programs suitable in clinical and organizational contexts.

Nonpharmacological interventions used in the perioperative period to prevent anxiety in adolescents: a scoping review

OBJECTIVE

The objective of this scoping review was to examine and map the range of nonpharmacological interventions used in the perioperative period to prevent anxiety in adolescents.

INTRODUCTION

Undergoing surgery involves experiencing fears and uncertainties that lead to an increase in anxiety levels. The interventions used to prevent anxiety in the perioperative period in adolescents must be appropriate to their developmental stage.

INCLUSION CRITERIA

Studies involving adolescents (10 to 19 years of age) undergoing any type of surgical procedure and specifying any nonpharmacological interventions administered to prevent anxiety, implemented in the perioperative period, were included in this review.

METHODS

A comprehensive search strategy using multiple databases was employed to find relevant studies. The databases search included MEDLINE via PubMed; CINAHL Plus with Full Text via EBSCO; Cochrane Central Register of Controlled Trials; LILACS; Scopus; Library, Information Science and Technology Abstracts; PsycINFO; JBI Connect+; and Cochrane Database of Systematic Reviews. Sources of unpublished studies and gray literature were TDX - Tesis Doctorals en Xarxa (Spain); RCAAP - Repositório Científico de Acesso Aberto de Portugal; OpenGrey - System for Information on Grey Literature in Europe; and MedNar. Studies published in English, Spanish, or Portuguese were included. There was no date restriction, or geographical or cultural limitation applied to the search. The relevant studies and their reported outcomes were organized and analyzed.

RESULTS

The database search yielded 1438 articles, and three additional records were added after hand searching. Title, abstract, and full-text review identified 11 papers that met the inclusion criteria. The final data set represented 947 participants. The data were analyzed according to the type of nonpharmacological intervention, population, concept (outcome measured and tool used), context (physical location; preoperative vs. postoperative), frequency and duration of the intervention, and which professional team member implemented the intervention. Eight nonpharmacological interventions were identified, applied either in the preoperative or postoperative context. The nurses were the main professionals administering the nonpharmacological interventions to the adolescents.

CONCLUSIONS

A variety of nonpharmacological interventions were used in the perioperative period to prevent anxiety in adolescents. The most common interventions were music/musicotherapy and hypnosis/guided imagery. However, other interventions such as therapeutic play, preoperative preparation program, mothers' presence during the anesthesia induction, distraction, relaxation training, massage therapy, and reading were also identified. These interventions were used alone or in a combination of two interventions, either preoperatively or postoperatively. The adolescents in the early stage (10 to 14 years) were the most studied group and the adolescents in the late stage (17 to 19 years) were the least studied. Future research should focus on the implementation of nonpharmacological interventions in the perioperative period involving adolescents, particularly late adolescents. A systematic review on the effect of nonpharmacological interventions for anxiety management in adolescents in the perioperative period should be conducted.

SCOPING REVIEW REGISTRATION

Open Science Framework: https://osf.io/jhwca/.

Pilot study on the effectiveness of Reminiscence Therapy on cognition, depressive symptoms, and quality of life in nursing home residents

Aim

This study aimed to assess the effectiveness of the group Reminiscence Therapy (RT) on cognition, depressive symptoms, and quality of life (QOL) in older adults recruited in nursing homes.

Methods

A pilot study with a one-group pretest-posttest design was conducted between September 2017 and March 2018 in five nursing homes from central Portugal. A comprehensive RT program (Core program followed by a Follow-up program) was provided to clinically stable volunteers aged 65 years or more, who did not have severe cognitive impairment.

Results

From the 50 older adults (32 women and 18 men, with mean age of 83.32±7.76, and mean education level of 5.48±4.05) considered eligible to participate in the study, 35 (mean age: 84.17±7.46, mean education level of 6.14±4.49) completed the Core Program and 28 completed the Follow-up Program (mean age: 84.25±7.66, mean education level of 6.18±4.57). Based on the Wilcoxon Test, it was observed that the participants' cognitive performance did not change during the two RT programs. No significant changes were confirmed in relation to depressive symptomatology and QOL.

Conclusion

Although no statistically significant improvements of the older adults' cognitive function, depressive symptomatology, and quality of life were found, the stabilization of such outcomes are relevant from a clinical viewpoint. Further studies are necessary to confirm these findings.

Does the Aged Simulation Suit help nursing students provide better care? - A phenomenological study

BACKGROUND

The use of simulation in the training of nurses has increased in the last decades, allowing the acquisition and development of several competencies.

OBJECTIVE

Understand the experiences of nursing students who used the aged simulation suit.

METHODOLOGY

Qualitative study of a phenomenological nature. The participants were nursing students, who used the aged simulation suit. Data collection was made through the interview, and the data analysis was performed following the Giorgi phenomenological method.

RESULTS

Three themes reflect the essence of the experience: Wear the skin of the elderly; Confrontation with their own ageing process; Skills development.

CONCLUSION

If, on the one hand, the students who used the aged simulation suit experienced sensory and motor impairment and consequent confrontation with their own ageing process, on the other hand, they experienced the development of scientific, relational and citizenship skills. It is expected that the results of this work will foster the use of the aged simulation suit as a complementary methodology, with potential impact on the quality of care and health gains.

Palliative rehabilitation interventions in palliative care: a scoping review protocol

OBJECTIVE

The objective of this scoping review is to examine and map interventions of palliative rehabilitation that are implemented and evaluated in palliative care.

INTRODUCTION

Palliative rehabilitation is defined as the process of helping individuals with a progressive, often advanced or incurable disease reach their physical, psychological, and social potential consistent with physiological and environmental limitations and life preferences. Rehabilitation may prolong functional independence and improve quality of life. Information on palliative rehabilitation interventions, their characteristics, contexts, and population is dispersed throughout the literature, hence the need for a scoping review.

INCLUSION CRITERIA

This scoping review will consider all studies that focus on qualified health care professionals working in palliative care who are caring for patients 18 years of age or older, and studies that focus on the concepts of palliative rehabilitation interventions. This scoping review will consider all palliative rehabilitation interventions implemented and evaluated in the context of palliative care.

METHODS

The search strategy aims to find published and unpublished studies. The databases to be searched will include CINAHL Complete, PubMed, Scopus, SciELO, Cochrane Central Register of Controlled Trials, and PEDro. The search for unpublished studies will include DART-Europe, OpenGrey, and RCAAP. Studies published in English, Spanish, and Portuguese carried out from 2009 onward will be considered for inclusion. Retrieved papers will be screened for inclusion by two reviewers. Data will be extracted and presented in tabular form and a narrative summary that aligns with the review's objective. Any disagreements that arise between the reviewers will be resolved through discussion or with a third reviewer.

A Study Protocol for Development and Validation of a Clinical Prediction Model for Frailty (ModulEn): a new European Commitment to Tackling Frailty

There is a growing need to implement and evaluate the technological solutions that allow the early detection of age-related frailty and enable assessment of the predictive values of frailty components. The broad use of these solutions may ensure an efficient and sustainable response of health and social care systems to the challenges related to demographic aging. In this paper, we present the protocol of the ModulEn study that aims to develop and validate a predictive model for frailty. For this purpose, the sample composed by older adults aged 65-80 years and recruited from the community will be invited to use an electronic device ACM Kronowise® 2.0. This device allows proactive and continuous monitoring of circadian health, physical activity, and sleep and eating habits. It will be used during a period of seven to ten days. The participants will also be given the questionnaires evaluating the variables of interest, including frailty level, as well as their experience and satisfaction with the device use. Data provided from these two sources will be combined and the relevant associations will be identified. In our view, the implications of this study' findings for clinical practice include the possibility to develop and validate tools for timely prevention of frailty progress. In the long term, the ModulEn may contribute to the critical reduction of frailty burden in Europe.

The construction of the health professional in palliative care contexts: a scoping review on caring for the person at the end of life

Aim

The aim of the study was to map of the literature on the elements contributing to the construction of the health care professional in the context of palliative care.

Methods

Scoping review based on Arksey and O'Malley framework. PubMed, Embase, CINAHL, Scopus databases, and gray literature were the sources searched (2005-2015), completed by reference searching, hand searching, and expert consultations. Primary studies focusing on different professionals working in palliative care units or hospice centers were eligible for inclusion.

Results

From a total of 3632 articles, 22 met the inclusion criteria. The content of the studies was described and classified in 5 elements: (i) construction and application of the concept of care; (ii) psychosocial effects that the daily care produces; (iii) working conditions that influence the caregiving provided; (iv) knowledge mobilized in the provision of care; and (v) strategies adopted by health care professionals to build relationships. Data about nurses, physicians, and psychologists were found, but no data were found about social workers. Gaps identified in the publications were as follows: relationship competencies and strategies adopted; the real needs from educational programs; and the view of other professionals.

Conclusions

Key elements identified in the concept of the construction of the health care professional should be addressed in future interventions: prevention of emotional exhaustion, depersonalization, and achievement of a greater personal accomplishment. In addition, none of the articles retrieved offered the different perspectives of all the disciplines in a multidisciplinary team.

Prevalence of burnout in health professionals working in palliative care: a systematic review

BACKGROUND

More than ever, the current increasing need for palliative care leads to health professionals providing this type of care which further leads to multiple challenges, and stressful and demanding situations. The multiple challenges of working in palliative care put health professionals working in this context at the risk of burnout.

OBJECTIVES

To examine the evidence on the prevalence of burnout among health professionals working in palliative care.

INCLUSION CRITERIA TYPES OF PARTICIPANTS

The current review included studies that encompass qualified health professionals working in palliative care, caring for patients 18 years of age or older.

CONDITION

The current review considered studies reporting on the point prevalence of burnout, measured by a burnout scale, such as, but not limited to, the Maslach Burnout Inventory, Burnout Measure and Copenhagen Burnout Inventory.

CONTEXT

The current review considered studies conducted in the context of specialist palliative care, more specifically, palliative care units, specialized palliative home care or hospices.

TYPES OF STUDIES

The current review considered observational study designs, including prospective and retrospective cohort, case-control and cross-sectional studies.

SEARCH STRATEGY

An initial search of MEDLINE (via PubMed) and CINAHL was undertaken, followed by a second search for published and unpublished studies since 1975 in major healthcare-related electronic databases. Studies written in English, Spanish and Portuguese were included.

METHODOLOGICAL QUALITY

Two independent reviewers assessed the methodological quality of studies using the standardized critical appraisal instrument from the Joanna Briggs Institute. No studies were excluded from the review based on the methodological appraisal.

DATA EXTRACTION

Data were extracted using a data extraction table, taking into account the review questions.

DATA SYNTHESIS

Significant differences were found between condition measures, thus we were unable to perform a meta-analysis.

RESULTS

Eight cross-sectional studies met the inclusion criteria, with a total of 1406 health professionals. The sample was limited to nurses, physicians and social workers. None of the included articles presented data about other health professionals. Seven of the included studies assessed the prevalence of burnout using the same instrument - the Maslach Burnout Inventory. Data revealed a prevalence of burnout of 17.3% among health professionals. Personal Accomplishment was the sub-scale from the Maslach Burnout Inventory that had the highest prevalence (19.5%). Nurses had higher levels of Emotional Exhaustion (19.5%) and Depersonalization (8.2%), and physicians had lower levels of Personal Accomplishment (41.2%). The prevalence of burnout was, however, higher in social workers (27%). The palliative care context with the highest prevalence of burnout was home care (19.6%).

CONCLUSION

The current systematic review contributes to a body of empirical knowledge that can facilitate the professional development of palliative care teams by highlighting the prevalence of burnout in health professionals, which staff category is the most affected (social workers), and which palliative care context has the highest prevalence (home care).

Comfort experience in palliative care: a phenomenological study

Background

Palliative care aims to provide maximum comfort to the patient. However it is unknown what factors facilitate or hinder the experience of comfort, from the perspective of inpatients of palliative care units. This lack of knowledge hinders the development of comfort interventions adjusted to these patients. The aim of this research is to describe the comfort and discomfort experienced by inpatients at palliative care units.

Methods

A phenomenological descriptive study was undertaken. Ten inpatients were recruited from a Spanish palliative care unit and seven from a Portuguese palliative care unit. Data were collected using individual interviews and analysed following the method of Giorgi.

Results

Four themes reflect the essence of the lived experience: The Palliative Care as a response to the patient’s needs with advanced disease, attempt to naturalize advanced disease, confrontation with their own vulnerability, openness to the spiritual dimension.

Conclusions

Informants revealed that they experience comfort through humanized care, differentiated environment, symptomatic control, hope and relationships. The discomfort emerges from the losses and powerlessness against their situation. Even if such findings may seem intuitive, documenting them is essential because it invites us to reflect on our convictions about what it means to be comfortable for these patients, and allows incorporating this information in the design of focused interventions to maximize the comfort experience.

Electronic supplementary material

The online version of this article (doi:10.1186/s12904-016-0145-0) contains supplementary material, which is available to authorized users.