Application of the capability approach to Indigenous Peoples health and well-being: protocol for a mixed-methods scoping review

Background
Indigenous Peoples are subject to marginalisation, and experience systematic disadvantage in relation to health outcomes. Human development initiatives may help determine whether, and how, Indigenous Peoples are able to be agents of their own development and improve their health and well-being. This scoping review protocol outlines a process for synthesising the existing evidence that has applied the capability approach (CA) to Indigenous People’s health and/or well-being.

Methods and analysis
A mixed-method scoping review is proposed including academic peer-reviewed publications and grey literature. Screening inclusion criteria will include Indigenous populations, using the CA approach to conceptualise health and/or well-being, and be available in English, Spanish, French or Portuguese. Publications that meet these criteria will undergo data extraction. Qualitative and quantitative data will be thematically and descriptively analysed and interpreted.

Ethics and dissemination
The proposed scoping review does not involve collecting data directly from Indigenous Peoples but will be based on previous research conducted within Indigenous settings. The current protocol and the proposed scoping review incorporate aspects of community involvement to guide the research process.
This scoping review constitutes the first phase of a wider participatory action research project conducted with the Indigenous Kankuamo Peoples of Colombia. The findings of this review will be reported to local partners, published in a peer-reviewed journal and an executive summary will be shared with wider stakeholders. Within the wider project, the review will be considered alongside primary data to inform the development of tools/approaches of mental health and well-being for the Kankuamo communities.

Leggi
Dicembre 2022

Presentation of benefits and harms in cancer screening guidelines for Koreans: a systematic review protocol

Introduction
Cancer screening guidelines should be based on the best available evidence, presenting both the benefits and harms of screening in a manner applicable to stakeholders. How the potential benefits and harms of screening are presented determine the intent of guideline developers and the delivery of recommendations. Therefore, we will systematically review the cancer screening guidelines for Koreans to evaluate the presentation and detailed ways of the benefits and harms of the recommended cancer screening practices.

Methods and analysis
To identify cancer screening guidelines for Koreans, we will search international electronic databases, including MEDLINE, Embase and domestic literature databases (Korean Studies Information Service System, Research Information Sharing Service, KoreaMED, Korean Medical Database, National Assembly Library and Korea Institute of Science and Technology Information) as well as guideline databases (Guideline International Network, National Institute for Health and Care Excellence, Turning Research Into Practice medical database, WHO guidelines and Korean Medical Guideline Information Center), from inception to November 2022. We will include cancer screening guidelines for healthcare practitioners and patients. Furthermore, we will focus on the most updated guidelines when multiple versions of guidelines are available for a specific intervention and cancer pairs from the same development group. Two reviewers will independently and in duplicate conduct reference screening and data extraction. Data will be extracted based on recommendations from each guideline and how their benefits and harms are presented. The general characteristics of cancer screening guidelines, including cancer type, recommended screening methods, certainty of evidence, direction and strength of recommendation, will be collected. In addition, we will obtain key information on the presentation of the benefits and harms of screening interventions, including quantification of their relative and absolute effects of screening interventions. Finally, our findings will be presented descriptively, and a summary of the results will be provided.

Ethics and dissemination
Ethics approval is not required as we will only use published materials. We will disseminate our findings through publication in peer-reviewed journals.

Leggi
Dicembre 2022

School-based Hygiene Intervention to Prevent HelicObacter Pylori infection among childrEn (SHIP HOPE): protocol for a cluster-randomised controlled trial

Introduction
Helicobacter pylori infection rates are high in China and worldwide, and maintaining good hygiene is effective in preventing H. pylori infection. Childhood is a critical stage for developing good hygiene practices. Therefore, in this study, we aimed to explore whether a comprehensive hygiene intervention can prevent H. pylori infection in primary schools in China.

Methods and analysis
The School-based Hygiene Intervention to Prevent HelicObacter Pylori infection among childrEn study is a cluster-randomised controlled trial, which will include approximately 2400 children in grades 2–4 from 60 classes in 10 primary schools of Linqu County, Shandong Province. Schools will be randomly assigned (1:1) via a computer-generated list, to receive either comprehensive hygiene intervention (intervention) or the usual health education lessons (control), with stratification by area (urban or rural). The interventions will include the following: (1) Children’s education: lessons and cartoon books designed to provide basic knowledge about hygiene, H. pylori, hand hygiene, diet and oral hygiene will be provided to children; (2) Caregiver’s education: children will be empowered to share hygiene-related knowledge with their caregivers as homework; caregivers will be also invited to the school for hygiene lessons; (3) School hygiene promotion: suggestions will be provided for improving the hygienic environment. Children in control schools will receive usual health education lessons according to the arrangements of each school. The primary outcome is the prevalence and incidence of H. pylori infection among children at 1-year follow-up. The secondary outcomes are H. pylori and hygiene knowledge, family eating customs and hygiene practices among children and their caregivers, as well as school absences owing to diarrhoea. Additionally, growth in children is set as an exploratory outcome. General linear mixed models will be used to analyse differences between the intervention and control schools.

Ethics and dissemination
Ethics approval has been obtained from the Institution Review Board of Tsinghua University (No: 20220020). Written informed consent will be obtained from each child and one of their caregivers. The findings of this study will be actively disseminated through scientific publications and conference presentations.

Trial registration number
ChiCTR2200056191.

Leggi
Dicembre 2022

Protocol for mixed-method systematic review of urology in medical school education

Introduction
Throughout clinical practice, most doctors will encounter patients with urological conditions. Inclusion of urological topics within medical school curriculums is important to allow doctors to effectively diagnose and manage these conditions, independently and with support from urologists. Awareness of urological education interventions and their effectiveness is essential for improving the quality and outcomes of medical student education. No systematic review of medical school education interventions on urological topics has previously been conducted. This mixed-method systematic review will assess the effectiveness of medical school education interventions on urological topics.

Methods and analysis
This mixed-methods systematic review will include qualitative and quantitative studies involving education interventions or practices regarding urological topics conducted within a medical school curriculum. Studies regarding other curriculums including premedical education, junior doctor prevocational education or vocational urological training will be excluded. A search of CINAHL, ERIC, EMBASE, MEDLINE will be conducted for studies published since the year 2001. Dual independent screening of titles and abstracts prior to full text review will be undertaken for all identified results during the initial searches. Any disagreement will be settled by a third reviewer. A convergent segregated approach will be used to synthesise qualitative and quantitative data independently, with the results juxtaposed to identify shared and divergent findings between study types.

Ethics and dissemination
No ethical approval was required for this review. Findings from this review will be disseminated via publication, reports and conference presentations.

Leggi
Dicembre 2022

Strategies and best practices that enhance participation in regular physical activities among undergraduate university students: a systematic review protocol

Introduction
Physical activity has health benefits, including lowered obesity, diabetes and hypertension levels. However, participation in regular physical activities among undergraduate students is declining and, instead, physical inactivity sets the path for sedentarism. Strategies and best practices used to enhance participation in regular physical activities among undergraduate students are beneficial for mitigating sedentariness and promoting healthy lifestyles. Therefore, this study aims to present a systematic review protocol that focuses on the strategies and best practices used to enhance participation in regular physical activities among undergraduate university students.

Methods and analysis
Quantitative, qualitative and mixed-methods design studies will be included and appraised. The following databases will be searched: PubMed, Science Direct, Academic Search Complete, ERIC, Web of Science, SAGE, CINAHL Plus and SPORTDiscus. Database searches on physical activities among undergraduate university students will be generated to answer the following research question: What are the strategies and best practices used to enhance participation in regular physical activities among undergraduate university students? Two independent reviewers will conduct the primary screening of articles from 2011 to 2022. A third reviewer will be consulted to solve any disagreements. Study selection will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and study quality will be assessed by the Johanna Biggs Institute checklist. Results from the selected articles will be extracted, summarised and categorised based on the type of study participants, study design and setting, and methodological quality. A narrative description will synthesise the findings to answer the objectives of this review.

Ethics and dissemination
Ethics approval for this study was granted by the Humanities and Social Science Research Ethics Committee at the University of the Western Cape, reference number: HS21/10/24. The results will be disseminated through a peer-reviewed publication and conference presentation.

Leggi
Dicembre 2022

Distribution, frequency and clinical presentation of leptospirosis and coinfections: a systematic review protocol

Introduction
Leptospirosis is a zoonotic disease with high prevalence in low-income and middle-income countries and tropical and subtropical regions. The clinical symptoms of the disease are similar to symptoms presented by other endemic infectious diseases that could be present simultaneously. Thus, leptospirosis could be masked by similar infections like dengue, malaria, hantavirus, melioidosis and borreliosis, among others. Therefore, leptospirosis could present itself as an under-reported infection or as a coinfection with another pathogen, as has been reported in the literature. However, there is a lack of documented evidence about the specific risk factors of leptospirosis infection, the symptoms, the coinfection’s mortality and the frequency of coinfection. Additionally, leptospirosis coinfections have not been considered a neglected public health concern. Therefore, this systematic review aims to evaluate published articles that show the risk factors associated with leptospirosis infection and coinfection with other pathogens.

Methods and analysis
The search process to identify eligible studies will be conducted including the LILACS, ProQuest, PubMed and Scopus databases with no restriction in terms of publication date. Also, grey literature will be included in the research. Authors will independently screen the title and abstracts of the articles identified from the search using Rayyan free software. Eligibility criteria include peer-reviewed research articles written in English or Spanish, including observational studies, cohorts, case–control, cross-sectional, ecological studies and report cases. The systematic review will include studies that report descriptions of leptospirosis cases with coinfection or co-occurrence. The search will be accomplished by articles from 1950 to May 2022. The data will be extracted in a standard extraction form using an Excel format.

Ethics and dissemination
Results will be published in a peer-reviewed journal. Also, findings will be disseminated through scientific meetings. Ethical approval will not be required as this is a systematic review and primary data will be not collected or included.

PROSPERO registration number
CRD42021234754.

Leggi
Dicembre 2022

Person-centredness in dementia care: study protocol for an integrative review of theoretical approaches

Introduction
The concept of personhood is particularly important in person-centred dementia care because its overall aim is to maintain the personhood of people living with dementia despite disease progression. In a previous review on autonomy for people with dementia, two different underlying concepts of personhood were identified: a rationalistic and a social constructionist concept of personhood. The present integrative review aims to (1) identify existing theoretical approaches in person-centred dementia care, (2) describe the constitutive components for these theoretical approaches, (3) report the goals and/or outcomes to be achieved by person-centred care for people living with dementia and (4) identify the underlying concepts of personhood.

Methods and analysis
For our integrative review the search terms were derived from the research questions and clustered according to the ‘PICo’ (Population, Interest, Context) framework. A systematic literature search for theoretical approaches of ‘person-centred dementia care’ will be performed on MEDLINE (via PubMed), CINAHL (via EBSCO) and PsycINFO (via EBSCO). The title/abstract and full-text screening will be performed independently by two researchers according to the inclusion criteria. The data analysis procedure will have two steps: (1) identification and extraction of general information (e.g., type of publication and name of theoretical approaches described) and (2) a qualitative content analysis to analyse the components, goals, outcomes and understanding of the respective underlying conceptions of personhood within the theoretical approaches. The extraction of general information (e.g., authors) will be performed by one researcher and qualitative content analysis will be performed independently by two researchers using MAXQDA software. Any disagreements will be resolved through discussion between the two researchers or, if no consensus can be reached, with all coauthors.

Ethics and dissemination
Due to the nature of a review, ethical approval is not required. We will disseminate our results in peer-reviewed journals and at (inter)national conferences.

Leggi
Dicembre 2022

Understanding discrimination towards persons experiencing homelessness: A scoping review protocol

Introduction
Given the increasing rates of homelessness in recent years, there is an urgent need to address the ongoing discrimination and societal disinterest in preventing, reducing and ending homelessness. There is no systematic review of experiences of stigma and discrimination among persons experiencing homelessness or interventions to combat this discrimination. The objective for the proposed study is to identify ways in which persons experiencing homelessness have been stigmatised and discriminated against, the results of these experiences, and interventions to reduce stigma and discrimination towards persons experiencing homelessness.

Methods and analysis
We are conducting a scoping review with guidance from the JBI Manual for Evidence Synthesis and Arksey and O’Malley’s framework. From 15 to 19 July 2022, we searched the following databases from our institutional licensed years of coverage: Medline, Embase, CINAHL Complete, Academic Search Ultimate, APA PsycINFO, Science Citation Index Expanded, Social Sciences Citation Index, Arts & Humanities Citation Index, Emerging Sources Citation Index, Left, PAIS International, PILOTS, Psychology & Behavioral Sciences Collection, Sociological Abstracts, and Dissertations and Theses Global. Two independent reviewers are screening study titles/abstracts and will independently screen the full texts. Study inclusion criteria include any study type reporting primary findings of English-language research on non-refugee persons experiencing homelessness in any type of setting or service worldwide. Three reviewers will then chart data of our included studies. Data will be extracted and organised into categories and subthemes in tabular form. To understand the validity of the scoping review findings in the local context and to gather additional perspectives on the topic, we will conduct an ‘expert consultation’ workshop.

Ethics and dissemination
This study has ethics approval from the University of Utah Institutional Review Board. Review findings will be disseminated through a peer-reviewed journal and at conferences. We plan to preregister this protocol with Open Science Framework.

Leggi
Dicembre 2022

Quality and reporting of patient-reported outcomes in elderly patients with hip fracture: a systematic review

Objective
To assess how patient-reported outcomes (PROs) are reported and to assess the quality of reporting PROs for elderly patients with a hip fracture in both randomised controlled trials (RCTs) and observational studies.

Design
Systematic review.

Data sources
Medline, Embase and CENTRAL were searched on 1 March 2013 to 25 May 2021.

Eligibility criteria
RCTs and observational studies on geriatric (≥65 years of age) patients, with one or more PRO as outcome were included.

Data extraction and synthesis
Primary outcome was type of PRO; secondary outcome and quality assessment was measured by adherence to the Consolidated Standards of Reporting Trials (CONSORT) extension for patient-reported outcomes (CONSORT-PRO). Because of heterogeneity in study population and outcomes, data pooling was not possible.

Results
3659 studies were found in the initial search. Of those, 67 were included in the final analysis. 83.6% of studies did not adequately mention missing data, 52.3% did not correctly report how PROs were collected and 61.2% did not report adequate effect size. PRO limitations were adequately reported in 20.9% of studies and interpretation of PROs was adequately reported in 19.4% of studies. Most Quality of Life (QoL) outcomes were measured by the EuroQol 5-Dimension 3-Levels, and pain as well as patient satisfaction by Visual Analogue Scale.

Conclusion
This study found that a high variety of PRO measures are used to evaluate geriatric hip fracture care. In addition, 47.8% of studies examining PROs in elderly patients with hip fracture do not satisfy at least 50% of the CONSORT-PRO criteria. This enables poorly conducted research to be published and used in evidence-based medicine and, consequently, shared decision-making. More efforts should be undertaken to improve adequate reporting. We believe extending the CONSORT-PRO extension to Strengthening the Reporting of Observational Studies in Epidemiology for observational studies would be a valuable addition to current guidelines.

Leggi
Dicembre 2022

Smoking cessation interventions for Hispanic/Latino(a) adults in the USA: protocol for a systematic review and planned meta-analysis

Introduction
Hispanic smokers face multiple cultural and socioeconomic barriers to cessation that lead to prominent health disparities, including a lack of language-appropriate, culturally relevant, evidence-based smoking cessation interventions. This systematic review will examine the literature on smoking cessation interventions for Hispanic adults in the USA to assess (1) the availability of interventions, (2) the methodological quality of the studies evaluating the interventions and (3) the efficacy of the interventions.

Methods and analysis
A systematic literature search will be conducted, in English with no date limits, through the following databases starting at year of inception: Medical Allied Health Literature, Embase, American Psychology Association Psychology Articles, Cumulative Index to Nursing and Allied Health Literature Complete, ScienceDirect, Health & Medicine Collection and Web of Science Core Collection. Trial registries and grey literature sources will be searched to identify ongoing or unpublished studies. Literature search will be rerun prior to eventual submission of the review to ensure the inclusion of relevant studies. Quantitative studies evaluating the efficacy of a smoking cessation intervention (ie, smoking cessation as a measured outcome) for Hispanic adult smokers in the USA will be included in the systematic review. Two authors will independently identify relevant studies, extract data and conduct quality and risk of bias assessments. Discrepancies in coding will be discussed between the two reviewers and pending disagreements will be resolved by a third reviewer. First, the quality of all studies will be assessed, then randomised controlled trials (RCTs) will be further evaluated for risk of bias using Cochrane’s Risk of Bias Tool. All eligible studies will be summarised descriptively. If data allow, the efficacy of smoking cessation interventions tested in RCTs, with a minimum follow-up of 6 months, will be quantitatively estimated using ORs and 95% CIs. The association between intervention type/modality and efficacy will be assessed via subgroup analyses.

PROSPERO registration number
CRD42022291068.

Leggi
Dicembre 2022

Kidney function, cardiovascular outcomes and survival of living kidney donors with hypertension: a systematic review protocol

Introduction
Hypertension has been considered a contraindication for living kidney donation in the past. Since transplantation from living kidney donors remains the best modality for kidney failure, there is now an increased acceptance of living kidney donors with hypertension. However, the safety of this practice for the cardiovascular and kidney health of the donor is unclear. We will conduct a systematic review to summarise and synthesise the existing literature on this topic.

Methods and analysis
A systematic review of prospective randomised and non-randomised and retrospective studies will be conducted. MEDLINE, EMBASE, Cochrane CENTRAL and EBM reviews published from January 1946 to December 2021 will be reviewed. Primary outcome will be the difference in the survival, major adverse cardiovascular events, estimated glomerular filtration rate of 45 mL/min or less and development of end-stage kidney failure, between living kidney donors with and without hypertension. Study screening, selection, and data extraction will be performed by two independent reviewers. Studies must fulfil all eligibility criteria for inclusion into the systematic review and meta-analysis. The Risk of Bias in Non-Randomised studies tool will be used to assess bias.

Ethics and dissemination
No ethical approval is required for this systematic review. The results of this review will be disseminated in a peer-reviewed, open-access journal to ensure access to all stakeholders in kidney transplantation and to inform clinical guidelines on the evaluation and follow-up care of living kidney donor candidates.

PROSPERO registration number
CRD42022300119.

Leggi
Dicembre 2022

Accuracy of the neutrophil-to-lymphocyte ratio for the diagnosis of neonatal sepsis: a systematic review and meta-analysis

Objectives
The purpose of this study was systematically and quantitatively to assess the value of the neutrophil-to-lymphocyte ratio (NLR) for the diagnosis of neonatal sepsis by systematic review and meta-analysis.

Design
Systematic review and meta-analysis.

Methods
Eight major databases, including The Cochrane, PubMed, Embase, Web of Science, CNKI, Wanfang, China Biomedical Literature Database and VIP Database, were systematically searched for NLR diagnoses of neonatal sepsis from inception to June 2022. Two investigators independently conducted the literature search, screening, data extraction and quality evaluation with the Quality Assessment of Diagnostic Accuracy Studies-2 checklist. Statistical analysis was performed using Review Manager V.5.3, Stata V.16.0, R (V.3.6.0) and Meta-DISC V.1.4.

Results
A total of 14 studies comprising 1499 newborns were included in this meta-analysis. With a cut-off value ranging from 0.1 to 9.4, the pooled sensitivity of the NLR in the diagnosis of neonatal sepsis was 0.74 (95% CI: 0.61 to 0.83), the pooled specificity was 0.88 (95% CI: 0.73 to 0.95), the positive likelihood ratio (LR+) was 6.35 (95% CI: 2.6 to 15.47), the negative likelihood ratio (LR–) was 0.30 (95% CI: 0.19 to 0.46), the diagnostic OR (DOR) was 12.88 (95% CI: 4.47 to 37.08), area under the curve (AUC) was 0.87 (95% CI: 0.84 to 0.89). In the subgroup analysis of early-onset neonatal sepsis, the pooled sensitivity was 0.75 (95% CI: 0.47 to 0.91), the pooled specificity was 0.99 (95% CI: 0.88 to 1.00), the LR+ was 63.3 (95% CI: 5.7 to 696.8), the LR– was 0.26 (95% CI: 0.10 to 0.63), the DOR was 247 (95% CI: 16 to 3785) and the AUC was 0.97 (95% CI: 0.95 to 0.98).

Conclusions
Our findings suggest that the NLR is a helpful indicator for the diagnosis of early neonatal sepsis, but it still needs to be combined with other laboratory tests and specific clinical manifestations.

Leggi
Dicembre 2022

Work situation of patients with stroke who have returned to work: a scoping review protocol

Introduction
The incidence of stroke in working-age adults is increasing. Many patients face cognitive, emotional and physical impairments and their subsequent influences on returning to work. An increasing number of studies have been conducted on the transformation from unemployment to returning to work. The criteria for returning to work only used the ‘working yes/no’ as the primary outcome. Although some researchers have investigated the characteristics of patients with stroke who have returned to work, there is a paucity of evidence regarding the work situation. This scoping review aimed to examine and map the work situation of patients with stroke who have returned to work.

Methods and analysis
This study will be based on the Joanna Briggs Institute Reviewers’ Manual for scoping reviews. A systematic literature search will be conducted using related medical subject headings and keywords on the work situation of patients with stroke who have returned to work. Relevant publications will be searched using 17 data sources, including grey literature sources, published in English or Chinese between 1957 and 2022. None of the articles will have restrictions on the data sources or study designs. The study selection and search results will be reported and presented according to the Preferred Reporting Items for Systematic Review and Meta-Analyses extension for scoping reviews flow diagram. The results will be presented in a table format based on the data extraction tool.

Ethics and dissemination
This study is exempted from a medical ethical review. This scoping review addresses the knowledge gap by identifying and synthesising the work situation of patients with stroke who have returned to work, which will provide helpful information for various stakeholders. This scoping review will be submitted and published in a peer-reviewed scientific journal.

Leggi
Dicembre 2022

Supporting patient and public partners in writing lay summaries of scientific evidence in healthcare: a scoping review protocol

Introduction
Despite growing interest among patient and public partners to engage in writing lay summaries, evidence is scarce regarding the availability of resources to support them. This protocol describes the process of conducting a scoping review to: (1) summarise the source, criteria and characteristics, content, format, intended target audience, patient and public involvement in preparing guidance and development processes in the available guidance for writing lay summaries; (2) contextualise the available guidance to the needs/preferences of patient and public partners and (3) create a patient and public partner-informed output to support their engagement in writing lay summaries.

Method and analysis
A scoping review with an integrated knowledge translation approach will be used to ensure the collaboration between patient/public partners and researchers in all steps of the review. To meet objective 1, the English language evidence within a healthcare context that provides guidance for writing lay summaries will be searched in peer-reviewed publications and grey literature. All screening and extraction steps will be performed independently by two reviewers. Extracted data will be organised by adapting the European Union’s principles for summaries of clinical trials for laypersons. For objectives 2 and 3, a consultation exercise will be held with patient and public partners to review and contextualise the findings from objective 1. A directed content analysis will be used to organise the data to the needs of the public audience. Output development will follow based on the results.

Ethics and dissemination
Ethics approval will be obtained for the consultation exercise. Our target audience will be stakeholders who engage or are interested in writing lay summaries. Our dissemination products will include a manuscript, a lay summary and an output to support patient and public partners with writing lay summaries. Findings will be published in a peer-reviewed journal and presented at relevant conferences.

Open science framework registration
osf.io/2dvfg.

Leggi
Dicembre 2022

Impact of intrawork rest breaks on doctors performance and well-being: systematic review

Objectives
To summarise evidence on intrawork breaks and their associated effect on doctors’ well-being and/or performance at work.

Design
Systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 statement guidelines

Data sources
Embase, PubMed, Web of Science (Core Collection) and PsychINFO were systematically searched on 6 June 2021.

Eligibility criteria
No restrictions were placed on language, study design or date of publication.

Data extraction and analysis
Methodological quality was appraised using Cochrane’s Risk of Bias (ROB-2), Cochrane’s Risk of Bias in Non-randomised Studies (ROBINS-I), and the Johanna Briggs Institute (JBI) checklists for cross-sectional, cohort and qualitative studies. Quantitative synthesis was not undertaken due to substantial heterogeneity of design and outcomes. Results are presented narratively.

Results
Database searches returned 10 557 results and searches of other sources returned two additional records. Thirty-two papers were included in the systematic review, comprised of 29 unique studies, participants and topics and 3 follow-up studies. A variety of well-being and performance outcome measures were used. Overall, findings indicate that intrawork breaks improved some measures of well-being and/or work performance. However, methodological quality was judged to be low with a high risk of bias in most included studies.

Discussion
Using existing evidence, it is not possible to conclude with confidence whether intrawork breaks improve well-being and/or work performance in doctors. There is much inconsistency regarding how breaks are defined, measured and the outcomes used to assess effectiveness. Future research should seek to: (a) define and standardise the measurement of breaks, (b) use valid, reliable outcome measures to evaluate their impact on well-being and performance and (c) minimise the risk of bias in studies where possible.

PROSPERO registration number
CRD42020156924; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=156924.

Leggi
Dicembre 2022

Development and applications of the anaesthetists non-technical skills behavioural marker system: protocol for a systematic review

Introduction
The high incidence of unsafe anaesthetic care leads to adverse events and increases the burden on patient safety. An important reason for unsafe anaesthesia care is the lack of non-technical skills (NTS), which are defined as personal cognitive, social or interpersonal skills, among anaesthetists. The anaesthetists’ NTS (ANTS) behavioural marker system has been widely used to evaluate and improve anaesthetists’ behavioural performance to ensure patient safety. This protocol describes a planned systematic review aiming to determine the validity and reliability of the ANTS behavioural marker system and its application as a tool for the training and assessment of ANTS and for improving patient safety.

Methods and analysis
This systematic review follows the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocol. Studies that applied the ANTS behavioural marker system in a meaningful way, including using the ANTS behavioural marker system to guide data collection, analysis, coding, measurement, and/or reporting, which have been published in peer-reviewed journals, will be eligible. A citation search strategy will be employed. We will search Scopus and Web of Science for publications from 2002 to May 2022, which cite the three original ANTS behavioural marker system publications by Fletcher et al. We will also search the references of the relevant reviews for additional eligible studies. For each study, two authors will independently screen papers to determine eligibility and will extract the data. The quality of the included studies will be assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklists. A framework analysis approach that consists of five steps—familiarisation, identifying a thematic data extraction framework, indexing, charting, mapping and interpretation—will be used to synthesise and report the data.

Ethics and dissemination
Ethics approval is not required for this study. The findings will be disseminated primarily through peer-reviewed publications and conference presentations.

PROSPERO registration number
CRD42022297773.

Leggi
Dicembre 2022