BackgroundUse of theory is essential for advancing the science of knowledge translation (KT) and for increasing the likelihood that KT interventions will be successful in reducing existing research-practice gaps in health care. As a sociological theory of knowledge, social constructivist theory may be useful for informing the design and evaluation of KT interventions. As such, this scoping review explored the extent to which social constructivist theory has been applied in the KT literature for healthcare professionals.MethodsSearches were conducted in six databases: Ovid MEDLINE (1948 – May 16, 2011), Ovid EMBASE, CINAHL, ERIC, PsycInfo, and AMED. Inclusion criteria were: publications from all health professions, research methodologies, as well as conceptual and theoretical papers related to KT. To be included in the review, key words such as constructivism, social constructivism, or social constructivist theories had to be included within the title or abstract. Papers that discussed the use of social constructivist theories in the context of undergraduate learning in academic settings were excluded from the review. An analytical framework of quantitative (numerical) and thematic analysis was used to examine and combine study findings.ResultsOf the 514 articles screened, 35 papers published between 1992 and 2011 were deemed eligible and included in the review. This review indicated that use of social constructivist theory in the KT literature was limited and haphazard. The lack of justification for the use of theory continues to represent a shortcoming of the papers reviewed. Potential applications and relevance of social constructivist theory in KT in general and in the specific studies were not made explicit in most papers. For the acquisition, expression and application of knowledge in practice, there was emphasis on how the social constructivist theory supports clinicians in expressing this knowledge in their professional interactions.ConclusionsThis scoping review was the first to examine use of social constructivism in KT studies. While the links between social constructivism and KT have not been fully explored, the Knowledge to Action framework has strong constructivist underpinnings that can be used in moving forward within the broader KT enterprise.

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While generalization is limited by the small sample size, findings include a comprehensive list of rehabilitation needs following treatment for HNC, factors that facilitate and hinder recovery of functional health, and specific suggestions for the development of rehabilitation consult intervention for survivors of HNC.

The objective is to estimate the extent to which existing health care interventions designed specifically to target health-related quality of life (HRQL) in persons with multiple sclerosis (MS) achieve this aim. The structured literature search was conducted using multiple electronic databases including Ovid MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature and the Cochrane Central Register of Controlled Trial, for the years 1960 to 2011. The methodological quality of selected randomized controlled trials (RCTs) was assessed using the Cochrane Collaboration's recommended domain-based method. Effect size (ES) was used to measure the effect of each intervention on HRQL. The studies were combined using a random-effects model to account for inter-study variation. Heterogeneity was tested for using the I-test and publication bias was assessed using funnel plots and the Egger weighted regression statistic. Thirty-nine RCTs met the criteria, all with acceptable methodological quality. Six major types of interventions were identified through the search. The smallest effect was observed for self-management and complementary and alternative medicine (ES=0.2), followed by medication (ES=0.3) then cognitive training and exercise (ES=0.4), and psychological interventions to improve mood (ES=0.7). The magnitude of positive effect on HRQL varied between the different types of interventions. The extent to which interventions are able to improve HRQL depends on delivering a potent intervention to those persons who have the potential to benefit.

BackgroundEvidence suggests that rehabilitation interventions can improve function and quality of life in survivors of head and neck cancer (HNC), but there is a lack of coordinated, integrated services, and those offered are inconsistent. To address these gaps, we will develop and conduct preliminary evaluation of a rehabilitation consult, built on the theoretical foundations of goal setting and self-management, and composed of a brief functional evaluation, a resource compendium, and collaborative goal-setting and action planning processes.Methods/designThe development of the rehabilitation consult will be guided by intervention mapping, which consists of six steps: 1. Needs assessment; 2. Definition of program objectives; 3. Selection of theory-based intervention methods; 4. Production and pretesting; 5. Adoption, implementation and sustainability planning; 6. Process and effect evaluation. Within the intervention mapping framework, an iterative process of constructing drafts and mini-evaluations with consumers and experts will be used, modifying the rehabilitation consult intervention until a version suitable for formal evaluation is established. The rehabilitation consult will then be evaluated using a prospective, mixed method, single group design with 30 survivors of head and neck cancer. Outcomes will be assessed pre- and post-intervention and at 6-month follow-up.DiscussionSurvivors of head and neck cancer have among the most complex rehabilitation needs of all cancer patients. The rehabilitation consult is expected to improve knowledge and uptake of rehabilitation resources and strategies in survivors of head and neck cancer and thereby improve long-term function and quality of life. If the rehabilitation consult is effective in cancer patients with such high and diverse needs, this project will produce a toolkit that will be adaptable for other types of cancer in other jurisdictions.

This review has provided an overview of the scope of rehabilitation interventions available for survivors of head and neck cancer and preliminary information about their efficacy. This is foundational information for the development and refinement of rehabilitation interventions and programs for head and neck cancer survivors. Implications for Rehabilitation The existing evidence suggests that survivors of head and neck cancer can benefit from early screening of potential rehabilitation needs and being involved in preventive rehabilitation programs pre-surgery when possible. Rehabilitation programs should consider swallowing interventions for patients as evidence reports improved swallowing function, decreased pain and discomfort, and reduced duration of feeding tube use. Rehabilitation programs should consider nutritional interventions after radiotherapy: Patients benefited from stabilized weights, improved nutritional status, and an improved quality of life. Physical exercise interventions demonstrated improvements in physical function, muscular endurance, range of motion, overall quality of life, and showed reductions in pain, and fatigue.

Background:The definition of health for people with cancer is not focused solely on the physiology of illness and the length of life remaining, but is also concerned with improving the well-being and the quality of the life (QOL) remaining to be lived. This study aimed to identify the constructs most associated with QOL in people with advanced cancer.Methods:Two hundred three persons with recent diagnoses of different advanced cancers were evaluated with 65 variables representing individual and environmental factors, biological factors, symptoms, function, general health perceptions and overall QOL at diagnosis. Three independent stepwise multiple linear regressions identified the most important contributors to overall QOL. R2 ranking and effect sizes were estimated and averaged by construct.Results:The most important contributor of overall QOL for people recently diagnosed with advanced cancer was social support. It was followed by general health perceptions, energy, social function, psychological function and physical function.Conclusions:We used effect sizes to summarise multiple multivariate linear regressions for a more manageable and clinically interpretable picture. The findings emphasise the importance of incorporating the assessment and treatment of relevant symptoms, functions and social support in people recently diagnosed with advanced cancer as part of their clinical care.

This study provides evidence that the PGI would be a good measure for patients and clinicians to use together to identify areas of concern that require attention and monitor changing needs.