JBI database of systematic reviews and implementation reports
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JBI Database System Rev Implement Rep · Mar 2016
ReviewExperiences and management of fatigue in everyday life among adult patients living with heart failure: a systematic review of qualitative evidence.
Fatigue, a common and distressing symptom of heart failure, is a non-specific, invisible and subjective experience, which is difficult to describe and for which there are no effective interventions. Fatigue negatively impacts on patients' everyday life, prognosis and quality of life, therefore it is important that patients can manage, monitor and respond to changes in fatigue. To cope with fatigue patients may need or seek advice on self-management strategies. ⋯ Further qualitative research is needed to consider cultural factors of importance for managing fatigue in everyday life among patients with heart failure. Furthermore research should explore and test different kinds of physical and mind-body activities on the patients' functional capacity and wellbeing.
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JBI Database System Rev Implement Rep · Mar 2016
The prevalence of burnout in health professionals working in palliative care: a systematic review protocol.
The objective of this review is to examine the evidence on the prevalence of burnout among health professionals working in palliative care. More specifically, the review focuses on the following questions: What is the prevalence of burnout among health professionals working in palliative care? Is there a difference in the prevalence of burnout in different subgroups of health professionals working in palliative care (such as, but not limited to, nurses, physicians, social workers, psychologists)? Is there a difference in the prevalence of burnout among health professionals working in different contexts of palliative care (palliative care units, home care, hospices)?
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JBI Database System Rev Implement Rep · Feb 2016
Review Comparative StudyThe effectiveness of patient navigation programs for adult cancer patients undergoing treatment: a systematic review.
Advancements in technology and medical treatment have made cancer care treatment more complex. With the current trend of sub-specialization in health care, cancer patients commonly receive care from multiple specialists and have wider treatment options. In view of this, there is a need to coordinate care and integrate information to enhance care and quality of outcomes for patients. Since the successful implementation of programs for increasing the survival rate of breast cancer patients at Harlem Hospital Center, New York, USA, patient navigation programs have been widely introduced in healthcare settings. Some literature has identified nurses as a primary candidate in assuming the role of a navigator. However, there is a need to further explore the effectiveness of patient navigation programs for their effectiveness in improving quality of life, and patient satisfaction and outcomes during the commencement of cancer treatment. ⋯ Nurse-led patient navigation programs were not effective in addressing outcomes such as quality of life and distress levels, the systematic review did not find any significant difference between the two groups. However, there was a statistically significance difference in increasing patient satisfaction.There is limited evidence that patient navigation programs improve the outcomes of quality of life and reduce distress (for adult patients with cancer undergoing treatment). However, there is good evidence that patient navigation programs improve patients' satisfaction. Therefore it is recommended that patient navigation programs are used for adult cancer patients in the acute care setting to improve patients' satisfaction.There may be a need to explore a more rigorous evaluation of nurse-led navigation programs to determine their effectiveness. Researchers should consider multi-site studies and larger sample sizes for better generalization.
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JBI Database System Rev Implement Rep · Feb 2016
Review Meta AnalysisEffectiveness of discharge interventions from hospital to home on hospital readmissions: a systematic review.
Many discharge interventions are developed to reduce unplanned hospital readmissions, but it is unclear which interventions are more effective. ⋯ Interventions designed to improve the care transition from hospital to home are effective in reducing hospital readmission. These interventions preferably start in the hospital and continue after discharge rather than starting after discharge. Enhancing patient empowerment is a key factor in reducing hospital readmissions.Interventions to reduce hospital readmissions should start during hospital stay and continue in the community (grade A recommendation). This requires financial systems to support and facilitate collaboration between hospitals and home care.Interventions that support patient empowerment are more effective in reducing hospital readmissions (grade B recommendation). To promote patient empowerment caregivers must be trained to increase patients' capacity to self-care.Future research should focus on interventions that improve patient empowerment and the effects of discharge interventions after more than three months.
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JBI Database System Rev Implement Rep · Feb 2016
ReviewThe experience of adults who choose watchful waiting or active surveillance as an approach to medical treatment: a qualitative systematic review.
"Watchful waiting" or "active surveillance" is an alternative approach in the medical management of certain diseases. Most often considered appropriate as an approach to treatment for low-risk prostate cancer, it is also found in the literature in breast cancer surveillance, urinary lithiasis, lymphocytic leukemia, depression and small renal tumors. ⋯ The synthesized findings of the review conclude that the process of making the decision to choose watchful waiting is complex. Through the process patients and their significant others experience an array of emotions that often lead to uncertainty and anxiety. Once the decision is made patients must cope with the knowledge that they have a troubling diagnosis and make the necessary adjustments. An empathic, reassuring relationship with a healthcare practitioner eases the burden of this process.Healthcare providers need to recognize that not all patients are "at peace" with the decision of choosing watchful waiting. Uncertainty and fear may intensify during this time as well as feelings of stress and anxiety. Patients and their significant others often attempt to adapt in the best way they know how but the effectiveness of their coping strategies needs to be assessed. In addition, healthcare providers need to also be aware that with the increased anxiety and stress associated with watchful waiting, patients' understanding of healthcare information and the ability to ask questions may be diminished. Both providers and patients benefit from open discussions related to the many aspects of uncertainty and fear related to making and living with the decision. Employing a shared decision making model with regard to the management of the array of issues that comes from both making the decision and living with it is recommended. It appears that patients are very sensitive to recognizing when the care they are receiving lacks empathy. Communication that is open, empathic, and non-judgmental is essential. A willingness to discuss sensitive issues such as sexual function needs to be conveyed. Lastly, providers and their staff need to remain attentive to the importance of articulating aspects of the situation that are hopeful and optimistic as many patients, during their visits, take their cues regarding their health status from non-verbal and verbal interactions.Future studies should investigate.