Musculoskeletal injuries and musculoskeletal pain are prevalent among nurses compared to many other occupational groups.
To identify interventions that may be effective at reducing the prevalence and ...impact of musculoskeletal injuries and pain in registered nurses.
Systematic review.
Seven databases were systematically searched, including MEDLINE, CINAHL, EMBASE, PsycInfo, Academic Search Complete, Health Source Nursing, and the Cochrane Database of Systematic Reviews.
Peer-reviewed journal articles reporting interventions designed to reduce the occurrence of musculoskeletal injuries and pain among registered nurses, published between January 2004 and June 2016, were eligible for inclusion. Randomised and non-randomised controlled trials, as well as studies implementing before-after designs were included. Studies investigating interventions in samples predominately comprised of nursing aides or non-nursing personnel were excluded. Relevant articles were collected and critically analysed using the Effective Public Health Practice Project methodology. Two reviewers independently extracted data and performed quality appraisals for each study. A narrative synthesis of study findings was performed.
Twenty studies met criteria for inclusion in the review. Types of interventions reported included: patient lift systems (N = 8), patient handling training (N = 3), multi-component interventions (N = 7), cognitive behavioural therapy (N = 1), and unstable shoes (N = 1). Only two studies received a ‘strong’ quality rating according to quality assessment criteria. One of these found no evidence for the effectiveness of patient handling training; the other found preliminary support for unstable shoes reducing self-reported pain and disability among nurses. Overall, evidence for each intervention type was limited.
There is an absence of high quality published studies investigating interventions to protect nurses from musculoskeletal injuries and pain. Further research (including randomised controlled trials) is needed to identify interventions that may reduce the high rates of injury and pain among nurses.
Background
Digital contact tracing (DCT) was a central component of the global response to containing COVID‐19. Research has raised concerns that DCT could exacerbate inequities, yet the experiences ...of diverse communities at greater risk from COVID‐19 are typically underrepresented.
Methods
The present study aimed to understand the perceived barriers to the adoption of the app amongst Māori, Pasifika, and disabled people. Focus groups and interviews were undertaken with Māori, Pasifika, and disability sector stakeholders and community participants.
Results
Participants (n = 34) generally expressed willingness to utilise DCT and support its adoption within the communities. Simultaneously, participants revealed how the app could marginalise community members who struggled with the usability and those distrusting of the government's COVID‐19 interventions.
Conclusions
The findings highlight how addressing communication inequality can assist in the development of contact‐tracing responses that are both effective and equitable. The study provides insights about the role of information and communication technologies as health resources.
Patient or Public Contribution
Consulting with members of the target communities was central throughout the present study, including recommendations for potential participants, participation in interviews and sharing early findings for feedback. This study reports on focus groups and interviews with individuals from Māori and disability sectors.
Compares rates of recovery (according to a measure of disability) over 24 months following injury for those with no pre-existing comorbid conditions, one comorbidity and multimorbidity from within a ...general injury population. Aims to add important knowledge to the evidence base helping researchers and health providers identify and implement better supports for those with poorer recovery rates. Source: National Library of New Zealand Te Puna Matauranga o Aotearoa, licensed by the Department of Internal Affairs for re-use under the Creative Commons Attribution 3.0 New Zealand Licence.
In Ghana, the community-based health planning and services (CHPS) policy highlights the significance of both community health management committees (CHMCs) and community health volunteers (CHVs) in ...the Ghanaian health system. However, research into their specific effects on health system improvement is scarce. Some research has focussed on the roles of the CHMCs/CHVs in implementing specific targeted health interventions but not on improving the overall health system. Therefore, this research aims to examine the role of the CHMCs and CHVs in improving the Ghanaian health system.
The study was conducted in three districts in the Ashanti region of Ghana. A total of 35 participants, mainly health service users and health professionals, participated in the study. Data were collected using semi-structured individual in-depth interviews. Participants were selected according to their patient-public engagement or community health activity roles. Data were transcribed and analysed descriptively using NVIVO 12 Plus.
We found that the effectiveness of CHMCs and CHVs in health systems improvement depends largely on how members are selected. Additionally, working through CHMC and CHVs improves resource availability for community health services, and using them in frontline community health activities improves health outcomes.
Overall, we recommend that, for countries with limited healthcare resources such as Ghana, leveraging the significant role of the CHMCs and CHVs is key in complementing government's efforts to improve resource availability for healthcare services. Community health management committees and CHVs are key in providing basic support to communities with limited healthcare personnel. Thus, there is a need to strengthen their capacities to improve the overall health system.
Abstract
Background
Community‐based health interventions have been implemented as a key strategy for achieving improved health outcomes in Ghana. Effectiveness, however, largely depends on the ...successful implementation of patient–public engagement (PPE). Although several PPE studies have been conducted in Ghana, little research has been done to understand the specific role of PPE in the context of implementing community‐based health programmes. This paper, therefore, examines the extent of PPE implementation in three selected community‐based health programmes (Community‐based Health Planning and Service CHPS, Community‐based Maternal and Child Health and Buruli Ulcer) to understand their specific effects on health outcomes.
Methods
Three focus groups, involving 26 participants, were held in three districts of the Ashanti region of Ghana. Participants were mainly health service users involving community health committee members/volunteers, residents and health professionals. They were invited to participate based on their roles in the design and implementation of the programmes. Participants focused on each of Rifkin's spider‐gram components. Data were transcribed and analysed descriptively using NVIVO 12 Plus.
Results
PPE implementation was found to be extensive across the three programmes in specific areas such as organisation and resource mobilisation. PPE was more restricted in relation to community needs assessment, leadership and management, particularly for the CHPS and Buruli Ulcer programmes.
Conclusion
Findings suggest that benefits from community‐based health interventions are likely to be greater if PPE can be widely implemented across all dimensions of the spider‐gram framework.
Abstract
Background
Actively involving patients and communities in health decisions can improve both peoples’ health and the health system. One key strategy is Patient-Public Engagement (PPE). This ...scoping review aims to identify and describe PPE research in Sub-Saharan Africa; systematically map research to theories of PPE; and identify knowledge gaps to inform future research and PPE development.
Methods
The review followed guidelines for conducting and reporting scoping reviews. A systematic search of peer-reviewed English language literature published between January 1999 and December 2019 was conducted on Scopus, Medline (Ovid), CINAHL and Embase databases. Independent full text screening by three reviewers followed title and abstract screening. Using a thematic framework synthesis, eligible studies were mapped onto an engagement continuum and health system level matrix to assess the current focus of PPE in Sub-Saharan Africa.
Results
Initially 1948 articles were identified, but 18 from 10 Sub-Saharan African countries were eligible for the final synthesis. Five PPE strategies implemented were: 1) traditional leadership support, 2) community advisory boards, 3) community education and sensitisation, 4) community health volunteers/workers, and 5) embedding PPE within existing community structures. PPE initiatives were located at either the ‘involvement’ or ‘consultation’ stages of the engagement continuum, rather than higher-level engagement. Most PPE studies were at the ‘service design’ level of the health system or were focused on engagement in health research. No identified studies reported investigating PPE at the ‘individual treatment’ or ‘macro policy/strategic’ level.
Conclusion
This review has successfully identified and evaluated key PPE strategies and their focus on improving health systems in Sub-Saharan Africa. PPE in Sub-Saharan Africa was characterised by tokenism rather than participation. PPE implementation activities are currently concentrated at the ‘service design’ or health research levels. Investigation of PPE at all the health system levels is required, including prioritising patient/community preferences for health system improvement.
Patient recall or the application of population norms are commonly used methods to estimate (unobservable) health status prior to acute-onset illness or injury; however, both measures are potentially ...subject to bias. This article reports tests of the validity of both approaches, and discusses the implications for reporting changes in health-related quality of life following acute-onset illness or injury.
Recalled pre-injury health status and health status at 5- and 12-months post-injury were collected from participants in a prospective cohort study of people injured in New Zealand. Reported post-injury health status was compared with recalled pre-injury status and New Zealand norms for two groups: those who reported having fully recovered, and those who had not.
There was a small but statistically significant difference between pre- and post-injury health state valuations for people who had fully recovered, with recalled pre-injury health status being higher than reported post-injury health. Perceived health status for those who had fully recovered was significantly higher than the population norm.
Retrospective evaluation of health status is more appropriate than the application of population norms to estimate health status prior to acute-onset injury or illness, although there may be a small upward bias in such measurements.
Māori have been found to experience marked health inequities compared to non-Māori, including for injury. Accessing healthcare services post-injury can improve outcomes; however, longer-term ...experiences of healthcare access for injured Māori are unknown. This paper reports on data from the longitudinal Prospective Outcomes of Injury Study - 10 year follow up (POIS-10) Māori study in Aotearoa/New Zealand (NZ), to qualitatively understand Māori experiences of accessing injury-related healthcare services long-term.
Follow-up telephone interviews were conducted with 305 POIS-10 Māori participants, who were injured and recruited 12-years earlier, experiencing a range of injury types and severities. Free text responses about trouble accessing injury-related health services were thematically analysed.
Sixty-one participants (20%) reported trouble accessing injury-related health services and provided free text responses. Three related themes describing participants' experiences were connected by the overarching concept that participants were engaging with a system that was not operating in a way it was intended to work: 1) Competing responsibilities and commitments encapsulates practical barriers to accessing services, such as a lack of time and having to prioritise other responsibilities such as work or whānau (family); 2) Disrupted mana refers to the feelings of personal disempowerment through, for example, receiving limited support, care or information tailored to participants' circumstances and is a consequence of patients contending with the practical barriers to accessing services; and 3) Systemic abdication highlights systemic barriers including conflicting information regarding diagnoses and treatment plans, and healthcare provider distrust of participants.
Twelve years post-injury, a considerable proportion of Māori reported experiencing barriers to accessing healthcare services. To restore a sense of manaakitanga and improve Māori access to healthcare, Māori-specific supports are required and systemic barriers must be addressed and removed.
Abstract Objectives Functional status can be affected for considerable time after injury. Individual's functional status trajectories, or pathways, following injury may provide insights into ...achieving, or not achieving, optimal functional status. This study aims to (1) investigate functional status trajectories of injured individuals over two years by multiple dimensions and, (2) determine whether there are differences in functional status trajectories between those hospitalised and non-hospitalised. Methods Data from the Prospective Outcomes of Injury Study, a longitudinal cohort ( n = 2856) of injured New Zealanders, was used. Functional status was assessed using the EQ-5D (plus a cognitive dimension) at 3, 12 and 24 months post injury. For each dimension (mobility, self-care, usual activities, pain/discomfort anxiety/depression and cognition), individual-level trajectories were created based on whether participants had attained (or exceeded) their pre-injury functional status at each time-point. Results Participants had varied pathways to attaining their pre-injury functional status which was not revealed by cross-sectional group-level data. When all dimensions were considered together, 24% of participants attained their pre-injury functional status but did not maintain it at a subsequent phase. By EQ-5D dimension, this varied from 5% (self-care) to 22% (pain/discomfort). Twenty-six percent of non-hospitalised participants attained, but did not maintain, their pre-injury status compared to 18% of those hospitalised. Conclusions Cross-sectional group-level prevalence does not adequately depict the underlying pathways experienced by individual participants. Our analyses indicate the importance of following up all study participants in longitudinal studies, including those reporting to have attained ‘recovery’ and of not under-estimating the impact of non-hospitalised injuries.
Injury is a leading cause of disability. Twenty years ago, we knew financial costs of injury were high but little was known about the short, medium and long-term outcomes after injury. In 2006, a ...Pilot Study and engagement with Māori across the country was undertaken to discuss the planned main study to understand how best to design a study that was meaningful and beneficial to Māori and policy-makers. Between 2007–2009, 2,856 injured New Zealanders (including 20% Māori) with an Accident Compensation Corporation (ACC) entitlement claim were recruited to the Prospective Outcomes of Injury Study (POIS). Participants shared detailed information (at 3, 12 and 24 months, and 12-years post-injury) about a broad range of topics including: the injury, socio-demographics, health, health services access, employment and wellbeing. Administrative data about injury-related hospitalisations, the sentinel injury and subsequent injuries were also collected, as well as in-depth qualitative interviews. This paper focuses on the why, how and impacts of POIS, especially in relation to Māori design and approaches, capability and capacity building, and leadership. Focusing on these aspects for Māori within POIS over time has ensured delivery of findings capable of informing and improving outcomes and policy. In particular, POIS has had considerable impact, influencing ACC's research strategy and outcomes' focus, and has provided disability, health, and wellbeing outcomes knowledge previously unavailable, especially for Māori.
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