Gathering evidence for routine decision-making

This paper is based on the opening keynote address at the 9th International Evidence Based Library and Information Practice Conference, Philadelphia, 18-21 June 2017

Assessing the impact of evidence summaries in library and information practice

Objective This study developed, validated and administered an instrument to investigate the impact of research evidence summaries published in the journal, Evidence Based Library and Information Practice. Methods Using the critical incident technique, this mixed methods study began by developing and testing a survey questionnaire, disseminating it to readers of the journal and conducting follow-up interviews with a subsample. Findings A total of 86 practitioners responded to the survey and 13 took part in interviews. Evidence summaries led to impact at four levels: librarian knowledge, librarian practice, workplace practice, and library users. The instrument was revised as a result of the findings. Conclusion This study provides unique insight into whether evidence summaries are an effective means of bridging the research-practice gap for the library community and its scholarly communication channels. The validated impact assessment instrument may also be adapted for other means of disseminating research in library and information practice

160: Being evidence based : a health library perspective

Health librarians play a key role in the evidence based practice (EBP) movement by providing services and support to find, access, interpret and disseminate evidence. Health librarians also pioneered the concept of evidence based practice within the library profession evidence based library and information practice (EBLIP) and has developed a strong evidence base for their work. This presentation explores the concept of EBLIP within the health library profession and the dual role they play in supporting and undertaking EBP. A range of studies that demonstrate the effectiveness and impact of the services provided by health librarians are summarised to provide an overview of the evidence of the health library profession. The presentation concludes by putting forward the view that being evidence based is an approach that involves: questioning practice, gathering or creating the evidence, using evidence wisely and using professional skills to help others make evidence based decisions

The effectiveness of shared care in cancer survivors - a systematic review

Objectives: To determine whether the shared care model during the follow-up of cancer survivors is effective in terms of patient-reported outcomes, clinical outcomes, and continuity of care. Methods: Using systematic review methods, studies were searched from six electronic databases—MEDLINE (n = 474), British Nursing Index (n = 320), CINAHL (n = 437), Cochrane Library (n = 370), HMIC (n = 77), and Social Care Online (n = 210). The review considered all health-related outcomes that evaluated the effectiveness of shared care for cancer survivors. Results: Eight randomised controlled trials and three descriptive papers were identified. The results showed the likelihood of similar effectiveness between shared care and usual care in terms of quality of life, mental health outcomes, unmet needs, and clinical outcomes in cancer survivorship. The reviewed studies indicated that shared care overall is highly acceptable to cancer survivors and primary care practitioners, and shared care might be cheaper than usual care. Conclusions: The results from this review suggest that the patient satisfaction of shared care is higher than usual care, and the effectiveness of shared care is similar to usual care in cancer survivorship. Interventions that formally involve primary care and improve the communication between primary care and hospital care could support the PCPs in the follow-up. Keywords: shared care , survivors , follow-up , cance

A client focused perspective of the effectiveness of Counselling for Depression (CfD)

Background In the UK, only one in four people with a diagnosis of depression receive any form of treatment. To address this, the Improving Access to Psychological Therapies (IAPT) programme was established with the main therapeutic approach being cognitive behavioural therapy (CBT). This raised concern regarding client choice, prompting the development of a new evidence-based manualised therapy, namely ‘Counselling for Depression’ [CfD]. To date, the client's view of the effectiveness of CfD has not been researched. Aims The aims of this study were twofold: (1) to explore and evaluate CfD from the perspective of the client and (2) to inform the counselling profession of the client's perception of what is occurring within this therapeutic approach. Methodology This qualitative study used Interpretative Phenomenological Analysis, the ideographic aspect valuing each individual narrative and the contribution it makes towards a larger account of the phenomenon from a small group of people. Twelve participants receiving CfD completed a Helpful Aspects of Therapy questionnaire after each counselling session, with ten participating in a semi-structured interview post counselling. Findings Four superordinate themes were identified: A helpful process, Client's view of a counsellor, Gains and Negative aspects. Participants perceived this model of therapy as helpful, feeling understood by their counsellors and able to work through issues in a safe therapeutic relationship. Negative findings related to counselling being ‘hard work’ and a dislike of the time limitation that curtailed the work. Implications Participants believed this type of counselling met their needs, reassuring practitioners that CfD is helpful to their clients

A co-designed social media intervention to satisfy information needs and improve outcomes in patients with chronic kidney disease : a longitudinal study

Background The number of people living with a long-term condition is increasing worldwide. Social media offers opportunities for patients to exchange information and experiences with others with the same condition, potentially leading to better self-management and improved patient outcomes, at minimal costs to health service providers. Objective This paper describes how an online network with a range of social media platforms was created, with the help of a group of patients with chronic kidney disease, and specialist professionals. The project evaluation considered whether information needs and health-related and social outcomes were met. Methods Longitudinal in-depth evaluation of the creation of the moderated network; observation of the use of the platforms; self-efficacy surveys (baseline and 6 months); semistructured interviews (at baseline and 6 months). Results 15 patients and professionals participated in the co-design of the network (hub), initially launched with 50 patients. Several platforms were needed to engage patients at different levels, and encourage generation of information, with the support of moderators. 14 separate patients participated in the evaluation. Satisfaction of information needs through social engagement improved self-efficacy (in 13 participants) with better self-care and management of illness. Social outcomes included seeking employment and an increase in social capital. Conclusion: An online network (hub) with several social media platforms helped patients with chronic kidney disease to manage their condition. Careful design with users resulted in a sustainable network with wider applicability across health and social care

Inequalities and outcomes : end stage kidney disease in ethnic minorities

The international evidence about outcomes of End Stage Kidney Disease (ESKD) for ethnic minorities was reviewed to identify gaps and make recommendations for researchers and policy makers. Nine databases were searched systematically with 112 studies from 14 different countries included and analysed to produce a thematic map of the literature. Reviews (n = 26) highlighted different mortality rates and specific causes between ethnic groups and by stage of kidney disease associated with individual, genetic, social and environmental factors. Primary studies focussing on uptake of treatment modalities (n = 19) found ethnic differences in access. Research evaluating intermediate outcomes and quality of care in different treatment phases (n = 35) e.g. dialysis adequacy, transplant evaluation and immunosuppression showed ethnic minorities were disadvantaged. This is despite a survival paradox for some ethnic minorities on dialysis seen in studies of longer term outcomes (n = 29) e.g. in survival time post-transplant and mortality. There were few studies which focussed on end of life care (n = 3) and ethnicity. Gaps identified were: limited evidence from all stages of the ESKD pathway, particularly end of life care; a lack of system oriented studies with a reliance on national routine datasets which are limited in scope; a dearth of qualitative studies; and a lack studies from many countries with limited cross country comparison and learning. Differences between ethnic groups occur at various points and in a variety of outcomes throughout the kidney care system. The combination of individual factors and system related variables affect ethnic groups differently indicating a need for culturally intelligent policy informed by research to prevent disadvantage

Midwifery continuity : the use of social media

Background Continuity models of midwifery care improve women’s experiences of care and clinical outcomes, but organisationally driven working practices do not facilitate a continuity model and the midwifery care received by most women is fragmented (Sandall et al., 2016, NHS England, 2016). Little is known about the potential for continuity of midwifery care to be achieved using an electronic platform. This paper examines the experiences of women accessing known midwives through a social media platform and their experiences and perception of continuity of care. Methods The study forms part of a larger research project aiming to increase understanding about online social learning within professionally moderated social media based communities. This paper reports specifically the concept of midwifery continuity within the online communities. Two secret Facebook groups consisting of 31 mothers and 4 midwife moderators were created (17 mothers & 2 midwives / 14 mothers & 2 midwives). Primary data included 8 online and face to face focus groups, conducted at approximately 10 week intervals, and 28 individual one to one interviews with members of the online community within six weeks of giving birth. Data analysis A thematic analysis using a priori themes was undertaken. This involved coding data which evidenced relational, informational and management continuity across the entire dataset (28 interviews and 8 focus groups). The analysis was undertaken broadly following the six stages described by Braun and Clarke (2006). Findings Relational and informational continuity were identified across the data. Relational continuity was evident for both the participants and the midwife moderators; informational continuity was described by the participants. Management continuity was not identified. Continuity through social media use was valued by both the mothers and the midwives. Conclusion Information and relational continuity needs of women can be met using professionally moderated, social media based groups. They may provide an alternative means of facilitating the continuity that is so often lacking in traditional models of care