Article type
Abstract
"Background
Clinical guidelines are a means to inform clinicians and other stakeholders about basing healthcare on evidence. The JBI model of evidence-based health care highlights that an intervention should be both effective, feasible, appropriate, meaningful, and effective. However, clinical guidelines are mainly informed by quantitative evidence although it is internationally acknowledged that qualitative evidence complements quantitative evidence of effectiveness. Qualitative evidence informs about e.g., patients’, relatives’, or staffs’ perceptions, experiences and preferences regarding an intervention and assisting clinicians in judging whether the intervention is likely to be acceptable and feasible to implement. In a clinical guideline on early and prolonged skin-to-skin contact (SSC) between preterm infants and their parents, qualitative evidence was used to strengthen the recommendations.
Objective
How to integrate qualitative evidence in a clinical guideline to support and strengthen recommendations.
Methods
The PICo Mnemonic (Population, phenomenon of Interest, Context) was used to specify the clinical question. A meta-aggregative approach was used to synthesize qualitative data, which corresponds to Cochranes’ meta-analytical approach. It is important that analysis of quantitative and qualitative evidence is based on comparable review-approaches as it strengthens the access to combine the evidence and make the recommendations more consistent.
Results
Qualitative evidence shows that most parents of preterm infants want to contribute to early and prolonged SSC. Although some parents perceive it as stressful, they also experience a positive effect on both the infant and themselves. Most nurses will motivate and facilitate SSC, as they experience that it positively affects preterm infants and their parents.
The initial recommendation based on the quantitative evidence was moderate but when qualitative evidence was added the recommendation could be changed to a strong recommendation.
Conclusions
Qualitative evidence in clinical guidelines is important as such evidence can change the strength of recommendations. In addition, qualitative evidence can contribute with perspectives which should be taken into consideration when implementing an intervention such as SSC.
"
Clinical guidelines are a means to inform clinicians and other stakeholders about basing healthcare on evidence. The JBI model of evidence-based health care highlights that an intervention should be both effective, feasible, appropriate, meaningful, and effective. However, clinical guidelines are mainly informed by quantitative evidence although it is internationally acknowledged that qualitative evidence complements quantitative evidence of effectiveness. Qualitative evidence informs about e.g., patients’, relatives’, or staffs’ perceptions, experiences and preferences regarding an intervention and assisting clinicians in judging whether the intervention is likely to be acceptable and feasible to implement. In a clinical guideline on early and prolonged skin-to-skin contact (SSC) between preterm infants and their parents, qualitative evidence was used to strengthen the recommendations.
Objective
How to integrate qualitative evidence in a clinical guideline to support and strengthen recommendations.
Methods
The PICo Mnemonic (Population, phenomenon of Interest, Context) was used to specify the clinical question. A meta-aggregative approach was used to synthesize qualitative data, which corresponds to Cochranes’ meta-analytical approach. It is important that analysis of quantitative and qualitative evidence is based on comparable review-approaches as it strengthens the access to combine the evidence and make the recommendations more consistent.
Results
Qualitative evidence shows that most parents of preterm infants want to contribute to early and prolonged SSC. Although some parents perceive it as stressful, they also experience a positive effect on both the infant and themselves. Most nurses will motivate and facilitate SSC, as they experience that it positively affects preterm infants and their parents.
The initial recommendation based on the quantitative evidence was moderate but when qualitative evidence was added the recommendation could be changed to a strong recommendation.
Conclusions
Qualitative evidence in clinical guidelines is important as such evidence can change the strength of recommendations. In addition, qualitative evidence can contribute with perspectives which should be taken into consideration when implementing an intervention such as SSC.
"