Pub Date : 2024-08-08DOI: 10.12688/hrbopenres.13941.1
C. Casey, Claire M Buckley, P. M. Kearney, M. D. Griffin, S. F. Dinneen, T. P. Griffin
Introduction Diabetes is one of the leading causes of chronic kidney disease. Social deprivation is recognised as a risk factor for complications of diabetes, including diabetic kidney disease. The effect of deprivation on rate of decline in renal function has not been explored in the Irish Health System to date. The objective of this study is to explore the association between social deprivation and the development/progression of diabetic kidney disease in a cohort of adults living with diabetes in Ireland. Methods This is a retrospective cohort study using an existing dataset of people living with diabetes who attended the diabetes centre at University Hospital Galway from 2012 to 2016. The variables included in this dataset include demographic variables, type and duration of diabetes, clinical variables such as medication use, blood pressure and BMI and laboratory data including creatinine, urine albumin to creatinine to ratio, haemoglobin A1c and lipids. This dataset will be updated with laboratory data until January 2023. Individual’s addresses will be used to calculate deprivation indices using the Pobal Haase Pratschke (HP) deprivation index. Rate of renal function decline will be calculated using linear mixed-effect models. The relationship between deprivation and renal function will be assessed using linear regression (absolute and relative rate of renal function decline based on eGFR) and logistic regression models (rapid vs. non-rapid decline).
{"title":"The impact of social deprivation on development and progression of diabetic kidney disease","authors":"C. Casey, Claire M Buckley, P. M. Kearney, M. D. Griffin, S. F. Dinneen, T. P. Griffin","doi":"10.12688/hrbopenres.13941.1","DOIUrl":"https://doi.org/10.12688/hrbopenres.13941.1","url":null,"abstract":"Introduction Diabetes is one of the leading causes of chronic kidney disease. Social deprivation is recognised as a risk factor for complications of diabetes, including diabetic kidney disease. The effect of deprivation on rate of decline in renal function has not been explored in the Irish Health System to date. The objective of this study is to explore the association between social deprivation and the development/progression of diabetic kidney disease in a cohort of adults living with diabetes in Ireland. Methods This is a retrospective cohort study using an existing dataset of people living with diabetes who attended the diabetes centre at University Hospital Galway from 2012 to 2016. The variables included in this dataset include demographic variables, type and duration of diabetes, clinical variables such as medication use, blood pressure and BMI and laboratory data including creatinine, urine albumin to creatinine to ratio, haemoglobin A1c and lipids. This dataset will be updated with laboratory data until January 2023. Individual’s addresses will be used to calculate deprivation indices using the Pobal Haase Pratschke (HP) deprivation index. Rate of renal function decline will be calculated using linear mixed-effect models. The relationship between deprivation and renal function will be assessed using linear regression (absolute and relative rate of renal function decline based on eGFR) and logistic regression models (rapid vs. non-rapid decline).","PeriodicalId":508744,"journal":{"name":"HRB Open Research","volume":"13 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141925590","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 : 2024-07-26DOI: 10.12688/hrbopenres.13923.1
Reham A Lasheen, Paul Kavanagh, Brian Doyle, Cheyenne Downey, Rikke Siersbaek, D. Stanistreet, Frank Doyle
Background Health behaviours, whether protective or harmful in nature, significantly impact health outcomes. Nevertheless, it is recognised that adherence to a healthy lifestyle and enabling behaviour change remains a significant challenge. In efforts to optimise healthcare delivery to ensure positive health outcomes, behavioural economics has provided critical insights on various tools aimed at behaviour change, one of which is financial incentives. However, financial incentive programmes are complex, heterogeneous in design and context-dependant which renders them challenging to implement in real-life settings. Hence, careful consideration to facilitators of and barriers to their implementation to maximise their use is warranted. Aim This study aims to investigate the factors that influence the implementation of financial incentive programmes targeted at any behaviour change in real-life settings, as reported by key stakeholders, to guide future implementation initiatives. We will also conduct a sensitivity analysis comparing smoking to other behaviours, given its significant detrimental impact on health outcomes and its role in widening health disparities. Methods A systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Rapid Review 2020 guidelines, as well as expert recommendations, will be undertaken, to identify stakeholder-reported challenges and enablers of implementation of financial incentive programmes globally. Seven electronic databases, including MEDLINE, EMBASE and CENTRAL, will be searched for papers published from inception to June 2024. A narrative synthesis of the findings will be presented and subsequently mapped to the Theoretical Domains Framework and the Behaviour Change Wheel. Sensitivity analysis comparing findings from smoking studies will be compared to other behaviours. Ethics and dissemination Ethical approval is not required for the review. The protocol and rapid review will be submitted to an open-access peer-reviewed journal for publication. The review findings will allow for the design of effective financial incentive interventions informed by theory, which are adaptable and applicable across various settings.
{"title":"Facilitators and Barriers to Implementation of Financial Incentive Interventions for Health Behaviour Change: A Systematic Review Protocol","authors":"Reham A Lasheen, Paul Kavanagh, Brian Doyle, Cheyenne Downey, Rikke Siersbaek, D. Stanistreet, Frank Doyle","doi":"10.12688/hrbopenres.13923.1","DOIUrl":"https://doi.org/10.12688/hrbopenres.13923.1","url":null,"abstract":"Background Health behaviours, whether protective or harmful in nature, significantly impact health outcomes. Nevertheless, it is recognised that adherence to a healthy lifestyle and enabling behaviour change remains a significant challenge. In efforts to optimise healthcare delivery to ensure positive health outcomes, behavioural economics has provided critical insights on various tools aimed at behaviour change, one of which is financial incentives. However, financial incentive programmes are complex, heterogeneous in design and context-dependant which renders them challenging to implement in real-life settings. Hence, careful consideration to facilitators of and barriers to their implementation to maximise their use is warranted. Aim This study aims to investigate the factors that influence the implementation of financial incentive programmes targeted at any behaviour change in real-life settings, as reported by key stakeholders, to guide future implementation initiatives. We will also conduct a sensitivity analysis comparing smoking to other behaviours, given its significant detrimental impact on health outcomes and its role in widening health disparities. Methods A systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Rapid Review 2020 guidelines, as well as expert recommendations, will be undertaken, to identify stakeholder-reported challenges and enablers of implementation of financial incentive programmes globally. Seven electronic databases, including MEDLINE, EMBASE and CENTRAL, will be searched for papers published from inception to June 2024. A narrative synthesis of the findings will be presented and subsequently mapped to the Theoretical Domains Framework and the Behaviour Change Wheel. Sensitivity analysis comparing findings from smoking studies will be compared to other behaviours. Ethics and dissemination Ethical approval is not required for the review. The protocol and rapid review will be submitted to an open-access peer-reviewed journal for publication. The review findings will allow for the design of effective financial incentive interventions informed by theory, which are adaptable and applicable across various settings.","PeriodicalId":508744,"journal":{"name":"HRB Open Research","volume":"19 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141801584","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 : 2024-07-26DOI: 10.12688/hrbopenres.13929.1
Irene Gibson, C. Kerins, L. Foley, Lisa Hynes, Molly Byrne, A. Murphy, Caitlin Marie Reardon, J. W. McEvoy, O. Meade
Background Despite growing evidence for the effectiveness of digital cardiac rehabilitation (CR) uptake of this technology remains low. Understanding the factors that influence implementation of digital CR in clinical practice is a growing area of research. The aim of this nested qualitative study was to explore health worker perspectives on factors influencing implementation of a digital CR programme. Methods Using convenience sampling, semi-structured interviews were conducted with health workers, including health care professionals (nurses, dietitians, physiotherapists) and those in administrative and managerial roles who were involved in delivering and referring patients to Croí MySláinte, a 12-week digital CR intervention delivered during the Coronavirus 2019 pandemic. The updated Consolidated Framework for Implementation Research (CFIR) guided data collection and framework analysis. Results Interviews were conducted with 14 health workers. Factors influencing implementation of Croí MySláinte were multiple, with some operating independently and others in combination. They related to: (i) characteristics of individuals (e.g., senior leadership support, commitment and motivation of Health workers to meet patient needs, technical capability, workload and perceived fit with role); (ii) features of the programme (e.g., accessibility and convenience for patients, the digital platform, patient self- monitoring tools, the multidisciplinary team and core components); (iii) the external environment (e.g., partnership and connections between organisations, broadband and COVID-19); (iv) the internal environment (e.g., organisational culture, teamwork, resources including funding, digital infrastructure and staffing); and (v) the implementation process (e.g., engaging patients through provision of technical support). Conclusion The study findings suggest that factors influencing implementation of digital CR operate at multiple levels. Therefore, multi-level implementation strategies are required if the true potential of digital health in improving equitable cardiac rehabilitation access, participation and patient outcomes is to be realised.
{"title":"Factors influencing implementation of digital cardiac rehabilitation: A qualitative analysis of health workers perspectives","authors":"Irene Gibson, C. Kerins, L. Foley, Lisa Hynes, Molly Byrne, A. Murphy, Caitlin Marie Reardon, J. W. McEvoy, O. Meade","doi":"10.12688/hrbopenres.13929.1","DOIUrl":"https://doi.org/10.12688/hrbopenres.13929.1","url":null,"abstract":"Background Despite growing evidence for the effectiveness of digital cardiac rehabilitation (CR) uptake of this technology remains low. Understanding the factors that influence implementation of digital CR in clinical practice is a growing area of research. The aim of this nested qualitative study was to explore health worker perspectives on factors influencing implementation of a digital CR programme. Methods Using convenience sampling, semi-structured interviews were conducted with health workers, including health care professionals (nurses, dietitians, physiotherapists) and those in administrative and managerial roles who were involved in delivering and referring patients to Croí MySláinte, a 12-week digital CR intervention delivered during the Coronavirus 2019 pandemic. The updated Consolidated Framework for Implementation Research (CFIR) guided data collection and framework analysis. Results Interviews were conducted with 14 health workers. Factors influencing implementation of Croí MySláinte were multiple, with some operating independently and others in combination. They related to: (i) characteristics of individuals (e.g., senior leadership support, commitment and motivation of Health workers to meet patient needs, technical capability, workload and perceived fit with role); (ii) features of the programme (e.g., accessibility and convenience for patients, the digital platform, patient self- monitoring tools, the multidisciplinary team and core components); (iii) the external environment (e.g., partnership and connections between organisations, broadband and COVID-19); (iv) the internal environment (e.g., organisational culture, teamwork, resources including funding, digital infrastructure and staffing); and (v) the implementation process (e.g., engaging patients through provision of technical support). Conclusion The study findings suggest that factors influencing implementation of digital CR operate at multiple levels. Therefore, multi-level implementation strategies are required if the true potential of digital health in improving equitable cardiac rehabilitation access, participation and patient outcomes is to be realised.","PeriodicalId":508744,"journal":{"name":"HRB Open Research","volume":"10 26","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141801331","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 : 2024-07-23DOI: 10.12688/hrbopenres.13918.1
F. Riordan, Cathy Breen, Margaret Humphreys, Sean F. Dinneen, Sheena M. McHugh
Background To date, evaluations of the structured diabetes education programme, Dose Adjustment for Normal Eating (DAFNE), have focused on improvements in clinical and psychosocial outcomes, however, little is known about implementation and participant attendance across centres. We compared participant profile, course delivery and retention across Irish and UK centres and patterns of course delivery pre and during Covid-19. Methods Data collected annually by DAFNE centres (01.01.2019 to 01.01.2022) were analysed. Multivariable logistic regression assessed the association between demographic (age, gender) and clinical variables (years since diagnosis; DKA requiring admission in past 12 months; severe hypoglycaemic event (hypo) in the last year), course format and country, with non-completion (attended <5 sessions). Results Overall, 6749 people attended DAFNE courses across 91 centres in 3 years. Compared to Ireland, UK-based course attendees were slightly older on average and had diabetes for longer. In 2019 (pre-Covid), 86 centres delivered an average of 10 courses per centre (range: 1 to 30). During Covid (2020) when remote format courses were first offered, 79 centres delivered an average of 5 courses per centre (1 to 15). Overall, 10% of participants did not complete. Younger age, having a severe hypo in the last year, and attending a remote course (vs. standard 5-day face-to-face) were associated with non-completion. Conclusions Course delivery varies widely across centres. This may reflect centre size and resource availability. Although participant non-completion was low, our data do not capture those who withdraw pre-course. Future work should explore barriers and facilitators of course acceptance and retention.
{"title":"Delivery of Dose Adjustment For Normal Eating (DAFNE) in the UK and Ireland 2019-2022","authors":"F. Riordan, Cathy Breen, Margaret Humphreys, Sean F. Dinneen, Sheena M. McHugh","doi":"10.12688/hrbopenres.13918.1","DOIUrl":"https://doi.org/10.12688/hrbopenres.13918.1","url":null,"abstract":"Background To date, evaluations of the structured diabetes education programme, Dose Adjustment for Normal Eating (DAFNE), have focused on improvements in clinical and psychosocial outcomes, however, little is known about implementation and participant attendance across centres. We compared participant profile, course delivery and retention across Irish and UK centres and patterns of course delivery pre and during Covid-19. Methods Data collected annually by DAFNE centres (01.01.2019 to 01.01.2022) were analysed. Multivariable logistic regression assessed the association between demographic (age, gender) and clinical variables (years since diagnosis; DKA requiring admission in past 12 months; severe hypoglycaemic event (hypo) in the last year), course format and country, with non-completion (attended <5 sessions). Results Overall, 6749 people attended DAFNE courses across 91 centres in 3 years. Compared to Ireland, UK-based course attendees were slightly older on average and had diabetes for longer. In 2019 (pre-Covid), 86 centres delivered an average of 10 courses per centre (range: 1 to 30). During Covid (2020) when remote format courses were first offered, 79 centres delivered an average of 5 courses per centre (1 to 15). Overall, 10% of participants did not complete. Younger age, having a severe hypo in the last year, and attending a remote course (vs. standard 5-day face-to-face) were associated with non-completion. Conclusions Course delivery varies widely across centres. This may reflect centre size and resource availability. Although participant non-completion was low, our data do not capture those who withdraw pre-course. Future work should explore barriers and facilitators of course acceptance and retention.","PeriodicalId":508744,"journal":{"name":"HRB Open Research","volume":"129 22","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141811438","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 : 2024-07-23DOI: 10.12688/hrbopenres.13899.1
Niamh M. Cummins, Christine Fitzgerald, Una M. Cronin, Alan M. Batt, Ann-Marie Bright, Brian Doyle, Michelle O'Toole, Julia Williams, K. Bowles
Background Paramedicine research and education has progressed significantly over the past two decades in Ireland. The Pre-Hospital Emergency Care Council recently commissioned a research team to develop a new National Research Strategy for Irish paramedicine. The strategy will serve to build research capacity and establish research priorities into the future. This study aims to explore the perspectives of diverse stakeholders to identify barriers and facilitators to the implementation of a national research strategy for paramedicine in Ireland. Methods The research employed an action research approach. Purposeful and snowball sampling was used to identify and recruit participants (n=37) from diverse stakeholders and knowledge users working in the out-of-hospital setting. Data collection took the form of focus groups (n=6) facilitated by experienced researchers. Audio recordings were transcribed verbatim using Otter AI and thematic analysis was performed in NVivo. Results Barriers and facilitators to the implementation of the research strategy exist at individual and system levels. The themes developed from the Focus Groups included; Challenges in the Research Landscape and Opportunities to Build a Research Ecosystem. Individual barriers included Experience and Skills, Time and Wellbeing. At system level, Operational, Educational, and Professional barriers were identified in addition to an undeveloped Research Infrastructure (Leadership, Support, Funding and Data Access). Individual facilitators included; Professional Identity, Evolving Roles and Protected Time. At system level, Collaboration, Knowledge Translation, Educational facilitators and Professional facilitators, in combination with a strong Research Infrastructure were considered important for successful implementation of the Research Strategy. Conclusions The findings are congruent with international studies and highlight the complexity of implementing a national research strategy aligned with the needs of diverse stakeholders in the out-of-hospital setting. Collaboration will be essential for successful strategy implementation. To ensure optimal effectiveness of the research strategy the development of an implementation plan is recommended.
{"title":"Barriers and facilitators to the implementation of a national research strategy for paramedicine in Ireland: Findings from a focus group study","authors":"Niamh M. Cummins, Christine Fitzgerald, Una M. Cronin, Alan M. Batt, Ann-Marie Bright, Brian Doyle, Michelle O'Toole, Julia Williams, K. Bowles","doi":"10.12688/hrbopenres.13899.1","DOIUrl":"https://doi.org/10.12688/hrbopenres.13899.1","url":null,"abstract":"Background Paramedicine research and education has progressed significantly over the past two decades in Ireland. The Pre-Hospital Emergency Care Council recently commissioned a research team to develop a new National Research Strategy for Irish paramedicine. The strategy will serve to build research capacity and establish research priorities into the future. This study aims to explore the perspectives of diverse stakeholders to identify barriers and facilitators to the implementation of a national research strategy for paramedicine in Ireland. Methods The research employed an action research approach. Purposeful and snowball sampling was used to identify and recruit participants (n=37) from diverse stakeholders and knowledge users working in the out-of-hospital setting. Data collection took the form of focus groups (n=6) facilitated by experienced researchers. Audio recordings were transcribed verbatim using Otter AI and thematic analysis was performed in NVivo. Results Barriers and facilitators to the implementation of the research strategy exist at individual and system levels. The themes developed from the Focus Groups included; Challenges in the Research Landscape and Opportunities to Build a Research Ecosystem. Individual barriers included Experience and Skills, Time and Wellbeing. At system level, Operational, Educational, and Professional barriers were identified in addition to an undeveloped Research Infrastructure (Leadership, Support, Funding and Data Access). Individual facilitators included; Professional Identity, Evolving Roles and Protected Time. At system level, Collaboration, Knowledge Translation, Educational facilitators and Professional facilitators, in combination with a strong Research Infrastructure were considered important for successful implementation of the Research Strategy. Conclusions The findings are congruent with international studies and highlight the complexity of implementing a national research strategy aligned with the needs of diverse stakeholders in the out-of-hospital setting. Collaboration will be essential for successful strategy implementation. To ensure optimal effectiveness of the research strategy the development of an implementation plan is recommended.","PeriodicalId":508744,"journal":{"name":"HRB Open Research","volume":"99 23","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141812208","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 : 2024-07-17DOI: 10.12688/hrbopenres.13912.1
Jennifer M. Ryan, M. Norris, Aisling Walsh, Amanda Breen, O. Hensey, Claire Kerr, Sebastian Koppe, G. Lavelle, M. Owens, M. Walsh, Thilo Kroll, Jennifer Fortune
Background Poor transition from child- to adult-oriented healthcare may lead to negative outcomes and dissatisfaction with services in adulthood. The aim of the study was to examine how transition is provided to and experienced by young people with CP in Ireland. This report provides integrated quantitative and qualitative findings and implications based on the totality of knowledge generated. Methods A convergent parallel mixed-methods study was conducted. Data were collected from people with CP aged 16-22 years, parents, and health professionals using surveys and semi-structured interviews, informed by a framework of nine key transition practices. Quantitative and qualitative findings were integrated at the interpretation stage of the research using integration through joint displays. Implications were developed through discussions with health professionals, young people, and parents. Results Surveys were completed by 75 young people/parents and 108 health professionals. Interviews were conducted with 13 young people, 14 parents, and 27 health professionals. There was complementarity between quantitative and qualitative findings indicating lack of a named worker, limited information provision, insufficient self-management support, no opportunity to meet the adult team, limited contact with the GP, and no opportunity for attending formal life skills training. There was dissonance between quantitative and qualitative findings regarding appropriate level of parental involvement. There was silence between quantitative and qualitative findings for promotion of health self-efficacy and senior manager responsible for transition, with quantitative findings indicating these were not present for most young people, but qualitative findings not describing these practices Conclusion Implications of integrated findings include the need for a standardised transition pathway, intentional actions to enable parents and young people to adapt to changing roles, provision of information in a collaborative and phased approach, a common understanding of self-management between young people, parents and health professionals, and the need to involve adults’ services and GPs in transition.
{"title":"Transition from child to adult health services for young people with cerebral palsy in Ireland; implications from a mixed-methods study","authors":"Jennifer M. Ryan, M. Norris, Aisling Walsh, Amanda Breen, O. Hensey, Claire Kerr, Sebastian Koppe, G. Lavelle, M. Owens, M. Walsh, Thilo Kroll, Jennifer Fortune","doi":"10.12688/hrbopenres.13912.1","DOIUrl":"https://doi.org/10.12688/hrbopenres.13912.1","url":null,"abstract":"Background Poor transition from child- to adult-oriented healthcare may lead to negative outcomes and dissatisfaction with services in adulthood. The aim of the study was to examine how transition is provided to and experienced by young people with CP in Ireland. This report provides integrated quantitative and qualitative findings and implications based on the totality of knowledge generated. Methods A convergent parallel mixed-methods study was conducted. Data were collected from people with CP aged 16-22 years, parents, and health professionals using surveys and semi-structured interviews, informed by a framework of nine key transition practices. Quantitative and qualitative findings were integrated at the interpretation stage of the research using integration through joint displays. Implications were developed through discussions with health professionals, young people, and parents. Results Surveys were completed by 75 young people/parents and 108 health professionals. Interviews were conducted with 13 young people, 14 parents, and 27 health professionals. There was complementarity between quantitative and qualitative findings indicating lack of a named worker, limited information provision, insufficient self-management support, no opportunity to meet the adult team, limited contact with the GP, and no opportunity for attending formal life skills training. There was dissonance between quantitative and qualitative findings regarding appropriate level of parental involvement. There was silence between quantitative and qualitative findings for promotion of health self-efficacy and senior manager responsible for transition, with quantitative findings indicating these were not present for most young people, but qualitative findings not describing these practices Conclusion Implications of integrated findings include the need for a standardised transition pathway, intentional actions to enable parents and young people to adapt to changing roles, provision of information in a collaborative and phased approach, a common understanding of self-management between young people, parents and health professionals, and the need to involve adults’ services and GPs in transition.","PeriodicalId":508744,"journal":{"name":"HRB Open Research","volume":" 33","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141830212","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 : 2024-06-12DOI: 10.12688/hrbopenres.13885.1
Margaret Mc Grath, Fiona Condon, Megan Kiely, Jenna Keane, R. Usher
Background Hospital-acquired deconditioning (HAD) is recognised as a state of reduced physiological, psychological, and functional after an acute hospitalization. Older people, particularly those with physical and social complexities are at risk of hospital-associated deconditioning, which is associated with increased length of stay in hospital, institutionalization, mortality, and increased healthcare costs. Thus, identification of effective approaches for the assessment, management, and prevention of HAD are pertinent. Occupational therapy has a potential role to play in prevention and treatment of HAD among older people. This scoping review will identify and map existing occupational therapy interventions which address deconditioning among older people. Methods This scoping review will be conducted using the framework proposed by the Joanna Briggs Institute and the Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for scoping reviews (PRISMA-ScR), will be used to guide the reporting. A comprehensive search strategy using relevant key words and index terms will be developed and applied across Embase (OVID), Medline (OVID), CINHAL (EBSCO), PsychInfo (ProQuest), SCOPUS databases. This will be followed by search of the reference lists of selected sources and hand-search relevant data-hubs. The search will cover studies published in English from January 2014 to the present date. Titles and abstracts will be screened against inclusion criteria. Data will be extracted using a form developed for this review. The Template for Intervention Description and Replication (TIDieR) checklist (Hoffmann et al., 2014) will be applied to papers where specific interventions are reported. Key information on assessment and intervention practices will be categorised and classified in a narrative summary. Conclusion This scoping review will examine current practice internationally regarding the role of occupational therapy in prevention and treatment of HAD among older people.
背景 医院获得性机能减退（HAD）被认为是急性住院后生理、心理和功能减退的一种状态。老年人，尤其是那些身体和社会状况复杂的老年人，面临着住院引起的机能减退的风险，这与住院时间延长、住院、死亡率和医疗费用增加有关。因此，确定评估、管理和预防 HAD 的有效方法至关重要。职业疗法在预防和治疗老年人 HAD 方面具有潜在的作用。本范围界定综述将确定和绘制现有的职业疗法干预措施，以解决老年人身体机能减退的问题。方法 本次范围界定综述将采用乔安娜-布里格斯研究所（Joanna Briggs Institute）提出的框架进行，并将使用范围界定综述的 "系统综述和荟萃分析首选报告项目扩展"（PRISMA-ScR）来指导报告。将使用相关关键词和索引术语制定全面的检索策略，并将其应用于 Embase (OVID)、Medline (OVID)、CINHAL (EBSCO)、PsychInfo (ProQuest) 和 SCOPUS 数据库。随后还将检索所选资料来源的参考文献目录，并手工检索相关数据集。检索将涵盖 2014 年 1 月至今用英文发表的研究。将根据纳入标准对标题和摘要进行筛选。将使用为本综述开发的表格提取数据。对于报告了具体干预措施的论文，将采用干预措施描述和复制模板（TIDieR）核对表（Hoffmann 等人，2014 年）。有关评估和干预措施的关键信息将在叙述性摘要中进行归类和分类。结论 本范围界定综述将研究当前国际上有关职业疗法在预防和治疗老年人 HAD 中的作用的实践。
{"title":"Occupational therapy interventions to address hospital associated deconditioning among older people: A scoping review protocol","authors":"Margaret Mc Grath, Fiona Condon, Megan Kiely, Jenna Keane, R. Usher","doi":"10.12688/hrbopenres.13885.1","DOIUrl":"https://doi.org/10.12688/hrbopenres.13885.1","url":null,"abstract":"Background Hospital-acquired deconditioning (HAD) is recognised as a state of reduced physiological, psychological, and functional after an acute hospitalization. Older people, particularly those with physical and social complexities are at risk of hospital-associated deconditioning, which is associated with increased length of stay in hospital, institutionalization, mortality, and increased healthcare costs. Thus, identification of effective approaches for the assessment, management, and prevention of HAD are pertinent. Occupational therapy has a potential role to play in prevention and treatment of HAD among older people. This scoping review will identify and map existing occupational therapy interventions which address deconditioning among older people. Methods This scoping review will be conducted using the framework proposed by the Joanna Briggs Institute and the Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for scoping reviews (PRISMA-ScR), will be used to guide the reporting. A comprehensive search strategy using relevant key words and index terms will be developed and applied across Embase (OVID), Medline (OVID), CINHAL (EBSCO), PsychInfo (ProQuest), SCOPUS databases. This will be followed by search of the reference lists of selected sources and hand-search relevant data-hubs. The search will cover studies published in English from January 2014 to the present date. Titles and abstracts will be screened against inclusion criteria. Data will be extracted using a form developed for this review. The Template for Intervention Description and Replication (TIDieR) checklist (Hoffmann et al., 2014) will be applied to papers where specific interventions are reported. Key information on assessment and intervention practices will be categorised and classified in a narrative summary. Conclusion This scoping review will examine current practice internationally regarding the role of occupational therapy in prevention and treatment of HAD among older people.","PeriodicalId":508744,"journal":{"name":"HRB Open Research","volume":"113 17","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141352120","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 : 2024-06-06DOI: 10.12688/hrbopenres.13879.1
Nazia AlAmri, Sunita Panda, Valerie Smith
Background The involvement of husbands and male partners in childbirth no longer ceases at conception and pregnancy, rather fathers wish to be more involved in supporting their partners during childbirth. This aligns with the World Health Organization's (WHO) call for promoting male participation in childbirth, emphasising the benefits of support and the positive impact attending childbirth has for husbands/partners, and their maternal partner. This knowledge has led to global initiatives promoting "humanised" birth and a family-approach. To gain in-depth insight and understanding of childbirth attendance from the perspectives of fathers, a qualitative evidence synthesis is proposed. Methods To explore fathers' experiences, views, and perspectives of childbirth attendance. All studies that used qualitative methodologies to explore the phenomenon of interest will be included. MEDLINE, CINAHL, PsycINFO, MIDIRS, Web of Science, and Google Scholar will be systematically searched from their dates of inception to present, supplemented by a search for grey literature and a search of the reference list of included studies. Peer Review of Electronic Search Strategies (PRESS) will be used to ensure the comprehensiveness of the search strategy. Methodological quality assessment of included studies, using The Critical Appraisal Skills Programme assessment tool, and will be extracted from the included studies by two reviewers independently using a standard data extraction form. Thomas and Harden’s three-stage approach will be used to thematically synthesise the data: coding of data, developing descriptive themes, and generation of analytical themes. The Grading of Recommendations Assessment, Development, and Evaluation-Confidence in the Evidence from Reviews of Qualitative research (GRADE-CERQual confidence in the synthesised findings Comprehensive insight and understanding of fathers’ perspectives of childbirth attendance will be ascertained PROSPERO Registration No CRD42023470902
背景丈夫和男性伴侣对分娩的参与不再停留在受孕和怀孕阶段，相反，父亲们希望在分娩期间更多地参与对其伴侣的支持。这与世界卫生组织（WHO）关于促进男性参与分娩的呼吁相一致，强调了支持分娩的益处以及分娩对丈夫/伴侣及其产妇伴侣的积极影响。这一认识促使全球倡议提倡 "人性化 "分娩和家庭方式。为了从父亲的角度深入洞察和了解分娩护理，我们提出了一项定性证据综述。方法 探讨父亲对分娩护理的经验、看法和观点。所有使用定性方法探讨相关现象的研究都将被纳入。将系统地检索 MEDLINE、CINAHL、PsycINFO、MIDIRS、Web of Science 和 Google Scholar 中从开始至今的所有研究，并检索灰色文献和所纳入研究的参考文献目录。为确保检索策略的全面性，将采用同行评审电子检索策略（PRESS）。两位审稿人将使用 "批判性评估技能计划"（The Critical Appraisal Skills Programme）评估工具对纳入研究进行方法学质量评估，并使用标准数据提取表从纳入研究中独立提取数据。将采用托马斯和哈登的三阶段方法对数据进行主题综合：数据编码、开发描述性主题和生成分析性主题。建议评估、发展和评价的分级--定性研究综述证据的可信度（GRADE-CERQual confidence in the synthesized findings 将确定对父亲分娩就诊观点的全面洞察和理解 PROSPERO 注册号 CRD42023470902
{"title":"Fathers' experiences, views and perspectives of childbirth attendance: A qualitative evidence synthesis protocol","authors":"Nazia AlAmri, Sunita Panda, Valerie Smith","doi":"10.12688/hrbopenres.13879.1","DOIUrl":"https://doi.org/10.12688/hrbopenres.13879.1","url":null,"abstract":"Background The involvement of husbands and male partners in childbirth no longer ceases at conception and pregnancy, rather fathers wish to be more involved in supporting their partners during childbirth. This aligns with the World Health Organization's (WHO) call for promoting male participation in childbirth, emphasising the benefits of support and the positive impact attending childbirth has for husbands/partners, and their maternal partner. This knowledge has led to global initiatives promoting \"humanised\" birth and a family-approach. To gain in-depth insight and understanding of childbirth attendance from the perspectives of fathers, a qualitative evidence synthesis is proposed. Methods To explore fathers' experiences, views, and perspectives of childbirth attendance. All studies that used qualitative methodologies to explore the phenomenon of interest will be included. MEDLINE, CINAHL, PsycINFO, MIDIRS, Web of Science, and Google Scholar will be systematically searched from their dates of inception to present, supplemented by a search for grey literature and a search of the reference list of included studies. Peer Review of Electronic Search Strategies (PRESS) will be used to ensure the comprehensiveness of the search strategy. Methodological quality assessment of included studies, using The Critical Appraisal Skills Programme assessment tool, and will be extracted from the included studies by two reviewers independently using a standard data extraction form. Thomas and Harden’s three-stage approach will be used to thematically synthesise the data: coding of data, developing descriptive themes, and generation of analytical themes. The Grading of Recommendations Assessment, Development, and Evaluation-Confidence in the Evidence from Reviews of Qualitative research (GRADE-CERQual confidence in the synthesised findings Comprehensive insight and understanding of fathers’ perspectives of childbirth attendance will be ascertained PROSPERO Registration No CRD42023470902","PeriodicalId":508744,"journal":{"name":"HRB Open Research","volume":"18 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141378907","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 : 2024-06-04DOI: 10.12688/hrbopenres.13898.1
G. Maher, A. Khashan, J. McKernan, F. McCarthy, Richard Greene
Background Since 2016, maternity units across Ireland have been switching from paper clinical notes to an electronic health record called the Maternal and Newborn Clinical Management System (MN-CMS). Currently, four units have implemented the MN-CMS: Cork University Maternity Hospital (CUMH), University Hospital Kerry (UHK), Rotunda Hospital and National Maternity Hospital (NMH). The MN-CMS provides opportunity for new data-driven discovery to answer important research questions on maternal and child health. Aim Provide detailed information on how a request can be made to access anonymised MN-CMS data for research purposes, as well as current timelines involved from initial request to data access. Methods A request to collaborate should be made to the clinical lead within each maternity unit where data is being requested in the first instance. A detailed protocol and data collection sheet should be drafted and forwarded to the National Information Governance Group for approval. A Data Protection Impact Assessment should be completed, and permission to access data from each maternity unit must be applied for separately from each unit’s local Ethics Committee. Upon receipt of ethical approval, an application to the Local Information Governance Group must be submitted if requesting data from CUMH and/or UHK. Data can then be extracted and anonymised by the data manager at the respective unit and transferred securely to relevant project personnel. Results The timeline from initial request to data access can range from approximately 6-12 months, depending on number of maternity units from which data is being requested and number of variables being requested from each unit. Conclusions Accessing MN-CMS data for research can be a complex process. A national standardised process for managing the data is needed. This would allow a clear pathway to be developed for accessing data to facilitate new data-driven discovery in the area of maternal and child health.
{"title":"Accessing Anonymised Data from Ireland’s Maternal and Newborn Clinical Management System for Research Purposes","authors":"G. Maher, A. Khashan, J. McKernan, F. McCarthy, Richard Greene","doi":"10.12688/hrbopenres.13898.1","DOIUrl":"https://doi.org/10.12688/hrbopenres.13898.1","url":null,"abstract":"Background Since 2016, maternity units across Ireland have been switching from paper clinical notes to an electronic health record called the Maternal and Newborn Clinical Management System (MN-CMS). Currently, four units have implemented the MN-CMS: Cork University Maternity Hospital (CUMH), University Hospital Kerry (UHK), Rotunda Hospital and National Maternity Hospital (NMH). The MN-CMS provides opportunity for new data-driven discovery to answer important research questions on maternal and child health. Aim Provide detailed information on how a request can be made to access anonymised MN-CMS data for research purposes, as well as current timelines involved from initial request to data access. Methods A request to collaborate should be made to the clinical lead within each maternity unit where data is being requested in the first instance. A detailed protocol and data collection sheet should be drafted and forwarded to the National Information Governance Group for approval. A Data Protection Impact Assessment should be completed, and permission to access data from each maternity unit must be applied for separately from each unit’s local Ethics Committee. Upon receipt of ethical approval, an application to the Local Information Governance Group must be submitted if requesting data from CUMH and/or UHK. Data can then be extracted and anonymised by the data manager at the respective unit and transferred securely to relevant project personnel. Results The timeline from initial request to data access can range from approximately 6-12 months, depending on number of maternity units from which data is being requested and number of variables being requested from each unit. Conclusions Accessing MN-CMS data for research can be a complex process. A national standardised process for managing the data is needed. This would allow a clear pathway to be developed for accessing data to facilitate new data-driven discovery in the area of maternal and child health.","PeriodicalId":508744,"journal":{"name":"HRB Open Research","volume":"83 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141268339","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 : 2024-06-04DOI: 10.12688/hrbopenres.13894.1
N. Merriman, M. Walsh, Niamh O'Regan, Marie Carrigan, Pamela Hickey, Louise Brent, Catherine Blake
Background Neurocognitive disorders (NCDs), including delirium, cognitive impairment, or dementia are prevalent in up to 39% of older adults in acute care, particularly older trauma patients. Undiagnosed NCDs result in poor outcomes, such as increased incidence of depressive symptoms, longer length of stay, and mortality. Objective This study aims to identify the diagnostic test accuracy of screening tools for the detection of NCDs in older trauma patients in acute settings. Design Systematic review protocol. Literature search Electronic databases (MEDLINE, Embase, CINAHL, PsycInfo, Cochrane Library) will be searched for journal articles. Search terms related to NCDs, delirium and cognitive screening tools, and diagnostic accuracy will be included. Study selection criteria Cross-sectional, prospective, or retrospective cohort studies of adults aged ≥60 post-trauma, in an acute setting, will be included where the study aimed to validate a screening tool for detection of 1) delirium or 2) cognitive impairment, or dementia against a reference standard of a clinical decision, based on standardised diagnostic criteria or a validated tool. Data synthesis Two review authors will conduct study selection, data extraction, and appraisal. Data will be extracted based on the Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies (PRISMA-DTA) checklist. Studies will be assessed for methodological quality by two independent review authors using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. Narrative summaries will be generated describing risk of bias and concerns regarding applicability. Quantitative synthesis of study findings will be conducted. Conclusion This systematic review will aim to identify screening tools with the best diagnostic accuracy for detection of 1) delirium and 2) cognitive impairment or dementia in adults aged ≥60 post-trauma in acute care settings. Results will inform clinical practice to enhance the probability of patients with NCDs receiving appropriate care and management. Registration PROSPERO https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024518730 (11/03/2024).
{"title":"Diagnostic test accuracy of screening tools for the detection of neurocognitive disorders in older adults post-trauma: A protocol for a systematic review","authors":"N. Merriman, M. Walsh, Niamh O'Regan, Marie Carrigan, Pamela Hickey, Louise Brent, Catherine Blake","doi":"10.12688/hrbopenres.13894.1","DOIUrl":"https://doi.org/10.12688/hrbopenres.13894.1","url":null,"abstract":"Background Neurocognitive disorders (NCDs), including delirium, cognitive impairment, or dementia are prevalent in up to 39% of older adults in acute care, particularly older trauma patients. Undiagnosed NCDs result in poor outcomes, such as increased incidence of depressive symptoms, longer length of stay, and mortality. Objective This study aims to identify the diagnostic test accuracy of screening tools for the detection of NCDs in older trauma patients in acute settings. Design Systematic review protocol. Literature search Electronic databases (MEDLINE, Embase, CINAHL, PsycInfo, Cochrane Library) will be searched for journal articles. Search terms related to NCDs, delirium and cognitive screening tools, and diagnostic accuracy will be included. Study selection criteria Cross-sectional, prospective, or retrospective cohort studies of adults aged ≥60 post-trauma, in an acute setting, will be included where the study aimed to validate a screening tool for detection of 1) delirium or 2) cognitive impairment, or dementia against a reference standard of a clinical decision, based on standardised diagnostic criteria or a validated tool. Data synthesis Two review authors will conduct study selection, data extraction, and appraisal. Data will be extracted based on the Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies (PRISMA-DTA) checklist. Studies will be assessed for methodological quality by two independent review authors using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. Narrative summaries will be generated describing risk of bias and concerns regarding applicability. Quantitative synthesis of study findings will be conducted. Conclusion This systematic review will aim to identify screening tools with the best diagnostic accuracy for detection of 1) delirium and 2) cognitive impairment or dementia in adults aged ≥60 post-trauma in acute care settings. Results will inform clinical practice to enhance the probability of patients with NCDs receiving appropriate care and management. Registration PROSPERO https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024518730 (11/03/2024).","PeriodicalId":508744,"journal":{"name":"HRB Open Research","volume":"10 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141266836","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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