IntroductionLong-term and late effects of cancer treatments can cause functional limitations and reduce quality of life. Cancer rehabilitation services, which can comprise physical exercise, psychological support and educational interventions depending on the individual’s needs, have been found to have a positive effect on health-related quality of life worldwide. However, accessibility or the lack of awareness on available help can act as barriers and influence the uptake of services, resulting in people having unmet rehabilitation needs. In Wales, UK, 41% of people, who have had health and social care needs resulting from cancer and its treatments, reported that they did not receive care when needed. The reason for this lack of support has not yet been fully investigated. The aim of this study is to investigate the conditions in which cancer rehabilitation services work and their underpinning mechanisms in South Wales, UK, specifically addressing barriers, facilitators and costs.Methods and analysisRealist evaluation, which explains for whom a service works in what circumstances and how through context-mechanism-outcome pattern conjunctions, will be used in three phases to investigate the conditions in which cancer rehabilitation services work and their underpinning mechanisms. Phase 1 will be secondary analysis of a cancer rehabilitation database from a local Health Board to give context to who are accessing rehabilitation. Phase 2 will be thematic analysis of face-to-face, semistructured rehabilitation participant (n=20) and healthcare professional (n=20) interviews to explore the mechanisms of how cancer rehabilitation works. Phase 3 will be two case studies and cost-consequences analysis of cancer rehabilitation services.Ethics and disseminationThis study received favourable ethical opinion from London South-East Research Ethics Committee (17/LO/2123) in December 2017. This project is part of the author’s PhD thesis and it is expected that the findings will be disseminated in academic journals and at local and international conferences.
While evidence for the importance of transmission of SARS-CoV-2 from contaminated surfaces is limited, ozone disinfection methods have been considered for surface cleaning as a response to stopping the spread of the virus in educational settings. This rapid evidence summary aimed to search the available literature and summarise findings on the surface survival of SARS-CoV-2, efficacy and effectiveness of ozone machines against SARS-CoV-2, and benefits and harms caused by using these cleaning technologies, including their impact on health. Alternative cleaning technologies, such as light-based technologies and hydrogen peroxide vapour, were also investigated. Findings indicate that gaseous ozone can inactivate different bacteria and viruses, although there is a lack of direct evidence investigating the effect of these cleaning methods on SARS-CoV-2 in real-world settings, specifically in schools. However, regarding harm, ozone is a highly reactive oxidising agent, and high concentrations can contribute to decay of building materials, and health issues (mainly respiratory) by direct exposure or by-product formation. Therefore, leading environmental health organisations do not recommend the use of ozone cleaning technologies in real-world settings, such as schools. Research and policy focus may need to shift towards other interventions that could help reduce transmission, and consequently minimise disruption to education.
The National Health Service (NHS) is experiencing an acute workforce shortage in every discipline, at a time when waiting times are at a record high and there is a growing backlog resulting from the COVID-19 pandemic. This Rapid Review aimed to explore the effectiveness of interventions or innovations relevant to the Welsh NHS context to support recruitment and retention of clinical staff. The review is based on the findings of existing reviews supplemented by a more in-depth evaluation of included primary studies conducted in the UK or Europe. The review identifies a range of interventions that can be used for enhancing recruitment and retention in Wales, particular in rural areas, and supports multiple- component interventions. The findings highlight the importance of providing and locating undergraduate and post graduate training in rural locations. The findings also corroborate the use of bursary schemes for training, such as those already available for Nursing in Wales. Further, more robust evaluations, based on comparative studies, are required to assess the effectiveness of interventions to support recruitment and retention of clinical staff. There was limited evidence on interventions aimed at allied health professionals. Most of the primary studies included in the reviews used cohort (pre-post test) or cross-sectional designs. Most studies lacked a comparison group and did not use statistical analysis.TOPLINE SUMMARYWhat is a Rapid Review?Our rapid reviews use a variation of the systematic review approach, abbreviating or omitting some components to generate the evidence to inform stakeholders promptly whilst maintaining attention to bias. They follow the methodological recommendations and minimum standards for conducting and reporting rapid reviews, including a structured protocol, systematic search, screening, data extraction, critical appraisal, and evidence synthesis to answer a specific question and identify key research gaps. They take 1-2 months, depending on the breadth and complexity of the research topic/ question(s), extent of the evidence base, and type of analysis required for synthesis.This report is linked to a prior rapid evidence map published as: What innovations (including return to practice) would help attract, recruit, or retain NHS clinical staff? A rapid evidence map, report number – REM00028 (May 2022)Background / Aim of Rapid ReviewThe National Health Service (NHS) is experiencing an acute workforce shortage in every discipline, at a time when waiting times are at a record high and there is a growing backlog resulting from the COVID-19 pandemic. This Rapid Review aimed to explore the effectiveness of interventions or innovations relevant to the Welsh NHS context to support recruitment and retention of clinical staff. The review is based on the findings of existing reviews supplemented by a more in-depth evaluation of included primary studies conducted in the UK or Europe.Key FindingsExtent of the evidence base8 systematic reviews and 1 scoping review (with an evaluation component) were included. The reviews included 292 primary studies (218 unique studies), 9 of which were conducted in Europe and UK.The reviews focused on dentists (n=1), general practitioners (n=1), physicians (n=1); the medical workforce including undergraduates (n=1), medical undergraduates (n=1), and a variety of different health professionals (n=3) including those in training (n=1).Most reviews (n=8) looked for evidence of interventions within rural, remote or underserved areas.The interventions were mapped across categories described by the WHO (2010).Recency of the evidence baseMost of the primary studies (n=275) were conducted within the last 20 years.Evidence of effectivenessEducational interventions (8 reviews):Selecting students based on rural background: positive association with recruitment and retention (moderate-low quality evidence from 5 reviews).Locating education institutions in rural areas / providing training within rural oriented medical schools: positive association with recruitment and retention (low quality evidence from 3 reviews).Exposure to rural health topics as part of the taught curricula for undergraduates and postgraduates: positive association with recruitment (moderate-low quality evidence from 2 reviews).Rural clinical placements, fellowships or internships in undergraduate or post-graduate education: mixed evidence associated with rural intentions or actual employment (recruitment and retention; low quality review evidence from 7 reviews).Facilitating continuing education for rural and remote healthcare professionals: positive association with rural recruitment and retention (low quality evidence from 2 reviews).‘Rural-based training programmes’: positive association for doctors and healthcare professionals (Moderate quality evidence from 2 reviews) with rural recruitment and retention.Regulatory interventions requiring return to service in rural areas (6 reviews):Bonded schemes, scholarships or bursaries: positive association with recruitment but not retention (Low quality evidence from 2 reviews)Visa Waivers: mixed evidence on recruitment and retention (4 reviews)Financial incentives: mixed evidence (1 review)Loan repayments: associated with high retention (low quality evidence from 1 review)Access to professional licences and/or provider number for international medical graduates: associated with low retention (low quality evidence from 1 review)Accelerated clinical training: positive association with retention (low quality evidence from 1 review)Enhance scope of practice: positive association with retention (low quality evidence from 1 review)Compulsory service: effective/positive association with retention (low quality evidence from 2 reviews)National Health Insurance scheme: effective in terms of recruitment and retention (low certainty review evidence from 1 review; only one small study identified)Financial incentives without return to service requirement (3 reviews):Benefits that make working in rural areas more attractive and offset other costs/losses (e.g. higher salaries) or in-kind benefits (e.g. subsidised or free housing or vehicles): inconclusive evidence for high income countries, but positive association in middle income countries for improving recruitment and retention (low quality evidence from 3 review). A very low-quality UK study reported a positive association.Loan re-payment programmes: positive association with retention (low quality evidence from 1 review)Personal and professional support – factors that improve living and working conditions in rural areas (3 reviews):Positive association with retention (low level evidence from 3 reviews)Bundled strategies (4 reviews):There was consensus that multi-component interventions positively impacted on recruitment, and retention of rural workforcePolicy ImplicationsThe review identifies a range of interventions that can be used for enhancing recruitment and retention in Wales, particular in rural areas, and supports multiple-component interventions.The findings highlight the importance of providing and locating undergraduate and post graduate training in rural locations.The findings corroborate the use of bursary schemes for training, such as those already available for Nursing in Wales.Further, more robust evaluations, based on comparative studies, are required to assess the effectiveness of interventions to support recruitment and retention of clinical staff. There was limited evidence on interventions aimed at allied health professionals.Strength of EvidenceMost of the primary studies included in the reviews used cohort (pre-post test) or cross-sectional designs. Most studies lacked a comparison group and did not use statistical analysis.
Ambulance waiting times across the UK have increased in recent years. The numbers of ambulance staff leaving services across the UK is increasing every year. Strategies to help recruit and retain all ambulance staff, including paramedics are important. This rapid evidence summary aimed to investigate what innovations can help with their recruitment and retention.Eight primary studies were identified:RecruitmentEvidence from a UK survey suggests that factors negatively influencing paramedic recruitment include competitive job market, lack of locally trained professionals, and newly qualified professionals starting with higher debt. Evidence from the US suggests that factors supporting recruitment concern future paramedics wanting to enter a caring profession or an exciting job. Additionally, strategies to recruit emergency medical technicians need to include the motivational aspects of growth, advancement, recognition, and responsibility. Evidence indicates that factors hindering recruitment of emergency medical technicians and/ or paramedics include rural working, and ambulance services not seen as a primary career path.RetentionEvidence from a UK survey suggests that pay, reward, stress and workload are factors that hinder paramedic retention. Evidence recommends retention strategies for paramedics, such as reviewing banding, improving work conditions and career progression, changing the way ambulances are dispatched to calls, and providing retention premiums. Evidence from the US suggests that pay, benefits, opportunities for advancement, continuous professional development, burnout, stress, workload, nearing retirement and career change are factors that influence retention of emergency medical technicians and/ or paramedics. Evidence from Thailand suggests that remuneration and professionalism are factors supporting paramedic retention.More up-to-date information is needed on the recruitment and retention of ambulance staff in UK settings. Further research providing a more detailed investigation of factors influencing recruitment and retention may be useful. The development or implementation of future strategies to help the recruitment and retention of paramedics and emergency medical technicians should be accompanied by a planned impact evaluation.Funding statementThe Wales Centre For Evidence Based Care was funded for this work by the Wales Covid-19 Evidence Centre, itself funded by Health & Care Research Wales on behalf of Welsh Government.Wales COVID-19 Evidence Centre (WCEC) Rapid Evidence SummaryWhat innovations help with the recruitment and retention of ambulance staff: a rapid evidence summary Report number – RES00050 (November 2022)Rapid Evidence Summary DetailsReview conducted byThe Wales Centre For Evidence Based CareReview Team▪Deborah Edwards▪Judit Csontos▪Liz Gillen▪Judith CarrierReview submitted to the WCEC on:24thNovember 2022Stakeholder consultation meeting: 14thNovember 2022Rapid Evidence Summary report issued by the WCEC in: December 2022WCEC Team:Ruth Lewis, Adrian Edwards, Alison Cooper and Micaela Gal involved in drafting the Topline Summary and editing.This review should be cited asRES00050, Wales COVID-19 Evidence Centre. A rapid evidence summary of what innovations help with the recruitment and retention of ambulance staff. November 2022DisclaimerThe views expressed in this publication are those of the authors, not necessarily Health and Care Research Wales. The WCEC and authors of this work declare that they have no conflict of interest.What innovations help with the recruitment and retention of ambulance staff: a rapid evidence summary Report number – RES00050 (November 2022)TOPLINE SUMMARYWhat is a Rapid Evidence Summary?Our Rapid Evidence Summaries (RES) are designed to provide an interim evidence briefing to inform further work and provide early access to key findings. They are based on a limited search of key resources and the assessment of abstracts. Priority is given to studies representing robust evidence synthesis. No quality appraisal or evidence synthesis are conducted, and the summary should be interpreted with caution.Who is this summary for?Welsh Ambulance Service NHS TrustBackground / Aim of Rapid Evidence SummaryAmbulance waiting times across the UK have increased in recent years, with emergency service performance targets missed. Reasons for the decreasing performance include increasing demand, problems with moving patients through the system, and workforce issues. The numbers of ambulance staff leaving services across the UK is increasing every year with the most acute retention problems affecting paramedics. Strategies to help recruit and retain all ambulance staff, including paramedics are important, therefore this rapid evidence summary aims to investigate what innovations can help with their recruitment and retention.Key FindingsEight primary studies were identified.Extent of the evidence base▪Quantitative descriptive surveys (n=6) and qualitative studies (n=2)▪Studies were from USA (n=6),UK (n=1)and Thailand (n=1).Recency of the evidence base▪The review included evidence available up until October 2022. Included studies were published between 2005 and 2021 with the UK study published in 2015.Summary of findings▪Participants were paramedics (n=3), emergency medical technicians (EMTs) (n=2), paramedics and EMTs (n=2), and emergency medical service directors (n=1).▪Studies focused on factors and strategies influencing ambulance staff recruitment (n=5) and/ or retention (n=7).Recruitment▪Evidence from aUK surveysuggests that factors that negatively influenceparamedicrecruitment includecompetitive job market, lack of locally trained professionals, and newly qualified professionals starting with higher debt.▪Evidence from the US suggests that factors supporting recruitment concernfuture paramedicswanting to enter a caring profession or an exciting job. Additionally, strategies to recruitEMTsneed to include the motivational aspects of growth, advancement, recognition, and responsibility.▪Evidence from the US indicates that factors that hinder recruitment ofEMTs and/ or paramedicsinclude rural working, and ambulance services not seen as a primary career path.▪There wereno studiesthat evaluated theeffectiveness of innovations or strategies to improve ambulance staff recruitment.Retention▪Evidence from aUK surveysuggests thatpay, reward, stress and workloadare factors that hinderparamedicretention.▪Evidence from aUK surveyrecommends retention strategies forparamedics, such as reviewingbanding, improving work conditions and career progression, changing the way ambulances are dispatched to calls, and providing retention premiums.▪Evidence from the US suggests that pay, benefits, opportunities for advancement, continuous professional development, burnout, stress, workload, nearing retirement and career change are factors that influence retention and job satisfaction ofEMTs and/ or paramedics.▪Evidence from Thailand suggests that remuneration and professionalism are factors supportingparamedicretention.▪There wereno studiesthat evaluated theeffectiveness of innovations or strategies to improve ambulance staff retention.Implications for practice and research▪More up-to-date information is needed on the recruitment and retention of ambulance staff in UK settings.▪Further research that provides a more detailed investigation of factors influencing recruitment and retention may be useful, in particular regarding reasons for leaving the profession.▪The development or implementation of future strategies to help the recruitment and retention of paramedics and EMTs should be accompanied by a planned impact evaluation.
A purposive sample of healthcare professionals (n=20) and people affected by cancer (n=15) was recruited from two study sites. • Eligible healthcare professionals had at least one year experience in cancer rehabilitation. People affected by cancer were recruited if they received rehabilitation from one of the study sites. • Approval was granted by London SouthEast Research Ethics Committee (17/LO/2123). • Written informed consent was obtained from every participant. • Audio recorded, semi-structured one-onone interviews were transcribed verbatim. • Three interviews were dyadic due to people's partner's joining. • Thematic analysis was based on Braun and Clarke (2006).
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.