Palliative care for all? A review of the evidence in community hospitals

The provision of palliative care in the UK has traditionally focused on people with cancer. People who are elderly, live in rural areas or have diagnoses other than cancer often have difficulty accessing palliative care services. Community hospitals could be important for those groups currently under-served. A literature review was conducted to determine the role played by community hospitals in the provision of palliative care in the U.K. Papers were identified using a keyword search of six electronic databases and hand search of five journals. Fifteen papers were identified according to inclusion and exclusion criteria. Findings indicate that many community hospitals in the UK already have the resources to counter inequalities in access to general palliative care. Much of the evidence uses quantitative methods based on small or non-representative samples and retrospective data collection approaches. Insufficient information about the populations involved meant that findings could not be fully interpreted. More prospective research using qualitative methods involving patients, carers and nurses is required to fully understand the complexities of providing palliative care in this setting.     

Qualitative research in palliative care 1990-1999: a descriptive review

A collaborative, evaluative review of qualitative research in palliative care published between 1990 and 1999 has been conducted. Nearly 30,000 articles in 48 journals from specialist palliative care, oncology, death studies, medicine, nursing, gerontology, health and the social sciences were examined. From these journals, 138 articles (0.5%) reporting qualitative research with a focus on palliative care in the context of death, dying or bereavement were identified. These articles were reviewed using a proforma designed by the group. This article describes the review process, and the following findings: the distribution of different forms of qualitative research in palliative care; the location of such papers; the focus of the research; and the research methodology and methods adopted.     

医学期刊发表灾害护理文献的分析

目的分析国内医学期刊发表的灾害护理文献,为灾害护理证据的生产和传播提供参考。方法检索中国知网CNKI全文数据库医药卫生专辑（1991～2010.01）,收集灾害护理相关文献,进行分类和描述性统计分析。结果 207篇文献中,2008年前发表32篇（15.47%）,2008年及以后发表175篇（85.53%）。文献分布于67种医学期刊,其中护理类17种98篇（47.34%）,非护理类50种109篇（52.66%）。统计源期刊137篇（66.18%）,其他期刊70篇（33.72%）。护理类统计源期刊收录79篇,占护理类期刊刊发数的80.61%。以经验类128篇（61.84%）,理论类60篇（28.98%）,研究类19篇（9.18%）;内容以医疗救护类94篇（61.84%）,管理类72篇（28.98%）,教育类31篇（14.98%）,其他类10篇（4.83%）;医疗救护类文献中,未见慢性病相关文献。结论 2008年是灾害护理文献增长的分界点,统计源期刊是证据的主要来源。灾害护理文献以经验类为主,涵盖灾害医疗救护、管理及教育,需要开发灾害慢性病护理证据。     

A systematic review and narrative synthesis of inclusive health and social care research with people with intellectual disabilities: How are co-researchers involved and what are their experiences?

Background

Using inclusive research methods with people with intellectual disabilities is increasingly common. A recent consensus statement identified key elements when conducting and reporting inclusive research with people with intellectual disabilities. This review identifies the range of health and social care research topics using inclusive research methodologies, systematically appraises the involvement of researchers with intellectual disabilities, and identifies facilitators and barriers to inclusive research. Researchers' experiences of engaging with inclusive research are synthesised.

Method

Seventeen empirical studies focused upon inclusive health and social care research were identified. The associated inclusive research methodologies employed, and the stages in which researchers with intellectual disabilities were involved, along with the experiences of researchers with and without intellectual disabilities were synthesised.

Results

Papers focused on a broad range of health and social care topics and largely employed qualitative or mixed-methods designs. Researchers with intellectual disabilities were frequently involved with data collection, analysis and dissemination. Facilitators of inclusive research comprised sharing power, team working, having sufficient resources and making research methodologies accessible.

Conclusions

Researchers with intellectual disabilities are involved in a wide range of methodologies and research tasks. How the added value of inclusive research is measured and its impact on outcomes, require consideration.     

Ready for a paradigm shift? Part 2: Introducing qualitative research methodologies and methods

This paper explores a number of commonly used methodologies and methods in qualitative research, namely grounded theory, case study, phenomenology, ethnography and narrative research. For each methodology a brief history of its development and variants is given, followed by typical methods of data collection and analysis. Examples of manual therapy qualitative research studies are highlighted for each methodology. Data collection methods are then discussed and include individual interviews, focus groups, observation and documentary analysis. A frequently used method of data analysis, thematic analysis, is briefly explained. Finally, the strategies to enhance the quality of qualitative research is explored and compared to those of quantitative research.     

The nursing contribution to qualitative research in palliative care 1990-1999: a critical evaluation

BACKGROUND: Qualitative research plays an important part in providing evidence for practice in nursing, and is gaining greater acceptance within medicine. However, questions remain about what criteria are most appropriate for evaluating qualitative research. To date, little systematic evaluation of qualitative research in palliative care has been conducted. AIMS: This paper is based on a larger study in which we conducted a critical review of qualitative research in palliative care from nursing, medicine, specialist palliative care, sociology, death studies, medical anthropology, and gerontology journals published between 1990 and 1999. The aim of this paper is to present an account of the strengths and weaknesses of qualitative palliative care research in nursing, using data from this review. METHODS: In the larger study, 138 papers from 50 journals were reviewed critically using a tool developed to assess both content and quality; in one part of this tool reviewers recorded open-ended comments on the strengths and weaknesses of each paper. In this paper, we present a thematic analysis of reviewers' comments on a subgroup of 67 nursing papers from the main review, together with an analysis of comments on 29 papers from a comparison group of death studies, medical anthropology, and sociology journals. Patterns of positive and negative evaluation are identified and used to generate an account of strengths and weaknesses in qualitative palliative care research in nursing. FINDINGS: Over 40% of the subgroup of papers from nursing journals received positive comments on topic and quality of writing; around 30% received positive comments on contribution to understanding, practical value, and conceptual or theoretical issues. Less than 20% received positive comments on other critical dimensions. Over 40% of nursing papers received negative comments on the link between data, analysis, and findings, other aspects of method and theoretical and conceptual issues. A higher proportion of papers in the comparison group received positive comments on conceptual and theoretical issues and contribution to understanding. CONCLUSIONS: Nearly half the nursing papers reviewed were judged to be well written or to have a well-chosen topic. However, more than 40% of papers drew negative comments about key methods-related issues. Arguably therefore efforts to improve the quality of research evidence should focus on this area.     

Bibliometric analysis of papers on mild cognitive impairment nursing in China

PurposeTo supply further references by analyzing the status of research on mild cognitive impairment nursing in China.MethodsPapers on mild cognitive impairment nursing published between 2005 and 2014 were collected from China National Knowledge Infrastructure, Wanfang Data, and China Biological Medicine database, while their publication dates, journals, and types were subjected to a bibliometric analysis using NoteExpress and Excel.ResultsA total of 68 papers were collected from the selected databases. The number of papers on mild cognitive impairment nursing increased annually. The selected papers were published in 44 journals, 55.88% of them were published in core journals, 35.29% received funding support, 35.29% were published by hospitals affiliated to colleges, 47.06% were published by other local hospitals, author collaboration is 2.66, and 66.18% showed co-authorship. These papers covered a wide range of topics, but were only conducted based on clinical interventions. Around 29.41% of these papers had a citation frequency of over 5, the highest citation frequency was 29, and the highest h-index was 23.ConclusionBeijing and Shanghai established core author groups for mild cognitive impairment nursing research. These studies should focus on the community and psychological nursing of such impairment. Targeted nursing interventions on different types of mild cognitive impairment should be adopted, new avenues for research should be opened, and various research methods should be introduced.     

从文献分析看我国护生关怀能力培养的研究现状

目的分析我国护理专业护生关怀能力培养的教育教学现状,为关怀护理教学的实施和改革提供依据。方法检索截至2011年12月的中国生物医学文献数据库、维普数据库、中国知网数据库和万方全文数据库有关护生关怀能力教育教学的文献,用文献计量法和内容分析法对获取文献进行分析。结果共检出文献45篇,来源于不同层次院校和综合医院,涉及中专、大专、本科各层次护理学生,研究的重点为关爱能力培养的现状和影响因素分析,文献类型以现状调查研究为主,质性研究最少。结论关怀能力培养的研究日益受重视,影响因素和培养策略逐步被提出,但具体教学内容、教学策略、教材编写、课程设置、评价方法需要进一步研究。     

国内护理领域高影响力期刊2016~2018年发表质性研究报告的质量评价

目的评价中国科学引文数据库(Chinese science citation database,CSCD)收录护理类期刊发表的质性研究报告质量。方法计算机检索CSCD数据库,搜集CSCD收录的4本护理期刊发表的质性研究,检索时限均为2016年1月至2018年12月。由2名研究者独立筛选文献和提取资料后,采用COREQ清单对纳入文献进行评价,使用SPSS 25.0软件进行统计分析。结果共纳入223篇质性研究,COREQ清单评价结果显示:43.8%(14/32)的条目充分报告率低于50%,其中78.6%(11/14)的条目充分报告率低于20%,条目4的充分报告率为0。亚组分析结果显示,被引频次是否≤5次和有无基金资助在COREQ各条目上的充分报告率差异无统计学意义。结论 CSCD收录护理类期刊发表的质性研究报告质量有待进一步提高,建议国内护理期刊在稿约中引入COREQ清单,并在编辑审稿和同行评议中严格执行。     

Research in Nursing in Critical Care 1995–2009: a cause for celebration

Aim: The purpose of this article is to analyse the research papers published in Nursing in Critical Care ( n = 168) over the past 15 years to examine trends in methodology, theoretical contribution and authorship.
Background: Research is a contested term and the paper starts with defining the criteria by which papers were selected for the review.
Methods: The approach undertaken was a documentary review based on an adaptation of Schatzman's dimensional analysis. Papers were loaded into a matrix then categorized and grouped to determine trends and frequency.
Conclusion: Research papers published in the journal reflect a wide range of interests and broad spread of research methods. Qualitative and quantitative data are used by authors but to distinguish papers into these two categories would be over simplistic. Systematic reviews along with randomized control trials and studies using a quasi-experimental design are the least frequently occurring approaches in the published papers, although they are growing in number in recent years. All the papers make explicit the implications for clinical practice and as such contribute to the growing body of knowledge to inform critical care nursing practice.     

Trends in publication of research papers by Australian-based nurse authors

Analysis of Australian nursing research output is becoming more important as academic institutions move into implementing quality programs of research output. Notable in determining research quality is the publication of research papers in journals with a high ranking within the Institute for Scientific Information (ISI) or Excellence in Research for Australia (ERA). This paper reports an analysis of Australian nurse researcher output in journals highly ranked by the ISI and ERA. Research abstracts were analysed for topic, sources of data, location of research and methodological paradigm. A total of 530 articles from five Australian and from five USA and UK journals were analysed. There was an increase in output from the period of prior analyses in 2000. Practice issues are the most common topic followed closely by nurse education. While most studies used nurses as sources of data there were more studies in which consumers of nursing care were the point of inquiry. Both qualitative and quantitative methods were utilised. Given the importance of rationalising nursing practice and adding new knowledge to evidence based care, it is imperative for the nursing profession to disseminate research findings. Failure to do this may result in poor return in investment outcomes for the future of nursing in Australia and internationally.     

Clarivate listed nursing journals in 2020: what they publish and how they measure use of social media

Objectives: To investigate what the most common types of articles that nursing journals purport to publish are and what they actually publish. And to investigate the extent to which academic nursing journals listed by Clarivate track alternative metrics.Methods: Journals included in the nursing Journal Citation Report (JCR) journal category in 2019 described as nursing were identified and considered suitable for inclusion in the analysis. Instructions for authors were reviewed online and mention of each type of article is identified. The tables of contents of each issue of each journal published during 2019 were examined and the types of articles published were extracted to a spreadsheet into permitted article types and published articles. Likewise, the use of alternative metrics by each journal was extracted to a spreadsheet. Pearson's and Spearman's correlation analysis was applied to investigate the relationship between articles permitted and articles published.Results: In the 2020 JCR, 123 journals were listed. The most common article type permitted was original research (n = 117),followed by review papers (n = 116), and discussion papers (n = 63). Original research (n = 7045); review papers (n = 1268);discussion papers (n = 1225); editorials (n = 793) and commentaries (n = 776) were the most commonly published categories of the article. Of journals examined, 108 (96.8％) tracked mentions on social media and the Altmetric score was most commonly used (75％). There was a strong correlation (r = 0.73; P = 0.002) between the numbers of articles permitted and published and a strong correlation (ρ = 0.86; P < 0.001) in terms of the rankings of the permitted and published articles.Conclusions: There is a relationship between the most frequently permitted article types and those published, especially for the most frequent categories of both. Original articles, review papers, and discussion papers are the backbone of academic publishing in nursing with original articles vastly outweighing review and discussion papers. Most Clarivate listed journals now use some method of tracking alternative metrics indicating how seriously publishers take their social media profiles.     

Palliative sedation: a review of the research literature

The overall aim of this paper is to systematically review the following important aspects of palliative sedation: prevalence, indications, survival, medication, food and fluid intake, decision making, attitudes of physicians, family experiences, and efficacy and safety. A thorough search of different databases was conducted for pertinent research articles published from 1966 to June 2007. The following keywords were used: end of life, sedation, terminal sedation, palliative sedation, refractory symptoms, and palliative care. Language of the articles was limited to English, French, German, and Dutch. Papers reporting solely on the sedatives used in palliative care, without explicitly reporting the prevalence or intensity of sedation, and papers not reporting on primary research (such as reviews or theoretical articles) were excluded. Methodological quality was assessed according to the criteria of Hawker et al. (2002). The search yielded 130 articles, 33.8% of which were peer-reviewed empirical research studies. Thirty-three research papers and one thesis were included in this systematic review. This review reveals that there still are many inconsistencies with regard to the prevalence, the effect of sedation, food and fluid intake, the possible life-shortening effect, and the decision-making process. Further research to clarify all of this should be based on multicenter, prospective, longitudinal, and international studies that use a uniform definition of palliative sedation, and valid and reliable instruments. Only through such research will it be possible to resolve some of the important ethical issues related to palliative sedation.     

基于Web of Science数据库护理不良事件文献的计量学分析

目的 通过Web of Science数据库了解全球护理不良事件的整体状况,为今后相关研究提供参考。方法 检索Web of Science数据库收录的关于护理不良事件的文献,利用Web of Science及书目共现系统对检索结果从文献发表数量、杂志分布、作者、发文机构、国家等方面进行分析。结果 共检索到797篇文献,研究起步较晚,文献数量大体呈逐年上升趋势。刊载文献数量最多的期刊是《American Journal of Nursing》。发文最多的国家是美国。结论 本研究发现不良护理事件的研究还未引起广泛关注。目前研究主要探讨影响护理不良事件发生的因素以及上报制度的完善,但较少文献深入探讨护理不良事件发生的本质原因,未来应形成我国文化背景的指导管理理论,形成适合本土文化的不良事件管理模式,从而进一步构建护理不良事件的干预模型。     

Variability in the assessment of adverse events in a multicenter clinical trial

BACKGROUND: Consistent documentation, characterization, and evaluation of adverse events (AEs) are needed during multicenter clinical trials to ensure accuracy of data reported to the US Food and Drug Administration and in the medical literature. OBJECTIVE: The purpose of this study was to identify and characterize variations in the assessment of AEs by clinical trial personnel. METHODS: During the annual meeting of personnel from a multicenter, controlled clinical trial of an investigational new drug treatment for opioid dependence, an oral presentation of procedures for AE data collection was given to 25 principal investigators and ancillary study personnel who assessed AEs for the study. A post-test using 3 hypothetical AE cases in which AEs were categorized by type of reaction, relatedness to study drug, severity, action taken, and outcome was completed by study participants. Cases and expected responses were reviewed for content and validity by clinical research pharmacists who were not involved with the study. The level of agreement with expected responses was assessed using McNemar symmetry chi-square tests. RESULTS: Assessments of type of AE, relatedness to study drug, and severity were less frequently aligned with expected responses than were action taken and outcome (P < 0.013). Less consistency with expected responses was found in I case than in the other 2, suggesting that certain types of AEs may be more difficult to assess. CONCLUSIONS: There was considerable variability in categorization of AEs in an exercise following training for AE data collection. Type of report, relatedness, and severity were found to have more variability in reporting than did action taken or outcome. The results suggest that unless data are gathered to verify reliability of reporting, subcategorization of AE data should be undertaken cautiously. Further research is needed regarding methods for improving consistency in reporting of AEs.     

World Health Organization Announcement

This qualitative research synthesis reviews interpretive scholarly papers on multi-disciplinary primary care teams. A bibliographic search was conducted in electronic databases: Medline, Embase, and the Web of Science Citation Index, and in the references of retrieved papers. The research consists of a taxonomic analysis of 19 qualitative studies about primary care teams published in peer-reviewed journals between 2001 and July 2008 in English and French. Nineteen qualitative studies were synthesized. Two major concerns emerged: (1) strategies for organizational change toward effective co-operative practice, and (2) dimensions of team interactions and work relations. The authors conclude that qualitative results suggest common strategies to improve the development of primary care teams, while identifying dimensions of team interactions that remain problematic. A fundamental aspect of team formation appears to be overlooked, i.e., the construction of a collective identity, which would involve the whole team in a shared ideal of co-operative practice. The adoption of discourse analysis is suggested as a more sophisticated qualitative methodology to explore this issue.