An example of rapid evidence assessment review
| Stages | Example |
|---|---|
| Background | Living with a child with a long-term condition is challenging because of illness-specific demands. A critical evaluation of research exploring parents’ experiences of living with a child with a long-term condition was timely because international health policy advocates that patients with long-term conditions are active partners in care Key message: Set the scene and build up a rationale for undertaking the review |
| Aims and objectives | What are parents’ experiences of living with a child with a long-term condition? Aim: To explore parents’ experiences of living with a child with a long-term condition Specific objectives: Describe parents’ accounts of living with a child with a long-term condition; identify systems that enable or hinder parents’ role as care manger Key message: Clear and focused question, aim and objectives must address the clinical or research problem |
| Review design and methods | A rapid evidence review was undertaken adhering to UK CRD guidance. MEDLINE, CINAHL, PSYCINFO data bases were searched and hand searching of the Journal of Advanced Nursing and Child: Care, Health and Development. Studies written in English language describing parents’ experiences of living with a child with a long-term condition were included (January 1999–December 2009). Thematic analysis underpinned data synthesis. Quality appraisal involved assessing each study against predetermined CASP criteria Key message: Design and methods should flow and be presented logically |
| Findings | 34 studies were included and despite variability in their quality there were similarities across findings. 3 themes emerged from the synthesis of study findings: Parental impact: parents’ experienced confusion, disbelief, anxiety, turmoil and a loss of identity following their child's diagnosis; these feelings dissipated as parents focused on meeting their child's needs. For some parents a more enduring grief evolved Illness management: parents wanted information about—the disease and treatments; accessing services and support networks; and strategies to help them cope. For some families caregiving formed a significant part of parenting their child above usual parenting tasks, consequently parents developed considerable expertise in managing their child's condition Social context: often family life was disrupted because of the unpredictability of the child's condition, yet parents strove to create a normal family environment Key message: Outline the quality of the research reviewed; summarise key findings into a seamless narrative |
| Discussion | The care of children with long-term conditions is delivered primarily at home; parents have little choice in undertaking complex care and treatments. Mastering care regimes develops through experience; developing expertise occurred through blending knowledge and skill acquisition with experiential knowledge in order to adapt to changes in the child's condition Key message: Explain findings by drawing on relevant theories and health policy as appropriate |
| Conclusion | Parents developed considerable expertise in managing their child's condition. Yet, parents’ perceive they not always supported in their role as manager for their child's condition. Several research gaps were identified: reasons for poor collaborative working between parents and health professionals are unclear; paucity of research exploring/evaluating strategies to support expert parents in role as care manger Key message: Highlight key issues emerging from review and how findings will influence practice |
CASP, Critical Appraisal Skills Programme; CRD, Centre for Reviews and Dissemination.