Pub Date : 2024-11-07DOI: 10.1016/j.ijnurstu.2024.104954
Xuerong Zhang, Xiaoping Wang
{"title":"Comment on Raya-Benítez et al. (2024) 'Effectiveness of non-instrumental early mobilization to reduce the incidence of deep vein thrombosis in hospitalized patients'","authors":"Xuerong Zhang, Xiaoping Wang","doi":"10.1016/j.ijnurstu.2024.104954","DOIUrl":"10.1016/j.ijnurstu.2024.104954","url":null,"abstract":"","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"161 ","pages":"Article 104954"},"PeriodicalIF":7.5,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631863","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 : 2024-11-06DOI: 10.1016/j.ijnurstu.2024.104949
Frances Fengzhi Lin , Jacqueline Peet , Lauren Murray , Mahesh Ramanan , Kylie Jacobs , Jane Brailsford , Amelia Osmond , Moreblessing Kajevu , Peter Garrett , Alexis Tabah , Carol Mock , Yingyan Chen
Background
Patient flow problems, including discharge delay and after-hours discharge, have been a consistently major issue, especially for intensive care units (ICUs). Evidence suggests that discharge delay and after-hours discharge are associated with increased ICU and hospital length of stay, leading to worsened patient outcomes and increased healthcare costs. They can also increase ICU readmission and post-ICU mortality. The factors influencing discharge processes are not well elucidated.
Objective
This study aimed to explore the barriers and facilitators to the ICU patient discharge processes in adult ICUs.
Methods
This qualitative exploratory multisite observational study was conducted in three regional adult ICUs in Queensland, Australia. We used staff interviews, fieldnotes, and document analysis as data collection techniques. Data analysis commenced with a deductive content analysis using the Structure, Process, and Outcomes framework. Following this, an inductive process was taken using the Theoretical Domains Framework.
Findings
We conducted 59 staff interviews and analysed the discharge documents across three sites. Four domains, including context and resources, beliefs about consequences, social/professional role and identity, and behaviour regulation, were strongly related to the factors that influenced the discharge processes. The findings revealed barriers to discharge, including finding the right bed, disconnected and ineffective information systems, ineffective communication and coordination within and across teams and departments, and uncertainty and inconsistency in discharge decision making. Facilitators included clarity on professional roles in ICU discharge, effective communication within the ICU team, and context specific strategies to support the discharge processes.
Conclusions
The findings provide an in-depth understanding of the barriers and facilitators to the ICU discharge processes. Multifaceted strategies should be considered to facilitate and manage ICU discharge safely and efficiently, including the use of clearer discharge criteria and guidelines, digital systems that aid communication and coordination, and early planning of ICU patient discharge.
{"title":"Who gets the bed: Factors influencing the intensive care exit block: A qualitative study","authors":"Frances Fengzhi Lin , Jacqueline Peet , Lauren Murray , Mahesh Ramanan , Kylie Jacobs , Jane Brailsford , Amelia Osmond , Moreblessing Kajevu , Peter Garrett , Alexis Tabah , Carol Mock , Yingyan Chen","doi":"10.1016/j.ijnurstu.2024.104949","DOIUrl":"10.1016/j.ijnurstu.2024.104949","url":null,"abstract":"<div><h3>Background</h3><div>Patient flow problems, including discharge delay and after-hours discharge, have been a consistently major issue, especially for intensive care units (ICUs). Evidence suggests that discharge delay and after-hours discharge are associated with increased ICU and hospital length of stay, leading to worsened patient outcomes and increased healthcare costs. They can also increase ICU readmission and post-ICU mortality. The factors influencing discharge processes are not well elucidated.</div></div><div><h3>Objective</h3><div>This study aimed to explore the barriers and facilitators to the ICU patient discharge processes in adult ICUs.</div></div><div><h3>Methods</h3><div>This qualitative exploratory multisite observational study was conducted in three regional adult ICUs in Queensland, Australia. We used staff interviews, fieldnotes, and document analysis as data collection techniques. Data analysis commenced with a deductive content analysis using the Structure, Process, and Outcomes framework. Following this, an inductive process was taken using the Theoretical Domains Framework.</div></div><div><h3>Findings</h3><div>We conducted 59 staff interviews and analysed the discharge documents across three sites. Four domains, including context and resources, beliefs about consequences, social/professional role and identity, and behaviour regulation, were strongly related to the factors that influenced the discharge processes. The findings revealed barriers to discharge, including finding the right bed, disconnected and ineffective information systems, ineffective communication and coordination within and across teams and departments, and uncertainty and inconsistency in discharge decision making. Facilitators included clarity on professional roles in ICU discharge, effective communication within the ICU team, and context specific strategies to support the discharge processes.</div></div><div><h3>Conclusions</h3><div>The findings provide an in-depth understanding of the barriers and facilitators to the ICU discharge processes. Multifaceted strategies should be considered to facilitate and manage ICU discharge safely and efficiently, including the use of clearer discharge criteria and guidelines, digital systems that aid communication and coordination, and early planning of ICU patient discharge.</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"161 ","pages":"Article 104949"},"PeriodicalIF":7.5,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631871","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}
<div><h3>Background</h3><div>Digital technologies promise to reduce nurses' workload and increase quality of care. However, considering the plethora of single and review studies published to date, maintaining a comprehensive overview of digital technologies' impact on nursing and effectively utilizing available evidence is challenging.</div></div><div><h3>Objective</h3><div>This review aims (i) to map published reviews on digital nursing technologies, based on their aims and the specific technologies investigated, to synthesize evidence on how these technologies' uses is associated with (ii) nurses' work-related and organizational factors, professional behavior, and health and work safety and (iii) ethically relevant outcomes for people in need of care.</div></div><div><h3>Design</h3><div>Preregistered overview of reviews (PROSPERO-ID: CRD42023389751).</div></div><div><h3>Setting(s)</h3><div>We searched for systematic reviews in eight databases, five key journals, and reference lists of included reviews published in English until May 21, 2024.</div></div><div><h3>Methods</h3><div>We used the AMSTAR 2 checklist to assess the methodological quality of included reviews reporting associations with nursing outcomes. The extracted data were analyzed by their frequency and narratively synthesized.</div></div><div><h3>Results</h3><div>We identified 213 reviews on digital technologies' uses in the nursing sector. Most of these focused on information and communication technologies. The most frequently reported research objectives encompass technology usage and/or general experiences with it and technology-related consequences for care recipients. Regarding work-related and organizational factors, beneficial impacts were found for the execution of nursing tasks, information management and job control. Depending on the technology type, reviews reported mixed effects for documentation activities, communication/collaboration and mainly negative effects on nurses' workload. Concerning occupational safety and health-related and further nurse outcomes, reviews reported mostly positive effects on nurses' job satisfaction and professional competence. Adverse effects related to mental and physical strain, such as increased frustration, fatigue, and burnout. Regarding ethically relevant outcomes, robotic and telecare technologies had the most reported findings. Most evidence concerned effects on the principles of beneficence/non-maleficence and respect for autonomy.</div></div><div><h3>Conclusions</h3><div>Digital nursing technologies' legitimacy hinges on their impact on patient outcomes and nurses' work, safety, and health. This review identifies a diverse array of these technologies, with both positive and negative effects. However, due to narrative limitations, meta-analysis was impractical. Future research should quantitatively assess the effects of various digital nursing technologies on work, safety, health, and ethical outcomes.</div><div><strong>Tweetable ab
{"title":"Digital technologies in nursing: An umbrella review","authors":"Larissa Schlicht , Johannes Wendsche , Marlen Melzer , Letizia Tschetsche , Ulrike Rösler","doi":"10.1016/j.ijnurstu.2024.104950","DOIUrl":"10.1016/j.ijnurstu.2024.104950","url":null,"abstract":"<div><h3>Background</h3><div>Digital technologies promise to reduce nurses' workload and increase quality of care. However, considering the plethora of single and review studies published to date, maintaining a comprehensive overview of digital technologies' impact on nursing and effectively utilizing available evidence is challenging.</div></div><div><h3>Objective</h3><div>This review aims (i) to map published reviews on digital nursing technologies, based on their aims and the specific technologies investigated, to synthesize evidence on how these technologies' uses is associated with (ii) nurses' work-related and organizational factors, professional behavior, and health and work safety and (iii) ethically relevant outcomes for people in need of care.</div></div><div><h3>Design</h3><div>Preregistered overview of reviews (PROSPERO-ID: CRD42023389751).</div></div><div><h3>Setting(s)</h3><div>We searched for systematic reviews in eight databases, five key journals, and reference lists of included reviews published in English until May 21, 2024.</div></div><div><h3>Methods</h3><div>We used the AMSTAR 2 checklist to assess the methodological quality of included reviews reporting associations with nursing outcomes. The extracted data were analyzed by their frequency and narratively synthesized.</div></div><div><h3>Results</h3><div>We identified 213 reviews on digital technologies' uses in the nursing sector. Most of these focused on information and communication technologies. The most frequently reported research objectives encompass technology usage and/or general experiences with it and technology-related consequences for care recipients. Regarding work-related and organizational factors, beneficial impacts were found for the execution of nursing tasks, information management and job control. Depending on the technology type, reviews reported mixed effects for documentation activities, communication/collaboration and mainly negative effects on nurses' workload. Concerning occupational safety and health-related and further nurse outcomes, reviews reported mostly positive effects on nurses' job satisfaction and professional competence. Adverse effects related to mental and physical strain, such as increased frustration, fatigue, and burnout. Regarding ethically relevant outcomes, robotic and telecare technologies had the most reported findings. Most evidence concerned effects on the principles of beneficence/non-maleficence and respect for autonomy.</div></div><div><h3>Conclusions</h3><div>Digital nursing technologies' legitimacy hinges on their impact on patient outcomes and nurses' work, safety, and health. This review identifies a diverse array of these technologies, with both positive and negative effects. However, due to narrative limitations, meta-analysis was impractical. Future research should quantitatively assess the effects of various digital nursing technologies on work, safety, health, and ethical outcomes.</div><div><strong>Tweetable ab","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"161 ","pages":"Article 104950"},"PeriodicalIF":7.5,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142720194","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 : 2024-10-31DOI: 10.1016/j.ijnurstu.2024.104948
Xiaoxu Wang , Lili Zang , Xueyuan Hui , Xiaoxuan Meng , Shuo Qiao , Liping Fan , Qinghui Meng
<div><h3>Background</h3><div>Cancer imposes significant psychological distress on both patients and caregivers. Dyadic interventions are designed to concurrently address the health problems of both, yet there remains limited evidence as to which specific dyadic interventions yield the most effective outcomes for both partners.</div></div><div><h3>Objectives</h3><div>To systematically synthesize and evaluate the comparative efficacy of various dyadic interventions on a wide range of outcomes within cancer patient-caregiver dyads.</div></div><div><h3>Methods</h3><div>Searches of eight electronic databases from inception to July 2, 2023, were performed. Data extraction and quality assessment were independently conducted by two reviewers utilizing the Cochrane risk of bias tool and the Jadad score. Stata 17.0 was used for network meta-analysis, with the Surface Under the Cumulative Ranking (SUCRA) curve employed to rank interventions based on efficacy for each outcome. Effect sizes were reported using standardized mean difference (SMD) with a 95 % confidence interval (CI), and publication bias was assessed via Egger’s test. The study protocol was registered in PROSPERO under CRD42023467172.</div></div><div><h3>Result</h3><div>A total of 37 studies, spanning 8 countries, were included. According to SUCRA rankings, WeChat couple-based psychosocial support and the eHealth symptom and complication management program were identified as the most effective interventions for improving quality of life in both patients and caregivers (SUCRA = 82.1 %, SMD = 7.30, 95 % CI: 1.02, 13.58; SUCRA = 86.6 %, SMD =<!--> <!-->1.17, 95 % CI: 0.04, 2.31, respectively). Emotionally focused therapy was ranked as the most effective intervention for enhancing dyadic adjustment (SUCRA = 100 %, SMD = 1.63, 95 % CI: 0.91, 2.36; SUCRA = 99.9 %, SMD = 2.04, 95 % CI: 1.26, 2.82, respectively). Couple-based intimacy enhancement and telephone-based dyadic psychosocial interventions were deemed most effective interventions in alleviating anxiety (SUCRA = 88.2 %, SMD = −<!--> <!-->0.83, 95 % CI: −<!--> <!-->1.65, −<!--> <!-->0.00; SUCRA = 95.6 %, SMD = −<!--> <!-->1.08, 95 % CI: −<!--> <!-->1.76, −<!--> <!-->0.41, respectively), while telephone-based dyadic psychosocial intervention and coping skills training were the most efficacious interventions for reducing depression in both partners (SUCRA = 95.2 %, SMD = −<!--> <!-->0.89, 95 % CI: −<!--> <!-->1.55, −<!--> <!-->0.23; SUCRA = 99.8 %, SMD = −<!--> <!-->2.31, 95 % CI: −<!--> <!-->3.27, −<!--> <!-->1.35, respectively). Additionally, caregiver educational program was ranked highest for reducing caregivers burden (SUCRA = 95.6 %, SMD = −<!--> <!-->1.20, 95 % CI: −<!--> <!-->1.55, −<!--> <!-->0.23).</div></div><div><h3>Conclusion</h3><div>The highest-ranked dyadic interventions identified in this analysis offer valuable insights for clinical practice, providing strategies to enhance the quality of life, strengthen dyadic relationships, a
{"title":"Dyadic interventions for cancer patient-caregiver dyads: A systematic review and network meta-analysis","authors":"Xiaoxu Wang , Lili Zang , Xueyuan Hui , Xiaoxuan Meng , Shuo Qiao , Liping Fan , Qinghui Meng","doi":"10.1016/j.ijnurstu.2024.104948","DOIUrl":"10.1016/j.ijnurstu.2024.104948","url":null,"abstract":"<div><h3>Background</h3><div>Cancer imposes significant psychological distress on both patients and caregivers. Dyadic interventions are designed to concurrently address the health problems of both, yet there remains limited evidence as to which specific dyadic interventions yield the most effective outcomes for both partners.</div></div><div><h3>Objectives</h3><div>To systematically synthesize and evaluate the comparative efficacy of various dyadic interventions on a wide range of outcomes within cancer patient-caregiver dyads.</div></div><div><h3>Methods</h3><div>Searches of eight electronic databases from inception to July 2, 2023, were performed. Data extraction and quality assessment were independently conducted by two reviewers utilizing the Cochrane risk of bias tool and the Jadad score. Stata 17.0 was used for network meta-analysis, with the Surface Under the Cumulative Ranking (SUCRA) curve employed to rank interventions based on efficacy for each outcome. Effect sizes were reported using standardized mean difference (SMD) with a 95 % confidence interval (CI), and publication bias was assessed via Egger’s test. The study protocol was registered in PROSPERO under CRD42023467172.</div></div><div><h3>Result</h3><div>A total of 37 studies, spanning 8 countries, were included. According to SUCRA rankings, WeChat couple-based psychosocial support and the eHealth symptom and complication management program were identified as the most effective interventions for improving quality of life in both patients and caregivers (SUCRA = 82.1 %, SMD = 7.30, 95 % CI: 1.02, 13.58; SUCRA = 86.6 %, SMD =<!--> <!-->1.17, 95 % CI: 0.04, 2.31, respectively). Emotionally focused therapy was ranked as the most effective intervention for enhancing dyadic adjustment (SUCRA = 100 %, SMD = 1.63, 95 % CI: 0.91, 2.36; SUCRA = 99.9 %, SMD = 2.04, 95 % CI: 1.26, 2.82, respectively). Couple-based intimacy enhancement and telephone-based dyadic psychosocial interventions were deemed most effective interventions in alleviating anxiety (SUCRA = 88.2 %, SMD = −<!--> <!-->0.83, 95 % CI: −<!--> <!-->1.65, −<!--> <!-->0.00; SUCRA = 95.6 %, SMD = −<!--> <!-->1.08, 95 % CI: −<!--> <!-->1.76, −<!--> <!-->0.41, respectively), while telephone-based dyadic psychosocial intervention and coping skills training were the most efficacious interventions for reducing depression in both partners (SUCRA = 95.2 %, SMD = −<!--> <!-->0.89, 95 % CI: −<!--> <!-->1.55, −<!--> <!-->0.23; SUCRA = 99.8 %, SMD = −<!--> <!-->2.31, 95 % CI: −<!--> <!-->3.27, −<!--> <!-->1.35, respectively). Additionally, caregiver educational program was ranked highest for reducing caregivers burden (SUCRA = 95.6 %, SMD = −<!--> <!-->1.20, 95 % CI: −<!--> <!-->1.55, −<!--> <!-->0.23).</div></div><div><h3>Conclusion</h3><div>The highest-ranked dyadic interventions identified in this analysis offer valuable insights for clinical practice, providing strategies to enhance the quality of life, strengthen dyadic relationships, a","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"161 ","pages":"Article 104948"},"PeriodicalIF":7.5,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683262","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 : 2024-10-31DOI: 10.1016/j.ijnurstu.2024.104947
Mei-di Shen , Xiang-dong Ding , Li Fu , Hong-xiao He , Si-bing Chen , Yin-chu Hu , Chong-kun Wang , Li-hua Ren
Background
A series of multi-sensory interventions are proved to be effective in reducing pain among premature infants. Nevertheless, there lacks a comparison of these interventions to find the most suitable and optimal one for clinical decision-making.
Objective
This systematic review and network meta-analysis aims to compare the effectiveness of various multi-sensory interventions, and to identify the optimal intervention for alleviating pain in premature infants.
Methods
A comprehensive literature search was performed on August 19, 2024 to identify pertinent clinical trials. The Cochrane Risk of Bias (version 2) was used to assess the quality and potential bias of each included study. Network meta-analysis was used to assess the effectiveness of various interventions and to identify the optimal ones.
Results
A total of 18 clinical trials involving 1408 premature infants were included. Three multi-sensory interventions were shown to be superior to routine practice in reducing pain among premature infants, including tactile-kinesthetic intervention, tactile-auditory intervention and tactile-visual-gustatory-olfactory intervention (all, P < 0.05). Among these interventions, tactile-kinesthetic intervention ranks the best for its effectiveness in alleviating procedural pain among premature infants. Subgroup network meta-analysis demonstrated that the tactile-visual-gustatory-auditory-olfactory intervention ranked the best for its effectiveness in reducing pain from invasive procedures, with the tactile-auditory intervention best for non-invasive procedures.
Conclusions
Our study suggests that cautious assessment and identification should be prioritized to select appropriate multi-sensory interventions based on pain procedures, thus to effectively reduce pain in premature infants. Subsequent studies are needed to refine and optimize these strategies for broader application.
{"title":"Comparative effectiveness of multi-sensory interventions for reducing pain among premature infants: A systematic review and network meta-analysis","authors":"Mei-di Shen , Xiang-dong Ding , Li Fu , Hong-xiao He , Si-bing Chen , Yin-chu Hu , Chong-kun Wang , Li-hua Ren","doi":"10.1016/j.ijnurstu.2024.104947","DOIUrl":"10.1016/j.ijnurstu.2024.104947","url":null,"abstract":"<div><h3>Background</h3><div>A series of multi-sensory interventions are proved to be effective in reducing pain among premature infants. Nevertheless, there lacks a comparison of these interventions to find the most suitable and optimal one for clinical decision-making.</div></div><div><h3>Objective</h3><div>This systematic review and network meta-analysis aims to compare the effectiveness of various multi-sensory interventions, and to identify the optimal intervention for alleviating pain in premature infants.</div></div><div><h3>Methods</h3><div>A comprehensive literature search was performed on August 19, 2024 to identify pertinent clinical trials. The Cochrane Risk of Bias (version 2) was used to assess the quality and potential bias of each included study. Network meta-analysis was used to assess the effectiveness of various interventions and to identify the optimal ones.</div></div><div><h3>Results</h3><div>A total of 18 clinical trials involving 1408 premature infants were included. Three multi-sensory interventions were shown to be superior to routine practice in reducing pain among premature infants, including tactile-kinesthetic intervention, tactile-auditory intervention and tactile-visual-gustatory-olfactory intervention (all, <em>P</em> < 0.05). Among these interventions, tactile-kinesthetic intervention ranks the best for its effectiveness in alleviating procedural pain among premature infants. Subgroup network meta-analysis demonstrated that the tactile-visual-gustatory-auditory-olfactory intervention ranked the best for its effectiveness in reducing pain from invasive procedures, with the tactile-auditory intervention best for non-invasive procedures.</div></div><div><h3>Conclusions</h3><div>Our study suggests that cautious assessment and identification should be prioritized to select appropriate multi-sensory interventions based on pain procedures, thus to effectively reduce pain in premature infants. Subsequent studies are needed to refine and optimize these strategies for broader application.</div></div><div><h3>PROSPERO registry</h3><div>CRD42024510352.</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"161 ","pages":"Article 104947"},"PeriodicalIF":7.5,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142578686","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 : 2024-10-28DOI: 10.1016/j.ijnurstu.2024.104937
Jiaqi Li , Yingying Fan , Ruoyu Luo , Yangyang Wang , Na Yin , Wenhao Qi , Tiancha Huang , Ju Zhang , Jiyong Jing
Background
Humanized care is a novel concept in the prevention of delirium, with family involvement being a crucial component. Currently, there is controversy regarding the effectiveness of family involvement in preventing delirium among critically ill patients, and the impact of varying levels of family involvement on delirium prevention remains unclear.
Objective
The purpose of this study is twofold: (a) to investigate the influence of family involvement on delirium among critically ill patients, and (b) to explore the effectiveness of different levels of family involvement in preventing delirium in these patients.
Design
A systematic review and meta-analysis.
Methods
From database inception to July 2024, a comprehensive search was conducted across PubMed, EMBASE, CINAHL, Web of Science, and the Cochrane CENTRAL database. Randomized controlled trials that examined family involvement were included in the review.
Results
This review included a total of 11 randomized controlled trials, encompassing 3113 critically ill patients. Family involvement was found to significantly reduce the incidence of delirium among critically ill patients (RR = 0.46, 95%CI = 0.31 to 0.69), decrease the duration of delirium (WMD = − 2.18, 95 % CI = − 4.14 to − 0.22), and shorten the length of Intensive Care Unit (ICU) stay (WMD = − 1.46, 95%CI = − 2.43 to − 0.50). Three different levels of family involvement—direct participation in care (RR = 0.37, 95%CI = 0.26 to 0.51), family visits and companionship (RR = 0.56, 95 % CI = 0.25 to 1.25), and indirect participation (RR = 0.77, 95 % CI = 0.29 to 2.07)—varies in their effectiveness for delirium prevention.
Conclusions
Family involvement significantly impacts delirium prevention in critically ill patients. The effectiveness of delirium prevention varies depending on the level of family involvement, with direct participation of family members in caregiving demonstrating a more pronounced effect in reducing delirium incidence among critically ill patients.
Registration
The review protocol has been registered in the PROSPERO International prospective register of systematic reviews (CRD42024563095).
{"title":"Family involvement in preventing delirium in critically ill patients: A systematic review and meta-analysis","authors":"Jiaqi Li , Yingying Fan , Ruoyu Luo , Yangyang Wang , Na Yin , Wenhao Qi , Tiancha Huang , Ju Zhang , Jiyong Jing","doi":"10.1016/j.ijnurstu.2024.104937","DOIUrl":"10.1016/j.ijnurstu.2024.104937","url":null,"abstract":"<div><h3>Background</h3><div>Humanized care is a novel concept in the prevention of delirium, with family involvement being a crucial component. Currently, there is controversy regarding the effectiveness of family involvement in preventing delirium among critically ill patients, and the impact of varying levels of family involvement on delirium prevention remains unclear.</div></div><div><h3>Objective</h3><div>The purpose of this study is twofold: (a) to investigate the influence of family involvement on delirium among critically ill patients, and (b) to explore the effectiveness of different levels of family involvement in preventing delirium in these patients.</div></div><div><h3>Design</h3><div>A systematic review and meta-analysis.</div></div><div><h3>Methods</h3><div>From database inception to July 2024, a comprehensive search was conducted across PubMed, EMBASE, CINAHL, Web of Science, and the Cochrane CENTRAL database. Randomized controlled trials that examined family involvement were included in the review.</div></div><div><h3>Results</h3><div>This review included a total of 11 randomized controlled trials, encompassing 3113 critically ill patients. Family involvement was found to significantly reduce the incidence of delirium among critically ill patients (RR = 0.46, 95%CI = 0.31 to 0.69), decrease the duration of delirium (WMD = −<!--> <!-->2.18, 95 % CI = −<!--> <!-->4.14 to −<!--> <!-->0.22), and shorten the length of Intensive Care Unit (ICU) stay (WMD = −<!--> <!-->1.46, 95%CI = −<!--> <!-->2.43 to −<!--> <!-->0.50). Three different levels of family involvement—direct participation in care (RR = 0.37, 95%CI = 0.26 to 0.51), family visits and companionship (RR = 0.56, 95 % CI = 0.25 to 1.25), and indirect participation (RR = 0.77, 95 % CI = 0.29 to 2.07)—varies in their effectiveness for delirium prevention.</div></div><div><h3>Conclusions</h3><div>Family involvement significantly impacts delirium prevention in critically ill patients. The effectiveness of delirium prevention varies depending on the level of family involvement, with direct participation of family members in caregiving demonstrating a more pronounced effect in reducing delirium incidence among critically ill patients.</div></div><div><h3>Registration</h3><div>The review protocol has been registered in the PROSPERO International prospective register of systematic reviews (CRD42024563095).</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"161 ","pages":"Article 104937"},"PeriodicalIF":7.5,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142561414","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 : 2024-10-28DOI: 10.1016/j.ijnurstu.2024.104946
Ruotong Peng , Yunfei Du , Jing Chang , Yongzhen Guo , Shaolong Hu , Xiao Wan , Zeng Cao , Hui Feng
Background
Nudge is an attempt to easily and cheaply influence an individual's health judgments, decisions, or behaviors in nuanced and predictable ways. To date, there are no published reviews of the evidence for or against nudges as health promotion strategies in older adults.
Objective
This review aims to summarize what is known about the impact of various nudges that target different kinds of health behavior in older adults.
Design
A scoping review.
Review methods
We conducted a comprehensive search across the PubMed, Web of Science, Embase, EBSCOhost, and the Cochrane Library databases from the earliest available date to March 2024. To gain a broad understanding of this field, we used relevant search terms related to ‘nudge’ and ‘older adult’. All articles selected and data extracted were double-checked. Nudges were summarized and analyzed according to Thaler's dual-systems theory taxonomy.
Results
Overall, 18 articles were selected. Nudges have been applied to reduce overuse in healthcare (n = 7), enhance vaccination uptake (n = 4), raise dietary intake (n = 3), increase physical activity (n = 1), improve lifestyle management (n = 1), improve hand hygiene (n = 1), and improve terminal treatment (n = 1). Twelve nudges were used to promote health for older adults. Type I nudges included environmental cues, reminders, default options, and feedback. Type II nudges were framing, social norms, social comparison, highlighted suggested choices, pre-commitment, accountability justification, expert authority, and gamification. Most, but not all, nudges have proven to be feasible and effective for health promotion among older adults.
Conclusions
This encouraging evidence suggests there is potential for nudges to promote health among older adults. Future research should tailor nudges to individual and cultural characteristics, explore the most effective nudges and long-term effects, expand nudges to more health domains, implement age-friendly digital nudges, and analyze the nursing economics of nudges.
{"title":"Using nudges to promote health among older adults: A scoping review","authors":"Ruotong Peng , Yunfei Du , Jing Chang , Yongzhen Guo , Shaolong Hu , Xiao Wan , Zeng Cao , Hui Feng","doi":"10.1016/j.ijnurstu.2024.104946","DOIUrl":"10.1016/j.ijnurstu.2024.104946","url":null,"abstract":"<div><h3>Background</h3><div>Nudge is an attempt to easily and cheaply influence an individual's health judgments, decisions, or behaviors in nuanced and predictable ways. To date, there are no published reviews of the evidence for or against nudges as health promotion strategies in older adults.</div></div><div><h3>Objective</h3><div>This review aims to summarize what is known about the impact of various nudges that target different kinds of health behavior in older adults.</div></div><div><h3>Design</h3><div>A scoping review.</div></div><div><h3>Review methods</h3><div>We conducted a comprehensive search across the PubMed, Web of Science, Embase, EBSCOhost, and the Cochrane Library databases from the earliest available date to March 2024. To gain a broad understanding of this field, we used relevant search terms related to ‘nudge’ and ‘older adult’. All articles selected and data extracted were double-checked. Nudges were summarized and analyzed according to Thaler's dual-systems theory taxonomy.</div></div><div><h3>Results</h3><div>Overall, 18 articles were selected. Nudges have been applied to reduce overuse in healthcare (n = 7), enhance vaccination uptake (n = 4), raise dietary intake (n = 3), increase physical activity (n = 1), improve lifestyle management (n = 1), improve hand hygiene (n = 1), and improve terminal treatment (n = 1). Twelve nudges were used to promote health for older adults. Type I nudges included environmental cues, reminders, default options, and feedback. Type II nudges were framing, social norms, social comparison, highlighted suggested choices, pre-commitment, accountability justification, expert authority, and gamification. Most, but not all, nudges have proven to be feasible and effective for health promotion among older adults.</div></div><div><h3>Conclusions</h3><div>This encouraging evidence suggests there is potential for nudges to promote health among older adults. Future research should tailor nudges to individual and cultural characteristics, explore the most effective nudges and long-term effects, expand nudges to more health domains, implement age-friendly digital nudges, and analyze the nursing economics of nudges.</div></div><div><h3>Registration</h3><div>Open Science Framework websites (OSF.IO/PGY25).</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"161 ","pages":"Article 104946"},"PeriodicalIF":7.5,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142561413","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 : 2024-10-26DOI: 10.1016/j.ijnurstu.2024.104945
Paul W. Marshall , Jocelyne R. Benatar , Angie Hennessy , Tia Lindbom , Cara Gallagher , Imran Khan-Niazi , Usman Rashid , Michael Kingsley
<div><h3>Background</h3><div>Cardiac rehabilitation programmes, while demonstrating benefits, face challenges in universal adoption, particularly in New Zealand. This study evaluates the long-term impact of cardiac rehabilitation participation and attendance on survival and readmission rates in the Auckland Health District.</div></div><div><h3>Objective</h3><div>To examine the impact of patient participation in nurse-led lifestyle rehabilitation and physiotherapy exercise rehabilitation on key outcomes, including all-cause mortality, and all-cause, cardiac-specific, and kidney disease readmission rates.</div></div><div><h3>Design</h3><div>Retrospective cohort study.</div></div><div><h3>Setting</h3><div>Auckland Health District, New Zealand.</div></div><div><h3>Participants</h3><div>3331 patients registered in the Auckland cardiac rehabilitation programme between 2016 and 2020.</div></div><div><h3>Methods</h3><div>Data analysis included examining associations between attendance at nurse-led lifestyle and physiotherapy-led exercise sessions and outcomes at 12, 24 months, and 2022 year-end, including all-cause mortality, all-cause readmission, and cardiac-specific readmission rates. Analysis methods included survival analysis, Cox proportional regression, and logistic binary regression, controlling for confounders using propensity score weights and baseline factors.</div></div><div><h3>Results</h3><div>1363 (40.9 %) patients attended at least one lifestyle rehabilitation session (average 5.0 ± 2.9 sessions), 1121 (33.7 %) patients attended at least one exercise rehabilitation session (average 6.8 ± 7.4 sessions), and 649 (19.5 %) patients attended at least one lifestyle and one exercise rehabilitation session. Increased likelihood of participation in rehabilitation was explained by ethnicity, while current and historical tobacco use, history of heart failure, receiving an angiogram, PCI, or other treatment such as medical management or implantable devices were associated with lower odds of participation. Participation in rehabilitation (average 7.9 ± 6.1 sessions) was associated with a higher mean survival estimate (7.6 years vs. 6.4 years, p < 0.001) while Cox proportional hazard regression, controlling for baseline factors and propensity score weights showed that a single session of rehabilitation attended had a 2.1 % decreased risk of mortality (hazard ratio = 0.98, 95 % CI: 0.96 to 0.99, p = 0.29). The cumulative hazard ratio for average attendance (7.9 ± 6.1 sessions) was 0.85 (95 % CI: 0.83 to 0.86, p < 0.001) indicating a 15 % decreased risk of mortality during follow-up. 20 % lower kidney disease readmission rates were observed among participants over the next 24 months (p < 0.05). However, no differences in all-cause or cardiac-specific readmission rates were observed.</div></div><div><h3>Conclusions</h3><div>The study supports the effectiveness of cardiac rehabilitation in improving long-term survival for Auckland Health District
{"title":"Long-term patient outcomes from a multidisciplinary cardiac rehabilitation programme with integrated nurse specialist support: A retrospective cohort study","authors":"Paul W. Marshall , Jocelyne R. Benatar , Angie Hennessy , Tia Lindbom , Cara Gallagher , Imran Khan-Niazi , Usman Rashid , Michael Kingsley","doi":"10.1016/j.ijnurstu.2024.104945","DOIUrl":"10.1016/j.ijnurstu.2024.104945","url":null,"abstract":"<div><h3>Background</h3><div>Cardiac rehabilitation programmes, while demonstrating benefits, face challenges in universal adoption, particularly in New Zealand. This study evaluates the long-term impact of cardiac rehabilitation participation and attendance on survival and readmission rates in the Auckland Health District.</div></div><div><h3>Objective</h3><div>To examine the impact of patient participation in nurse-led lifestyle rehabilitation and physiotherapy exercise rehabilitation on key outcomes, including all-cause mortality, and all-cause, cardiac-specific, and kidney disease readmission rates.</div></div><div><h3>Design</h3><div>Retrospective cohort study.</div></div><div><h3>Setting</h3><div>Auckland Health District, New Zealand.</div></div><div><h3>Participants</h3><div>3331 patients registered in the Auckland cardiac rehabilitation programme between 2016 and 2020.</div></div><div><h3>Methods</h3><div>Data analysis included examining associations between attendance at nurse-led lifestyle and physiotherapy-led exercise sessions and outcomes at 12, 24 months, and 2022 year-end, including all-cause mortality, all-cause readmission, and cardiac-specific readmission rates. Analysis methods included survival analysis, Cox proportional regression, and logistic binary regression, controlling for confounders using propensity score weights and baseline factors.</div></div><div><h3>Results</h3><div>1363 (40.9 %) patients attended at least one lifestyle rehabilitation session (average 5.0 ± 2.9 sessions), 1121 (33.7 %) patients attended at least one exercise rehabilitation session (average 6.8 ± 7.4 sessions), and 649 (19.5 %) patients attended at least one lifestyle and one exercise rehabilitation session. Increased likelihood of participation in rehabilitation was explained by ethnicity, while current and historical tobacco use, history of heart failure, receiving an angiogram, PCI, or other treatment such as medical management or implantable devices were associated with lower odds of participation. Participation in rehabilitation (average 7.9 ± 6.1 sessions) was associated with a higher mean survival estimate (7.6 years vs. 6.4 years, p < 0.001) while Cox proportional hazard regression, controlling for baseline factors and propensity score weights showed that a single session of rehabilitation attended had a 2.1 % decreased risk of mortality (hazard ratio = 0.98, 95 % CI: 0.96 to 0.99, p = 0.29). The cumulative hazard ratio for average attendance (7.9 ± 6.1 sessions) was 0.85 (95 % CI: 0.83 to 0.86, p < 0.001) indicating a 15 % decreased risk of mortality during follow-up. 20 % lower kidney disease readmission rates were observed among participants over the next 24 months (p < 0.05). However, no differences in all-cause or cardiac-specific readmission rates were observed.</div></div><div><h3>Conclusions</h3><div>The study supports the effectiveness of cardiac rehabilitation in improving long-term survival for Auckland Health District ","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"161 ","pages":"Article 104945"},"PeriodicalIF":7.5,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142578684","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 : 2024-10-24DOI: 10.1016/j.ijnurstu.2024.104936
Shiou-Yun Huang , Chia-Yi Chiao , Li-Yin Chien
<div><h3>Background</h3><div>Chronic constipation is a common distressing symptom. Abdominal massage is a safe, noninvasive, and comfortable intervention. However, it is rarely used in formal clinical practice as its' effectiveness for chronic constipation remains unclear.</div></div><div><h3>Objective</h3><div>This systematic review aimed to investigate the effectiveness of abdominal massage on defecation frequency, stool consistency, colonic transit time, constipation symptoms, quality of life, laxative use, and adverse events in adults. Additionally, we aimed to compare the effectiveness of abdominal massage in chronic constipation with different etiologies and types of abdominal massage techniques.</div></div><div><h3>Methods</h3><div>Data from eight English and Chinese electronic databases until May 15, 2024, including randomized controlled trials (RCT) and quasi-experimental studies, were used. The risk of bias was assessed using the Cochrane risk-of-bias tool. Results were synthesized using a random-effect model. This study was registered on the 7th of January 2023 to the International Prospective Register of Systematic Reviews (PROSPERO, CRD42023385243).</div></div><div><h3>Results</h3><div>A total of 23 studies with 1431 participants were eligible for the meta-analysis. Abdominal massage statistically significantly increased weekly defecation frequency (MD = 1.59; 95 % CI 1.06, 2.11; df = 10; I<sup>2</sup> = 82 %), decreased gut transit time (MD = −<!--> <!-->21.53 h; 95 % CI −<!--> <!-->35.94, −<!--> <!-->7.12; df = 3; I<sup>2</sup> = 65 %), and decreased constipation symptoms (SMD = −<!--> <!-->1.06; 95 % CI −<!--> <!-->1.33, −<!--> <!-->0.80; df = 18; I<sup>2</sup> = 79 %) as compared to the control group; however, it did not reduce laxative use (OR: 0.43, 95 % CI 0.14, 1.34, p = 0.15; I<sup>2</sup> = 74 %). In subgroup analysis, the effectiveness of defecation frequency appeared to be greater for functional constipation (SMD = 1.23; 95 % CI 0.87, 1.60; df = 6; I<sup>2</sup> = 86 %) as compared to opioid-induced constipation (SMD = 1.06; 95 % CI 0.61, 1.50; df = 5; I<sup>2</sup> = 5 %) or neurogenic bowel dysfunction (SMD = 0.68; 95 % CI 0.26, 1.10; df = 4; I<sup>2</sup> = 51 %). There were statistically significant differences in defecation frequency between the functional constipation and neurogenic bowel dysfunction groups (p = 0.075). Acupressure and aromatherapy massage had a greater effect on defecation frequency (SMD = 1.63; 95 % CI 1.06, 2.21; df = 3; I<sup>2</sup> = 86 %) than circular massage (SMD = 0.90; 95 % CI 0.57, 1.22; df = 10; I<sup>2</sup> = 68 %) or electric device massages (SMD = 0.83; 95 % CI 0.15, 1.51; df = 1; I<sup>2</sup> = 82 %); however, high heterogeneity and a limited number of articles were encountered. No adverse reactions were observed in the non-neurogenic bowel dysfunction group.</div></div><div><h3>Conclusion</h3><div>This study reveals the efficacy of abdominal massage in alleviating symptoms of chr
{"title":"Effectiveness of abdominal massage on chronic constipation in adults: A systematic review and meta-analysis","authors":"Shiou-Yun Huang , Chia-Yi Chiao , Li-Yin Chien","doi":"10.1016/j.ijnurstu.2024.104936","DOIUrl":"10.1016/j.ijnurstu.2024.104936","url":null,"abstract":"<div><h3>Background</h3><div>Chronic constipation is a common distressing symptom. Abdominal massage is a safe, noninvasive, and comfortable intervention. However, it is rarely used in formal clinical practice as its' effectiveness for chronic constipation remains unclear.</div></div><div><h3>Objective</h3><div>This systematic review aimed to investigate the effectiveness of abdominal massage on defecation frequency, stool consistency, colonic transit time, constipation symptoms, quality of life, laxative use, and adverse events in adults. Additionally, we aimed to compare the effectiveness of abdominal massage in chronic constipation with different etiologies and types of abdominal massage techniques.</div></div><div><h3>Methods</h3><div>Data from eight English and Chinese electronic databases until May 15, 2024, including randomized controlled trials (RCT) and quasi-experimental studies, were used. The risk of bias was assessed using the Cochrane risk-of-bias tool. Results were synthesized using a random-effect model. This study was registered on the 7th of January 2023 to the International Prospective Register of Systematic Reviews (PROSPERO, CRD42023385243).</div></div><div><h3>Results</h3><div>A total of 23 studies with 1431 participants were eligible for the meta-analysis. Abdominal massage statistically significantly increased weekly defecation frequency (MD = 1.59; 95 % CI 1.06, 2.11; df = 10; I<sup>2</sup> = 82 %), decreased gut transit time (MD = −<!--> <!-->21.53 h; 95 % CI −<!--> <!-->35.94, −<!--> <!-->7.12; df = 3; I<sup>2</sup> = 65 %), and decreased constipation symptoms (SMD = −<!--> <!-->1.06; 95 % CI −<!--> <!-->1.33, −<!--> <!-->0.80; df = 18; I<sup>2</sup> = 79 %) as compared to the control group; however, it did not reduce laxative use (OR: 0.43, 95 % CI 0.14, 1.34, p = 0.15; I<sup>2</sup> = 74 %). In subgroup analysis, the effectiveness of defecation frequency appeared to be greater for functional constipation (SMD = 1.23; 95 % CI 0.87, 1.60; df = 6; I<sup>2</sup> = 86 %) as compared to opioid-induced constipation (SMD = 1.06; 95 % CI 0.61, 1.50; df = 5; I<sup>2</sup> = 5 %) or neurogenic bowel dysfunction (SMD = 0.68; 95 % CI 0.26, 1.10; df = 4; I<sup>2</sup> = 51 %). There were statistically significant differences in defecation frequency between the functional constipation and neurogenic bowel dysfunction groups (p = 0.075). Acupressure and aromatherapy massage had a greater effect on defecation frequency (SMD = 1.63; 95 % CI 1.06, 2.21; df = 3; I<sup>2</sup> = 86 %) than circular massage (SMD = 0.90; 95 % CI 0.57, 1.22; df = 10; I<sup>2</sup> = 68 %) or electric device massages (SMD = 0.83; 95 % CI 0.15, 1.51; df = 1; I<sup>2</sup> = 82 %); however, high heterogeneity and a limited number of articles were encountered. No adverse reactions were observed in the non-neurogenic bowel dysfunction group.</div></div><div><h3>Conclusion</h3><div>This study reveals the efficacy of abdominal massage in alleviating symptoms of chr","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"161 ","pages":"Article 104936"},"PeriodicalIF":7.5,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631869","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 : 2024-10-23DOI: 10.1016/j.ijnurstu.2024.104933
Xiaoxia Qiao , Lili Ji , Yaru Jin , Huaxin Si , Yanhui Bian , Wenyu Wang , Qinqin Liu , Jiaqi Yu , Wendie Zhou , Cuili Wang
Objectives
To evaluate the effectiveness of a theory-underpinning exercise intervention among Chinese community-dwelling (pre)frail older adults, and the impacts of intervening late as opposed to intervening early.
Methods
This was a stepped-wedge cluster-randomized trial. Participants were enrolled from six communities in a county of central China from January to November in 2021 (n = 149). A 12-week exercise intervention based on the integration of Health Belief Model, Theory of Planned Behavior and Health Action Process Approach was implemented among 149 community-dwelling (pre)frail older adults during the study period. The primary outcomes were frailty and muscle mass, muscle strength and physical performance. Secondary outcomes included physical disability, fear of falling, cognitive function, depressive symptoms, social support and quality of life. Assessments were conducted at baseline and at 12, 24 and 36 weeks. A multilevel regression model was used for statistical analysis.
Results
The positive effects were statistically significant on frailty (β = − 1.166, p = 0.016), muscle mass (β = 1.499, p = 0.005), handgrip strength (β = 14.758, p < 0.001), physical performance (Short Physical Performance Battery, β = 6.043, p < 0.001), physical disability (Activities of Daily Living: β = 0.462, p = 0.043; Instrumental Activities of Daily Living: β = 0.693, p = 0.049;) and fear of falling (β = − 1.490, p = 0.003), cognitive function (β = − 0.466, p = 0.011), depressive symptoms (β = − 0.541, p < 0.001), social support (β = 27.661, p < 0.001), physical (β = 2.413, p = 0.013) and mental (β = 7.837, p < 0.001) components of quality of life at 0-week postintervention, and most of them persisted at 12- and 24-week postintervention. The effectiveness significantly differed by the time of interventions on muscle mass (β = − 1.217, p = 0.002), 5-time chair stand test (β = − 1.172, p = 0.018), cognitive function (β = 0.600, p = 0.014) and mental component of quality of life (β = − 12.679, p = 0.002).
Conclusion
The theory-underpinning exercise intervention has positive immediate and persistent effects on frailty, frailty-related characteristics as well as physical, mental and social functioning among Chinese community-dwelling (pre)frail older adults. Late intervention attenuated the significant intervention effect.
{"title":"Effectiveness of a theory-underpinning exercise intervention among community-dwelling (pre)frail older adults: A stepped-wedge cluster-randomized trial","authors":"Xiaoxia Qiao , Lili Ji , Yaru Jin , Huaxin Si , Yanhui Bian , Wenyu Wang , Qinqin Liu , Jiaqi Yu , Wendie Zhou , Cuili Wang","doi":"10.1016/j.ijnurstu.2024.104933","DOIUrl":"10.1016/j.ijnurstu.2024.104933","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the effectiveness of a theory-underpinning exercise intervention among Chinese community-dwelling (pre)frail older adults, and the impacts of intervening late as opposed to intervening early.</div></div><div><h3>Methods</h3><div>This was a stepped-wedge cluster-randomized trial. Participants were enrolled from six communities in a county of central China from January to November in 2021 (n = 149). A 12-week exercise intervention based on the integration of Health Belief Model, Theory of Planned Behavior and Health Action Process Approach was implemented among 149 community-dwelling (pre)frail older adults during the study period. The primary outcomes were frailty and muscle mass, muscle strength and physical performance. Secondary outcomes included physical disability, fear of falling, cognitive function, depressive symptoms, social support and quality of life. Assessments were conducted at baseline and at 12, 24 and 36 weeks. A multilevel regression model was used for statistical analysis.</div></div><div><h3>Results</h3><div>The positive effects were statistically significant on frailty (<em>β</em> = −<!--> <!-->1.166, <em>p</em> = 0.016), muscle mass (<em>β</em> = 1.499, <em>p</em> = 0.005), handgrip strength (<em>β</em> = 14.758, <em>p</em> < 0.001), physical performance (Short Physical Performance Battery, <em>β</em> = 6.043, <em>p</em> < 0.001), physical disability (Activities of Daily Living: <em>β</em> = 0.462, <em>p</em> = 0.043; Instrumental Activities of Daily Living: <em>β</em> = 0.693, <em>p</em> = 0.049;) and fear of falling (<em>β</em> = −<!--> <!-->1.490, <em>p</em> = 0.003), cognitive function (<em>β</em> = −<!--> <!-->0.466, <em>p</em> = 0.011), depressive symptoms (<em>β</em> = −<!--> <!-->0.541, <em>p</em> < 0.001), social support (<em>β</em> = 27.661, <em>p</em> < 0.001), physical (<em>β</em> = 2.413, <em>p</em> = 0.013) and mental (<em>β</em> = 7.837, <em>p</em> < 0.001) components of quality of life at 0-week postintervention, and most of them persisted at 12- and 24-week postintervention. The effectiveness significantly differed by the time of interventions on muscle mass (<em>β</em> = −<!--> <!-->1.217, <em>p</em> = 0.002), 5-time chair stand test (<em>β</em> = −<!--> <!-->1.172, <em>p</em> = 0.018), cognitive function (<em>β</em> = 0.600, <em>p</em> = 0.014) and mental component of quality of life (<em>β</em> = −<!--> <!-->12.679, <em>p</em> = 0.002).</div></div><div><h3>Conclusion</h3><div>The theory-underpinning exercise intervention has positive immediate and persistent effects on frailty, frailty-related characteristics as well as physical, mental and social functioning among Chinese community-dwelling (pre)frail older adults. Late intervention attenuated the significant intervention effect.</div></div><div><h3>Trial registration</h3><div>Chinese Clinical Trial Registry ChiCTR2100041981.</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"161 ","pages":"Article 104933"},"PeriodicalIF":7.5,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142578685","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}
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