Objectives The aim of this scoping review was to identify and review current evidence-based practice (EBP) models and frameworks. Specifically, how EBP models and frameworks used in healthcare settings align with the original model of (1) asking the question, (2) acquiring the best evidence, (3) appraising the evidence, (4) applying the findings to clinical practice and (5) evaluating the outcomes of change, along with patient values and preferences and clinical skills. Design A Scoping review. Included sources and articles Published articles were identified through searches within electronic databases (MEDLINE, EMBASE, Scopus) from January 1990 to April 2022. The English language EBP models and frameworks included in the review all included the five main steps of EBP. Excluded were models and frameworks focused on one domain or strategy (eg, frameworks focused on applying findings). Results Of the 20 097 articles found by our search, 19 models and frameworks met our inclusion criteria. The results showed a diverse collection of models and frameworks. Many models and frameworks were well developed and widely used, with supporting validation and updates. Some models and frameworks provided many tools and contextual instruction, while others provided only general process instruction. The models and frameworks reviewed demonstrated that the user must possess EBP expertise and knowledge for the step of assessing evidence. The models and frameworks varied greatly in the level of instruction to assess the evidence. Only seven models and frameworks integrated patient values and preferences into their processes. Conclusion Many EBP models and frameworks currently exist that provide diverse instructions on the best way to use EBP. However, the inclusion of patient values and preferences needs to be better integrated into EBP models and frameworks. Also, the issues of EBP expertise and knowledge to assess evidence must be considered when choosing a model or framework.
To examine whether a one-hour art-making session during blood and marrow transplantation (BMT) treatment significantly affects therapy-related symptoms, state anxiety, and stress. A pre- and post-test crossover design. An urban outpatient cancer center in the midwestern United States. A convenience sample of 20 patients, aged 20-68 years (X = 38.5), receiving treatment at a BMT clinic. Participants completed a demographic questionnaire, the Therapy-Related Symptom Checklist, and the Spielberger State-Trait Anxiety Index, and provided salivary cortisol samples. After pretesting, individuals were assigned to either a wait list or intervention. Individuals in the wait-list group received the usual treatment before completing the post-test measures. Individuals in the intervention group participated in a one-hour art-making session, after which they completed post-test measures. Participants then crossed over to the other group. Art making, stress, state anxiety, and therapy-related symptoms. Therapy-related symptom concerns for the intervention group at post-test were significantly lower than at pretest; no change ocurred in the control group. The salivary cortisol levels were significantly lower at post-test in the intervention and control groups. No change occurred in the anxiety levels of participants in the intervention and control groups. The study hypothesis was partially supported. Art making decreased therapy-related symptoms (e.g., feeling sluggish, difficulty concentrating). Use of more physiologic indices to measure stress and replication on a larger sample are suggested. Individuals receiving BMT may benefit from participation in art-making interventions. Art making is easy to implement in a clinic setting and allows for positive interactions between nurses and patients.
1 January 2019 in Clinical Medicine Insights: Pediatrics
Objective: To understand the swimming experience from the perspective of children with autism spectrum disorder (ASD) and their families. Methods: We interviewed 12 diverse families using a semi-structured interview with follow-up probing questions related to their swimming experiences. Interviews were transcribed verbatim and coded by researchers. Results: Themes included family water activities, safety, characteristics of ASD, instructional methods, swim skills, swimming preferences, barriers/challenges, and benefits of swimming. Findings indicate positive experiences and skill acquisition were prevalent when instructional methods matched a child’s unique needs. Parents revealed they were more confident in safety as their children’s swimming competence improved. Individualized instructional methods and unique characteristics of ASD may influence perceived safety.
22 August 2016 in American Journal of Occupational Therapy
Obesity is a public health concern for the population in general and for children with autism spectrum disorder (ASD) specifically. The purpose of this study was to understand relationships between sensory patterns, obesity, and physical activity engagement of children with ASD (N = 77) sampled from a specialized community-based swimming program. This retrospective correlational study analyzed program data. Results show that almost half (42.2%) of the children were overweight or obese, and sensory avoiding behaviors were related to higher body mass index (BMI). Children participated in few formal and informal physically active recreation activities. Sensory seeking behaviors were associated with increased participation in informal activities, and higher BMI was associated with less participation in both formal and informal activities. Practitioners should consider sensory processing patterns and BMI when developing community-based programs to promote physical activity of children with ASD.
7 December 2011 in European Journal of Cancer Care
This study explored blood and marrow transplantation (BMT) patients' perceptions of an art-making experience during BMT treatment. Participants including patients receiving BMT for a variety of cancers (10 men/10 women, aged 20-68) were offered a 1 hour tile-painting activity during treatment. Participants with cognitive impairment and respiratory precautions were excluded from the study. Researchers followed immune precaution protocols for the safety of participants. Data were collected through semi-structured, in-depth interviews with 20 participants to gather information about their perceptions of the art-making experience in a BMT clinic setting. Interview recordings were transcribed verbatim and analysed. Researchers coded transcripts independently and discussed outcomes together to achieve agreement on themes. Twelve themes emerged from the data, with the three most prevalent themes being Occupying Time (20.5%), Creative Expression (13.5%), and Reactions to Tile Painting (13.5%). Other themes included Support (12.2%), Side Effects (7.3%), Other Activities Suggested by Patients (7%), BMT Treatment Process (6.2%), Shared Painting Experience (5.9%), Life Outlook (5.2%), BMT Life Changes (3.8%), Spirituality (3%) and Barriers (1.9%). Through analysis of these themes, researchers have identified this art-making experience as a diversional or meaningful way to spend time during treatment, a medium for creative expression, and a distraction from negative side effects of the BMT process.
Objective. Autistic children experience sensory challenges that interfere with participation and increase parent stress. Sensory-based interventions are used to address childrens behaviors affected by sensory processing difficulties, but research is limited regarding use of sensory garments to support participation of autistic children. This study explored sensory garment effects on participation, parental competence, and perceived stress of autistic children and their parents. Method. Twenty-one children were recruited and 17 males with ASD and atypical sensory processing patterns completed the 14-week study. The Canadian Occupational Performance (COPM) and Goal Attainment Scaling (GAS) were used to set and monitor participation goals. After a baseline period, children wore sensory garment(s) for 8 weeks. The COPM, GAS, Parent Stress Index-Short Form (PSI-SF), and Parent Sense of Competence Scale (PSOC) were administered four times (prebaseline, before and after the intervention, and three weeks postintervention). Results. There were moderate to large significant differences in both COPM and GAS scores after the intervention and from the beginning to the end of the study indicating sensory garments may improve participation of autistic children. There were no significant differences in PSI or PSOC at any timepoint. Two children rejected the garments. Conclusions. Parent- or child-selected sensory garments may improve participation in individually meaningful activities for children who can tolerate wearing them. Childrens improvement in participation did not improve parent stress or competence, possibly due to the passive nature of the intervention. More research is needed explore the influence of heterogeneous sensory patterns on response to intervention.