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Authentic leadership holds great potential to impact positive nursing and organizational outcomes. However, authentic leadership's connection to organizational culture, self-efficacy, and work engagement remains underreported.
To investigate the associations of authentic leadership, organizational culture, self-efficacy, and work engagement among nurses.
Cross-sectional and correlational design employing consecutive sampling in recruiting nurses (n = 534) between May and October 2024. Four validated self-report scales were used to collect data. Structural equation modeling analysis was used to examine the study variables' interrelationships.
Organizational culture significantly predicted authentic leadership (β = 0.91, p = 0.004), while authentic leadership significantly influenced both self-efficacy (β = −0.16, p = 0.041) and work engagement (β = 0.57, p = 0.001). Meanwhile, self-efficacy directly and positively influences work engagement (β = 0.24, p = 0.002). Organizational culture had significant indirect effects on both self-efficacy (β = −0.14, p = 0.042) and work engagement (β = 0.48, p = 0.001) through the mediation of authentic leadership. Finally, self-efficacy mediated the association between authentic leadership and work engagement (β = −0.04, p = 0.002).
The study shed light on the complex and interwoven relationships among several essential constructs—specifically, authentic leadership, organizational culture, self-efficacy, and work engagement. These factors collectively contribute to the creation and maintenance of a dynamic and supportive working environment for nurses.
Integrating evidence-based practice (EBP) into nursing is critical for improving clinical outcomes, yet adoption remains limited due to ongoing individual and organizational barriers.
The EBP Scholars Program was developed to overcome barriers and foster a culture of evidence-based nursing practice within a pediatric healthcare system.
Launched in 2007 during the organization's Magnet journey, the program is grounded in scientific, educational, and implementation science principles. Selected through a competitive application process, scholars engage in a seven-month structured curriculum grounded in the 8 A's Model of EBP. Learning outcomes are evaluated using pre- and post-program scores on the Evidence-Based Practice Knowledge Assessment Questionnaire (EBP-KAQ).
The program has enrolled 147 participants and graduated 124. On average, participants increased their EBP knowledge by 15.7%. Scholar-led projects have led to over 40 policy updates, new care guidelines, and measurable quality and safety improvements. Graduates have produced 43 posters, 18 podium presentations, and 9 peer-reviewed publications.
The EBP Scholars Program offers a scalable model for embedding EBP in healthcare. Through strategic leadership, interdisciplinary collaboration, and structured mentorship, it has advanced evidence-based care, professional development, and a culture of continuous improvement.
Stroke survivors frequently experience multiple co-occurring symptoms that cluster together, significantly affecting their quality of life and rehabilitation outcomes. However, previous research has predominantly focused on individual symptoms in isolation, limiting the potential to inform more comprehensive, symptom cluster-based approaches to post-stroke care.
This scoping review aimed to synthesize existing evidence on the assessment tools used to evaluate them, the analytical techniques employed to identify them, and the composition of symptom clusters in people with stroke.
A comprehensive literature search was conducted across seven databases (PubMed, EMBASE, APA PsycInfo, CINAHL, Web of Science, China National Knowledge Infrastructure, and Wanfang) for studies published between 2001 and April 2025. Methodological quality was assessed using the JBI Critical Appraisal Checklists. Data were extracted on study characteristics, measurement instruments, analytical techniques, and symptom cluster composition.
Fourteen studies comprising 6556 stroke patients were included. A total of 11 assessment tools and six analytical techniques were identified, with exploratory factor analysis being the most commonly used. Seven common symptom clusters were synthesized: pain and fatigue, somatic movement dysfunction, cognitive impairment, affective disturbance, mood and sleep dysregulation, psychological distress, and gastrointestinal symptoms. The most frequently reported symptom cluster was pain and fatigue. Considerable heterogeneity was found across studies in terms of measurement instruments, analytical techniques, and symptom cluster composition.
This review highlights the methodological inconsistencies and diversity in symptom cluster research in stroke populations. The findings underscore the need for standardized, culturally adaptable assessment tools and longitudinal designs to capture the dynamic nature of symptom clusters. This comprehensive review summarizes common symptom clusters in stroke patients and provides clinicians and researchers with valuable insights to help them develop more effective symptom management strategies and ultimately improve patient outcomes.
PROSPERO: CRD420251069463
Quality improvement is a well-known and commonly utilized approach to improving care and outcomes that is built on process improvement methods but not practice improvement methods. Because quality care includes both process and practice elements, process improvement alone cannot ensure quality outcomes will be achieved. This calls for a new approach.
To share an innovative, synergistic, and collaborative quality framework: Evidence-based Quality in Practice and Process: The EQUiPP Framework.
The EQUiPP Framework's intent is to provide structure for collaborative efforts to effectively identify best practices/processes, implement and sustain change, and improve outcomes. The framework provides guidance to decrease the frequency of implementing ineffective changes by deriving effective solutions … the first time, every time.
A team of experts used a consensus approach to develop the framework.
A precursor to this framework, the Practice and Process Improvement = Quality (PPQ) Model, was evaluated by individual expert review and a two-day beta test workshop. Feedback was obtained during the workshop when participants applied the model in activities reflecting real-world healthcare scenarios. When used in both DNP student work and real-world health systems, fundamental flaws were identified which resulted in the necessity to develop a different conceptualization. The framework described here is a new approach to improving quality care.
The EQUiPP Framework is a tool that provides the synergistic integration of both practice improvement (EBP) and process improvement methodologies to successfully implement and sustain best practices to achieve and sustain quality outcomes.
The EQUiPP Framework aligns EBP and process improvement, allowing clinicians and students to work collaboratively to identify and effectively, as well as efficiently, implement and sustain best practices to deliver quality outcomes.
Nursing students are the primary reserve force for hospital nurses. With the shrinking of nurse human resources and the increase in turnover rates, understanding the job preferences of nursing students is crucial for attracting nursing students.
To systematically review published studies on discrete choice experiments involving nursing students.
Ten databases were systematically searched from their inception to January 15, 2025. Two researchers independently used the International Society for Pharmacoeconomics and Outcomes Research checklist to evaluate the quality of the included studies. Thematic analysis was used to classify the attributes into broad categories and corresponding subcategories. The frequency, significance, relative importance, and willingness-to-pay of each attribute in the included studies were analyzed.
Fifteen studies spanning 12 countries were included, with a total of 102 individual attributes extracted and divided into two broad categories and six subcategories. Non-financial attributes were the most frequently reported broad category. The subgroup analyses indicated that nursing students from high-income countries valued income and were highly concerned about the working atmosphere.
Linking Evidence to Action:
The results of this systematic review provide important evidence for developing incentive policies to attract nursing students to the nursing profession.
In clinical oncology nursing practice, the preservation of quality of life is an essential component. E-health interventions have been proven effective in improving quality of life in patients with cancer, but the optimal content and delivery format remain undetermined.
To compare the efficacy of e-health interventions with varying contents and delivery formats in improving quality of life in patients with cancer.
Network meta-analysis of randomized controlled trials.
Six databases, including Medline, Web of Science, Embase, CINAHL, the Cochrane Central Register of Controlled Trials, and PsycINFO, were searched from inception to October 25, 2025.
Two reviewers independently screened studies and extracted data. A pairwise meta-analysis and a network meta-analysis were performed sequentially to determine the efficacy of different contents and delivery formats of e-health interventions in improving quality of life in patients with cancer.
A total of 50 studies included e-health interventions with eight contents and five delivery formats. The results identified health education (SUCRA = 82.2%), symptom management (SUCRA = 72.2%), and rehabilitation interventions (SUCRA = 71.1%) as the three most effective e-health intervention contents for improving quality of life in patients with cancer. Among delivery formats, app-based (SUCRA = 82.1%), internet/web-based (SUCRA = 71.5%), and telephone-based e-health interventions (SUCRA = 53.3%) ranked among the top three.
This study explored the efficacy of different contents and delivery formats of e-health interventions in improving quality of life in patients with cancer. These results are expected to provide an evidence-based basis for clinical oncology nursing practice.
PROSPERO number: CRD42025638829
Nurse-led self-care interventions represent a promising approach for chronic pain management. However, a comprehensive synthesis of their efficacy is lacking.
This systematic review and meta-analysis assessed the impact of the interventions on four key outcomes in chronic pain patients: pain intensity, quality of life, anxiety levels, and depression severity.
The study was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. An electronic search for relevant articles spanning from inception to November 2024 was carried out across multiple databases, including EMBASE, PubMed, CENTRAL, Web of Science (Core Collection), CINAHL, Scopus, and PsycINFO. The Cochrane Risk of Bias Tool was used to assess the quality of the included studies. The meta-analysis was conducted using Stata 18 and Review Manager 5.4, and a GRADE evidence profile was subsequently generated.
The systematic review and meta-analysis involved 30 studies in total. The results of the data analysis indicated that the interventions alleviated pain intensity (SMD = −0.30, 95% CI: −0.41 to −0.20, Z = 5.57, p < 0.001). They also enhanced quality of life (SMD = 0.28, 95% CI: 0.14 to 0.42, Z = 3.83, p < 0.001), while reducing anxiety (SMD = −0.15, 95% CI: −0.29 to −0.01, Z = 2.11, p = 0.03) and depression symptoms (SMD = −0.27, 95% CI: −0.45 to −0.09, Z = 2.88, p = 0.004).
This systematic review demonstrated that nurse-led self-care interventions benefit chronic pain patients. Future research should conduct more rigorous randomized controlled trials to strengthen the evidence base for using such interventions in chronic pain management.
Globally, doctorally-prepared nurses have pursued career paths centered on research and academic leadership. In the United States, alongside the PhD in nursing, there exists a distinct educational pathway, the Doctor of Nursing Practice (DNP), which emphasizes clinical practice. However, the actual career trajectories of individuals from both groups often diverge from these traditional expectations, prompting questions about how their roles are integrated within academic and clinical environments.
This systematic review aims to critically examine the career pathways of nurses with doctoral degrees, with a focus on the intersection of research and clinical practice.
Following the PRISMA guidelines, a systematic search of five databases (PROQUEST Nursing, Scopus, EBSCO, EMBASE, and PubMed) was conducted on October 14, 2024. We identified 6003 references, with 23 studies ultimately meeting inclusion criteria. Thematic analysis was used to synthesize findings.
PhD and DNP nurses in the US exhibit overlapping yet nontraditional career paths, with PhDs taking on clinical leadership and DNPs entering academia. Globally, PhD nurses often hold hybrid roles in research, education, and limited clinical practice. Across contexts, both groups face role misalignment and identity challenges, including marginalization and limited institutional support.
The findings highlight the blurring of traditional boundaries between PhD and DNP career paths, underscoring the need for flexible career models that combine academic and clinical practice as a viable option to address these challenges.
The review was registered in PROSPERO (Registration Number)
The COVID-19 pandemic exacerbated burnout, isolation, and disconnection among healthcare workers, leading to national calls to address workplace mental health. Storytelling has emerged as an effective strategy to build belonging, resilience, and connection. In response, a pediatric healthcare system launched an evidence-based storytelling initiative rooted in narrative medicine and visual symbolism.
To strengthen workplace culture by fostering connection, psychological safety, and meaning through structured storytelling.
Developed in partnership with Dear World, the intervention integrated guided reflection, peer sharing, and professional photography. Initially focused on staff, the initiative expanded to include adolescent and young adult patients. Implementation included phased rollout, train-the-trainer models, onboarding integration, and multimedia engagement. Evaluation methods included pre- and post-surveys and organizational metrics, with the Connection During Conversations Scale (CDCS) used to assess effectiveness across different session formats.
Over 2 years, 1818 participants attended 60 events. Significant improvements in perceived connection and belonging were observed (p < 0.001), with 94% reporting stronger connections to colleagues and 93% to organizational values. CDCS analysis of Year 2 participants (n = 148) demonstrated comparable effectiveness between full and abbreviated session formats, with slightly stronger outcomes in full sessions. As part of broader workforce engagement efforts, nurse turnover declined from 21% to 13%, contributing to $2.3 million in projected cost avoidance.
This scalable, low-cost initiative offers a sustainable model for rehumanizing healthcare. Its integration into orientation, leadership development, and wellness programs underscores its value in fostering connection, resilience, and retention across high-stress care settings.
Preventing central line associated bloodstream infections is feasible; although numerous hospitals continue to face challenges in achieving this important patient safety goal.
The aim of this project was to reduce the incidence of central line associated bloodstream infections in the intensive care unit.
This evidence-based practice quality improvement project was conducted in the general intensive care unit with 35 beds in King Abdullah Medical City in response to an increase in reported central line associated bloodstream infections cases. A searchable clinical question was formulated, and the relevant literature was reviewed and critically appraised to identify effective prevention strategies. Multimodal Interventions were then implemented and evaluated. The Plan, Do, Study, Act methodology was integrated with an evidence-based practice model to enhance the effectiveness, sustainability, and overall quality of the initiatives.
Central line associated bloodstream infection rates decreased from 1.37 to 0.62 per 1000 central line days in the intensive care unit following implementation of the interventions. Moreover, the project generated a total cost savings of $244,201 USD (915,756 SAR), reflecting reduced costs associated with central line associated bloodstream infection cases over the subsequent 18 months.
Implementation of multimodal interventions is essential to decrease central line associated bloodstream infection rate in intensive care units.
The handover process is a critical component of patient safety, enabling effective communication and the transfer of responsibility among nurses. However, despite their critical role, it is often compromised by interruptions, lack of standardization, and variability in practice, which may reduce quality and nurse satisfaction. Existing tools primarily measure information transfer and efficiency but rarely incorporate nurses' perspectives on safety and satisfaction. This gap underscores the need for a validated instrument that comprehensively assesses handover quality from both a professional and safety perspective.
To develop and validate the Handover Quality Questionnaire (HAND-Q), a tool assessing nurses' satisfaction with handovers and their perceived impact on patient safety.
HAND-Q development included a conceptualization phase (literature review, expert discussions) and a validation phase (pilot and large-scale testing). Exploratory and Confirmatory Factor Analyses (EFA, CFA) assessed psychometric properties.
EFA revealed four factors: Satisfaction, Patient Safety, Care Pathway Safety, and Handover Content. CFA confirmed good model fit. Inter-factor correlations showed strong links between handover quality and safety, alongside discrepancies between satisfaction and objective standards.
The HAND-Q offers a practical tool to assess handover quality, support standardization, enhance patient safety, and inform training and digital solutions.
Technology-assisted interventions offer a promising alternative to conventional cardiac rehabilitation. However, there is limited evidence on their effectiveness, particularly in non-Western settings with emphasis on exercise self-efficacy.
To evaluate the effects of a 12-week, technology-assisted hybrid cardiac rehabilitation (TecHCR) program on physical, physiological, and psychological outcomes of patients with coronary heart disease.
A two-arm parallel randomized controlled trial including 160 participants was randomly assigned to either TecHCR or usual care. TecHCR was underpinned by the Health Belief Model, consisting of three supervised exercise training and occupational therapy sessions, a fitness watch for exercise self-monitoring, six audio-visual educational videos, and a weekly video call follow-up. Data were collected at baseline, immediately post-intervention, and at 24 weeks post-intervention.
Participants in TecHCR demonstrated significantly greater improvement in exercise self-efficacy (β = 5.909, 95% CI [3.146, 8.672]; p < 0.001), health-promoting behaviors (β = 9.058, 95% CI [5.524, 12.591]; p < 0.001), and perceived anxiety levels (β = −1.255, 95% CI [−1.893, −0.616]; p < 0.001) at immediate post-intervention and (β = 8.506, 95% CI [4.951, 12.061]; p < 0.001, β = 14.563, 95% CI [8.809, 20.317]; p < 0.001, β = −1.145, 95% CI [−1.975, −0.315]; p = 0.007, respectively) 24 weeks post-intervention when compared with the control group. No statistically significant improvements were observed in perceived depression and cardiovascular risk factors.
The TecHCR program, combining supervised sessions with technology-assisted components, is an effective approach for significantly improving exercise self-efficacy, health-promoting behaviors, and anxiety in patients with coronary heart disease. Healthcare institutions should consider implementing hybrid programs to overcome barriers to traditional cardiac rehabilitation, leveraging technology to extend support and maintain patient engagement beyond supervised sessions.
clinicaltrials.gov identifier: NCT04862351
Smoking cessation is a pressing public health concern. Behavioral therapy has been widely promoted as a means to aid smoking cessation. Acceptance and commitment therapy (ACT), based on the principles of cognitive behavioral therapy, can help participants accept, rather than suppress, the physical and emotional experiences and thoughts associated with not smoking, identify experiential avoidance behaviors, strengthen the determination to quit, and ultimately commit to adaptive behavioral changes guided by smoking-cessation-related values, thereby achieving the goal of quitting smoking.
To assess the effects of ACT compared with other smoking cessation interventions by examining three key outcomes: cessation rates, smoking behaviors, and psychological outcomes.
We searched 8 databases and 2 registration platforms, covering the period from inception to March 26, 2025. We included only randomized controlled trials that recruited adult smokers and implemented ACT for smoking cessation, with the comparison group receiving either active treatment, no treatment, or any other intervention.
A total of 23 studies involving 8951 participants were included. The findings indicated that, compared with all types of control interventions, ACT significantly increased smoking cessation rates both immediately postintervention (RR = 1.48, 95% CI [1.03, 2.14], p = 0.04, I 2 = 81%) and at short-term follow-up (RR = 1.63, 95% CI = 1.31 to 2.01, p < 0.01, I 2 = 0%). Subgroup analyses showed that ACT significantly improved short-term cessation rates compared with behavioral support (RR = 1.60, 95% CI [1.27, 2.02], p < 0.01, I 2 = 0%), while, compared with the blank control, ACT significantly increased smoking cessation rates across three different time points (postintervention: RR = 3.11, 95% CI [2.13, 4.54], p < 0.01, I 2 = 0%; medium-term follow-up: RR = 2.55, 95% CI [1.32, 4.93], p < 0.01; long-term follow-up: RR = 3.33, 95% CI [1.66, 6.68], p < 0.01). Narrative synthesis suggested that compared with behavioral therapy, ACT may confer benefits in improving psychological outcomes, while compared with the blank control, it may also reduce daily cigarette consumption and nicotine dependence, and enhance psychological outcomes.
Acceptance and commitment therapy may be a beneficial approach for improving cessation rates, enhancing smoking cessation behaviors, and promoting psychological well-being among adult smokers. However, the quality of the included evidence was limited, thereby weakening the strength of these findings. Future rigorously designed trials with larger sample sizes, particularly those comparing ACT against other smoking cessation interventions, are warranted to further confirm its effects.
The role of the interprofessional evidence-based practice (EBP) mentor is critical to integrate best practices into healthcare and academic environments to improve outcomes and reduce costs for patients, families, providers, students, and faculty. This study aimed to validate the knowledge, skills, and attitudes/beliefs (KSAs) needed for the EBP mentor. This role delineation study (RDS) assessed knowledge about the EBP mentor role and tasks as related to the steps and competencies of EBP.
Interprofessional EBP experts participated in an advisory panel. Focus groups were conducted with the advisory panel members to identify the KSAs needed for expert EBP mentors. The steps of EBP were broken into 11 domains to align with the processes and strategies needed for EBP methodology. The focus group data were analyzed to identify the KSAs for each domain. A role delineation survey was developed. Interprofessional experts were invited to complete the survey to validate the KSAs needed for the EBP mentor role. The online survey included demographic information and 11 sections that aligned with the steps of EBP and the 107 KSA items needing to be validated.
A total of 251 interprofessional EBP experts completed the survey (232 nurses, 19 interprofessionals). Healthcare providers comprised 82.5% of the sample, academic/researchers 15.5%, and “worked in both settings” 2%. The results reported strong inter-rater reliability (ranging from 0.836 to 0.955) and strong validity for each of the 11 domains and KSAs.
Findings from this study support the EBP mentor role and will guide interprofessional EBP education and EBP mentor positions in healthcare systems. The study showed that the tasks of the EBP mentor were consistent across settings, educational degrees, and professional roles. Validity for the tasks/role for an interprofessional Evidence-based Practice Certification was clear and outlined expectations for the EBP mentor role.
Palliative care reduces caregiver burden, alleviates patient symptoms, and supports treatment decision-making. However, despite these benefits, there is limited evidence on the effectiveness of palliative care interventions for caregivers of individuals with advanced dementia.
To integrate and analyze data on the effectiveness of palliative care interventions in improving caregiver outcomes in order to ensure that both patients and caregivers receive the support necessary for optimal care experiences, quality of life management, and advanced care planning.
A systematic search was conducted of six databases to identify relevant studies published from database inception to 12 December 2024. Randomized controlled trials (RCTs) investigating palliative care interventions for caregivers of people with advanced dementia were included. Version 2 of the Cochrane Risk of Bias tool was used to assess the risk of bias in the methodology of each study. Standardized mean differences (SMDs) between each intervention and control group were calculated. A random-effects DerSimonian and Laird model was applied to generate pooled SMD estimates for each outcome and assess its heterogeneity. A leave-one-out sensitivity analysis was performed to ensure the stability of the pooled effect sizes.
Eight RCTs were included in the final analysis. Palliative care interventions appeared to reduce conflict in decision-making among caregivers of people with advanced dementia.
Palliative care interventions were successful in reducing conflict in decision-making of caregivers of people with advanced dementia. However, the modality's effects on caregiver satisfaction and caregiver distress need further investigation.
Future palliative care interventions for caregivers of advanced dementia patients should focus on developing the contents of palliative care materials based on evidence-based evaluations and explore strategies to improve engagement between patients, caregivers, and healthcare professionals.
Although some research supports the maintenance of positive outcomes from cardiac rehabilitation Phase II (CR II) up to 12 months, the barriers to maintaining physical activity and risk factor management during CR maintenance (CR III) are well known.
To investigate participants' ability to sustain clinical, quality-of-life (QOL), and behavioral outcomes and share their experiences 6 months after CR II completion.
Longitudinal explanatory sequential pre-CR/post-CR study in a community hospital within a large health system. A convenience sample of 155 participants completed a reassessment of health outcomes. Participants also completed an online survey about barriers and facilitators during and after CR II. Analysis methods included MANOVA and summative content analysis.
The sample was mostly male, white, non-Hispanic, and college educated, with a mean age of 67.9 years. CR II participants sustained most behavioral outcomes, but not all clinical outcomes. Outcomes that improved/maintained were physical activity, tobacco status, diet, and QOL. Outcomes that worsened/returned to pre-CR II were weight, blood pressure, and depression. Participants described their motivation for staying healthy, top concerns, goals, barriers, and strengths/resources. Common responses included exercise, weight, diet, quality of life, family, and friends.
Our findings suggest the need for the implementation of innovative strategies during CR II that may extend past discharge into CR III. These include the introduction of digital technology and eHealth to provide value-added service to patients and a solid foundation for future maintenance and a structured, behavioral weight loss intervention. Establishing these tools, in addition to developing a support system will help patients to initiate maintenance care before program completion.
Psychosocial interventions are recognized as effective nonpharmacological treatments that can enhance the mental well-being of women dealing with perinatal loss. However, as these interventions vary widely, there is currently no review that systematically evaluates and ranks their effects on the mental health of women affected by perinatal loss.
The aim of this study is to integrate the existing evidence, assess and compare the effects of psychosocial interventions on negative emotions among women experiencing perinatal loss, rank the effect sizes of various interventions, and identify the most effective intervention on the basis of different outcome measures.
Seven English-language databases were systematically searched for randomized controlled trials (RCTs) focusing on women experiencing perinatal loss, with publications up to August 20, 2024. Traditional pairwise meta-analyses were performed using Review Manager 5.4.1, while Stata 18.0 was employed for network meta-analysis and evidence synthesis. The surface under the cumulative ranking curve (SUCRA) was used to assess the efficacy of the interventions. The protocol was registered with PROSPERO under number CRD42024530312.
A total of 30 RCTs encompassing 6181 participants were included in the analysis. On the basis of the SUCRA rankings, problem-solving therapy was identified as an effective treatment for alleviating depression and anxiety among women experiencing perinatal loss (depression: SUCRA = 82.55%, SMD = −1.34, 95% CI [−2.41, −0.27]; anxiety: SUCRA = 97.7%, SMD = −2.83, 95% CI [−4.26, −1.40]). Additionally, bereavement intervention emerged as the most effective approach for improving grief symptoms (SUCRA = 81.60%, SMD = −1.11, 95% CI [−2.14, −0.09]).
Compared with traditional treatment, psychosocial intervention can improve the psychological state of women with perinatal loss, and the differences in the effects of face-to-face and technology-assisted interventions should be further explored. Moreover, problem-solving therapy has proven to be effective and appears to be the most effective method for alleviating depressive and anxiety symptoms among women experiencing perinatal loss, while bereavement support is the most effective method for grief due to perinatal loss. Nursing and health policymakers can develop various intervention strategies according to the varied psychological states of women experiencing perinatal loss.
The global prevalence of chronic kidney disease (CKD) has continued to rise over time. Pharmacological therapy is the mainstay of conventional CKD treatment; however, many CKD patients find it difficult to adhere to their medication regimen.
To systematically evaluate and compare the effects of various self-management support strategies for patients with CKD.
We searched PubMed, Embase, The Cochrane Library, Web of Science, and Scopus to identify quasi-randomized and RCTs comparing the effectiveness of different self-management support strategies in CKD patients, The search spanned from database inception to June 24, 2025. Two reviewers independently screened the literature, extracted information, assessed the quality of studies, and we performed analysis using RevMan 5.0 and STATA 14.0 software.
Eighty-one studies were included, examining 10 strategies. Compared to conventional interventions, face-to-face combined tele-guidance, group visits, tele-guidance, and multi-component structured interventions significantly improved patients' self-efficacy. Surface under the cumulative ranking curve (SUCRA) of different self-management support strategies influencing self-efficacy ranked in the top three were face-to-face combined tele-guidance, group visits and tele-guidance. Empowerment interventions, cognitive behavioral therapy (CBT) and tele-guidance enhanced quality of life compared to conventional interventions. The SUCRA for quality of life ranked highest for empowerment, CBT and face-to-face combined tele-guidance. Additionally, we found that these strategies were beneficial in improving patients' blood pressure, IDWG, renal disease knowledge, and self-management.
The study offers evidence on effective self-management support strategies for CKD patients, highlighting face-to-face combined tele-guidance might be the most effective intervention for increasing self-efficacy, while empowerment might be the most effective intervention for increasing quality of life in CKD patients. These findings can help healthcare providers design better programs to improve patient outcomes. However, more high-quality RCTs are needed to confirm findings.
PROSPERO: CRD42024596581
FreshRSS 