Health measurement scales

OBJECTIVE. We explored whether people who become alcohol dependent at younger ages are more likely to seek alcohol-related help or treatment or experience chronic relapsing dependence. METHODS. In 2001–2002 the National Institute on Alcohol Abuse and Alcoholism completed a face-to-face interview survey with a multistage probability sample of 43 093 adults aged ≥18, with a response rate of 81%. We focused on 4778 persons diagnosable as alcohol dependent ever in their lives using Diagnositic and Statistical Manual of Mental Disorders, Fourth Edition criteria. Logistic regression examined whether respondents ever sought alcohol-related help or treatment, controlling for respondent demographics, number of dependence symptoms experienced, smoking and illicit drug use, childhood antisocial personality and depression, family history of alcoholism, and age of drinking onset. RESULTS. Of persons ever alcohol dependent, 15% were diagnosable before age 18, 47% before age 21, and two thirds before age 25. Twenty-eight percent reported ≥2 dependence episodes, 45% experienced an episode exceeding 1 year, and 34% reported 6 or 7 dependence criteria. Relative to those first alcohol dependent at ≥30 years, 21% of those ever dependent, the odds of ever seeking help were lower among those first dependent before ages 18, 20, and 25. Yet, persons first dependent at ≤25 years had significantly greater odds of experiencing multiple dependence episodes, episodes exceeding 1 year, and more dependence symptoms. Analyses indicated that the previously reported increased odds that persons who start to drink at an early age develop features of chronic relapsing dependence may have resulted from early drinkers being more likely to develop alcohol dependence at younger ages. This, in turn, increased their odds of experiencing multiple and longer episodes of alcohol dependence with more symptoms. CONCLUSIONS. Adolescents need to be screened and counseled about alcohol, and treatment services should be reinforced by programs and policies to delay age of first alcohol dependence.

Age of Alcohol-Dependence Onset: Associations with Severity of Dependence and Seeking Treatment.

Despite the problem of inadequate recruitment to randomised trials, there is little evidence to guide researchers on decisions about how people are effectively recruited to take part in trials. The PRioRiTy study aimed to identify and prioritise important unanswered trial recruitment questions for research. The PRioRiTy study - Priority Setting Partnership (PSP) included members of the public approached to take part in a randomised trial or who have represented participants on randomised trial steering committees, health professionals and research staff with experience of recruiting to randomised trials, people who have designed, conducted, analysed or reported on randomised trials and people with experience of randomised trials methodology. This partnership was aided by the James Lind Alliance and involved eight stages: (i) identifying a unique, relevant prioritisation area within trial methodology; (ii) establishing a steering group (iii) identifying and engaging with partners and stakeholders; (iv) formulating an initial list of uncertainties; (v) collating the uncertainties into research questions; (vi) confirming that the questions for research are a current recruitment challenge; (vii) shortlisting questions and (viii) final prioritisation through a face-to-face workshop. A total of 790 survey respondents yielded 1693 open-text answers to 6 questions, from which 1880 potential questions for research were identified. After merging duplicates, the number of questions was reduced to 496. Questions were combined further, and those that were submitted by fewer than 15 people and/or fewer than 6 of the 7 stakeholder groups were excluded from the next round of prioritisation resulting in 31 unique questions for research. All 31 questions were confirmed as being unanswered after checking relevant, up-to-date research evidence. The 10 highest priority questions were ranked at a face-to-face workshop. The number 1 ranked question was “How can randomised trials become part of routine care and best utilise current clinical care pathways?” The top 10 research questions can be viewed at www.priorityresearch.ie
 . The prioritised questions call for a collective focus on normalising trials as part of clinical care, enhancing communication, addressing barriers, enablers and motivators around participation and exploring greater public involvement in the research process.

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Identifying trial recruitment uncertainties using a James Lind Alliance Priority Setting Partnership – the PRioRiTy (Prioritising Recruitment in Randomised Trials) study

The aim of this systematic review was to describe the association between adolescent sense of coherence (SOC) and health and identify the future direction for research in this area. Systematic searches were conducted (2007-2014) in the PubMed, CINAHL, PsycINFO and Cochrane electronic databases and carried out manual searches in three scientific journals. A total of 827 original papers were found and 23 were selected. Based on the results, adolescents' sense of coherence (SOC) was related to health in terms of the adolescents' quality of life, health behaviour, mental health and family relationships by using 31 different health-related instruments. In conclusion, the use of the SOC approach for adolescents can provide a useful view of their health during this transition phase to adulthood. Due to the large variation in the additional instruments used, combining and comparing the results proved challenging. More comparative and longitudinal research is needed to increase understanding of adolescents' health in relation to SOC and develop services that support both elements.

A systematic review of adolescents' sense of coherence and health.

Standards and Operational Guidance for Ethics Review of Health-Related Research with Human Participants

Transition to adult life of young people leaving foster care: A qualitative systematic review

The transition to adult life for those leaving foster care is a multidimensional phase of their personal development. Care leavers’ life outcomes are poorer in education, employment, income, housing and parenthood compared with their peers from the general population. They suffer more than other youngsters from mental health and behavioral problems, substance abuse and involvement with criminality. This study aims to gather, assess and synthesize the current empirical evidence about subjective perceptions and experiences of former youth in foster care regarding their independent living during the transition to adulthood. A systematic review was conducted of studies drawn from six databases and included quantitative studies from 2010 to 2017. Of the 37 eligible studies identified, 13 were selected for final review. Data was analyzed using a narrative method. Foster care leavers identified themselves as adult and were quite confident about their future and potential for independent living. They had different coping strategies and profiles, but often faced the same challenges in finding employment, education and having a person whom they could rely on. Among the factors that supported the transition to independent living were care leavers’ personal characteristics, certain care-specific features, good education, sufficient prerequisites for a safe life and social support. This review looked at various descriptive studies based on different conceptual perspectives, cultural contexts and methodologies. The evidence, however, still remains relatively insubstantial. Further studies are needed to provide more reliable evidence-based recommendations to inform service development, staff education and additional research activities.

/pdf/young-people-s-preparedness-for-adult-life-and-coping-after-3astn4sqmg.pdf

Young People’s Preparedness for Adult Life and Coping After Foster Care: A Systematic Review of Perceptions and Experiences in the Transition Period

Background:In order to protect the autonomy of human subjects, we need to take their culture into account when we are obtaining informed consent.Objective and research design:This study describes the cultural aspects related to informed consent in health research and is based on electronic searches that were conducted using the Scopus, PubMed, CINAHL, and Cochrane databases published between 2000 and 2013. A total of 25 articles were selected.Findings:Our findings indicate that cultural perspectives relating to the informed consent process are essential during the whole research process and particularly crucial in the planning phase of a study. Our study indicates that appropriate communication between different stakeholders plays a vital role in cultural understanding.Discussion and conclusion:The researchers’ awareness of cultural differences and their ability to work in a culturally sensitive way are key factors in improving study participation and retention in a multicultural context. Taking cultural ...

Cultural aspects related to informed consent in health research A systematic review

AIM To gather and synthesize current empirical evidence on remote leadership and to provide knowledge that can be used to develop successful remote leadership in health care. DESIGN A integrative literature review with an integrated mixed methods design. DATA SOURCES The literature search was carried out between February and March 2019 in the CINAHL, Medline (Ovid), PsycInfo, Scopus, SocIndex, Web of Science and Business Source Elite (EBSCO) databases. REVIEW METHODS An integrative review was conducted to identify relevant studies published from 2010 to 2019. Of the 88 eligible studies, 21 studies met the inclusion criteria and were selected for the final review. The included studies were analysed using mixed methods synthesis, more specifically, data-based convergent synthesis. RESULTS The performed analysis identified three main themes: characteristics of successful remote leadership; enhancing the leader-member relationship; and challenges in remote leadership. The first theme included the following sub-themes: remote leader characteristics; trust; communication; and leading the team culture. The second theme covered the importance of organizing regular face-to-face meetings, clear communication policies and the connection between positive team spirit and good remote leader-member relationship, while the third theme emphasized leader- and member-related challenges for remote work. CONCLUSIONS As none of the identified studies had been conducted in a health care setting, future remote leadership research must also specifically consider the health care context. This will be pivotal to exploring how remote work can foster a safe workplace culture, empower health care workers, increase job satisfaction and improve patient outcomes. IMPACT Remote leadership has rarely been studied in the health care context. Trust, communication, team spirit and a leader's characteristics are central to remote leadership, a finding which is useful for re-evaluating and improving the current culture at health care organizations.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/jan.15028

Towards remote leadership in health care: Lessons learned from an integrative review.

Background Future nursing shortages and advanced technological developments mean that robots and automated devices could play a valuable role in nursing, but little has been published on their use, and outcomes, to date. Aim This integrative review identified how robots are currently used in nursing and the outcomes of those initiatives. Design This study used integrative review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Data sources We searched the CINAHL, PubMed, Web of Science, and Scopus databases for peer-reviewed papers published in English from January 2010 to August 2018. Review methods The five-stage review process by Whittemore and Knafl was used. Results The 25 included papers showed that robots and automated devices were mainly used in nursing to deliver medication, monitor patients, and provide nursing treatments. The outcomes were evaluated in relation to patient safety, working time and workload, usability, and the end users' satisfaction. In addition, the costs, care outcomes, nurses' behaviour, and changes in working procedures were considered. Conclusions Robots and automated devices have the potential to develop nurses' work, but more research and critical evaluations are needed to find the most suitable devices and focus on the functions that will provide the best outcomes for nurses' work.

Suyen Karki

Papers

Transition to adult life of young people leaving foster care: A qualitative systematic review

Young People’s Preparedness for Adult Life and Coping After Foster Care: A Systematic Review of Perceptions and Experiences in the Transition Period

Cultural aspects related to informed consent in health research A systematic review

Towards remote leadership in health care: Lessons learned from an integrative review.

The use of robots and other automated devices in nurses' work: An integrative review.