Pub Date : 2024-09-13DOI: 10.1016/j.ijnurstu.2024.104908
Ourega-Zoé Ejebu , Julia Philippou , Joanne Turnbull , Anne Marie Rafferty , William Palmer , Jane Prichard , Iain Atherton , Michelle Jamieson , Lucina Rolewicz , Matthew Williams , Jane Ball
Background
Shortages of nurses are one of the biggest challenges healthcare systems face around the world. Given the wide range of contexts and individuals working in nursing, a ‘one-size-fits-all’ retention strategy is unlikely to be effective. Knowing what matters most to nurses at different career stages would help employers and policy-makers who want to enhance nurse retention to design tailored strategies.
Objective
To review and synthesise findings from recently published literature on the push-pull factors influencing nurses' decisions at the micro level, to enter and stay (or leave) at key career stages (i.e. pre-career, training, early-, mid- and late-career, and return to practice).
Methods
We undertook a set of structured searches of the literature and a narrative synthesis to explore factors that motivate individuals to enter the nursing profession and the push-pull factors influencing nurse retention at different career stages. Electronic databases CINAHL, Medline, Scopus and Embase were searched in December 2022 (and updated in November 2023) for English language publications. Additional health workforce sources, such as King's Fund and Nuffield Trust, were also searched.
Results
227 articles met the criteria for inclusion in the narrative review. Some push-pull factors were common to nurses across all career stages, including workplace support, flexible schedule patterns, opportunities for career advancement, fair treatment and salaries. In contrast, some challenges and push-pull factors were unique to each career stage. Students experienced difficulty in adjusting and balancing education and life; early-career nurses experienced transition shocks; mid-career nurses were frustrated by the lack of career advancement; late-career nurses desired more recognition; nurses returning to practice were discouraged by their lack of confidence and the cost of return-to-practice courses.
Conclusion
Our findings reinforce the view that factors influencing nurses' choices about whether to enter, continue or leave nursing jobs are multi-factorial and multi-dimensional. Policy and employment practices should be informed by research that has a more nuanced insight into what matters most to whom and at what career stage.
Tweetable abstract
Nuanced insight into motivations is needed to attract and retain a mix of nurse throughout their careers @ZEjebu @julia_philippou @JaneEball.
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Pub Date : 2024-09-13DOI: 10.1016/j.ijnurstu.2024.104906
Joelle Yan Xin CHUA , Mahesh CHOOLANI , Cornelia Yin Ing CHEE , Huso YI , Yiong Huak CHAN , Joan Gabrielle LALOR , Yap Seng CHONG , Shefaly SHOREY
<div><h3>Background</h3><div>Transitioning to parenthood is a stressful period that makes parents more prone to depression and anxiety. Mobile application-based interventions and chatbots could improve parents' well-being across the perinatal period. Hence, the Parentbot - a Digital healthcare Assistant was developed to support parents across the perinatal period.</div></div><div><h3>Objective</h3><div>To evaluate the effectiveness of the Parentbot - a Digital healthcare Assistant in improving parenting self-efficacy (primary outcome), stress, depression, anxiety, social support, parent–child bonding, and parenting satisfaction (secondary outcomes) among parents across the perinatal period.</div></div><div><h3>Methods</h3><div>A two-group pre-test and repeated post-test randomized controlled trial was used where 118 heterosexual couples (118 mothers and 118 fathers) were recruited from a public tertiary hospital in Singapore. Couples were randomly assigned to the intervention group receiving the Parentbot - a Digital healthcare Assistant and standardized care (59 couples) and a control group receiving the standard care only (59 couples). Data collection occurred at baseline (><!--> <!-->24 weeks of gestation – age of viability in Singapore) and at one month (post-test 1) and three months (post-test 2) postpartum. Linear mixed models were used to compare parental outcomes between groups and a linear mixed model with repeated measures was used to analyze within-group differences. General linear models were used to conduct subgroup analyses of mothers and fathers between groups.</div></div><div><h3>Results</h3><div>After adjusting for baseline values and sociodemographic covariates, parents in the intervention group had higher parenting self-efficacy compared to the control group at one-month postpartum (mean difference = 1.22, 95 % CI: 0.06 to 2.39, p = 0.04; Cohen standardized effect size = 0.14), and mothers had lower state-anxiety compared to the control group at three-months postpartum (mean difference = −<!--> <!-->2.21, 95 % CI: −<!--> <!-->4.18 to −<!--> <!-->0.24, p = 0.03; Cohen standardized effect size = −<!--> <!-->0.22). Non-statistically significant differences between groups were reported for the other parental outcomes.</div></div><div><h3>Conclusions</h3><div>This study showed that the Parentbot - a Digital healthcare Assistant is feasible and promising in supporting parents especially enhancing their self-efficacy across the perinatal period. The lack of statistical significance in most outcomes showed that further evaluation of the intervention is required among varied populations of parents across different cultural and geographical contexts. The intervention could be enhanced to support more diverse groups of parents including single parents, parents with high-risk pregnancies and infants with medical complications, and parents with limited English language skills. Future trials could explore the cost-effectiveness of such in
{"title":"The effectiveness of Parentbot - a digital healthcare assistant - on parenting outcomes: A randomized controlled trial","authors":"Joelle Yan Xin CHUA , Mahesh CHOOLANI , Cornelia Yin Ing CHEE , Huso YI , Yiong Huak CHAN , Joan Gabrielle LALOR , Yap Seng CHONG , Shefaly SHOREY","doi":"10.1016/j.ijnurstu.2024.104906","DOIUrl":"10.1016/j.ijnurstu.2024.104906","url":null,"abstract":"<div><h3>Background</h3><div>Transitioning to parenthood is a stressful period that makes parents more prone to depression and anxiety. Mobile application-based interventions and chatbots could improve parents' well-being across the perinatal period. Hence, the Parentbot - a Digital healthcare Assistant was developed to support parents across the perinatal period.</div></div><div><h3>Objective</h3><div>To evaluate the effectiveness of the Parentbot - a Digital healthcare Assistant in improving parenting self-efficacy (primary outcome), stress, depression, anxiety, social support, parent–child bonding, and parenting satisfaction (secondary outcomes) among parents across the perinatal period.</div></div><div><h3>Methods</h3><div>A two-group pre-test and repeated post-test randomized controlled trial was used where 118 heterosexual couples (118 mothers and 118 fathers) were recruited from a public tertiary hospital in Singapore. Couples were randomly assigned to the intervention group receiving the Parentbot - a Digital healthcare Assistant and standardized care (59 couples) and a control group receiving the standard care only (59 couples). Data collection occurred at baseline (><!--> <!-->24 weeks of gestation – age of viability in Singapore) and at one month (post-test 1) and three months (post-test 2) postpartum. Linear mixed models were used to compare parental outcomes between groups and a linear mixed model with repeated measures was used to analyze within-group differences. General linear models were used to conduct subgroup analyses of mothers and fathers between groups.</div></div><div><h3>Results</h3><div>After adjusting for baseline values and sociodemographic covariates, parents in the intervention group had higher parenting self-efficacy compared to the control group at one-month postpartum (mean difference = 1.22, 95 % CI: 0.06 to 2.39, p = 0.04; Cohen standardized effect size = 0.14), and mothers had lower state-anxiety compared to the control group at three-months postpartum (mean difference = −<!--> <!-->2.21, 95 % CI: −<!--> <!-->4.18 to −<!--> <!-->0.24, p = 0.03; Cohen standardized effect size = −<!--> <!-->0.22). Non-statistically significant differences between groups were reported for the other parental outcomes.</div></div><div><h3>Conclusions</h3><div>This study showed that the Parentbot - a Digital healthcare Assistant is feasible and promising in supporting parents especially enhancing their self-efficacy across the perinatal period. The lack of statistical significance in most outcomes showed that further evaluation of the intervention is required among varied populations of parents across different cultural and geographical contexts. The intervention could be enhanced to support more diverse groups of parents including single parents, parents with high-risk pregnancies and infants with medical complications, and parents with limited English language skills. Future trials could explore the cost-effectiveness of such in","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"160 ","pages":"Article 104906"},"PeriodicalIF":7.5,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-12DOI: 10.1016/j.ijnurstu.2024.104907
Pheona van Huizen , Philip L. Russo , Elizabeth Manias , Lisa Kuhn , Clifford J. Connell
<div><h3>Background</h3><div>Hazardous drugs are inherently toxic and present a potential occupational exposure risk to nurses and midwives. Hazardous drugs require special handling to minimise the risk of exposure and adverse health effects. Although the use of hazardous drugs in oncology services is well recognised, they are also used in other healthcare areas where nurses and midwives may be unaware there is a risk.</div></div><div><h3>Objective</h3><div>To investigate what nurses and midwives know and do about their occupational exposure to hazardous drugs, and what factors affect their knowledge and practice.</div></div><div><h3>Design</h3><div>Mixed methods systematic review.</div></div><div><h3>Methods</h3><div>A systematic review was conducted, and studies were included if the authors described what nurses or midwives knew about hazardous drugs, or what they did in their clinical practice to reduce their risk of occupational exposure (PROSPERO registration CRD42024437493). The databases were searched for any year until the 26th of January 2024.Two independent reviewers extracted data using Covidence and assessed the risk of bias. The data were extracted into the categories of knowledge of risk and safe handling practices, attitude and factors affecting these, and activities that posed the greatest risk of exposure (preparation, administration, and disposal of hazardous drugs, cleaning hazardous drug spills, and handling excreta from patients who had recently been treated with hazardous drugs).</div></div><div><h3>Results</h3><div>Of the 2702 articles that were identified, 59 quantitative and 3 qualitative studies were included in this review. No studies reported on midwives handling hazardous drugs. Most studies investigated nurses working in oncology services. Nurses reported a lack of education about the risk and safe handling. They were often responsible for preparing hazardous drugs and there was inconsistency in their compliance when using personal protective equipment. Nurses did not always perceive that there was a real risk of exposure, were concerned about the effect of wearing personal protective equipment on their relationship with patients and perceived they lacked the time to don equipment.</div></div><div><h3>Conclusions</h3><div>The risk of occupational exposure to hazardous drugs outside of oncology services was rarely investigated. There were no studies reporting what midwives knew and did about their risk of occupational exposure to hazardous drugs. When nurses were aware of the risks, this did not necessarily translate into the implementation of safe handling practices or the consistent use of personal protective equipment because of a perceived low risk, lack of personal protective equipment availability, and prioritising personal or patient comfort over safety measures.</div><div><strong>Tweetable abstract:</strong> Nurses and midwives are often unknowingly exposed to the toxic effects of hazardous drugs when they pre
{"title":"Knowledge and safe handling practices affecting the occupational exposure of nurses and midwives to hazardous drugs: A mixed methods systematic review","authors":"Pheona van Huizen , Philip L. Russo , Elizabeth Manias , Lisa Kuhn , Clifford J. Connell","doi":"10.1016/j.ijnurstu.2024.104907","DOIUrl":"10.1016/j.ijnurstu.2024.104907","url":null,"abstract":"<div><h3>Background</h3><div>Hazardous drugs are inherently toxic and present a potential occupational exposure risk to nurses and midwives. Hazardous drugs require special handling to minimise the risk of exposure and adverse health effects. Although the use of hazardous drugs in oncology services is well recognised, they are also used in other healthcare areas where nurses and midwives may be unaware there is a risk.</div></div><div><h3>Objective</h3><div>To investigate what nurses and midwives know and do about their occupational exposure to hazardous drugs, and what factors affect their knowledge and practice.</div></div><div><h3>Design</h3><div>Mixed methods systematic review.</div></div><div><h3>Methods</h3><div>A systematic review was conducted, and studies were included if the authors described what nurses or midwives knew about hazardous drugs, or what they did in their clinical practice to reduce their risk of occupational exposure (PROSPERO registration CRD42024437493). The databases were searched for any year until the 26th of January 2024.Two independent reviewers extracted data using Covidence and assessed the risk of bias. The data were extracted into the categories of knowledge of risk and safe handling practices, attitude and factors affecting these, and activities that posed the greatest risk of exposure (preparation, administration, and disposal of hazardous drugs, cleaning hazardous drug spills, and handling excreta from patients who had recently been treated with hazardous drugs).</div></div><div><h3>Results</h3><div>Of the 2702 articles that were identified, 59 quantitative and 3 qualitative studies were included in this review. No studies reported on midwives handling hazardous drugs. Most studies investigated nurses working in oncology services. Nurses reported a lack of education about the risk and safe handling. They were often responsible for preparing hazardous drugs and there was inconsistency in their compliance when using personal protective equipment. Nurses did not always perceive that there was a real risk of exposure, were concerned about the effect of wearing personal protective equipment on their relationship with patients and perceived they lacked the time to don equipment.</div></div><div><h3>Conclusions</h3><div>The risk of occupational exposure to hazardous drugs outside of oncology services was rarely investigated. There were no studies reporting what midwives knew and did about their risk of occupational exposure to hazardous drugs. When nurses were aware of the risks, this did not necessarily translate into the implementation of safe handling practices or the consistent use of personal protective equipment because of a perceived low risk, lack of personal protective equipment availability, and prioritising personal or patient comfort over safety measures.</div><div><strong>Tweetable abstract:</strong> Nurses and midwives are often unknowingly exposed to the toxic effects of hazardous drugs when they pre","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"160 ","pages":"Article 104907"},"PeriodicalIF":7.5,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0020748924002207/pdfft?md5=a9d3174f281a218738a3d5c2955534bb&pid=1-s2.0-S0020748924002207-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-10DOI: 10.1016/j.ijnurstu.2024.104894
Harmony Mang Yan Ho, Heidi Sze Lok Fan, Gunther Huagang Hu, Nitya Nagesh, Hoi Lam Ip, Emily Tsz Yan Leung, Edmond Pui Hang Choi, Kris Yuet Wan Lok
Objective
The objective of this study is to determine the effectiveness of layperson-based interventions in sustaining exclusive breastfeeding and to identify the optimal characteristics of such layperson-led strategies for promoting exclusive breastfeeding.
Methods
A systematic review and meta-analysis were conducted using a comprehensive search in seven electronic databases from their inception to January 2024. Two independent reviewers assessed the risk of bias using version 2 of the Cochrane Risk of Bias tool for randomized trials.
Results
Out of the 29,703 articles identified, 27 studies met the inclusion criteria and were included in the analysis. A total of 38,412 participants were included in these studies. The majority of the included studies utilized home visits as the intervention method. However, there is limited data available for other interventions, such as group discussions, phone support, short message service, and combined approaches, making it difficult to determine their effectiveness. Laypersons, with or without breastfeeding experience, were found to be effective intervention providers.
Discussion
Home visit interventions conducted by laypersons have proven effective in promoting exclusive breastfeeding. To maximize effectiveness, the content of home visits should be tailored based on the stages of pregnancy, and ideally, the duration of the visits should extend up to six months postpartum to sustain breastfeeding.
Registration
The protocol for this review is registered on PROSPERO (registration number: CRD42021235078). A major deviation from the protocol was the exclusion of network meta-analysis due to the small number of articles identified and the primary outcome being the exclusive breastfeeding rate.
{"title":"Effectiveness of layperson-based interventions in promoting exclusive breastfeeding: A systematic review and meta-analysis","authors":"Harmony Mang Yan Ho, Heidi Sze Lok Fan, Gunther Huagang Hu, Nitya Nagesh, Hoi Lam Ip, Emily Tsz Yan Leung, Edmond Pui Hang Choi, Kris Yuet Wan Lok","doi":"10.1016/j.ijnurstu.2024.104894","DOIUrl":"10.1016/j.ijnurstu.2024.104894","url":null,"abstract":"<div><h3>Objective</h3><p>The objective of this study is to determine the effectiveness of layperson-based interventions in sustaining exclusive breastfeeding and to identify the optimal characteristics of such layperson-led strategies for promoting exclusive breastfeeding.</p></div><div><h3>Methods</h3><p>A systematic review and meta-analysis were conducted using a comprehensive search in seven electronic databases from their inception to January 2024. Two independent reviewers assessed the risk of bias using version 2 of the Cochrane Risk of Bias tool for randomized trials.</p></div><div><h3>Results</h3><p>Out of the 29,703 articles identified, 27 studies met the inclusion criteria and were included in the analysis. A total of 38,412 participants were included in these studies. The majority of the included studies utilized home visits as the intervention method. However, there is limited data available for other interventions, such as group discussions, phone support, short message service, and combined approaches, making it difficult to determine their effectiveness. Laypersons, with or without breastfeeding experience, were found to be effective intervention providers.</p></div><div><h3>Discussion</h3><p>Home visit interventions conducted by laypersons have proven effective in promoting exclusive breastfeeding. To maximize effectiveness, the content of home visits should be tailored based on the stages of pregnancy, and ideally, the duration of the visits should extend up to six months postpartum to sustain breastfeeding.</p></div><div><h3>Registration</h3><p>The protocol for this review is registered on PROSPERO (registration number: CRD42021235078). A major deviation from the protocol was the exclusion of network meta-analysis due to the small number of articles identified and the primary outcome being the exclusive breastfeeding rate.</p></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"160 ","pages":"Article 104894"},"PeriodicalIF":7.5,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0020748924002074/pdfft?md5=e4474faa3d43c3dca2eb7a327c494872&pid=1-s2.0-S0020748924002074-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142243512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-07DOI: 10.1016/j.ijnurstu.2024.104903
Nyasha V. Dzavakwa , Katharina Kranzer , Palwasha Khan , Constance R.S. Mackworth-Young , Hilda A. Mujuru , Rashida A. Ferrand , Victoria Simms
Objective
To systematically review literature from randomised controlled trials (RCTs) investigating the effectiveness of electronic monitoring device informed interventions on adherence and clinical outcomes in children and adolescents with chronic conditions.
Study design
A systematic review was conducted. An electronic literature search covering studies, with no pre-specified starting date up to June 2024, was performed in Medline, EMBASE, Web of Science, Cochrane and Trials databases was conducted.
Participants
RCTs of electronic monitoring device informed interventions in individuals aged 0 to 18 years with chronic conditions, were identified, with no restriction on geography or publication date.
Methods
Extracted data was synthesised. As a result of differences in definitions and analysis of adherence and clinical outcomes across the studies a pooled meta-analysis was not possible therefore, a descriptive analysis was conducted. Risk of bias across all studies was assessed using the Cochrane Collaboration risk of bias tool.
Results
11 RCTs, with 1485 children and adolescents were included. Studies were all from high- and middle-income countries, conducted among children and adolescents with asthma, and one each among children and adolescents with kidney transplant, multiple sclerosis, and epilepsy. Eight of the 11 studies reported a positive effect on adherence. Only four studies reported a positive effect on clinical outcomes and seven studies found no effect on clinical outcomes.
Conclusions
Electronic monitoring device interventions show promise in improving adherence in children and adolescents with chronic conditions, in a limited number of chronic conditions, mostly asthma. Evidence for the efficacy of electronic monitoring device informed interventions on clinical outcomes and from low-income settings is lacking.
Systematic review registration
PROSPERO, CRD42022312057, registered in March 2022.
Tweetable abstract
Electronic monitoring device informed interventions may improve treatment adherence in children and adolescents with chronic conditions but evidence from low-income settings is lacking @nyasha_dzavakwa @KatharinaKranz4 @dopapus @hilda_mujuru @rashida_abbferr @vickysimms_epi
{"title":"Electronic monitoring device informed interventions for treatment adherence and clinical outcomes in children and adolescents: A systematic review","authors":"Nyasha V. Dzavakwa , Katharina Kranzer , Palwasha Khan , Constance R.S. Mackworth-Young , Hilda A. Mujuru , Rashida A. Ferrand , Victoria Simms","doi":"10.1016/j.ijnurstu.2024.104903","DOIUrl":"10.1016/j.ijnurstu.2024.104903","url":null,"abstract":"<div><h3>Objective</h3><p>To systematically review literature from randomised controlled trials (RCTs) investigating the effectiveness of electronic monitoring device informed interventions on adherence and clinical outcomes in children and adolescents with chronic conditions.</p></div><div><h3>Study design</h3><p>A systematic review was conducted. An electronic literature search covering studies, with no pre-specified starting date up to June 2024, was performed in Medline, EMBASE, Web of Science, Cochrane and Trials databases was conducted.</p></div><div><h3>Participants</h3><p>RCTs of electronic monitoring device informed interventions in individuals aged 0 to 18 years with chronic conditions, were identified, with no restriction on geography or publication date.</p></div><div><h3>Methods</h3><p>Extracted data was synthesised. As a result of differences in definitions and analysis of adherence and clinical outcomes across the studies a pooled meta-analysis was not possible therefore, a descriptive analysis was conducted. Risk of bias across all studies was assessed using the Cochrane Collaboration risk of bias tool.</p></div><div><h3>Results</h3><p>11 RCTs, with 1485 children and adolescents were included. Studies were all from high- and middle-income countries, conducted among children and adolescents with asthma, and one each among children and adolescents with kidney transplant, multiple sclerosis, and epilepsy. Eight of the 11 studies reported a positive effect on adherence. Only four studies reported a positive effect on clinical outcomes and seven studies found no effect on clinical outcomes.</p></div><div><h3>Conclusions</h3><p>Electronic monitoring device interventions show promise in improving adherence in children and adolescents with chronic conditions, in a limited number of chronic conditions, mostly asthma. Evidence for the efficacy of electronic monitoring device informed interventions on clinical outcomes and from low-income settings is lacking.</p></div><div><h3>Systematic review registration</h3><p>PROSPERO, CRD42022312057, registered in March 2022.</p></div><div><h3><strong>Tweetable abstract</strong></h3><p>Electronic monitoring device informed interventions may improve treatment adherence in children and adolescents with chronic conditions but evidence from low-income settings is lacking @nyasha_dzavakwa @KatharinaKranz4 @dopapus @hilda_mujuru @rashida_abbferr @vickysimms_epi</p></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"160 ","pages":"Article 104903"},"PeriodicalIF":7.5,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0020748924002165/pdfft?md5=b9607bb3722c4d29a0025148a9d4889c&pid=1-s2.0-S0020748924002165-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142243514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-07DOI: 10.1016/j.ijnurstu.2024.104905
Xu Wang , Wai Tong Chien , Yuen Yu Chong
<div><h3>Background</h3><div>Asthma is a prevalent chronic disease affecting school-age children, with substantial psychosocial implications for children and their parents.</div></div><div><h3>Objectives</h3><div>This review aimed to synthesise current evidence on the effects of psychosocial interventions for families of school-age children with asthma and investigate the optimal features of effective interventions.</div></div><div><h3>Methods</h3><div>Embase, MEDLINE, PsycINFO, CINAHL, Web of Science Core Collection, Cochrane Central Register of Controlled Trials, Google Scholar, CNKI, and Wanfang Data were searched from inception to November 2023. Randomised controlled trials (RCTs) examining psychosocial interventions in children aged six to twelve with asthma on asthma symptoms and parental stress were included. Emergency department visits, hospitalisations, lung function, psychological symptoms and health-related quality of life in both children and parents were secondary outcomes. Data were pooled for short-term (≤ three months), medium-term (> three months and ≤ six months), and long-term (> six months) follow-ups. Risk of bias was appraised using version 2 of the Cochrane risk of bias tool for randomised trials. Meta-analysis was performed using RevMan 5.4.1.</div></div><div><h3>Results</h3><div>Seven RCTs with 884 parent–child dyads from two countries were included. Meta-analyses found that psychosocial interventions improved asthma control (k = 2, n = 301, standardised mean difference [SMD] 0.35, 95 % confidence interval [CI] 0.12 to 0.58, P = 0.003), sleep problem (k = 2, n = 149, SMD -0.47, 95 % CI -0.79 to −<!--> <!-->0.14, P = 0.005), cough (k = 2, n = 149, SMD -0.97, 95 % CI -1.59 to −<!--> <!-->0.35, P = 0.002), wheezing (k = 2, n = 149, SMD -0.76, 95 % CI -1.09 to −<!--> <!-->0.42, P < 0.0001), and parental stress (k = 6, n = 813, SMD -0.32, 95 % CI -0.61 to −<!--> <!-->0.02, P = 0.03), compared to controls in the short term. Subgroup analysis revealed significant effects of psychoeducation, family empowerment interventions, and acceptance and commitment therapy-based interventions on reducing parental stress. No significant intervention effects were observed on parental symptoms of depression at any follow-up. Narrative synthesis indicated that psychosocial interventions may provide benefits in children's health-related quality of life in the short term, parental symptoms of anxiety in the medium term, and activity limitation, cough, and wheezing in the long term. The intervention effects for other reviewed outcomes were inconsistent.</div></div><div><h3>Conclusions</h3><div>Psychosocial interventions demonstrate possible benefits for families of school-aged children with asthma in asthma symptoms, parental stress, and children's health-related quality of life within three months post-intervention and parental symptoms of anxiety at six months post-intervention. Future research with rigorous design should investigate th
{"title":"Effectiveness of psychosocial interventions for improving asthma symptoms and parental stress in families of school-age children with asthma: A systematic review and meta-analysis","authors":"Xu Wang , Wai Tong Chien , Yuen Yu Chong","doi":"10.1016/j.ijnurstu.2024.104905","DOIUrl":"10.1016/j.ijnurstu.2024.104905","url":null,"abstract":"<div><h3>Background</h3><div>Asthma is a prevalent chronic disease affecting school-age children, with substantial psychosocial implications for children and their parents.</div></div><div><h3>Objectives</h3><div>This review aimed to synthesise current evidence on the effects of psychosocial interventions for families of school-age children with asthma and investigate the optimal features of effective interventions.</div></div><div><h3>Methods</h3><div>Embase, MEDLINE, PsycINFO, CINAHL, Web of Science Core Collection, Cochrane Central Register of Controlled Trials, Google Scholar, CNKI, and Wanfang Data were searched from inception to November 2023. Randomised controlled trials (RCTs) examining psychosocial interventions in children aged six to twelve with asthma on asthma symptoms and parental stress were included. Emergency department visits, hospitalisations, lung function, psychological symptoms and health-related quality of life in both children and parents were secondary outcomes. Data were pooled for short-term (≤ three months), medium-term (> three months and ≤ six months), and long-term (> six months) follow-ups. Risk of bias was appraised using version 2 of the Cochrane risk of bias tool for randomised trials. Meta-analysis was performed using RevMan 5.4.1.</div></div><div><h3>Results</h3><div>Seven RCTs with 884 parent–child dyads from two countries were included. Meta-analyses found that psychosocial interventions improved asthma control (k = 2, n = 301, standardised mean difference [SMD] 0.35, 95 % confidence interval [CI] 0.12 to 0.58, P = 0.003), sleep problem (k = 2, n = 149, SMD -0.47, 95 % CI -0.79 to −<!--> <!-->0.14, P = 0.005), cough (k = 2, n = 149, SMD -0.97, 95 % CI -1.59 to −<!--> <!-->0.35, P = 0.002), wheezing (k = 2, n = 149, SMD -0.76, 95 % CI -1.09 to −<!--> <!-->0.42, P < 0.0001), and parental stress (k = 6, n = 813, SMD -0.32, 95 % CI -0.61 to −<!--> <!-->0.02, P = 0.03), compared to controls in the short term. Subgroup analysis revealed significant effects of psychoeducation, family empowerment interventions, and acceptance and commitment therapy-based interventions on reducing parental stress. No significant intervention effects were observed on parental symptoms of depression at any follow-up. Narrative synthesis indicated that psychosocial interventions may provide benefits in children's health-related quality of life in the short term, parental symptoms of anxiety in the medium term, and activity limitation, cough, and wheezing in the long term. The intervention effects for other reviewed outcomes were inconsistent.</div></div><div><h3>Conclusions</h3><div>Psychosocial interventions demonstrate possible benefits for families of school-aged children with asthma in asthma symptoms, parental stress, and children's health-related quality of life within three months post-intervention and parental symptoms of anxiety at six months post-intervention. Future research with rigorous design should investigate th","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"160 ","pages":"Article 104905"},"PeriodicalIF":7.5,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142311971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cancer-related fatigue is the most common symptom of subjective and persistent nature in cancer patients, which almost runs through the whole process of disease and treatment and rehabilitation, seriously affects the effect of anti-tumor treatment and reduces the quality of life of patients. Non-pharmacological management is one of the key links to relieve cancer-related fatigue, however, there are many types of non-pharmacological management and the related guidelines do not recommend the optimal nursing program for cancer-related fatigue. In our study, Network Meta-analysis was used to compare the effectiveness of different non-pharmacological therapies in Cancer-related fatigue to make their treatment and care more clinically valuable.
Methods
Randomized controlled trials about non-pharmacological therapies for cancer-related fatigue were searched in Chinese and English databases including China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform, Chinese Scientific Journal database, Chinese Biomedical Database, Google Scholar, Pubmed, Web of science, Cochrane Library, Sci-Hub, ScienceDirect, and other relevant medical websites including Medlive and DingXiangYuan. The search time was from the establishment of the database to December 2023. The quality of the included Randomized controlled trials was evaluated by two trained researchers using the Cochrane Risk of Bias Assessment Tool, and data were independently extracted from the included literature and analyzed by reticulated Meta-analysis using Stata 18.0 statistical software.
Results
A total of 49 studies with 24 non-drug management methods, and 3887 patients were included. The results of network meta-analysis showed that the use of massage therapy to improve cancer-related fatigue had a more significant advantage over conventional nursing measures and other non-pharmacological therapies in cancer patients, followed by infrared laser moxibustion and ginger-isolated moxibustion with traditional Chinese medicine characteristics, while the worst effect was strengthening excise.
Conclusions
The existing evidence shows that massage therapy has the best effect in the intervention of cancer-related fatigue. However, due to the diversity of non-pharmacological therapies and the small number of studies included in each therapy, the coverage of this study is insufficient, and more large-sample, multi-center and high-quality randomized controlled trials are needed for further verification in the future.
背景：癌症相关性疲劳是癌症患者最常见的主观持续性症状，几乎贯穿了患者发病、治疗和康复的全过程，严重影响了抗肿瘤治疗的效果，降低了患者的生活质量。非药物治疗是缓解癌症相关性疲劳的关键环节之一，然而非药物治疗种类繁多，相关指南并未推荐癌症相关性疲劳的最佳护理方案。在我们的研究中，我们采用了网络 Meta 分析法来比较不同非药物疗法对癌症相关性疲劳的疗效，以使其治疗和护理更具临床价值：方法：在中国知网、万方数据知识服务平台、中文科技期刊数据库、中国生物医学数据库、Google Scholar、Pubmed、Web of science、Cochrane Library、Sci-Hub、ScienceDirect等中英文数据库以及Medlive、丁香园等相关医学网站检索癌症相关性疲劳非药物疗法的随机对照试验。检索时间为数据库建立至 2023 年 12 月。由两名经过培训的研究人员使用 Cochrane 偏倚风险评估工具对纳入的随机对照试验进行质量评估，并从纳入的文献中独立提取数据，使用 Stata 18.0 统计软件进行网状 Meta 分析：共纳入49项研究，24种非药物治疗方法，3887名患者。网络荟萃分析结果显示，与常规护理措施和其他非药物疗法相比，使用按摩疗法改善癌症患者的癌症相关性疲劳具有更显著的优势，其次是红外线激光灸和具有中医特色的隔姜灸，而效果最差的是加强切除术：结论：现有证据表明，按摩疗法对癌症相关疲劳的干预效果最好。结论：现有证据表明，按摩疗法在癌症相关疲劳的干预中效果最好，但由于非药物疗法的多样性以及每种疗法纳入研究的数量较少，本研究的覆盖面还不够广，未来还需要更多的大样本、多中心、高质量的随机对照试验来进一步验证。
{"title":"The effectiveness of different non-pharmacological therapies on cancer-related fatigue in cancer patients:A network meta-analysis","authors":"Yingyin Long , Zhenfeng Zhou , Shuang Zhou , Guijuan Zhang","doi":"10.1016/j.ijnurstu.2024.104904","DOIUrl":"10.1016/j.ijnurstu.2024.104904","url":null,"abstract":"<div><h3>Background</h3><div>Cancer-related fatigue is the most common symptom of subjective and persistent nature in cancer patients, which almost runs through the whole process of disease and treatment and rehabilitation, seriously affects the effect of anti-tumor treatment and reduces the quality of life of patients. Non-pharmacological management is one of the key links to relieve cancer-related fatigue, however, there are many types of non-pharmacological management and the related guidelines do not recommend the optimal nursing program for cancer-related fatigue. In our study, Network Meta-analysis was used to compare the effectiveness of different non-pharmacological therapies in Cancer-related fatigue to make their treatment and care more clinically valuable.</div></div><div><h3>Methods</h3><div>Randomized controlled trials about non-pharmacological therapies for cancer-related fatigue were searched in Chinese and English databases including China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform, Chinese Scientific Journal database, Chinese Biomedical Database, Google Scholar, Pubmed, Web of science, Cochrane Library, Sci-Hub, ScienceDirect, and other relevant medical websites including Medlive and DingXiangYuan. The search time was from the establishment of the database to December 2023. The quality of the included Randomized controlled trials was evaluated by two trained researchers using the Cochrane Risk of Bias Assessment Tool, and data were independently extracted from the included literature and analyzed by reticulated Meta-analysis using Stata 18.0 statistical software.</div></div><div><h3>Results</h3><div>A total of 49 studies with 24 non-drug management methods, and 3887 patients were included. The results of network meta-analysis showed that the use of massage therapy to improve cancer-related fatigue had a more significant advantage over conventional nursing measures and other non-pharmacological therapies in cancer patients, followed by infrared laser moxibustion and ginger-isolated moxibustion with traditional Chinese medicine characteristics, while the worst effect was strengthening excise.</div></div><div><h3>Conclusions</h3><div>The existing evidence shows that massage therapy has the best effect in the intervention of cancer-related fatigue. However, due to the diversity of non-pharmacological therapies and the small number of studies included in each therapy, the coverage of this study is insufficient, and more large-sample, multi-center and high-quality randomized controlled trials are needed for further verification in the future.</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"160 ","pages":"Article 104904"},"PeriodicalIF":7.5,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0020748924002177/pdfft?md5=d4654267dc25a78a7e047fef979774a3&pid=1-s2.0-S0020748924002177-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-07DOI: 10.1016/j.ijnurstu.2024.104902
Yuanjiao Yan , Chenshan Huang , Rong Lin , Mingfeng Chen , Yunxian Wang , Yifei Xu , Yueqi Chao , Chufan Zhang , Wenqian Sun , Nafang Wang , Yu Ye , Mojun Lin , Hong Li
<div><h3>Background</h3><p>Combined art activities can improve the neural network function within various brain regions involved in emotions, cognition, and behavior, thereby preventing or reversing cognitive decline. However, few studies have systematically examined its effects. Furthermore, the impact of nurse-led art-based cognitive intervention on cognitive and psychological health is unclear.</p></div><div><h3>Objective</h3><p>To evaluate the effects of a nurse-led staged integral art-based cognitive intervention in older adults on the Alzheimer's disease spectrum.</p></div><div><h3>Design</h3><p>This was a randomized wait-list controlled trial with allocation concealment and blinding of outcome assessors and data analysts. All data were collected between April 2021 and January 2023 and analyzed from January to March 2023.</p></div><div><h3>Setting</h3><p>One memory clinic and four medical partnership communities.</p></div><div><h3>Participants</h3><p>A total of 144 participants with subjective or objective memory decline (aged ≥<!--> <!-->60 years).</p></div><div><h3>Methods</h3><p>Participants were randomized into an intervention group (n = 72) and a wait-list control group (n = 72), in a 1:1 ratio. The intervention group underwent a 16-week, 24-session nurse-led staged integral art-based cognitive intervention program, which was based on neurocognitive function training patterns. The control group underwent the program after the follow-up assessment. General and specific domains of cognitive function and other health-related outcomes were measured at baseline (T0), immediately after the intervention (T1), and at the 6-month follow-up (T2).</p></div><div><h3>Results</h3><p>Of the 144 participants (mean [SD] age, 71.6 [5.8] years; 50 [34.7 %] males and 94 [65.3 %] females), 130 and 115 completed the questionnaires at T1 and T2, respectively. The average attendance rate in the intervention group was 86.0 %. At T1, the intervention group showed greater improvement than the control group did in general cognitive functions (MoCA, between-group mean difference, 1.4 [95 % CIs, 0.4 to 2.5], p = 0.009). Additionally, the intervention group demonstrated statistically significant improvement compared to the control group in language, memory, quality of life, sleep quality and physical activity level at T1. Statistically significant group differences remained in sleep quality (PSQI, between-group mean difference, −<!--> <!-->1.3 [95 % CIs, −<!--> <!-->2.5 to −<!--> <!-->0.1], p = 0.035) at the 6-month follow-up.</p></div><div><h3>Conclusions</h3><p>In this randomized controlled trial of a nurse-led staged integral art-based cognitive intervention program, older adults on the Alzheimer's disease spectrum who participated in the program experienced improved cognition and psychological health.</p></div><div><h3>Registration</h3><p>This study was registered with ChiCTR.org (ChiCTR2100044959) on April 3, 2021.</p></div><div><h3>Tweetable abstract</h3><p>A
{"title":"Effects of a nurse-led staged integral art-based cognitive intervention for older adults on the Alzheimer's disease spectrum: A randomized controlled trial","authors":"Yuanjiao Yan , Chenshan Huang , Rong Lin , Mingfeng Chen , Yunxian Wang , Yifei Xu , Yueqi Chao , Chufan Zhang , Wenqian Sun , Nafang Wang , Yu Ye , Mojun Lin , Hong Li","doi":"10.1016/j.ijnurstu.2024.104902","DOIUrl":"10.1016/j.ijnurstu.2024.104902","url":null,"abstract":"<div><h3>Background</h3><p>Combined art activities can improve the neural network function within various brain regions involved in emotions, cognition, and behavior, thereby preventing or reversing cognitive decline. However, few studies have systematically examined its effects. Furthermore, the impact of nurse-led art-based cognitive intervention on cognitive and psychological health is unclear.</p></div><div><h3>Objective</h3><p>To evaluate the effects of a nurse-led staged integral art-based cognitive intervention in older adults on the Alzheimer's disease spectrum.</p></div><div><h3>Design</h3><p>This was a randomized wait-list controlled trial with allocation concealment and blinding of outcome assessors and data analysts. All data were collected between April 2021 and January 2023 and analyzed from January to March 2023.</p></div><div><h3>Setting</h3><p>One memory clinic and four medical partnership communities.</p></div><div><h3>Participants</h3><p>A total of 144 participants with subjective or objective memory decline (aged ≥<!--> <!-->60 years).</p></div><div><h3>Methods</h3><p>Participants were randomized into an intervention group (n = 72) and a wait-list control group (n = 72), in a 1:1 ratio. The intervention group underwent a 16-week, 24-session nurse-led staged integral art-based cognitive intervention program, which was based on neurocognitive function training patterns. The control group underwent the program after the follow-up assessment. General and specific domains of cognitive function and other health-related outcomes were measured at baseline (T0), immediately after the intervention (T1), and at the 6-month follow-up (T2).</p></div><div><h3>Results</h3><p>Of the 144 participants (mean [SD] age, 71.6 [5.8] years; 50 [34.7 %] males and 94 [65.3 %] females), 130 and 115 completed the questionnaires at T1 and T2, respectively. The average attendance rate in the intervention group was 86.0 %. At T1, the intervention group showed greater improvement than the control group did in general cognitive functions (MoCA, between-group mean difference, 1.4 [95 % CIs, 0.4 to 2.5], p = 0.009). Additionally, the intervention group demonstrated statistically significant improvement compared to the control group in language, memory, quality of life, sleep quality and physical activity level at T1. Statistically significant group differences remained in sleep quality (PSQI, between-group mean difference, −<!--> <!-->1.3 [95 % CIs, −<!--> <!-->2.5 to −<!--> <!-->0.1], p = 0.035) at the 6-month follow-up.</p></div><div><h3>Conclusions</h3><p>In this randomized controlled trial of a nurse-led staged integral art-based cognitive intervention program, older adults on the Alzheimer's disease spectrum who participated in the program experienced improved cognition and psychological health.</p></div><div><h3>Registration</h3><p>This study was registered with ChiCTR.org (ChiCTR2100044959) on April 3, 2021.</p></div><div><h3>Tweetable abstract</h3><p>A ","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"160 ","pages":"Article 104902"},"PeriodicalIF":7.5,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142229096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-06DOI: 10.1016/j.ijnurstu.2024.104895
Qianwen Yan , Chuanmei Zhu , Linna Li , Yunhuan Li , Yang Chen , Xiaolin Hu
<div><h3>Objective</h3><div>To investigate the efficacy of targeted palliative care interventions on depression, quality of life and caregiver burden in informal caregivers of advanced cancer patients, along with the consequences of various intervention types.</div></div><div><h3>Design</h3><div>This study performed a comprehensive review and a meta-analysis of randomized controlled trials.</div></div><div><h3>Method</h3><div>An extensive search was carried out across eight databases, namely, PubMed, Embase, CLNAHL, PsyclNFO, Cochrane, VIP, CNKI, and WANFANG, spanning from the inception of the library to May 4, 2024. Two examiners independently screened the articles and extracted the data according to the eligibility criteria formulated in accordance with the PICOS principles. The meta-analysis was conducted utilizing the StataCorp (version 16.0), estimating the impacts of the interventions through the computation of the standardized mean difference (SMD) and the 95 % confidence interval (CI). Sensitivity analysis was carried out using a one-way-out method. Egger's test and the Duval and Tweedie trim-and-fill methods were used to explore the potential publication bias. The Cochrane risk-of-bias tool was used to evaluate the methodological quality of the included studies, and the overall quality of evidence was evaluated using the GRADE method.</div></div><div><h3>Results</h3><div>This study pooled 16 RCTs (including 2046 informal caregivers) that were published from 2007 to 2023. The meta-analysis results indicated that the targeted palliative care interventions significantly improved depression (SMD = −<!--> <!-->0.74, 95 % CI: [−<!--> <!-->1.25, −<!--> <!-->0.23], <em>P</em> < 0.01) and quality of life (SMD = 0.63, 95 % CI: [0.08, 1.17], <em>P</em> = 0.03), though not in terms of caregiver burden (SMD = −<!--> <!-->0.33, 95 % CI: [−<!--> <!-->0.95, 0.29], <em>P</em> = 0.30) among informal caregivers of advanced cancer patients. Analysis of the subgroups revealed a correlation between short-term interventions, under three months, and the improvement of depression. Strategies focused solely on caregivers have proven effective in alleviating depression. Interventions utilizing offline methods have been shown to not only lower depression levels but also improve the quality of life for caregivers.</div></div><div><h3>Conclusions</h3><div>The targeted palliative care interventions effectively improved informal caregivers' depression and quality of life, yet they fail to markedly lessen the caregiver burden. To better support informal caregivers, interveners ought to adopt personalized strategies based on comprehensive consideration of the duration, format, and delivery methods of the interventions. Simultaneously, further exploration and effort from scholars are necessary to enhance the accessibility of palliative care services, and to effectively incorporate academic research findings into clinical practice.</div></div><div><h3>Registration</h3><
{"title":"The effect of targeted palliative care interventions on depression, quality of life and caregiver burden in informal caregivers of advanced cancer patients: A systematic review and meta-analysis of randomized controlled trials","authors":"Qianwen Yan , Chuanmei Zhu , Linna Li , Yunhuan Li , Yang Chen , Xiaolin Hu","doi":"10.1016/j.ijnurstu.2024.104895","DOIUrl":"10.1016/j.ijnurstu.2024.104895","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the efficacy of targeted palliative care interventions on depression, quality of life and caregiver burden in informal caregivers of advanced cancer patients, along with the consequences of various intervention types.</div></div><div><h3>Design</h3><div>This study performed a comprehensive review and a meta-analysis of randomized controlled trials.</div></div><div><h3>Method</h3><div>An extensive search was carried out across eight databases, namely, PubMed, Embase, CLNAHL, PsyclNFO, Cochrane, VIP, CNKI, and WANFANG, spanning from the inception of the library to May 4, 2024. Two examiners independently screened the articles and extracted the data according to the eligibility criteria formulated in accordance with the PICOS principles. The meta-analysis was conducted utilizing the StataCorp (version 16.0), estimating the impacts of the interventions through the computation of the standardized mean difference (SMD) and the 95 % confidence interval (CI). Sensitivity analysis was carried out using a one-way-out method. Egger's test and the Duval and Tweedie trim-and-fill methods were used to explore the potential publication bias. The Cochrane risk-of-bias tool was used to evaluate the methodological quality of the included studies, and the overall quality of evidence was evaluated using the GRADE method.</div></div><div><h3>Results</h3><div>This study pooled 16 RCTs (including 2046 informal caregivers) that were published from 2007 to 2023. The meta-analysis results indicated that the targeted palliative care interventions significantly improved depression (SMD = −<!--> <!-->0.74, 95 % CI: [−<!--> <!-->1.25, −<!--> <!-->0.23], <em>P</em> < 0.01) and quality of life (SMD = 0.63, 95 % CI: [0.08, 1.17], <em>P</em> = 0.03), though not in terms of caregiver burden (SMD = −<!--> <!-->0.33, 95 % CI: [−<!--> <!-->0.95, 0.29], <em>P</em> = 0.30) among informal caregivers of advanced cancer patients. Analysis of the subgroups revealed a correlation between short-term interventions, under three months, and the improvement of depression. Strategies focused solely on caregivers have proven effective in alleviating depression. Interventions utilizing offline methods have been shown to not only lower depression levels but also improve the quality of life for caregivers.</div></div><div><h3>Conclusions</h3><div>The targeted palliative care interventions effectively improved informal caregivers' depression and quality of life, yet they fail to markedly lessen the caregiver burden. To better support informal caregivers, interveners ought to adopt personalized strategies based on comprehensive consideration of the duration, format, and delivery methods of the interventions. Simultaneously, further exploration and effort from scholars are necessary to enhance the accessibility of palliative care services, and to effectively incorporate academic research findings into clinical practice.</div></div><div><h3>Registration</h3><","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"160 ","pages":"Article 104895"},"PeriodicalIF":7.5,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-04DOI: 10.1016/j.ijnurstu.2024.104893
Selma Kok , Lisette Schoonhoven , Lisette M. Vernooij , Johannes B. Reitsma , Carolien Verstraten , Silke F. Metzelthin , Nienke Bleijenberg , Janneke M. de Man-van Ginkel
<div><h3>Background</h3><div>During acute hospital admission, patients often experience loss of functional status. A low level of physical activity is associated with higher levels of loss of functional status. Stimulating physical activity to maintain functional status is considered essential nursing care. Function Focused Care is a promising approach stimulating physical activity. In a previous study, Function Focused Care in Hospital was deemed feasible.</div></div><div><h3>Objective</h3><div>To determine the effectiveness of Function Focused Care in Hospital compared with usual care on the functional status of hospitalized stroke and geriatric patients.</div></div><div><h3>Design</h3><div>A multicenter stepped wedge cluster trial.</div></div><div><h3>Methods</h3><div>A neurological and a geriatric ward of an academic hospital and a general hospital in the Netherlands participated in this study; each was considered a cluster in the trial. The primary outcome was patients' functional status over time, measured with the Barthel Index and Elderly Mobility Scale. Secondary outcomes were the patients' length of stay, fear of falling, self-efficacy, motivation, resilience, and outcome expectations for functional and exercise activities. Data was collected at hospital admission (baseline), day of discharge, and three and six months after discharge via patient files and questionnaires and analyzed with generalized linear mixed models.</div></div><div><h3>Results</h3><div>In total, we included 892 patients, of which 427 received Function Focused Care in Hospital and 465 received usual care. Although we did not find significant differences in the Barthel Index and Elderly Mobility Scale at discharge or follow-up, we found a significant decrease in the mean length of stay (−<!--> <!-->3.3 days, 95 % CI −<!--> <!-->5.3 to −<!--> <!-->1.1) in favor of the Function Focused Care in Hospital group. In addition, in the Function Focused Care in Hospital group, a larger proportion of patients were discharged to home compared to the control group (38.2 % vs. 29.0 %, p = 0.017), who were discharged more often to a care facility.</div></div><div><h3>Conclusion</h3><div>The length of hospital stay was substantially decreased, and discharge to home was more common in the group receiving Function Focused Care in Hospital with equal levels of independence in Activities of Daily Living and mobility in both groups upon discharge. Although significant differences in the Barthel Index and Elderly Mobility Scale were not found, we observed that neurological and geriatric patients were discharged significantly earlier compared to the control group.</div></div><div><h3>Registration</h3><div><span><span>https://onderzoekmetmensen.nl/en/trial/24287</span><svg><path></path></svg></span> (date of first recruitment: 05-02-2016).</div><div><strong>Tweetable abstract</strong>: Patients receiving Function Focused Care in Hospital were discharged from the hospital 3.3 days earlier and
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