Patients’ perspectives on the medical primary-secondary care interface : systematic review and synthesis of qualitative research

Funding NHS Highland Research, Development & Innovation Department, Aberdeen University, and Stirling University provided funds to meet publication costs.Peer reviewedPublisher PD

A systematic review and narrative summary of family-based smoking cessation interventions to help adults quit smoking

Background: Smoking is the most significant preventable cause of morbidity and early mortality in the world. The family is an influential context in which smoking behaviour occurs. Methods: A systematic review and narrative summary of family-based interventions to help adults quit smoking was conducted. Results: Eight controlled trials were included. Risk of bias was high. The smoking-related outcome of the intervention was self-reported smoking status/abstinence, validated by objective measures (including saliva thiocynate or breath carbon monoxide). Follow-up ranged from six weeks to five years. The main target groups were: pregnant women (1), pregnant women who smoked (2), men at risk of cardiovascular disease (2), adult smokers (1), parents who smoked (1) and couples who both smoked (1). Interventions included family members but most did not go further by drawing on family, systemic or relational theories to harness the influence of family on smoking behaviour. Only three studies directly compared the effects on smoking behaviour of a family-based (i.e. interventions that involve a member of the family) versus an individual-based (i.e. interventions that use behaviour change techniques that focus on the individual) intervention. None of these studies found significant differences between groups on the smoking behaviour of the main target group. Conclusions: We have yet to develop family-based smoking cessation interventions that harness or re-direct the influence of family members on smoking behaviour in a positive way. Thus, it is likely that individualised-approaches to smoking cessation will prevail.Publisher PDFPeer reviewe

Barriers and facilitators to the implementation of the advanced nurse practitioner role in primary care settings: a scoping review

Background: Workload and workforce issues in primary care are key drivers for the growing international trend to expand nursing roles. Advanced nurse practitioners are increasingly being appointed to take on activities and roles traditionally carried out by doctors. Successful implementation of any new role within multidisciplinary teams is complex and time-consuming, therefore it is important to understand the factors that may hinder or support implementation of the advanced nurse practitioner role in primary care settings. Objectives: To identify, appraise and synthesise the barriers and facilitators that impact implementation of advanced practitioner roles in primary care settings. Methods: A scoping review conducted using the Arksey and O’Malley (2005) framework and reported in accordance with PRISMA-ScR. Eight databases (Cochrane Library, Health Business Elite, Kings Fund Library, HMIC, Medline, CINAHL, SCOPUS and Web of Science) were searched to identify studies published in English between 2002 and 2017. Study selection and methodological assessment were conducted by two independent reviewers. A pre-piloted extraction form was used to extract the following data: study characteristics, context, participants and information describing the advanced nurse practitioner role. Deductive coding for barriers and facilitators was undertaken using a modified Yorkshire Contributory Framework. We used inductive coding for barriers or facilitators that could not be classified using pre-defined codes. Disagreements were addressed through discussion. Descriptive data was tabulated within evidence tables, and key findings for barriers and facilitators were brought together within a narrative synthesis based on the volume of evidence. Findings: Systematic searching identified 5976 potential records, 2852 abstracts were screened, and 122 full texts were retrieved. Fifty-four studies (reported across 76 publications) met the selection criteria. Half of the studies (n=27) were conducted in North America (n=27), and 25/54 employed a qualitative design. The advanced nurse practitioner role was diverse, working across the lifespan and with different patient groups. However, there was little agreement about the level of autonomy, or what constituted everyday activities. Team factors were the most frequently reported barrier and facilitator. Individual factors, lines of responsibility and ‘other’ factors (i.e. funding), were also frequently reported barriers. Facilitators included individual factors, supervision and leadership and ‘other’ factors (i.e. funding, planning for role integration). Conclusion: Building collaborative relationships with other healthcare professionals and negotiating the role are critical to the success of the implementation of the advanced nurse practitioner role. Team consensus about the role and how it integrates into the wider team is also essential

Insufficient Reporting of Factors Associated with Exercise Referral Scheme Uptake, Attendance, and Adherence: A Systematic Review of Reviews

Background: Exercise Referral Schemes (ERS) are prescribed programmes aimed at tackling physical inactivity and associated non-communicable disease. Inconsistencies in reporting, recording and delivering ERS make it challenging to identify what works, why, and for whom. Methods: PRISMA guided this narrative review of reviews. Fifteen electronic databases were searched for systematic reviews of ERS. Reviewers applied inclusion criteria and quality assessed via the AMSTAR tool. Data on uptake, attendance and adherence were extracted. Results: Eleven reviews met the inclusion criteria. AMSTAR quality was medium. Definitions of uptake varied within reviews. Uptake ranged from 35%-81%. Groups reported as more likely to take up ERS included, (i) females and (ii) older adults. Attendance was defined variably but ranged from 12%-49%. Men were more likely to attend ERS. Effect of medical diagnosis upon uptake and attendance was inconsistent. Exercises prescribed were unreported and therefore, adherence to exercise prescriptions was unreported. The influence of theoretically-informed approaches on uptake, attendance and adherence was generally lacking, however, self-determination, peer support and supervision support were reported as influencing attendance. Conclusions: There was insufficient reporting across studies about uptake, attendance and adherence. Complex interventions like ERS require consistent definitions, recording and reporting of these key facets, but this is not evident from the existing literature

Prospectus, September 23, 1992

https://spark.parkland.edu/prospectus_1992/1017/thumbnail.jp

Evidence of the effectiveness and patient experience of formalised social support for people with a diagnosis of heart failure.

Final report to Chest, Heart & Stroke Scotland. This systematic review was undertaken during December 2014 to June 2015, andwas commissioned by Chest, Heart and Stroke Scotland (CHSS). The review teamcomprised of systematic review experts, and experts in heart failure and/orloneliness

Evidence of the effectiveness and patient experience of formalised social support for people with a diagnosis of heart failure.

Final report to Chest, Heart & Stroke Scotland. This systematic review was undertaken during December 2014 to June 2015, andwas commissioned by Chest, Heart and Stroke Scotland (CHSS). The review teamcomprised of systematic review experts, and experts in heart failure and/orloneliness

Psychological first aid for workers in care and nursing homes: systematic review

Background: The Covid-19 pandemic has produced unprecedented challenges across all aspects of health and social care sectors globally. Nurses and healthcare workers in care homes have been particularly impacted due to rapid and dramatic changes to their job roles, workloads, and working environments, and residents’ multimorbidity. Developed by the World Health Organisation, Psychological First Aid (PFA) is a brief training course delivering social, emotional, supportive, and pragmatic support that can reduce the initial distress after disaster and foster future adaptive functioning. Objectives: This review aimed to synthesise findings from studies exploring the usefulness of PFA for the well-being of nursing and residential care home staff. Methods: A systematic search was conducted across 15 databases (Social Care Online, Kings Fund Library, Prospero, Dynamed, BMJ Best Practice, SIGN, NICE, Ovid, Proquest, Campbell Library, Clinical Trials, Web of Knowledge, Scopus, Ebsco CINAHL, and Cochrane Library), identifying peer-reviewed articles published in English language from database inception to 20th June 2021. Results: Of the 1,159 articles screened, 1,146 were excluded at title and abstract; the remaining 13 articles were screened at full text, all of which were then excluded. Conclusion: This review highlights that empirical evidence of the impact of PFA on the well-being of nursing and residential care home staff is absent. PFA has likely been recommended to healthcare staff during the Covid-19 pandemic. The lack of evidence found here reinforces the urgent need to conduct studies which evaluates the outcomes of PFA particularly in the care home staff population

Behavioural Sciences Contribution to Suppressing Transmission of Covid-19 in the UK: A Systematic Literature Review

BackgroundGovernments have relied on their citizens to adhere to a variety of transmission-reducing behaviours (TRBs) to suppress the Covid-19 pandemic. Understanding the psychological and sociodemographic predictors of adherence to TRBs will be heavily influenced by the particular theories used by researchers. This review aims to identify the theories and theoretical constructs used to understand adherence to TRBs during the pandemic within the UK social and legislative context.MethodsA systematic review identified studies to understand TRBs of adults in the UK during the pandemic. Identified theoretical constructs were coded to the Theoretical Domains Framework. Data are presented as a narrative summary.ResultsThirty-five studies (n = 211,209) investigated 123 TRBs, applied 13 theoretical frameworks and reported 50 sociodemographic characteristics and 129 psychological constructs. Most studies used social cognition theories to understand TRBs and employed cross-sectional designs. Risk of sampling bias was high. Relationships between constructs and TRBs varied, but in general, beliefs about the disease (e.g. severity and risk perception) and about TRBs (e.g. behavioural norms) influenced behavioural intentions and self-reported adherence. More studies than not found that older people and females were more adherent.ConclusionsBehavioural scientists in the UK generated a significant and varied body of work to understand TRBs during the pandemic. However, more use of theories that do not rely on deliberative processes to effect behaviour change and study designs better able to support causal inferences should be used in future to inform public health policy and practice.Prospero RegistrationCRD42021282699