Marleen Corremans

Objectives: The aim of this project was to improve the self-management of diabetes among elderly residents in a Belgian home for the aged. Introduction: Diabetes is a common chronic condition with significant comorbidity. Incidence is increasing, but a third of patients with diabetes are unaware that they have the disease. The treatment of diabetes requires a multifactorial approach. Treatment guidelines on diabetes recommend involving patients in monitoring their condition because supported self-management improves daily glycemic control. Methods: This evidence implementation project used the JBI Evidence Implementation Framework, which follows three phases. In the first phase, the area of change, stakeholders’ role, and practice context and readiness for change are investigated. In the second phase, a baseline audit is conducted to compare current practice with best practice. Strategies are then implemented to address any areas of non-compliance with best practice. In the third phase, a follow-up audit is conducted to evaluate changes in practice. Results: At baseline, six criteria had 0% compliance, two criteria had compliance lower than 50%, and only 49% of health care workers were familiar with the procedure for hypoglycemia treatment. Improvement strategies included creating awareness among health workers. In the follow-up audit, one criterion improved from 0% to 100%, three criteria improved from 0% to 85%, two criteria reached the threshold of 50% compliance, and one criterion reached 19%. Further audits are needed to ensure sustainability. Conclusions: This project improved diabetes self-management in elderly people living in a Belgian home for the aged. An in-depth planning phase with internal facilitation and interdisciplinary collaboration between all co-workers addressed barriers related to quality systems, structure, communication, and education. Spanish http://links.lww.com/IJEBH/A258

The number of people with type 2 diabetes is increasing, both in our country and internationally. Accurate monitoring is very important. After all, accurate monitoring of blood values can prevent long-term problems such as chronic wounds or eye disease. Involving the patient in monitoring this condition is also recommended by treatment guidelines. Supported self-management improves daily glycemic control. Zorgbedrijf Antwerp, an organisation with home care services, nursing homes and units for assited-living, was looking for good ways to encourage this self-management among caregivers. Both in their home care services and in the residential care centers, Zorgbedrijf experienced insufficient involvement with the elderly to take control of their disease process. Among staff, they notice insufficient attention to education and empowerment for their residents with diabetes. Several interventions are suggested from the literature to promote self-management in older people with type 2 diabetes. A 2017 systematic review concludes that effective self-management interventions use communication, data provided by the patient, education and feedback. To put these interventions into practice, several implementation models are available. The JBI Evidence Implementation Framework (EIF) devotes explicit attention to the methodical application of new up-to-date evidence and, in addition to a step-by-step plan for determining readiness, offers guidance in determining indicators. This ensures sustainable implementation. More than a theoretical framework, this model also includes practical tools for the search for the best available evidence, the interventions to be implemented and the criteria to measure effect. In Belgium, this model has never been used before, but numerous successful projects are available abroad. With funding of Ebpracticenet, a pilot project was set up- to implement self management for diabetes in one nursing home from Zorgbedrijf, using the JBI EIF, guided by the Belgian Interuniversity Collaboration for Evidence-based Practice (BICEP). Important in the Framework is the use of an internal facilitator. First, this internal facilitator was trained by Bicep to search for evidence and how to use audit and feedback in implementation projects. Clinical leadership is taught to support equity in the stakeholders. In a second phase a multidisciplinary working group was established with all relevant stakeholders. This group was given the mandate to set up criteria and methods for implementation. In this way, clinical engagement is taken into account. Eight criteria were chosen from an evidence summary provided by the JBI database. An in depth context analysis looked revealed additional barriers in structure, culture, communication, resources, leadership, knowledge or attitudes. At present, baseline measurement is finished. Together with the working group, an action plan has been formulated and the kickoff meeting is planned. What we can see already is a project that is driven by a whole team, bottom up. From December to March 2023 , the self-management will start for all eligible new residents. At the ICIC conference, the follow up measurement will show us all relevant results and give us the data for a sustainable follow up of the project.

Objective: The objective of this review is to investigate what is known about culture-based prescribing to improve mental health and well-being. Introduction: Culture-based prescribing, where a person is referred by a clinical professional to an arts or cultural activity aimed at improving mental health and well-being, is increasingly used as a community-based source of support. Although culture-based prescribing seems promising, the field is heterogeneous with respect to definition, underlying hypotheses, and cultural activity. This hampers its further development and implementation. Inclusion criteria: We will consider publications that report on or explore culture-based prescribing to improve mental health and well-being for adults with symptoms related to mental health conditions who are seeking care from any clinical professional. Methods: We will search 8 electronic literature databases for published or unpublished reports on culture-based prescribing, without date limits. We will also search for gray literature and screen reference lists of relevant reviews. No language restrictions will be applied during the screening process, but for data extraction, we will only extract studies in languages our team has proficiency in. The screening and data extraction will be performed by 2 reviewers, independently. Data analysis will be descriptive, with results tabulated separately for each subquestion. The results will be complemented with a narrative summary. Review registration: Open Science Framework https://osf.io/ndbqj

Background: Guidelines aim to support evidence-informed practice but are inconsistently used without implementation strategies. Our prior scoping review revealed that guideline implementation interventions were not selected and tailored based on processes known to enhance guideline uptake and impact. The purpose of this study was to update the prior scoping review.Methods: We searched MEDLINE, EMBASE, AMED, CINAHL, Scopus, and the Cochrane Database of Systematic Reviews for studies published from 2014 to January 2021 that evaluated guideline implementation interventions. We screened studies in triplicate and extracted data in duplicate. We reported study and intervention characteristics and studies that achieved impact with summary statistics.Results: We included 118 studies that implemented guidelines on 16 clinical topics. With regard to implementation planning, 21% of studies referred to theories or frameworks, 50% pre-identified implementation barriers, and 36% engaged stakeholders in selecting or tailoring interventions. Studies that employed frameworks (n=25) most often used the theoretical domains framework (28%) or social cognitive theory (28%). Those that pre-identified barriers (n=59) most often consulted literature (60%). Those that engaged stakeholders (n=42) most often consulted healthcare professionals (79%). Common interventions included educating professionals about guidelines (44%) and information systems/technology (41%). Most studies employed multi-faceted interventions (75%). A total of 97 (82%) studies achieved impact (improvements in one or more reported outcomes) including 10 (40% of 25) studies that employed frameworks, 28 (47.45% of 59) studies that pre-identified barriers, 22 (52.38% of 42) studies that engaged stakeholders, and 21 (70% of 30) studies that employed single interventions.Conclusions: Compared to our prior review, this review found that more studies used processes to select and tailor interventions, and a wider array of types of interventions across the Mazza taxonomy. Given that most studies achieved impact, this might reinforce the need for implementation planning. However, even studies that did not plan implementation achieved impact. Similarly, even single interventions achieved impact. Thus, a future systematic review based on this data is warranted to establish if the use of frameworks, barrier identification, stakeholder engagement, and multi-faceted interventions are associated with impact.Trial registration: The protocol was registered with Open Science Framework (https://osf.io/4nxpr) and published in JBI Evidence Synthesis.

Objective: This study will synthesize the available evidence on the prevalence and incidence of chemotherapy-induced taste alterations in adult cancer patients. Introduction: Taste and smell alterations in cancer patients due to chemotherapy affect patients’ quality of life and can cause malnutrition. Recent knowledge about the incidence and prevalence of chemotherapy-induced taste alterations may enable tailored food interventions for this specific population. Describing variations in taste changes in subgroups of chemotherapy is important to inform taste steering interventions. Inclusion criteria: The review will consider studies that include adult cancer patients who are receiving or have received chemotherapy as a treatment for an oncologic issue. It will include studies that investigate the prevalence and incidence of chemotherapy-induced taste alterations that have been assessed objectively or subjectively by patient-reported outcomes. Methods: A systematic search will be performed of the following databases: MEDLINE (PubMed), CINAHL (Ovid), Embase, and OpenSIGLE. Analytical, observational, and cross-sectional studies will be considered. All studies will undergo critical appraisal, data extraction, and synthesis. Data will be extracted using the JBI standardized data extraction tool for prevalence and incidence. Type and frequency of treatment and cytostatic agent will be extracted. The population will be described by age and gender. In addition, study methods and proportions of interest to the review question will be extracted. Pooled prevalence estimates will be calculated using a random effects model. Systematic review: PROSPERO CRD42020136706

Aim: Alterations in taste are distressing side effects for cancer patients receiving chemotherapy. The Center for Gastrology (Belgium) developed a self-care intervention based on taste control. This intervention contains an assessment of the individual taste and food hedonics. It provides recipes based on the individual assessed hedonics profile, so patients can self-prepare personalized meals. This study aims to describe the experiences of oncologic patients with the home baking of personalized bread. Design: A qualitative, descriptive design with individual semi-structured interviews was used. Methods: In August 2018, eleven face-to-face interviews were conducted until data saturation. Results: The analysis of the interviews revealed five major themes: "Stepping out of your role," "Having something positive to do," "gaining insight," "receiving recognition" and "practical limitations."

Purpose: Taste and smell alterations are known side-effects of an oncological treatment with chemotherapy and can cause reduced food intake and lead to malnutrition and cachexia. ESPEN guidelines state that organizations should foresee a protocol to identify patients at nutritional risk and that screening should be available for all patients. The Chemotherapy-induced Taste alteration Scale (CiTAS) is described as a self -reported scale with a high reliability and validity. The aim of this study is to make a back translation and validation of the Chemotherapy-Induced Taste Alteration Scale in Dutch.Methods: The evaluation instrument was constructed in a three-phased project. First, the Japanese version was backtranslated to Dutch and piloted in a cognitive interview. In a second phase, a Delphi procedure was followed. Context validity and Cronbach’s alpha were calculated. In a third phase comfirmatory analysis was tested.Results and conclusion: The overall Cronbach’s alpha was 0.89. The convergent and discriminant validity show us that the items that should be related indeed are, like the items in the construct and that items that shouldn’t, are not, as between the constructs. The scale was successfully backward translated and validated in Dutch and is ready to be used to screen Dutch speaking cancer patients with chemotherapy as a treatment for their cancer diagnosis. This version of CiTAS can be implemented in the Flemish speaking part of Belgium and in the Netherlands.