A B S T R A C T Background:Having support from an informal carer is important for heart failure patients. Carers have the potential to improve patient self-care. At the same time, it should be acknowledged that caregiving could affect the carer negatively and cause emotional reactions of burden and stress. Dyadic (patient and informal carer) heart failure self-care interventions seek to improve patient self-care such as adherence to medical treatment, exercise training, symptom monitoring and symptom management when needed. Currently, no systematic assessment of dyadic interventions has been conducted with a focus on describing components, examining physical and delivery contexts, or determining the effect on patient and/or carer outcomes.Objective: To examine the components, context, and outcomes of dyadic self-care interventions.Design: A systematic review registered in PROSPERO, following PRISMA guidelines with a narrative analysis and realist synthesis. Data Sources: PubMed, EMBASE, Web of Science, PsycINFO, and Cochrane Central Register of Controlled Trials were searched using MeSH, EMTREE terms, keywords, and keyword phrases for the following concepts: dyadic, carers, heart failure and intervention. Eligible studies were original research, written in English, on dyadic self-care interventions in adult samples. Review methods:We used a two-tiered analytic approach including both completed studies with power to determine outcomes and ongoing studies including abstracts, small pilot studies and protocols to forecast future directions.Results: Eighteen papers -12 unique, completed intervention studies (two quasi-and ten experimental trials) from 2000 to 2016 were reviewed.Intervention components fell into three groups -education, support, and guidance. Interventions were implemented in 5 countries, across multiple settings of care, and involved 3 delivery modes -face to face, telephone or technology based. Dyadic intervention effects on cognitive, behavioral, affective and health services utilization outcomes were found within studies. However, findings across studies were inconclusive as some studies reported positive and some non-sustaining outcomes on the same variables. All the included papers had methodological limitations including insufficient sample size, mixed intervention effects and counter-intuitive outcomes. Conclusions:We found that the evidence from dyadic interventions to promote heart failure selfcare, while growing, is still very limited. Future research needs to involve advanced sample size justification, innovative solutions to increase and sustain behavior change, and use of mixed methods for capturing a more holistic picture of effects in clinical practice. Contribution of the paper:What is already known about the topic?• Having support from an informal carer is important for heart failure (HF) patients • Dyadic (patient and informal carer) HF self-care interventions seek to improve patient self-care such as adherence to medical treatment, exercise training, symptom monitoring and symptom...
IntroductionThe authors examined the time that medical librarians spent on specific tasks for systematic reviews (SRs): interview process, search strategy development, search strategy translation, documentation, deliverables, search methodology writing, and instruction. We also investigated relationships among the time spent on SR tasks, years of experience, and number of completed SRs to gain a better understanding of the time spent on SR tasks from time, staffing, and project management perspectives.MethodsA confidential survey and study description were sent to medical library directors who were members of the Association of Academic Health Sciences Libraries as well as librarians serving members of the Association of American Medical Colleges or American Osteopathic Association.ResultsOf the 185 participants, 143 (77%) had worked on an SR within the last 5 years. The number of SRs conducted by participants during their careers ranged from 1 to 500, with a median of 5. The major component of time spent was on search strategy development and translation. Average aggregated time for standard tasks was 26.9 hours, with a median of 18.5 hours. Task time was unrelated to the number of SRs but was positively correlated with years of SR experience.ConclusionThe time required to conduct the librarian’s discrete tasks in an SR varies substantially, and there are no standard time frames. Librarians with more SR experience spent more time on instruction and interviews; time spent on all other tasks varied widely. Librarians also can expect to spend a significant amount of their time on search strategy development, translation, and writing.
The objective of collecting library statistics is “to assess the quality and effectiveness of services [and resources] provided by the library” (Poll, 2001, p.307). A review of the literature shows that measurement of electronic resources is a concern, that standards are necessary, and collaboration with publishers is required. As libraries spend more of their valuable resources to provide access to the electronic environment, they need to turn their attention to the effective measurement of electronic resources. In order to do this, libraries must determine relevant statistics (including those that can be collected internally by the library), request vendors to provide standardized statistics, and finally, evaluate the data in the context of their unique setting to enable sound decision-making. Libraries also need to utilize user surveys in addition to local and content-provider statistics, to get a clearer picture of their user’s needs and satisfaction with library services and resources. Although the task is daunting, obtaining reliable statistics in the electronic environment is needed and continues to be another challenging area in academic libraries. This chapter will examine the various issues involved in gathering usage statistics for library electronic resources, including questions relating to why libraries collect statistics, what needs to be collected, and how data are collected. The chapter will also address the challenges encountered in collecting data, the perspective of content-providers, and the issues involved in data presentation. Finally, there will be a short review of several key initiatives on statistics for electronic collections.
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