Systematic Reviews on the Basis of Methodological Criteria

doi:10.1016/S0031-9406(05)66175-5

Physiotherapy

Volume 83, Issue 6, June 1997, Pages 284-289

https://doi.org/10.1016/S0031-9406(05)66175-5 Get rights and content

Summary

This paper describes a method of systematic reviewing. This method puts much emphasis on the methodological quality of the randomised clinical trials involved. Various items concerning the internal validity, precision and relevance of the studies are scored in such a way that next to the methodological quality the amount of uncertainty about it also becomes visible. These quality assessments are not only useful for systematic reviews, but also have an educational function for researchers with respect to the design and publication of a clinical trial.

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Factors affecting provision of oral health care for people with special health care needs: A systematic review
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Special health care needs (SHCNs) individuals experience higher levels of dental problems including accessing oral health (OH) facilities. Improving standard of OH care in SHCNs requires identifying barriers and enablers. The aim of this study was to perform a systematic review of prior researches to identify OH care barriers and enablers for SHCN individuals.
Electronic searching was conducted systematically in PubMed and Cochrane databases. The PICOS parameters were formulated for the inclusion of studies, and the PRISMA method was used to select the articles. Two reviewers independently screened the articles for eligibility and to minimise the risk of bias in the studies and also searched the contents of key articles, quality of methodology, outcomes and reference lists of all the studies included.
A total of 1316 (PubMed 956, Cochrane 360) studies were found initially and after title and abstract screening and also removal of duplication, reviewers selected 53 papers from PubMED and 19 articles from Cochrane to go through full articles and led to the final confirmation of 21 studies. Common challenges included lack of OH knowledge and awareness, difficulty in accessing treatment, transportation problem, treatment cost, and lack of inter-professional collaboration for specialized services. Potential solutions included OHE training and services for patients and caregivers, easy access to dental services, specialized dental practitioners and use of a combination of expertise to meet the demands of SHCN individuals.
This brief analysis will establish dental obstacles to the provision of information to policymakers for SHCN population at organizational, individuals and policy levels. It will help in effective planning for providing and improving OH care quality in caregivers.
Individual and organizational factors of nurses' job satisfaction in long-term care: A systematic review
2021, International Journal of Nursing Studies
In long-term care facilities, nurses’ job satisfaction predicts staff turnover, which adversely affects resident outcomes. Thus, it is important to develop a comprehensive understanding of factors affecting nurses’ job satisfaction in long-term care facilities.
To analyze factors associated with job satisfaction among nurses in nursing homes from individual and organizational perspectives utilizing a deductive approach.
Systematic literature review
Nursing homes.
Registered nurses and licensed practical nurses in nursing homes.
A systematic literature review of seven online databases (EMBASE, CINAHL, PsychINFO, MEDLINE, PubMed, Scopus, and Web of Science) to July 23, 2020 was conducted. Studies were included if they examined factors associated job satisfaction in the target population and setting. Decision rules on how to determine factors important to nurse job satisfaction were developed a priori. Two team members independently screened the publications for inclusion, extracted data, and assessed included publications for methodological quality; conflicts were resolved through a consensus process and consultation of the third senior team member when needed.
Twenty-eight studies were included. Of these, 20 studies were quantitative, 6 were qualitative, and 2 were mixed methods. Factors associated with job satisfaction were grouped into two categories: individual and organizational. Individual factors significantly associated with job satisfaction were age, health status, self-determination/autonomy, psychological empowerment, job involvement, work exhaustion, and work stress. Individual factors identified as not important or equivocal were gender and experience as a nurse/in aged care. No organizational factors were identified as important for nurses’ job satisfaction. Facility ownership, supervisor/manager support, resources, staffing level, and social relationships were identified as equivocal or not important. Findings from qualitative studies identified relationship with residents as an important factor for job satisfaction.
Factors identified as important to nurses’ job satisfaction differ from those reported among care aides in nursing homes and nurses employed in acute care settings, suggesting that there is a need for unique approaches to enhance nurses’ job satisfaction in nursing homes.
Job satisfaction among critical care nurses: A systematic review
2018, International Journal of Nursing Studies
Nursing shortages, particularly in critical care units, are a major concern worldwide. Job satisfaction is a key factor associated with the high turnover of critical care nurses.
The purpose of this systematic review was to synthesize the evidence on critical care nurses’ job satisfaction. Specific research questions were: 1. How is job satisfaction defined and measured in studies of critical care nurses? 2a. What is the level of job satisfaction among critical care nurses? 2b. How has it changed over time? 2c. Do nurses’ levels of job satisfaction differ by type of critical care unit? 3. What factors are associated with critical care nurses’ job satisfaction?
Systematic review.
We searched five electronic databases from January 1980 to May 2015: MEDLINE, CINAHL, PsychINFO, EMBASE, and Proquest Nursing & Allied Health Source.
Two team members independently screened all titles and abstracts and extracted data and assessed methodological quality on all included papers. A narrative synthesis with vote counting was undertaken.
A total of 1995 titles were identified, of which 61 satisfied our inclusion criteria. Only 24 (39%) of the included studies reported a conceptual definition of job satisfaction. Forty-two different quantitative measures of job satisfaction were identified, of which only 10 (24%) were used in multiple studies. The weighted mean job satisfaction score for critical care nurses across all studies was 56% satisfied and demonstrated fluctuations over time. Four factors showed significant positive relationships to job satisfaction: 1. shift worked – rotating 8- to 12-h and rotating days, evenings or nights; 2. Autonomy; 3. personnel resources and staffing; and 4. teamwork and cohesion; while two factors showed significant negative relationships to job satisfaction: 1. job stress; and 2. burnout-emotional exhaustion.
From this review, we did not find any evidence to support relationships between individual (socio-demographic) factors and critical care nurses’ job satisfaction. We did however find evidence to support relationships between several employment and organizational factors and job satisfaction. Several of these factors are different from those reported among general hospital nurses and long-term care nursing staff, supporting the need for differential strategies to improve critical care nurses’ job satisfaction. While the findings from this review hold promise as potential targets of future job satisfaction interventions, there were several methodological problems inherent in many of the studies.
Barriers and facilitators in providing oral care to nursing home residents, from the perspective of care aides: A systematic review and meta-analysis
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Oral health of nursing home residents is generally poor, with severe consequences for residents’ general health and quality of life and for the health care system. Care aides in nursing homes provide up to 80% of direct care (including oral care) to residents, but providing oral care is often challenging. Interventions to improve oral care must tailor to identified barriers and facilitators to be effective. This review identifies and synthesizes the evidence on barriers and facilitators care aides perceive in providing oral care to nursing home residents.
We systematically searched the databases MEDLINE, Embase, Evidence Based Reviews—Cochrane Central Register of Controlled Trials, CINAHL, and Web of Science. We also searched by hand the contents of key journals, publications of key authors, and reference lists of all studies included. We included qualitative and quantitative research studies that assess barriers and facilitators, as perceived by care aides, to providing oral care to nursing home residents. We conducted a thematic analysis of barriers and facilitators, extracted prevalence of care aides reporting certain barriers and facilitators from studies reporting quantitative data, and conducted random-effects meta-analyses of prevalence.
We included 45 references that represent 41 unique studies: 15 cross-sectional studies, 13 qualitative studies, 7 mixed methods studies, 3 one-group pre-post studies, and 3 randomized controlled trials. Methodological quality was generally weak. We identified barriers and facilitators related to residents, their family members, care providers, organization of care services, and social interactions. Pooled estimates (95% confidence intervals) of barriers were: residents resisting care = 45% (15%–77%); care providers’ lack of knowledge, education or training in providing oral care = 24% (7%–47%); general difficulties in providing oral care = 26% (19%–33%); lack of time = 31% (17%–47%); general dislike of oral care = 19% (8%–33%); and lack of staff = 22% (13%–31%).
We found a lack of robust evidence on barriers and facilitators that care aides perceive in providing oral care to nursing home residents, suggesting a need for robust research studies in this area. Effective strategies to overcome barriers and to increase facilitators in providing oral care are one of the most critical research gaps in the area of improving oral care for nursing home residents. Strategies to prevent or manage residents’ responsive behaviors and to improve care aides’ oral care knowledge are especially needed.
Factors influencing health-related quality of life among long-term care residents experiencing pain: a systematic review protocol
2024, Systematic Reviews
Common tool structures and approaches to risk of bias assessment: implications for systematic reviewers
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¹: Henrica C W de Vet PhD, Robert A de Bie MSc PT, Geert J M G van der Heijden PhD PT, Arianne P Verhagen MSc PT MT, Petra Sijpkes MSc PT and Paul G Knipschild MD PhD work in the Department of Epidemiology, University of Maastricht, the Netherlands.

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FOCUSSystematic Reviews on the Basis of Methodological Criteria

Summary

Controlled Clinical Trials

Journal of Clinical Epidemiology

Controlled Clinical Trials

‘Efficacy of chiropractic manipulation for back pain; Blinded review of relevant randomised clinical trials’

Journal of Manipulative and Physiological Therapeutics

‘The efficacy of laser therapy for musculoskeletal and skin disorders; A criteria-based meta analysis of randomised clinical trials’

Physical Therapy

‘The efficacy of physiotherapy for musculoskeletal disorders: Overview of the current state of knowledge’

European Journal of Physical and Medical Rehabilitation

‘Efficacy of physiotherapy for musculoskeletal disorders: What can we learn from research?’

British Journal of General Practice

Clinical Epidemiology: The essentials

FOCUS
Systematic Reviews on the Basis of Methodological Criteria