Psychosocial interventions to improve social functioning of children and adolescents with chronic physical conditions: A systematic review

A systematic review of studies evaluating the effect of psychosocial interventions on social functioning in youth (aged 8–18 years) with chronic physical health conditions was conducted. Following the PRISMA guidelines, 13 studies met inclusion criteria. Format and content of interventions and outcome measures varied significantly across studies, precluding meta-analysis. Despite small effect sizes, the findings provide promising support for decreased loneliness and peer problems following intervention, as well as improvements in prosocial behaviors and social acceptance. Many interventions focused largely on communicating about the health condition and were not designed to address a broad range of social difficulties. Targeted interventions to address the unique social challenges of this population may result in improved social functioning.     

Educational interventions to improve handover in health care: a systematic review

Medical Education 2011: 45 : 1081–1089 Context Effective handover within the health care setting is vital to patient safety. Despite published literature discussing strategies to improve handover, the extent to which educational interventions have been used and how such interventions relate to the published theoretical models of handover remain unclear. These issues were investigated through a systematic review of the literature. Methods Any studies involving educational interventions to improve handover amongst undergraduate or postgraduate doctors or nurses were considered. A standardised search of online databases was carried out independently by both authors and consensus reached on the inclusion of studies. Data extraction and quality assessment were also completed independently, after which a content analysis of interventions was conducted and key themes extracted. Results Ten studies met the inclusion criteria. Nine studies reported outcomes demonstrating improved attitudes or knowledge and skills, and one demonstrated transfer of skills to the workplace. Amongst the included studies, the strength of conclusions was variable. Poor reporting of interventions impeded replication. Analysis of available content revealed themes in three major areas: teamwork and leadership; professional responsibility with regard to error prevention, and information management systems. Methods used included exercises based on simulation and role‐play, and group discussions or lectures focused on errors and patient safety. Conclusions There is a paucity of research describing educational interventions to improve handover and assessing their effectiveness. The quality of published studies is generally poor. Some evidence exists to demonstrate that skills can be transferred to the workplace, but none was found to demonstrate that interventions improve patient safety.     

A systematic review of Indigenous caregiver functioning and interventions

Purpose

There is a global increase in chronic, degenerative illnesses that require long-term intervention and support as a result of the aging population. The majority of support needs are met by informal family caregivers. While there have been three decades of research focusing on caregivers in general, the extent to which research has focused on Indigenous caregivers is unclear. Worldwide, Indigenous peoples face severe economic and health disadvantages that may make them even more vulnerable to the negative aspects of informal caregiving. The current systematic review aimed to synthesize the extant literature on Indigenous caregiver functioning and the interventions that are efficacious in alleviating Indigenous caregiver distress.

Methods

Systematic review Inclusion criteria were peer-reviewed quantitative studies examining Indigenous caregiver functioning or evaluating Indigenous caregiver interventions.

Results

1172 unique records were located in the final search undertaken; only 7 articles, representing 6 unique studies, met the full inclusion criteria. Most studies contained numerous methodological weaknesses that compromised the reliability and validity of findings. Available studies suggest poor health and high burden among Indigenous relative to non-Indigenous caregivers. However, high levels of positive aspects of caregiving were reported in one study. A single intervention study suggests that poor health outcomes among Indigenous caregivers can be alleviated, though the quality and focus of this study was sub-optimal.

Conclusions

Overall, there is very little quality evidence around Indigenous caregiver functioning. Future research in this area would benefit from greater adherence to the standards of research that contribute to a strong and reliable evidence base.

     

Counseling interventions delivered in women with breast cancer to improve health-related quality of life: a systematic review

Background

Higher survival rates for breast cancer patients have led to concerns in dealing with short- and long-term side effects. The most common complications are impairment of shoulder functions, pain, lymphedema, and dysesthesia of the injured arm; psychological consequences concern: emotional distress, anxiety, and depression, thereby, deeply impacting/affecting daily living activity, and health-related quality of life.

Objective

To perform a systematic review for assessing the efficacy or effectiveness of interventions aiming at improving health-related quality of life, return to daily activity, and correct lifestyles among breast cancer patients.

Methods

A literature search was conducted in December 2016 using the databases PubMed and Scopus. Search terms included: (counseling) AND (breast cancer) AND (quality of life). Articles on counseling interventions to improve quality of life, physical and psychological outcomes were included.

Results

Thirty-five articles met the inclusion criteria. The interventions were grouped in five main areas: concerning lifestyle counseling interventions, related to combined interventions (physical activity and nutritional counseling), physical therapy, peer counseling, multidisciplinary approach, included psychological, psycho-educational interventions, and cognitive-behavior therapy (CBT). Exercise counseling as well as physical therapy are effective to improve shoulder mobility, healing wounds, and limb strength. Psychological therapies such as psychoeducation and CBT may help to realize a social and psychological rehabilitation.

Conclusion

A multidisciplinary approach can help in sustaining and restoring impaired physical, psychosocial, and occupational outcomes of breast cancer patients.

     

Cost-effectiveness of interventions to support self-care: a systematic review

OBJECTIVES: Interventions to support patient self-care of their condition aim to improve patient health and reduce health service costs. Consequently, they have attracted considerable policy interest. There is some evidence of clinical effectiveness but less attention has been paid to whether these interventions are cost-effective. This study examines the quality and quantity of existing evidence of the cost-effectiveness. METHODS: A systematic review was carried out to assess the extent and quality of economic evaluations of self-care support interventions. Thirty-nine economic evaluations were assessed against a quality checklist developed to reflect the special features of these interventions. RESULTS: The majority of the studies claimed that self-care support interventions were cost-effective or cost saving. The overall quality of economic evaluations was poor because of flaws in study designs, especially a narrow definition of relevant costs and short follow-up periods. CONCLUSIONS: The current evidence base does not support any general conclusion that self-care support interventions are cost-effective, but ongoing trials may provide clearer evidence.     

Influenza vaccination for healthcare workers who work with the elderly: systematic review

Aim

To identify studies of influenza vaccination of HCWs and influenza in elderly residents in long-term care facilities.

Scope

We searched seven electronic databases for randomised controlled trials (RCTs) and non-RCTs. Two reviewers independently extracted data and assessed trial quality.

Conclusions

The key outcomes are serologically proven influenza, pneumonia, and deaths from pneumonia, and pooled data from three C-RCTs showed no effect. Pooled data from three C-RCTs showed lower resident all-cause mortality, but as influenza constituted less than 10% of all deaths even in epidemic years we question the appropriateness of this outcome measure. Pooled data from three C-RCTs showed vaccination of HCWs reduced ILI and data from one C-RCT that HCW vaccination reduced GP consultations for ILI, but as influenza constitutes less than 25% of ILI and we did not show that HCW influenza vaccination reduced serologically proven influenza we question whether this effect is due to confounding.     

Workplace-based work disability prevention interventions for workers with common mental health conditions: a review of the literature

Introduction To summarize evidence on workplace-based work disability prevention (WDP) interventions in workers with common mental health conditions (CMHCs). Primary outcomes of interest were work absence duration and work functioning; secondary outcomes were quality of life, and economic costs. Methods We conducted a systematic literature search in 5 electronic databases (MEDLINE, EMBASE, CINAHL, PsychINFO, Web of Science) for studies published from 2007 to 2009. Two reviewers screened for studies: (1) Targeting workers with CMHCs absent from, or struggling at, work; (2) evaluating workplace-based WDP interventions; (3) assessing our primary outcome(s); and (4) with controlled trials. Quality assessment (using 29 criteria) was performed by two reviewers. Results Our search yielded 671 abstracts: 8 eligible studies and of sufficient quality. We identified three main intervention elements: (a) Facilitation of access to clinical treatment; (b) Workplace-based high-intensity psychological intervention; and (c) Facilitation of navigation through the disability management system. Moderate evidence was found that facilitation of treatment improved work functioning, quality of life and economic outcomes, with limited evidence for work absence duration. Moderate evidence was found that psychological interventions, primarily cognitive-behavioral therapy, improved work functioning, quality of life, and economic outcomes. Moderate evidence indicated that facilitation of navigation through the disability management system improved work absence duration. Conclusions Workplace-based interventions could improve work disability outcomes for workers with CMHCs. Facilitation of access to clinical treatment, and workplace-based high-intensity psychological intervention were most effective in improving work functioning and quality of life, and in reducing costs.     

Effect of MSDs and scope of ergonomic interventions among rubber processing workers: a systematic review

Background:The rubber processing workers experience various types of musculoskeletal disorders (MSDs) due to awkward postures, repetitive movements, and manual loads etc. Research on MSDs and ergonomic interventions in this area is limited. Therefore, the present systematic review aims to (i) identify various operations done by rubber processing workers and their associated MSDs, (ii) explore the ergonomic intervention and post-intervention study and its impact among the workers, (iii) identify the research gaps in MSDs and ergonomic interventions through bibliometric analysis.Methods:Comprehensive electronic searches were conducted in Web of Science, ScienceDirect and PubMed for the search term “Ergonomics” or “Musculoskeletal disorder” and “Rubber” for the article published before 2020. Eleven papers were identified for the review of MSDs and ergonomic interventions; data were extracted to summarize sample size, data collection methods, analyzing tools, various operations, MSDs, and ergonomic interventions.Results:The reviewed article is classified according to various operations such as rubber tapping, latex collection, rubber sheeting and sheet pressing. The review reveals that most of the workers experience lower back pain, which involved a traditional way of operating. Every author is trying to recommend some interventions, but post-intervention studies are limited.Conclusions:Due to the limited post-intervention study, there is a scope of ergonomic interventions in every operation. So, the implementation of a proper ergonomic tool with adequate awareness improves the MSDs among the rubber processing workers. The review will help to identify the various intervention gaps in different operations associated with rubber farming.     

The treatment of generalised anxiety disorder. A systematic review

We have reviewed the treatment of generalised anxiety disorder (GAD). Previous systematic reviews, clinical guidelines, and controlled trials were critically appraised, and described. Cognitive therapy, anxiety management therapy, certain antidepressants (paroxetine, imipramine, trazodone, opipramol), benzodiazeines and buspirone are effective treatments for GAD. The application of these findings in the clinical situation was discussed.     

A systematic review of interventions to improve recall of medical advice in healthcare consultations

Background

In order for patients to adhere to healthcare advice, it is essential that they are able to recall this following a consultation. Although psychological research exists which highlights techniques and factors postulated to influence recall, only a limited body of work has been conducted to evaluate their effectiveness in a clinical context.

Aim

To carry out a systematic review of intervention trials designed to enhance recall of medical information.

Methods

We searched Medline (1950–April 2007); Embase (1980–April 2007); Cinahl (1982–April 2007); PsychINFO (1969–2007); and the Cochrane Library Collection. Secondary searches were made through reference to relevant journals and reference lists from relevant papers/review papers.

Results

From 69 papers provisionally identified, 34 papers met the inclusion criteria. Nine recall interventions had been evaluated (audio recordings, written materials, adjunct questions, prompt sheets, visual aids, cognitive strategies, rehearsal, communication styles and personalized teaching). Despite the experimental and theoretical evidence which could have informed cognitive interventions to enhance recall of healthcare advice, most studies primarily focused on the use of written and/or audio-recorded medical instructions. Although the majority of studies supported these approaches insofar as they enhanced recall, the findings were equivocal.

Conclusion

While written and tape-recorded instructions appear to improve recall in most situations, a dearth of interventions incorporating psychological theory was readily apparent. Further research is required in clinical settings to determine if cognitive interventions based on a more over-arching psychological model of recall are effective.     

Cost effectiveness of HIV and sexual reproductive health interventions targeting sex workers: a systematic review

Background

Sex workers have high incidences of HIV and other sexually transmitted diseases. Although, interventions targeting sex workers have shown to be effective, evidence on which strategies are most cost-effective is limited. This study aims to systematically review evidence on the cost-effectiveness of sexual health interventions for sex workers on a global level. It also evaluates the quality of available evidence and summarizes the drivers of cost effectiveness.

Methods

A search of published articles until May 2018 was conducted. A search strategy consisted of key words, MeSH terms and other free text terms related to economic evaluation, sex workers and sexual and reproductive health (SRH) was developed to conduct literature search on Medline, Web of Science, Econlit and the NHS Economic Evaluation Database. The quality of reporting the evidence was evaluated using the CHEERS checklist and drivers of cost-effectiveness were reported.

Results

Overall, 19 studies met the inclusion criteria. The majority of the studies were based in middle-income countries and only three in low-income settings. Most of the studies were conducted in Asia and only a handful in Sub-Saharan Africa and Latin America. The reviewed studies mainly evaluated the integrated interventions, i.e. interventions consisted a combination of biomedical, structural or behavioural components. All interventions, except for one, were highly cost-effective. The reporting quality of the evidence was relatively good. The strongest drivers of cost-effectiveness, reported in the studies, were HIV prevalence, number of partners per sex worker and commodity costs. Furthermore, interventions integrated into existing health programs were shown to be most cost-effective.

Conclusion

This review found that there is limited economic evidence on HIV and SRH interventions targeting sex workers. The available evidence indicates that the majority of the HIV and SRH interventions targeting sex workers are highly cost-effective, however, more effort should be devoted to improving the quality of conducting and reporting cost-effectiveness evidence for these interventions to make them usable in policy making. This review identified potential factors that affect the cost-effectiveness and can provide useful information for policy makers when designing and implementing such interventions.

     

Behavior-change interventions to improve hand-hygiene practice: a review of alternatives to education

Despite the role of hand hygiene in preventing infectious disease, compliance remains low. Education and training are often cited as essential to developing and maintaining hand-hygiene compliance, but generally have not produced sustained improvements. Consequently, this literature review was conducted to identify alternative interventions for compelling change in hand-hygiene behavior. Of those, interventions employing social pressures have demonstrated varying influence on an individual's behavior, while interventions that focus on organizational culture have demonstrated positive results. However, recent research indicates that handwashing is a ritualized behavior mainly performed for self-protection. Therefore, interventions that provoke emotive sensations (e.g., discomfort, disgust) or use social marketing may be the most effective.     

Do area-based interventions to reduce health inequalities work? A systematic review of evidence

Reducing health inequalities by focusing health promotion efforts on specific areas rather than individuals is based on the premise that changing something about a place may improve health outcomes for people living in that place. This paper examines the evidence base regarding the efficacy of area-based interventions by reviewing evaluations of interventions aimed at reducing inequities between groups and which are based on changing a specific place. Only 24 papers met our review criteria. The overall success of area-based interventions was difficult to gauge due to the use of multiple strategies, inadequate evaluation reports, variation in the size or type of area, insufficient funding for implementation, policy changes over the course of the program and lack of long-term evaluations. However, the value of changing a place, area or location in some way was demonstrated in several studies which were adequately funded and evaluated. Thus, there is some evidence that area-based interventions reduce inequities, but more well-designed and well-timed evaluations of outcomes are necessary to draw any firmer conclusions. Explicit attention must also be given to geographical concepts associated with an area-based approach, such as area, scale, location and locality, neighbourhood, community and place.     

Hepatitis A in workers exposed to sewage: a systematic review

OBJECTIVES—To assess whether the scientific literature supports the hypothesis that workers exposed to sewage are at higher risk of hepatitis A (HA).
METHODS—All original papers reporting epidemiological studies published in English, French, or German which reported on the risk of HA infection in workers exposed to sewage were eligible. They were identified by several methods and each original paper was assessed independently with a checklist by two people. Studies were classified according to the strength of their design. Non-eligible studies were also examined to assess the impact of publication bias. If the risk estimates diverged widely, causes for heterogeneity were assessed. A distinction was made between seroprevalence studies based on subclinical HA (defined only by the presence of anti-HA antibodies) and clinical HA.
RESULTS—17 eligible studies were identified. No indication of an increased risk of clinical HA could be found. For seroprevalence the studies with the strongest design suggested a slightly increased risk of subclinical HA with an odds ratio (OR) <2.5. Heterogeneity was considerable and precluded a meta-analysis. Considering non-eligible studies would still decrease the OR.
CONCLUSIONS—The systematic review does not confirm an increased risk of clinical HA in workers exposed to sewage. An increased risk of subclinical HA cannot be excluded but the association between seropositivity and exposure to sewage was not strong and became still weaker if publication bias was taken into account.