Qualitative systematic literature review: the experience of being in seclusion for adults with mental health difficulties

Purpose: To conduct a systematic search of the peer-reviewed qualitative literature investigating the lived experience of seclusion for adults with mental health difficulties, to appraise the quality of the existing literature and synthesise findings. Background: Seclusion is a controversial intervention for the short-term management of unsafe behaviours in inpatient mental health services. There has been some sporadic interest in the service-users' experiences of this. Design: Systematic literature review and meta-synthesis. Data Sources: Databases MEDLINE, EMBASE, CINAHL and PSYCHINFO were searched in July 2015. Review Methods: The JBI QARI tools for critical appraisal and data extraction were used to review papers and synthesise findings. Findings: A small number of papers was found, which were of mixed quality. Value: The existing research is limited in both quantity and quality. Although most participants from the existing research described seclusion as mostly negative with the potential for causing iatrogenic harm, some described more positive experiences, often in the context of compassionate interactions with staff. Summary Statement: Why is this research or review needed? • The use of seclusion is common within mental health services but there is an absence of evidence for the purported theoretical rationale for its use. • Studies of the experiences of individuals placed in seclusion are small in number, of mixed quality and with mixed findings. • A systematic literature review and meta-synthesis of the existing qualitative literature investigating the lived experience of seclusion for adults with mental health difficulties was conducted, to synthesize the existing evidence base and make suggestions for future developments in research and practice. What are the key findings? • The existing research is limited both in quantity and quality. • Despite the limitations of existing research, the evidence does not support the purported theoretical rationale for the therapeutic use of seclusion. This poses a significant challenge to a common practice within mental health settings. • Seclusion has the potential to cause iatrogenic harm, particularly where interactions with nursing staff are not experienced as compassionate. • The actions of nursing staff in implementing seclusion procedures may mitigate iatrogenic harm. • Individuals who have experienced seclusion have suggestions for how to improve its use. How should the findings be used to influence policy/practice/research/education? • There is clearly scope for further, high quality research into people’s experiences of seclusion, particularly within the UK. • The findings include concrete ways in which the practice of seclusion can be improved. • Action research methods may offer a useful way of implementing and evaluating changes in practice

Views of nurses and other health and social care workers on the use of assistive humanoid and animal-like robots in health and social care: a scoping review

Background: Robots are introduced and used in many health and social care settings, from the operating room to the care of older adults with dementia. Objectives: The goal of this scoping review is to provide an overview of the existing evidence related to the views of nursing staff and other health and social care workers about the use of assistive humanoid and animal-like robots in the health and social care sector. Methods: Using the Joanna Briggs Institute guidelines we searched MEDLINE, PUBMED, CINHAL, EMBASE, PsycInfo, Web of Science, and IEEE Xplore digital library. Nineteen (19) articles met the inclusion and exclusion criteria and were retrieved, reviewed and summarised. Results: Health and social care workers reported mixed views regarding the use of robots in a healthcare setting. They mainly focused on the impact that robots could have on their patients and not to themselves. They considered an array of tasks that robots could perform; they addressed the issue of patient safety and raised concerns about privacy. Conclusions: A limited number of studies have explored the views of health and social care workers about the use of robots. Considering the fast pace with which technology is advancing in the care field, and with professionals in health and social care increasingly being asked to use such technologies, it is critical to conduct more research in this area Impact Statement: Robots will increasingly have a role to play in nursing, health and social care. The potential impact will be challenging for the healthcare workforce. It is therefore important for nurses and other health and social care workers to engage in discussion regarding the contribution of robots and their impact not only on nursing care but also on future roles of health and social care workers

The Effectiveness of the Internet in Improving Breastfeeding Outcomes: A Systematic Review

Breastfeeding is the normal and safest way to nurture an infant, and prolonged exclusive breastfeeding duration to 6 months will yield the greatest gains in optimum infant development. Despite this knowledge fewer than 35% of infants worldwide are exclusively breastfed during the first 4 months of life. With the advent of the Internet has been the development of many varied e-Health interventions. Using the Internet to support breastfeeding is a relatively novel method of health intervention in an area which has traditionally always been face-to-face. The aim of this article is to review the literature on the provision of Internet-based breastfeeding information and support intervention programs. A systematic literature review of current evidence was conducted using the electronic databases CINAHL (via EBSCOhost), Medline, Current Contents, PsycINFO, and Web of Knowledge for English-language publications from 2000 to May 2013. Inclusion criteria limited interventions to those delivered to women of childbearing age who accessed the Internet to source breastfeeding information and support. Only studies reporting breastfeeding outcomes (eg, breastfeeding duration) were included. A total of 1379 articles with citations and abstracts were identified as potentially relevant after searching the identified databases. One study was eligible for inclusion and reported positive outcomes, however methodological issues limit the interpretation of these results. Numerous study limitations and problems with scientific rigor make it difficult to extend study findings to antenatal and postnatal care. More rigorous evidence is needed before breastfeeding Internet interventions replace traditional methods of support and education for women intending to breastfeed

PROTOCOL: Psychosocial processes and intervention strategies behind islamist deradicalisation: a scoping review

info:eu-repo/semantics/publishedVersio

Balint groups in undergraduate medical education: a systematic review

Objective: Though Balint groups feature increasingly in UK medical school curricula, there is no evidence-based consensus on what undergraduates might gain from participation, and how this might happen. To address this, we systematically reviewed primary research studies involving medical student Balint groups and their relationship with patient-centredness, using narrative synthesis. Data sources: Four major databases were searched from origin until 9 September 2016. The Journal of the Balint Society was hand-searched from 1971 until 9 September 2016. Study selection: English language studies reporting quantitative and/or qualitative methods examining Balint groups in medical students vs. other/no comparator. Results: Eight studies were included. Quantitative findings report statistically significant improvements to student’s empathy and intellectual interest following group participation vs. control (p = 0.03, p = 0.046, respectively). Discussion content was similar across high-income countries. There was considerable heterogeneity when students rated the efficacy of groups. All evidence had high or unclear risk of bias, or was of medium/low quality. Conclusion: Balint groups might help medical students to become more patient-centred, by increasing students’ empathic abilities and supporting their personal and professional growth. Groups are more subjectively effective when optional rather than compulsory. Discussion content is comparable to groups in continuing medical education

Pain assessment for people with dementia: a systematic review of systematic reviews of pain assessment tools.

BACKGROUND: There is evidence of under-detection and poor management of pain in patients with dementia, in both long-term and acute care. Accurate assessment of pain in people with dementia is challenging and pain assessment tools have received considerable attention over the years, with an increasing number of tools made available. Systematic reviews on the evidence of their validity and utility mostly compare different sets of tools. This review of systematic reviews analyses and summarises evidence concerning the psychometric properties and clinical utility of pain assessment tools in adults with dementia or cognitive impairment. METHODS: We searched for systematic reviews of pain assessment tools providing evidence of reliability, validity and clinical utility. Two reviewers independently assessed each review and extracted data from them, with a third reviewer mediating when consensus was not reached. Analysis of the data was carried out collaboratively. The reviews were synthesised using a narrative synthesis approach. RESULTS: We retrieved 441 potentially eligible reviews, 23 met the criteria for inclusion and 8 provided data for extraction. Each review evaluated between 8 and 13 tools, in aggregate providing evidence on a total of 28 tools. The quality of the reviews varied and the reporting often lacked sufficient methodological detail for quality assessment. The 28 tools appear to have been studied in a variety of settings and with varied types of patients. The reviews identified several methodological limitations across the original studies. The lack of a 'gold standard' significantly hinders the evaluation of tools' validity. Most importantly, the samples were small providing limited evidence for use of any of the tools across settings or populations. CONCLUSIONS: There are a considerable number of pain assessment tools available for use with the elderly cognitive impaired population. However there is limited evidence about their reliability, validity and clinical utility. On the basis of this review no one tool can be recommended given the existing evidence