guidance

指导
  • 文章类型: Journal Article
    背景:患者参与研究的一个组成部分,也被称为耐心和公众参与,通过补偿适当地承认患者伴侣的贡献(例如,共同作者,酬金)。尽管已知补偿患者伴侣的好处,我们之前的工作表明,补偿很少报道,研究人员认为在这个问题上缺乏指导。为了解决这个差距,我们确定并总结了患者合作伙伴补偿的可用指南和政策文件.
    方法:我们按照JBI建议的方法进行了范围审查。我们搜索了灰色文献(谷歌,GoogleScholar)于2022年3月,Overton(国际政策文件数据库)于2022年4月。我们包括文章,关于患者合作伙伴对其研究贡献的补偿的指导或政策文件。两名审阅者独立提取和综合了文档特征和建议。
    结果:我们确定了65个指南或政策文件。大多数文件在加拿大出版(57%,n=37)或英国(26%,n=17)。最常见的推荐非经济补偿方法是为患者伴侣提供培训机会(40%,n=26),并促进患者伴侣出席会议(38%,n=25)。大多数指导文件(95%)建议进行财务补偿(即为他们的研究贡献提供具有货币价值的东西)患者合作伙伴。跨指导文件,经济补偿的建议货币价值相对一致,并且与患者伴侣所扮演的角色和/或具体参与活动相关.例如,获得患者伴侣反馈的中值货币价值(即,咨询)为19美元/小时(美元)(范围为12美元-50美元/小时)。我们确定了一些指导特定人群补偿的文件,包括青年和土著人民。
    结论:存在多种公开可用的资源来指导研究人员,患者合作伙伴和机构制定量身定制的患者合作伙伴补偿策略。我们的发现挑战了缺乏指导会阻碍患者伴侣经济补偿的看法。未来的努力应优先考虑这些补偿策略的有效实施,以确保患者合作伙伴得到适当的认可。
    患者伴侣共同作者告知了方案制定,标识的数据项,和解释的发现。
    BACKGROUND: An integral aspect of patient engagement in research, also known as patient and public involvement, is appropriately recognising patient partners for their contributions through compensation (e.g., coauthorship, honoraria). Despite known benefits to compensating patient partners, our previous work suggested compensation is rarely reported and researchers perceive a lack of guidance on this issue. To address this gap, we identified and summarised available guidance and policy documents for patient partner compensation.
    METHODS: We conducted this scoping review in accordance with methods suggested by the JBI. We searched the grey literature (Google, Google Scholar) in March 2022 and Overton (an international database of policy documents) in April 2022. We included articles, guidance or policy documents regarding the compensation of patient partners for their research contributions. Two reviewers independently extracted and synthesised document characteristics and recommendations.
    RESULTS: We identified 65 guidance or policy documents. Most documents were published in Canada (57%, n = 37) or the United Kingdom (26%, n = 17). The most common recommended methods of nonfinancial compensation were offering training opportunities to patient partners (40%, n = 26) and facilitating patient partner attendance at conferences (38%, n = 25). The majority of guidance documents (95%) suggested financially compensating (i.e., offering something of monetary value) patient partners for their research contributions. Across guidance documents, the recommended monetary value of financial compensation was relatively consistent and associated with the role played by patient partners and/or specific engagement activities. For instance, the median monetary value for obtaining patient partner feedback (i.e., consultation) was $19/h (USD) (range of $12-$50/h). We identified several documents that guide the compensation of specific populations, including youth and Indigenous peoples.
    CONCLUSIONS: Multiple publicly available resources exist to guide researchers, patient partners and institutions in developing tailored patient partner compensation strategies. Our findings challenge the perception that a lack of guidance hinders patient partner financial compensation. Future efforts should prioritise the effective implementation of these compensation strategies to ensure that patient partners are appropriately recognised.
    UNASSIGNED: The patient partner coauthor informed protocol development, identified data items, and interpreted findings.
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  • 文章类型: Journal Article
    目的:肌肉减少症的高患病率和对临床结局的显著影响在临床实践中引起了广泛的关注。多个组织发布了关于肌少症的指导文件,为临床实践和/或研究提供循证建议。我们旨在评估纳入文件的方法学质量,并综合现有的筛选建议,诊断,和肌少症的干预。
    方法:我们在PubMed上进行了搜索,Embase,Scopus,科克伦图书馆,中国国家知识基础设施,指南数据库,以及指导组织和专业学会的临床实践网站,关于肌少症的共识声明和立场文件,2023年4月17日之前发表的肌肉萎缩或肌肉损失。三名独立审稿人使用AGREEII工具来评估这些文件的方法学质量。
    结果:包括2010年至2023年之间发布的36个指导文件。七份文件满足了所有AGREEII领域的≥50%。七人接受了德尔菲程序,六人对建议的强度进行了评分。筛选过程(n=21),肌肉减少症的早期诊断(n=12),诊断为肌肉减少症和严重肌肉减少症(n=10),越来越多的人推荐管理(n=21)。SARC-F(n=14)是最推荐的筛查工具,肌肉功能评估被认为是诊断肌肉减少症的第一步。年龄相关和疾病相关的肌少症的管理策略主要集中在运动和营养干预上。
    结论:指导文件提供了具有重要指导意义的参考性建议。但是,建议的不一致和方法的严谨性表明缺乏高质量的证据。
    OBJECTIVE: Sarcopenia has garnered extensive attention in clinical practice since its high prevalence and significant impact on clinical outcomes. Multiple organizations have published guidance documents on sarcopenia, offering evidence-based recommendations for clinical practice and/or research. We aimed to appraise the methodological quality of the included documents and synthesize available recommendations for the screening, diagnosis, and intervention of sarcopenia.
    METHODS: We conducted a search on PubMed, Embase, Scopus, Cochrane Library, China National Knowledge Infrastructure, guideline database, and guideline organizations and professional societies websites for clinical practices, consensus statements and position papers in terms of sarcopenia, muscle atrophy or muscle loss published before April 17, 2023. The AGREE II instrument was used by three independent reviewers to assess the methodological quality of these documents.
    RESULTS: Thirty-six guidance documents published between 2010 and 2023 were included. Seven documents fulfilled ≥ 50% of all the AGREE II domains. Seven underwent a Delphi process and six graded the strength of the recommendations. The process of screening (n=21), early diagnosis of sarcopenia (n=12), diagnosis of sarcopenia and severe sarcopenia (n=10), and management (n=21) were increasingly recommended. SARC-F (n=14) was the most recommended screening tool, and the assessment of muscle function was considered the first step in diagnosing sarcopenia. The management strategy for both age-related and disease-related sarcopenia mainly focused on exercise and nutrition intervention.
    CONCLUSIONS: The guidance documents have provided referential recommendations that have great guiding significance. But the inconsistency in recommendations and variation in methodological rigour suggests that high-quality evidence is lacking yet.
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  • 文章类型: Journal Article
    认识到技术辅助交互式远程康复在不同人群中的兴趣和益处日益增加,本综述的目的是系统评价交互式远程康复治疗对改善老年人和神经系统疾病患者平衡和步态表现的影响。本系统评价的研究方案已在国际前瞻性系统评价登记册(PROSPERO)注册,其唯一标识符为CRD42024509646。2014年1月至2024年2月在WebofScience上发表的英文研究,Pubmed,Scopus,和谷歌学者进行了检查。在确认的247人中,经过初步筛选和资格筛选,选出17人,和他们的方法学质量评估与观察队列和横断面研究的美国国立卫生研究院质量评估工具。所有17项研究表明,老年人和中风患者的平衡和步态表现得到改善,帕金森病,以及通过虚拟现实进行4周或更长时间的交互式远程康复治疗后的多发性硬化症,智能手机或平板电脑应用程序,或视频会议。这项系统评价的结果可以为交互式远程康复技术的未来设计和实施提供信息,并改善老年人和神经系统疾病患者的平衡和步态训练运动方案。
    Recognizing the growing interests and benefits of technology-assisted interactive telerehabilitation in various populations, the aim of this review is to systematically review the effects of interactive telerehabilitation with remote monitoring and guidance for improving balance and gait performance in older adults and individuals with neurological conditions. The study protocol for this systematic review was registered with the international prospective register of systematic reviews (PROSPERO) with the unique identifier CRD42024509646. Studies written in English published from January 2014 to February 2024 in Web of Science, Pubmed, Scopus, and Google Scholar were examined. Of the 247 identified, 17 were selected after initial and eligibility screening, and their methodological quality was assessed with the National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-sectional Studies. All 17 studies demonstrated balance and gait performance improvement in older adults and in individuals with stroke, Parkinson\'s disease, and multiple sclerosis following 4 or more weeks of interactive telerehabilitation via virtual reality, smartphone or tablet apps, or videoconferencing. The findings of this systematic review can inform the future design and implementation of interactive telerehabilitation technology and improve balance and gait training exercise regimens for older adults and individuals with neurological conditions.
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  • 文章类型: Journal Article
    背景:罕见疾病登记处(RDR)是改善临床护理和推进研究的有价值的工具。然而,它们通常在质量上有所不同,在结构上,并且在操作上可以确定其潜在效用,作为支持有关批准和资助罕见疾病新疗法的决策的证据来源。
    目的:该研究项目的目的是回顾有关罕见疾病注册的文献,并确定提高RDR质量的最佳实践。
    方法:在本范围审查中,从2010年至2023年4月,我们搜索了MEDLINE和EMBASE以及监管机构和卫生技术评估机构的网站,以获取提供指导或建议的文献,以确保,改进,或保持RDR的质量。
    结果:搜索产生了1,175个独特的参考,其中64人符合纳入标准。被认为与其质量相关的RDR的特征与被认为是高质量RDR的最佳实践的三个主要领域和几个子领域一致:(1)治理(注册目的和描述;治理结构;利益相关者参与;可持续性;道德/法律/隐私;数据治理;文档;以及培训和支持);(2)数据(标准化疾病分类;通用数据元素;数据字典;数据收集;数据质量和保证;基础设施(虚拟基础设施的可重用性);
    结论:尽管RDR由于其人口少且分散而面临许多挑战,RDR可以通过使用关于强有力治理的标准和原则来生成高质量的数据,以支持医疗保健决策。质量数据实践,和IT基础设施。
    BACKGROUND: Rare disease registries (RDRs) are valuable tools for improving clinical care and advancing research. However, they often vary qualitatively, structurally, and operationally in ways that can determine their potential utility as a source of evidence to support decision-making regarding the approval and funding of new treatments for rare diseases.
    OBJECTIVE: The goal of this research project was to review the literature on rare disease registries and identify best practices to improve the quality of RDRs.
    METHODS: In this scoping review, we searched MEDLINE and EMBASE as well as the websites of regulatory bodies and health technology assessment agencies from 2010 to April 2023 for literature offering guidance or recommendations to ensure, improve, or maintain quality RDRs.
    RESULTS: The search yielded 1,175 unique references, of which 64 met the inclusion criteria. The characteristics of RDRs deemed to be relevant to their quality align with three main domains and several sub-domains considered to be best practices for quality RDRs: (1) governance (registry purpose and description; governance structure; stakeholder engagement; sustainability; ethics/legal/privacy; data governance; documentation; and training and support); (2) data (standardized disease classification; common data elements; data dictionary; data collection; data quality and assurance; and data analysis and reporting); and (3) information technology (IT) infrastructure (physical and virtual infrastructure; and software infrastructure guided by FAIR principles (Findability; Accessibility; Interoperability; and Reusability).
    CONCLUSIONS: Although RDRs face numerous challenges due to their small and dispersed populations, RDRs can generate quality data to support healthcare decision-making through the use of standards and principles on strong governance, quality data practices, and IT infrastructure.
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  • 文章类型: Journal Article
    背景:健康应用程序越来越被认为是增强医疗保健服务的重要工具。许多国家,特别是撒哈拉以南非洲地区,可以从使用健康应用程序支持自我管理中受益匪浅,从而有助于实现全民健康覆盖和第三个可持续发展目标。然而,在应用商店中发布的大多数健康应用都是未知或质量差的,这对患者安全构成了风险。监管标准和指南可以帮助解决这种风险并促进患者安全。
    目的:本综述旨在评估支持撒哈拉以南非洲循证最佳实践的健康应用的监管标准和指南,重点是自我管理。
    方法:应用了范围审查的方法学框架。在以下数据库中构建并应用了搜索策略,灰色文献来源,和机构网站:PubMed,Scopus,世界卫生组织(世卫组织)非洲指数,OpenGrey,世卫组织非洲图书馆区域办事处,ICTworks,世卫组织电子卫生政策目录,他的加强资源中心,国际电信联盟,卫生部网站,和Google。搜索范围为2005年1月至2024年1月。使用演绎性描述性内容分析对发现进行了分析。对政策分析框架进行了调整,并用于组织调查结果。用于利益相关者分析的报告项目工具根据关键利益相关者在管理自我管理的健康应用程序中的角色,指导识别和映射关键利益相关者。
    结果:该研究包括来自31个撒哈拉以南非洲国家的49份文件。虽然所有文件都与利益相关者识别和映射相关,只有3个监管标准和指南包含有关健康应用程序监管的相关信息。这些标准和指南主要旨在建立相互信任;促进融合,inclusion,和公平获得服务;并解决执行问题和协调不力。他们提供了有关系统质量的指导,软件获取和维护,安全措施,数据交换,互操作性和集成,相关利益相关者的参与,和公平获得服务。加强落实,这些标准突出了法律权威,协调活动,能力建设,需要监测和评估。一些利益相关者,包括政府,监管机构,资助者,政府间和非政府组织,学术界,和医疗保健界,被确定为在管理健康应用程序方面发挥关键作用。
    结论:健康应用程序在支持撒哈拉以南非洲的自我管理方面具有巨大潜力,但是缺乏监管标准和指导是一个主要障碍。因此,为了将这些应用程序安全有效地集成到医疗保健中,应该更加重视监管。向具有有效法规的国家学习可以帮助撒哈拉以南非洲建立更强大和反应更灵敏的法规体系,确保整个地区健康应用的安全和有益使用。
    RR2-10.1136/bmjopen-2018-025714。
    BACKGROUND: Health apps are increasingly recognized as crucial tools for enhancing health care delivery. Many countries, particularly those in sub-Saharan Africa, can substantially benefit from using health apps to support self-management and thus help to achieve universal health coverage and the third sustainable development goal. However, most health apps published in app stores are of unknown or poor quality, which poses a risk to patient safety. Regulatory standards and guidance can help address this risk and promote patient safety.
    OBJECTIVE: This review aims to assess the regulatory standards and guidance for health apps supporting evidence-based best practices in sub-Saharan Africa with a focus on self-management.
    METHODS: A methodological framework for scoping reviews was applied. A search strategy was built and applied across the following databases, gray literature sources, and institutional websites: PubMed, Scopus, World Health Organization (WHO) African Index Medicus, OpenGrey, WHO Regional Office for Africa Library, ICTworks, WHO Directory of eHealth policies, HIS Strengthening Resource Center, International Telecommunication Union, Ministry of Health websites, and Google. The search covered the period between January 2005 and January 2024. The findings were analyzed using a deductive descriptive content analysis. The policy analysis framework was adapted and used to organize the findings. The Reporting Items for Stakeholder Analysis tool guided the identification and mapping of key stakeholders based on their roles in regulating health apps for self-management.
    RESULTS: The study included 49 documents from 31 sub-Saharan African countries. While all the documents were relevant for stakeholder identification and mapping, only 3 regulatory standards and guidance contained relevant information on regulation of health apps. These standards and guidance primarily aimed to build mutual trust; promote integration, inclusion, and equitable access to services; and address implementation issues and poor coordination. They provided guidance on systems quality, software acquisition and maintenance, security measures, data exchange, interoperability and integration, involvement of relevant stakeholders, and equitable access to services. To enhance implementation, the standards highlight that legal authority, coordination of activities, building capacity, and monitoring and evaluation are required. A number of stakeholders, including governments, regulatory bodies, funders, intergovernmental and nongovernmental organizations, academia, and the health care community, were identified to play key roles in regulating health apps.
    CONCLUSIONS: Health apps have huge potential to support self-management in sub-Saharan Africa, but the lack of regulatory standards and guidance constitutes a major barrier. Hence, for these apps to be safely and effectively integrated into health care, more attention should be given to regulation. Learning from countries with effective regulations can help sub-Saharan Africa build a more robust and responsive regulatory system, ensuring the safe and beneficial use of health apps across the region.
    UNASSIGNED: RR2-10.1136/bmjopen-2018-025714.
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  • 文章类型: Journal Article
    背景:在护理教育中,弥合理论知识和实践技能之间的差距对于培养临床实践能力至关重要。护理学生在获得这些基本技能时遇到挑战,使自我效能感成为他们专业发展的重要组成部分。自我效能感与个人对执行任务和克服挑战的能力的信念有关,对临床技能获取和学术成功具有重要意义。先前的研究强调了护理专业学生的自我效能感与其临床能力之间的紧密联系。技术已经成为一种有前途的工具,通过实现个性化的学习体验和深入的讨论来增强自我效能感。然而,有必要进行全面的文献审查,以评估现有的知识体系并确定研究差距。
    目的:本研究的目的是系统地绘制和识别已发表的关于使用技术支持指导模式来激发护生在临床实践中的自我效能感的研究中的差距。
    方法:本范围审查遵循Arksey和O\'Malley的框架,并根据系统审查和范围审查荟萃分析的首选报告项目(PRISMA-ScR)进行报告。一个系统的,在ERIC进行了全面的文献检索,CINAHL,MEDLINE,Embase,PsycINFO,和WebofScience在2011年1月至2023年4月之间发表的研究。手动搜索所包含论文的参考列表以确定其他研究。成对的作者筛选了这些论文,评估合格,并提取数据。数据是按主题组织的。
    结果:共纳入8项研究,确定了四个主题组:(1)学习支持的技术解决方案,(2)临床实践中的学习重点,(3)自我效能感的教学策略和理论方法,(4)自我效能感和互补结果的评估。
    结论:指导模式采用多种技术方案,激发护生在临床实践中的自我效能感,导致积极的发现。8项研究中有7项结果没有统计学意义,强调需要进一步完善所应用的干预措施。护士教育者在应用学习策略和理论方法来提高护生的自我效能中起着举足轻重的作用。但是护士导师和同龄人的贡献不容忽视。未来的研究应考虑让用户参与干预过程,并使用适合研究干预目标的有效工具。确保相关性并实现跨研究的比较。
    In nursing education, bridging the gap between theoretical knowledge and practical skills is crucial for developing competence in clinical practice. Nursing students encounter challenges in acquiring these essential skills, making self-efficacy a critical component in their professional development. Self-efficacy pertains to individual\'s belief in their ability to perform tasks and overcome challenges, with significant implications for clinical skills acquisition and academic success. Previous research has underscored the strong link between nursing students\' self-efficacy and their clinical competence. Technology has emerged as a promising tool to enhance self-efficacy by enabling personalized learning experiences and in-depth discussions. However, there is a need for a comprehensive literature review to assess the existing body of knowledge and identify research gaps.
    The aim of this study is to systematically map and identify gaps in published studies on the use of technology-supported guidance models to stimulate nursing students\' self-efficacy in clinical practice.
    This scoping review followed the framework of Arksey and O\'Malley and was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR). A systematic, comprehensive literature search was conducted in ERIC, CINAHL, MEDLINE, Embase, PsycINFO, and Web of Science for studies published between January 2011 and April 2023. The reference lists of the included papers were manually searched to identify additional studies. Pairs of authors screened the papers, assessed eligibility, and extracted the data. The data were thematically organized.
    A total of 8 studies were included and four thematic groups were identified: (1) technological solutions for learning support, (2) learning focus in clinical practice, (3) teaching strategies and theoretical approaches for self-efficacy, and (4) assessment of self-efficacy and complementary outcomes.
    Various technological solutions were adopted in the guidance models to stimulate the self-efficacy of nursing students in clinical practice, leading to positive findings. A total of 7 out of 8 studies presented results that were not statistically significant, highlighting the need for further refinement of the applied interventions. Nurse educators play a pivotal role in applying learning strategies and theoretical approaches to enhance nursing students\' self-efficacy, but the contributions of nurse preceptors and peers should not be overlooked. Future studies should consider involving users in the intervention process and using validated instruments tailored to the studies\' intervention objectives, ensuring relevance and enabling comparisons across studies.
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  • 文章类型: Journal Article
    目的:通过对现有证据的系统评价,评估针对癌症心理症状的指导和非指导数字干预的参与度和疗效。
    方法:PubMed,Scopus,心理信息,MEDLINE,和CINAHL数据库进行了搜索。符合条件的出版物是在癌症环境中使用的指导或非指导数字心理干预的随机对照试验,报告干预效果和/或参与度。使用Cochrane偏倚风险(RoB)工具评估研究方法学质量。随机效应荟萃分析对结果进行了足够的数据,对干预类型和随访期进行亚组分析。
    结果:纳入43项研究。研究因指导水平而异,使用的技术类型,持续时间,和评估的结果。大多数研究具有较高的总体RoB。荟萃分析表明,指导性干预显著减少了痛苦,焦虑,和疲劳,而非指导没有。对于抑郁症和生活质量,指导性和非指导性干预措施均取得了显著改善.指导干预报告的干预参与程度高于非指导干预。
    结论:对于癌症患者,有指导的数字心理干预可能比无指导的数字心理干预更有效。特别是在减少痛苦方面,焦虑,和疲劳。虽然这两种类型都能改善抑郁和生活质量,指导干预与更高的患者参与度相关.这些发现表明,数字干预可以补充传统的癌症护理,保证对长期效应和成本效益进行进一步研究。
    OBJECTIVE: To evaluate engagement with and efficacy of guided versus non-guided digital interventions targeting psychological symptoms of cancer via a systematic review of current evidence.
    METHODS: PubMed, Scopus, PsychINFO, MEDLINE, and CINAHL databases were searched. Eligible publications were randomised controlled trials of guided or non-guided digital psychological interventions used in cancer settings reporting intervention efficacy and/or engagement. Study methodological quality was assessed using the Cochrane risk of bias (RoB) tool. Random effects meta-analyses were performed on outcomes with sufficient data, with sub-group analyses of intervention type and follow-up period.
    RESULTS: Forty-three studies were included. Studies varied by level of guidance, type of technology used, duration, and outcomes assessed. Most studies had a high overall RoB. Meta-analysis indicated that guided interventions significantly reduced distress, anxiety, and fatigue, while non-guided did not. For depression and quality of life, both guided and non-guided interventions produced significant improvements. Guided interventions reported higher levels of intervention engagement than non-guided.
    CONCLUSIONS: Guided digital psychological interventions were likely to be more effective than non-guided ones for cancer patients, particularly in reducing distress, anxiety, and fatigue. Whilst both types were found to improve depression and life quality, guided interventions were associated with higher patient engagement. These findings suggest digital interventions could supplement traditional cancer care, warranting further research concerning long-term effects and cost-efficiency.
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  • 文章类型: Systematic Review
    背景:在围产期使用或正在接受药物治疗的妇女通常有复杂的需求并出现合并症。怀孕期间使用阿片类药物的女性,和他们的婴儿,经历糟糕的结果。妇女在怀孕期间使用药物是公共卫生的优先事项。这项范围审查旨在(1)绘制临床指南,英国各地针对围产期使用或正在接受药物治疗的女性的治疗方案和良好实践指导,(2)确定建议的卫生和社会护理最佳做法,以优化结果并减少这些妇女的不平等;(3)确定指导中的潜在差距。
    方法:我们遵循了JoannaBriggsInternational(JBI)关于范围审查和PRISMAScr扩展的指导。注册的协议,包含明确的搜索策略,inclusion,并遵守排除标准.审稿人双重筛选了25%,讨论分歧。使用预定义的模板提取数据,并在表中绘制。围绕商定的类别组织了最佳实践建议。
    结果:在筛选的968个文档中,111符合纳入标准。这些文件包括整个英国,国家,区域,和组织政策文件。它们与围产期使用药物或正在接受药物治疗的妇女相关的程度各不相同,他们应用的设置,和他们的目标用户。大多数是在没有患者或公众参与的情况下创建的,并且缺乏任何明确的证据基础。总的来说,文件推荐了与主要专业人员的综合护理模式,明确转诊途径和机构之间的信息共享。指导建议应将转介给专业助产士,药物,和社会关怀服务。全面评估,建议包括父亲/伴侣。最近的文件提倡采用创伤护理方法。在需要的情况下,建议在整个怀孕期间使用阿片类药物替代疗法(OST)。在产后为妇女提供支持方面发现了潜在的差距,尤其是当他们的孩子从他们的照顾。
    结论:此推荐实践综合为从业人员提供了关键信息,服务提供商和政策制定者。它还强调了指南必须以证据为基础,根据围产期使用药物或正在接受药物治疗的妇女的经验,并解决将婴儿从护理中移出的产后妇女的支持需求。
    BACKGROUND: Women who use or are in treatment for drug use during the perinatal period often have complex needs and presenting comorbidity. Women who use opioids during pregnancy, and their infants, experience poor outcomes. Drug use by women during pregnancy is a public health priority. This scoping review aimed to (1) map clinical guidelines, treatment protocols and good practice guidance across the UK for women who use or are in treatment for drug use during the perinatal period, (2) identify recommended best practice across health and social care for optimising outcomes and reducing inequalities for these women and (3) identify potential gaps within guidance.
    METHODS: We followed the Joanna Briggs International (JBI) guidance on scoping reviews and PRISMA Scr extension. A registered protocol, containing a clear search strategy, inclusion, and exclusion criteria was adhered to. Reviewers double screened 25%, discussing disagreements. Data were extracted using a predefined template and charted in tables. Recommendations for best practice were organised around agreed categories.
    RESULTS: Of 968 documents screened, 111 met the inclusion criteria. The documents included UK-wide, national, regional, and organisational policy documents. They varied in the degree they were relevant to women who use or are in treatment for drug use during the perinatal period, the settings to which they applied, and their intended users. Most were created without patient or public involvement and lacked any clear evidence base. Overall, documents recommended an integrated model of care with a lead professional, clear referral pathways and information sharing between agencies. Guidance suggested referrals should be made to specialist midwives, drug, and social care services. A holistic assessment, inclusive of fathers / partners was suggested. Recent documents advocated a trauma-informed care approach. Opioid substitution therapy (OST) was recommended throughout pregnancy where required. Potential gaps were identified around provision of support for women postnatally, especially when their baby is removed from their care.
    CONCLUSIONS: This synthesis of recommended practice provides key information for practitioners, service providers and policy makers. It also highlights the need for guidelines to be evidence-based, informed by the experiences of women who use or are in treatment for drug use during the perinatal period, and to address the support needs of postnatal women who have their babies removed from their care.
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  • 文章类型: Journal Article
    本范围审查旨在确定和系统地审查已发布的制图审查,以评估其共性和异质性,并确定是否应做出更多努力来标准化方法和报告。搜索了以下数据库;OvidMEDLINE,Embase,CINAHL,PsycINFO,坎贝尔协作数据库,社会科学文摘,图书馆与信息科学文摘(LISA)。在对标题和摘要中包含的20篇引文的随机样本进行试点测试之后,两名团队成员独立完成所有筛查.在全文筛选时试行了十篇文章,然后由两名团队成员独立审查每个引文。通过讨论解决了这两个阶段的差异。在对五个相关全文文章的随机样本进行试点测试之后,一名团队成员提取了所有相关数据。数据抽象中的不确定性由另一个团队成员解决。共有335篇文章符合此范围审查的条件,随后被纳入。多年来,已发布的制图评论数量从2010年的5个增加到2021年的73个。此外,在报告所包括的制图审查,包括他们的研究问题方面存在显著的差异,先验协议,方法论,数据综合和报告。这项工作进一步突出了证据综合方法方面的差距。证据综合组织制定的进一步指导,比如JBI和坎贝尔,有可能澄清研究人员经历的挑战,考虑到每年发布的测绘评论的规模。
    This scoping review aims to identify and systematically review published mapping reviews to assess their commonality and heterogeneity and determine whether additional efforts should be made to standardise methodology and reporting. The following databases were searched; Ovid MEDLINE, Embase, CINAHL, PsycINFO, Campbell collaboration database, Social Science Abstracts, Library and Information Science Abstracts (LISA). Following a pilot-test on a random sample of 20 citations included within title and abstracts, two team members independently completed all screening. Ten articles were piloted at full-text screening, and then each citation was reviewed independently by two team members. Discrepancies at both stages were resolved through discussion. Following a pilot-test on a random sample of five relevant full-text articles, one team member abstracted all the relevant data. Uncertainties in the data abstraction were resolved by another team member. A total of 335 articles were eligible for this scoping review and subsequently included. There was an increasing growth in the number of published mapping reviews over the years from 5 in 2010 to 73 in 2021. Moreover, there was a significant variability in reporting the included mapping reviews including their research question, priori protocol, methodology, data synthesis and reporting. This work has further highlighted the gaps in evidence synthesis methodologies. Further guidance developed by evidence synthesis organisations, such as JBI and Campbell, has the potential to clarify challenges experienced by researchers, given the magnitude of mapping reviews published every year.
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  • 文章类型: Journal Article
    在人道主义反应中提供疫苗需要对证据进行严格和持续的分析。本系统综述描绘了受危机影响环境中疫苗可预防疾病的疫苗接种指南的规范格局。搜索了2000年至2022年之间发布的指南,英语和法语,在人道主义行为者的网站上,Google,还有Bing.在GlobalHealth和Embase中进行了同行评审的数据库搜索。筛选所有纳入文件的参考列表。我们向在人道主义背景下从事疫苗接种工作的专业人员传播了一项在线调查。共有48份符合条件的指导文件,包括技术指导(n=17),描述性指导(n=16),作战指导(n=11),证据审查(n=3),和伦理指导(n=1)。大多数是针对5岁以下儿童的世界卫生组织文件(n=21)。关键评估显示,受影响人群的纳入不足,指南制定的严格性有限。我们发现有关疫苗的信息有限,包括,黄热病,霍乱,脑膜炎球菌,甲型肝炎,和水痘,以及人乳头瘤病毒(HPV)。在人道主义背景下,针对疫苗可预防疾病的疫苗接种指南过多。然而,在关键和系统地纳入证据方面仍然存在差距,纳入“零剂量”儿童和受影响人群的概念,伦理指导,以及HPV和非普遍推荐疫苗的具体建议,必须解决的问题。
    Delivering vaccines in humanitarian response requires rigourous and continuous analysis of evidence. This systematic review mapped the normative landscape of vaccination guidance on vaccine-preventable diseases in crisis-affected settings. Guidance published between 2000 and 2022 was searched for, in English and French, on websites of humanitarian actors, Google, and Bing. Peer-reviewed database searches were performed in Global Health and Embase. Reference lists of all included documents were screened. We disseminated an online survey to professionals working in vaccination delivery in humanitarian contexts. There was a total of 48 eligible guidance documents, including technical guidance (n = 17), descriptive guidance (n = 16), operational guidance (n = 11), evidence reviews (n = 3), and ethical guidance (n = 1). Most were World Health Organization documents (n = 21) targeting children under 5 years of age. Critical appraisal revealed insufficient inclusion of affected populations and limited rigour in guideline development. We found limited information on vaccines including, yellow fever, cholera, meningococcal, hepatitis A, and varicella, as well as human papilloma virus (HPV). There is a plethora of vaccination guidance for vaccine-preventable diseases in humanitarian contexts. However, gaps remain in the critical and systematic inclusion of evidence, inclusion of the concept of \"zero-dose\" children and affected populations, ethical guidance, and specific recommendations for HPV and non-universally recommended vaccines, which must be addressed.
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