Donald Maciver

Key characteristics of knowledge transfer and exchange in healthcare: integrative literature review

AIM This paper presents the results of a review of literature relating to knowledge transfer and exchange in healthcare. BACKGROUND Treatment, planning and policy decisions in contemporary nursing and healthcare should be based on sound evidence wherever possible, but research knowledge remains generally underused. Knowledge transfer and exchange initiatives aim to facilitate the accessibility, application and production of evidence and may provide solutions to this challenge. This review was conducted to help inform the design and implementation of knowledge transfer and exchange activities for a large healthcare organization. DATA SOURCES Databases: ASSIA, Business Source Premier, CINAHL, PsychInfo, Medline and the Cochrane Database of Systematic Reviews. REVIEW METHODS An integrative literature review was carried out including an extensive literature search. English language systematic reviews, literature reviews, primary quantitative and qualitative papers and grey literature of high relevance evaluating, describing or discussing knowledge transfer or exchange activities in healthcare were included for review (January 1990-September 2009). FINDINGS Thirty-three papers were reviewed (four systematic reviews, nine literature reviews, one environmental scan, nine empirical studies and ten case studies). CONCLUSION Robust research into knowledge transfer and exchange in healthcare is limited. Analysis of a wide range of evidence indicates a number of commonly featured characteristics but further evaluation of these activities would benefit their application in facilitating evidence-based practice in nursing.

Parents’ Experiences of Caring for a Child With Chronic Pain:

Involvement of parents in their children’s pain management is universally accepted as best practice, yet there is little understanding of their needs. Twelve parents of children with chronic pain were recruited to this study in which the impact of caring for a child with chronic pain was explored. All parents started in distress, and most moved into a stance that enabled them to balance the child’s needs with their own. These parents discussed “stepping back” from their child’s distress and gaining mastery over fearful emotional reactions. A minority remained in distress, finding an adaptive response to the child’s pain challenging. Catastrophic thinking, fear of pain, and the desire to fulfill a nurturing parental role led parents to place themselves continually “on call.” Findings indicate that parents might require support to care effectively for their children, and that many of the actions necessitated by children’s pain require complex and counterintuitive decisions.

Developmental Coordination Disorder: A synthesis of evidence to underpin an allied health professions' framework

Children with Developmental Coordination Disorder (DCD) lack the motor coordination necessary to perform tasks considered appropriate for their age, given normal intellectual ability and the absence of other neurological disorders. DCD is a common childhood disorder that can develop into a long‐term condition that has a significant impact on society. A key method of managing DCD is through the assessment and interventions of allied health professionals (AHPs). To date, no integrated AHP framework for the assessment and treatment of DCD exists. The present article illustrates the methods used to synthesise multiple data sources (policy, scientific evidence, service user views and AHP perspectives) by a multidisciplinary group of AHP researchers and practitioners. Through this process a series of principles of good practice were identified, and then developed into a framework for AHPs working with children with DCD. In this article the methodology used to enable synthesis from different evidence sources will be presented, as will the resultant framework. The findings will then be discussed within the current literature emphasising the importance of health/education partnership in the support and management of these children.

Services for children with developmental co-ordination disorder: The experiences of parents

BACKGROUND Parents provide valuable information on their experiences of engaging with therapy services for their children, which can inform the future development of these services. The aim of this study was to explore the views and experiences of parents who had accessed therapy services for their child with developmental co-ordination disorder (DCD). METHODS Seven focus groups were conducted incorporating 52 parents who had a child diagnosed with, or fitting the diagnostic criteria for DCD. Focus groups were audiotaped, transcribed and analysed thematically. FINDINGS Parents reported struggling to gain access to therapy services. When they gained access, they found the services beneficial for their child but continued to experience difficulties regarding the quality of service delivery. CONCLUSIONS/IMPLICATIONS The study suggests that parents thought some health-care professionals lacked knowledge and understanding of DCD, which they believed impacted upon early recognition and access to services. They perceived that therapy at an early age was vital for childrens development, and indicated that a clearer path for accessing these services was necessary in addition to improved service quality. They called for an increase in awareness of DCD by all therapy service professionals to aid early recognition and improved treatment.

Elements of life satisfaction amongst elderly people living in institutions in Malaysia: A mixed methodology approach

Background Changes in demographic characteristics, social structure and economic status have shifted the direction of care of elderly people in Malaysia. Subsequently, nursing homes and institutions for elderly people becoming a significant care option. The aim of this study is to identify the level of life satisfaction and to examine the elements of life satisfaction amongst the elderly people living in the institutions. Methods In this mixed methodology, a survey using translated version of Satisfaction with Life Scale (SWLS) was conducted to 82 participants who conformed to the inclusion criteria. Twenty participants who volunteered to discuss about their live experience regarding life satisfaction living in a public elderly institution in Malaysia. The participants were stratified according to age group and gender. Four focus groups were conducted and the Interpretative Phenomenological Analysis were used to identify the key themes emerged from the focus groups. Results The level of life satisfaction is equivalent to the norms and there is no statistical significant difference between the levels with the demographic variables. Two main themes were developed, contentment and acceptance, reflecting the elements of life satisfaction of the participants in the institution. Conclusion The findings are inconsistent with previous findings. However, it identified new elements of life satisfaction for elderly people in the institution.

Enabling integrated knowledge acquisition and management in health care teams

Basing treatment, policy and planning decisions on the best available research knowledge remains a central principle in modern health care around the world, yet many health professionals find acquiring and managing published research knowledge challenging. In this paper, we report on a Soft Systems Methodology-based collaborative action research initiative with a specialist mental health service from the United Kingdoms National Health Service. Our objective was to design and implement improvements to their knowledge acquisition and management activities in order to facilitate sustained and effective evidence-based practices. We report on both the factors found to impede effective research knowledge acquisition and management and the development of more integrated knowledge management processes designed to improve the situation.

Services for children with developmental co-ordination disorder: an evaluation against best practice principles

Abstract Purpose: The National Health Service in Scotland published a best practice framework to support occupational therapists and physiotherapists to deliver effective services for children with developmental co-ordination disorder (DCD); however, adherence is variable. To highlight areas for development, this study compared the care pathway within a paediatric DCD service against the NHS Scotland framework. Methods: A partnership of researchers and clinicians based in the United Kingdom conducted a qualitative study with 37 participants (N = 13 interview participants, N = 24 workshop participants). In-depth interviews and/or workshops were used to map the DCD service against the NHS framework. Identified gaps were aligned with four key stages of the care pathway. Qualitative analysis software was used to analyse the data. Results: Core principles to guide future development were identified for each phase of the pathway. These core principles related to the NHS framework and focused on issues such as involving the family, defining clear pathways and enhancing children’s participation. Participants identified potential strategies for service improvement such as developing community-based interventions and information provision. Conclusion: Challenges when providing services for children with DCD include confusing service pathways and poor partnership working. It is, therefore, important that clinicians utilise collaborative working strategies that support children’s participation. Implications for Rehabilitation There are numerous challenges related to the implementation of best practice principles into the provision of therapy services for children with developmental coordination disorder (DCD). It is important that AHPs seek ways of engaging parents and educational professionals at all stages of the care pathway in order to ensure optimum service provision for the child. Addressing participation is an important aspect and community-based strategies may be particularly beneficial, both as a preventative activity and as an intervention approach.

Living With Dementia: A Meta-synthesis of Qualitative Research on the Lived Experience

Abstract Purpose of the Study To identify and examine the published qualitative research evidence relative to the experience of living with dementia. Design and Methods Metasynthesis was used as the methodological framework to guide data collection and analysis. Results Three themes were identified. The first theme considered the main condition-related changes experienced by people with dementia (PWD) and showed how these are interlinked and impact upon various areas of people’s lives. The second theme indicated that amidst these changes, PWD strive to maintain continuity in their lives by employing various resources and coping strategies. The third theme underlined the role of contextual factors. The reviewed evidence indicates that, the emerging experience of PWD and their potential to adjust to the continuous changes is influenced by access to and quality of both personal and contextual resources which remain in a constant, transactional relationship to each other. Implications The findings were interpreted and discussed in the context of relevant theoretical frameworks and research evidence. It was considered that current evidence and findings presented in this review can be further explored and expanded upon in a more systematic way through research conducted within the theoretical framework of dynamic systems theory. Further research would be also beneficial to explore the subjective experience of dementia from a participatory perspective. Exploring the application of these theoretical standpoints would contribute to the current state of knowledge and offer both PWD and carers fresh perspective on the nature of change and potential for adaptability in dementia.

What in-patients want: a qualitative study of what's important to mental health service users in their recovery (Wayfinder Partnership)

Purpose – The purpose of this paper is to present a qualitative analysis of the facilitators of recovery in in-patient psychiatric rehabilitation from the service users’ perspective. Design/methodology/approach – Interviews with 31 in-patients were coded and analysed thematically at an interpretive level using an inductive approach. Findings – The dominant themes identified were hope, agency, relationships and opportunity. Totally, 20 subthemes were identified. Agency was more important to men than women and agency, hope and relationships were all more important to detained patients. Research limitations/implications – Interview data were collected in writing rather than taped. The results may not be transferrable to patient populations with significantly different demographic or service factors. Practical implications – Services need to target interventions at the areas identified by service users as important in their recovery. The findings suggest both environmental and relational aspects of care that ...

Vocational rehabilitation: Facilitating evidence based practice through participatory action research

Background Improving vocational rehabilitation in line with the current evidence base is an area of considerable interest. Aims To describe the strategies used by a multidisciplinary team in the initial stages of a participatory action research (PAR) approach to improving a vocational rehabilitation service. Method A literature review and PAR process were completed. One hundred and fifteen participants engaged in multifaceted data collection and analysis, building consensus around key principles for a new vocational rehabilitation service. Results A synthesis of our literature review and PAR process was developed into a set of principles for practice which we plan to implement across the service. Conclusions We have developed methodologies in interdisciplinary collaborations spanning statutory and non-statutory services. We have developed a set of principles for practice and detailed plans for implementation are being drawn up to inform provision in the future.