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Twenty-four/seven: a mixed-method systematic review of the off-shift literature.

ABSTRACT: AIM:This article is a report of a review that aimed to synthesize qualitative and quantitative evidence of 'off-shifts' (nights, weekends and/or holidays) on quality and employee outcomes in hospitals. BACKGROUND:Healthcare workers provide 24-hour-a-day, 7-day-a-week service. Quality and employee outcomes may differ on off-shifts as compared to regular hours. DATA SOURCES:Searches for studies occurred between the years 1985-2011 using computerized databases including Business Source Complete, EconLit, ProQuest, PubMed and MEDLINE. REVIEW DESIGN AND METHODS: Design was a mixed-method systematic review with quantitative and qualitative studies. To be included, studies met the following criteria: (1) the independent variable was an off-shift; (2) the article was a research study and peer-reviewed; (3) the article could be obtained in English; and (4) the article pertained to health care. Studies were not excluded on design. RESULTS:Sixty studies were included. There were 37 quality outcome, 19 employee outcome and four qualitative studies. In the quality outcome studies, researchers often used quantitative, longitudinal study designs with large sample sizes. Researchers found important differences between patients admitted on weekends and mortality. Important differences were also found between nighttime birth and mortality and rotating night work and fatigue, stress and low mental well-being. Most studies (9 of 12) did not find an important association between patients admitted at night and mortality. CONCLUSION:Patient outcomes on weekends and employee outcomes at night are worse than during the day. It is important to further investigate why care on off-shifts differs from weekly day shifts.

SUBMITTER: de Cordova PB

PROVIDER: S-EPMC3428734 | biostudies-literature | 2012 Jul

REPOSITORIES: biostudies-literature

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Twenty-four/seven: a mixed-method systematic review of the off-shift literature.

de Cordova Pamela B PB Phibbs Ciaran S CS Bartel Ann P AP Stone Patricia W PW

Journal of advanced nursing 20120311 7

<h4>Aim</h4>This article is a report of a review that aimed to synthesize qualitative and quantitative evidence of 'off-shifts' (nights, weekends and/or holidays) on quality and employee outcomes in hospitals.<h4>Background</h4>Healthcare workers provide 24-hour-a-day, 7-day-a-week service. Quality and employee outcomes may differ on off-shifts as compared to regular hours.<h4>Data sources</h4>Searches for studies occurred between the years 1985-2011 using computerized databases including Busine ...[more]

PMID: 22905343

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Project description:Background The construct of working alliance has been used to operationalise the patient–clinician relationship. Research evidence from the rehabilitation literature has established an association between the construct and several patient outcomes. The aim of this systematic literature review was to study working alliance in the chiropractic discipline. Method This review followed a mixed method systematic review methodology: EBSCO (The Allied and Complementary Medicine Database), EBSCO (MEDLINE), EBSCO PsycINFO, Web of Science Core Collection, Chiro index, and grey literature were searched for quantitative, qualitative, and mixed methods studies on 17th March 2021. Qualitative appraisal was conducted using the Mixed Methods Appraisal Tool, version 2018. The qualitative component was synthesised via thematic synthesis and explored patients’ and chiropractors’ perceptions of the nature and role of working alliance. The quantitative component was synthesised via narrative synthesis to examine how the construct has been measured in research and what its effect on clinical outcomes and patient satisfaction is. The findings were integrated in the discussion section. Results Thirty studies were included. The qualitative component found that both patients and chiropractors consider working alliance as a key factor in the treatment journey. The findings illustrated that the construct includes the bond between a patient and a chiropractor which is underpinned by trust and attentiveness to patients’ needs, values and preferences. Qualitative data also suggested that strong working alliance has the potential to improve patients’ adherence to treatment and that it is characterised by ongoing negotiation of expectations about the goals of care and the tasks involved in the treatment plan. The quantitative component highlighted that even though working alliance is relevant to the chiropractic discipline, very few studies have quantitatively measured the construct and its effect. Conclusion The findings of this review emphasise the subjective importance of working alliance in the chiropractic clinical encounter. However, there were not enough homogenous studies measuring the effect of working alliance on clinical outcomes and patient satisfaction to conduct a meta-analysis. Future research should focus on evaluating potential direct and mediated effects on patient outcomes. Supplementary Information The online version contains supplementary material available at 10.1186/s12998-022-00442-4.

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Twenty-four/seven: a mixed-method systematic review of the off-shift literature.

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Twenty-four/seven: a mixed-method systematic review of the off-shift literature.

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