Journal of evaluation in clinical practice
-
Review Meta Analysis
Supplemental perioperative oxygen for reducing surgical site infection: a meta-analysis.
To assess the efficacy of supplemental perioperative oxygenation for prevention of surgical site infection (SSI). Data sources Computerized PUBMED and MEDLINE search supplemented by manual searches for relevant articles. Study selection Randomized, controlled trials evaluating efficacy of supplemental perioperative oxygenation versus standard care for prevention of SSI in patients' undergoing colorectal surgery. Data synthesis Data on incidence of SSI were abstracted as dichotomous variables. Pooled estimates of the relative risk (RR) and 95% confidence interval (CI) were obtained using the DerSimonian and Laird random effects model and the Mantel-Haenzel fixed effects model. Heterogeneity was assessed using the Cochran Q statistic and I(2). ⋯ Our analysis showed that supplemental perioperative oxygenation is beneficial in preventing SSI in patients undergoing colorectal surgery. Because of heterogeneity in study design and patient population, additional randomized trials are needed to determine whether this confers benefit in all patient populations undergoing other types of surgery. Supplemental perioperative oxygenation is a low-cost intervention that we recommend be implemented in patients undergoing colorectal surgery pending the results of further studies. Further research is needed to determine whether or not supplemental hyperoxia may cause unanticipated adverse effects.
-
Randomized Controlled Trial
A randomized controlled trial of an at-home preparation programme for Japanese preschool children: effects on children's and caregivers' anxiety associated with surgery.
To determine whether the implementation of at-home psychological preparation programme for children and family prior to surgery can reduce anxiety for Japanese preschool children undergoing herniorrhaphy and their caregivers assessed as an appropriate outpatient care. ⋯ A specially designed at-home preparation programme as an outpatient care is effective to encourage parent-child verbal interaction concerning surgery and reduce both children and caregivers' anxiety associated with surgery.
-
To investigate the presence and rates of anxiety and depression in postsurgical patients. ⋯ The results suggest that post-operative depression does occur in orthopaedic surgery. The prevalence may be higher than that reported in other surgical specialities. These findings emphasize the need for evaluation of patients' psychiatric state post-operatively.
-
This study describes the psychometric characteristics, validity and reliability of the revised version of the perceptions of care adjective checklist (PCACL-R) with women who had recently given birth. Data were collected from a national survey of women's experiences of maternity care (n = 2960). ⋯ The PCACL-R is consequently recommended as a valid, reliable, respondent acceptable and easy to administer instrument to assess women's experiences of their care during labour and childbirth. The measurement characteristics of the PCACL-R suggest that the tool could be incorporated into both clinical and research contexts with confidence. The checklist terms used are applicable to other phases of maternity care and indeed to a wide range of health care contexts. Exploratory use in with other user groups is recommended.
-
Peer feedback is well placed to play a key role in satisfying educational and governance standards in general practice. Although the participation of general practitioners (GPs) as reviewers of evidence will be crucial to the process, the professional, practical and emotional issues associated with peer review are largely unknown. This study explored the experiences of GP reviewers who make educational judgements on colleagues' significant event analyses (SEAs) in an established peer feedback system. ⋯ Acting as a peer reviewer is perceived by this group of GPs to be an important professional duty. However, the difficulties, emotions and tensions they experience when making professional judgements on aspects of colleagues' work need to be considered when developing a feasible and rigorous system of educational feedback. This is especially important if peer review is to facilitate the 'external verification' of evidence for appraisal and governance.