International Journal of Nursing Studies最新文献

{"title":"Forecasting rehabilitation needs in emerging economies: A multi-country analysis based on the Global Burden of Disease Study 2021","authors":"Lang Chen ,&nbsp;Chuwei Tian ,&nbsp;Zhongkai Bian ,&nbsp;Lijuan Gao ,&nbsp;Wenwen Jiang ,&nbsp;Hang Wu ,&nbsp;Liu Shi ,&nbsp;Qi Yong H. Ai ,&nbsp;Yunfeng Rui ,&nbsp;Hongxing Wang ,&nbsp;Jinyu Wang","doi":"10.1016/j.ijnurstu.2026.105345","DOIUrl":"10.1016/j.ijnurstu.2026.105345","url":null,"abstract":"<div><h3>Background</h3><div>Emerging economies, represented by BRICS countries (Brazil, China, India, Russian Federation and South Africa), have a substantial impact on the global rehabilitation needs. However, the rehabilitation needs of BRICS countries remain unascertained. This study aimed to explore the rehabilitation needs of the BRICS countries from 1990 to 2021 and predict the trend of rehabilitation needs.</div></div><div><h3>Methods</h3><div>Relevant data pertaining to eight condition categories (encompassing 27 individual conditions) requiring rehabilitation were retrieved from the Global Burden of Disease Study 2021. The joinpoint regression models were employed to calculate average annual percentage changes to quantify trends in age-standardized rates. The autoregressive integrated moving average models were used to predict rehabilitation needs until 2036.</div></div><div><h3>Results</h3><div>The number of prevalent cases of total conditions requiring rehabilitation increased from 634 million (95% uncertainty interval [UI] 608–664) in 1990 to 1.093 billion (95% UI 1.056–1.135) in 2021, an increase of 72.2%. The years lived with disability counts of total conditions increased from 79 million (95% UI 60–101) in 1990 to 147 million (95% UI 112–189) in 2021, an increase of 85.6%. Since 1990, the age-standardized prevalence rates of total rehabilitation needs have been decreasing in all BRICS countries. The number of people needing rehabilitation will continue to grow, with 1.469 billion people in BRICS countries requiring rehabilitation services by 2036. The highest contribution to the need for rehabilitation in BRICS countries was musculoskeletal disorders with about 676 million people (95% UI 630–716) across eight condition categories, and hearing loss with 232 million people (95% UI 205–260) among 27 individual conditions.</div></div><div><h3>Conclusions</h3><div>The need for rehabilitation in BRICS countries has increased substantially over the past 32 years and will continue to increase until 2036. Although the rehabilitation needs are based on modeled estimates from the Global Burden of Disease Study 2021, we strongly recommend that rehabilitation services targeting these needs, particularly for musculoskeletal disorders and hearing loss within sensory impairments, be integrated into primary care systems.</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"176 ","pages":"Article 105345"},"PeriodicalIF":7.1,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145995295","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}

{"title":"The effect of postoperative back massage on pain, sleep outcomes and serum cortisol after open-heart surgery: A randomized controlled trial","authors":"Yasemin Özhanlı ,&nbsp;Ayşegül Güneş ,&nbsp;Nuray Akyüz ,&nbsp;Suna Uzun ,&nbsp;Müşerref Kurt ,&nbsp;Oğuz Omay ,&nbsp;Berna Yıldırım Şık ,&nbsp;Şükriye Şahin","doi":"10.1016/j.ijnurstu.2026.105343","DOIUrl":"10.1016/j.ijnurstu.2026.105343","url":null,"abstract":"<div><h3>Background</h3><div>Massage is widely recognized as an effective non-pharmacological intervention for reducing pain and anxiety after cardiac surgery. However, its effects on <strong>sleep outcomes</strong> and <strong>biological stress markers</strong> remain underexplored.</div></div><div><h3>Aim</h3><div>To evaluate the impact of back massage on postoperative pain, subjective and objective sleep outcomes, and serum cortisol levels in patients undergoing open-heart surgery.</div></div><div><h3>Methods</h3><div>A prospective randomized controlled trial was conducted with 72 patients scheduled for elective open-heart surgery. Participants were randomized (1:1) to an intervention group (back massage) or a control group (routine care with light touch). The intervention consisted of three standardized sessions (15–20 min each) on the first postoperative day. Outcomes included pain (Numeric Rating Scale-Pain), subjective sleep quality (Richard–Campbell Sleep Scale), objective sleep duration (smartwatch measurement), and serum cortisol levels. Data were analyzed using repeated-measures analysis of variance and Brunner–Langer tests in a per-protocol population (n = 64).</div></div><div><h3>Results</h3><div>Back massage was associated with significantly longer total sleep duration (p = 0.037) and greater reduction in pain scores, with significant group, time, and group × time effects (p = 0.002, p &lt; 0.001, p = 0.048). Cortisol levels decreased over time in both groups (p &lt; 0.001), but without significant between-group differences. Subjective sleep quality improved in both groups, and analgesic use declined, with no significant variation between groups. No adverse events were observed.</div></div><div><h3>Conclusion</h3><div>This randomized controlled trial demonstrates that back massage is a safe and feasible intervention after open-heart surgery, improving objectively measured sleep duration and reducing pain. By incorporating objective sleep measures and a biological stress marker (serum cortisol), this study provides novel insights that extend beyond the traditionally reported outcomes of pain and anxiety, supporting massage as a complementary strategy within multimodal nursing care.</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"176 ","pages":"Article 105343"},"PeriodicalIF":7.1,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145995296","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}

{"title":"Construction of a classification system for long-term care service needs among the elderly based on cluster analysis and machine learning: A multi-center, cross-sectional study in central China","authors":"Fang Li ,&nbsp;Weihong Huang ,&nbsp;Yuting Zeng ,&nbsp;Yanfang Long ,&nbsp;Jing Peng ,&nbsp;Jianzhong Hu ,&nbsp;Jing Li ,&nbsp;Xi Chen ,&nbsp;Li Li","doi":"10.1016/j.ijnurstu.2026.105344","DOIUrl":"10.1016/j.ijnurstu.2026.105344","url":null,"abstract":"<div><h3>Background</h3><div>Rapid global aging has led to an increasing demand for long-term care services for the elderly; however, current long-term care systems are underdeveloped and under-resourced. It is essential to develop an effective classification system to guide resource allocation that is tailored to the needs of the elderly.</div></div><div><h3>Objectives</h3><div>This study aimed to construct a classification system for long-term care service needs among the elderly based on cluster analysis and machine learning.</div></div><div><h3>Design</h3><div>Multi-center, cross-sectional study.</div></div><div><h3>Settings</h3><div>Community and nursing homes in Changsha, Hunan Province, China.</div></div><div><h3>Participants</h3><div>1270 elderly aged ≥<!--> <!-->65 years, who were randomly divided into the training set (70%) and test set (30%).</div></div><div><h3>Methods</h3><div>Cluster analysis was conducted based on service time from caregivers, nurses, and doctors. Machine learning approaches were used to determine classification criteria based on sociodemographic information and 17 secondary indicators of long-term care service needs. The best model was selected based on its accuracy and area under the curve in the test set and was then interpreted using Shapley Additive exPlanations.</div></div><div><h3>Results</h3><div>Five clusters of needs for long-term care services were identified, with the number and proportion of participants in each cluster as follows: 612 (48.2%), 299 (23.5%), 172 (13.5%), 150 (11.8%), and 37 (2.9%), respectively. The five clusters varied significantly in sociodemographic characteristics and long-term care service needs. The random forest model demonstrated the best predictive performance among the five models tested. The Shapley Additive exPlanations method identified the 10 most influential features that impacted the random forest model predictions.</div></div><div><h3>Conclusions</h3><div>The classification system for long-term care service needs can accurately distinguish among the elderly with varying levels of long-term care needs, guiding optimal service allocation and promoting the sustainable development of the long-term care service system.</div></div><div><h3>Trial registration</h3><div>The trial is registered at the Ethics Committee of Xiangya Hospital, Central South University (No. 202105083). Registration date 05/2021. First recruitment 06/2021.</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"177 ","pages":"Article 105344"},"PeriodicalIF":7.1,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145995297","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}

{"title":"Implementing integrated care for older adults in primary health care: A systematic scoping review","authors":"Mingyao Sun ,&nbsp;Jingyi Liu ,&nbsp;Mo Yi ,&nbsp;Siye Chen ,&nbsp;Yaqi Huang ,&nbsp;Yan Ivy Zhao ,&nbsp;Angela Yee Man Leung ,&nbsp;Zhiwen Wang","doi":"10.1016/j.ijnurstu.2026.105342","DOIUrl":"10.1016/j.ijnurstu.2026.105342","url":null,"abstract":"<div><h3>Background</h3><div>As populations age worldwide, primary health care systems face increasing challenges in addressing the complex health and social needs of older adults. Integrated care offers a promising approach to promote healthy ageing by providing coordinated, person-centred services across care settings. However, there is a lack of synthesised evidence on integrated care implementation in primary health care, which limits our understanding of its full potential.</div></div><div><h3>Objective</h3><div>To map how integrated care for older adults has been implemented in primary health care worldwide, identify the most scalable components, and highlight practice and policy implications for strengthening primary health care systems.</div></div><div><h3>Methods</h3><div>We conducted a scoping review to synthesise evidence on the implementation and outcomes of integrated care interventions for older adults in primary health care settings. We systematically searched PubMed, Embase, and CINAHL for studies published in the past ten years. Eligible studies included interventional designs targeting individuals aged ≥<!--> <!-->60 years and implemented integrated care as defined by the WHO. Data were extracted and analysed using narrative synthesis and frequency analysis.</div></div><div><h3>Results</h3><div>A total of 181 studies across 26 countries were included. Most interventions were community- or primary health care-based, multidisciplinary (91%), and involved cross-sectoral integration (47%). Core components included care coordination/personalised care planning (67%), physical activity (40%), health education (38%), and psychosocial support (29%). Overall, 88% of studies reported positive outcomes, most often at the patient level. However, implementation outcomes such as acceptability (21%), feasibility (19%), and fidelity (9%) were inconsistently assessed. Evidence was dominated by high-income settings, with limited representation from low- and middle-income countries.</div></div><div><h3>Conclusions</h3><div>Integrated care in primary health care shows broad potential to improve outcomes for older adults, particularly when built around care coordination, team-based delivery, and person-centred planning. Scalable models are those that use existing primary health care resources, integrate community health workers, and employ low-cost digital tools. Yet critical gaps remain in implementation fidelity, sustainability, and equity, especially in resource-limited settings. Embedding integrated care within quality improvement cycles can accelerate adoption and adaptation, offering a pathway for primary health care systems worldwide to promote healthy ageing.</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"176 ","pages":"Article 105342"},"PeriodicalIF":7.1,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145995298","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}

{"title":"Digital communication services facilitating nurse–patient dialog for home dwelling older adults: A scoping review","authors":"Katrine Staats ,&nbsp;Ying Jiang ,&nbsp;Xi Vivien Wu ,&nbsp;Ellen Karine Grov ,&nbsp;Ann-Helen Torstveit","doi":"10.1016/j.ijnurstu.2026.105340","DOIUrl":"10.1016/j.ijnurstu.2026.105340","url":null,"abstract":"<div><h3>Background</h3><div>The global aging population presents significant challenges for healthcare systems, as older adults often face chronic illnesses, functional limitations, and emotional challenges. Effective communication between nurses and home-dwelling older adults plays a key role in assessing needs, coordinating services, and ensuring quality care. Digital communication services have emerged as promising tools to enhance nurse–patient dialog. However, barriers such as physical or cognitive impairments, limited digital literacy, and usability challenges hinder their adoption and effectiveness.</div></div><div><h3>Objective</h3><div>This scoping review aimed to map existing evidence on how digital communication services facilitate nurse–patient dialog for home-dwelling older adults.</div></div><div><h3>Design</h3><div>A scoping review was performed following Arksey and O'Malley's framework.</div></div><div><h3>Data sources</h3><div>A systematic search was carried out in April 2024 with an updated search in May 2025, across five electronic databases: Medline, Embase, PsycINFO, CINAHL (EBSCOhost) and Web of Science.</div></div><div><h3>Results</h3><div>A total of 37 studies were included in the review, highlighting the overarching theme of “nodes in the digital nurse-patient communication”, with three main themes: (1) digital communication services, (2) dynamic nurse–patient relationship and, (3) challenges in maintaining effective dialog.</div></div><div><h3>Conclusion</h3><div>Digital communication services, such as mobile applications, telemonitoring systems, and video conferencing, have the potential to enhance nurse–patient interactions by improving safety, efficiency, and emotional well-being. However, success depends on addressing usability challenges and supporting nurses with adequate resources. While digital tools cannot fully replicate trust, empathy, and dignity fostered through in-person interactions, hybrid care models integrating digital tools with in-person visits may offer promising approaches to delivering person-centered, dignified care that empowers older adults to live independently and securely in their homes.</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"176 ","pages":"Article 105340"},"PeriodicalIF":7.1,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145962454","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}

{"title":"The effects of a nurse-led smartphone-based intervention after coronary artery bypass grafting: A randomised controlled trial","authors":"Mohammadamin Mahmoodi ,&nbsp;Mahnaz Antikchi ,&nbsp;Shaghayegh Saeidinasab ,&nbsp;Fatemeh Bakhshi","doi":"10.1016/j.ijnurstu.2026.105341","DOIUrl":"10.1016/j.ijnurstu.2026.105341","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Patients after coronary artery bypass grafting often face suboptimal recovery, including pain, reduced quality of life, and haemodynamic instability, worsened by limited self-care knowledge and inadequate post-discharge support. Nurse-led smartphone-based interventions may offer a scalable solution for resource-limited settings.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;To evaluate the effects of a nurse-led, smartphone-based educational and follow-up intervention on pain, quality of life, and haemodynamic stability in patients undergoing elective coronary artery bypass grafting.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;div&gt;Single-blind, randomized controlled trial.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Settings&lt;/h3&gt;&lt;div&gt;A tertiary cardiac surgery center in Shiraz, Iran, from July 2024 to April 2025.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Participants&lt;/h3&gt;&lt;div&gt;Eighty-four adults undergoing elective coronary artery bypass grafting, randomized (1:1) to intervention or control groups, with 80 completing the study (40 per group).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;The intervention group received a three-phase programme: (1) pre-operative education via videos, messages, and a face-to-face session; (2) in-hospital education and daily symptom monitoring for pain and self-care; (3) 30-day post-discharge follow-up with weekly nurse-led calls and real-time messaging. Controls received standard care with one handout. Outcomes included pain (visual analog scale), quality of life (SF-36 Health Survey), and hemodynamic indices (blood pressure, heart rate). Pain and haemodynamic indices were assessed at baseline, three times daily for four days in the general ward following post-intensive care unit discharge (12 time points), and weekly post-discharge (days 7, 14, 21, 30; 4 time points), totaling 17 assessments. Quality of life was assessed at baseline and 30 days post-discharge. Data were analyzed using Mann–Whitney U tests, t-tests, and repeated-measures analysis of variance.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The intervention group had lower pain scores (in-hospital: 3.96 ± 0.42 vs. 4.29 ± 0.35, p &lt; 0.001, d = −&lt;!--&gt; &lt;!--&gt;0.85, 95% CI -0.50 to −&lt;!--&gt; &lt;!--&gt;0.16; post-discharge: 1.45 ± 0.38 vs. 2.01 ± 0.50, p &lt; 0.001, d = −&lt;!--&gt; &lt;!--&gt;1.26, 95% CI -0.76 to −&lt;!--&gt; &lt;!--&gt;0.36) and reduced post-discharge blood pressure and heart rate. Total quality of life scores showed no significant between-group differences at 30 days (adjusted ANCOVA: adjusted mean difference = 0.15, 95% CI −&lt;!--&gt; &lt;!--&gt;1.27 to 1.57, p = 0.832), while the pain domain improved significantly in the intervention group (p = 0.002, r = −&lt;!--&gt; &lt;!--&gt;0.35). Group-by-time interactions were significant for pain and haemodynamic outcomes (p &lt; 0.05).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;This nurse-led, smartphone-based intervention reduced pain, improved pain-related quality of life, and stabilized haemodynamic parameters post-coronary artery bypass grafting. Easily integrated into nursing practice, it support","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"176 ","pages":"Article 105341"},"PeriodicalIF":7.1,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145962452","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}

{"title":"Why primary caregivers fail to report pediatric pain: A qualitative study","authors":"Qiao Shen ,&nbsp;Xiaoqiong Wei ,&nbsp;Dong Roman Xu ,&nbsp;Xiaoping Jiang ,&nbsp;Hangyang Li ,&nbsp;Hongyao Leng ,&nbsp;Xianlan Zheng","doi":"10.1016/j.ijnurstu.2026.105339","DOIUrl":"10.1016/j.ijnurstu.2026.105339","url":null,"abstract":"<div><h3>Background</h3><div>In many East Asian hospital settings where family members are closely involved in bedside care, caregivers play a crucial role in recognizing and reporting children's pain during hospitalization. Yet they often fail to inform healthcare providers, leading to inadequate interventions and prolonged suffering. While previous studies focused on whether pain is reported, the psychological mechanisms underlying non-reporting remain poorly understood, limiting the development of effective support strategies.</div></div><div><h3>Objective</h3><div>To explore why primary caregivers failed to report pediatric pain to healthcare providers, focusing on their decision-making process and influencing factors.</div></div><div><h3>Design</h3><div>Qualitative descriptive study.</div></div><div><h3>Setting(s)</h3><div>Multiple medical and surgical wards of a tertiary pediatric hospital in Chongqing, China.</div></div><div><h3>Participants</h3><div>Seventeen primary caregivers who observed their child in pain but did not report it to healthcare providers were purposively recruited.</div></div><div><h3>Methods</h3><div>Semi-structured interviews were conducted between January and March 2025. Data were analyzed using directed content analysis guided by Protection Motivation Theory.</div></div><div><h3>Results</h3><div>Five themes and 17 subthemes were identified, revealing that caregivers' failure to report pediatric pain is a dynamic process shaped by attention activation, threat appraisal, coping appraisal, individual factors, and environmental factors. The process often begins with attentional filtering, where pain cues are overlooked due to competing demands or perceived normality. Once attention is activated, caregivers engage in threat and coping appraisals, which may involve underestimating the threat of pain, valuing pain tolerance, doubting reporting efficacy, holding strong self-management beliefs, or anticipating costs. These dual-path appraisals are influenced by personal traits and prior experiences, along with environmental factors like verbal persuasion, observational learning, and healthcare constraints, with some directly impeding communication. Together, these elements interact to suppress reporting, often accompanied by alternative soothing strategies.</div></div><div><h3>Conclusions</h3><div>Caregivers' failure to report pediatric pain is not a simple omission but a result of complex cognitive and contextual processes. Attentional disengagement and biased appraisals, shaped by personal beliefs and environmental cues, jointly suppress reporting behaviors. Understanding these mechanisms offers a foundation for targeted interventions that enhance caregiver awareness, reshape pain perceptions, and promote supportive communication in pediatric care.</div></div><div><h3>Registration</h3><div>Not registered.</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"177 ","pages":"Article 105339"},"PeriodicalIF":7.1,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145961706","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}

{"title":"Strategies to promote effective staff-family relationships in the care of older people in residential aged care settings: A systematic review","authors":"Emily Haesler ,&nbsp;Linda McAuliffe ,&nbsp;Deirdre Fetherstonhaugh ,&nbsp;Kane Solly","doi":"10.1016/j.ijnurstu.2026.105338","DOIUrl":"10.1016/j.ijnurstu.2026.105338","url":null,"abstract":"<div><h3>Background</h3><div>In residential aged care settings, the relationships between family members and care staff are recognised as a factor in high quality care.</div></div><div><h3>Objective</h3><div>To determine the effectiveness of interventions designed to promote constructive staff-family relationships in the care of older people in aged care facilities.</div></div><div><h3>Design</h3><div>Systematic review and planned meta-analysis.</div></div><div><h3>Methods</h3><div>A systematic review was conducted using a comprehensive search, updating a previous review. Searches were conducted in seven electronic databases to 17 December 2024. Risk of bias was assessed by two independent reviewers using the Cochrane Risk of Bias Tool (ROB-2) and Risk of Bias in Non-Randomized Studies of Interventions (ROBINS-I). Statistical analysis was not possible due to incomplete data reporting in most studies. GRADE Certainty of Evidence was conducted using the GRADEPro GDT software.</div></div><div><h3>Results</h3><div>There were nine studies identified. Studies reported outcome measures that reflected characteristics of a constructive staff-family relationship, the experience of staff, the experience of family and outcomes relevant to older people receiving care. There was moderate certainty of evidence that an intervention designed to promote a constructive staff-family relationship might lead to small absolute benefits for older people, particularly reduction in hospital transfers. The evidence for quantifiable benefits for staff and family members was highly uncertain.</div></div><div><h3>Conclusions</h3><div>Through a comprehensive review and evidence evaluation, we have identified that interventions to promote staff-family relationships require long term organisation and staff commitment, may require high intensity and durations to achieve a sustained impact, and the outcomes may be better evaluated using person-level analysis and qualitative data.</div></div><div><h3>Registration number</h3><div>Prospero: CRD42023453919.</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"176 ","pages":"Article 105338"},"PeriodicalIF":7.1,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145956981","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}

{"title":"Effectiveness of Need-Driven Dementia-Compromised Behavior model-based interventions on behavioral and psychological symptoms of dementia: A systematic review and meta-analysis","authors":"Jun-ah Song,&nbsp;Yoosun Yang,&nbsp;Iktae Kim,&nbsp;Jiyeon Kim,&nbsp;Soyeon Hong,&nbsp;Hongjin Cheon","doi":"10.1016/j.ijnurstu.2026.105337","DOIUrl":"10.1016/j.ijnurstu.2026.105337","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Behavioral and psychological symptoms of dementia occur in most people with dementia. The Need-Driven Dementia-Compromised Behavior model interprets symptoms as expressions of unmet needs rather than problematic behaviors, explained through the interaction of background and proximal factors.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;This study aimed to examine the effectiveness of Need-Driven Dementia-Compromised Behavior model-based interventions on behavioral and psychological symptoms in dementia.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Randomized controlled trials published up to October 3, 2025, were systematically searched in PubMed, CINAHL, EMBASE, and Web of Science. The essential criteria of model-based interventions were defined as (A) recognition of behavior as expression, (B) assessment of background and proximal factors, and (C) individualized approach based on assessment. Only interventions meeting all criteria were included. Studies not in English, not peer-reviewed, pharmacological in nature, or not exclusively targeting people with dementia were excluded. Study quality was assessed using the Revised Cochrane risk-of-bias tool, and the certainty of evidence was evaluated using the GRADE methodology. Meta-analysis was conducted using a random-effects model, with all effect sizes calculated immediately post-intervention and adjusted for baseline differences. Subgroup and meta-regression analysis were performed based on criterion A alignment (explicit vs. implicit), residence type (community vs. facility), and intervention level (individual vs. care system).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;39 studies were included in the systematic review, of which 22 were included in the meta-analysis. Need-Driven Dementia-Compromised Behavior model-based interventions showed statistically significant reductions in overall behavioral and psychological symptoms (SMD = −&lt;!--&gt; &lt;!--&gt;0.308, 95% CI: −&lt;!--&gt; &lt;!--&gt;0.589 to −&lt;!--&gt; &lt;!--&gt;0.027). In the analysis of individual symptoms, significant reductions were observed in agitation (SMD = −&lt;!--&gt; &lt;!--&gt;0.391, 95% CI: −&lt;!--&gt; &lt;!--&gt;0.670 to −&lt;!--&gt; &lt;!--&gt;0.111) and depression (SMD = −&lt;!--&gt; &lt;!--&gt;0.431, 95% CI: −&lt;!--&gt; &lt;!--&gt;0.792 to −&lt;!--&gt; &lt;!--&gt;0.071). Subgroup analysis revealed consistent statistically significant effects in interventions explicitly aligned with criterion A and in facility settings, with individual-level and care system-level interventions each showing statistically significant effects on different symptoms. Sensitivity analysis confirmed robust findings.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Need-Driven Dementia-Compromised Behavior model-based interventions alleviated overall behavioral and psychological symptoms of dementia, agitation and depressive symptoms. Subgroup analysis provide evidence supporting interventions that explicitly incorporate the model's core concept and facility-based delivery while suggesting the combination of care system capacity building with ","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"176 ","pages":"Article 105337"},"PeriodicalIF":7.1,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145956982","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}

{"title":"Forecasting long-term care demands for dementia in China (2020–2040): A Markov model analysis of urban-rural disparities","authors":"Peijia Zhu ,&nbsp;Qifan Yang ,&nbsp;Jie Chen ,&nbsp;Liangwen Zhang ,&nbsp;Ya Fang","doi":"10.1016/j.ijnurstu.2025.105328","DOIUrl":"10.1016/j.ijnurstu.2025.105328","url":null,"abstract":"<div><h3>Background</h3><div>Since no cure for dementia has been found, providing accessible long-term care has become a major global public health challenge. The reliance on informal care has become a significant issue in global healthcare systems, especially in regions with limited formal care resources. The impact of dementia care demands at different stages on resource allocation in China remains unclear.</div></div><div><h3>Objective</h3><div>This study projects dementia care costs and workforce gaps from 2020 to 2040 using a nationwide Markov model to analyze long-term care demands under urban–rural disparities.</div></div><div><h3>Design</h3><div>A micro-simulation study.</div></div><div><h3>Methods</h3><div>We developed a Markov model with five health states (healthy, mild, moderate, severe dementia, and death) based on a Chinese aging cohort, using a 1-year cycle. The model integrated multi-source data (Chinese Longitudinal Healthy Longevity Survey, United Nations projections, official statistics, and surveys) to project age, gender, and urban–rural specific changes in dementia care demands among the population aged 65 and above. Scenario analyses (low and high standards) were conducted to predict care costs and workforce demands from both formal and informal care perspectives over 20 years.</div></div><div><h3>Results</h3><div>By 2040, China's dementia population is forecast to reach 29.83 million, with mild dementia accounting for 60.32 % of cases. Informal care will remain dominant, with workforce gaps ranging from 3.37 million (low standard) to 5.78 million (high standard). The burden is heaviest among rural females aged 65–69, but overall, urban areas face higher burdens than rural ones. Cumulative long-term care costs over 20 years are estimated to range from US$387.74 million (low standard, 0.0026 % of 2020 GDP) to US$937.52 million (high standard, 0.0064 % of 2020 GDP), driven primarily by increasing new dementia cases due to population aging.</div></div><div><h3>Conclusions</h3><div>Our study highlights the urgent need for enhanced informal care support, early screening for mild dementia, and an accessible long-term care system to address growing challenges. The findings provide a foundation for developing a visualization tool to support real-time policy decision-making in dementia care resource planning.</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"176 ","pages":"Article 105328"},"PeriodicalIF":7.1,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145956983","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}