Background There is no simple, single treatment for schizophrenia and present approaches are based on clinical research and experience. Pharmacotherapy is the most common treatment for schizophrenia; however, unwanted side-effects are often problematic, and medications do not provide important coping skills. These skills are provided through forms of psychotherapy. Psychotherapy has been examined from a range of perspectives, including the effectiveness of group and individual treatments on behaviours and symptoms of schizophrenia. This review reports on the effectiveness of forms of group and individual therapy.
Objectives The objective of this review was to present the best available information on the use of group therapy and individual therapy in the treatment of schizophrenia. This review summarises the findings of all relevant studies relating to these interventions. This review attempted to answer the question: which is more effective in improving symptoms in patients with schizophrenia, group or individual therapy?
Inclusion criteria The review included adult patients with schizophrenia. Interventions of interest were forms of group and individual therapy aimed at lessening the symptoms of schizophrenia. For the purposes of this review, individual therapy was regarded as a one-to-one interaction between a patient and a therapist, and group therapy excluded family therapy. Studies that examined symptom reduction, including measures of mental state, quality of life and social function, were included in this review. This review attempted to determine the efficacy of group and individual therapy in the treatment of schizophrenia. Therefore, randomised or pseudo-randomised controlled trials that address the use or comparison of these treatment modalities were included. High-quality systematic reviews of evidence of effectiveness were also included.
Results Based on the search terms used, 28 references relating to the use of some form of group or individual therapy, in the treatment of chronic schizophrenia, were identified. Of these, nine were excluded for not meeting the stated inclusion criteria and 19 were included in the analysis (17 trials and two systematic reviews). From these studies numerous treatment types were compared for the management of chronic schizophrenia. Meta-analysis was not possible given the level of heterogeneity in trial methods and measurement scales.
Recommendations The following recommendations are made:
•
Individual cognitive behavioural therapy (ICBT) can be effective in improving overall mental state and global functioning (level I).
{"title":"Effectiveness of individual therapy and group therapy in the treatment of schizophrenia","authors":"Craig Lockwood RN BN GradDipNSc(ClinNurs) MNSc, Tamara Page RN BN HyperbaricNursCert GradDipNSc(HighDep), Tiffany Conroy-Hiller RN BN DipBusFLM","doi":"10.1111/j.1479-6988.2004.00016.x","DOIUrl":"https://doi.org/10.1111/j.1479-6988.2004.00016.x","url":null,"abstract":"<div>\u0000 \u0000 <p><b>Background </b> There is no simple, single treatment for schizophrenia and present approaches are based on clinical research and experience. Pharmacotherapy is the most common treatment for schizophrenia; however, unwanted side-effects are often problematic, and medications do not provide important coping skills. These skills are provided through forms of psychotherapy. Psychotherapy has been examined from a range of perspectives, including the effectiveness of group and individual treatments on behaviours and symptoms of schizophrenia. This review reports on the effectiveness of forms of group and individual therapy.</p>\u0000 <p><b>Objectives </b> The objective of this review was to present the best available information on the use of group therapy and individual therapy in the treatment of schizophrenia. This review summarises the findings of all relevant studies relating to these interventions. This review attempted to answer the question: which is more effective in improving symptoms in patients with schizophrenia, group or individual therapy?</p>\u0000 <p><b>Inclusion criteria </b> The review included adult patients with schizophrenia. Interventions of interest were forms of group and individual therapy aimed at lessening the symptoms of schizophrenia. For the purposes of this review, individual therapy was regarded as a one-to-one interaction between a patient and a therapist, and group therapy excluded family therapy. Studies that examined symptom reduction, including measures of mental state, quality of life and social function, were included in this review. This review attempted to determine the efficacy of group and individual therapy in the treatment of schizophrenia. Therefore, randomised or pseudo-randomised controlled trials that address the use or comparison of these treatment modalities were included. High-quality systematic reviews of evidence of effectiveness were also included.</p>\u0000 <p><b>Results </b> Based on the search terms used, 28 references relating to the use of some form of group or individual therapy, in the treatment of chronic schizophrenia, were identified. Of these, nine were excluded for not meeting the stated inclusion criteria and 19 were included in the analysis (17 trials and two systematic reviews). From these studies numerous treatment types were compared for the management of chronic schizophrenia. Meta-analysis was not possible given the level of heterogeneity in trial methods and measurement scales.</p>\u0000 <p><b>Recommendations </b> The following recommendations are made:</p>\u0000 <p>\u0000 \u0000 </p><ul>\u0000 \u0000 <li><span>• </span>\u0000 \u0000 \u0000 <p>Individual cognitive behavioural therapy (ICBT) can be effective in improving overall mental state and global functioning (level I).</p>\u0000 </li>\u0000 \u0000 <li><span>• </span>\u0000 \u0000 \u0000 ","PeriodicalId":100738,"journal":{"name":"JBI Reports","volume":"2 10","pages":"309-338"},"PeriodicalIF":0.0,"publicationDate":"2004-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1479-6988.2004.00016.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71952017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2004-10-01DOI: 10.1111/J.1479-6988.2004.00015.X
Ann M McKillop
Purpose This report presents an evaluation of the implementation of a Best Practice Information Sheet related to tracheal suctioning of adults with an artificial airway. The Centre for Evidence-Based Nursing Aotearoa based in Auckland, New Zealand, conducted a systematic review of the evidence and produced a Best Practice Information Sheet. The present study is an evaluation of the impact of this information sheet. The study also describes the process used to implement the Best Practice Information Sheet at each of three study sites. Method A survey of 105 nurses was conducted at three sites: one in New Zealand and two in Australia. Using a before/after design, data were collected at the time of release of the Best Practice Information Sheet and then approximately 12 months later. Suctioning practice was observed with a focus on assessment of the patient by the nurse, the procedure used to suction and the bases for decisions made about suctioning. Before and after data were compared to capture the possible effects on practice of the recommendations in the Best Practice Information Sheet. Those involved in leading the implementation process at each site were interviewed by telephone, notes from the interviews were thematically analysed and comparisons were drawn. Results The degree of uptake of the evidence was variable across the three sites and across the recommendations. For a number of recommendations, there was a modest trend towards the uptake of the recommendations of the Best Practice Information Sheet. Other recommendations were congruent with existing usual practice and therefore no change was observed. Each study site employed a range of strategies to implement the Best Practice Information Sheet. Improved practice was seen in relation to a greater number of recommendations at one site. This site appears to have used more sources of information to evaluate the quality of practice, which may have raised the profile of suctioning and its impact on patients. Conclusions This study suggests a trend towards a modest uptake of best practice recommendations into nursing practice demonstrated by some behavioural changes within a 12-month period in the context of an implementation plan and a Best Practice Information Sheet.
{"title":"Evaluation of the implementation of a best practice information sheet: tracheal suctioning of adults with an artificial airway","authors":"Ann M McKillop","doi":"10.1111/J.1479-6988.2004.00015.X","DOIUrl":"https://doi.org/10.1111/J.1479-6988.2004.00015.X","url":null,"abstract":"Purpose This report presents an evaluation of the implementation of a Best Practice Information Sheet related to tracheal suctioning of adults with an artificial airway. The Centre for Evidence-Based Nursing Aotearoa based in Auckland, New Zealand, conducted a systematic review of the evidence and produced a Best Practice Information Sheet. The present study is an evaluation of the impact of this information sheet. The study also describes the process used to implement the Best Practice Information Sheet at each of three study sites. \u0000 \u0000Method A survey of 105 nurses was conducted at three sites: one in New Zealand and two in Australia. Using a before/after design, data were collected at the time of release of the Best Practice Information Sheet and then approximately 12 months later. Suctioning practice was observed with a focus on assessment of the patient by the nurse, the procedure used to suction and the bases for decisions made about suctioning. Before and after data were compared to capture the possible effects on practice of the recommendations in the Best Practice Information Sheet. Those involved in leading the implementation process at each site were interviewed by telephone, notes from the interviews were thematically analysed and comparisons were drawn. \u0000 \u0000Results The degree of uptake of the evidence was variable across the three sites and across the recommendations. For a number of recommendations, there was a modest trend towards the uptake of the recommendations of the Best Practice Information Sheet. Other recommendations were congruent with existing usual practice and therefore no change was observed. Each study site employed a range of strategies to implement the Best Practice Information Sheet. Improved practice was seen in relation to a greater number of recommendations at one site. This site appears to have used more sources of information to evaluate the quality of practice, which may have raised the profile of suctioning and its impact on patients. \u0000 \u0000Conclusions This study suggests a trend towards a modest uptake of best practice recommendations into nursing practice demonstrated by some behavioural changes within a 12-month period in the context of an implementation plan and a Best Practice Information Sheet.","PeriodicalId":100738,"journal":{"name":"JBI Reports","volume":"11 5 1","pages":"293-308"},"PeriodicalIF":0.0,"publicationDate":"2004-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83755486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2004-09-27DOI: 10.1111/j.1479-6988.2004.00015.x
Ann McKillop RN MA
Purpose This report presents an evaluation of the implementation of a Best Practice Information Sheet related to tracheal suctioning of adults with an artificial airway. The Centre for Evidence-Based Nursing Aotearoa based in Auckland, New Zealand, conducted a systematic review of the evidence and produced a Best Practice Information Sheet. The present study is an evaluation of the impact of this information sheet. The study also describes the process used to implement the Best Practice Information Sheet at each of three study sites.
Method A survey of 105 nurses was conducted at three sites: one in New Zealand and two in Australia. Using a before/after design, data were collected at the time of release of the Best Practice Information Sheet and then approximately 12 months later. Suctioning practice was observed with a focus on assessment of the patient by the nurse, the procedure used to suction and the bases for decisions made about suctioning. Before and after data were compared to capture the possible effects on practice of the recommendations in the Best Practice Information Sheet. Those involved in leading the implementation process at each site were interviewed by telephone, notes from the interviews were thematically analysed and comparisons were drawn.
Results The degree of uptake of the evidence was variable across the three sites and across the recommendations. For a number of recommendations, there was a modest trend towards the uptake of the recommendations of the Best Practice Information Sheet. Other recommendations were congruent with existing usual practice and therefore no change was observed. Each study site employed a range of strategies to implement the Best Practice Information Sheet. Improved practice was seen in relation to a greater number of recommendations at one site. This site appears to have used more sources of information to evaluate the quality of practice, which may have raised the profile of suctioning and its impact on patients.
Conclusions This study suggests a trend towards a modest uptake of best practice recommendations into nursing practice demonstrated by some behavioural changes within a 12-month period in the context of an implementation plan and a Best Practice Information Sheet.
{"title":"Evaluation of the implementation of a best practice information sheet: tracheal suctioning of adults with an artificial airway","authors":"Ann McKillop RN MA","doi":"10.1111/j.1479-6988.2004.00015.x","DOIUrl":"https://doi.org/10.1111/j.1479-6988.2004.00015.x","url":null,"abstract":"<p><b>Purpose </b> This report presents an evaluation of the implementation of a Best Practice Information Sheet related to tracheal suctioning of adults with an artificial airway. The Centre for Evidence-Based Nursing Aotearoa based in Auckland, New Zealand, conducted a systematic review of the evidence and produced a Best Practice Information Sheet. The present study is an evaluation of the impact of this information sheet. The study also describes the process used to implement the Best Practice Information Sheet at each of three study sites.</p><p><b>Method </b> A survey of 105 nurses was conducted at three sites: one in New Zealand and two in Australia. Using a before/after design, data were collected at the time of release of the Best Practice Information Sheet and then approximately 12 months later. Suctioning practice was observed with a focus on assessment of the patient by the nurse, the procedure used to suction and the bases for decisions made about suctioning. Before and after data were compared to capture the possible effects on practice of the recommendations in the Best Practice Information Sheet. Those involved in leading the implementation process at each site were interviewed by telephone, notes from the interviews were thematically analysed and comparisons were drawn.</p><p><b>Results </b> The degree of uptake of the evidence was variable across the three sites and across the recommendations. For a number of recommendations, there was a modest trend towards the uptake of the recommendations of the Best Practice Information Sheet. Other recommendations were congruent with existing usual practice and therefore no change was observed. Each study site employed a range of strategies to implement the Best Practice Information Sheet. Improved practice was seen in relation to a greater number of recommendations at one site. This site appears to have used more sources of information to evaluate the quality of practice, which may have raised the profile of suctioning and its impact on patients.</p><p><b>Conclusions </b> This study suggests a trend towards a modest uptake of best practice recommendations into nursing practice demonstrated by some behavioural changes within a 12-month period in the context of an implementation plan and a Best Practice Information Sheet.</p>","PeriodicalId":100738,"journal":{"name":"JBI Reports","volume":"2 9","pages":"293-308"},"PeriodicalIF":0.0,"publicationDate":"2004-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1479-6988.2004.00015.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72008251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background This systematic review updates a previous review published in 2001. Cleansing is a vital component of wound management; however; little attention has been give to the solutions and techniques used for cleansing purposes. The objective of this review was to assess the effectiveness of different solutions, pressures and techniques used for wound cleansing to prevent infection and promote wound healing.
Search strategy Randomised and clinical controlled trials were identified using the Cochrane Central Register of Controlled Trials (CENTRAL). Additional searches of other databases and hand searches of journals and bibliographies was undertaken to identify further trials.
Selection criteria All randomised and clinical controlled trials involving adults and/or children whose wounds were cleaned with commercial cleansers, normal saline, water, chlorhexidine, hydrogen peroxide or povidone-iodine were eligible for inclusion. Studies that utilised solutions for preoperative skin cleansing, compared solutions for burns or dental procedures, and those that compared dressings for patients with ulcers were excluded from this review. Outcomes included rate of healing, incidence of infections or levels of bacterial count. Selection of potential articles, assessment of methodological quality and data abstraction was conducted independently by two reviewers. Trials with similar patients, comparisons, and outcomes were pooled. The data were analysed using Cochrane Review Manager 4.2. Where pooling was inappropriate, trials are discussed in a narrative review.
Results Fourteen randomised controlled trials were included that compared various solutions for wound cleansing. The evidence indicates that there is no difference in the infection and healing rates in acute and chronic wounds cleansed with either tap water or normal saline. An irrigation pressure of 13 psi is effective for cleansing wounds and reducing infection without causing tissue trauma.
There were no studies comparing common techniques for wound cleansing such as swabbing or scrubbing. Showering postoperative wounds did not demonstrate any difference in infection rates; however, it increased the morale of the patient. Whirlpool therapy was effective in reducing inflammation and pain in surgical wounds.
Conclusions These conclusions are based on the best available clinical evidence. However, there is an urgent need to support these findings with rigorous research as some of the conclusions are based on single studies with limited sample sizes.
Solutions for wound cleansing:
•
The evidence supports the use of potable tap water for cleansing lacerations in both adults and children and postoperative
{"title":"Effectiveness of solutions, techniques and pressure in wound cleansing","authors":"Ritin Fernandez RN MN(CritCare), Rhonda Griffiths RN CM BEd(Nurs) MSc(Hons) DrPH, Cheryl Ussia RN CertWoundMan","doi":"10.1111/j.1479-6988.2004.00013.x","DOIUrl":"https://doi.org/10.1111/j.1479-6988.2004.00013.x","url":null,"abstract":"<div>\u0000 \u0000 <p><b>Background </b> This systematic review updates a previous review published in 2001. Cleansing is a vital component of wound management; however; little attention has been give to the solutions and techniques used for cleansing purposes. The objective of this review was to assess the effectiveness of different solutions, pressures and techniques used for wound cleansing to prevent infection and promote wound healing.</p>\u0000 <p><b>Search strategy </b> Randomised and clinical controlled trials were identified using the Cochrane Central Register of Controlled Trials (CENTRAL). Additional searches of other databases and hand searches of journals and bibliographies was undertaken to identify further trials.</p>\u0000 <p><b>Selection criteria </b> All randomised and clinical controlled trials involving adults and/or children whose wounds were cleaned with commercial cleansers, normal saline, water, chlorhexidine, hydrogen peroxide or povidone-iodine were eligible for inclusion. Studies that utilised solutions for preoperative skin cleansing, compared solutions for burns or dental procedures, and those that compared dressings for patients with ulcers were excluded from this review. Outcomes included rate of healing, incidence of infections or levels of bacterial count. Selection of potential articles, assessment of methodological quality and data abstraction was conducted independently by two reviewers. Trials with similar patients, comparisons, and outcomes were pooled. The data were analysed using Cochrane Review Manager 4.2. Where pooling was inappropriate, trials are discussed in a narrative review.</p>\u0000 <p><b>Results </b> Fourteen randomised controlled trials were included that compared various solutions for wound cleansing. The evidence indicates that there is no difference in the infection and healing rates in acute and chronic wounds cleansed with either tap water or normal saline. An irrigation pressure of 13 psi is effective for cleansing wounds and reducing infection without causing tissue trauma.</p>\u0000 <p>There were no studies comparing common techniques for wound cleansing such as swabbing or scrubbing. Showering postoperative wounds did not demonstrate any difference in infection rates; however, it increased the morale of the patient. Whirlpool therapy was effective in reducing inflammation and pain in surgical wounds.</p>\u0000 <p><b>Conclusions </b> These conclusions are based on the best available clinical evidence. However, there is an urgent need to support these findings with rigorous research as some of the conclusions are based on single studies with limited sample sizes.</p>\u0000 <p>Solutions for wound cleansing:</p>\u0000 <p>\u0000 \u0000 </p><ul>\u0000 \u0000 <li><span>• </span>\u0000 \u0000 \u0000 <p>The evidence supports the use of potable tap water for cleansing lacerations in both adults and children and postoperative","PeriodicalId":100738,"journal":{"name":"JBI Reports","volume":"2 7","pages":"231-270"},"PeriodicalIF":0.0,"publicationDate":"2004-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1479-6988.2004.00013.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71934361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Vital signs traditionally consist of blood pressure, temperature, pulse rate and respiratory rate, and are an important component of monitoring the patient’s progress during hospitalisation. An initial search of the literature indicated that there was a vast volume of published information relating to this topic; however, there had been no previous attempt to systematically review this literature. This review was therefore initiated to identify, appraise and summarise the best available evidence relating to the measurement of vital signs in hospital patients.
Objectives The objectives of this review were to present the best available information related to the monitoring of patient vital signs with regard to their purpose, limitations, optimal frequency of measurements, and what measures should constitute vital signs. The review also sought to identify additional issues of importance related to the individual parameters of temperature measurement, blood pressure assessment, pulse rate measurement and respiratory rate measurement.
Review methods This review considered all studies that related to the objectives and included neonatal, paediatric and/or adult hospital patients. The outcome measures of interest were those related to the accuracy of, required frequency of or the need for vital signs. The review also considered any study addressing some aspect of vital signs measurement to ensure all issues of importance were identified. The search sought to find both published and unpublished studies. Databases searched included CINAHL, Medline, Current Contents, Cochrane Library, Embase and Dissertation Abstracts. The references of all identified studies were examined for additional references. All studies were checked for methodological quality, and data was extracted using a data extraction tool.
Results Although a variety of measures may be useful additions to the traditional four vital sign parameters, only pulse oximetry and smoking status have been shown to change patient care and outcomes. There are suggestions that vital sign monitoring has become a routine procedure, but little useful information was identified in regard to the optimal frequency of vital sign measurement. It was noted that many of the important issues related to vital sign measurement have not been investigated through research.
There is currently only limited research related to respiratory rate as a vital sign; however, its value as an indicator of serious illness has not been reliably established. There is only limited research relating to pulse rate measurements. Although routinely used for all hospital patients, the ability to detect serious physiological changes by assessment of pulse rate has not been rigorously evaluated. Many factors were identified that could potentially influence the accuracy of blood pressure measurement. Auscultat
{"title":"Vital signs","authors":"Craig Lockwood RN BN GradDipNSc(ClinNurs) MNSc, Tiffany Conroy-Hiller RN BN DipBusFLM GradCertUnivTeachLearn, Tamara Page RN BN HyperbaricNursCert GradDipNSc(HighDep) MNSc","doi":"10.1111/j.1479-6988.2004.00012.x","DOIUrl":"https://doi.org/10.1111/j.1479-6988.2004.00012.x","url":null,"abstract":"<div>\u0000 \u0000 <p><b>Background </b> Vital signs traditionally consist of blood pressure, temperature, pulse rate and respiratory rate, and are an important component of monitoring the patient’s progress during hospitalisation. An initial search of the literature indicated that there was a vast volume of published information relating to this topic; however, there had been no previous attempt to systematically review this literature. This review was therefore initiated to identify, appraise and summarise the best available evidence relating to the measurement of vital signs in hospital patients.</p>\u0000 <p><b>Objectives </b> The objectives of this review were to present the best available information related to the monitoring of patient vital signs with regard to their purpose, limitations, optimal frequency of measurements, and what measures should constitute vital signs. The review also sought to identify additional issues of importance related to the individual parameters of temperature measurement, blood pressure assessment, pulse rate measurement and respiratory rate measurement.</p>\u0000 <p><b>Review methods </b> This review considered all studies that related to the objectives and included neonatal, paediatric and/or adult hospital patients. The outcome measures of interest were those related to the accuracy of, required frequency of or the need for vital signs. The review also considered any study addressing some aspect of vital signs measurement to ensure all issues of importance were identified. The search sought to find both published and unpublished studies. Databases searched included CINAHL, Medline, Current Contents, Cochrane Library, Embase and Dissertation Abstracts. The references of all identified studies were examined for additional references. All studies were checked for methodological quality, and data was extracted using a data extraction tool.</p>\u0000 <p><b>Results </b> Although a variety of measures may be useful additions to the traditional four vital sign parameters, only pulse oximetry and smoking status have been shown to change patient care and outcomes. There are suggestions that vital sign monitoring has become a routine procedure, but little useful information was identified in regard to the optimal frequency of vital sign measurement. It was noted that many of the important issues related to vital sign measurement have not been investigated through research.</p>\u0000 <p>There is currently only limited research related to respiratory rate as a vital sign; however, its value as an indicator of serious illness has not been reliably established. There is only limited research relating to pulse rate measurements. Although routinely used for all hospital patients, the ability to detect serious physiological changes by assessment of pulse rate has not been rigorously evaluated. Many factors were identified that could potentially influence the accuracy of blood pressure measurement. Auscultat","PeriodicalId":100738,"journal":{"name":"JBI Reports","volume":"2 6","pages":"207-230"},"PeriodicalIF":0.0,"publicationDate":"2004-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1479-6988.2004.00012.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72128184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objectives The objective of this review was to present the best available information on the use of cognitive behaviour therapy using either group cognitive therapy (GCT) or individual cognitive therapy (ICT) in the treatment of depression. The primary question to be addressed in this review was: For the treatment of long-term depression, using a cognitive behavioural approach, is group therapy or individual therapy the most effective?
Inclusion criteria Studies that included adolescents or adults with long-term depression and a measured Beck Depression Inventory (BDI) value of ≥12 or Hamilton Rating Scale for Depression (HRSD) of ≥14 were included. Interventions of interest were forms of cognitive behaviour therapy utilising either an individual or group approach. For the purpose of this review individual therapy was regarded as a one-to-one interaction between the patient and the therapist. Group therapy excluded family therapy. This review excluded studies that involved pharmacotherapy alone as the only intervention and studies that involved combined group and individual treatment. Outcome measures of interest were reduction in depression inventory scores, specifically the BDI and/or the HRSD. This study considered any randomised or pseudo-randomised controlled trials that addressed the use or comparison of GCT or ICT.
Results Individual and group cognitive behavioural therapies for moderately or severely depressed adults (BDI ≥ 14) were comparable with each other in effectiveness and both were superior to providing no treatment at all. Individual cognitive therapy was equal to or better than tricyclic antidepressant drugs given at recommended therapeutic dosages for depressed people with a mean BDI of 30. This information was based on level II evidence.
Recommendations The following recommendations were made for adults:
1
Either GCT or ICT can be used to treat moderate to severe depression. The choice of therapy should be dependent upon the clinician's perceived receptiveness of the particular patient to group or individual treatment.
2
The use of computer-assisted therapy is a useful adjunct to GCT in moderate to severely depressed patients.
3
ICT can effectively replace pharmacotherapy in moderate to severely depressed patients if the patient is opposed to being treated with drug therapy.
4
GCT has not been compared to pharmacotherapy so no direct reco
{"title":"Comparing the effectiveness of cognitive behaviour therapy using individual or group therapy in the treatment of depression","authors":"Craig Lockwood RN BN GradDipNSc(AcuteCare) MNSc, Tamara Page RN BN HyperbaricNursCert GradDipNSc(HighDep) MNSc, Tiffany Conroy-Hiller RN BN DipBusFLM GradCertUnivTeachLearn","doi":"10.1111/j.1479-6988.2004.00011.x","DOIUrl":"https://doi.org/10.1111/j.1479-6988.2004.00011.x","url":null,"abstract":"<div>\u0000 \u0000 <p><b>Objectives </b> The objective of this review was to present the best available information on the use of cognitive behaviour therapy using either group cognitive therapy (GCT) or individual cognitive therapy (ICT) in the treatment of depression. The primary question to be addressed in this review was: For the treatment of long-term depression, using a cognitive behavioural approach, is group therapy or individual therapy the most effective?</p>\u0000 <p><b>Inclusion criteria </b> Studies that included adolescents or adults with long-term depression and a measured Beck Depression Inventory (BDI) value of ≥12 or Hamilton Rating Scale for Depression (HRSD) of ≥14 were included. Interventions of interest were forms of cognitive behaviour therapy utilising either an individual or group approach. For the purpose of this review individual therapy was regarded as a one-to-one interaction between the patient and the therapist. Group therapy excluded family therapy. This review excluded studies that involved pharmacotherapy alone as the only intervention and studies that involved combined group and individual treatment. Outcome measures of interest were reduction in depression inventory scores, specifically the BDI and/or the HRSD. This study considered any randomised or pseudo-randomised controlled trials that addressed the use or comparison of GCT or ICT.</p>\u0000 <p><b>Results </b> Individual and group cognitive behavioural therapies for moderately or severely depressed adults (BDI ≥ 14) were comparable with each other in effectiveness and both were superior to providing no treatment at all. Individual cognitive therapy was equal to or better than tricyclic antidepressant drugs given at recommended therapeutic dosages for depressed people with a mean BDI of 30. This information was based on level II evidence.</p>\u0000 <p><b>Recommendations </b> The following recommendations were made for adults:</p>\u0000 <p>\u0000 \u0000 </p><ul>\u0000 \u0000 <li><span>1 </span>\u0000 \u0000 \u0000 <p>Either GCT or ICT can be used to treat moderate to severe depression. The choice of therapy should be dependent upon the clinician's perceived receptiveness of the particular patient to group or individual treatment.</p>\u0000 </li>\u0000 \u0000 <li><span>2 </span>\u0000 \u0000 \u0000 <p>The use of computer-assisted therapy is a useful adjunct to GCT in moderate to severely depressed patients.</p>\u0000 </li>\u0000 \u0000 <li><span>3 </span>\u0000 \u0000 \u0000 <p>ICT can effectively replace pharmacotherapy in moderate to severely depressed patients if the patient is opposed to being treated with drug therapy.</p>\u0000 </li>\u0000 \u0000 <li><span>4 </span>\u0000 \u0000 \u0000 <p>GCT has not been compared to pharmacotherapy so no direct reco","PeriodicalId":100738,"journal":{"name":"JBI Reports","volume":"2 5","pages":"185-206"},"PeriodicalIF":0.0,"publicationDate":"2004-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1479-6988.2004.00011.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71921459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2004-04-14DOI: 10.1111/j.1479-6988.2004.00010.x
Emily J Haesler BN RN PGradDipAdvNurs(Gerontics)
Background The promotion of sleep in older adults is a significant issue in high-level residential aged care facilities, with as many as 67% of residents experiencing disruptions to their sleep patterns. Not only do health concerns such as cognitive impairment, pain and incontinence impact upon this population's sleep quality and quantity, but environmental factors including noise, light and night-time nursing care also affect sleep of those residing in institutions. In order to address the issue of sleep disruption, assessment and diagnosis of sleep problems and implementation of interventions that are effective in promoting sleep are essential.
Objectives The objective of this review was to determine the most effective tools for the assessment and diagnosis of sleep in older adults in high-level aged care. The review also sought to determine the most effective strategies for the promotion of sleep in this population. Outcome measures for this review were: indicators of improved sleep quality and quantity, including an improvement in daytime functioning and improved night-time sleep; reduction in use of hypnotics and sedatives; and increased satisfaction with sleep.
Search strategy A literature search was performed using the following databases for the years 1993–2003: AgeLine, APAIS Health, CINAHL, Cochrane Library, Current Contents, Dissertation Abstracts International, Embase, Medline, Proquest, PsycInfo, Science Citations Index. A second search stage was conducted through review of reference lists of studies retrieved during the first search stage. The search was limited to published and unpublished material in English language.
Selection criteria The review was limited to papers addressing sleep diagnosis, assessment and/or management in adults aged 65 or over who were residing in high-level aged care. The review included randomised controlled trials (RCTs) and, due to the limited number of RCTs available, non-RCTs, cohort and case control studies and qualitative research were also considered for inclusion. Research was included if it addressed the assessment, diagnosis or management of sleep using outcome measure of improved night-time sleep or daytime function, improvements in resident satisfaction with sleep or reduction in medication use associated with sleep. The types of interventions considered by this review were alternative therapies including massage, aromatherapy and medicinal herbs; behavioural or cognitive interventions; biochemical interventions; environmental interventions; pharmacological interventions and related nocturnal interventions such as continence care. Instruments and strategies to diagnose and assess the sleep of older high-level care residents, including objective and subjective assessment tools, were considered by this review.
Data collection and analysis All retrieved papers were c
{"title":"Effectiveness of strategies to manage sleep in residents of aged care facilities†","authors":"Emily J Haesler BN RN PGradDipAdvNurs(Gerontics)","doi":"10.1111/j.1479-6988.2004.00010.x","DOIUrl":"https://doi.org/10.1111/j.1479-6988.2004.00010.x","url":null,"abstract":"<div>\u0000 \u0000 <p><b>Background </b> The promotion of sleep in older adults is a significant issue in high-level residential aged care facilities, with as many as 67% of residents experiencing disruptions to their sleep patterns. Not only do health concerns such as cognitive impairment, pain and incontinence impact upon this population's sleep quality and quantity, but environmental factors including noise, light and night-time nursing care also affect sleep of those residing in institutions. In order to address the issue of sleep disruption, assessment and diagnosis of sleep problems and implementation of interventions that are effective in promoting sleep are essential.</p>\u0000 <p><b>Objectives </b> The objective of this review was to determine the most effective tools for the assessment and diagnosis of sleep in older adults in high-level aged care. The review also sought to determine the most effective strategies for the promotion of sleep in this population. Outcome measures for this review were: indicators of improved sleep quality and quantity, including an improvement in daytime functioning and improved night-time sleep; reduction in use of hypnotics and sedatives; and increased satisfaction with sleep.</p>\u0000 <p><b>Search strategy </b> A literature search was performed using the following databases for the years 1993–2003: AgeLine, APAIS Health, CINAHL, Cochrane Library, Current Contents, Dissertation Abstracts International, Embase, Medline, Proquest, PsycInfo, Science Citations Index. A second search stage was conducted through review of reference lists of studies retrieved during the first search stage. The search was limited to published and unpublished material in English language.</p>\u0000 <p><b>Selection criteria </b> The review was limited to papers addressing sleep diagnosis, assessment and/or management in adults aged 65 or over who were residing in high-level aged care. The review included randomised controlled trials (RCTs) and, due to the limited number of RCTs available, non-RCTs, cohort and case control studies and qualitative research were also considered for inclusion. Research was included if it addressed the assessment, diagnosis or management of sleep using outcome measure of improved night-time sleep or daytime function, improvements in resident satisfaction with sleep or reduction in medication use associated with sleep. The types of interventions considered by this review were alternative therapies including massage, aromatherapy and medicinal herbs; behavioural or cognitive interventions; biochemical interventions; environmental interventions; pharmacological interventions and related nocturnal interventions such as continence care. Instruments and strategies to diagnose and assess the sleep of older high-level care residents, including objective and subjective assessment tools, were considered by this review.</p>\u0000 <p><b>Data collection and analysis </b> All retrieved papers were c","PeriodicalId":100738,"journal":{"name":"JBI Reports","volume":"2 4","pages":"115-183"},"PeriodicalIF":0.0,"publicationDate":"2004-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1479-6988.2004.00010.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72151525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2004-03-17DOI: 10.1111/j.1479-6988.2004.00009.x
Alan Pearson RN PhD FRCNA FRCN, Jane Chalmers BDS MSc PhD
Objective The objective of this systematic review was to report on the best available evidence relating to oral hygiene for adults with dementia in residential aged care facilities, including:
•
documenting the prevalence and incidence, as well as the experiences and increments, of oral diseases and conditions
•
the use of assessment tools by carers to evaluate oral health
•
oral hygiene care strategies to prevent oral diseases and conditions
•
the provision of dental treatment and the ongoing management of oral diseases and conditions.
Inclusion criteria This review considered any randomised or non-randomised controlled studies, cohort studies, case-control studies, multiple time series studies, uncontrolled studies, descriptive studies and opinions of respected authorities (including theses and other publications) related to residents with dementia living in residential aged care facilities in Australia and overseas; community-dwelling adults with dementia; and special needs adult populations (for preventive oral hygiene care strategies and interventions).
The review considered studies and publications designed to:
1
quantify the oral health status of older adults living in residential aged care facilities;
2
quantify the oral health status of adults with dementia living in the community and in residential aged care facilities;
3
evaluate tools used to assess the oral health of residents by staff and carers working in residential aged care facilities;
4
evaluate preventive oral hygiene care strategies and interventions used in special needs adult populations (including adults with dementia); and
5
evaluate oral health care training and oral hygiene care provision, staff and carers working in residential aged care facilities.
{"title":"Oral hygiene care for adults with dementia in residential aged care facilities","authors":"Alan Pearson RN PhD FRCNA FRCN, Jane Chalmers BDS MSc PhD","doi":"10.1111/j.1479-6988.2004.00009.x","DOIUrl":"https://doi.org/10.1111/j.1479-6988.2004.00009.x","url":null,"abstract":"<div>\u0000 \u0000 <p><b>Objective </b> The objective of this systematic review was to report on the best available evidence relating to oral hygiene for adults with dementia in residential aged care facilities, including:</p>\u0000 <p>\u0000 \u0000 </p><ul>\u0000 \u0000 <li><span>• </span>\u0000 \u0000 \u0000 <p>documenting the prevalence and incidence, as well as the experiences and increments, of oral diseases and conditions</p>\u0000 </li>\u0000 \u0000 <li><span>• </span>\u0000 \u0000 \u0000 <p>the use of assessment tools by carers to evaluate oral health</p>\u0000 </li>\u0000 \u0000 <li><span>• </span>\u0000 \u0000 \u0000 <p>oral hygiene care strategies to prevent oral diseases and conditions</p>\u0000 </li>\u0000 \u0000 <li><span>• </span>\u0000 \u0000 \u0000 <p>the provision of dental treatment and the ongoing management of oral diseases and conditions.</p>\u0000 </li>\u0000 </ul>\u0000 \u0000 <p><b>Inclusion criteria </b> This review considered any randomised or non-randomised controlled studies, cohort studies, case-control studies, multiple time series studies, uncontrolled studies, descriptive studies and opinions of respected authorities (including theses and other publications) related to residents with dementia living in residential aged care facilities in Australia and overseas; community-dwelling adults with dementia; and special needs adult populations (for preventive oral hygiene care strategies and interventions).</p>\u0000 <p>The review considered studies and publications designed to:</p>\u0000 <p>\u0000 \u0000 </p><ul>\u0000 \u0000 <li><span>1 </span>\u0000 \u0000 \u0000 <p>quantify the oral health status of older adults living in residential aged care facilities;</p>\u0000 </li>\u0000 \u0000 <li><span>2 </span>\u0000 \u0000 \u0000 <p>quantify the oral health status of adults with dementia living in the community and in residential aged care facilities;</p>\u0000 </li>\u0000 \u0000 <li><span>3 </span>\u0000 \u0000 \u0000 <p>evaluate tools used to assess the oral health of residents by staff and carers working in residential aged care facilities;</p>\u0000 </li>\u0000 \u0000 <li><span>4 </span>\u0000 \u0000 \u0000 <p>evaluate preventive oral hygiene care strategies and interventions used in special needs adult populations (including adults with dementia); and</p>\u0000 </li>\u0000 \u0000 <li><span>5 </span>\u0000 \u0000 \u0000 <p>evaluate oral health care training and oral hygiene care provision, staff and carers working in residential aged care facilities.</p>\u0000 ","PeriodicalId":100738,"journal":{"name":"JBI Reports","volume":"2 3","pages":"65-113"},"PeriodicalIF":0.0,"publicationDate":"2004-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1479-6988.2004.00009.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71964699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2004-03-01DOI: 10.1111/J.1479-6988.2004.00008.X
A. Pearson
Techniques for the systematic review of evidence of effectiveness are now well established. Health-care professionals argue, however, for a need to recognise evidence of appropriateness and feasibility and for the development of methodologies to appraise and synthesise the results of qualitative research. This paper describes a participatory project designed to develop systems to systematically review qualitative evidence. The Q ualitative Assessment and Review Instrument is described in detail, and a suite of programs designed to conduct comprehensive reviews of evidence for health-care practice is outlined. As evidence-based practice increases in sophistication, and its influence in health service delivery expands, the need for broadening the view of what constitutes legitimate evidence is advanced by clinicians and the approach described attempts to achieve a balance in evidence review that recognises the value of quantitative and qualitative evidence.
{"title":"Balancing the evidence: incorporating the synthesis of qualitative data into systematic reviews","authors":"A. Pearson","doi":"10.1111/J.1479-6988.2004.00008.X","DOIUrl":"https://doi.org/10.1111/J.1479-6988.2004.00008.X","url":null,"abstract":"Techniques for the systematic review of evidence of effectiveness are now well established. Health-care professionals argue, however, for a need to recognise evidence of appropriateness and feasibility and for the development of methodologies to appraise and synthesise the results of qualitative research. This paper describes a participatory project designed to develop systems to systematically review qualitative evidence. The Q ualitative Assessment and Review Instrument is described in detail, and a suite of programs designed to conduct comprehensive reviews of evidence for health-care practice is outlined. As evidence-based practice increases in sophistication, and its influence in health service delivery expands, the need for broadening the view of what constitutes legitimate evidence is advanced by clinicians and the approach described attempts to achieve a balance in evidence review that recognises the value of quantitative and qualitative evidence.","PeriodicalId":100738,"journal":{"name":"JBI Reports","volume":"91 1","pages":"45-64"},"PeriodicalIF":0.0,"publicationDate":"2004-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80591371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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