BackgroundA systematic review was conducted to analyse journal articles that describe or measure the impact of leg ulceration on patients' quality of life (QoL) in order to improve the content of an educational programme that aims to enhance self-care agency in leg ulcer patients.MethodOriginal articles published in English and German between 1990 and 2006 were included if the findings were analysed at the level of patients. Articles were excluded if (1) they investigated the impact of specific treatments or settings on QoL or (2) focused mainly on arterial ulcers or diabetic foot ulcers.ResultsTwenty-four original research articles met the inclusion criteria; 11 studies used a quantitative, 11 studies a qualitative, and 2 used a mixed method approach. The findings were collapsed into 5 core domains. Quantitative studies commonly investigated the parameters of pain, sleep, social isolation, and physical mobility. Patients had significantly more pain, more restrictions regarding social functioning, less vitality, and limitations with respect to emotional roles compared to the respective controls. Other problem areas identified were restrictions in work capacity, recreation, social interaction, psychological well-being, as well as problems caused by treatment regimes. Inconclusive results were obtained regarding pain intensity, physical restrictions, and gender effects.LimitationsNumerous original studies neither undertook a differentiation of participants by ulcer aetiology nor did they analyse the results according to gender differences.ConclusionAs leg ulceration has an impact on QoL, national guidelines on the treatment of leg ulceration need to more specifically address these far-ranging effects identified in this review.

Literature reviews generally analyse and synthesis the evidence (or lack thereof) in a particular topic area and they are an increasingly popular form of scholarly activity. The scoping review is a popular literature review approach that has been adopted across the social and health sciences over the last fifteen years. With this upsurge in use, differences of opinion about how to analyse and report scoping reviews has also grown. Drawing on work carrying out a scoping review on oral health and child maltreatment, we put forward a structured approach to analysis and reporting of such reviews: the PAGER (Patterns, Advances, Gaps, Evidence for practice and Research recommendations) framework. In this article, we reflect on the strengths and limitations of the framework, drawing on examples, laying out the methodological processes, and making suggestions as to how it might improve reporting. The article makes a contribution to efforts that seek to improve the reporting and utility of scoping reviews in health and social research.

Despite the widespread use of Health Care Support Workers (HCSWs) in providing palliative and end‐of‐life care, there is little information available about their contributions towards supporting patients who want to be cared for at home or to die at home. Between January and April 2011, a systematic review was conducted to address two questions: (i) What particular tasks/roles do HCSWs perform when caring for people at the end of life and their families to comply with their desire to remain at home?; (ii) What are the challenges and supporting factors that influence HCSWs’ ability to provide palliative and end‐of‐life care in the community? Databases searched for relevant articles published between 1990 until April 2011 included CINAHL, EMBASE, PsychINFO, British Nursing Index, Web of Science, Medline and ASSIA. In total, 1695 papers were identified and their titles and abstracts were read. Ten papers met the eligibility criteria of the study. After the methodological quality of the studies was appraised, nine papers were included in the review. Judgements regarding eligibility and quality were undertaken independently by the authors. The findings indicate that HCSWs invest a great deal of their time on emotional and social support as well as on assisting in the provision of personal care. They are also involved in providing care for the dying, respite care for family members and offer domestic support. Although it is important to acknowledge the many positive aspects that HCSWs provide, the findings suggest three challenges in the HCSWs role: emotional attachment, role ambiguity and inadequate training. Support factors such as informal peer grief‐support groups, sense of cohesiveness among HCSWs and task orientation enabled HCSWs to overcome these challenges. To conclude, induction and training programmes, a defined period of preceptorship, appropriate support, supervision and clearly defined role boundaries may be helpful in reducing the challenges identified in HCSWs’ roles.

This paper is a discussion regarding vignette development and administration as a means of protecting research participants in social research. Health and social care researchers investigate a plethora of issues that may be sensitive or upsetting, for example, abuse or bereavement. This exposes participants to potential emotional harm caused by revisiting the original trauma. Using research methods that offer a protective layer is important. Evidence suggests that vignettes provide protection for research participants by placing distance between their experience and that of the vignette character. However, there are few methodological papers regarding vignette use. Utilising examples from our own research, we engage in a critical discussion regarding vignette development and administration. The paper offers a new framework to support researchers -particularly those in health and social care -in the development and administration of vignettes. We contend that the framework supports best practice in vignette use, particularly when researching sensitive issues.

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