OBJECTIVE: This qualitative systematic review and meta-aggregation aimed to synthesise evidence regarding perceptions of patients, practitioners, and stakeholders on the use of Silver Diamine Fluoride (SDF) for the management of dental caries.
METHODS: This review was reported in alignment with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) and is registered with PROSPERO (CRD42023390301) and the Joanna Briggs Systematic Reviews register.
METHODS: References were retrieved from PubMed, Web of Science, Scopus, and EMBASE using a pre-established search strategy.
METHODS: Qualitative and mixed-methods studies examining perspectives of patients, practitioners, and/or stakeholders on the use of SDF were included. The initial search identified 650 articles eligible for inclusion, out of which 14 articles were included in the review. Reviewers synthesised findings and generated 11 distinct categories grouped into three synthesised findings: 1) Clinical use; 2) Staining; 3) Facilitators and barriers.
CONCLUSIONS: Practitioners and patients viewed SDF as a therapeutic option with multiple benefits. While aesthetic concerns may be a barrier to some groups, the acceptance of the treatment was influenced by other factors, such as trusting professional advice.
CONCLUSIONS: Patient education is key for increased SDF acceptance. This systematic review can assist clinicians in addressing concerns regarding SDF therapy. Findings have the potential to inform policy decisions that address oral health inequities through patient-centred health care models.

OBJECTIVE: Prior work identified 6 key value elements (attributes of treatment and desired outcomes) for individuals living with major depressive disorder (MDD) in managing their condition: mode of treatment, time to treatment helpfulness, MDD relief, quality of work, interaction with others, and affordability. The objective of our study was to identify whether previous cost-effectiveness analyses (CEAs) for MDD treatment addressed any of these value elements. A secondary objective was to identify whether any study engaged patients, family members, and caregivers in the model development process.
METHODS: We conducted a systematic literature review to identify published model-based CEAs. We compared the elements of the published studies with the MDD patient value elements elicited in prior work to identify gaps and areas for future research.
RESULTS: Of 86 published CEAs, we found that 7 included patient out-of-pocket costs, and 32 included measures of productivity, which were both priorities for individuals with MDD. We found that only 2 studies elicited measures from patients for their model, and 2 studies engaged patients in the modeling process.
CONCLUSIONS: Published CEA models for MDD treatment do not regularly include value elements that are a priority for this patient population nor do they include patients in their modeling process. Flexible models that can accommodate elements consistent with patient experience are needed, and a multistakeholder engagement approach would help accomplish this.

BACKGROUND: Rheumatoid arthritis (RA) is characterized by intermittent flares of disease activity with a significant impact on patients\' lives. However, distinguishing flare from daily symptom variation may be approached differently by patients and healthcare providers, potentially hampering shared decision-making when treating RA.
OBJECTIVE: To provide a comprehensive overview of RA flare definitions reported in the published literature, and to compare these with patients\' perceptions of the flare concept according to qualitative evidence.
METHODS: A systematic search was conducted on August 30th, 2022, and updated on September 30th, 2023, for both quantitative and qualitative studies reporting \"flare\" or related terms in the context of RA. We searched the following databases: Pubmed, EMBASE, Web of Science, Cochrane Library, and CINAHL. Definitions of RA flare reported in quantitative studies were summarized descriptively. In parallel, a thematic synthesis of qualitative studies was performed to outline patients\' views on the concept of flare, and to compare these with the currently used definitions.
RESULTS: Among 32,864 potentially eligible records, 304 studies were included, 5 of which used qualitative/mixed methods to study patients\' perceptions of flare. Remarkably, 62 different definitions for RA flare were reported, with many studies reporting more than one. The most commonly used definitions (54 %) were based on disease activity indices, with DAS28-based definitions the most widely applied (84 %). For each of the disease activity indices, several different cutoffs to define flares were used. Various definitions based on physician report were applied in 24 % of cases, while patient-reported criteria represented only 15 % of the applied definitions. Thematic synthesis of the qualitative/mixed-methods studies highlighted the multidimensional impact of flares on patients\' lives, resulting in five sequential overarching themes: \"Living with RA: a balancing act\", \"Flare: a disturbance of this balance\", \"The biopsychosocial impact of flares\", \"Self-management: the first line of defense\", and \"Medical help: the last resort\". In turn, these five themes were underpinned by a central theme of \"Uncertainty and variability\".
CONCLUSIONS: We found a striking heterogeneity regarding the conceptualization and measurement of RA flare in the published literature. Although qualitative evidence highlighted the considerable impact of flares on patients\' wellbeing, the majority of reported flare definitions were not based on patient report. There is a need to bridge this gap by aligning patients\' and healthcare professionals\' views on what distinguishes a flare from acceptable symptom variability when living with RA.

BACKGROUND: Implementing patient-reported outcome measures (PROMs) to measure and evaluate health outcomes is increasing worldwide. Along with this emerging trend, it is important to identify which guidelines, frameworks, checklists, and recommendations exist, and if and how they have been used in implementing PROMs, especially in clinical quality registries (CQRs).
OBJECTIVE: This review aims to identify existing publications, as well as publications that discuss the application of actual guidelines, frameworks, checklists, and recommendations on PROMs\' implementation for various purposes such as clinical trials, clinical practice, and CQRs. In addition, the identified publications will be used to guide the development of a new guideline for PROMs\' implementation in CQRs, which is the aim of the broader project.
METHODS: A literature search of the databases MEDLINE, Embase, CINAHL, PsycINFO, and Cochrane Central Register of Controlled Trials will be conducted since the inception of the databases, in addition to using Google Scholar and gray literature to identify literature for the scoping review. Predefined inclusion and exclusion criteria will be used for all phases of screening. Existing publications of guidelines, frameworks, checklists, recommendations, and publications discussing the application of those methodologies for implementing PROMs in clinical trials, clinical practice, and CQRs will be included in the final review. Data relating to bibliographic information, aim, the purpose of PROMs use (clinical trial, practice, or registries), name of guideline, framework, checklist and recommendations, the rationale for development, and their purpose and implications will be extracted. Additionally, for publications of actual methodologies, aspects or domains of PROMs\' implementation will be extracted. A narrative synthesis of included publications will be conducted.
RESULTS: The electronic database searches were completed in March 2024. Title and abstract screening, full-text screening, and data extraction will be completed in May 2024. The review is expected to be completed by the end of August 2024.
CONCLUSIONS: The findings of this scoping review will provide evidence on any existing methodologies and tools for PROMs\' implementation in clinical trials, clinical practice, and CQRs. It is anticipated that the publications will help us guide the development of a new guideline for PROMs\' implementation in CQRs.
BACKGROUND: PROSPERO CRD42022366085; https://tinyurl.com/bdesk98x.
UNASSIGNED: DERR1-10.2196/52572.

BACKGROUND: Recovery Colleges (RCs) represent an approach to enhancing mental wellbeing through education, lived experience and co-production. Despite their increasing presence, scant literature explores the operationalisation of RCs and their embodiment of co-production principles. The aim of this scoping review was to investigate the operationalisation of RCs and their application of co-production in RCs located in high-income countries over the past decade.
METHODS: Employing an established scoping review methodology, searches were conducted across seven academic databases. Ten primary studies met the inclusion criteria. In addition, stakeholders were consulted to validate themes and uncover knowledge gaps.
RESULTS: Findings suggest that RCs are inherently idiosyncratic, adapted to suit local contexts. Discussions persist regarding their optimal institutional contexts and positioning and the interpretation of key terms such as \'recovery\' and \'co-production\', influencing daily operations and stakeholder involvement. Challenges surrounding measuring success against fidelity criteria underscore the need for a broader understanding of RC value and sustainability.
CONCLUSIONS: This review offers a synopsis of the existing literature offering insights concerning the operationalisation of RCs. Through a synthesis of diverse primary studies, it systematically identifies and describes the operational nuances within the RC landscape and the fundamental elements underpinning RC operations, while shedding light on critical knowledge gaps in both research and practice. SO WHAT?: This review underscores the importance of a broader understanding of RC value and sustainability, offering insights for both research and practice in the field of mental health and wellbeing. This review highlights the significance of further exploration and refinement of RC operationalisation to enhance their effectiveness and impact in supporting mental wellbeing.

UNASSIGNED: Cardiovascular (CV) disease is a major cause of morbidity and mortality for patients with glomerular disease. Despite the fact that mechanisms underpinning CV disease risk in this population are likely distinct from other forms of kidney disease, treatment and preventive strategies tend to be extrapolated from studies of patients with undifferentiated chronic kidney disease (CKD). There is an unmet need to delineate the pathophysiology of CV disease in patients with glomerular disease, establish unique risk factors, and identify novel therapeutic targets for disease prevention. The aims of this narrative review are to summarize the existing knowledge regarding the epidemiology, molecular mechanisms, and management of CV disease in patients with common glomerular disease, highlight the patient perspective, and propose specific areas for future study.
UNASSIGNED: The literature for this narrative review was accessed using common research search engines, including PubMed, PubMed Central, Medline, and Google Scholar. Information for the patient perspective section was collected through iterative discussions with a patient partner.
UNASSIGNED: We reviewed the epidemiology, molecular mechanisms of disease, management approaches, and the patient perspective in relation to CV disease in patients with glomerulopathies. Throughout, we have highlighted the current knowledge and have discussed future research approaches, both clinical and translational, while integrating the patient perspective.
UNASSIGNED: Patients with glomerular disease have significant CV disease risk driven by multifactorial, molecular mechanisms originating from their glomerular disease but complicated by existing comorbidities, kidney disease, and medication side effects. The current approach to risk stratification and treatment relies heavily on existing data from CKD patients, but this may not always be appropriate given the unique pathophysiology and mechanisms associated with CV disease risk in patients with glomerular disease. We highlight the need for ongoing glomerular disease-focused studies aimed to better delineate CV disease risk, while integrating the patient perspective.
UNASSIGNED: This is a narrative review and does not represent a comprehensive and systematic review of the literature.
UNASSIGNED: Les maladies cardiovasculaires sont une cause majeure de morbidité et de mortalité chez les patients atteints d’une maladie glomérulaire. Bien que les mécanismes qui sous-tendent le risque de maladie cardiovasculaire dans cette population sont probablement distincts des autres formes de néphropathies, le traitement et les stratégies préventives ont tendance à être extrapolés à partir d’études portant sur des patients atteints d’insuffisance rénale chronique indifférenciée. Il existe ainsi un besoin de délimiter la physiopathologie des maladies cardiovasculaires chez les patients atteints d’une maladie glomérulaire, d’établir les facteurs de risque propres à la maladie glomérulaire et d’identifier de nouvelles cibles thérapeutiques pour la prévenir. Les objectifs de cette revue narrative sont de résumer les connaissances existantes concernant l’épidémiologie, les mécanismes moléculaires et la prise en charge des maladies cardiovasculaires chez les patients atteints d’une maladie glomérulaire commune, de mettre en évidence le point de vue des patients et de proposer des domaines précis pour de futures études.
UNASSIGNED: La documentation a été consultée par le biais des moteurs de recherche courants, notamment PubMed, PubMed Central, Medline et Google Scholar. Les points de vue des patients ont été recueillis au moyen de discussions itératives avec un patient partenaire.
UNASSIGNED: Nous avons examiné l’épidémiologie et les mécanismes moléculaires de la maladie, les approches de prise en charge et la perspective des patients en lien avec les maladies cardiovasculaires chez les patients atteints d’une maladie glomérulaire. Nous avons fait état des connaissances actuelles et discuté des approches à envisager pour les recherches futures, tant cliniques que translationnelles, tout en intégrant la perspective du patient.
UNASSIGNED: Les patients atteints d’une maladie glomérulaire présentent un risque significatif de maladie cardiovasculaire associé à des mécanismes moléculaires multifactoriels provenant de la maladie glomérulaire elle-même. Ce risque est compliqué par les comorbidités existantes, la néphropathie et les effets secondaires des médicaments. L’approche actuelle de stratification du risque et de traitement repose en grande partie sur les données existantes pour les patients atteints d’insuffisance rénale chronique; cette approche pourrait ne pas toujours convenir, compte tenu de la physiopathologie unique et des mécanismes associés au risque de maladie cardiovasculaire chez les patients atteints d’une maladie glomérulaire. Nos résultats mettent en lumière le besoin d’études continues, axées sur les maladies glomérulaires, qui visent à mieux cerner le risque de maladies cardiovasculaires chez ces patients, tout en intègrant leur point de vue.
UNASSIGNED: Il s’agit d’une revue narrative; cette étude ne constitue pas une revue exhaustive et systématique de la littérature.

OBJECTIVE: To summarise, interpret and synthesize research findings on patients\' and nurses\' experiences of caring in nursing across clinical practices.
BACKGROUND: Caring is a universal element of nursing; however, economic restrictions often negatively impact health services, and time shortages and limited numbers of staff may characterize care encounters. It is unclear how these contextual conditions affect patients\' and nurses\' experiences of caring.
METHODS: This integrative literature review covers papers published between 2000 and 2022. Four databases-PubMed, PsycINFO (via Ovid), MEDLINE (via Ovid) and CINAHL (via EBSCO)-were systematically searched for eligible papers in May 2022. The included studies were critically appraised. Content analysis was performed to interpret and synthesize the findings. In accordance with the EQUATOR guidelines, the PRISMA 2020 and PRISMA-S checklists were used. An Integrative review methodology guided the process.
RESULTS: In total, 33 studies were included in the review. Three themes captured the experiences of caring in nursing: (1) the complexity of the nursing care context, (2) the professionalism of the nurse, and (3) the trusting patient-nurse relationship.
CONCLUSIONS: The experience of caring in nursing depended on nurses\' competence and discretion in the personal encounter framed by the nursing context. The caring relationship was based on reciprocity, but it remains asymmetrical, as the nurse had the power and responsibility to empower the patient. Barriers, such as increased demands for efficiency and resource scarcity, may hinder the experience of caring in nursing.
UNASSIGNED: By promoting an ongoing discussion of caring in nursing, nurse management can systematically support nurses in reflecting on their practice in diverse and complex clinical contexts.
UNASSIGNED: No patient or public contribution was made due to the study design.

BACKGROUND: Electroconvulsive therapy (ECT) is a well-accepted intervention for treatment-resistant, serious mental illnesses. Its acceptability, efficacy, and tolerability are well documented in high-income settings, but less so in lower- and middle-income countries (LMICs). This report is a narrative review of ECT practice in the latter setting.
METHODS: A literature search was conducted using Medline and PubMed. Initial results yielded 81 publications in English. Following the screening, 19 papers were included to evaluate the information on ECT practice and perceptions.
RESULTS: Reports from LMICs on efficacy, tolerability, and perceptions of ECT were relatively sparse. In general, they confirm its use mostly for treatment-resistant major mental illnesses (i.e., depression, schizophrenia, bipolar disorder). Both modified and unmodified forms of ECT are used and considered equally effective, although the former is better tolerated. Use of unmodified ECT remains significant in LMICs due to its low cost and limited resource requirements. In general, there is satisfaction with ECT and its outcomes. The education of patients and families, content process, and research have been noted as areas to improve.
CONCLUSIONS: ECT is perceived as an effective intervention in LMICs, but use of unmodified ECT remains controversial. There is a need for the development and use of global guidelines to improve clinician training, knowledge sharing with patients and their families, and outcome research.

UNASSIGNED: Many studies using Patient-reported outcomes (PRO) data have been conducted to monitor symptoms and health-related quality of life during follow-up after cancer treatment. However new ways of using (e)PROs have emerged. We aimed to explore the Danish landscape of the use of PRO in a research setting, where PRO is used actively in cancer patients undergoing treatment, and give an overview of how it is embraced by patients and clinicians.
UNASSIGNED: A literature search was performed in June 2023, using the keywords Denmark, cancer, and patient-reported outcomes. An expert on literature searches identified the search terms, and double screening was performed at both abstract and screening levels and full-text stage. The software tool Covidence was used.
UNASSIGNED: 467 articles were retrieved and 19 studies were included. They described the type of ePRO instrument used and the application of active ePRO i.e. a dialogue tool in the clinical encounter, release of alerts to clinicians, and enhancement of self-management. Finally, a development in the use of active ePROs over time is elucidated and we show how it is embraced by patients and clinicians.
UNASSIGNED: This mini-review gives an overview of how ePRO solutions are tested in oncological research in Denmark and embraced by patients and clinicians. ePRO solutions in a Danish setting seem well-suited for self-management. However, if more impact is warranted, clinicians need to engage in reviewing and using ePROs. Moreover, for successful implementation, the integration of ePROs in electronic health records must be supported by IT specialists and management.

OBJECTIVE: Issues regarding clinician communication remain an important source of complaints within healthcare. This systematic review aims to determine cancer patients\' and their family caregivers\' views on which clinicians\' communication behaviors can harm (i.e. eliciting negative feelings/consequences for patients/family caregivers).
METHODS: We searched for all types of peer-reviewed studies that determined adult (≥18 years) cancer patients\' and/or family caregivers\' perspectives on which clinicians\' communication behaviors can harm in several databases (PubMed, Embase, Web of Science, Cochrane Library, Emcare, PsycINFO and Academic Search Premier), supplemented by expert-consultation. Studies were screened using the Artificial intelligence screening tool of ASReview and data was analyzed using Thematic Analysis. To assess the quality of the studies the Qualsyst critical appraisal tool was used.
RESULTS: A total of 47 studies were included. Four main themes of harmful communication behaviors were identified: (1) Lack of tailored information provision (e.g. giving too little or too much/specific information) (2) Lack of tailored decision making (ranging from; patient exclusion, to the patients\' responsibility, and/or haste) (3) Lack of feeling seen and heard (seen as a disease, not as a human being; not listened to concerns and emotions) (4) Lack of feeling held and remembered (forgotten agreements; lack of care continuity).
CONCLUSIONS: Our results reveal an overview of patients\' and family caregivers\' perspectives on which clinicians\' communication behaviors can harm. Harm could be prevented when information and decision involvement are tailored and patients\' and family caregivers\' needs to feel seen, heard, held and remembered are met.