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  • 1. Fridlund, Bengt
    et al.
    Andersson, Ewa K.
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Bala, Sidona-Valentina
    Dahlman, Gull-Britt
    Ekwall, Anna K.
    Glasdam, Stinne
    Hommel, Ami
    Lindberg, Catharina
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Persson, Eva I.
    Rantala, Andreas
    Sjöström-Strand, Annica
    Wihlborg, Jonas
    Samuelson, Karin
    Essentials of Teamcare in Randomized Controlled Trials of Multidisciplinary or Interdisciplinary Interventions in Somatic Care: A Systematic Review2015In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, ISSN 2162-5344, Vol. 12, no 5, p. 1089-1101Article, review/survey (Refereed)
    Abstract [en]

    Background: Teamcare should, like all patient care, also contribute to evidence-based practice (EBP). Randomized controlled trials (RCTs) focusing on teamcare have been performed but no study has addressed its essentials. How far this EBP has progressed in different health aspects is generally established in systematic reviews of RCTs. Aim: The aim is to determine the essentials of teamcare including the nurse profession in RCTs of multi- or interdisciplinary interventions in somatic care focusing on the stated context, goals, strategies, content as well as effectiveness of quality of care. Methods: A systematic review was performed according to Cochrane review assumptions to identify, appraise and synthesize all empirical evidence meeting pre-specified eligibility criteria. The PRISMA statement guided the data selection process of 27 articles from PubMed and CINAHL. Results: Eighty-five percent of RCTs in somatic care showed a positive effectiveness of teamcare interventions, of which interdisciplinary ones showed a greater effectiveness compared with the multidisciplinary approach (100% vs 76%). Also theory-based RCTs presented higher positive effectiveness (85%) compared with non-theory-based RCTs (79%). The RCTs with positive effectiveness showed greater levels for professional-centered ambition in terms of goals and for team-directed initiatives in terms of strategy, and a significantly higher level for patient-team interaction plans in terms of content was shown. Conclusions: Teamcare RCTs are still grounded in the multidisciplinary approach having a professional-centered ambition while interdisciplinary approaches especially those that are theory-based appear to be essential with regard to positive effectiveness and preferable when person-centered careis applied.

  • 2. Fridlund, Bengt
    et al.
    Jönsson, A.C.
    Andersson, Ewa
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Bala, S.-V.
    Dahlman, G.-B.
    Forsberg, A.
    Glasdam, S.
    Krstensson, A.
    Lindberg, Catharina
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Sivberg, B.
    Essentials of Nursing Care in Randomized Controlled Trials of Nurse-Led Interventions in Somatic Care: A Systematic Review2014In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 4, no 3, p. 181-197Article in journal (Refereed)
    Abstract [en]

    Background: Nursing practice has to contribute to evidence pointing out why there is a need for more nurse-designed randomized control trials (RCTs) focusing on evidence-based practice (EBP). How far this EBP has progressed in different health aspects is usually established by systematic reviews of RCTs. Nurse-led RCTs exist but no study has addressed the essentials of nursing care. Aim: The aim was therefore to determine the essentials of nurses’ interventions by means of nurse-led RCTs in somatic care focusing on the stated context, goals, content, strategies as well as the nurse’s role related to effectiveness. Methods: A systematic review was realized according to Cochrane review assumptions to identify, appraise and synthesize all empirical evidence meeting pre-specified eligibility criteria. The PRISMA statement guided the data extraction process (n = 55) from PubMed and CINAHL. Results: Of the RCTs in somatic care, 71% showed a positive effectiveness of nurse-led interventions, of which the nurse had a significant role with regard to being the main responsible in 67% of the studies. Also, 47% of the RCTs presented a theoretical standpoint related to the nurse-led interventions and most prominent were international evidence-based guidelines. Goals were found to have either a patient-centered or a professional-centered ambition. Strategies were based on patient-directed initiatives, nurse-patient-directed initiatives or nurse-directed initiatives, while contents were built upon either a patient-nurse interaction or a nursing management plan. Conclusions: This review underlines the necessity of a holistic view of a person, as nurse-led RCTs comprising a patient-centered ambition, patient-directed initiative and patient-nurse interaction plan showed beneficial nursing care effectiveness, particularly if theory-based. In a nurse-led RCT, a basic theoretical perspective is advantageous as well as to elucidate the role of the nurse in relation to the estimated effects.

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