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Building public trust and confidence in secondary use of health data for healthcare improvement and research: a qualitative study pre-protocol. 建立公众对二次使用健康数据改善医疗保健和开展研究的信任和信心:定性研究预案。
Pub Date : 2024-06-17 eCollection Date: 2023-01-01 DOI: 10.12688/hrbopenres.13711.2
Tina Bedenik, Caitriona Cahir, K Bennett

Background  Secondary use of health data provides opportunities to drive improvements in healthcare provision, personalised medicine, comparative effectiveness research, health services innovation, and policy and practice. However, secondary data use requires compliance with relevant legislation, implementation of technical safeguards, ethical data management, and respect for data sharers. Existing evidence suggests widespread support for secondary use of health data among the public, which co-exists with concerns about privacy, confidentiality and misuse of data. Balancing the protection of individuals' rights against the use of their health data for societal benefits is of vital importance, and trust underpins this process. The study protocol explores how to build public trust and confidence in the secondary use of health data through all key stakeholder groups in Ireland, towards developing a culture that promotes a safe and trustworthy use of data. Methods  This study will adopt a qualitative cross-sectional approach conducted in accordance with the Consolidated Criteria for Reporting Qualitative Research COREQ guidelines. Participants in the study will include academics and researchers; healthcare professionals, data protection, ethics and privacy experts and data controllers; pharmaceutical industry and patients and public. Purposive and convenience sampling techniques will be utilised to recruit the participants, and data will be collected utilizing focus groups that may be supplemented with semi-structured interviews. Data will be coded by themes using reflexive thematic analysis (TA) and collective intelligence (CI) will be convened post-analysis to explore the preliminary findings with the participants. Ethics and Dissemination  Ethical approval was obtained from the Royal College of Surgeons in Ireland Research Ethics Committee (REC202208013). Final data analysis and dissemination is expected by Q1 2024. Findings will be disseminated through peer-reviewed journal publications, presentations at relevant conferences, and other academic, public and policy channels. Lay summaries will be designed for Public and Patient Involvement (PPI) contributors and general public.

背景 健康数据的二次使用为推动改善医疗服务、个性化医疗、比较效益研究、医疗服务创新以及政策和实践提供了机会。然而,二次数据使用需要遵守相关法律、实施技术保障措施、进行合乎道德的数据管理以及尊重数据共享者。现有证据表明,公众普遍支持对健康数据的二次使用,但同时也存在对数据隐私、保密性和滥用的担忧。在保护个人权利与利用其健康数据为社会造福之间取得平衡至关重要,而信任则是这一过程的基础。本研究方案探讨了如何通过爱尔兰所有主要利益相关者群体建立公众对二次使用健康数据的信任和信心,从而形成一种促进安全、可信数据使用的文化。研究方法 本研究将采用横断面定性方法,按照定性研究报告综合标准 COREQ 指南进行。参与研究的人员将包括学者和研究人员;医疗保健专业人员、数据保护、伦理和隐私专家以及数据控制者;制药行业以及患者和公众。在招募参与者时,将采用有目的的抽样和方便抽样技术,并通过焦点小组收集数据,同时可能辅以半结构化访谈。数据将通过反思性主题分析(TA)按主题进行编码,分析后将召集集体智慧(CI)与参与者共同探讨初步结果。伦理与传播 已获得爱尔兰皇家外科学院研究伦理委员会(REC202208013)的伦理批准。最终数据分析和传播预计将于 2024 年第一季度完成。研究结果将通过同行评审的期刊出版物、相关会议上的发言以及其他学术、公共和政策渠道进行传播。将为 "公众与患者参与"(Public and Patient Involvement,PPI)撰稿人和公众设计非专业摘要。
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引用次数: 0
Patient reported outcome measures in childbirth and postpartum maternal quality of life: a protocol for systematic review of measurement properties. 患者报告的分娩和产后产妇生活质量的结果测量:测量特性的系统审查方案。
Pub Date : 2024-06-06 eCollection Date: 2021-01-01 DOI: 10.12688/hrbopenres.13445.2
Laura J O'Byrne, Gillian M Maher, Ali S Khashan, Richard A Greene, John Browne, Fergus P McCarthy

Background: Patient centred healthcare is the corner stone to many healthcare strategies. Patient specific health needs should be at the fore of healthcare improvements and quality measurements. Patient reported outcome measures (PROM) that support real world clinical effectiveness assessments are increasingly being used to highlight domains where there is the greatest scope for change.

Objectives: This systematic review aims to identify and evaluate existing patient reported assessment measures/tool(s) that can be used in developing a PROM for postpartum women. We will assess and evaluate their measurement properties in a transparent and structured way in accordance with the COSMIN guidelines.

Methods: Methodological guidelines for systematic reviews of PROMs have been developed by the COSMIN initiative and will be followed for this systematic review. A systematic literature review will be performed using PubMed, CINAHL and EMBASE from inception to the present day. Two reviewers independently will judge eligibility, conduct data extraction and assess the methodological quality of each study as per COSMIN guidelines. Inclusion criteria: studies should concern PROM with an aim to evaluate measurement properties in the development or the evaluation of a PROM of interest. Included PROM will focus upon postpartum women assessing morbidity and quality of care. All peer reviewed studies with an assessment tool designed for patient completion will be considered. Exclusion criteria; abstract, letters and non-peer reviewed publications. Studies will be graded on measurement properties and quality of evidence as laid out by COSMIN. All studies and characteristics eligible for inclusion will be summarised and a recommendation to the most suitable measurement tool(s) will be given.

Discussion: We will provide a comprehensive description of all available patient reported assessment tools available for childbirth and postpartum quality of life and recommend based on COSMIN guidelines the most suitable instrument(s) available for use.

背景:以患者为中心的医疗保健是许多医疗保健策略的基石。患者特定的健康需求应该放在医疗保健改进和质量衡量的首位。支持真实世界临床有效性评估的患者报告结果测量(PROM)越来越多地被用于强调变化范围最大的领域。目的:本系统综述旨在确定和评估现有患者报告的评估措施/工具,这些措施/工具可用于开发产后妇女胎膜早破。我们将根据COSMIN指南,以透明和结构化的方式评估和评估其测量特性。方法:COSMIN倡议制定了PROM系统审查的方法指南,并将在本次系统审查中遵循。从开始到现在,将使用PubMed、CINAHL和EMBASE进行系统的文献综述。两名评审员将根据COSMIN指南独立判断资格,进行数据提取,并评估每项研究的方法学质量。纳入标准:研究应关注PROM,目的是评估感兴趣的PROM的开发或评估中的测量特性。胎膜早破将侧重于产后妇女评估发病率和护理质量。将考虑所有具有专为患者完成而设计的评估工具的同行评审研究。排除标准;摘要、信件和未经同行评审的出版物。研究将根据COSMIN的规定,对测量特性和证据质量进行分级。将总结所有符合纳入条件的研究和特征,并推荐最合适的测量工具。讨论:我们将全面描述所有可用于分娩和产后生活质量的患者报告评估工具,并根据COSMIN指南推荐最适合使用的仪器。
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引用次数: 0
A qualitative exploration of advantages and disadvantages to using technology in the process of randomised controlled trial recruitment. 对随机对照试验招募过程中使用技术的利弊进行定性探索。
Pub Date : 2024-06-06 eCollection Date: 2023-01-01 DOI: 10.12688/hrbopenres.13776.2
Lauren A Muldowney, Sinéad M Hynes, Megan Oglesby, Christopher P Dwyer

Background: Despite its importance, recruiting a sufficient sample size for randomised controlled trials (RCTs) can pose a significant challenge, which has real-world impact on reliability of evidence, trial completion and ultimately, patient care. Technology has potential to enhance the recruitment process, but there is a lack of evidence regarding its current use and effectiveness. Consistent with findings from the PRioRiTy I study, the current research aims to explore the advantages and disadvantages to using technology during the recruitment process for RCTs.

Methods: Semi-structured interviews (n=7) were conducted with researchers involved in RCT recruitment in Ireland. Subsequently, a Public & Patient Involvement (PPI) panel focus group (n=3) was conducted to add further depth to these findings. The data were qualitatively analysed through 'Reflexive Thematic Analysis' to extract prominent themes.

Results: A superordinate theme arose: 'Tech is just a medium so that you can reach more people', along with two themes, which were corroborated by the PPI focus group: 'Technology is used if and when the benefits outweigh the costs' and 'Success of recruitment through technology depends on the nature of the study.'

Conclusions: This study provided a deeper understanding of the factors which influence researchers to employ technology in recruitment for RCTs. Implications suggest that future researchers should aim to adapt their recruitment approaches to meet digital tool preferences of their target cohort; and engage with patient groups in the community to allow networking opportunities for future studies. This research may contribute towards maximising efficiency in RCT recruitment.

背景:尽管随机对照试验(RCT)非常重要,但为其招募足够的样本量仍是一项巨大的挑战,这会对证据的可靠性、试验的完成以及最终的患者护理产生现实影响。技术具有加强招募过程的潜力,但目前缺乏有关其使用和有效性的证据。与 PRioRiTy I 研究结果一致,本研究旨在探讨在 RCTs 征募过程中使用技术的利弊:方法:对爱尔兰参与 RCT 招募的研究人员进行了半结构式访谈(n=7)。随后,还进行了公众与患者参与(PPI)小组焦点小组讨论(人数=3),以进一步深化这些发现。通过 "反思性主题分析 "对数据进行了定性分析,以提取突出主题:结果:产生了一个超级主题:"技术只是一种媒介,这样你就可以接触到更多的人",同时还有两个主题得到了公众宣传焦点小组的证实:"如果或当收益大于成本时,就会使用技术 "和 "通过技术招募的成功与否取决于研究的性质":本研究让我们更深入地了解了影响研究人员在 RCT 征募中使用技术的因素。其启示是,未来的研究人员应努力调整其招募方法,以满足目标人群对数字工具的偏好;并与社区中的患者群体接触,为未来的研究提供建立联系的机会。这项研究可能有助于最大限度地提高 RCT 招募的效率。
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引用次数: 0
Methods of suicide used by people with cancer: a scoping review protocol 癌症患者使用的自杀方法:范围界定审查协议
Pub Date : 2024-05-21 DOI: 10.12688/hrbopenres.13886.1
D. Ni Dhalaigh, Zubair Kabir, Fahmi Ismail, Paul Corcoran, D. Wiggin, Eugene Cassidy
Background People with cancer are at a higher risk of suicide than the general population. Access to means of suicide is an important volitional risk factor that if targeted at a population level as a modifiable risk factor can reduce incidence of suicide death. People with cancer are often prescribed multiple medications that have a high case fatality when taken in overdose and therefore have increased access to specific means of high lethality self-harm. The aim of this review is to examine the methods of suicide used by people with cancer, the study designs used to explore these and what, if any, comparisons have been made to the general population. Methods This scoping review will follow JBI scoping review methodology guidelines and be reported according to PRISMA ScR checklist. A systematic search will be conducted of Embase (Elsevier), CINAHL Plus (EBSCO), PsycInfo (EBSCO), Psycharticles (EBSCO), and Pubmed (NCBI) databases and grey literature sources. A data collection tool will be specifically designed and piloted independently by two reviewers. Findings will be presented descriptively, graphically, and narratively as appropriate. Results The results of this review will identify the breadth of evidence in relation to methods of suicide used by people with cancer, explore how different methods are defined and categorised, how the topic has been studies, and ascertain if a systematic review is possible.
背景癌症患者的自杀风险高于普通人群。获得自杀手段是一个重要的自愿风险因素,如果将其作为一个可改变的风险因素在人群中加以控制,就可以降低自杀死亡的发生率。癌症患者通常会被处方多种药物,而过量服用这些药物的致死率很高,因此他们有更多机会获得高致死率的特定自残手段。本综述旨在研究癌症患者使用的自杀方法、用于探讨这些方法的研究设计以及与普通人群的比较(如果有的话)。方法 本范围界定综述将遵循 JBI 范围界定综述方法指南,并根据 PRISMA ScR 核对表进行报告。将对 Embase (Elsevier)、CINAHL Plus (EBSCO)、PsycInfo (EBSCO)、Psycharticles (EBSCO) 和 Pubmed (NCBI) 数据库及灰色文献来源进行系统检索。将专门设计数据收集工具,并由两名审稿人独立试用。研究结果将酌情以描述、图表和叙述的方式呈现。结果 本综述的结果将确定与癌症患者使用的自杀方法有关的证据的广度,探讨如何对不同的方法进行定义和分类,如何对该主题进行研究,并确定是否有可能进行系统性综述。
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引用次数: 0
The use of small group based educational interventions in General Practice to improve antimicrobial prescribing behaviours: a mixed methods systematic review protocol 在全科医生中使用以小组为基础的教育干预措施来改善抗菌药物处方行为:混合方法系统性审查方案
Pub Date : 2024-05-20 DOI: 10.12688/hrbopenres.13878.1
Kevin F. Roche, Anthony Maher, Eimear C. Morrissey, Rosie Dunne, Andrew W Murphy, Gerard J. Molloy
Background Inappropriate use of antimicrobial agents in healthcare settings is one area that has received attention as a possible route to mitigate the threat of antimicrobial resistance. Globally, the highest consumption of antimicrobials in human healthcare originates from prescriptions in Primary Care. Strategies to increase appropriate antibiotic prescribing, which can mean not prescribing an antibiotic e.g. cases of viral infection, have been developed and evaluated. This systematic review aims to review the literature of studies of group based in person educational interventions designed to increase appropriate antibiotic prescribing behaviours in General Practice settings. Methods EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, MEDLINE and PsycINFO will be systematically searched from inception until February 2024 for primary studies of group based educational interventions designed to improve the antimicrobial prescribing behaviours in General Practice. Qualitative, quantitative and mixed methods studies that report on the phenomenon of interest will be included. All identified articles will be double screened at title and abstract level. One reviewer will then screen all included studies at full text level, extract the data, code the intervention and perform risk of bias assessment with a second reviewer performing verification of a randomly selected 20% of the articles. We will use an integrated approach to mixed method systematic reviews and will perform a narrative, or if possible quantitative, synthesis. Discussion The review will identify and assess the efficacy and / or effectiveness of small group based educational interventions designed to improve the antibiotic prescribing behaviours of General Practitioners. By using a mixed methods approach we aim to identify the salient content of the included interventions and the perspectives of participants on the content and delivery of the included interventions. We will use the findings to inform the design and content of a small group educational intervention for GP registrars.
背景 在医疗保健环境中抗菌剂的不当使用是一个备受关注的领域,也是减轻抗菌剂耐药性威胁的一个可能途径。在全球范围内,人类医疗保健中消耗最多的抗菌药来自初级保健处方。已经制定并评估了增加适当抗生素处方的策略,这可能意味着在病毒感染等情况下不开具抗生素处方。本系统性综述旨在综述以小组为基础、旨在提高全科医生抗生素处方合理性的个人教育干预研究文献。方法 将对 EMBASE、CINAHL、Cochrane Central Register of Controlled Trials、MEDLINE 和 PsycINFO 进行系统检索,检索时间从开始到 2024 年 2 月,检索对象为旨在改善全科医生抗菌药物处方行为的基于小组的教育干预的主要研究。将纳入报告相关现象的定性、定量和混合方法研究。所有确定的文章都将在标题和摘要层面进行双重筛选。然后,一名审稿人将对所有纳入的研究进行全文筛选、提取数据、对干预措施进行编码并进行偏倚风险评估,第二名审稿人将对随机抽取的 20% 的文章进行核实。我们将采用混合方法系统性综述的综合方法,并进行叙述性综述,或在可能的情况下进行定量综述。讨论 本综述将确定和评估旨在改善全科医生抗生素处方行为的以小组为基础的教育干预措施的效力和/或有效性。通过采用混合方法,我们旨在确定所纳入干预措施的主要内容以及参与者对所纳入干预措施的内容和实施的看法。我们将利用研究结果为针对全科医生注册人员的小组教育干预措施的设计和内容提供参考。
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引用次数: 0
Memory-making interventions for children and their families receiving pediatric palliative or bereavement care: A systematic review protocol 为接受儿科姑息关怀或丧亲关怀的儿童及其家人提供记忆生成干预:系统性审查协议
Pub Date : 2024-05-20 DOI: 10.12688/hrbopenres.13891.1
Razieh Safarifard, Gemma Kiernan, Yvonne Corcoran, Eileen Courtney, John Mitchell, T. Akard, Veronica Lambert
Background In paediatric palliative and bereavement care, providing comprehensive support that extends beyond medical treatment to address the emotional and psychosocial needs of children and their families is essential. Memory-making interventions play a critical role in capturing cherished moments and fostering emotional resilience. However, widespread consensus on the foundation and scope of memory-making interventions in paediatric contexts remains sparse. This review aims to identify, appraise, and synthesise the evidence on memory-making interventions for children with life-limiting or life-threatening conditions and their family members receiving palliative or bereavement care. Methods This systematic review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). A systematic search will be undertaken from January 1, 1985, to February 27, 2024, across the following databases: PubMed, EMBASE, CINAHL (EBSCO), PsycINFO (EBSCO), Web of Science, the Cochrane Library, and Scopus. Studies across diverse research designs that examine children (0-19 years) with life-limiting or life-threatening conditions undergoing memory-making interventions with psychosocial or other outcomes will be included. Screening, data extraction, and quality appraisal will be performed by two independent reviewers, with a third reviewer resolving discrepancies. Joanna Briggs Institute guidelines for conducting mixed methods systematic reviews will be used to inform the data analysis and synthesis process. Conclusions This review will provide critical insights into the existing evidence base on memory-making interventions in paediatric palliative and bereavement care, highlighting psychosocial and other impacts, implementation factors, and evidence quality. By identifying best practices and gaps in knowledge, this evidence review may inform future research and intervention design, or adaptation, and contribute to the enhancement of healthcare for children with life-limiting and life-threatening conditions and their families. Registration This review was registered in PROSPERO, the International Prospective Register of Systematic Reviews (CRD42024521388; 18/03/2024).
背景 在儿科姑息治疗和丧亲关怀中,提供超出医疗范围的全面支持以满足儿童及其家人的情感和社会心理需求至关重要。建立记忆的干预措施在捕捉珍贵时刻和培养情感复原力方面发挥着至关重要的作用。然而,关于儿科记忆干预的基础和范围的广泛共识仍然很少。本综述旨在识别、评估和综合有关为患有局限生命或危及生命疾病的儿童及其接受姑息或丧亲关怀的家庭成员提供记忆干预的证据。方法 本系统性综述将遵循系统性综述和元分析首选报告项目 (PRISMA)。从 1985 年 1 月 1 日至 2024 年 2 月 27 日,将在以下数据库中进行系统检索:PubMed、EMBASE、CINAHL (EBSCO)、PsycINFO (EBSCO)、Web of Science、Cochrane Library 和 Scopus。将收录采用不同研究设计、对患有局限生命或危及生命疾病的儿童(0-19 岁)进行记忆干预并取得社会心理或其他结果的研究。筛选、数据提取和质量评估将由两名独立审稿人完成,并由第三名审稿人解决差异问题。乔安娜-布里格斯研究所(Joanna Briggs Institute)的混合方法系统综述指南将用于数据分析和综合过程。结论 本综述将为儿科姑息关怀和丧亲关怀中记忆形成干预的现有证据基础提供重要见解,突出社会心理和其他影响、实施因素和证据质量。通过确定最佳实践和知识差距,本证据综述可为未来的研究和干预设计或调整提供参考,并有助于加强对患有局限生命和危及生命疾病的儿童及其家人的医疗保健。注册 本综述已在系统综述国际前瞻性注册中心 PROSPERO 注册(CRD42024521388;18/03/2024)。
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引用次数: 0
Assessing the stability of psychobiological stress reactivity during adolescence: mixed-effect modelling of cortisol responses to laboratory stressors 评估青春期心理生物应激反应的稳定性:皮质醇对实验室应激源反应的混合效应模型
Pub Date : 2024-04-25 DOI: 10.12688/hrbopenres.13874.1
J. O'Shea, S. Dockray, Elizabeth Susman
Background Our team published a systematic review highlighting the lack of a comprehensive measure of health and wellbeing for postpartum women. The aim of this project was to examine the feasibility of a combination of existing measures, chosen for their coverage of key domains and psychometric rigour. The primary objective was to examine the validity and completeness of the novel outcome set within the first week (T1), 6 weeks (T2), and 12 weeks postpartum (T3). Secondary objectives were to examine concordance between patient-clinician reports of delivery complications and assess postpartum response rates. Methods Participants completed demographic and delivery details as well as completing a combination of existing PROM tools: the PQoL (Postpartum women’s Quality of life questionnaire), ICIQ-UI-SF (International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form) and 2 sexual health questions. Participants also rated the validity of these tools. Results The response rates were 69% (n=59)T1, 67% (n=57)T2 and 48% (41)T3. Complete responses at T1 55% (n=47),T2 53% (n=45)T3 44% (n=37). The median time taken to complete the survey was 7 minutes. Across the three time points ~70% (70.2% T1, 73.3% T2, 69% T3) of respondents felt that all outcomes that mattered most to them were captured. The difference between complication rates reported by patients and clinicians was 0% for neonatal and high-dependency unit admissions. Obstetric anal sphincter injury (OASI) was reported by 2 patients and 1 clinician. Postpartum haemorrhage (PPH) was reported by 4 (28%) despite electronic records recording PPH occurrence in 14 patients at T1. Conclusions A combination of tools and additional sexual health questions collected from postpartum women using an online survey across three postnatal time points appears feasible and has good validity and completeness. Patient-clinician concordance in the reporting of complication rates was high for all but PPH where patients tended to report lower rates.
背景 我们的团队发表了一篇系统性综述,强调了产后妇女的健康和幸福缺乏全面的衡量标准。本项目旨在研究现有测量方法组合的可行性,这些测量方法是根据其关键领域的覆盖范围和心理测量的严谨性而选择的。首要目标是检验产后第一周(T1)、产后 6 周(T2)和产后 12 周(T3)的新结果集的有效性和完整性。次要目标是检查患者和医生对分娩并发症报告的一致性,并评估产后反应率。方法 参与者填写人口统计学和分娩详细信息,并完成现有的 PROM 工具组合:PQoL(产后妇女生活质量问卷)、ICIQ-UI-SF(尿失禁国际咨询问卷-尿失禁简表)和 2 个性健康问题。参与者还对这些工具的有效性进行了评分。结果 T1、T2 和 T3 的回复率分别为 69%(59 人)、67%(57 人)和 48%(41 人)。完整回答率分别为:T1 55% (n=47)、T2 53% (n=45)、T3 44% (n=37)。完成调查所用时间的中位数为 7 分钟。在三个时间点中,约 70% 的受访者(70.2% T1、73.3% T2、69% T3)认为所有对他们来说最重要的结果都被记录了下来。患者和临床医生报告的并发症发生率在新生儿和重症监护室入院患者中的差异为 0%。有 2 名患者和 1 名临床医生报告了产科肛门括约肌损伤(OASI)。产后出血(PPH)有 4 例(28%),尽管电子记录显示在 T1 有 14 例患者发生了 PPH。结论 在产后三个时间点上,通过在线调查从产后妇女处收集工具和附加性健康问题的组合似乎是可行的,并且具有良好的有效性和完整性。在所有并发症发生率的报告中,除 PPH 外,患者与医生的一致性都很高,因为患者报告的 PPH 发生率往往较低。
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引用次数: 0
The impact of regulation on the quality of care in nursing homes in Ireland: a time-series analysis of change in compliance 监管对爱尔兰养老院护理质量的影响:对合规变化的时间序列分析
Pub Date : 2024-04-24 DOI: 10.12688/hrbopenres.13821.1
L. Behan, Carol Grogan, L. Keyes
Background Quality in health and social care is of paramount importance. Regulation is often used for ensuring or promoting quality in care services. Services are typically regulated by independent public authorities, which monitor services for compliance with regulations. There is limited research, however, on services’ compliance with regulations to provide a high quality of care. This study aims to examine nursing home compliance with regulations relating to quality. Methods Secondary legislation used for regulating nursing homes in Ireland was mapped to the Donabedian’s quality framework with each regulation categorised as either “structure”, “process” or “outcome”. The regulations categorised as “outcome” were determined to be quality-related regulations; such regulations were extracted and became this study’s area of focus. Published inspection reports from the regulator in Ireland for a three year period (2019 to 2021) (n=1,153) were assessed. The frequency with which the “outcome regulations” were inspected in nursing homes, and the proportion of compliance achieved, was calculated. Change in compliance levels across the three years was evaluated using Chi2 tests. Results Ten regulations were categorised as “outcome regulations” and addressed the following areas: positive behaviour; protection; residents' rights; communication; visits; personal possessions; food and nutrition; information for residents; medicines and pharmaceutical services; and complaints procedures. Compliance with two regulations (‘Regulation 9: Residents’ rights’ and ‘Regulation 11: Visits’) significantly improved during the three years (p<0.05). Compliance with ‘Regulation 12: Personal Possessions’ significantly decreased over the three years, however, so did the proportion found not compliant. While there was no significant change in the other regulations examined, compliance trended towards improvement, except for one regulation, ‘Regulation 20: Information for residents’, which trended downwards. Conclusion This analysis of national-level data found improvements in compliance across nearly all quality-related regulations demonstrating that regulation can be a positive influence on quality maintenance and improvement.
背景 医疗和社会护理的质量至关重要。监管通常用于确保或促进护理服务的质量。服务通常由独立的公共机构监管,这些机构负责监督服务是否符合规定。然而,有关服务机构遵守法规以提供高质量护理服务的研究却十分有限。本研究旨在考察养老院是否遵守与质量相关的法规。方法 将爱尔兰用于监管疗养院的二级法规与多纳比德质量框架进行映射,并将每项法规分为 "结构"、"过程 "或 "结果 "三类。被归类为 "结果 "的法规被确定为与质量相关的法规;这些法规被提取出来,成为本研究的重点领域。对爱尔兰监管机构发布的三年期(2019 年至 2021 年)检查报告(n=1,153)进行了评估。计算了疗养院检查 "结果条例 "的频率以及达到要求的比例。采用 Chi2 检验法评估了三年内合规水平的变化。结果 十项条例被归类为 "结果条例",涉及以下方面:积极行为、保护、住客权利、沟通、探访、个人物品、食品和营养、住客信息、药品和医药服务以及投诉程序。在这三年中,两项条例("条例 9:住客权利 "和 "条例 11:探访")的遵守情况明显改善(p<0.05)。条例 12:个人物品 "的合规率在三年内明显下降,但不合规的比例也有所下降。其他条例的合规情况没有明显变化,但 "条例 20:居民信息 "的合规情况呈下降趋势。结论 这份国家级数据分析发现,几乎所有与质量有关的条例的合规情况都有所改善,这表明条例对质量的保持和提高具有积极影响。
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引用次数: 0
What is known from the existing literature about the treatment of Mallet Injury using 3D printed splints? A Scoping Review Protocol 关于使用 3D 打印夹板治疗槌状损伤的现有文献有哪些?范围界定审查协议
Pub Date : 2024-04-24 DOI: 10.12688/hrbopenres.13865.1
Una M. Cronin, Alice Shannon, Micheal ó hAodha, Aidan O'Sullivan, Niamh M. Cummins, Leonard OŚullivan
Background Mallet finger injuries are a frequent cause of hospital attendance, being the fifth most common injury in the body. They are therefore a frequent cause of hospital visits. To date, these injuries have primarily been managed using generic splints. As a generic splint provides a generic fit, patients who receive these are not provided with a custom splint experience. As the size and fit of these splints are not bespoke to the patient’s anatomy, patients may not always find the fit comfortable and may find complying with these splints difficult at times. However, an opportunity is developing within healthcare where custom splinting can be obtained for some using Three-D (3D) printing. The rationale for this review is to gain an understanding of the research that has been conducted on 3D printing of mallet injury splints. Objective The objective of this scoping review is to map the current literature on 3D printing associated with mallet finger injury. Methods The Joanna Briggs Institute (JBI) methodology for scoping reviews will be used throughout along with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Two researchers will search the databases that will include CINAHL, Embase, Cochrane, EbscoHost, Medline/Pubmed, Science Direct, Web of Science, and Google Scholar. The search will include grey literature and a hand search of sources falling outside the chosen databases. Screen titles, abstracts, and full-text articles will be reviewed by two researchers independently using Rayaan software. The data extracted from the literature will first be presented in a tabulated chart followed by a narrative synthesis. Registration The protocol was registered on 6th September 2023, with the Open Science Framework. Registration DOI: https://doi.org/10.17605/OSF.IO/FSJPK
背景槌状指损伤是一种常见的医院就诊原因,是人体第五大常见损伤。因此,它们也是医院就诊的常见原因。迄今为止,这些损伤主要使用普通夹板处理。由于普通夹板提供的是通用型夹板,因此接受这种夹板治疗的患者无法获得定制夹板的体验。由于这些夹板的尺寸和合身性并不是根据患者的解剖结构量身定制的,因此患者可能并不总能感到合身舒适,而且有时可能会发现很难坚持使用这些夹板。不过,医疗保健领域正在出现一个机会,即可以利用三维打印技术为某些患者定制夹板。本综述旨在了解有关3D打印槌伤夹板的研究。目标 本综述旨在了解目前与槌状指损伤相关的 3D 打印文献。方法 采用乔安娜-布里格斯研究所 (Joanna Briggs Institute,JBI) 的范围界定综述方法以及范围界定综述的系统综述和 Meta 分析首选报告项目扩展 (PRISMA-ScR)。两名研究人员将检索包括 CINAHL、Embase、Cochrane、EbscoHost、Medline/Pubmed、Science Direct、Web of Science 和 Google Scholar 在内的数据库。搜索将包括灰色文献和所选数据库之外的手工搜索。筛选出的标题、摘要和全文将由两名研究人员使用 Rayaan 软件独立审阅。从文献中提取的数据将首先以表格的形式呈现,然后进行叙述性综合。注册 本协议于 2023 年 9 月 6 日在开放科学框架下注册。注册 DOI: https://doi.org/10.17605/OSF.IO/FSJPK
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引用次数: 0
Primary care prescribing prior to lung cancer diagnosis (PPP-Lung): protocol for a systematic review 肺癌诊断前的基层医疗处方(PPP-Lung):系统性审查协议
Pub Date : 2024-04-24 DOI: 10.12688/hrbopenres.13798.1
Benjamin Jacob, Vivian X. W. Teng, Delphi Morris, Bethany Wickramsinghe, F. Moriarty, Heather Burns, Kathleen Bennett, Patrick Redmond
Background Lung cancer is the second most common cancer and the leading cause of cancer death worldwide. A significant reason for its high mortality is delayed diagnosis, with lung cancer typically diagnosed at an advanced stage. Previous research has shown that prescribing rates of certain medications increase in the 24 months preceding a cancer diagnosis. This suggests a potential opportunity for early diagnosis of lung cancer by the identification of high-risk patients based on the prescribing of medications associated with a subsequent lung cancer diagnosis. Our aim is to identify all prescribing events associated within an increased incidence of primary lung cancer in the subsequent 24 months. Methods We will conduct a systematic review, and, where possible, a meta-analysis, reporting the findings in accordance with the PRISMA reporting guideline. All peer-reviewed studies in the English language that quantitatively describe an association between prescribing data and lung cancer diagnosis using a control group will be eligible. Details regarding prescribing rate in the lung cancer group versus the control group will be extracted with study characteristics. Quality appraisal of studies, using ROBINS-E will be used for assessing risk of bias. For each drug studied, we will report prescribing rate ratios (PRRs) with 95% confidence intervals (CIs). A meta-analysis using a pooled estimate of PRRs, either by fixed or random-effect models, will be performed if possible. Conclusions This systematic review will summarise the evidence on drugs that, when prescribed, suggest the possibility of an as-yet-undiagnosed lung cancer. This research has the potential to impact clinical practice by informing targeted screening strategies and refining early detection protocols for this harmful disease. If achieved, this could increase the numbers of lung cancers diagnosed at an earlier stage, with consequent improvements to patients in terms of survival, treatment tolerability and quality of life.
背景 肺癌是全球第二大常见癌症,也是导致癌症死亡的主要原因。肺癌死亡率高的一个重要原因是诊断延迟,肺癌通常在晚期才被确诊。以往的研究表明,在癌症确诊前的 24 个月内,某些药物的处方率会增加。这表明,根据与随后的肺癌诊断相关的药物处方来识别高危患者,是早期诊断肺癌的潜在机会。我们的目标是确定在随后 24 个月内与原发性肺癌发病率增加相关的所有处方事件。方法 我们将进行系统回顾,并在可能的情况下进行荟萃分析,按照 PRISMA 报告指南报告研究结果。所有通过同行评议、使用对照组定量描述处方数据与肺癌诊断之间关系的英文研究均符合条件。肺癌组与对照组的处方率详情将与研究特征一起提取。将使用 ROBINS-E 对研究进行质量评价,以评估偏倚风险。对于所研究的每种药物,我们将报告处方率比(PRR)及 95% 置信区间(CI)。如有可能,我们将采用固定或随机效应模型对处方率比进行汇总估算,并进行荟萃分析。结论 本系统综述将总结有关药物的证据,这些药物在处方时提示可能存在尚未确诊的肺癌。这项研究有可能影响临床实践,为有针对性的筛查策略提供依据,并完善这一有害疾病的早期检测方案。如果能做到这一点,就能增加早期诊断出肺癌的人数,从而提高患者的生存率、治疗耐受性和生活质量。
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引用次数: 0
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HRB open research
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