Interventions to reduce dependency in personal activities of daily living in community-dwelling adults who use homecare services: protocol for a systematic review

Background There is a growing demand for services whereby individuals receive assistance from care workers for personal care within the home. This has led to the development of re-ablement or restorative homecare services that provide time-limited input aimed at reducing dependency in personal activities of daily living, and preventing or delaying the need for further homecare support. However, little is currently known about how such interventions are configured, or how they may affect individuals’ ability to carry out personal care independently. Methods/Design We will seek to identify studies that compare an intervention designed to reduce dependency in personal activities of daily living with routine input or usual care as the control. We will include randomised controlled trials, nonrandomised controlled trials, and controlled before and after studies. We will also include interrupted time series studies. We shall search electronic databases in addition to searching for ongoing and unpublished studies, and where appropriate will contact key authors. Two reviewers will independently screen articles for inclusion; will assess risk of bias using quality assessment tools; and will carry out data extraction using pre-prepared forms. Any disagreements, at any stage, will be resolved by discussion and the involvement of a third reviewer if needed. We will produce a narrative summary of the results. A meta-analysis will be conducted if sufficient data are available of appropriate quality and comparability. Discussion The findings from this review will inform future practice within homecare re-ablement services; will inform policy decisions about the structure, organisation and content of such services; and will identify areas where further research is warranted

‘Dammed taxi cab’ – how silent communication in questionnaires can be understood and used to give voice to children's experiences

'Dammed taxi cab' - a 12-year-old boy wrote these words in the margins of a questionnaire, and within this paper they will serve as a point of departure for the discussion of the use of questionnaires as a way to voice children's experiences. The overall aim of this paper is to enable understanding of and discuss the use of questionnaires as a way to voice children's experiences. An analysis in accordance with a life-world approach has provided the lens through which to explore messages that can occur in questionnaires. The key research questions that will be explored in an attempt to answer the overall aim are: (i) how can unanswered questions and notes in the margins of a questionnaire be understood? and (ii) why is a questionnaire not always completed, according to the intention of its creators? To develop an understanding of this we analysed a number of questionnaires with unanswered questions and notes in the margins using a life-world approach. During the analysis two themes emerged: silent messages and messages being silenced. Finally, we discuss the legitimacy of questionnaires in childhood research and possible implications for practice when using this method to give voice to children's experiences.</p