Qualitative synthesis

定性合成
  • 文章类型: Journal Article
    综合有关执行心肺复苏(CPR)的外行反应者经验的定性证据。
    使用Thomas和Harden方法进行定性证据合成。PubMed,科克伦图书馆,WebofScience,OVIDMedline,Embase,CINAHL,CNKI,和万方数据库进行了系统搜索。研究的质量由关键评估技能计划工具(CASP)进行评估。
    总共确定了5,610项研究,9项研究纳入分析.产生了四个分析主题:心肺复苏术前的情绪矛盾,心肺复苏期间的心理耐受性,心肺复苏后的感知体验,增强心理韧性。
    在心肺复苏术期间,产妇反应者面临复杂的心理体验,这可能容易受到心理影响,如“损失厌恶”,\"\"旁观者效应\"和\"知识诅咒。“除了及时的心肺复苏再培训,应指导外行响应者管理心理困扰并提高心理韧性。更重要的是,心理后遗症可能是持久的,需要在评估跨学科性的基础上进行持续的心理干预和随访。
    UNASSIGNED: To synthesize qualitative evidence on the experience of lay responders performing cardiopulmonary resuscitation (CPR).
    UNASSIGNED: Qualitative evidence synthesis was performed using the Thomas and Harden method. The PubMed, Cochrane Library, Web of Science, OVID Medline, Embase, CINAHL, CNKI, and WanFang databases were systematically searched. The quality of the research was assessed by the Critical Assessment Skills Program Tool (CASP).
    UNASSIGNED: A total of 5,610 studies were identified, and 9 studies were included in the analysis. Four analytical themes were generated: emotional ambivalence before CPR, psychological tolerance during CPR, perceived experience after CPR, and enhancing psychological resilience.
    UNASSIGNED: Lay responders face complicated psychological experience during CPR, which may be susceptible to psychological effects such as \"loss aversion,\" \"bystander effects\" and \"knowledge curse.\" In addition to the timely retraining of CPR, lay responders should be instructed to manage psychological distress and improve psychological resilience. More importantly, the psychological sequelae may be long-lasting, requiring ongoing psychological intervention and follow-up based on valuing transdisciplinarity across endeavours.
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  • 文章类型: Journal Article
    背景:癌症相关认知障碍(CRCI)是癌症患者在治疗过程中常见的,35%的患者在治疗完成后出现认知障碍。记忆受损,注意,执行功能,和信息处理速度的报告最多,通常会对日常功能和生活质量(QoL)产生负面影响。尽管有大量的报道,这种不良副作用在常见癌症类型中的调查不足,缺乏对CRCI经验的洞察力。
    目的:本定性综合旨在探索与常见癌症的CRCI经验相关的证据。它还旨在了解CRCI在各种癌症类型中的患病率,认知领域,及其对QoL和功能能力的影响。
    方法:对数据库的全面搜索,包括PubMed,美国心理学会PsycINFO,CINAHL,还有Scopus,将进行。共有2名独立审稿人将筛选标题和摘要以供收录,其次是全文筛选。第三名审核人员将解决数据筛选和纳入过程中出现的任何冲突。随后,将使用关键评估技能计划(CASP)工具进行数据提取和质量评估。结果将使用主题分析进行分析。
    结果:本评论是2023年1月资助的博士课程的一部分。审查于2023年6月开始,目前正在进行数据分析。定性合成将探索跨常见癌症的CRCI的经验。纳入的研究预计将报告许多癌症类型,如乳腺癌,前列腺癌,白血病,还有肺癌.包含的研究类型最有可能是访谈,焦点小组,和具有定性成分的调查。
    结论:该方案强调了定性合成的必要性,该方案将探索跨常见癌症类型的CRCI的经验。它将提供对CRCI的生活经验和可能受到不成比例影响的认知领域的宝贵见解。对CRCI的进一步管理干预和临床试验治疗的需求不断增长,对患者体验的定性探索对其发展至关重要。这种定性合成将为未来的发展提供信息,并有助于改善癌症后的QoL。
    DERR1-10.2196/56888。
    BACKGROUND: Cancer-related cognitive impairment (CRCI) is commonly experienced by patients with cancer during treatment, and 35% of patients experience cognitive impairment after treatment completion. Impairments in memory, attention, executive functioning, and information processing speed are most reported and often negatively impact daily functioning and quality of life (QoL). Despite the large scale of reports, this adverse side effect is underinvestigated across common cancer types, and there is a lack of insight into the CRCI experience.
    OBJECTIVE: This qualitative synthesis aims to explore the evidence in relation to the experience of CRCI across common cancers. It also aims to understand the prevalence of CRCI across various cancer types, cognitive domains, and its impact on QoL and functional ability.
    METHODS: A comprehensive search of databases, including PubMed, American Psychological Association PsycINFO, CINAHL, and Scopus, will be conducted. A total of 2 independent reviewers will screen titles and abstracts for inclusion, followed by full-text screening. A third reviewer will resolve any arising conflicts in the process of data screening and inclusion. Subsequently, data extraction and quality assessment using the Critical Appraisal Skills Programme (CASP) tool will be conducted. The results will be analyzed using thematic analysis.
    RESULTS: This review is part of a PhD program funded in January 2023. The review commenced in June 2023, and data analysis is currently in progress. The qualitative synthesis will explore the experiences of CRCI across common cancers. The included studies are expected to report on numerous cancer types such as breast cancer, prostate cancer, leukemia, and lung cancer. The included study types are most likely to be interviews, focus groups, and surveys with qualitative components.
    CONCLUSIONS: This protocol highlights the need for a qualitative synthesis that will explore the experience of CRCI across common cancer types. It will provide valuable insight into the lived experience of CRCI and the cognitive domains that may be disproportionately affected. There is a growing demand for further management interventions and clinically tested treatments of CRCI and the qualitative exploration of patient experience is crucial for their development. This qualitative synthesis will inform future developments and will contribute to improving QoL after cancer.
    UNASSIGNED: DERR1-10.2196/56888.
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  • 文章类型: Journal Article
    背景:孕妇和产后妇女在COVID-19大流行中的经历,以及COVID-19对围产期健康的情感和社会心理影响,在高收入国家都有很好的记录。增加焦虑和恐惧,隔离,在许多研究中广泛描述了妊娠和产后中断。本研究的目的是探索,描述和综合研究,这些研究涉及高收入国家孕妇和产后妇女在大流行前两年的经历。
    方法:纳入了与高收入国家妇女在大流行期间的经历有关的研究的定性证据综合。两名评审员使用主题综合方法和NVivo20软件提取数据。GRADE-CERQual(对定性研究评论证据的信心)用于评估对评论结果的信心。
    结果:68项研究符合资格,并接受抽样框架以确保数据的丰富性。总的来说,36项抽样研究为主题的发展做出了贡献,次主题和审查结果。有六个主要主题:(1)处理公共卫生限制;(2)导航不断变化的卫生政策;(3)适应接受社会支持的替代方式;(4)处理对自己心理健康的影响;(5)管理新的和不断变化的信息;(6)有弹性和乐观。根据GRADE-CERQual评估,在这些主题下制定了17项审查结果,并具有高度至中等的信心。
    结论:这份综合报告的结果为实践和政策制定者提供了不同的策略,以更好地支持妇女,婴儿和他们的家人在未来的紧急反应。这些策略包括优化护理交付,加强沟通,支持社会和心理健康。
    BACKGROUND: Pregnant and postpartum women\'s experiences of the COVID-19 pandemic, as well as the emotional and psychosocial impact of COVID-19 on perinatal health, has been well-documented across high-income countries. Increased anxiety and fear, isolation, as well as a disrupted pregnancy and postnatal period are widely described in many studies. The aim of this study was to explore, describe and synthesise studies that addressed the experiences of pregnant and postpartum women in high-income countries during the first two years of the pandemic.
    METHODS: A qualitative evidence synthesis of studies relating to women\'s experiences in high-income countries during the pandemic were included. Two reviewers extracted the data using a thematic synthesis approach and NVivo 20 software. The GRADE-CERQual (Confidence in the Evidence from Reviews of Qualitative research) was used to assess confidence in review findings.
    RESULTS: Sixty-eight studies were eligible and subjected to a sampling framework to ensure data richness. In total, 36 sampled studies contributed to the development of themes, sub-themes and review findings. There were six over-arching themes: (1) dealing with public health restrictions; (2) navigating changing health policies; (3) adapting to alternative ways of receiving social support; (4) dealing with impacts on their own mental health; (5) managing the new and changing information; and (6) being resilient and optimistic. Seventeen review findings were developed under these themes with high to moderate confidence according to the GRADE-CERQual assessment.
    CONCLUSIONS: The findings from this synthesis offer different strategies for practice and policy makers to better support women, babies and their families in future emergency responses. These strategies include optimising care delivery, enhancing communication, and supporting social and mental wellbeing.
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  • 文章类型: Systematic Review
    背景:对实时发生的社交焦虑(SA)和SA障碍(SAD)的前兆和后果的理解越来越感兴趣,导致使用动态评估(AA)的研究激增。尽管这一领域的研究呈指数级增长,这些研究尚未合成。
    目的:这篇综述旨在确定和描述通过使用AA对SA和SAD的理解的最新进展。
    方法:遵循PRISMA(系统评价和荟萃分析的首选报告项目)指南,在Scopus进行了系统的文献检索,PubMed,和WebofScience。
    结果:共有70篇文章符合纳入标准。这些研究的定性综合表明,AA允许对情感的探索,认知,以及与SA和SAD经验相关的行为动力学。与SA和SAD的可用型号一致,情绪调节,坚持不懈的认知,认知因素,物质使用,互动模式是纳入研究的主要主题。此外,将AA纳入研究心理干预措施,使用传感器和生物传感器的多模态评估,和跨文化差异是一些确定的新兴主题。
    结论:AA构成了一种非常强大的方法,可以从实验室实验和通常的自我报告措施的补充角度来掌握SA,照亮认知,情感,以及SA的行为前兆和后果以及SAD作为精神障碍的发展和维持。
    BACKGROUND: There has been an increased interest in understanding social anxiety (SA) and SA disorder (SAD) antecedents and consequences as they occur in real time, resulting in a proliferation of studies using ambulatory assessment (AA). Despite the exponential growth of research in this area, these studies have not been synthesized yet.
    OBJECTIVE: This review aimed to identify and describe the latest advances in the understanding of SA and SAD through the use of AA.
    METHODS: Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a systematic literature search was conducted in Scopus, PubMed, and Web of Science.
    RESULTS: A total of 70 articles met the inclusion criteria. The qualitative synthesis of these studies showed that AA permitted the exploration of the emotional, cognitive, and behavioral dynamics associated with the experience of SA and SAD. In line with the available models of SA and SAD, emotion regulation, perseverative cognition, cognitive factors, substance use, and interactional patterns were the principal topics of the included studies. In addition, the incorporation of AA to study psychological interventions, multimodal assessment using sensors and biosensors, and transcultural differences were some of the identified emerging topics.
    CONCLUSIONS: AA constitutes a very powerful methodology to grasp SA from a complementary perspective to laboratory experiments and usual self-report measures, shedding light on the cognitive, emotional, and behavioral antecedents and consequences of SA and the development and maintenance of SAD as a mental disorder.
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  • 文章类型: Review
    这项范围审查严格评估了参与刑事司法系统(CJS)的母亲中有关精神障碍的证据,并提供了精神障碍的汇总患病率。总的来说,27项研究包括在审查中,有23项研究来自美利坚合众国,26项研究侧重于被监禁的母亲。研究结果支持了精神疾病负担沉重的证据,在涉及CJS的母亲中。确定了导致精神障碍的几个因素,包括虐待/监禁/精神疾病史,更多的怀孕,育儿责任,少接触孩子,和贫困的社会支持,它们是用社会生态模型组织的。然而,目前的证据基础存在明显的差距,包括评估的方法和结果不一致,缺乏大量的,纵向研究。该研究强调了高质量纵向研究的重要性,以扩展有关CJS参与母亲中不同风险或保护因素与精神障碍之间因果途径的知识。
    This scoping review critically assessed evidence regarding mental disorders among mothers involved with the criminal justice system (CJS) and provided pooled prevalence rates of mental disorders. In total, 27 studies were included in the review, with 23 studies from the United States of America and 26 focused on incarcerated mothers. The findings supported the evidence on substantial burden of mental disorders, among CJS-involved mothers. Several factors contributing to mental disorders were identified, including history of abuse/incarceration/mental illness, a greater number of pregnancies, child-rearing responsibilities, less contact with children, and poor social support, which were organised using a socioecological model. However, significant gaps in the current evidence base were apparent, including inconsistencies in methodologies and outcomes assessed and a lack of large, longitudinal studies. The study highlights the importance of high-quality longitudinal research to extend knowledge around causal pathways between different risk or protective factors and mental disorders among CJS-involved mothers.
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  • 文章类型: Journal Article
    目的:缺乏关于市场进入时的安全性和有效性的证据促使需要考虑采用生命周期方法来评估医疗器械。但目前还不清楚生命周期评估意味着什么。这项研究试图探索“生命周期”和“生命周期评估”的默认含义,体现在用于医疗设备的评估模型/框架中。
    方法:借鉴定性证据综合方法,采用归纳法,开发新的方法来识别,评价,分析,并综合用于医疗设备的生命周期评估模型。从编码的关键文本中提取数据(包括目的;受众;表征;输出;时间;和模型类型),分类,和比较,从四个广泛的角度探索体现的意义。
    结果:合成中包括52个模型。它们表现出意义的显著异质性,形式,范围,定时,和目的。“生命周期”可能代表一个阶段,一系列的阶段,一个创新的循环,或者一个系统。“生命周期评估”侧重于利益相关者群体的总体目标,并可以使用单一或重复的评估来告知有关采用卫生技术(医疗保健)的决策,资源分配(决策),投资于新产品开发或营销(贸易和工业),或市场监管(法规)。监管机构采用生命周期方法导致将证据生成推迟到上市后阶段。
    结论:使用“生命周期评估”方法来告知报销决策,不得因接受不充分的报销决策安全性和有效性证据而进一步危害证据生成和患者安全。
    OBJECTIVE: Lack of evidence regarding safety and effectiveness at market entry is driving the need to consider adopting a lifecycle approach to evaluating medical devices, but it is unclear what lifecycle evaluation means. This research sought to explore the tacit meanings of \"lifecycle\" and \"lifecycle evaluation\" as embodied within evaluation models/frameworks used for medical devices.
    METHODS: Drawing on qualitative evidence synthesis methods and using an inductive approach, novel methods were developed to identify, appraise, analyze, and synthesize lifecycle evaluation models used for medical devices. Data was extracted (including purpose; audience; characterization; outputs; timing; and type of model) from key texts for coding, categorization, and comparison, exploring embodied meaning across four broad perspectives.
    RESULTS: Fifty-two models were included in the synthesis. They demonstrated significant heterogeneity of meaning, form, scope, timing, and purpose. The \"lifecycle\" may represent a single stage, a series of stages, a cycle of innovation, or a system. \"Lifecycle evaluation\" focuses on the overarching goal of the stakeholder group, and may use a single or repeated evaluation to inform decision-making regarding the adoption of health technologies (Healthcare), resource allocation (Policymaking), investment in new product development or marketing (Trade and Industry), or market regulation (Regulation). The adoption of a lifecycle approach by regulators has resulted in the deferral of evidence generation to the post-market phase.
    CONCLUSIONS: Using a \"lifecycle evaluation\" approach to inform reimbursement decision-making must not be allowed to further jeopardize evidence generation and patient safety by accepting inadequate evidence of safety and effectiveness for reimbursement decisions.
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  • 文章类型: Journal Article
    背景:近年来,事实证明,移动心理干预可有效减少自我伤害和自杀相关行为。因此,必须不断增强用户体验并满足患者的需求,以促进移动心理健康干预措施的发展。识别具有移动心理健康需求的患者对于心理健康专业人员来说可能是一项挑战。为了解决这个问题,我们对定性研究进行了系统综述,以综合参与自我伤害和自杀相关行为的患者对基于移动和互联网的心理干预的需求.
    方法:本研究遵循系统评价和荟萃分析报表(PRISMA)的首选报告项目和定性研究报表综合报告(ENTREQ)的增强透明度。我们探索了11个数据库,并使用专题分析综合了结果。
    结果:共纳入16项定性和混合方法研究。研究发现,具有自我伤害和自杀相关行为的患者对移动心理干预的需求包括治疗,技术,文化,隐私,通信,情感支持,个性化,和自我管理。与技术接受模型(TAM)一致,具有自我伤害和自杀相关行为的患者的需求受到移动干预的感知易用性和感知有用性的影响。然而,调查结果还强调了同伴支持的重要性和未满足的需求,通信,自我管理,和授权使用移动心理干预对患者的自我伤害和自杀相关行为。
    结论:该领域的研究表明,具有自我伤害和自杀相关行为的患者的需求涵盖多个阶段,包括基本的治疗和技术需求以及高级情感需求。这种复杂性使得通过数字干预来解决从事自我伤害和自杀相关行为的患者的需求变得具有挑战性。在未来,应鼓励精神卫生专业人员参与多学科合作,以扩大数字干预措施的使用,加强患者的远程自我管理,为精神病患者的持续护理提供新策略。我们在PROSPERO(CRD42022324958)上注册了审查方案。
    In recent years, mobile psychological interventions have proven effective in reducing self-injury and suicide-related behaviors. Therefore, it is essential to continually enhance the user experience and address patients\' needs to facilitate the development of mobile mental health interventions. Identifying patients with mobile mental health needs can be challenging for mental health professionals. To address this, we conducted a systematic review of qualitative research to synthesize the needs of patients engaged in self-injury and suicide-related behaviors for mobile and internet-based psychological interventions.
    This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (PRISMA) and the Enhancing Transparency in Reporting the Synthesis of Qualitative Research statement (ENTREQ). We explored 11 databases and synthesized the results using thematic analysis.
    Sixteen qualitative and mixed-method studies were included. The study found that the needs of patients with self-injury and suicide-related behaviors for mobile psychological intervention included therapy, technology, culture, privacy, communication, emotional support, personalization, and self-management. Consistent with the Technology Acceptance Model (TAM), the needs of patients with self-injury and suicide-related behaviors are influenced by the perceived ease of use and perceived usefulness of the mobile intervention. However, the findings also highlight the importance and unmet needs of peer support, communication, self-management, and empowerment in using mobile psychological interventions for patients with self-injury and suicide-related behaviors.
    Studies in this area have shown that the needs of patients with self-harm and suicide-related behaviors cover multiple stages, including basic therapeutic and technical needs and advanced emotional needs. This complexity makes it challenging to address the needs of patients engaged in self-injury and suicide-related behaviors through digital interventions. In the future, mental health professionals should be encouraged to participate in multidisciplinary collaborations to expand the use of digital interventions, enhancing remote self-management for patients and providing new strategies for the ongoing care of psychiatric patients. We registered the review protocol on PROSPERO (CRD42022324958).
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  • 文章类型: Journal Article
    银屑病关节炎(PsA)是一种复杂且使人衰弱的慢性炎症性关节疾病,通常与银屑病有关,并在其早期诊断和治疗中提出了重大挑战。因此,这项研究旨在调查初级保健机构中PsA的诊断复杂性,以阐明患病率,障碍,以及延迟诊断的影响。为了实现我们的研究目标,我们使用元人种学方法进行了定性综合,这是一种合成定性数据的可靠方法。我们系统地搜索了PubMed,WebofScience,和Embase数据库使用预定义的搜索词,如“银屑病关节炎,\"\"诊断,“和”初级保健。“纳入标准是英语的叙述性文章,提供了对PsA在初级保健中的诊断挑战的见解。会议介绍,原创文章,重复的文章被排除在外。我们的分析揭示了四个关键主题,阐明了初级保健中PsA诊断的多面性:(1)各种初始和非特异性症状,强调可以模仿其他条件的不同临床表现;(2)初级保健专业人员缺乏PsA的经验,强调教育和培训的重要性;(3)缺乏皮肤损伤,当不存在时,会使诊断复杂化;(4)诊断延迟,对患者的健康和生活质量有潜在的严重后果。这项研究强调了在初级保健环境中PsA诊断固有的挑战。这种疾病的多面性,再加上初级保健提供者的经验有限,通常会导致延迟诊断和随后的治疗开始。早期识别和干预对于优化患者预后至关重要。应对这些挑战需要采取全面的方法,包括增加临床怀疑,继续医学教育,跨学科合作,以及标准化诊断标准的利用。初级保健医生和专家之间的合作对于提高PsA诊断的准确性和及时性以及最终改善患者的健康状况和生活质量至关重要。
    Psoriatic arthritis (PsA) is a complex and debilitating chronic inflammatory joint disorder that is often associated with psoriasis and presents significant challenges in its early diagnosis and management. Therefore, this study aimed to investigate the diagnostic intricacies of PsA in primary care settings to shed light on the prevalence, barriers, and implications of delayed diagnosis. To achieve our research objectives, we conducted a qualitative synthesis using the meta-ethnographic method, which is a robust approach for synthesizing qualitative data. We systematically searched the PubMed, Web of Science, and Embase databases for relevant articles using predefined search terms such as \"psoriatic arthritis,\" \"diagnosis,\" and \"primary care.\" The inclusion criteria were narrative articles in English that provided insights into the diagnostic challenges of PsA in primary care. Conference presentations, original articles, and duplicate articles were excluded. Our analysis revealed four key themes that elucidated the multifaceted nature of PsA diagnosis in primary care: (1) a variety of initial and non-specific symptoms, highlighting the diverse clinical presentations that can mimic other conditions; (2) the lack of experience with PsA among primary care professionals, underscoring the importance of education and training; (3) the lack of skin lesions, which can complicate diagnosis when not present; and (4) a delay in diagnosis, with potentially severe consequences for patients\' health and quality of life. This study highlights the challenges inherent in the diagnosis of PsA in primary care settings. The multifaceted nature of the disease, coupled with limited experience among primary care providers, often results in delayed diagnosis and subsequent treatment initiation. Early recognition and intervention are pivotal for optimizing patient outcomes. Addressing these challenges necessitates a comprehensive approach involving heightened clinical suspicion, continuous medical education, interdisciplinary collaboration, and utilization of standardized diagnostic criteria. Collaboration between primary care physicians and specialists is crucial for enhancing the accuracy and timeliness of PsA diagnosis and ultimately improving patient well-being and quality of life.
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  • 文章类型: Journal Article
    我们旨在综合手部骨关节炎(HOA)患者的经历以及临床医生和护理人员对生活质量和治疗服务的看法。
    我们对MEDLINE进行了系统搜索,Embase,和CINAHL电子数据库,用于HOA的定性研究。我们使用关键评估技能计划(CASP)清单来评估方法质量并以主题方式综合研究结果。我们使用了GRADE-CERQual(建议评估的分级,发展,和评估-对定性研究评论的证据的信心),以评估证据的质量。
    我们确定了13项涉及HOA患者的研究(288名女性和39名男性,平均年龄61.4岁)和临床医生。从涉及HOA患者的研究中确定了五个主题:i)每当我使用它们时,我的手都会疼痛;ii)它阻止我进行日常活动;iii)阻止我做我重视的事情;iv)在心理上具有挑战性,v)我找到做事的方法。除疼痛外,证据质量较低,证据质量中等。大多数研究在欧洲和英国进行,参与者主要从医院招募。我们无法综合涉及临床医生的三项研究,因为每个研究都探讨了HOA的不同主题。没有涉及护理人员的研究。
    我们的研究结果强调了HOA在生活各个领域的影响以及在实践中对个性化心理支持的需求。
    UNASSIGNED: We aimed to synthesise the experiences of people living with hand osteoarthritis (HOA) and the perceptions of clinicians and carers relating to the quality of life and treatment services.
    UNASSIGNED: We undertook a systematic search on MEDLINE, Embase, and CINAHL electronic databases for qualitative studies in HOA. We used the Critical Appraisal Skills Programme (CASP) checklist to assess methodological quality and thematically-synthesise the findings. We used GRADE-CERQual (Grading of Recommendations Assessment, Development, and Evaluation- Confidence in the Evidence from Reviews of Qualitative Research) to assess the quality of the evidence.
    UNASSIGNED: We identified 13 studies involving people with HOA (288 women and 39 men, average age 61.4 years) and clinicians. Five themes were identified from studies involving people with HOA: i) My hands are painful whenever I use them; ii) It stops me doing everyday activities; iii) It stops me doing things I value; iv) It\'s psychologically challenging and v) I find ways of doing things. The quality of evidence was moderate except for pain with low quality of evidence. Most studies were conducted in Europe and the United Kingdom with participants recruited predominantly from hospital settings. We were not able to synthesise the three studies that involved clinicians as each explored different topics of HOA. There were no studies that involved carers.
    UNASSIGNED: Our findings highlighted the impact of HOA in various areas of life and the need for personalised psychological support in practice.
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  • 文章类型: Systematic Review
    背景:未经治疗的精神病(DUP)的持续时间仍然是全球优先事项。早期干预服务旨在减少治疗延误,但影响有限。本系统审查审查了寻求获得这些服务的障碍和促进者,确定服务级别更改的目标。
    方法:我们对相关数据库进行了系统评价(PsychINFO,MEDLINE,CINAHL,和Psycharticles)使用预定义的精神病搜索词,早期干预,障碍和促进者。鉴于大多数定性研究,提出了主题综合而不是荟萃分析。
    结果:搜索产生了10项研究。心理健康污名和歧视预测DUP,加上结构性障碍,限制了早期干预服务对及时获得推荐治疗的影响。综合定性研究产生了三个主题:知识,关系,和耻辱。缺乏知识,缺乏支持关系(社会和专业),和自我污名构成了寻求获得早期干预服务的重大障碍。
    结论:这是对寻求获得早期干预服务的障碍和促进者的第一次审查。调查结果强调了公共卫生和二级保健服务目标,以加快获得推荐的治疗方法,从而减少DUP。
    The duration of untreated psychosis (DUP) continues to be a global priority. Early intervention services were established to reduce treatment delays but have had limited impact. This systematic review examines barriers and facilitators to seeking access to these services, to identify targets for service level change.
    We conducted a systematic review of relevant databases (PsychINFO, MEDLINE, CINAHL, and PsychARTICLES) using pre-defined search terms for psychosis, early intervention, and barriers and facilitators. Given the majority of qualitative studies, a thematic synthesis rather than meta-analysis was indicated.
    The search yielded 10 studies. Mental health stigma and discrimination predict DUP, compounded by structural barriers which limit the impact of early intervention services on timely access to recommended treatments. Synthesis of the qualitative studies generated three themes: knowledge, relationships, and stigma. Lack of knowledge, absence of supportive relationships (social and professional), and self-stigma constitute significant barriers to seeking access to early intervention services.
    This is the first review of the barriers and facilitators to seeking access to early intervention services. The findings highlight public health and secondary care service targets to expedite access to recommended treatments and thereby reduce the DUP.
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