Engaging care partners of persons living with dementia in acceptance and commitment therapy (ACT) programs: a scoping review.

OBJECTIVES: Acceptance and commitment therapy (ACT) is a relatively new type of psychotherapy effective for treating depression and anxiety amongst family care partners of persons living with dementia [PLWD]. However, care partner engagement in mental health services is low and specific guidelines for designing ACT programs for care partners of PLWD do not exist. The purpose of this scoping review was to examine patterns in care partner engagement in ACT programs to identify program factors potentially influencing engagement. METHODS: A comprehensive scoping review according to Arksey and O'Malley's framework was followed. Databases and grey literature were searched for primary studies of ACT programs with care partners of PLWD. Data were charted and synthesized. RESULTS: Ten studies met inclusion criteria and were analyzed. Amongst these, engagement was highest in three ACT programs that were delivered individually, remotely and were therapist-led or supported. Conversely, engagement was the lowest in two ACT programs that were self-directed, web-based and had minimal or no care partner-therapist interaction. Program factors perceived as influencing engagement included tailoring and personalization, mode of delivery and format, therapeutic support and connectedness, program duration and pace. CONCLUSION: Findings from this review suggest that care partners engagement may be promoted by designing ACT programs that focus on the therapeutic client-therapist relationship, are delivered remotely and individually. Future research should focus on evaluation of best implementation practices for engagement and effectiveness.

Nursing students' experiences of a post-licensure practical nurse bridging program: a qualitative systematic review.

OBJECTIVE: The objective of this systematic review was to synthesize qualitative evidence on students' experiences of a post-licensure practical nurse to registered nurse bridging program. INTRODUCTION: A worldwide shortage of registered nurses has prompted governments and educational institutions to develop alternate pathways to nursing licensure. One strategy used to increase the supply of registered nurses is bridging programs. Such programs grant practical nurses academic credit for previous educational and practical experience, which allows them to complete a bachelor of nursing degree in a shorter length of time. Understanding the experience of students enrolled in bridging programs will help identify their specific needs and the educational support needed for them to successfully transition into the registered nurse role. INCLUSION CRITERIA: This review considered qualitative studies that examined the experiences of practical nurses enrolled in bridging programs. METHODS: The literature search was conducted in CINAHL, MEDLINE, Embase, and ERIC. The search for unpublished articles included ProQuest Dissertations & Theses and GreyNet International. Studies published in English were included with no date limits applied to the searches. Papers were screened independently by 2 reviewers against the inclusion criteria. Papers that met the criteria were appraised using the JBI critical appraisal checklist for qualitative research. Key findings were extracted from the included studies using a standardized tool and assigned a level of credibility. The review followed principles of meta-aggregation in line with the JBI approach. The final synthesized findings were graded according to the ConQual approach for establishing confidence in the output of qualitative research synthesis. RESULTS: Twenty-four studies, published between 1989 and 2020, were included in the review. A total of 83 findings were extracted and aggregated into 11 categories. From the 11 categories, 4 synthesized findings were developed and are summarized as: i) growth through professional advancement reflects that bridging students report personal growth and professional transformation when they return to school and study to become a registered nurse; ii) need for support indicates that bridging students recognize and appreciate a need to have positive support networks in their lives, mainly with their family, coworkers, and classmates; iii) expecting more reflects that, as adult learners with prior nursing experience, bridging students anticipate receiving more support from the educational institutions and higher levels of clinical expertise and competence amongst faculty than what is provided; and iv) finding balance indicates that bridging students struggle to balance and manage multiple roles and responsibilities in their lives as they return to school to study to become a registered nurse. CONCLUSION: The findings of this review highlight that, as adult learners with prior nursing experience, when post-licensure practical nurses return to study there is often a need to balance multiple roles and responsibilities. It is with the support of family, coworkers, classmates, and faculty that bridging students are able to manage competing personal and academic demands. While many bridging students express disappointment with some of the learning opportunities and/or faculty expertise associated with the nursing program, they ultimately achieve growth through both personal and professional advancement upon completing the program and becoming a registered nurse. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42021278408. SUPPLEMENTAL DIGITAL CONTENT: A French-language version of the abstract of this review is available as Supplemental Digital Content [ http://links.lww.com/SRX/A10 ].

Education and training for infection prevention and control provided by long-term care homes to family caregivers: a scoping review protocol.

OBJECTIVE: The objective of this review is to map the infection prevention and control education and training that long-term care homes use with families during a pandemic or infectious outbreak. INTRODUCTION: During the COVID-19 pandemic, restrictions were imposed on visits to long-term care homes to decrease the risk of virus transmission. These restrictions had negative consequences for both residents and families. A scoping review of infection prevention and control education and training used with families will inform family visitation practices and policies during future infectious outbreaks. INCLUSION CRITERIA: This review will examine literature describing infection prevention and control education and training provided to families in long-term care homes. Research and narrative papers, including experimental; quasi-experimental; descriptive observational quantitative and qualitative studies; and reviews, text, policy, and opinion papers, will be considered for inclusion. METHODS: A 3-step approach will be followed, in line with the JBI methodology for scoping reviews. Published literature will be searched for in databases, including CINAHL, Embase, ERIC, MEDLINE, and AgeLine. Published and unpublished papers will be considered from 1990 to the present, in English or French. The World Health Organization, Centers for Disease Control, and the Public Health Agency of Canada websites will be searched for unpublished and gray literature. Two authors will independently review and assess studies for inclusion and extract the data. The findings will be charted in a narrative summary and tables.

Effectiveness of general practitioner-delivered nutrition care interventions on dietary and health outcomes in adults with diet-related chronic conditions: a systematic review protocol.

OBJECTIVE: This systematic review will evaluate the effectiveness of nutrition care interventions delivered by general practitioners versus usual care or no care on dietary and health outcomes in adults with diet-related chronic conditions or risk states. INTRODUCTION: General practitioners are usually the first contacts in the health care system for patients with diet-related chronic conditions. While there is some evidence that general practitioners can be effective in delivering nutrition care for a number of outcomes, to inform future care, an update of the evidence is required as well as an examination of which components are associated with positive outcomes. INCLUSION CRITERIA: Published studies will be included if they report on adults with or at risk of diet-related chronic conditions; one-on-one nutrition care interventions individually delivered by general practitioners during primary care consultations; usual or no care as comparators; dietary and/or health outcomes with a minimum three-month follow-up; and randomized controlled trials. Included studies will be available in, or able to be translated into, English and will have no date restrictions. METHODS: The databases to be searched will include CINAHL, Embase, MEDLINE, and ProQuest Nursing and Allied Health. Following deduplication, two reviewers will independently screen the titles and abstracts in Covidence, followed by the full texts of potentially relevant studies. Disagreements will be resolved through discussion or with a third reviewer. Included studies will be critically appraised and data will be extracted using a modified JBI tool. Findings will be reported in tables and narrative synthesis, and pooled with statistical meta-analysis, where possible. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42021289011.

Nursing students' experiences of a post-licensure practical nurse bridging program: a qualitative systematic review protocol.

OBJECTIVE: This systematic review will synthesize the qualitative literature on students' experiences of a post-licensure practical nurse to registered nurse bridging program. INTRODUCTION: The worldwide shortage of registered nurses has prompted governments and educational institutions to develop alternative pathways to nursing licensure. One strategy used to increase the supply of registered nurses is bridging programs. These grant practical nurses academic credit for previous educational and practical experience, which allows them to complete a Bachelor of Nursing degree in a shorter period of time. However, attrition in bridging programs is a concern. Understanding the experiences of students enrolled in bridging programs will help identify their specific needs and the educational support needed for them to successfully transition into the registered nursing role. INCLUSION CRITERIA: This review will include published and unpublished studies that examine the experiences of practical nurses enrolled in bridging programs. Studies published in English will be considered, with no date limitations. METHODS: Databases to be searched include CINAHL, MEDLINE, Embase, and ERIC. Gray literature will be searched for in ProQuest Dissertations and Theses and GreyNet International. Reference lists of included studies will also be reviewed to identify additional studies. The critical appraisal of selected studies and the extraction of data will be independently undertaken by two reviewers using JBI methodology. The findings will be pooled using meta-aggregation to produce comprehensive synthesized findings. A ConQual Summary of Findings will also be presented. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42021278408.

Hospital-based patient navigation programmes for patients who experience injury-related trauma and their caregivers: a scoping review protocol.

INTRODUCTION: Patients who experience injury-related trauma tend to have complex care needs and often require support from many different care providers. Many patients experience gaps in care while in the hospital and during transitions in care. Providing access to integrated care can improve outcomes for these patients. Patient navigation is one approach to improving the integration of care and proactively supporting patients and their caregivers as they navigate the healthcare system. The objective of this scoping review is to map the literature on the characteristics and impact of hospital-based patient navigation programmes that support patients who experience injury-related trauma and their caregivers. METHODS AND ANALYSIS: This review will be conducted in accordance with Joanna Briggs Institute methodology for scoping reviews. The review will include primary research studies, unpublished studies and evaluation reports related to patient navigation programmes for injury-related trauma in hospital settings. The databases to be searched will include CINAHL (EBSCO), EMBASE (Elsevier), ProQuest Nursing & Allied Health, PsycINFO (EBSCO) and MEDLINE (Ovid). Two independent reviewers will screen articles for relevance against the inclusion criteria. Results will be presented in a Preferred Reporting Items for Systematic Reviews and Meta-analyses for Scoping Reviews (PRISMA-ScR) flow diagram and follow the PRISMA-ScR checklist. The extracted data will be presented both tabularly and narratively. ETHICS AND DISSEMINATION: Ethics approval is not required, as the scoping review will synthesise information from publicly available material. To disseminate the findings of this review, the authors will submit the results for publication in a medical or health sciences journal, present at relevant conferences and use other knowledge translation strategies to reach diverse stakeholders (eg, host webinars, share infographics).

Experiences of faculty and staff nurses working with nursing students during clinical placement in residential aged care facilities: a systematic review of qualitative evidence.

OBJECTIVE: The objective of this review was to synthesize evidence on the experiences of faculty and staff nurses working with nursing students in clinical placement in residential aged care facilities. INTRODUCTION: Nursing education helps prepare students to provide quality care to older adults. Nursing programs across the globe are championing the integration of content on the care of older adults into their curricula as well as recognizing the value of clinical placements that focus exclusively on this population. Staff nurses who work in residential aged care facilities often work alongside students. In this role, they can support faculty and mentor students. This review explored faculty and staff experiences of nursing student placements in such facilities. INCLUSION CRITERIA: This review considered qualitative studies that address the experiences of faculty and staff nurses working with nursing students in residential aged care facilities. Studies published in English from 1995 onward were included. METHODS: The literature search was conducted in CINAHL, MEDLINE, Embase, and ERIC. The search for unpublished articles included Proquest Dissertations and Theses and Google searches of the Canadian Nurses Association and American Nurses Association websites. Papers were screened by two reviewers independently against the inclusion criteria. Those meeting the criteria were appraised using the JBI critical appraisal checklist for qualitative research. Key findings from included studies were extracted using a standardized tool and classified as unequivocal, credible, or not supported. This review followed the principles of meta-aggregration in line with the JBI approach. RESULTS: Six studies, published between 2001 and 2017, were included in the review. A total of 32 findings were extracted and aggregated into nine categories. From the nine categories, four synthesized findings were developed: i) students enhance the environment, whereby faculty and staff perceive that student presence enhances the residential aged care work and living environment, ii) effort is required by faculty and staff to make the experience work, reflecting a need for faculty and staff to accept and work with negativities, iii) residential aged care facilities provide rich learning experiences, indicating an appreciation for available learning opportunities, and iv) importance of a residential aged care-academic partnership for a collaborative approach in creating positive experiences for faculty and staff working with students in this setting. CONCLUSION: Faculty and staff experiences highlight that residential aged care has the potential to provide students with valuable learning experiences, including how to provide comprehensive and quality nursing care to older adults. A lack of resources in residential aged care inspires faculty and staff to be creative in how they work with students. However, working with students can be challenging for faculty who lack interest and expertise in caring for older adults in this setting. Additionally, staff can become frustrated when they perceive that students do not value the learning opportunities that are available or do not appreciate the expertise required to work with older adults. Partnerships between residential aged care facilities and academic programs can ensure that faculty and staff have the support and resources required to optimize the clinical placements for students. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42020168698.

Effectiveness of Conservative Nonpharmacologic Therapies for Pain, Disability, Physical Capacity, and Physical Activity Behavior in Patients With Degenerative Lumbar Spinal Stenosis: A Systematic Review and Meta-Analysis.

OBJECTIVE: To investigate the effectiveness of conservative nonpharmacologic therapies on pain, disability, physical capacity, and physical activity outcomes in patients with degenerative lumbar spinal stenosis (LSS). DATA SOURCES: Systematic search of MEDLINE, EMBASE, CENTRAL, and PsycINFO from inception to November 4, 2019, without language restrictions. STUDY SELECTION: Pairs of review authors independently identified randomized controlled trials published in peer-reviewed scientific journals reporting on the effects of rehabilitation interventions on pain intensity (back or leg), disability, symptom severity, physical capacity, physical activity behavior, or adverse events (secondary outcome) in adults with LSS. The search identified 1718 records; data from 21 reports of 19 trials (1432 patients) were included. DATA EXTRACTION: Review author pairs independently extracted data and assessed included studies. We assessed risk of bias with the Cochrane tool, and overall study quality with the Grading of Recommendations Assessment, Development and Evaluation classification. DATA SYNTHESIS: We pooled data using random-effects meta-analyses; treatment effects were reported as mean differences (MD) and 95% confidence intervals (CI). Directed exercise and manual therapy was superior to self-directed or group exercise for improving short-term walking capacity (MD, 293.3 m; 95% CI, 61.7-524.9 m; low-quality evidence), back pain (MD, -1.1; 95% CI, -1.8 to -0.4; moderate quality evidence), leg pain (MD, -.9; 95% CI, -0.2 to -1.5; moderate-quality evidence), and symptom severity (MD, -0.3; 95% CI, -0.4 to -0.2; low quality evidence). There is very low quality evidence that rehabilitation is no better than surgery at improving intermediate- or long-term disability. Single trials provided conflicting evidence of effectiveness for a variety of therapies. CONCLUSIONS: For patients with LSS, there is low- to moderate-quality evidence that manual therapy with supervised exercises improves short-term walking capacity and results in small improvements in pain and symptom severity compared with self-directed or group exercise. The choice between rehabilitation and surgery for LSS is very uncertain owing to the very low quality of available evidence.

Teaching strategies and activities used for students' clinical placement in residential aged care facilities: a scoping review protocol.

OBJECTIVE: The objective of this scoping review is to examine and map current knowledge of teaching strategies and activities used with nursing students during clinical placements in residential aged care facilities. INTRODUCTION: Residential aged care facilities provide opportunities for nursing students to develop skills and interest in caring for older adults. Studies that address students' clinical placements in these settings highlight the benefits of and concerns with their experiences. Insight into the state of knowledge regarding teaching strategies used in residential aged care facilities could benefit nursing education programs and help to ensure student learning is maximized. INCLUSION CRITERIA: This scoping review will consider research and narrative reports on teaching activities and strategies used by nursing faculty and residential aged care facility staff in teaching nursing students. The concepts of interest include planned and intentional activities and strategies used to facilitate student learning and student clinical experiences. A clinical experience is defined as when a student enters a residential aged care facility and is assigned an individual or individuals to care for. METHODS: This scoping review will aim to locate published and unpublished literature employing a three-step search strategy. Only papers published in English from 1992 onward will be included. Data extracted from eligible papers will include details on the participants, context, strategy, activity and outcomes. Extracted data will be reported in a tabular form and presented narratively to address the review objective.

Teaching strategies and activities to enhance students' clinical placement in residential aged care facilities: a scoping review.

OBJECTIVE: The purpose of this scoping review was to examine teaching strategies and activities used in nursing students' clinical placement in residential aged care facilities. INTRODUCTION: Population aging necessitates that nursing curricula ensure student interest and commitment to working with older adults. While searching for suitable clinical placements that provide students with opportunities to care for older adults, nursing programs have turned to residential aged care facilities. Studies show that carefully planned placement in these environments supports students' needs and offers rich learning possibilities. INCLUSION CRITERIA: This review examined intentional teaching strategies and activities used during student placement in residential aged care facilities, and considered research and textual papers on the subject. The strategies and activities included those that took place prior to, during, or after the experience. METHODS: The review included qualitative and quantitative research reports as well as text and opinion papers. Only research reports and papers published in English from 1992 to August 2019 were included. The databases searched were: CINAHL (EBSCO), MEDLINE (Ovid), Academic Search Premier (EBSCO), Embase (Elsevier), ERIC (EBSCO), ProQuest Dissertations and Theses, and Google (with advanced search strategies). Two independent reviewers screened citations for inclusion while a third reviewer resolved discrepancies. A table was developed for data extraction to record data relating to the review objective. Specific data extracted included the details on research design, geographical location, year of publication, description of the teaching strategy or activity. RESULTS: Of the 84 research reports and papers that were eligible for full-text review, only 25 (30%) were included in the final set. Sixteen papers were research reports including a variety of qualitative, quantitative, and mixed method designs. The remaining nine were textual papers and included frameworks, descriptions, and evaluations of a teaching strategy or activity. Most research reports and papers identified more than one strategy and/or activity used concurrently. The use of care staff as student mentors and facility orientation for students were the two most common strategies and activities reported. CONCLUSION: A range of teaching approaches during clinical placements in residential aged care facilities was revealed. These approaches targeted students, staff of aged care facilities, and nursing faculty. Collaborative efforts between aged care facilities and educational institutions allowed for the pooling of resources and the delivery of teaching approaches to students and the engagement of care staff. Many of the approaches were co-designed by educational programs and residential aged care facilities. The number of approaches that used more than one teaching strategy and/or activity reflects an appreciation for the importance of student placements and the complexities of aged care facilities. A lack of longitudinal or evaluative research highlights a gap in the literature. There is a need for further work to understand and evaluate the long-term effects and benefits of teaching strategies and activities used to enhance students' clinical placements in resident aged care facilities.

Faculty and nursing staff experiences and perceptions of nursing students' clinical placements in residential aged care facilities: a qualitative systematic review protocol.

OBJECTIVE: The objective of this review is to synthesize evidence on the experiences and perceptions of faculty and staff nurses toward nursing students' clinical placements in residential aged care facilities. INTRODUCTION: Nursing education plays an important role in preparing students to provide quality care to older adults. Recent reports suggest that nursing programs across the globe are championing the integration of content on the care of older adults into their curricula as well as recognizing the value of clinical placements that focus exclusively on care for older adults, such as in residential aged care facilities. Student experiences in residential aged care facilities can play a significant role in helping shape professional identity as well as how the setting is viewed. Student interactions with nursing faculty and staff in the residential care learning environment are both recognized as being influential in this process. This review seeks to explore faculty and staff experiences and perceptions of nursing student placements in such facilities. INCLUSION CRITERIA: This review will consider qualitative studies that address the experiences and perceptions of faculty and staff nurses who work with nursing students in residential aged care facilities. Studies published in English and from 1995 onward will be sought. METHODS: Two reviewers will independently appraise studies and extract qualitative data using the JBI standardized critical appraisal and extraction instruments. Findings from the review will be categorized according to similarity in meaning, and categories subjected to a meta-synthesis to produce a single comprehensive set of synthesized findings.

An umbrella review of clinical practice guidelines for the management of patients with hip fractures and a synthesis of recommendations for the pre-operative period.

AIM: The aim of this review was to locate, retrieve and critically appraise practice guidelines for the management of hip fractures. Given increasing evidence that the early recognition and management of these fractures is integral to achieving optimal outcomes, recommendations for the pre-operative period were synthesized and compared. BACKGROUND: Hip fractures are associated with high rates of adverse outcomes and high healthcare costs which has resulted in the development of multiple practice guidelines to inform clinical decision-making. DESIGN: An umbrella review of practice guidelines was conducted which included a critical appraisal using the Appraisal of Guidelines, Research and Evaluation-II instrument and a synthesis of pre-operative management recommendations. DATA SOURCES: Multi-phased search for practice guidelines published in English using three bibliographic databases; three guideline network websites and three healthcare safety and quality organization websites with no date limit applied. Search was supplemented by contacting front-line knowledge users and content experts. REVIEW METHODS: Steps for evidence-informed practice were followed: form question then search for, appraise and synthesize the evidence. RESULTS: Five practice guidelines were appraised revealing significant variability in quality. The largest variability was in "rigour of development". Recommendations for pre-operative management were grouped into six categories: timing of surgery, expedited patient management, identification and treatment of correctable co-morbidities, pain management, preventative measures and multidisciplinary management. CONCLUSION: Results of this review illustrate that not all practice guidelines are of equal quality. Given the costs associated with the development and maintenance of high-quality practice guidelines, such work may be more efficiently completed through international collaborations and then adapted for national and regional healthcare contexts.

How You Use It Matters: Object Function Guides Attention During Visual Search in Scenes.

How does one know where to look for objects in scenes? Objects are seen in context daily, but also used for specific purposes. Here, we examined whether an object's function can guide attention during visual search in scenes. In Experiment 1, participants studied either the function (function group) or features (feature group) of a set of invented objects. In a subsequent search, the function group located studied objects faster than novel (unstudied) objects, whereas the feature group did not. In Experiment 2, invented objects were positioned in locations that were either congruent or incongruent with the objects' functions. Search for studied objects was faster for function-congruent locations and hampered for function-incongruent locations, relative to search for novel objects. These findings demonstrate that knowledge of object function can guide attention in scenes, and they have important implications for theories of visual cognition, cognitive neuroscience, and developmental and ecological psychology.

Factors influencing the role of cardiac autonomic regulation in the service of cognitive control.

Working from a model of neurovisceral integration, we examined whether adding response contingencies and motivational involvement would increase the need for cardiac autonomic regulation in maintaining effective cognitive control. Respiratory sinus arrhythmia (RSA) was recorded during variants of the Stroop color-word task. The Basic task involved "accepting" congruent items and "rejecting" words printed in incongruent colors (BLUE in red font); an added contingency involved rejecting a particular congruent word (e.g., RED in red font), or a congruent word repeated on an immediately subsequent trial. Motivation was increased by adding a financial incentive phase. Results indicate that pre-task RSA predicted accuracy best when response contingencies required the maintenance of a specific item in memory or on the Basic Stroop task when errors resulted in financial loss. Overall, RSA appeared to be most relevant to performance when the task encouraged a more proactive style of cognitive control, a control strategy thought to be more metabolically costly, and hence, more reliant on flexible cardiac autonomic regulation.