Development of indicators and analysis of barriers for assessment and prevention of cutaneous graft-versus-host disease after haematopoietic stem cell transplantation in children
Objective·To gain a comprehensive understanding of the current clinical status of assessment and prevention of cutaneous graft-versus-host disease (GVHD) after haematopoietic stem cell transplantation in children, construct review indicators, analyze obstacles and facilitators in the process of cond...
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Editorial Office of Journal of Shanghai Jiao Tong University (Medical Science)
2024-12-01
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| Series: | Shanghai Jiaotong Daxue xuebao. Yixue ban |
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| Online Access: | https://xuebao.shsmu.edu.cn/article/2024/1674-8115/1674-8115-2024-44-12-1552.shtml |
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| author | YANG Liling ZHAN Sha XUE Xiaoyan CHEN Kai LIU Qing WANG Li WANG Yiyi WU Meng LU Qunfeng |
| author_facet | YANG Liling ZHAN Sha XUE Xiaoyan CHEN Kai LIU Qing WANG Li WANG Yiyi WU Meng LU Qunfeng |
| author_sort | YANG Liling |
| collection | DOAJ |
| description | Objective·To gain a comprehensive understanding of the current clinical status of assessment and prevention of cutaneous graft-versus-host disease (GVHD) after haematopoietic stem cell transplantation in children, construct review indicators, analyze obstacles and facilitators in the process of conducting the study in light of clinical reality, and formulate strategies for change.Methods·Utilizing the JBI Evidence-Based Health Care Model as a theoretical guiding framework, the clinical problem was clarified. An evidence-based practice team was established, and a systematic literature search was conducted. The evidence was then evaluated and summarized. Additionally, review indicators were constructed, and review methods were clarified in relation to the evidence. Using the Ottawa Model of Research Use, the three dimensions of evidence change, potential adopters, and practice environment were analyzed for barriers and facilitators, and corresponding strategies were developed.Results·A total of 24 pieces of best evidence were included in the study, comprising five dimensions: skin assessment, assessment of protection, management of adverse skin reactions, medication guidance and follow-up and screening. Twenty-two review indicators were constructed on this basis, of which 14 had an implementation rate of <60% and 10 had an implementation rate of 0%; 8 had an implementation rate of >60% and 6 had an implementation rate of 100.00%. The main obstacles were the lack of relevant training and the absence of a rational management mechanism. The main facilitating factors were reliable sources of evidence and a high level of cooperation from potential stakeholders. Considering the results of the analysis of the implementation rate of the indicators under review and the obstacles, alternative measures were formulated.Conclusion·There is a large gap between the evidence and clinical practice for the assessment and prevention of cutaneous GVHD after paediatric haematopoietic stem cell transplantation. Clinical change should be effectively implemented based on barriers and facilitators. |
| format | Article |
| id | doaj-art-c9d09a67ccb84c4095aacf3e40c5a836 |
| institution | Kabale University |
| issn | 1674-8115 |
| language | zho |
| publishDate | 2024-12-01 |
| publisher | Editorial Office of Journal of Shanghai Jiao Tong University (Medical Science) |
| record_format | Article |
| series | Shanghai Jiaotong Daxue xuebao. Yixue ban |
| spelling | doaj-art-c9d09a67ccb84c4095aacf3e40c5a8362025-01-08T05:52:54ZzhoEditorial Office of Journal of Shanghai Jiao Tong University (Medical Science)Shanghai Jiaotong Daxue xuebao. Yixue ban1674-81152024-12-0144121552156010.3969/j.issn.1674-8115.2024.12.0081674-8115（2024）12-1552-09Development of indicators and analysis of barriers for assessment and prevention of cutaneous graft-versus-host disease after haematopoietic stem cell transplantation in childrenYANG Liling0ZHAN Sha1XUE Xiaoyan2CHEN Kai3LIU Qing4WANG Li5WANG Yiyi6WU Meng7LU Qunfeng8Department of Nursing, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai200233, ChinaDepartment of Haematology and Oncology, Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai200020, ChinaDepartment of Haematology and Oncology, Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai200020, ChinaDepartment of Haematology and Oncology, Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai200020, ChinaDepartment of Haematology and Oncology, Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai200020, ChinaDepartment of Haematology and Oncology, Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai200020, ChinaDepartment of Haematology and Oncology, Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai200020, ChinaDepartment of Haematology and Oncology, Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai200020, ChinaDepartment of Nursing, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai200233, ChinaObjective·To gain a comprehensive understanding of the current clinical status of assessment and prevention of cutaneous graft-versus-host disease (GVHD) after haematopoietic stem cell transplantation in children, construct review indicators, analyze obstacles and facilitators in the process of conducting the study in light of clinical reality, and formulate strategies for change.Methods·Utilizing the JBI Evidence-Based Health Care Model as a theoretical guiding framework, the clinical problem was clarified. An evidence-based practice team was established, and a systematic literature search was conducted. The evidence was then evaluated and summarized. Additionally, review indicators were constructed, and review methods were clarified in relation to the evidence. Using the Ottawa Model of Research Use, the three dimensions of evidence change, potential adopters, and practice environment were analyzed for barriers and facilitators, and corresponding strategies were developed.Results·A total of 24 pieces of best evidence were included in the study, comprising five dimensions: skin assessment, assessment of protection, management of adverse skin reactions, medication guidance and follow-up and screening. Twenty-two review indicators were constructed on this basis, of which 14 had an implementation rate of <60% and 10 had an implementation rate of 0%; 8 had an implementation rate of >60% and 6 had an implementation rate of 100.00%. The main obstacles were the lack of relevant training and the absence of a rational management mechanism. The main facilitating factors were reliable sources of evidence and a high level of cooperation from potential stakeholders. Considering the results of the analysis of the implementation rate of the indicators under review and the obstacles, alternative measures were formulated.Conclusion·There is a large gap between the evidence and clinical practice for the assessment and prevention of cutaneous GVHD after paediatric haematopoietic stem cell transplantation. Clinical change should be effectively implemented based on barriers and facilitators.https://xuebao.shsmu.edu.cn/article/2024/1674-8115/1674-8115-2024-44-12-1552.shtmlhaematopoietic stem cell transplantationgraft-versus-host disease (gvhd)review of indicator developmentbarrier factorevidence-based nursing |
| spellingShingle | YANG Liling ZHAN Sha XUE Xiaoyan CHEN Kai LIU Qing WANG Li WANG Yiyi WU Meng LU Qunfeng Development of indicators and analysis of barriers for assessment and prevention of cutaneous graft-versus-host disease after haematopoietic stem cell transplantation in children Shanghai Jiaotong Daxue xuebao. Yixue ban haematopoietic stem cell transplantation graft-versus-host disease (gvhd) review of indicator development barrier factor evidence-based nursing |
| title | Development of indicators and analysis of barriers for assessment and prevention of cutaneous graft-versus-host disease after haematopoietic stem cell transplantation in children |
| title_full | Development of indicators and analysis of barriers for assessment and prevention of cutaneous graft-versus-host disease after haematopoietic stem cell transplantation in children |
| title_fullStr | Development of indicators and analysis of barriers for assessment and prevention of cutaneous graft-versus-host disease after haematopoietic stem cell transplantation in children |
| title_full_unstemmed | Development of indicators and analysis of barriers for assessment and prevention of cutaneous graft-versus-host disease after haematopoietic stem cell transplantation in children |
| title_short | Development of indicators and analysis of barriers for assessment and prevention of cutaneous graft-versus-host disease after haematopoietic stem cell transplantation in children |
| title_sort | development of indicators and analysis of barriers for assessment and prevention of cutaneous graft versus host disease after haematopoietic stem cell transplantation in children |
| topic | haematopoietic stem cell transplantation graft-versus-host disease (gvhd) review of indicator development barrier factor evidence-based nursing |
| url | https://xuebao.shsmu.edu.cn/article/2024/1674-8115/1674-8115-2024-44-12-1552.shtml |
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