CareSearch

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https://hdl.handle.net/2328/27233

CareSearch palliative care knowledge network (or more simply CareSearch) is a suite of palliative care information and resources available at www.caresearch.com.au. The website is designed to support health professionals involved in providing palliative care and those needing palliative care and their families and friends.

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Correlates of perceived death competence: What role does meaning-in-life and quality-of-life play?
(Cambridge University Press, 2019-01-02) Miller-Lewis, Lauren; Tieman, Jennifer; Rawlings, Deb; Sanderson, Christine Ruth; Parker, Deborah
Objective Understanding factors that are associated with more adaptive death attitudes and competencies can inspire future health-promoting palliative care strategies and inform approaches to training and development for health professionals. The potential importance of meaning, purpose, quality, and values in life for promoting adaptive death attitudes has been highlighted, but there is limited research in this area, particularly in relation to death competence. The purpose of this cross-sectional study was to develop an understanding of demographic and life-related factors associated with perceived death competence, such as meaning in life and quality of life. Method During the course enrollment period of a Massive-Online-Open-Course about death and dying, 277 participants completed questionnaires on death competence, meaning in life, quality of life, and sociodemographic background. Result Findings indicated that greater presence of meaning in life, quality of life, age, death experience, and carer experience were each statistically significant unique predictors of death competence scores. Life-related variables were more strongly associated with death competence than demographic variables. Bereavement experience and experience caring for the dying was associated with greater death competence, but there were no differences on death competence between health professionals and the general community. Above all other factors, the presence of meaning in life was the strongest predictor of higher perceived competence in coping with death. Significance of results The findings demonstrate important interconnections between our attitudes about life and death. Knowledge of factors associated with poorer death competence may help identify those at risk of greater distress when facing death, and might prove useful additions to bereavement risk assessments. Understanding factors associated with greater death competence in health professionals and volunteers may help predict or prevent burnout and compassion fatigue, and help identify who would benefit from additional training and support. Future longitudinal studies including both health professionals and the general community are needed to determine the effect adaptive attitudes toward meaning in life can potentially have on bolstering subsequent adaptive coping and competence regarding death and dying.
Can Exposure to Online Conversations About Death and Dying Influence Death Competence? An Exploratory Study Within an Australian Massive Open Online Course
(Sage Journals, 2018-03-26) Miller-Lewis, Lauren; Tieman, Jennifer; Rawlings, Deb; Parker, Deborah; Sanderson, Christine Ruth
A Massive Open Online Course, Dying2Learn, was designed to foster community death conversations and strengthen community awareness of palliative care and death as a normal process. This exploratory study used a pre–post prospective design to determine if participation in Dying2Learn and exposure to online conversations about death and dying resulted in any significant influence on death competence in 134 participants who completed the Coping-with-Death-Scale both at the beginning and end of the course in 2016. Death competence refers to a range of attitudes and capabilities people have for dealing with death. Results at the end of the course indicated that engagement in Dying2Learn led to significant improvements in death competence scores over time (medium-to-large effect size). The positive impact was greater for those who completed more of the course, and effectiveness did not depend on sociodemographic characteristics. In conclusion, this study found that an online learning platform in the form of a Massive Open Online Course could engage community members in meaningful social discussion about death and dying, and that exposure to these conversations was beneficial for all participants regardless of previous exposure to death. Further exploration is required to determine whether this change in death competence will have an impact on participant’s behavior in the community regarding death conversations and preparedness.
How Do Clinicians Learn About Knowledge Translation? An Investigation of Current Web-Based Learning Opportunities
(JMIR Publications, 2017-07-13) Damarell, Raechel; Tieman, Jennifer
Background: Clinicians are important stakeholders in the translation of well-designed research evidence into clinical practice for optimal patient care. However, the application of knowledge translation (KT) theories and processes may present conceptual and practical challenges for clinicians. Online learning platforms are an effective means of delivering KT education, providing an interactive, time-efficient, and affordable alternative to face-to-face education programs. Objective: This study investigates the availability and accessibility of online KT learning opportunities for health professionals. It also provides an analysis of the types of resources and associated disciplines retrieved by a range of KT synonyms. Methods: We searched a range of bibliographic databases and the Internet (Google advanced option) using 9 KT terms to identify online KT learning resources. To be eligible, resources had to be free, aimed at clinicians, educational in intent, and interactive in design. Each term was searched using two different search engines. The details of the first 100 websites captured per browser (ie, n=200 results per term) were entered into EndNote. Each site was subsequently visited to determine its status as a learning resource. Eligible websites were appraised for quality using the AACODS (Authority, Accuracy, Coverage, Objectivity, Date, Significance) tool. Results: We identified 971 unique websites via our multiple search strategies. Of these, 43 were health-related and educational in intent. Once these sites were evaluated for interactivity, a single website matched our inclusion criteria (Dementia Knowledge Translation Learning Centre). Conclusions: KT is an important but complex system of processes. These processes overlap with knowledge, practice, and improvement processes that go by a range of different names. For clinicians to be informed and competent in KT, they require better access to free learning opportunities. These resources should be designed from the viewpoint of the clinician, presenting KT’s multifaceted theories and processes in an engaging, interactive way. This learning should empower clinicians to contextualize and apply KT strategies within their own care settings.
Knowing How Good Our Searches Are: An Approach Derived from Search Filter Development Methodology
(University of Alberta, 2015) Hayman, Sarah L
Objective – Effective literature searching is of paramount importance in supporting evidence based practice, research, and policy. Missed references can have adverse effects on outcomes. This paper reports on the development and evaluation of an online learning resource, designed for librarians and other interested searchers, presenting an evidence based approach to enhancing and testing literature searches. Methods – We developed and evaluated the set of free online learning modules for librarians called Smart Searching, suggesting the use of techniques derived from search filter development undertaken by the CareSearch Palliative Care Knowledge Network and its associated project Flinders Filters. The searching module content has been informed by the processes and principles used in search filter development. The self-paced modules are intended to help librarians and other interested searchers test the effectiveness of their literature searches, provide evidence of search performance that can be used to improve searches, as well as to evaluate and promote searching expertise. Each module covers one of four techniques, or core principles, employed in search filter development: (1) collaboration with subject experts; (2) use of a reference sample set; (3) term identification through frequency analysis; and (4) iterative testing. Evaluation of the resource comprised ongoing monitoring of web analytics to determine factors such as numbers of users and geographic origin; a user survey conducted online elicited qualitative information about the usefulness of the resource. Results – The resource was launched in May 2014. Web analytics show over 6,000 unique users from 101 countries (at 9 August 2015). Responses to the survey (n=50) indicated that 80% would recommend the resource to a colleague. Conclusions – An evidence based approach to searching, derived from search filter development methodology, has been shown to have value as an online learning resource. More information is needed about the reasons why people are using the resource beyond what could be ascertained by the survey results.
Finding the best available evidence: how can we know?
(International Federation of Library Associations and Institutions, 2015) Hayman, Sarah L; Tieman, Jennifer
The importance (in all scientific fields) of finding and using evidence is growing rapidly, with increased recognition that decisions should be based on sound evidence. Key to finding this evidence is effective searching. Alongside this imperative, the searching context is becoming more complex. The number of articles indexed is enormous and increasing. In the medical field, PubMed contains over 24 million citations with over 1 million entered in 2014. Effective searching requires an understanding of database mechanisms and the terminology (including associated thesauri) of each subject. Searchers need an understanding of the requirements of the end user: what is considered relevant and what are the levels of evidence? We suggest that a scientific approach be taken to the searching process, to ensure that the best available evidence is found, and that search methodology is tested and validated. What methods can we employ to indicate what we might have missed in our search? Search results should be tested and results fed back into the search, to improve searching effectiveness and thereby outcomes for the end user. Search filters are validated search strategies, created using known methodology, for a given bibliographic database. The relevant terminology and database mechanisms are built into a strategy that is created from, and tested against, subsets of a gold standard set of references. Results are screened by external reviewers with expert subject knowledge, to minimise bias. The search filter performance is rated for precision and sensitivity, to provide known effectiveness in a standard set that can be extrapolated to open search. Details of the methodology and the filter performance are published for transparency. CareSearch and Flinders Filters have developed a number of subject-based search filters. This paper discusses the importance of evidence-based searching; how these search filters are developed and lessons for general searching in scientific literature.
Palliative Care Knowledge for All Australians: Librarians’ Work within a Multidisciplinary Team Creating a National Health Knowledge Network
(International Federation of Library Associations and Institutions, 2015) Hayman, Sarah L; Tieman, Jennifer
This paper introduces Australia’s CareSearch Palliative Care Knowledge network, outlining its information services, underpinning principle of evidence-based information and the contribution of librarians, integral to the multidisciplinary team. CareSearch is a federal government-funded project to provide relevant and trustworthy information to clinicians, patients, carers and families about all aspects of palliative care. This subject touches all Australians at some point. The information provided must be accurate, accessible and tailored to users’ needs. CareSearch emphasises the importance of evidence-based information to support the best possible care for those at the end of life and their loved ones. CareSearch identifies and enables access to evidence and uses evidence-based research approaches in designing and developing the service. This complex project employs a multidisciplinarily skilled team, with a wide range of expertise including medicine, nursing, web technology, education, marketing and informatics. Librarians bring information management expertise into the pool of skills in CareSearch, undertaking identification, classification and organisation of resources. They work with clinicians to ensure relevancy and accuracy, with website technicians for best practice navigation, and with marketing professionals for effective communication. A key innovative aspect of CareSearch’s information service provision is the creation of subject-based search filters to target the best available evidence about palliative care (and related topics) in the published medical literature. The librarians at CareSearch and its associated project Flinders Filters follow established methodology to create and test search strategies using a gold standard set of references, advised by external clinical experts. The search filter embeds technical searching expertise into a search strategy link for clinicians to do a reliable real time search. Search filters are embedded throughout the website in clinical evidence pages, as URLs to take clinicians directly into PubMed in hundreds of searches on topics of relevance to palliative care.
Discovering the dementia evidence base: Tools to support knowledge to action in dementia care (innovative practice)
(SAGE Publications, 2015-05-28) Hayman, Sarah L; Tieman, Jennifer
Dementia requires expert care and decision making, based on sound evidence. Reliable evidence is difficult for busy dementia care professionals to find quickly. This study developed an experimentally tested search filter as an innovative tool to retrieve literature on dementia. It has a known retrieval performance and can be provided as an open access web link directly to current literature. The Dementia Search Filter was developed using validated methodology. An Expert Advisory Group of dementia care practitioners and researchers ratified a representative set of relevant studies and undertook post hoc relevance assessment, to ensure the usefulness of the search filter. The Dementia Search Filter is published on two websites and combined with expert searches to link to evidence on dementia, at end of life in aged care settings and more generally. Evidence accessed by the Dementia Search Filter will help overcome barriers to finding current relevant research in the field, for practitioners, researchers and decision makers.
Helping the clinician to help the patient: CareSearch evidence-based information for palliative care
(Australian Library and Information Association - Health Libraries Australia, 2012-12) Hayman, Sarah L
CareSearch revisited
(Australian Library and Information Association - Health Libraries Australia, 2013-09) Hayman, Sarah L
Improve your literature searches with the new smart searching modules
(Australian Library and Information Association - Health Libraries Australia, 2014-06) Hayman, Sarah L
Sarah Hayman reports on SMART SEARCHING, a free set of online self-paced modules for librarians and researchers who want to enhance their literature searching skills. The resource was developed by CareSearch Palliative Care Knowledge Network, with support from Flinders Filters and Health Libraries Australia as an outcome of the ALIA HLA/HCN Health Informatics Innovation Award in 2012.
Not published, not indexed: issues in generating and finding hospice and palliative care literature
(Mary Ann Liebert, Inc., 2010-01-06) Tieman, Jennifer; Abernethy, Amy Pickar; Currow, David Christopher
Not all research work and new knowledge within hospice and palliative care is converted to journal articles and published. Journal indexing does not equate with indexing all contents of all listed journals. There are journals that are not yet, or may not ever be, indexed on a major bibliographic database. Ensuring that clinicians and researchers are able to access all literature is as important as carrying out the research to develop this evidence.
CareSearch Online palliative care information for GPs
(Royal Australian College of General Practitioners, 2010-05) Sanderson, Christine Ruth; Tieman, Jennifer
General practitioners occupy a unique place in caring for patients with terminal illnesses who wish to continue living in the community. Supporting and encouraging GPs to offer or continue providing palliative care is not only important for individual patients and their families but for the health system and the whole community. The GP pages in the CareSearch website are designed to provide immediate access to relevant content and palliative care resources to assist GPs in this role.
Development of a heart failure filter for Medline: an objective approach using evidence-based clinical practice guidelines as an alternative to hand searching
(BioMed Central Ltd., 2011-01-28) Damarell, Raechel; Tieman, Jennifer; Sladek, Ruth; Davidson, Patricia
Background: Heart failure is a highly debilitating syndrome with a poor prognosis primarily affecting the elderly. Clinicians wanting timely access to heart failure evidence to provide optimal patient care can face many challenges in locating this evidence. This study developed and validated a search filter of high clinical utility for the retrieval of heart failure articles in OvidSP Medline. Methods: A Clinical Advisory Group was established to advise study investigators. The study set of 876 relevant articles from four heart failure clinical practice guidelines was divided into three datasets: a Term Identification Set, a Filter Development Set, and a Filter Validation Set. A further validation set (the Cochrane Validation Set) was formed using studies included in Cochrane heart failure systematic reviews. Candidate search terms were identified via word frequency analysis. The filter was developed by creating combinations of terms and recording their performance in retrieving items from the Filter Development Set. The filter’s recall was then validated in both the Filter Validation Set and the Cochrane Validation Set. A precision estimate was obtained post-hoc by running the filter in Medline and screening the first 200 retrievals for relevance to heart failure. Results: The four-term filter achieved a recall of 96.9% in the Filter Development Set; 98.2% in the Filter Validation Set; and 97.8% in the Cochrane Validation Set. Of the first 200 references retrieved by the filter when run in Medline, 150 were deemed relevant and 50 irrelevant. The post-hoc precision estimate was therefore 75%. Conclusions: This study describes an objective method for developing a validated heart failure filter of high recall performance and then testing its precision post-hoc. Clinical practice guidelines were found to be a feasible alternative to hand searching in creating a gold standard for filter development. Guidelines may be especially appropriate given their clinical utility. A validated heart failure filter is now available to support health professionals seeking reliable and efficient access to the heart failure literature.
OvidSP Medline-to-PubMed search filter translation: a methodology for extending search filter range to include PubMed's unique content
(BioMed Central Ltd., 2013-07-02) Damarell, Raechel; Tieman, Jennifer; Sladek, Ruth
Background: PubMed translations of OvidSP Medline search filters offer searchers improved ease of access. They may also facilitate access to PubMed’s unique content, including citations for the most recently published biomedical evidence. Retrieving this content requires a search strategy comprising natural language terms (‘textwords’), rather than Medical Subject Headings (MeSH). We describe a reproducible methodology that uses a validated PubMed search filter translation to create a textword-only strategy to extend retrieval to PubMed’s unique heart failure literature. Methods: We translated an OvidSP Medline heart failure search filter for PubMed and established version equivalence in terms of indexed literature retrieval. The PubMed version was then run within PubMed to identify citations retrieved by the filter’s MeSH terms (Heart failure, Left ventricular dysfunction, and Cardiomyopathy). It was then rerun with the same MeSH terms restricted to searching on title and abstract fields (i.e. as ‘textwords’). Citations retrieved by the MeSH search but not the textword search were isolated. Frequency analysis of their titles/ abstracts identified natural language alternatives for those MeSH terms that performed less effectively as textwords. These terms were tested in combination to determine the best performing search string for reclaiming this ‘lost set’. This string, restricted to searching on PubMed’s unique content, was then combined with the validated PubMed translation to extend the filter’s performance in this database. Results: The PubMed heart failure filter retrieved 6829 citations. Of these, 834 (12%) failed to be retrieved when MeSH terms were converted to textwords. Frequency analysis of the 834 citations identified five high frequency natural language alternatives that could improve retrieval of this set (cardiac failure, cardiac resynchronization, left ventricular systolic dysfunction, left ventricular diastolic dysfunction, and LV dysfunction). Together these terms reclaimed 157/834 (18.8%) of lost citations. Conclusions: MeSH terms facilitate precise searching in PubMed’s indexed subset. They may, however, work less effectively as search terms prior to subject indexing. A validated PubMed search filter can be used to develop a supplementary textword-only search strategy to extend retrieval to PubMed’s unique content. A PubMed heart failure search filter is available on the CareSearch website (www.caresearch.com.au) providing access to both indexed and non-indexed heart failure evidence.
Exploring nurses attitudes to, and use of, an online palliative care resource.
(2008) Rawlings, Deb; Tieman, Jennifer

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