Browsing by Author "Straus, Sharon"

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    Correction to: Methods for identifying 30 chronic conditions: application to administrative data
    (2019-09-04) Tonelli, Marcello; Wiebe, Natasha; Fortin, Martin; Guthrie, Bruce; Hemmelgarn, Brenda R; James, Matthew T; Klarenbach, Scott W; Lewanczuk, Richard; Manns, Braden J; Ronksley, Paul; Sargious, Peter; Straus, Sharon; Quan, Hude
    Following publication of the original manuscript [1], the authors noted several errors in Table 1. Details of the requested corrections are shown below:
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    Multi-disciplinary supportive end of life care in long-term care: an integrative approach to improving end of life
    (2021-05-22) Harasym, Patricia M.; Afzaal, Misha; Brisbin, Sarah; Sinnarajah, Aynharan; Venturato, Lorraine; Quail, Patrick; Kaasalainen, Sharon; Straus, Sharon; Sussman, Tamara; Virk, Navjot; Holroyd-Leduc, Jayna M.
    Abstract Background Optimal supportive end of life care for frail, older adults in long term care (LTC) homes involves symptom management, family participation, advance care plans, and organizational support. This 2-phase study aimed to combine multi-disciplinary opinions, build group consensus, and identify the top interventions needed to develop a supportive end of life care strategy for LTC. Methods A consensus-building approach was undertaken in 2 Phases. The first phase deployed modified Delphi questionnaires to address and transform diverse opinions into group consensus. The second phase explored and prioritized the interventions needed to develop a supportive end of life care strategy for LTC. Development of the Delphi questionnaire was based on findings from published results of physician perspectives of barriers and facilitators to optimal supportive end of life care in LTC, a literature search of palliative care models in LTC, and published results of patient, family and nursing perspectives of supportive end of life care in long term care. The second phase involved World Café Style workshop discussions. A multi-disciplinary purposive sample of individuals inclusive of physicians; staff, administrators, residents, family members, and content experts in palliative care, and researchers in geriatrics and gerontology participated in round one of the modified Delphi questionnaire. A second purposive sample derived from round one participants completed the second round of the modified Delphi questionnaire. A third purposive sample (including participants from the Delphi panel) then convened to identify the top priorities needed to develop a supportive end-of-life care strategy for LTC. Results 19 participants rated 75 statements on a 9-point Likert scale during the first round of the modified Delphi questionnaire. 11 participants (participation rate 58 %) completed the second round of the modified Delphi questionnaire and reached consensus on the inclusion of 71candidate statements. 35 multidisciplinary participants discussed the 71 statements remaining and prioritized the top clinical practice, communication, and policy interventions needed to develop a supportive end of life strategy for LTC. Conclusions Multi-disciplinary stakeholders identified and prioritized the top interventions needed to develop a 5-point supportive end of life care strategy for LTC.
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    Restricted visitation policies in acute care settings during the COVID-19 pandemic: a scoping review
    (2021-09-25) Moss, Stephana J.; Krewulak, Karla D.; Stelfox, Henry T.; Ahmed, Sofia B.; Anglin, Melanie C.; Bagshaw, Sean M.; Burns, Karen E. A.; Cook, Deborah J.; Doig, Christopher J.; Fox-Robichaud, Alison; Fowler, Robert; Hernández, Laura; Kho, Michelle E.; Kredentser, Maia; Makuk, Kira; Murthy, Srinivas; Niven, Daniel J.; Olafson, Kendiss; Parhar, Ken K. S.; Patten, Scott B.; Rewa, Oleksa G.; Rochwerg, Bram; Sept, Bonnie; Soo, Andrea; Spence, Krista; Spence, Sean; Straus, Sharon; West, Andrew; Parsons Leigh, Jeanna; Fiest, Kirsten M.
    Abstract Background Restricted visitation policies in acute care settings because of the COVID-19 pandemic have negative consequences. The objective of this scoping review is to identify impacts of restricted visitation policies in acute care settings, and describe perspectives and mitigation approaches among patients, families, and healthcare professionals. Methods We searched Medline, Embase, PsycINFO, Healthstar, CINAHL, Cochrane Central Register of Controlled Trials on January 01/2021, unrestricted, for published primary research records reporting any study design. We included secondary (e.g., reviews) and non-research records (e.g., commentaries), and performed manual searches in web-based resources. We excluded records that did not report primary data. Two reviewers independently abstracted data in duplicate. Results Of 7810 citations, we included 155 records. Sixty-six records (43%) were primary research; 29 (44%) case reports or case series, and 26 (39%) cohort studies; 21 (14%) were literature reviews and 8 (5%) were expert recommendations; 54 (35%) were commentary, editorial, or opinion pieces. Restricted visitation policies impacted coping and daily function (n = 31, 20%) and mental health outcomes (n = 29, 19%) of patients, families, and healthcare professionals. Participants described a need for coping and support (n = 107, 69%), connection and communication (n = 107, 69%), and awareness of state of well-being (n = 101, 65%). Eighty-seven approaches to mitigate impact of restricted visitation were identified, targeting families (n = 61, 70%), patients (n = 51, 59%), and healthcare professionals (n = 40, 46%). Conclusions Patients, families, and healthcare professionals were impacted by restricted visitation polices in acute care settings during COVID-19. The consequences of this approach on patients and families are understudied and warrant evaluation of approaches to mitigate their impact. Future pandemic policy development should include the perspectives of patients, families, and healthcare professionals. Trial registration: The review was registered on PROSPERO (CRD42020221662) and a protocol peer-reviewed prior to data extraction.
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    Selecting implementation models, theories, and frameworks in which to integrate intersectional approaches
    (2022-08-04) Presseau, Justin; Kasperavicius, Danielle; Rodrigues, Isabel B.; Braimoh, Jessica; Chambers, Andrea; Etherington, Cole; Giangregorio, Lora; Gibbs, Jenna C.; Giguere, Anik; Graham, Ian D.; Hankivsky, Olena; Hoens, Alison M.; Holroyd-Leduc, Jayna; Kelly, Christine; Moore, Julia E.; Ponzano, Matteo; Sharma, Malika; Sibley, Kathryn M.; Straus, Sharon
    Abstract Background Models, theories, and frameworks (MTFs) provide the foundation for a cumulative science of implementation, reflecting a shared, evolving understanding of various facets of implementation. One under-represented aspect in implementation MTFs is how intersecting social factors and systems of power and oppression can shape implementation. There is value in enhancing how MTFs in implementation research and practice account for these intersecting factors. Given the large number of MTFs, we sought to identify exemplar MTFs that represent key implementation phases within which to embed an intersectional perspective. Methods We used a five-step process to prioritize MTFs for enhancement with an intersectional lens. We mapped 160 MTFs to three previously prioritized phases of the Knowledge-to-Action (KTA) framework. Next, 17 implementation researchers/practitioners, MTF experts, and intersectionality experts agreed on criteria for prioritizing MTFs within each KTA phase. The experts used a modified Delphi process to agree on an exemplar MTF for each of the three prioritized KTA framework phases. Finally, we reached consensus on the final MTFs and contacted the original MTF developers to confirm MTF versions and explore additional insights. Results We agreed on three criteria when prioritizing MTFs: acceptability (mean = 3.20, SD = 0.75), applicability (mean = 3.82, SD = 0.72), and usability (median = 4.00, mean = 3.89, SD = 0.31) of the MTF. The top-rated MTFs were the Iowa Model of Evidence-Based Practice to Promote Quality Care for the ‘Identify the problem’ phase (mean = 4.57, SD = 2.31), the Consolidated Framework for Implementation Research for the ‘Assess barriers/facilitators to knowledge use’ phase (mean = 5.79, SD = 1.12), and the Behaviour Change Wheel for the ‘Select, tailor, implement interventions’ phase (mean = 6.36, SD = 1.08). Conclusions Our interdisciplinary team engaged in a rigorous process to reach consensus on MTFs reflecting specific phases of the implementation process and prioritized each to serve as an exemplar in which to embed intersectional approaches. The resulting MTFs correspond with specific phases of the KTA framework, which itself may be useful for those seeking particular MTFs for particular KTA phases. This approach also provides a template for how other implementation MTFs could be similarly considered in the future. Trial registration Open Science Framework Registration: osf.io/qgh64.
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    A systematic review of interventions to increase breast and cervical cancer screening uptake among Asian women
    (BioMed Central, 2012) Lu, Mingshan; Moritz, Sabina; Lorenzetti, Diane; Sykes, Lindsay; Straus, Sharon; Quan, Hude
    Funding provided by the Open Access Authors Fund.
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    The De-adoption of Low-value Clinical Practices in Adult Critical Care Medicine
    (2015-12-24) Niven, Daniel; Stelfox, H. Thomas; Straus, Sharon; Hemmelgarn, Brenda; Jeffs, Lianne
    Low-value clinical practices are common, and potentially harmful to patients and healthcare systems, yet the optimal approach to reducing (i.e. de-adopting) these practices is unknown. This thesis reports the results of three studies conducted with the overall objective of improving knowledge related to the de-adoption of low-value clinical practices in patients admitted to adult intensive care units (ICUs), an area known to have high resource consumption. First, a scoping review of the literature was conducted to systematically identify current knowledge regarding the science of de-adoption. From 109 citations, this review identified that current terminology is heterogeneous and poorly defined, that most of the literature evaluates the outcomes of some type of de-adoption effort, and that the most common (and least successful) approach to de-adoption is to wait for it to occur following passive diffusion of published research. A framework to guide the de-adoption process is proposed. Second, another scoping review using a replication research framework was conducted to identify low-value clinical practices among patients admitted to adult ICUs. Low-value practices were those wherein new evidence (i.e. replication research) suggests that an intervention previously thought to be beneficial is ineffective or harmful (i.e. evidence reversal). This review demonstrated that the results of nearly half of original replicated citations were reversed (n = 35, 49%), with the highest proportion of reversals in practices originally found to be beneficial (n = 21, 60%). Third, an interrupted time series analysis using the APACHE clinical database and patients admitted to adult ICUs in the United States examined the effects of replication research on clinical practice for a practice with evidence reversal, namely tight glycemic control. This study found notable changes in the practice of glycemic control following a clinical trial that demonstrated the benefits of tight glycemic control, with comparatively less change following a methodologically more rigorous trial that demonstrated its harmful effects. Taken together, the results of these three studies demonstrate the urgent need for additional research to understand and promote the de-adoption of low-value clinical practices.