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AnteayerInternacionales

Evidence‐Based CKD Prevention Strategies for Healthcare Professionals: Focusing on Primary and Secondary Prevention in Conservative Care

ABSTRACT

Background

Chronic kidney disease (CKD) is a significant public health problem that requires effective preventive and conservative methods to limit morbidity and death.

Aim

This study aims to give clinical practice an evidence-based basis for the clinical practice of healthcare professionals by methodically looking for the best available data on conservative strategies and CKD prevention in high-risk and early-stage patients.

Methods

The 6S evidence resource model was followed and states that evidence retrieval was done top-down, gathering necessary studies from January 2014 to July 30, 2024. Databases searched included BMJ Best Practice, DynaMed, NICE, GIN, SIGN, JBI Evidence Synthesis, JBI Evidence Implementation, Cochrane Library, and PubMed. Following the JBI grade of evidence and recommendation methodology, two reviewers independently examined and assessed the literature, extracting and summarizing evidence.

Results

Seventy-nine publications were identified: 18 guidelines, 1 randomized controlled trial, 2 expert consensus statements, 36 evidence summaries, and 22 systematic reviews and meta-analyses. Key findings were summarized across eight aspects: risk assessment and early detection, risk factors and prevention of genetic factors, management of diabetic nephrology, impact of bariatric surgery on preventing CKD, screening and diagnosis, treatment and prevention strategies, lifestyle modifications, and CKD prevention.

Linking Evidence to Action

This study summarized the best evidence for preventing CKD from eight aspects, which can help clinical or community medical professionals develop and apply CKD preventive strategies for high-risk groups and early-stage patients. By using these evidence-based strategies, healthcare professionals can reduce the incidence and progression of CKD, leading to fewer hospitalizations, improved kidney function preservation, and enhanced long-term survival and quality of life for patients. Future research should address identified gaps and explore the implementation of these strategies in diverse clinical settings.

Mindfulness‐Based Interventions to Reduce Stress and Depression Among Midwives and Nurses: A Meta‐Analysis Study

ABSTRACT

Background

Mindfulness-Based Interventions (MBIs) have gained traction in various healthcare settings, particularly for stress reduction among healthcare professionals. This meta-analysis aimed to evaluate the effectiveness of MBIs on reducing stress and depression in obstetrical nurses.

Methods

A comprehensive literature search was done across multiple databases, including Cochrane Library, PsycINFO/PsycNet, PubMed/MEDLINE, Web of Science, and Google Scholar. The risk of bias for each included study was assessed using the Cochrane Risk of Bias Tool. Subgroup analyses were done according to intervention time (less than 8 weeks, 8 weeks, more than 8 weeks) and population. Meta-analysis was done using random-effects models. Effect sizes were calculated using standardized mean differences (SMD). Heterogeneity was assessed using the I 2 statistic.

Results

The sample size in 55 studies was 4612 nurses and midwives (2904 in the intervention group and 1708 in the control group). The meta-analysis showed a significant overall effect of MBIs on reducing stress levels (SMD = −0.71; 95% CI [−0.97, −0.44]; p < 0.001), and depression (SMD = −0.74; 95% CI [−1.35, −0.13]; p < 0.001) among midwives and nurses. Subgroup analysis showed that the effects of intervention duration on reducing stress (X 2 = 3.01, p = 0.220) was not significant, but its effect on depression (X 2 = 61.46, p = 0.000) was significant.

Linking Evidence to Action

Healthcare organizations should integrate structured MBIs into staff wellness initiatives to promote mental well-being. Nursing education programs can include mindfulness components to strengthen coping skills. Future work should also examine combined mindfulness–CBT programs (e.g., MINDBODYSTRONG) and address organizational factors contributing to burnout for a more comprehensive approach.

Network Analysis of Self‐Efficacy and Professional Resilience in Emergency Nurses: A Multi‐Center Cross‐Sectional Study

ABSTRACT

Objective

This study aimed to investigate the network structural characteristics of self-efficacy and professional resilience among emergency nurses, identify core nodes within the network, and elucidate the key interactive mechanisms between these constructs.

Design

Descriptive cross-sectional study.

Methods

A multi-center cross-sectional study was conducted from January to February 2025, involving 612 emergency nurses from 20 hospitals in Sichuan, China. Data were collected using a self-administered demographic questionnaire, the General Self-Efficacy Scale, and the Chinese Emergency Nurse Professional Resilience Tool. An adjacent network integrating professional resilience and self-efficacy was developed. Key covariates—including title, position, tenure in the hospital or emergency department, education, and exposure to workplace violence—were included as control variables. Network precision and stability were evaluated using the correlation stability coefficient and confidence intervals for edge weights. To further test the robustness of the network model, sensitivity analyses were performed by adding each significant covariate to the original model. The Network Comparison Test was then used to compare the covariate-adjusted and unadjusted networks, assessing differences in network structure, overall strength, and edge weights.

Results

The analysis identified S9 as the central node in the network. The overall network showed satisfactory stability and precision. The Network Comparison Test showed no significant differences in network structure or global strength between the adjusted and unadjusted models, indicating that the network was stable and robust to covariate adjustment.

Conclusion

This network analysis revealed the interaction mechanisms between self-efficacy and professional resilience among emergency nurses through contemporaneous network modelling and identified S9 as the core node, suggesting that this coping strategy plays a key role in regulating psychological resources. The overall network demonstrated good stability and precision, with no statistically significant differences between the adjusted and unadjusted models according to the Network Comparison Test. These findings indicate that the network structure was robust to covariate adjustment and provide a reference for developing and optimising intervention strategies to enhance professional resilience among emergency nurses.

Implications

For Emergency Nurses and the Management of Emergency Nursing Practice: What problem does this study address?

This study addresses the gap in understanding how self-efficacy and occupational resilience interact in emergency nurses under high-stress conditions.

Key Findings

A contemporaneous network analysis revealed a central node linking self-efficacy and resilience, highlighting key pathways in their mutual influence.

Impact

The findings offer practical guidance for emergency nursing management, supporting the development of targeted strategies to strengthen nurses' resilience, enhance professional competence, and improve the quality of emergency care.

Reporting Method

This study is reported using the STROBE guidelines.

Patient or Public Contribution

No Patient or Public Involvement: This study did not include patient or public involvement in its design, conduct, or reporting.

Ethical Sensitivity as Mediator Between Conflict and Decision‐Making: A Cross‐Sectional Study of ICU Nurses

ABSTRACT

Aims

To examine the relationship between ethical conflicts and ethical decision-making ability, ethical sensitivity and demographic factors as mediator/moderator roles.

Design

A cross-sectional survey was conducted from June to December 2024.

Methods

This study involved 503 intensive care unit nurses from eight tertiary hospitals across Zhejiang, Guangdong and Guangxi provinces. Participants completed validated instruments including the Ethical Conflict Nursing Questionnaire-Critical Care Version, the Chinese Moral Sensitivity Questionnaire-Revised version and the Chinese Version of Judgement About Nursing Decision. SPSS 27.0 was used for descriptive statistics and Pearson correlation analysis, while PROCESS macro handled mediation and moderation analysis.

Results

The relationship between ethical conflict and decision-making ability was significantly mediated by both moral responsibility/strength and burden, with the latter demonstrating a stronger indirect effect. Furthermore, exploratory moderated mediation analysis showed that this mediation model varied significantly across different levels of work experience and types of intensive care unit. Given the exploratory nature of these findings, they require verification in future confirmatory studies.

Conclusions

The association between ethical conflict and decision-making ability was mediated by ethical sensitivity. This pathway was moderated by work environment and qualifications, indicating the need for tailored interventions.

Implications for the Profession and/or Patient Care

Developing nurses' ethical sensitivity is a key strategy for managers aiming to improve ethical decision-making when nurses face ethical conflicts.

Impact

This study addressed ambiguous findings regarding the relationship between ethical conflict and nurses' decision-making ability. For nurse managers, fostering ethical sensitivity among staff represents a key strategy for mitigating the ethical conflicts that are negatively associated with decision-making ability.

Reporting Method

The strengthening the reporting of observational studies in epidemiology statement (STROBE) was followed.

Patient or Public Contribution

No patient or public contribution.

Trial Registration

Chinese Clinical Trial Registry (ChiCTR): MR-33-24-032956

Relationship Between Sleep and Cognitive Frailty in Older Adults: A Systematic Review and Meta‐Analysis

ABSTRACT

Aim

To explore the relationship between sleep and cognitive frailty in older adults.

Design

A systematic review and meta-analysis.

Data Sources

The Web of Science, Cochrane Library, CINAHL, Embase, PsycINFO and PubMed databases were searched from inception to October 28, 2024.

Methods

Two investigators independently conducted literature screening, data extraction and quality assessment. The Joanna Briggs Institute Critical Appraisal Tool and Newcastle–Ottawa Scale were used to evaluate methodological quality. This review followed PRISMA guidelines.

Results

This review included 13 articles involving 14,223 individuals, and 10 studies included in the meta-analysis. Across 13 studies, the overall prevalence of cognitive frailty was 25%. Sleep problems were categorised into four categories; the results reported that poor sleep quality, long sleep time and insomnia were correlated with the presence of cognitive frailty. However, the relationship between short sleep time and cognitive frailty was not significant.

Conclusions

This review quantitatively suggested that sleep parameters such as long sleep time, insomnia and poor sleep quality were correlated with the presence of cognitive frailty. Future research should adopt longitudinal designs and use validated instruments to measure both quantitative and qualitative aspects of sleep, thereby facilitating a thorough examination of the strength of the relationship between sleep and cognitive frailty, as well as the direction of causality.

Impact

The review highlights the need to integrate comprehensive sleep assessments and targeted interventions into nursing care plans for older adults to enhance their sleep health. The findings will provide support for the development of effective interventions to prevent and manage cognitive frailty in the older population.

Patient or Public Contribution

No patient or public contribution.

Midwives' Perception Towards Male Partners' Involvement in Labour Companionship: A Qualitative Study

ABSTRACT

Background

Labour companionship is a recommendation by WHO that health authorities enable women to choose a companion during labour to ensure a safe and dignified labour experience for the birthing woman. However, most healthcare facilities in low- and middle-income countries do not necessarily consider this maternal need, which hampers a positive maternal experience during labour.

Objective

This study aims to examine midwives' perception towards the involvement of male partners in labour companionship.

Methods

An exploratory phenomenological approach was chosen and semi-structured interviews were used for this study.

Results

The four main themes identified in this study include ‘Understanding of male partners' involvement in labour companionship’, ‘Involvement of midwives in decision-making’, ‘Barriers to male partners' involvement in labour companionship’ and ‘Facilitators of male partners' involvement in labour companionship’.

Conclusion and Implications

This study found a lack of understanding among midwives of the significance of male partners' involvement in labour companionship; and the identification of hierarchical and authoritarian leadership as a barrier to midwives' participation in decision-making highlights the need for transformational leadership styles to empower midwives. Overall, the findings of this study can inform maternity care policy as well as resource development, education and professional training in the field of midwifery.

The Relationships Among Family Involvement, Diabetes Self‐Management and Glycaemic Control in Patients With Type 2 Diabetes: A Cross‐Sectional Study

ABSTRACT

Aims

To investigate diabetes family involvement, including supportive and nonsupportive family behaviours in China, and explore the relationships among opposite forms of family involvement, diabetes self-management and glycaemic control.

Design

A cross-sectional study.

Methods

Type 2 diabetes patients were recruited from hospitals in Nanjing, Shanghai and Jinan, and communities across China, between April 2023 and August 2023. A total of 1648 patients completed questionnaires regarding diabetes family involvement, diabetes self-management, perceived glycaemic control and patient characteristics. Data analysis was conducted using SPSS 26.0 and PROCESS macro.

Results

The mean scores for supportive and nonsupportive family behaviours were 19.14 out of 40 and 12.47 out of 30, respectively, resulting in an overall family involvement score of 6.67. Overall family involvement, especially supportive family behaviours, was positively related to diabetes self-management and perceived glycaemic control, whereas nonsupportive family behaviours were not. Diabetes self-management partially mediated the relationships between both overall family involvement and supportive family behaviours with perceived glycaemic control.

Conclusion

Diabetes family involvement was suboptimal. Overall family involvement, especially supportive family behaviours, could not only directly improve glycaemic control but also indirectly enhance it through promoting diabetes self-management.

Implications for the Profession and/or Patient Care

The findings highlight the importance of promoting supportive family involvement and patient self-management in diabetes management.

Impact

This study endorses the necessity for healthcare professionals to integrate the family unit into diabetes management and implement interventions at the family unit level, to address the neglect of families in current interventions. It also advocates for promoting supportive family involvement rather than all family involvement in future interventions. Promoting supportive family involvement and patient self-management can better improve patients' glycaemic control and alleviate the burden on medical and social systems.

Reporting Method

This study adheres to the STROBE guideline of reporting.

Patient or Public Contribution

No Patient or Public Contribution.

Dysphagia in Head and Neck Cancer Patients: A Qualitative Meta‐Synthesis of Patient and Caregiver Experiences and Perspectives

ABSTRACT

Background

Dysphagia not only affects the nutritional intake of head and neck cancer (HNC) patients but may also lead to social avoidance, emotional fluctuations, and a decline in life confidence. Furthermore, dysphagia places an additional psychological and physical burden on caregivers, significantly altering their lifestyles.

Method

This study employed a qualitative systematic review approach to comprehensively analyse the experiences and coping strategies of HNC patients and their caregivers in relation to dysphagia. Relevant qualitative studies published from the inception of the database through September 2024 were selected. The quality of the studies was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Qualitative Research (2016), and a meta-aggregation method was applied to synthesise and categorise the research themes. This study standardised the presentation of results in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines.

Results

A total of 14 studies were included, resulting in 63 research outcomes, which were consolidated into 12 new categories and integrated into 4 main themes: (1) the impact of dysphagia on daily life; (2) coping with the changes caused by dysphagia; (3) understanding of dysphagia and related needs; and (4) the physiological and psychological challenges faced, and the efforts to seek support.

Conclusions

The dual physiological and psychological challenges posed by dysphagia profoundly affect patients' daily lives, prompting ongoing adjustments to cope with these changes. Both patients and caregivers have a limited understanding of dysphagia but exhibit a strong need for support. These findings underscore the importance of providing comprehensive, individualised support for patients and caregivers to improve their quality of life and coping experiences.

Patient or Public Contribution

No Patient or Public Contribution. This study aims to analyse and synthesise the experiences and perspectives of patients and their caregivers reported in existing research. As no original data were collected and no direct interaction with patients or the public occurred, specific patient or public contributions are not included.

Identification of the Central Symptoms of Multidimensional Frailty Among Older Adults Using the Tilburg Frailty Indicator: A Network Analysis

ABSTRACT

Background

Symptom networks offer a new approach to explore the relationships among various symptoms and provide information for optimising precise symptom management strategies. However, no previous studies have identified the central symptoms of multidimensional frailty.

Design

A cross-sectional study was conducted from December 2023 to March 2024 in China.

Settings and Participants

A total of 933 community-dwelling older adults (aged 60 years or older) in China were recruited via convenience sampling.

Methods

Sociodemographic variables, clinical variables and scores on the Tilburg Frailty Indicator were assessed in all participants. The qgraph package and IsingFit package of R software were applied to construct the symptom network. Three node centrality indices (strength, betweenness and closeness) and the expected influence were calculated to identify the central symptoms of the multidimensional frailty network. All statistical analyses were performed in R.

Results

A total of 933 individuals were surveyed in this study, including 472 (50.6%) females. The median age of all participants was 71.0 years. A total of 408 subjects were assessed as multidimensional frailty. The prevalence of multidimensional frailty was 43.7%. The centrality indices revealed that ‘difficulty in walking’, ‘difficulty in maintaining balance’, and ‘feeling down’ were the symptoms with the largest strength and expected influence values.

Conclusion

This study primarily utilised network analysis to construct a symptom network of multidimensional frailty among community-dwelling older adults. The findings revealed that difficulty in walking, difficulty in maintaining balance, and feeling down were the most central symptoms.

Implications

This study identified the central symptoms of multidimensional frailty in older adults, which may serve as primary intervention targets. Nursing staff could incorporate targeted physical and psychological interventions into person-centred care plans.

Reporting Methods

This study was reported in accordance with the STROBE guidelines.

Patient or Public Contribution

No patient or public contribution was involved in this study.

The Role Transition Journey of Spousal Caregivers of People Living With Dementia: A Meta‐Synthesis of Qualitative Studies

ABSTRACT

Aim

To explore the role transition journey of spousal caregivers of people living with dementia based on transition theory.

Design

A meta-synthesis.

Methods

This review employed a directed content analysis approach to systematically synthesise qualitative evidence. The findings were reported in accordance with the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) guidelines and the Joanna Briggs Institute (JBI) Manual for Evidence Synthesis.

Data Sources

A comprehensive search was conducted in eight electronic databases for studies published from the inception of each database to November 2024.

Results

This review ultimately included a total of 31 studies. Three themes were identified, including role stage, role transition properties and role transition conditions of spousal caregivers of people living with dementia. Role stage of spousal caregivers of people living with dementia encompassed seven sub-themes; role transition properties of spousal caregivers of people living with dementia included five sub-themes; role transition conditions of spousal caregivers of people living with dementia involved six sub-themes.

Conclusions

This review synthesises evidence to explore the role transition journey of spousal caregivers of people living with dementia. The role transition properties highlight the impact of critical points and events, as well as caregivers' awareness, engagement, change and difference and transition time span during their role transition journey. The role transition conditions emphasise that personal meanings, cultural beliefs and attitudes, socioeconomic status, preparation and knowledge, as well as community and society simultaneously influence the role transition journey of the caregivers.

Reporting Method

The Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) guided the reporting of the study.

Patient or Public Contribution

No patient or public contribution.

Trial Registration

PROSPERO registration number: CRD 42024623402

Absolute Versus Relative Skin Temperature as Early Warning Indicator for Pressure Injury: A Systematic Review and Meta‐Analysis

ABSTRACT

Aims

Skin temperature, including absolute temperature (at bony prominence areas under long-term compression) and relative temperature (the difference between bony prominence and adjacent control area), may serve as early warning indicators for PI. However, the optimal indicator remains unclear. This meta-analysis therefore synthesises evidence on their association with PI risk to identify the best indicator and evaluate its early-warning accuracy.

Design

Systematic review and meta-analysis.

Methods

We included prospective cohort studies of adult patients investigating longitudinal associations between skin temperature and subsequent PI development. We pooled standardised mean difference (SMD) and odds ratios, complemented by summary receiver operating characteristic (SROC) curve analysis. The overall quality of evidence was evaluated using the GRADE method.

Data Sources

We researched PubMed, Embase, CINAHL, Cochrane Library (CENTRAL), Wanfang and CNKI databases from inception to September 25, 2024.

Results

After screening 1354 titles and abstracts, ten studies comprising 1742 participants were included in the final synthesis. No significant difference in absolute temperature (combined SMD) was found between the PI and non-PI groups (seven studies included). In addition, decreased relative temperature (< −0.1°C) was associated with a 16-fold increased likelihood of PI (95% CI 6.38–40.19, I 2 = 79.4%) (three studies included), with the SROC curve analysis showing an AUC of 0.776. According to GRADE, the evidentiary certainty was very low for AT and low for RT.

Conclusions

Relative temperature is significantly related to the risk of PI, supporting its role as a promising early warning indicator. Future studies should establish a standardised measurement protocol to facilitate its clinical application.

Implications for the Profession

Monitoring skin temperature changes holds promise as a non-invasive tool for early warning of PI risk. However, the amount and quality of available evidence limit our confidence in these findings, underscoring the need for further research before a definitive conclusion can be drawn.

Reporting Method

This study followed PRISMA guidelines.

Patient or Public Contribution

No patient or public contribution.

Trial Registration

PROSPERO CRD42024550099

A Scoping Review of Available Scales and Tools Used to Measure Obstetric Violence

ABSTRACT

Aim

To identify and describe instruments used to assess obstetric violence and evaluate their methodological quality and psychometric properties.

Design

A scoping review.

Data Sources

Ten databases [Medline (via PubMed), Web of Science, the Cochrane Library, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), SinoMed, Wanfang Database, China National Knowledge Infrastructure (CNKI), VIP Database and China Medical Journal Full-text Database] were searched from inception to June 2025.

Methods

Studies focusing on the development or validation of obstetric violence measurement tools were eligible for this review. Methodological quality and psychometric properties were evaluated using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist and criteria.

Results

A total of 19 studies encompassing 25 obstetric violence measurement tools were included. These studies were conducted in 15 countries between 2018 and 2025. The tools targeted postnatal and pregnant women, healthcare providers, students and other populations. Most studies reported data on content validity, structural validity and internal consistency. Limited information was available on cross-cultural validity/measurement invariance, reliability, measurement error, criterion validity, hypotheses testing for construct validity and responsiveness.

Conclusion

This review identified multiple obstetric violence instruments used across diverse populations and settings. Whilst the methodological quality and measurement properties of the included tools were sub-optimal, they nevertheless provide a foundation for the timely assessment of obstetric violence and subsequent research.

Implications for the Profession

Future research should prioritise the establishment of a unified definition of obstetric violence, alongside the development, adaptation and rigorous validation of measurement instruments to enhance their reliability and validity.

Impact

This review underscores the need for maternity care professionals and educators to critically evaluate existing tools for measuring obstetric violence, given their current methodological limitations.

Reporting Method

The PRISMA Extension for Scoping Reviews (PRISMA-ScR) checklist.

Patient or Public Contribution

No patient or public contribution.

Effectiveness of Health Coaching Interventions on Anxiety, Depression, Self‐Management Behaviors, Self‐Efficacy, and Quality of Life Among Older Adults: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials

ABSTRACT

Background

Health coaching has emerged as a promising intervention to improve health outcomes in older adults. However, its effectiveness has not been comprehensively synthesized.

Aim

To evaluate the effectiveness of health coaching interventions on anxiety, depression, quality of life, self-management behavior, and self-efficacy among older adults.

Methods

A systematic search of six English databases (PubMed, Scopus, CINAHL, Cochrane Library, APA PsycInfo, and ProQuest Dissertations & Theses Global) was conducted from inception to October 20, 2024. Standardized mean difference (SMD) and 95% confidence interval (CI) were calculated using meta-analysis with random or fixed effects. Sensitivity analyses, subgroup analyses, and publication bias tests were also performed.

Results

Thirty-five randomized controlled trials (RCTs) involving 20,200 older adults were included in this review. Meta-analysis results indicated that health coaching interventions could significantly improve anxiety (SMD: −0.09; 95% CI: −0.15, −0.04; I 2: 0%), quality of life (SMD: 0.22; 95% CI: 0.05, 0.39; I 2: 76%), self-management behaviors (SMD: 1.15; 95% CI: 0.45, 1.86; I 2: 95%), and self-efficacy (SMD: 0.18; 95% CI: 0.02, 0.33; I 2: 69%) among older adults, but had no significant effects on depression (SMD: −0.26; 95% CI: −0.64, 0.12; I 2: 98%).

Linking Evidence to Action

Health coaching interventions may enhance the well-being of older adults. However, the certainty of the current evidence was generally very low to moderate, and substantial heterogeneity existed across studies. Therefore, these findings should be interpreted with caution. More high-quality RCTs with extended follow-up, as well as analyses of differential effects across demographic information, are needed to provide more robust and generalizable evidence.

Effects of Non‐Pharmacological Interventions on Loneliness and Social Isolation in Cancer Patients: A Systematic Review and Network Meta‐Analysis

ABSTRACT

Background

Loneliness and social isolation are prevalent and persistent in cancer patients, affecting their psychosocial adjustment. Non-pharmacological interventions have been shown to be effective in previous studies; however, the most effective types of non-pharmacological interventions for this population remain unclear.

Aim

The aim of this systematic review and network meta-analysis (NMA) was to synthesize the existing evidence and compare the effectiveness of different types of non-pharmacological interventions in treating loneliness and social isolation among cancer patients.

Methods

A systematic search was conducted in PubMed, Web of Science, Cochrane Library, Embase, CINAHL, PsycINFO, and MEDLINE databases from their inception to December 2024. Randomized controlled trials (RCTs) evaluating non-pharmacological interventions targeting loneliness and social isolation in cancer patients were included. NMA was performed using Stata 17.0 software under a frequentist framework.

Results

A total of 13 RCTs were included, including 9 non-pharmacological interventions and 1151 cancer patients. In order of probability, group logotherapy (SUCRA: 99.9%, SMD: −1.62, 95% CI: −2.23 to −1.01) was the most effective intervention for alleviating loneliness and social isolation, followed by psychoeducational therapy (SUCRA: 76.9%, SMD: −0.62, 95% CI: −1.16 to −0.07) and supportive expressive group therapy (SUCRA: 65.7%, SMD: −0.40, 95% CI: −0.75 to −0.05).

Linking Evidence to Action

The NMA suggests that, in terms of short-term efficacy, group logotherapy may be considered the optimal choice for reducing loneliness and social isolation levels in cancer patients. Healthcare professionals could regularly conduct group logotherapy among cancer patients to promote their psychosocial adaptation.

Trial Registration

PROSPERO Registration Number: CRD42024616937

Global Prevalence of Chronic Pain Among Cancer Survivors: A Systematic Review and Proportional Meta‐Analysis of Observational Studies

ABSTRACT

Background

Cancer survivors often receive inadequate pain management, leading to impaired quality of life. Despite their importance, evidence on the global prevalence of chronic pain in cancer survivors remains insufficiently clear.

Aims

The systematic review and proportional meta-analysis aimed to estimate the pooled global prevalence of chronic pain among cancer survivors and to explore heterogeneity stratified by geographic region, cancer type, pain duration, and pain assessment tool.

Methods

Five databases (PubMed, Embase, Cochrane Library, CINAHL, and China National Knowledge Infrastructure) were searched up to September 2024 for studies in English or Chinese. The review followed MOOSE and PRISMA guidelines with PROSPERO registration (CRDxx). Studies were included if they reported chronic pain prevalence in cancer survivors using validated instruments or solely reported chronic pain. Two reviewers independently screened studies, extracted data, and assessed quality using the JBI Critical Appraisal Checklist for Analytical Cross-Sectional Studies. Pooled prevalence and 95% prediction intervals were calculated using a random-effects model with Freeman–Tukey double arcsine transformation. Subgroup analysis was used to explore heterogeneity. Leave-one-out analysis explored robustness. Funnel plot and Egger's test were used to examine publication bias.

Results

In total, 36 studies involving 39,806 participants were included. The pooled prevalence of chronic pain among cancer survivors was 41% (95% CI: 34%–49%) after testing robustness, with significant heterogeneity (I 2  = 99.32%). Subgroup analysis indicated significant group differences in prevalence rates by geographic region, cancer type, and pain duration (all p < 0.001).

Linking Evidence to Action

These findings stress the need for more extensive and tailored chronic pain management in current clinical practice. Additional research on chronic pain outcomes among pediatric cancer survivors, cancer populations within Africa and South America, and those with cancer types other than breast cancer is needed.

Trail Registration

PROSPERO Registration: CRD42024597090.

‘Can't Escape’—Survivors' Perspectives and Experiences of Psychological Detachment While Living With a Stoma: A Descriptive Qualitative Study

ABSTRACT

Aim

To explore survivors' perspectives and experiences of psychological detachment while living with a stoma.

Design

A qualitative descriptive study was conducted. This study followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist.

Methods

A total of 15 semi-structured interviews were conducted between February 2024 and May 2024. The phenomenological method proposed by Colaizzi was used to analyze the data.

Results

Four major themes emerged from the analysis: (1) Trapped in the Persistent Impact of Dual Traumas: Struggles with Adaptation; (2) Trapped by the Unrelenting Burden of Stoma Care: A Cycle of Powerlessness; (3) Trapped by the Shackles of a Stigmatised Identity: The Dilemma of Social Reintegration; and (4) Divergent Pathways of Detachment: Navigating Between Immersion and Transcendence. Within the main themes, eight subthemes were formulated.

Conclusion

This study thoroughly explored and elucidated the psychological detachment experiences of colorectal cancer survivors with a stoma, revealing its key role in mental health recovery and psychosocial rehabilitation and informing clinical interventions.

Implications for Practice

The study suggests that healthcare staff should guide survivors in drawing a clear boundary between stoma care and their personal life, encourage any correction of erroneous social cognition, and promote the positive development of psychological detachment among survivors.

Impact

This study explored the challenges of psychological detachment in stoma survivors, identifying key barriers like trauma, care burden, role misconceptions, and varying detachment levels. The findings can guide healthcare providers in supporting survivors' mental well-being and inform better survivorship care strategies.

Patient or Public Contribution

There was no patient or public contribution.

Research Capability and Influencing Factors Among Clinical Nurses: A Multicentre Cross‐Sectional Study

ABSTRACT

Aim

To evaluate the research capability of clinical nurses in China and identify the determinants associated with their capability.

Background

As nursing evolves into an increasingly independent discipline, the research capability of clinical nurses has become critical for the development of the profession, advancing evidence-based practice and improving patient care quality.

Methods

A multicentre cross-sectional survey was conducted using convenience sampling from September 2023 to February 2024, among clinical nurses in tertiary hospitals across three provinces in China. The Nursing Research Capability Self-Assessment Scale was used to assess the research capability of the nurses. Chi-square tests, one-way analysis of variance and multiple linear regression were used to examine factors associated with research capability. The Strengthening the Reporting of Observational Studies in Epidemiology was followed.

Results

A total of 1074 clinical nurses participated. The mean research capability score was 89.11 ± 27.69, reflecting a moderate level of research capability. However, two dimensions of research questions and literature review received lower scores. Multiple linear regression analysis identified that education level, professional title, administrative position and nursing job title (all p < 0.05) were independent predictors of research capability.

Conclusions

Clinical nurses exhibit moderate research capability, with notable deficiencies in formulating research questions and conducting literature reviews. Key factors influencing research capability include education, professional title, administrative position, and job title. Targeted training and development programmes should address these factors to enhance nurses' research competence and advance nursing science.

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