Reviewing Research Evidence for Nursing Practice: Systematic Reviews Edited by Christine Webb Professor of Health Studies Faculty of Health and Social Care, University of Plymouth, UK and Brenda Roe Professor of Health Sciences Institute of Health Research, Faculty of Health and Applied Social Sciences, Liverpool John Moores University, UK Reviewing Research Evidence for Nursing Practice Reviewing Research Evidence for Nursing Practice: Systematic Reviews Edited by Christine Webb Professor of Health Studies Faculty of Health and Social Care, University of Plymouth, UK and Brenda Roe Professor of Health Sciences Institute of Health Research, Faculty of Health and Applied Social Sciences, Liverpool John Moores University, UK © 2007 by Blackwell Publishing Ltd Except Chapter 4 © 2006 by John Wiley & Sons Ltd Blackwell Publishing editorial offices: Blackwell Publishing Ltd, 9600 Garsington Road, Oxford OX4 2DQ, UK Tel: +44 (0)1865 776868 Blackwell Publishing Inc., 350 Main Street, Malden, MA 02148-5020, USA Tel: +1 781 388 8250 Blackwell Publishing Asia Pty Ltd, 550 Swanston Street, Carlton, Victoria 3053, Australia Tel: +61 (0)3 8359 1011 The right of the Author to be identified as the Author of this Work has been asserted in accordance with the Copyright, Designs and Patents Act 1988. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by the UK Copyright, Designs and Patents Act 1988, without the prior permission of the publisher. First published 2007 by Blackwell Publishing Ltd ISBN: 978-1-4051-4423-0 Library of Congress Cataloging-in-Publication Data Reviewing research evidence for nursing practice : systematic reviews / edited by Christine Webb and Brenda Roe. p. ; cm. Includes bibliographical references and index. ISBN-13: 978-1-4051-4423-0 (pbk. : alk. paper) 1. Nursing—Research—Methodology. 2. Systematic reviews (Medical research) 3. Evidence-based nursing. I. Webb, Christine. II. Roe, Brenda H. [DNLM: 1. Clinical Nursing Research. 2. Review Literature. 3. Meta-Analysis. 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For further information on Blackwell Publishing, visit our website: www.blackwellnursing.com Contributors viii Preface x Introduction xi Brenda Roe and Christine Webb Part 1 Systematic Reviews and Meta-Analysis of Quantitative Research 1 1 Overview of Methods 3 Mike Clarke Introduction 3 Background 3 Question formulation and study identification for a systematic review 4 Appraising studies for inclusion in a systematic review 5 Collection of data 5 Statistical analysis 6 Updating systematic reviews 7 Appraising and using systematic reviews 7 Conclusion 7 References 7 2 Key Stages and Considerations when Undertaking a Systematic Review: Bladder Training for the Management of Urinary Incontinence 9 Brenda Roe Introduction 9 Developing a protocol 10 Literature searching 10 Publication bias 11 Inclusion criteria 12 Exclusion criteria 13 Quality assessment 13 Data extraction 16 Outcomes 17 Methods of the review 17 Results 19 Writing up a systematic review 20 Dissemination of systematic reviews 21 Conclusion 21 References 21 3 Prevention and Treatment of Urinary Incontinence after Stroke in Adults: Experiences from a Systematic Review for the Cochrane Collaboration 23 Lois Thomas and Beverley French Introduction 23 Overview of the review 23 Issues that arose when carrying out the review 24 Lessons for future similar reviews 29 Conclusion 29 References 30 Contents vi Contents 4 Pelvic Floor Muscle Training for Urinary Incontinence in Women 31 E. Jean C. Hay-Smith, Chantale L. Dumoulin and Peter Herbison Introduction 31 Overview of the review 31 Issues that arose when carrying out the review 47 Conclusion 48 References 50 5 Biofeedback and Anal Sphincter Exercises for Faecal Incontinence in Adults 52 Christine Norton Introduction 52 Background 52 Overview of the review 53 Issues that arose from carrying out the review 56 Conclusion 58 References 58 Part 2 Meta-synthesis and Meta- study of Qualitative Research 61 6 Overview of Methods 63 Myfanwy Lloyd Jones Introduction 63 What are meta-study and meta-synthesis? 63 A brief history 64 Key methodological aspects 65 Assessing the quality of a meta-synthesis 69 Conclusion 70 References 70 7 Coming Out as Ill: Understanding Self-disclosure in Chronic Illness from a Meta-synthesis of Qualitative Research 73 Barbara L. Paterson Introduction 73 The meta-study project 73 Challenges in the meta-study project 79 Conclusion 81 References 81 Appendix 7.1 84 Appendix 7.2 85 8 From Meta-synthesis to Method: Appraising the Qualitative Research Synthesis Report 88 Margarete Sandelowski Introduction 88 Components of a qualitative research synthesis report and evaluation criteria 89 Conclusion 108 References 109 9 Role Development in Acute Hospital Settings: A Systematic Review and Meta-synthesis 112 Myfanwy Lloyd Jones Introduction 112 Overview of the methods used in the meta-synthesis 112 Issues that arose while carrying out the meta-synthesis 118 Conclusion 130 References 131 Part 3 Integrative Reviews of Quantitative and Qualitative Research 135 10 Overview of Methods 137 David Evans Introduction 137 What is an integrative review? 137 Integrating qualitative and quantitative research in a review 138 Purpose 138 Protocol 139 Problem identification 139 Locating studies 141 Evaluating studies 142 Data collection 143 Data analysis 144 Integrative review report 145 Conclusion 147 References 147 11 Rigour in Integrative Reviews 149 Robin Whittemore Introduction 149 Rigour in integrative reviews 149 Quality in integrative reviews 154 Contents vii Conclusions 155 References 155 12 Habit Retraining for Urinary Incontinence in Adults 157 Joan Ostaszkiewicz and Beverly O’Connell Introduction 157 Background 157 Systematic review method 157 Systematic review results 158 Dilemmas encountered implementing the Cochrane systematic review criteria 160 Managing and integrating evidence from mixed design studies 161 Results 162 Discussion 170 Conclusion 174 References 174 Appendix 12.1 176 13 What Makes a Good Midwife? 188 Lynn Nicholls and Christine Webb Introduction 188 Background 188 Overview of the review 188 Methodological issues in the included studies 191 Summary of review findings 204 Issues arising from the review process 205 Conclusion 207 References 207 14 Older People and Respite Care 210 Rachel McNamara and Chris Shaw Introduction 210 Overview 212 Methodological issues 213 Lessons for future reviews 222 Conclusion 223 References 224 15 Use of Physical Restraint 226 David Evans Introduction 226 Focusing the review 226 Selection criteria 227 Search strategy 229 Critical appraisal 230 Data extraction 230 Data synthesis 230 Results 231 Conclusion 239 References 240 Part 4 Applications and Uses of Reviews 243 16 Using Systematic Reviews in Health Services 245 Donna Ciliska, Maureen Dobbins and Helen Thomas Introduction 245 Use of systematic reviews in clinical practice/programme planning or service provision 246 Use of reviews for policy decisions 246 Critical appraisal of reviews 247 Conclusion 251 References 252 17 Reflections on the Past, Present and Future of Systematic Reviews 254 Christine Webb and Brenda Roe Introduction 254 Why conduct systematic reviews? 255 The systematic review process 257 Searching for evidence 257 Quality assessment of included studies 258 Using systematic reviews 259 References 259 Index 261 Donna Ciliska is Professor in the School of Nursing at McMaster University and has an appointment as a nursing consultant with Hamilton Public Health. She is editor of the journal Evidence-Based Nursing , and has contributed as a co-editor to two evidence-based nursing texts. Her research interests include community health, obesity, eat- ing disorders and knowledge translation. Mike Clarke is Director of the UK Cochrane Centre, which provides training and support to systematic reviewers in the UK. He is Professor of Clinical Epidemiology at the University of Oxford, work- ing on systematic reviews of individual patient data. These include the breast cancer overview, which brings together data on more than 300 000 women in 400 randomised trials. He works on more than a dozen other systematic reviews across health care and on trials in pre-eclampsia, subarachnoid haemorrhage, breast cancer and poisoning – which are the world’s largest ran- domised trials in each condition. Maureen Dobbins is an associate professor in the School of Nursing at McMaster University and has an appointment as a nursing consultant with the City of Hamilton Public Health Services. She holds a career scientist award with the Ontario Ministry of Health and Long-Term Care. Her research interests include knowledge transfer and exchange, evidence-informed decision-making, community health, healthy body weight, physical activity and chronic disease prevention. Chantale L. Dumoulin is an assistant professor at the School of Physical and Occupational Therapy, Faculty of Medicine, University of Montreal, Canada. Her research interests include psycho- metric evaluation of measuring instruments, conservative interventions for urinary incontin- ence in women, service delivery and research dissemination. David Evans is Senior Lecturer in the Division of Health Sciences at the School of Nursing and Midwifery, University of South Australia. His areas of interest include all aspects of acute care nursing, evidence-based practice, safety and quality issues and practice evaluation. Beverley French is a senior research fellow at the University of Central Lancashire. Her experi- ence of quantitative systematic review is mainly in Cochrane reviews of interventions in stroke rehabilitation. She is currently involved in a num- ber of syntheses of wider evidence sources relat- ing to mental health advocacy, and community development and engagement. E. Jean C. Hay-Smith is a lecturer in the Rehabilita- tion Teaching and Research Unit at the Wellington School of Medicine and Health Sciences, Uni- versity of Otago, New Zealand. She is an editor of the Cochrane Incontinence Review Group. Her research interests include the conservative management of urinary incontinence (particularly pelvic floor muscle training), self-efficacy and treatment adherence. Contributors [...]... chapter by way of example, but all Cochrane systematic reviews follow the same format and provide an example of robust methods for systematically reviewing quantitative data from RCTs Guidelines for undertaking systematic reviews Textbooks and chapters (Sindhu, 1998; Glasziou et al., 2001; Egger et al., 2005), as well as handbooks 10 Reviewing Research Evidence for Nursing Practice (CRD, 2001; Green & Higgins,... parts Part 1 covers Systematic Reviews and Meta-Analysis of Quantitative Research and predominantly cites as examples reviews undertaken as part of the Cochrane Collaboration involving randomised controlled trials Part 2, entitled Meta-synthesis and Meta-study of xii Reviewing Research Evidence for Nursing Practice Qualitative Research, includes systematic reviews of qualitative evidence and studies,... systematic reviews of quantitative research, qualitative research, and integrative reviews incorporating both quantitative evidence and qualitative evidence The methods for systematic reviews are continuing to evolve and this book provides an indication of this evolution in one volume The book is primarily intended for nurses and nursing, but is of relevance to medical and health services researchers... have the time, confidence or skills to carry out research or systematic reviews for themselves Therefore they rely on reviews by other people when considering innovations and developments in their practice Our aim for this book, therefore, is to present readers with the issues arising from conducting systematic reviews and thereby to help them understand reviews that they identify and read when considering... Systematic Reviews It sets systematic reviews in historical context, from the evolution of systematic reviews for quantitative evidence, then the synthesis of qualitative evidence, followed more recently by integrative reviews which combine analysis and synthesis of both types of evidence in a review Finally, the possibility of undertaking synopses of a number of related systematic reviews using meta-study... the Royal College of Nursing Gastroenterology and Stoma Care Forum and is associate editor of Gastrointestinal Nursing Beverly O’Connell holds the Inaugural Chair in Nursing at the Deakin-Southern Health Nursing Research Centre Previously she held the positions of Chair in Nursing, Cabrini Health; Nursing Research Director, Sir Charles Gairdner Hospital; and Director of Nursing Research and Development,... conducting systematic reviews and to provide a ‘how to’ of the methods used, based on reviewers’ experiences of undertaking published systematic reviews It provides a selection of reviews carried out in a range of specialist areas related to clinical practice, along with recommendations for practice and future research Not only does the book inform people wishing to undertake systematic reviews themselves,... respite care and evidence of its effectiveness They provide an overview of the research aims, methodology and methodological issues They consider how to devise an appropriate search strategy to capture both quantitative and qualitative evidence, along xiv Reviewing Research Evidence for Nursing Practice with assessment of study quality – which for quantitative studies is more established than for qualitative... Collaboration and the Cochrane Library based on a global effort established in 1993 Clarke’s chapter looks at question formulation, study identification, appraisal of studies for inclusion, data collection, statistical analysis, updating of reviews and appraising and using systematic reviews He concludes that systematic reviews offer the best way to ensure that evidence is available on which to make decisions... global effort was established in 1993 (Chalmers, 1993) and more than 14 000 people in 100 countries are now involved in its efforts to prepare, maintain and promote the accessibility of systematic reviews of the effects of healthcare interventions (www.cochrane.org) Through this work, the Cochrane Database of Systematic Reviews (CDSR) now contains the full text for more than 3000 Cochrane systematic reviews, . Christine Webb xii Reviewing Research Evidence for Nursing Practice Qualitative Research, includes systematic reviews of qualitative evidence and studies,. Reviewing Research Evidence for Nursing Practice: Systematic Reviews Edited by Christine Webb Professor of