Although South Asian populations have among the highest burden of type 2 diabetes in the world, their diabetes management remains poor. We systematically reviewed studies on South Asian patient's ...perspectives on the barriers and facilitators to diabetes management.
We conducted a literature search using OVID, CINHAL and EMBASE (January, 1990 -February, 2014) evaluating the core components of diabetes management: interactions with health care providers, diet, exercise, and medication adherence. South Asian patients were self-reported as Indian, Pakistani, Malaysian-Indian or Bangladeshi origin. From 208 abstracts reviewed, 20 studies were included (19 qualitative including mixed methods studies, 1 questionnaire). Barriers and facilitators were extracted and combined using qualitative synthesis.
All studies included barriers and few facilitators were identified. Language and communication discordance with the healthcare provider was a significant barrier to receiving and understanding diabetes education. There was inconsistent willingness to partake in self-management with preference for following their physician's guidance. Barriers to adopting a diabetic diet were lack of specific details on South Asian tailored diabetic diet; social responsibilities to continue with a traditional diet, and misconceptions on the components of the diabetic diet. For exercise, South Asian patients were concerned with lack of gender specific exercise facilities and fear of injury or worsening health with exercise. Patients reported a lack of understanding about diabetes medication management, preference for folk and phytotherapy, and concerns about the long-term safety of diabetes medications. Facilitators included trust in care providers, use of culturally appropriate exercise and dietary advice and increasing family involvement. Overall themes for the barriers included lack of knowledge and misperceptions as well as lack of cultural adaptation to diabetes management.
Diabetes programs that focus on improving communication, addressing prevailing misconceptions, and culture specific strategies may be useful for improving diabetes management for South Asians.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Aim
To understand how registered nurses implement their nursing practice in correctional institutions with healthcare governance by a health authority (e.g. Ministry of Health).
Design
Straussian ...grounded theory.
Methods
Simultaneous data collection and analysis were undertaken using theoretical sampling, constant comparison and memo writing. Thirteen registered nurses engaged in semi‐structured telephone interviews about implementing their correctional nursing practice including, providing direct care to adult offenders. Data were collected (December 2018 to October 2019) until saturation occurred. Analytic coding (open, axial and final theoretical integration) was performed to identify the core category and subcategories around which the substantive theory was developed.
Results
The theory of Caring Behind Bars refers to the process of how registered nurses implemented their correctional nursing practice to care for offenders. The core category of Caring Behind Bars is comprised of five subcategories: tension between custody and caring, adaptability and advocacy, offender population, provision of care, and challenging and positive elements.
Conclusion
Caring Behind Bars required registered nurses to address tension between custody and caring by adapting and advocating to access offenders. The provision of care required registered nurses to use assessment skills and numerous resources to provide a variety of patient focused care to offenders. The consequences of Caring Behind Bars had challenging and positive elements.
Impact
The tension provides purposeful space to continue improving teamwork among correctional officers and registered nurses. More research is required about the impact of correctional healthcare governance models on professional practice and health outcomes. Frontline registered nurses can use the theory to make informed choices when providing care. Registered nurses practising in other domains of correctional nursing (i.e. administration, education and research) can also use this theory to advance and inform practice with the goal of promoting offender health.
Background
This meta‐narrative review, conducted according to the RAMESES (Realist And Meta‐narrative Evidence Syntheses: Evolving Standards) standards, critically examines the construct of ...self‐compassion to determine if it is an accurate target variable to mitigate work‐related stress and promote compassionate caregiving in healthcare providers.
Methods
PubMed, Medline, CINAHL, PsycINFO, and Web of Science databases were searched. Studies were coded as referring to: (1) conceptualisation of self‐compassion; (2) measures of self‐compassion; (3) self‐compassion and affect; and (4) self‐compassion interventions. A narrative approach was used to evaluate self‐compassion as a paradigm.
Results
Sixty‐nine studies were included. The construct of self‐compassion in healthcare has significant limitations. Self‐compassion has been related to the definition of compassion, but includes limited facets of compassion and adds elements of uncompassionate behavior. Empirical studies use the Self‐Compassion Scale, which is criticised for its psychometric and theoretical validity. Therapeutic interventions purported to cultivate self‐compassion may have a broader effect on general affective states. An alleged outcome of self‐compassion is compassionate care; however, we found no studies that included patient reports on this primary outcome.
Conclusion
We critically examine and delineate self‐compassion in healthcare providers as a composite of common facets of self‐care, healthy self‐attitude, and self‐awareness rather than a construct in and of itself.
Patients undergoing hematopoietic stem cell transplantation (HSCT) have significant learning needs that nurses must provide. The review question was "What teaching methods and strategies have been ...examined to deliver education to patients undergoing HSCT?"
The review was conducted in November 2022 using the following databases: Scopus®, Embase®, MEDLINE®, CINAHL®, PsycINFO®, and ERIC. The search comprised two main concepts: HSCT and patient education.
The search yielded 1,458 records after duplicates were removed, and 3 studies were included in this review. The studies were critically appraised using the Mixed Methods Appraisal Tool and deemed to be of moderate quality.
Problem-solving training was the teaching method used in all three studies. Satisfaction was noted among patients and those delivering the intervention. The effect of the training on information retention or application was not measured.
Additional research is needed to explore how to best educate patients undergoing HSCT while hospitalized. Structured teaching methods may have a sound theoretical basis and warrant additional investigation using more rigorous research methods.
•Helping Health Professionals (HHP) an students are among the highest risk occupational groups for compromised mental and physical health.•To examine the effectiveness of yoga interventions at ...ameliorating at mental and physical disorders among HHPs and students, an exhaustive systematic search was conducted.•Most frequently reported findings of yoga interventions included a reduction in stress, anxiety, depression, and musculoskeletal pain.•Mental and physical benefits can be obtained through implementation of yoga interventions for HHPs and HHP students across a variety of settings and backgrounds.•Researchers would benefit from following recommended guidelines for the design and reporting of yoga interventions to improve study quality and rigour.
Helping Health Professionals (HHP) and HHP students are among the highest risk occupational groups for compromised mental and physical health. There is a paucity of information regarding preventive interventions for mental and physical health in this group of healthcare providers.
The objective of this review was to examine the effectiveness of yoga interventions for the prevention and reduction of mental and physical disorders among HHPs and HHP students.
An exhaustive systematic search was conducted in May 2020. Databases searched in the OVID interface included: MEDLINE(R) and Epub Ahead of Print, In-Process & Other Non-Indexed Citations and Daily, Embase, and PsycINFO. EbscoHost databases searched included: CINAHL Plus with Full Text, SPORTDiscus with Full Text, Alt HealthWatch, Education Research Complete, SocINDEX with Full Text, ERIC, and Academic Search Complete. Scopus was also searched.
The search yielded 4,973 records, and after removal of duplicates 3197 records remained. Using inclusion and exclusion criteria, titles and abstracts were screened and full text articles (n = 82) were retrieved and screened. Twenty-five studies were identified for inclusion in this review. Most frequently reported findings of yoga interventions in this population included a reduction in stress, anxiety, depression, and musculoskeletal pain.
It is our conclusion that mental and physical benefits can be obtained through implementation of yoga interventions for HHPs and HHP students across a variety of settings and backgrounds. However, researchers would benefit from following recommended guidelines for the design and reporting of yoga interventions to improve study quality and rigour.
Aims and objectives
To develop an understanding of south Asian and Chinese people's preferences about where to find health information and how best to receive health information, relative to their ...white counterparts.
Background
South Asian and Chinese ethnic groups represent the largest proportion of Canada's growing visible minorities. There may be challenges to ensuring that south Asian and Chinese people have access to health information in the same way that others do.
Design
Qualitative descriptive.
Methods
Fifty‐two participants (12 white, 16 south Asian and 24 Chinese) engaged in six focus groups (two for each ethnocultural group). Focus groups were conducted in English, Punjabi and Cantonese, with the assistance of Punjabi and Cantonese interpreters. Questions were focused on how participants have preferred or would prefer to receive health information (e.g., when, where, what format, from whom), as well as the facilitators and barriers to understanding the health information.
Results
Participants agreed that although physicians were their primary source for health information, they also used written materials, media and the Internet to glean information. Participants identified concerns regarding the use of technical jargon by healthcare providers. South Asians and Chinese referred to their English language fluency and the lack of ethnoculturally specific information as additional challenges to understanding information they were offered. Whether and how family members were included in the communication process, also varied by ethnocultural group.
Conclusions
As Canada welcomes immigrants from other countries, and its population becomes more diverse, healthcare providers need to have an understanding of the potential diversity in how to approach offering health information.
Relevance to clinical practice
Healthcare providers need to consider what people of different ethnocultural backgrounds need when developing effective health communication strategies.
Background Cardiac rehabilitation and secondary prevention programs can prevent heart disease in high-risk populations. However, up to half of all patients referred to these programs do not ...subsequently participate. Although age, sex, and social factors are common predictors of attendance, to increase attendance rates after referral, the complex range of factors and processes influencing attendance needs to be better understood. Methods A systematic review using qualitative meta-synthesis was conducted. Ten databases were systematically searched using 100+ search terms until October 31, 2011. To be included, studies had to contain a qualitative research component and population-specific primary data pertaining to program attendance after referral for adults older than 18 years and be published as full articles in or after 1995. Results Ninety studies were included (2010 patients, 120 caregivers, 312 professionals). Personal and contextual barriers and facilitators were intricately linked and consistently influenced patients' decisions to attend. The main personal factors affecting attendance after referral included patients' knowledge of services, patient identity, perceptions of heart disease, and financial or occupational constraints. These were consistently derived from social as opposed to clinical sources. Contextual factors also influenced patient attendance, including family and, less commonly, health professionals. Regardless of the perceived severity of heart disease, patients could view risk as inherently uncontrollable and any attempts to manage risk as futile. Conclusions Decisions to attend programs are influenced more by social factors than by health professional advice or clinical information. Interventions to increase patient attendance should involve patients and their families and harness social mechanisms.
Collaborative approaches to vascular access selection are being increasingly encouraged to elicit patients’ preferences and priorities where no unequivocally superior choice exists. We explored how ...patients, their caregivers, and clinicians integrate principles of shared decision making when engaging in vascular access discussions.
Qualitative description.
Semistructured interviews with a purposive sample of patients, their caregivers, and clinicians from outpatient hemodialysis programs in Alberta, Canada.
We used a thematic analysis approach to inductively code transcripts and generate themes to capture key concepts related to vascular access shared decision making across participant roles.
42 individuals (19 patients, 2 caregivers, 21 clinicians) participated in this study. Participants identified how access-related decisions follow a series of major decisions about kidney replacement therapy and care goals that influence vascular access preferences and choice. Vascular access shared decision making was strengthened through integration of vascular access selection with dialysis-related decisions and timely, tailored, and balanced exchange of information between patients and their care team. Participants described how opportunities to revisit the vascular access decision before and after dialysis initiation helped prepare patients for their access and encouraged ongoing alignment between patients’ care priorities and treatment plans. Where shared decision making was undermined, hemodialysis via a catheter ensued as the most readily available vascular access option.
Our study was limited to patients and clinicians from hemodialysis care settings and included few caregiver participants.
Findings suggest that earlier, or upstream, decisions about kidney replacement therapies influence how and when vascular access decisions are made. Repeated vascular access discussions that are integrated with other higher-level decisions are needed to promote vascular access shared decision making and preparedness.
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Referral to cardiac rehabilitation and secondary prevention programs remains very low, despite evidence suggesting strong clinical efficacy. To develop evidence-based interventions to promote ...referral, the complex factors and processes influencing referral need to be better understood.
We performed a systematic review using qualitative meta-synthesis.
A comprehensive search of 11 databases was conducted. To be included, studies had to contain a qualitative research component wholly or in a mixed method design. Population specific data or themes had to be extractable for referral to programs. Studies had to contain extractable data from adults >18 years and published as full papers or theses during or after 1995.
A total of 2620 articles were retrieved: out of 1687 studies examined, 87 studies contained data pertaining to decisions to participate in programs, 34 of which included data on referral. Healthcare professional, system and patient factors influenced referrals. The main professional barriers were low knowledge or scepticism about benefits, an over-reliance on physicians as gatekeepers and judgments that patients were not likely to participate. Systems factors related to territory, remuneration and insufficient time and workload capacity. Patients had limited knowledge of programs and saw physicians as key elements of referral but found the process of attaining a referral confusing and challenging.
The greatest increases in patient referral to programs could be achieved by allowing referral from non-physicians or alternatively, automatic referral to a choice of hospital or home-based programs. All referring health professionals should receive educational outreach visits or workshops around the ethical and clinical aspects of programs.
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