Masters (HBMCoNM)

Permanent URI for this collectionhttps://repository.mbru.ac.ae/handle/1/1069

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Now showing 1 - 16 of 16

Exploring Nurses Perceptions and Beliefs Regarding the Causes of Medication Errors
(2022) Bilal, Amina Masood Bilal Mohammad
Abstract: Background: Patient safety is a fundamental challenge facing health organizations worldwide. Medication safety is a crucial element that falls under patient safety. Therefore, errors in medication administration may be directly associated with mortality and morbidity. This systematic review aims to explore nurses' perceptions and beliefs regarding the causes of medication errors. Methods: Three databases were utilized for systematic search through Mohammed Bin Rashid Medicine and Health Sciences University Library to access CINAHL, PubMed, and Medline. Additional data was sourced by cross-referencing in-text citations to collate the best available evidence exploring nurses' perceptions and beliefs regarding the causes of medication errors. Twelve articles were critically appraised, utilizing the Critical Appraisal Skills Program checklist (CASP). Results: Four themes were synthesized from a critical evaluation of the literature. These themes are -nurses believe that medication errors are primarily caused by - poor communication, staff shortage, poor skill mix and/or heavy workload, nurses' lack knowledge of the medication process, and when certain environmental factors are present. Conclusion: There were various causes for medication administration errors in nurses' perceptions and beliefs. This means an essential enhancement in medication safety is likely to require multiple, inter-relating, complex interventions, and attention to nurses' perceptions as they play a significant role in enhancing medication safety. Due to the lack of current research on this subject in the Middle East, more research should be conducted to examine medication safety in this part of the world.
The impact of nurse led educational intervention on anxiety in patients undergoing cardiac surgery
(College of Nursing & Midwifery, MBRU, 2021-11) Abdelrahman, Khadija Habib Kouhi
Background: Anxiety is the most common complication for patients who are undergoing cardiac surgery. It has been shown that preoperative anxiety has a negative impact on patient health and healing process. However, nursing education has a positive effect on reduce patient anxiety. Aim: To examine the impact of nurse leads educational interventions in the pre and post operative stage for patients attending cardiac surgery in reducing patient level of anxiety. Methodology: A systematic search was performed by using three databases from Mohammed Bin Rashid University of Medicine and Health Sciences Library. The resources that have been used for the literature review are CINAHAL complete, PubMed, and Medline complete. A total of six studies were included in this systematic literature review. A combination of qualitative and quasi-experimental study. Results: The literature review highlighted that patient’s anxiety can be reduced by several education interventions such as verbal education, booklet, leaflet, dialogue, audiotape, and having individual education session according to the patient source of anxiety. However, it has been showed that participants in the intervention group that received nursing led educational intervention had significant reduction in their anxiety level compare to the control group with the P value of (P < 0.001). However, the literature review also showed participant that receive audiotape education program, had no significant reducing in their level of anxiety with a P-value of (P > 0.05). conclusion: The literature review result shown that nursing education has a positive effect on reducing patients’ level of anxiety and post-operative complications. Preoperative education should be incorporated into nurses’ routine practice while preparing cardiac patients to reduce level of anxiety.
Exploring Nurses' Perceptions and Beliefs Regarding the Causes of Medication Errors
(College of Nursing & Midwifery, MBRU, 2022-08) Bilal, Amina Masood Bilal Mohammad
Background: Patient safety is a fundamental challenge facing health organizations worldwide. Medication safety is a crucial element that falls under patient safety. Therefore, errors in medication administration may be directly associated with mortality and morbidity. This systematic review aims to explore nurses' perceptions and beliefs regarding the causes of medication errors. Methods: Three databases were utilized for systematic search through Mohammed Bin Rashid Medicine and Health Sciences University Library to access CINAHL, PubMed, and Medline. Additional data was sourced by cross-referencing in-text citations to collate the best available evidence exploring nurses' perceptions and beliefs regarding the causes of medication errors. Twelve articles were critically appraised, utilizing the Critical Appraisal Skills Program checklist (CASP). Results: Four themes were synthesized from a critical evaluation of the literature. These themes are -nurses believe that medication errors are primarily caused by - poor communication, staff shortage, poor skill mix and/or heavy workload, nurses' lack knowledge of the medication process, and when certain environmental factors are present. Conclusion: There were various causes for medication administration errors in nurses' perceptions and beliefs. This means an essential enhancement in medication safety is likely to require multiple, inter-relating, complex interventions, and attention to nurses' perceptions as they play a significant role in enhancing medication safety. Due to the lack of current research on this subject in the Middle East, more research should be conducted to examine medication safety in this part of the world.
The Effectiveness of Nursing-Led Interventions in Promoting Self-Care Among Patients with Heart Failure: A Literature Review
(2023) Roussia, Soufiane
Background: Heart failure (HF) is one of the most prevalent chronic diseases in the world. It is considered an international pandemic affecting at least 64.3 million people around the globe (James et al., 2018). Despite the significant advances in HF pharmaceutical, device, and surgical interventions, mortality and morbidity remain high. Self-care management was reported as one of the most effective strategies in the treatment of patients with HF. However, many studies reported low selfcare practices among patients with heart failure. Aim This review aimed to evaluate and summarize research on the effectiveness of nursing-led interventions in promoting self-care for patients with HF. Methodology: a literature search was carried out in the following databases: Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, Scopus, Cochrane database, and Google Scholar. 20 experimental studies were retrieved, appraised by the Critical Appraisals Skills Programme (CASP) and the Joanna Briggs Institute (JBI) tools, and then critically analysed. Findings: Most studies reported the effectiveness of nurse-led interventions to enhance self-care among patients with heart failure with a p-value less than 0.05. Nurses used a variety of methods including face-to-face teaching, telehealth, mobile applications, and telephonic follow-up, theorybased nursing education, empowerment, and teachback techniques. Despite the effectiveness of those interventions, nurses must be aware of other factors demographic characteristics of patients, the intensity of interventions and follow-ups, and the importance of a multidisciplinary team. Conclusion: This review supports the effectiveness of nursing interventions. However, due to the variability in study subjects and the used interventions across the studies, more standardized research with larger size is highly recommended.
The Impact of COVID-19 Pandemic on Acute Coronary Syndrome Hospitalizations: A Literature Review
(2023) Hussein, Rawan Farook Haj
Background: The COVID-19 pandemic has created unprecedented challenges for healthcare systems worldwide. One significant concern is its potential impact on hospitalization rates for Acute Coronary Syndrome (ACS) patients. Understanding how the pandemic has influenced ACS admissions is crucial for optimizing patient care during global health crises. Aim: This dissertation aims to comprehensively investigate the implications of the COVID-19 pandemic on ACS hospitalization rates. By analyzing multiple studies and examining patient outcomes and long-term effects, the research seeks to provide a nuanced understanding of how the pandemic has affected ACS patients' healthcare-seeking behaviors, admission patterns, and subsequent complications. Methods: A systematic review of ten relevant studies was conducted. Inclusion and exclusion criteria were established to ensure that only high-quality research directly addressing the central question was considered. Studies were critically evaluated, and common limitations and strengths were assessed. Results: The studies consistently indicated a decline in ACS hospitalizations during the COVID-19 pandemic. Fear of contracting the virus, changes in patient behavior, and the strain on healthcare systems were identified as contributing factors. Importantly, the research highlighted the potential consequences of reduced hospital admissions, including delayed care and increased complications. While in-hospital mortality rates did not significantly increase, the studies revealed that delayed admissions might lead to more complex and severe presentations of ACS.The Conclusion: The dissertation findings highlight the significant impact of the COVID-19 pandemic on ACS hospitalization rates and the potential long-term implications for patient care. Addressing patient fears and promoting early healthcare-seeking behavior are crucial, along with ensuring that ACS patients continue to receive timely, appropriate care during global health crises. These insights have broader implications for healthcare preparedness during pandemics and other emergencies.
Examining The Influence Of COVID-19 On Suicide Behaviors Among Children, Adolescents, And Young Adults Up To The Age Of 21 Years: A Comprehensive Literature Review
(2023) Hassan, Layla Mohamoud Ismail
Introduction: The WHO declared COVID-19 a pandemic on March 11, 2020, leading to global measures like social distancing, school closures, mask mandates, and social restrictions. These actions disrupted lives significantly, notably among adolescents. A concerning trend during the pandemic has been the rise in adolescent suicide rates. This literature review aims to set the context for examining how the pandemic may have impacted adolescent suicide behaviors, comparing rates during the pandemic to the pre-pandemic period. Methodology: A total of eleven studies were included in this literature review after searching PubMed, CINHAL complete, and WorldCat databases. Result: Two main themes were identified. The first theme in the studies found alterations in the nature of suicidal behavior with a subtheme highlighting an increase in suicidal incidences and another subtheme were some studies found a temporal delay in suicide rate and behaviors or no change. The second theme found variations in patient characteristics during the covid-19 pandemic, adolescents aged 12 and older, female gender and having no previouse mental health condition were the main characteristic of patient exhibiting suicidal behaviors during the covid-19 infection. Strength, limitation, and recommendation: This is the first literature review examining the effect of covid-19 pandemic on children, adolescent, and young adult suicidal behavior, use of up-to-date studies, in eight different countries are some strengths of this literature review. Limitation of the literature review, most of the studies used retrospective and cross-sectional methods, such methods have major weakness that could interfere with the collection of data and interpretation of results. Recognizing the detrimental impact of COVID-19 restrictions on children and adolescents' mental health, it is crucial to implement targeted interventions. Schools, families, and healthcare professionals play a pivotal role in providing support and promoting mental well-being. Conclusion: Covid-19 infection had a big impact on the children, adolescents, and young adult’s suicidal behaviors and countries across the world need to priorities mental health wellbeing and find suitable strategies to tackle such incidences.
Health Related Quality of Life in Heart Transplant Recipient
(2024) Alseiari, Jawaher
Background: This dissertation delves into the multifaceted dimensions of the post-transplant journey through the lens of Heart Related Quality of Life (HRQoL) in heart transplant recipients. Aim: To comprehensively assess the impact of heart transplantation on patients' overall well-being, spanning physical, mental, social, and emotional aspects. Method: A systematic search using four databases was conducted for studies that met the inclusion criteria. Five studies were identified as suitable for inclusion in the review and appraised using a recognised CASP tool. Results: The findings highlight the transformative nature of heart transplantation, after reviewing the relevant studies on the subject, factors such as perceived control, and longitudinal psychological support emerge as critical contributors to enhancing HRQoL. Ultimately, this research advocates for a comprehensive approach to post-transplant care that addresses the multidimensional nature of HRQoL, empowering recipients, and promoting their overall well-being. Conclusion: This dissertation concludes with comprehensive implications and recommendations for professional practice, policy considerations, and continued research advancements, emphasizing patient-centred care and cross-cultural sensitivity to improve the quality of life for individuals who have undergone this life-saving procedure.
What are the family experiences in the PICU?
(2023) Ismail, Asma Mahmood Farah
This dissertation presents a comprehensive review of studies examining the family experience within Pediatric Intensive Care Units (PICUs). The overarching research question guiding this exploration was, "What are the family experiences in PICUs?" To address this question, a wide array of research studies was analyzed, offering valuable insights, uncovering common themes, exploring variations, and reflecting on the implications of these findings. The study outcomes accentuate several crucial elements that considerably impact the family experience within PICUs. Communication surfaced as a central motive, stressing the essential nature of transparent, compassionate, and empathetic exchanges between healthcare providers and parents. The demand for emotional and psychological backing was another persistent topic, showcasing the critical role of healthcare teams in mitigating parental distress and nurturing effective coping strategies. Sharing of information was pinpointed as a vital component of the family experience, as parents highlighted the significance of prompt and comprehensible medical details. Furnishing parents with knowledge empowered them to vigorously participate in care procedures and decision-making processes. Participation itself materialized as an important theme, emphasizing the merit of including parents as collaborators in their child's treatment, instead of just passive receivers of medical support. Although these common threads furnish a basis for apprehending the family experience in PICUs, dissimilarities were also noticeable. Contrasting viewpoints between parents, nurses, and doctors underscored the intricacies of the PICU surroundings and the obstacles in harmonizing expectations and priorities among varied stakeholders. The studies primary findings emphasize the supreme importance of communication, support, environment, information, and participation in molding the family experience in PICUs. Efficient communication, emotional reinforcement, and crafting family-centric settings can significantly enhance the well-being of families during their child's stay at the PICU. Prompt, exhaustive information enables parents to be proactive participants in their child's treatment while engagement fosters a sense of collaboration. These discoveries hold significant implications for healthcare professionals, establishments, policymakers, and families. By understanding and responding to the key themes identified in this analysis, these parties can collaborate to establish a more compassionate, supportive, and family-focused approach to care within the PICU. Ultimately, this would result in improved outcomes for critically ill children, enhanced parental coping mechanisms, and a more constructive and empowering experience for families during their challenging passage in the PICU. This dissertation's insights are not only valuable for improving family-centered care in PICUs but also contribute to the broader field of healthcare research, informing policies, practices, and future research directions.
What are the experience of neonatal nurses in providing palliative care in NICU?
(2022) Alzaabi, Khuloud Khudoum Khamis Khudoum
Background: The survival rate of infants in neonatal intensive care units has improved dramatically. However, there are still a significant number of infants with limited chances of survival. It has been estimated that 75% of neonatal deaths occur during the first week, and approximately one million newborns die related to multiple life-threatening conditions (WHO, 2022). Identifying facilitators and barriers to enhance palliative care provision is crucial. There have been adverse effects associated with a lack of palliative care protocols for neonatal palliative care. Also, it has been demonstrated that NICU nurses are uniquely qualified to influence infants' and their families' experiences with endof-life care. Aim: To explore neonatal nurses' perspectives on their experiences with palliative care for critically ill neonates in neonatal intensive care units. Design: Thomas and Harden’s (2008) thematic synthesis method design. Data Sources: The extended literature review studies were identified through three electronic databases (CINHAL, ASSIA, and PUBMED). Additional records were identified through google scholar and reference lists of the studies, which were systematically searched from March 2022 to July 2022. The eligibility criteria were primary qualitative studies, English language published between 2012 to 2022. Review Method: The included studies focused on neonatal nurses' experiences while providing palliative care for an infant with a life-threatening condition. Quality appraisal was applied using Critical Appraisal Skills Programme tool, and qualitative thematic, line-by-line coding was performed. Results: Eight primary qualitative studies were eligible for inclusion. Six descriptive themes were identified: the first descriptive theme is nurses' communication in relation with colleges, families, and parents, and it is sub-themes were (a) nurse's communication and enhancing parent decision-making, (b) nurses' communication in enhancing parent-infant attachment and their role in supporting extended families (c) Nurses communication between allied healthcare providers. The second descriptive theme is nurses' moral distress, values, and beliefs during palliative care, which is subthemed into three (a) nurses-moral distress and self-reflection during providing palliative care, (b) nurses-moral distress and developing strategies to cope with suffering, (c) nurses-moral distress and living with the grief. The third descriptive theme is nurses' lack of knowledge and educational needs and has one sub-theme (a) nurses' lack of knowledge in relation to lack of experiences. The fourth descriptive is nurses' attitudes in relation to cultural and religious considerations. The fifth descriptive theme is quality of life-enhancing nursing practices and has one sub-theme: nurses’ practice and enhance nursing practice by making memories. The sixth descriptive theme is nurses' perceived barriers to providing quality palliative care and their attitude toward death. Four analytical themes emerged: write more (a) Memories, (b) Balance, (c) Navigating (d) Trust.
Factors contributing to healthcare workers’ hesitancy to receive the COVID-19 vaccines
(2022) AlAmeri, Ameera Mohamed Saeed
Background: Vaccinations play a significant role to reach heard immunity which is a key strategy to control COVID-19 pandemic. Nevertheless, vaccine hesitancy remains a public health obstacle, which is still common among healthcare workers (HCWs). This review aims to look at the attitudes of healthcare workers and identify hesitancy factors toward the COVID-19 vaccines. Methods: Three databases were searched systematically CINAHL, PubMed, and Medline to retrieve relevant studies on healthcare workers hesitancy factors toward COVID-19 vaccines. The systematic search resulted in retrieving 11 studies which were published between 2019-2021 and were critically analysed using Joanna Briggs Institute checklist. Results: Five themes were identified from critical analysis of the literature. These themes are fear of the safety and efficacy of the COVID-19 vaccine, sociodemographic factors associated with the decision to receive the COVID-19 vaccine, Provision of direct care to patients with COVID-19, Information and source of information about the COVID-19 vaccines and Influenza vaccination during 2019-2021 and its relation to COVID-19 vaccine uptake. Conclusion: The issue of COVID-19 vaccine hesitancy among healthcare workers should be identified and addressed to increase vaccine uptake among them. Tailored and personalised communication strategies are needed to cover healthcare workers hesitancy. More importantly, providing trusted, updated, and reliable information on safety and 8 efficacy and other information related to COVID-19 vaccines should be provided with transparency.
The linkage between growing older, increased exercise and the management of blood pressure
(2023) Burqaiba, Hamda Khalid Burqaiba
Abstract: Cardiovascular diseases are a major global health concern. The World Health Organization (WHO) reported that an estimated 17.9 million people died of cardiovascularrelated complications in 2019. Cardiovascular diseases are lifestyle-based conditions and can be reduced through lifestyle changes, including diet and physical activities. This dissertation explores the impact of exercise for older people in terms of managing the hypertension to lower the risk of cardiovascular disease. In this investigation, the research aims to establish whether aerobic, resistance, and endurance exercises among older people can lower blood pressure and thus reduce the risk of cardiovascular disease. The dissertation is based on literature reviews of materials related to the topic. A systematic review of past investigations was done to compare and contrast the findings of the past studies. The investigator employed the PICO (population, intervention, comparison, and outcome) search strategy to identify the articles to be used. Sources were obtained from PubMed and MEDLINE databases for articles between January 2015 and December 2022 in English. Abstracts of the identified articles (refer to table 1) were used to determine the inclusion criteria. A total of 412 articles were initially identified- 280 from 8 PubMed and 132 from MEDLINE. After further analysis, nine papers were selected for analysis. The findings established that physical activities help older people to improve their health and reduce the risks of cardiovascular diseases. However, it was found that older people, particularly women, lack knowledge about the importance of physical activities in improving their health. Furthermore, taking part in yoga activities among older people was noted as an effective remedy for addressing stress issues and reducing the development and exacerbation of hypertension. In conclusion, this dissertation demonstrates that by participating in aerobic exercises, older people can lower blood pressure which is one risk factor of heart disease.
An exploration of the barriers which contribute to a delay in heart failure patients seeking medical help
(2021) AlHamdani, Shamma Ali
Background: Many patients worldwide suffer from heart failure, it is a chronic disease that has a great impact on patients' quality of life. Many previous studies show that there is a delay among patients with heart failure when it comes to treatment-seeking. Aim: To explore the barriers that influence patients with heart failure seeking medical assistance. Methodology: A systematic search was performed using CINAHAL complete, PubMed, Medline Complete, and Scopus databases. The studies were included if they met the following criteria: primary research published from 2011 to 2021 and written in the English language. Studies were included if participants were diagnosed with heart failure with an age range of 18 to 90 years old. All studies were critically reviewed using the appropriate critical appraisal skills programme (CASP) tool. Results: Nine studies were included in this systematic literature. The papers had an international focus, were quantitative and qualitative studies and explored the barriers faced by patients with heart failure, seeking treatment. Results of the review were discussed under five themes: lack of knowledge, mental health and psychological wellbeing; distance and accessibility to healthcare services; previous hospital experience, Corona virus pandemic. The results showed that patient’s cognitive ability must be considered. Distance from the healthcare provider impacted on patient’s accessibility to services. The impact of the corona virus pandemic instilled 10 fear within patients with many avoiding or delaying attending hospitals or seeking help. Importantly a good relationship with the healthcare professionals impacted positively on patient’s decision-making ability Conclusions: This review highlighted key information regarding why heart failure patients delay or avoid seeking medical help or treatment. There is a clear need for health education and promotion with patients and healthcare staff. Empowering patients to make good decisions related to their signs and symptoms is paramount in instilling confidence.
The impact of psychological support and education programs on patients’ pre/post ACID implantation.
(2022) Alsamahi, Aishah Ahmed
Background: The Automatic implantable cardioverter-defibrillator (AICD) can potentially save a patient's life; it was developed for the primary prevention of sudden cardiac death as well as the secondary prevention of sudden cardiac death. However, some individuals experience emotional stress after implantation. Various psychosocial interventions have been implemented to help improve patients' psychological well-being. Aim: To explore the impact of psychological support and education programs on patients’ pre/post-ACID implantation. Method: The study systematically search was mainly conducted in three primary databases CINAHL, MEDLINE, and Pubmed. A comprehensive search strategy was developed to identify appropriate article papers highlighting the impact of psychological support and education programs on patients’ pre/post-ACID implantation. Keywords were selected using the PIO framework to locate relevant studies. Study inclusion criteria were as follows: primary research published and peer-reviewed, published from 2011 to 2022, and published in the English text. We included studies if participants were having an AICD implant and adults only. Results: Seven studies fulfilled the inclusion and exclusion criteria, six of them were randomized controlled trials and one study was a mixed-method study. All of the studies proposed different interventions for patient post AICD and the core intervention for the majority was CBT. Conclusion: This review highlighted the effect of psychological interventions on anxiety , depression, quality of life, and hospitalization among AICD patients. According to this review, 9 psychological interventions have positive effects on anxiety, depression, and physical functioning in patients with AICD
The best clean catch method to collect none contaminated sample in non-toileted child
(2021) Alteneiji, Meirah
Background: Urinary tract infection (UTI) is the most common bacterial infections affected infants and younger children. To discover UTI, urinalysis is the test used to identify bacteria in the urine. Urinalysis is examined by three methods, visual examination, microscopic exam, and dipstick test. The common methods for sampling in non-toilet-trained children involve clean catch, urine bag, urine pad, in-out catheterisation urine, and suprapubic aspiration. Aim: The aim of this literature review is to explore the best methods to collect CCU sample from non-toilet-trained child without contamination. Methodology: When searching the literature, the systematic approach method was used. The search strategy used PIO from (population, intervention, and outcomes). The search results were generated using three electronic databases relevant to the review: Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, and PubMed. The quality of each study was evaluated using CASP tool. Searches were conducted between November 2020 to April 2021 because of the due of the deadline. An inclusion and exclusion criteria were established to determine which literature will be included in the review and which will be excluded. Included articles were eligible if they were in English language, full text article, published between 2010 and 2020, the sample is children or infants needs clean catch urine collection, nontoilet child and infants who need urine collection, and qualitative and quantitative papers and not systematic review. Results: Total of seven papers, four were randomised controlled trials and three were cohort studies addressed the clean catch method in non-toileted infants to collect none contamination urine sample. 9 Conclusion: The most used method to collect urine sample in this age is obtaining a cleancatch urine sample, however this method took an average of more than one hour to collect sample.
The Informed Consent Process in Percutaneous Coronary Intervention: A review
(2022) Alabdouli, Fatma Saleh Abdulrahman
Abstract: Informed consent is an essential process in observing the ethical issues in a medical facility. However, there is scanty of information on how the process is carried out. Percutaneous Coronary Intervention (PCI)is a widely known revascularization process. The process requires informed consent between the patients and the doctors to be executed. Therefore, the study conducted a systematic review of the available sources in the selected database to determine the patient’s and cardiologist's views of the informed consent process in PCI. The findings from the reviews of the 14 papers, most patients did not understand the ethical and legal principles behind the informed consent process in over 50% of the papers. Besides, the patients overestimated the benefits forget the risks associated, and lack information on the available alternative methods. In most scenarios, the patients are unaware of the procedure and the cardiologists fail to involve the patients in the process. The results demonstrated the lack of partnership between the cardiologists and the patients in the decision-making process. Therefore, there is a need for partnership between the patients and the doctors in the informed consent process.
Exploring cultural influences on communication among International Educated Nurses
(2021) Al Maazmi, Shaikha
Introduction: This paper presents a systematic literature review as part of an MSc program in specialist nursing. The review focusses on exploring the experiences of the Internationally Educated Nurses (IENs) with the cultural differences and its impact on the communication when working in a clinical setting which is different from their home country. The paper will begin by setting the chosen topic in context, giving some background to the important role IENs play in health and social care. The paper will then describe the methodology including the review design, the search strategy, the inclusion and exclusion criteria, the data bases accessed, the key search words and terms used. The paper will present the findings including the articles chosen to be part of the review, the overall results from these articles, which will be presented through a Preferred Reporting Items for Systematic Reviews and Meta-Analyses flowchart (PRISMA) and a table. Having critically reviewed, appraised, and assessed the quality of the articles and the findings. The common themes which they are 1. Need for support, 2. Communication, 3. Adjustment and they will be discussed in detail. The limitations and strengths of the review will be addressed and implications for practice will be presented.

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