Background Workplace aggression constitutes a serious issue for healthcare workers and organizations. Aggression is tied to physical and mental health issues at an individual level, as well as to absenteeism, decreased productivity or quality of work, and high employee turnover rates at an organizational level. To counteract these negative impacts, organizations have used a variety of interventions, including education and training, to provide workers with the knowledge and skills needed to prevent aggression. Objectives To assess the e ectiveness of education and training interventions that aim to prevent and minimize workplace aggression directed toward healthcare workers by patients and patient advocates. Search methods CENTRAL, MEDLINE, Embase, six other databases and five trial registers were searched from their inception to June 2020 together with reference checking, citation searching and contact with study authors to identify additional studies. Selection criteria Randomized controlled trials (RCTs), cluster-randomized controlled trials (CRCTs), and controlled before and a er studies (CBAs) that investigated the e ectiveness of education and training interventions targeting aggression prevention for healthcare workers. Data collection and analysis Four review authors evaluated and selected the studies resulting from the search. We used standard methodological procedures expected by Cochrane. We assessed the certainty of evidence using the GRADE approach. Education and training for preventing and minimizing workplace aggression directed toward healthcare workers (Review)
We found that two types of patient-mediated interventions, patient-reported health information and patient education, probably improve professional practice by increasing healthcare professionals' adherence to recommended clinical practice (moderate-certainty evidence). We consider the effect to be small to moderate. Other patient-mediated interventions, such as patient information may also improve professional practice (low-certainty evidence). Patient decision aids may make little or no difference to the number of healthcare professionals' adhering to recommended clinical practice (low-certainty evidence).The impact of these interventions on patient health and satisfaction, adverse events and resource use, is more uncertain mostly due to very low certainty evidence or lack of evidence.
Co-registration This review is co-registered within both the Cochrane and CampbellCollaborations. A version of this review can also be found in the Cochrane Library. KeywordsContributions Dalsbo and Smedslund wrote the protocol. All reviewers independently screened literature, reviewed potential trials, and extracted data. Smedslund analysed the data. Smedslund wrote the text of the completed systematic review. Dalsbo coordinated and wrote the 2010 updated version. Steiro, Winsvold and Clench-Aas contributed by giving comments, assessing studies and acting as mediators if necessary. Responsibility for updating the review is jointly shared between Dalsbo and Smedslund.
Background: Welfare-to-work programmes have replaced passive welfare recipiency as a means of fighting poverty in many developed countries during the latest decades. There is a belief that placing welfare recipients into subsidised jobs and/or strengthening their skills and knowledge will help them acquire steady jobs. There has, however, been no systematic review of the effects of such programmes on employment, earnings and welfare payments searching systematically for studies from all parts of the world. Objectives: To estimate the effects of work programmes, including elements such as job search assistance, job search training, subsidised employment, job clubs, vocational training, etc. on welfare recipients. employment and economic self-sufficiency. Selection criteria: Randomised controlled trials, quasi-randomised trials, or cluster randomised trials of welfare-to-work programmes. Data collection and analysis: Studies were evaluated independently by two reviewers according to a data extraction form. The GRADE system was used for quality assessment. Outcomes on employment, earnings, welfare payments, and proportion on welfare were included in meta-analyses. Main results: Randomised controlled impact evaluations of welfare-to-work programmes came almost exclusively from the United States. A total of 46 programmes with more than 412.000 participants were included in this review. Overall, 60.9 percent of intervention participants were employed at the follow-ups. But 57.9 percent of control participants were also employed. For all four outcomes, there was significant heterogeneity which could not be sufficiently explained by moderator analysis. The GRADE quality assessment showed that for all four outcomes, the quality of evidence was very low. Authors' conclusions: Welfare-to-work programmes in the USA have shown small, but consistent effects in moving welfare recipients into work, increasing earnings, and lowering welfare payments. The results are not clear for reducing the proportion of recipients receiving welfare. Little is known about the impacts of welfare-to-work programmes outside of the USA.
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