Multimedia psychoeducational interventions to support patient self-care in degenerative conditions: A realist review

O’Halloran, Peter; Scott, David A.; Reid, Joanne; Porter, Samuel

doi:10.1017/s1478951514001229

Cited by 10 publications

(9 citation statements)

References 25 publications

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“…The proliferation and acceptability of the internet has provided an alternative format for sharing health-related information which is convenient, accessible and allows the user the opportunity to remain anonymous. The effectiveness of using a web-based approach to deliver health care interventions has been demonstrated elsewhere [ 20 , 21 ] and has been recommended as a medium to help increase awareness and improve capacity regarding the provision of palliative care [ 22 ]. However, we should recognise that the use of websites to provide health related information may not be appropriate for all user groups particularly those who may not be regular internet users [ 20 , 23 ].…”

Section: Introductionmentioning

confidence: 99%

Development of an eHealth information resource for family carers supporting a person receiving palliative care on the island of Ireland

et al. 2019

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Background Many people receiving palliative care wish to die at home. Often, support from family or friends is key to ensuring that this wish is fulfilled. However, carers report feeling underprepared to undertake this role. This paper describes the process of developing a consensus and evidence based website to provide core information to help people support someone receiving palliative care on the island of Ireland. Methods The project comprised three phases: (1) a review of systematic reviews facilitated the identification of core information needs; (2) content was developed in collaboration with a Virtual Reference Group (VRG) comprising patients, carers and professionals; and, (3) subject experts within the project team worked with a web developer to précis the agreed content and ensure it was in a format that was appropriate for a website. Members of the VRG were then invited to test and approve the website before it was made available to the general public. Results Nineteen systematic reviews identified nine consensus areas of core information required by carers; a description of palliative care; prognosis and treatment of the condition; medication and pain management; personal care; specialist equipment; locally available support services; what to do in an emergency; nutrition; and, support for the carer. This information was shared with the VRG and used to develop website content. Conclusions We engaged with service users and professionals to develop an evidence-based website addressing the agreed core information needs of non-professional carers who wish to provide palliative care to a friend or relative.

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Section: Introductionmentioning

confidence: 99%

Development of an eHealth information resource for family carers supporting a person receiving palliative care on the island of Ireland

et al. 2019

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“…In our own empirical work relating to palliative care, we have been adopting the three parallel strategies outlined above [35–38]. …”

Section: Resultsmentioning

confidence: 99%

The possibility of critical realist randomised controlled trials

Porter

McConnell

Reid

2017

Trials

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BackgroundSome realists have criticised randomised controlled trials for their inability to explain the causal relations that they identify; to take into account the influence of the social context of the interventions they evaluate; and to account for individual difference. However, among realists, there is controversy over whether it is possible to improve trials by making them realist, or whether realism and the philosophical assumptions underlying trials are incompatible. This paper contributes to the debate in Trials on this issue. The debate thus far has concentrated on the possibility of combining trial methodology with that of realist evaluation.Main bodyWe concur with the contention that it is not feasible to combine randomised controlled trial design with the realist evaluation approach. However, we argue that a different variant of realism, critical realism, provides a more appropriate theoretical grounding for realist trials.In contrast to realist evaluation, which regards social mechanisms as an amalgam of social resources and people’s reasoning, critical realism insists on their distinction. It does so on the basis of its assertion of the need to distinguish between social structures (in which resources lie) and human agency (which is at least partly guided by reasoning). From this perspective, conceiving of social mechanisms as external to participants can be seen as a valid methodological strategy for supplementing the exclusive concentration of trials on outcomes.While accepting realist evaluation’s insistence that causality in open systems involves a configuration of multiple generative mechanisms, we adopt the critical realist interpretation of the experimental method, which sees it as creating artificial closure in order to identify the effects of specific causal mechanisms. If randomised controlled trials can be regarded as epidemiological proxies that substitute probabilistic controls over extraneous factors for closed experiments, their examination of the powers of discrete mechanisms through observation of the variation of outcomes is appropriate.ConclusionWhile there are still issues to be resolved, critical realist randomised controlled trials are possible and have the potential to overcome some of the difficulties faced by traditional trial designs in accounting for the influence of social context and individual interpretation.

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“…An integrated service from commencement of dialysis until death and into bereavement to support families was reported as an option to improve clinical care. 25 Models of RSC/PC also need to co-ordinate care for patients with multiple co- The effectiveness of using a web-based approach to deliver health care interventions has been demonstrated 27,28 and recommended as a medium to help increase awareness and improve capacity regarding the provision of PC. 29 Ireland reported on their creation of an eHEALTH information resource for family carers supporting a patient receiving PC.…”

Section: Possible Ways To Create a Renal Supportive Care/palliative Cmentioning

confidence: 99%

Radically Rethinking Renal Supportive and Palliative Care in South Africa

Wearne

Davidson

Motsohi

et al. 2021

Kidney International Reports

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The incidence of end-stage kidney disease (ESKD) is increasing worldwide; however, because of resource constraints, access to lifesaving kidney replacement therapy (KRT) remains limited in the state sector in South Africa. National guidelines mandate that only patients who are transplantable be accepted into state chronic dialysis programs. Once a patient is transplanted, there is an opportunity for a new patient to access a chronic dialysis slot. Given the resource scarcity, the South African Constitutional Court has ruled that rationing of dialysis is appropriate; however, this is not without cost both to patients and decision makers. Patients, both adults and pediatric, are often placed on a palliative care (PC) pathway not through choice but through circumstance. Renal supportive care (RSC) and PC involve an interdisciplinary approach to manage patients with ESKD to ensure that symptoms are managed optimally and to provide support during advanced disease. Innovative ways to address patient care at any age must be sought to ensure nonabandonment and adequate care with our limited resources.

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Multimedia psychoeducational interventions to support patient self-care in degenerative conditions: A realist review

Cited by 10 publications

References 25 publications

Development of an eHealth information resource for family carers supporting a person receiving palliative care on the island of Ireland

Development of an eHealth information resource for family carers supporting a person receiving palliative care on the island of Ireland

The possibility of critical realist randomised controlled trials

Radically Rethinking Renal Supportive and Palliative Care in South Africa

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