ABSTRACT
PURPOSE: To systematically review and evaluate the effects of humanized care of the critically ill on empathy among healthcare professionals, anxiety among relatives, and burnout and compassion fatigue in both groups. SOURCE: MEDLINE, PsycINFO, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials (CENTRAL), and ProQuest Dissertations were searched from inception to 29 June 2017 for studies that investigated the effects of interventions with potential to humanize care of the critically ill on the following outcomes: empathy among critical care professionals, anxiety among relatives, and burnout and compassion fatigue in either group. We defined a humanizing intervention as one with substantial potential to increase physical or emotional proximity to the patient. Two reviewers independently selected studies, extracted data, and assessed risk of bias and data quality. PRINCIPAL FINDINGS: Twelve studies addressing four discrete interventions (liberal visitation, diaries, family participation in basic care, and witnessed resuscitation) and one mixed intervention were included. Ten studies measured anxiety among 1,055 relatives. Two studies measured burnout in 288 critical care professionals. None addressed empathy or compassion fatigue. Eleven of the included studies had an overall high risk of bias. No pooled estimates of effect were calculated as a priori criteria for data synthesis were not met. CONCLUSIONS: We found insufficient evidence to make any quantitative assessment of the effect of humanizing interventions on any of these psychologic outcomes. We observed a trend towards reduced anxiety among family members who participated in basic patient care, liberal visitation, and diary keeping. We found conflicting effects of liberal visitation on burnout among healthcare professionals.
Subject(s)
Critical Care/psychology , Health Personnel/psychology , Humanism , Anxiety/epidemiology , Anxiety/prevention & control , Burnout, Professional/epidemiology , Burnout, Professional/prevention & control , Compassion Fatigue/prevention & control , Critical Illness/psychology , Empathy , Family/psychology , HumansABSTRACT
Purpose: The purpose of this study was to (a) confirm the barriers to and facilitators of physical activity (PA) among persons living with chronic kidney disease (CKD) in Ontario and (b) inform the design of a Kidney Foundation of Canada Active Living for Life programme for persons living with CKD. Method: Adults living with CKD in Ontario were invited to participate in a cross-sectional survey investigating opinions about and needs for PA programming. The 32-item survey contained four sections: programme delivery preferences, current PA behaviour, determinants of PA, and demographics. Data were summarized using descriptive statistics and thematic coding. Results: A total of 63 respondents participated. They had a mean age of 56 (SD 16) years, were 50% female, and were 54% Caucasian; 66% had some post-secondary education. The most commonly reported total weekly PA was 90 minutes (range 0-1,050 minutes). Most respondents (84%) did not regularly perform strength training, and 73% reported having an interest in participating in a PA programme. Conclusion: Individuals living with CKD require resources to support and maintain a physically active lifestyle. We identified a diversity of needs, and they require a flexible and individualized inter-professional strategy that is responsive to the episodic changes in health status common in this population.
Objectif : la présente étude visait à a) confirmer les obstacles et les incitatifs à l'activité physique (AP) chez les personnes atteintes d'une néphropathie chronique (NPC) en Ontario et b) étayer la conception du programme Une vie active pour la vie de la Fondation canadienne du rein pour les personnes atteintes d'une NPC. Méthodologie : des adultes de l'Ontario atteints d'une NPC ont été invités à participer à un sondage transversal sur leurs avis et leurs besoins liés aux programmes d'AP. Le sondage de 32 questions était divisé en quatre parties : préférences quant à la prestation du programme, comportements actuels en matière d'AP, déterminants de l'AP et démographie. Les chercheurs ont résumé les données à l'aide de statistiques descriptives et de codes thématiques. Résultats : au total, 63 répondants ont participé. Ils avaient un âge moyen de 56 ans (ÉT de 16 ans), 50 % étaient des femmes, 54 % étaient blancs et 66 % avaient une certaine éducation postsecondaire. L'AP physique hebdomadaire totale la plus déclarée était de 90 minutes (plage de 0 à 1 050 minutes). La plupart des répondants (84 %) ne faisaient pas d'entraînement musculaire régulier, et 73 % se sont dit intéressés à participer à un programme d'AP. Conclusion : les personnes atteintes d'une NPC ont besoin de ressources pour maintenir un mode de vie actif. Les chercheurs ont repéré une diversité de besoins et la nécessité d'une stratégie interprofessionnelle personnalisée qui tient compte des changements épisodiques de l'état de santé, courants dans cette population.
