Conectar
This systematic review and meta-analysis evaluated the efficacy of infrared (IR) devices versus the traditional palpation technique for first-attempt success of peripheral intravenous catheter (PIVC) insertion in adults.
Systematic review and meta-analysis of randomised controlled trials (RCTs).
A comprehensive search of PubMed, Embase, Cochrane Library, Scopus and CINAHL was conducted on 28 May 2024 and included articles in English or French published from 1st January 2000 onwards.
Eligible studies included RCTs comparing IR devices with the traditional palpation method for PIVC insertion in adults. The primary outcome was first-attempt success. Secondary outcomes included overall success, number of attempts, cannulation time and patient pain. The risk of bias was assessed using the RoB2 tool, and a random-effects model was applied for meta-analysis.
Five RCTs were included, involving 690 patients and 704 catheters, including 289 PIVCs in patients with Difficult Intravascular Access (DIVA) criteria. First attempt insertion success was similar when using infrared devices (139/331, 42%) and traditional palpation (143/373, 38%) with Risk Ratio (RR) 1.08 (95% CI, 0.69 to 1.70). No significant statistical differences were noted in secondary outcomes: overall insertion success, number of attempts, time to cannulate and patient pain. Clinical and statistical heterogeneity were substantial (primary analysis I 2 = 83%).
Current evidence does not support the systematic use of infrared devices to improve PIVC insertion success, reduce the number of attempts or alleviate patient pain compared with traditional palpation in adults. Further high-quality studies with suitable sample sizes and varied populations are needed to better establish the potential place of infrared devices.
This study highlights the limited benefit of IR devices in routine clinical practice and underscores the need for further research into their use in specialised settings.
No Patient or Public Involvement. This study did not include patient or public involvement in its design, conduct or reporting.
Ample evidence has shown the benefit of high-fidelity simulation (HFS) in promoting learning in pre-licensure nursing students, but the evidence for practising registered nurses has not been synthesised.
To evaluate the effects of HFS training on learning outcomes and satisfaction in practising registered nurses.
In this systematic review and meta-analysis, we searched PubMed, CINAHL, ERIC, Cochrane Library, Web of Science and China National Knowledge Infrastructure (CNKI) for studies published in English or Chinese from database inception to 31 May 2023 (updated on 20 April 2025). All randomised controlled trials (RCT) or quasi-experiments that compared HFS training with traditional methods (e.g., lecture) for practising registered nurses and reported learning outcomes and satisfaction were included. Risk of bias was assessed by the Cochrane risk-of-bias tool for randomised trials (RoB 2) and non-randomised trials (ROBINS-I). Inverse-variance random-effect models were used to calculate standardised mean differences (SMDs) with 95% confidence interval (CI). We followed the PRISMA 2020 guideline.
Of 1404 records, eight eligible studies (five RCTs and three quasi-experiments) involving 275 practising nurses were identified. Two RCTs had high risk of bias, while others showed some concerns or moderate risk of bias. Meta-analyses showed that HFS could promote knowledge acquisition (SMD = 0.65, 95% CI, [0.35, 0.95], p < 0.01, I2 = 0%), professional skills (SMD = 0.72, 95% CI, [0.41, 1.04], p < 0.01, I2 = 0%) and learning satisfaction (SMD = 1.24, 95% CI, [0.35, 2.13], p < 0.01; I2 = 67%), compared with traditional methods. The pooled effect on self-confidence was marginally insignificant (SMD = 0.59, 95% CI, [−0.04, 1.22], p = 0.07; I2 = 67%).
Compared with traditional training methods, HFS is effective in promoting knowledge acquisition, professional skills and learning satisfaction and may enhance self-confidence among practising nurses. To strengthen the evidence base, more rigorous RCTs with larger sample sizes, adequate reporting of HFS design, and standardised outcome measures are warranted.
PROSPERO (CRD42022358717). No Patient or Public Contribution.
This study aims to identify key antecedents of quiet quitting across industries through a three-level meta-analysis, evaluate their relevance to nursing and highlight aspects that have been under-explored in the nursing field, with the goal of guiding future research and interventions to improve nurse retention and engagement.
A three-level meta-analytic design incorporating subgroup analyses and moderator analyses was used to integrate quantitative evidence from studies across different industries and professions to examine the antecedents of quiet quitting.
Data were sourced from EBSCO, Web of Science, ScienceDirect, Scopus, JSTOR, ProQuest, SpringerLink, Emerald and Google Scholar for articles published between January 2020 and January 2025. Preprints from Research Square were also included.
Perceived workplace support reduces the likelihood of quiet quitting. Conversely, workplace conflicts, perceived injustice, burnout and stress are positively correlated with quiet quitting, with nurses exhibiting a higher tolerance for these factors compared to other sectors. Negative traits and passive work orientations exacerbate quiet quitting, whereas positive traits and proactive orientations show no significant effect across sectors. Additionally, organisational involvement, job satisfaction and well-being significantly reduce quiet quitting behaviours.
Quiet quitting is a widespread issue across various industries, including nursing. The findings call for nursing research to expand its focus beyond emotional exhaustion and workplace conflict to include nurses' psychological contracts breach and violations, nurses' individual traits, the degree of embeddedness within healthcare organisations and the maintenance of reciprocal exchanges.
This study identifies the key factors influencing nurses' quiet quitting, providing evidence to support the development of effective retention strategies for nursing leaders and policymakers. This is expected to improve nurse retention and job satisfaction, which, in turn, can enhance care quality and patient safety, thereby contributing to the sustainable development of healthcare systems.
PRISMA reporting method has been followed.
This study did not include patient or public involvement in its design, conduct or reporting.
A protocol for this study is preregistered at Open Science Framework (https://osf.io/4z5hs).
To identify and synthesise the levels of death anxiety and potential moderating factors in patients with advanced cancer.
A systematic review and meta-analysis of observational studies.
A comprehensive search was conducted across 10 electronic databases, including PubMed, Cochrane, Embase, Web of Science, CINAHL, PsycINFO, Scopus, Chinese Biomedical, China National Knowledge Infrastructure, and WANFANG, covering publications in both English and Chinese from inception through June 18, 2025.
Two independent reviewers performed study selection, data extraction, and quality assessment. Meta-analyses were conducted using STATA 16 software. Predefined subgroup analyses and meta-regression were carried out to examine variations in death anxiety among advanced cancer patients based on participant characteristics, disease-related factors, and study-level variables.
Twenty-one studies involving 4337 patients with advanced cancer met the inclusion criteria. These studies, published between 1978 and 2025, were conducted across five countries. Meta-analyses were performed separately for 16 studies using the original 15-item dichotomous Templer Death Anxiety Scale and 3 studies using an adapted five-point Likert version. Both analyses indicated high levels of death anxiety among patients. Differences in participant age, country, continent, and publication year contributed to the variation in findings.
Advanced cancer patients experience high levels of death anxiety, with age, country, continent, and publication year identified as key moderating factors. Targeting these factors through tailored interventions, promoting a supportive culture around death, and providing effective psychological training for patients can help reduce anxiety. These efforts aim to equip patients to understand and cope with the realities of death, ultimately improving their psychological well-being.
This review highlights the high levels of death anxiety in advanced cancer patients and identifies potential moderators. It underscores the need for targeted interventions to improve psychological care, particularly in end-of-life settings.
No patient or public contribution.
The review was registered on PROSPERO (registration number: CRD420251033114).
To appraise and synthesise existing research on the relationship between patient safety culture and missed nursing care.
Systematic review and meta-analysis.
Peer-reviewed articles published from 2010 onwards were searched from five databases (CINAHL, ProQuest, PubMed, ScienceDirect and Web of Science). A total of nine studies were identified. Among these, seven studies with a combined sample size of 1661 participants were included in the meta-analysis.
The meta-analysis revealed a significant negative correlation between overall patient safety culture and missed nursing care, with a pooled correlation coefficient of −0.205 (95% CI: −0.251 to −0.158) (p < 0.001). Heterogeneity was low to moderate (I 2 = 13.18%, 95% CI: 0.00 to 78.60), and publication bias tests indicated no significant bias (Egger's test p = 0.0603; Begg's test p = 0.3476).
The findings underscore a significant inverse relationship between patient safety culture and missed nursing care, highlighting the specific predictive roles of management support, organisational learning and unit-level safety culture. Enhancing patient safety culture within healthcare organisations can be a strategic approach to mitigate missed nursing care.
Nursing leaders and administrators should prioritise fostering a safety-oriented culture through targeted interventions, continuous education and supportive policies to improve patient care outcomes.
Preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines.
No patient or public contribution.
To assess the effectiveness, process, and economic outcomes of integrated care for community-dwelling frail older adults.
A systematic review and meta-analysis.
We searched nine databases, including PubMed, Web of Science, CINAHL, Embase, the Cochrane Library, CNKI, SinoMed, Wanfang, and VIP, three trial registers, grey literature, and reference lists up to April 2024, with an updated search in March 2025.
Randomised controlled trials and non-randomised studies of interventions involving integrated care for community-dwelling frail older adults were included. Data analysis was conducted using the Comprehensive Meta-Analysis software.
This review included 12 studies involving 6819 community-dwelling frail older adults from high-income regions. The results indicated that integrated care had significantly positive effects on frailty and functional ability, but not on social function, hospitalisation, nursing home admission, quality of life, and mortality. Outcomes of caregivers and professionals were rarely reported. The cost-effectiveness of integrated care has not been confirmed by limited evidence. Few studies have adopted a systematic approach to designing and conducting comprehensive process evaluations guided by scientific frameworks.
Integrated care improves frailty and functional ability in community-dwelling frail older adults but lacks consistent benefits for other outcomes. The lack of evidence on cost-effectiveness and the caregiver and professional outcomes highlight critical gaps in current research. The absence of systematic process evaluations underscores the need for future studies to adopt rigorous frameworks to assess them.
This implicates that more research, particularly in underserved regions that lack a high standard of usual medical services, should emphasise the outcomes of caregivers and healthcare professionals, process evaluation, and health economics. Policymakers and practitioners must consider these gaps when implementing integrated care programmes to ensure equitable and sustainable healthcare solutions.
PRISMA 2020 Checklist.
No patient or public contribution.
CRD42024568811
This study aimed to (1) evaluate the effectiveness of e-health interventions in improving physical activity and associated health outcomes during pregnancy, (2) compare the e-health functions employed across interventions and (3) systematically identify the behaviour change techniques (BCTs) used and examine their interrelationships.
A systematic review and meta-analysis following the PRISMA 2020 guidelines.
Randomised controlled trials were included. Meta-analyses and subgroup analyses were performed using RevMan 5.3. Social network analysis was conducted to determine the most central BCTs within the intervention landscape.
Ten databases were searched, including PubMed, Embase, Web of Science, Cochrane Library, ProQuest, Scopus, SinoMed, China National Knowledge Infrastructure, WanFang and the China Science and Technology Journal Database, from inception to April 22, 2024.
Thirty-five studies were included. Pooled analyses indicated that e-health interventions significantly improved both total (SMD: 0.19; 95% CI: 0.10 to 0.27; I 2 = 55%) and moderate-to-vigorous physical activity (SMD: 0.16, 95% CI: 0.06 to 0.26; I 2 = 53%) in pregnant women. Subgroup analyses revealed that interventions based on theoretical frameworks and those not specifically targeting overweight or obese women demonstrated greater effectiveness. Additionally, e-health interventions were associated with significant reductions in both total and weekly gestational weight gain. Six of the twelve e-health functions were utilised, with ‘client education and behaviour change communication’ being the most prevalent. Thirty unique BCTs were identified; among them, ‘instruction on how to perform the behaviour’, ‘self-monitoring’, ‘problem solving’, and ‘goal setting’ showed the highest degree of interconnectedness.
E-health interventions are effective in enhancing physical activity and reducing gestational weight gain during pregnancy. Incorporating theoretical frameworks and well-integrated BCTs is recommended to optimise intervention outcomes.
Integrating e-health interventions into existing perinatal care models holds promise for enhancing physical activity among pregnant women and improving maternal health outcomes.
This study adhered to the PRISMA checklist.
No patient or public involvement.
The study protocol was preregistered in the International Prospective Register of Systematic Reviews (CRD42024518740)
Thirst is the most common self-reported symptom in intensive care unit (ICU) patients. There is evidence that oral cooling interventions may alleviate thirst symptoms in ICU patients. However, the evidence needs to be critically evaluated.
To investigate the effect of oral cooling interventions on alleviating thirst symptoms of ICU patients and explore the effectiveness of different types of oral cooling by subgroup analysis.
The PubMed, Ovid Embase, the Cochrane Library, Wanfang Data and China National Knowledge Infrastructure databases were searched from inception to 29 October 2023. Randomised controlled trials (RCTs) that reported thirst intensity or thirst distress as outcomes were included. The certainty of the evidence was evaluated by the GRADE approach.
The meta-analysis comprised eight RCTs that included 813 ICU patients. The pooled analysis from eight RCTs showed that oral cooling interventions had significant beneficial effects on thirst intensity (weighted mean difference [WMD] = −2.73, 95% confidence interval [CI] = −3.62 to −1.85, p < 0.01; moderate certainty). The pooled analysis from four RCTs showed that oral cooling interventions could significantly lower the thirst distress scores (standardised mean difference = −0.80, 95% CI = −1.13 to −0.47, p < 0.01; low certainty). Subgroup analysis indicated that cold stimulation (WMD = −3.12) and cold combined with menthol stimulation (WMD = −1.72) could significantly lower the thirst intensity scores.
Oral cooling interventions including cold and menthol had beneficial effects on thirst intensity and thirst distress in ICU patients. The high heterogeneity in methods should be considered when interpreting the results.
This study provides references for the application of oral care strategy in the ICU care field, and encourages nurses to apply the oral cooling plan to improve patients' comfort.
This was a meta-analysis based on data from previous studies.
PROSPERO: CRD42023416059
Cancer is a major social, public health and economic problem worldwide, causing physical and psychological distress to patients. The emerging telemedicine model in healthcare delivery has garnered significant interest because of its potential effectiveness.
To assess the effects of telemedicine on distress, physical function, and self-efficacy in cancer patients.
This meta-analysis was conducted and reported in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) 2020 checklist.
Six databases were searched for relevant studies published from inception to October 2024. The literature search and data collection were conducted by two separate researchers. The quality of the methodologies in the studies included was evaluated using the Cochrane Risk of Bias Tool. Data analysis was conducted using Review Manager (version 5.4).
Compared with the control group, patients who received telemedicine experienced significant reductions in distress (SMD = −0.44, 95% CI: −0.62 to −0.25, p < 0.00001, I 2 = 46%) and significant increases in physical function (SMD = 0.11, 95% CI: 0.01–0.22, p = 0.04, I 2 = 0%) and self-efficacy (SMD = 0.46, 95% CI: 0.23–0.69, p < 0.0001, I 2 = 0%).
Telemedicine can effectively enhance the psychological health and physiological function of cancer patients, as well as their self-efficacy, suggesting a sustainable approach to the clinical care of cancer patients. Future studies are needed to further investigate the effectiveness of telemedicine interventions in different types of cancer patients and in different cultural contexts and to conduct long-term follow-up studies to evaluate their long-term effectiveness and cost-effectiveness.
This systematic review and meta-analysis provides evidence to offer effective and sustainable telemedicine care among cancer patients.
No patient or public contribution.
This study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (Registration number: CRD42024604929) under the title ‘The effectiveness of death education on death anxiety, depression and quality of life in patients with advanced cancer: A meta-analysis of randomised controlled trials’. The full study protocol could be obtained at https://www.crd.york.ac.uk/PROSPERO/view/CRD42024604929
Although multicomponent exercise is a popular nonpharmacological treatment, its effects on cognition vary across studies because of the diversities in exercise combinations. Identifying the most effective combination is of great importance to the prevention and treatment of cognitive impairment.
To compare and rank the efficacy of various multicomponent exercise interventions on cognition in people with cognitive impairment.
We searched PubMed, Web of Science, Embase, Cochrane, SPORTDiscus and PsycInfo databases up to April 2025 for eligible randomised controlled trials about multicomponent exercise interventions in people with cognitive impairment. Primary outcome was global cognition, with secondary outcomes being executive function and memory. Pairwise and network meta-analyses were performed using random-effects models.
Twenty-five trials involving 2298 participants were included. Pairwise meta-analyses showed multicomponent exercise interventions were effective on global cognition (standardised mean difference (SMD) = 0.59; 95% confidence interval (CI): 0.30, 0.89; p < 0.001) and executive function (SMD = 0.28; 95% CI: 0.12, 0.45; p < 0.001). Network meta-analyses revealed that aerobic exercise (AE) + balance & flexibility (BF) training had the highest probability (70.8%) of being the optimal exercise combination for global cognition (SMD = 1.07; 95% CI: 0.23, 1.90; p = 0.016), and AE + resistance exercise (RE) had the highest probability (43.1%) of being the optimal exercise combination for executive function (SMD = 0.56; 95% CI: 0.03, 0.10; p = 0.042). We did not observe significant effects of multicomponent exercise on memory.
AE + BF training is likely the most effective multicomponent exercise combination for global cognition, while AE + RE showed the optimal effect on executive function in people with cognitive impairment.
Our study contributes to guiding clinical professionals to design and conduct targeted multicomponent exercise interventions as per individual cognitive impairment characteristics to protect individual cognition.
No patient or public contribution applies to this work.
The study protocol was registered with PROSPERO (CRD42023489517).
Cognitive Behavioural Therapy (CBT) has demonstrated positive effects on emotional well-being and quality of life in individuals with dementia. Limited evidence constrains the generalisability of these findings.
This review was conducted in accordance with PRISMA guidelines. Randomised controlled trials (RCTs) that implemented CBT and assessed cognitive function, depressive symptoms, anxiety and quality of life in individuals with dementia were included. Seven databases—APA PsycINFO, CINAHL, Cochrane Library, Embase, MEDLINE, PubMed and Web of Science—were searched up to 10 October 2024. The Risk of Bias 2 (RoB-2) tool was used to evaluate the methodological quality of included studies. Pooled standardised mean differences (SMDs) with 95% confidence intervals (CIs) were calculated using random-effects models for each outcome.
A total of 10 RCTs, involving 1412 individuals with dementia and published between 2011 and 2024, were included in the analysis. CBT was associated with a reduction in anxiety (pooled SMD = −0.94; 95% CI = −1.33 to −0.55; I 2 = 0.00%; p < 0.04). No significant differences were found in cognitive function, depression or quality of life between those receiving CBT and those in the control groups.
This study suggests that CBT alleviates anxiety in people with dementia. However, further investigation is required to clarify its effects on cognitive function, depressive symptoms and quality of life. Future research should focus on the development of CBT protocols, alongside the exploration of relevant outcome measures.
CBT has shown potential in improving emotional well-being and quality of life in individuals with dementia. The findings inform healthcare professionals about its clinical utility and effectiveness in dementia care.
The findings suggest that traditional CBT may not fully address the needs of people with dementia, emphasising the importance of incorporating multisensory stimulation and caregiver involvement to enhance therapeutic outcomes.
To assess telehealth stoma care interventions' impact on stoma adjustment, self-efficacy, anxiety and ostomates' quality of life.
Systematic review and meta-analysis of randomised controlled trials.
Studies published until April 2025 were searched across eight databases—MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, Scopus, Web of Science, CINAHL, ClinicalTrials.gov and PQDT Global. Randomised controlled trials with individuals aged 18 and older who received telehealth stoma care interventions were included. A meta-analysis was performed using a random-effects model, with the GRADE approach employed to evaluate evidence certainty. This systematic review and meta-analysis complied with the PRISMA guideline and PRISMA 2020 checklist.
Eight studies were included in the meta-analysis. Telehealth interventions significantly improved stoma adjustment (SMD: 1.44, 95% CI: 0.22–2.66) and self-efficacy (MD: 10.23, 95% CI: 3.01–17.44), but did not significantly affect anxiety, while results regarding the effect on quality of life were inconsistent. Three studies showed a high risk of bias, while five showed some concerns. Evidence certainty was moderate for stoma adjustment, self-efficacy and stoma quality of life, and low for anxiety.
Telehealth can enhance stoma adjustment and self-efficacy, thereby improving management. However, the limited and inconsistent findings on anxiety and quality of life outcomes underscore the need for further high-quality research.
This review demonstrates that telehealth stoma care can be vital in improving stoma adjustment and self-efficacy in ostomates.
The PRISMA 2020 checklist.
Not Applicable.
To investigate the effects of the Family-Centred Empowerment Model on informal caregivers on individuals with chronic diseases.
The Family-Centred Empowerment Model may help address informal caregivers' challenges in chronic disease management, including caregiver burden. However, its effectiveness for informal caregivers of chronic disease patients remains unclear.
Systematic review and meta-analysis of randomised controlled trials and quasi-experimental studies.
The review followed the PRISMA 2020 guidelines. A comprehensive search was conducted in EMBASE, PubMed, Cochrane Library, Web of Science, CINAHL, CNKI, SinoMed and Wanfang Data from their inception to January 2024. Two investigators independently evaluated study quality using the Cochrane Risk of Bias Tool and the Joanna Briggs Institute checklist.
This review included 22 studies. The meta-analysis demonstrated that the Family-Centred Empowerment Model significantly reduced caregiver burden, stress and anxiety. Subgroup analyses further revealed a positive effect on reducing caregiver burden across both paediatric and adult patient populations. Additionally, the intervention's effect on caregiver burden remained significant for 1–3 months following the intervention. While the model did not significantly affect the pooled outcome for care ability, subgroup analyses indicated that the model was more effective at improving care ability 3 weeks post-intervention compared to immediately after the intervention.
The Family-Centred Empowerment Model for informal caregivers of chronic disease patients may help reduce caregiver burden, stress and anxiety, while gradually improving care ability. However, it has no significant effect on depression or family function.
The review provides valuable evidence to guide clinicians in implementing the Family-Centred Empowerment Model for informal caregivers of chronic disease patients. By applying this model, caregivers can reduce burdens, stress and anxiety while enhancing their care abilities.
As a systematic review and meta-analysis, these details did not apply to our work.
PROSPERO (CRD42024505357)
To evaluate the effectiveness of multidisciplinary transitional care interventions on functional status, quality of life and readmission rates of stroke patients.
Quantitative systematic review and meta-analysis.
Studies with interventions to ease the hospital-to-home transition of stroke patients that were delivered by multidisciplinary teams consisting of registered healthcare professionals from at least two disciplines were included. Cochrane Risk of Bias tool was used for quality appraisal.
Seven electronic databases (PubMed, Embase, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, Scopus and Web of Science) were searched for randomised controlled trials delivering transitional care interventions to hospitalised stroke patients.
Thirty-one randomised controlled trials were included in the final review. The studies featured multidisciplinary teams of two to nine professionals, most commonly nurses, physicians and physiotherapists. Although multidisciplinary care improved functional status and quality of life scores, the impact on readmission rates was inconclusive. Meta-analysis revealed significant improvements in functional status when care involved physicians, care coordinators (often nurses) or had teams of more than two healthcare professionals. Significant improvement in quality of life was also reported when care involved physicians or in teams with more than two healthcare professionals.
Multidisciplinary transitional care interventions show promise in improving functional status and quality of life after stroke. Their effectiveness depends on team composition and coordination, particularly the inclusion of physicians and care coordinators. Future research should address reporting gaps and evaluate broader strategies to reduce hospital readmissions.
Impact (Addressing)
What problem did the study address? ○
The effectiveness of multidisciplinary transitional care interventions for stroke patients.
○Evaluated the role of various healthcare professionals within these teams.
What were the main findings? ○
Multidisciplinary transitional care interventions significantly enhance stroke patients' functional status, especially within the first 3 months.
○Teams with care coordinators (often nurses) and supportive physicians improve functional outcomes, with effective communication being crucial despite underreporting of specific practices.
○Teams comprising of more than two health professionals can significantly improve stroke patients' functional status.
Where and on whom will the research have an impact? ○
Healthcare institutions and providers: The findings can guide healthcare institutions in developing and implementing effective transitional care services for stroke patients.
○Stroke patients: Patients receiving multidisciplinary transitional care are likely to experience enhanced functional recovery and improved ability to perform daily activities.
○Policymakers and researchers: The study highlights the need for more detailed reporting and research on communication practices within multidisciplinary teams and the importance of evaluating underreported outcomes like readmission rates.
Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) checklist.
No Patient or Public Contribution.
To determine the treatment effectiveness associated with mobile health-delivered cognitive behavioural therapy for insomnia (mCBT-I) interventions for adults with insomnia and to identify the potential characteristics associated with better treatment outcomes.
A systematic review and meta-analysis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) guidelines.
Seven English- and two Chinese-language databases were searched, without restrictions on publication dates, up to July 2024. Reference lists of relevant reviews and grey literature were included in the search. Randomised controlled trials evaluating mCBT-I in adults with insomnia and published in either English or Chinese were included in this meta-analysis. A random-effects model was used for data analysis, accompanied by additional subgroup analyses and meta-regression.
Sixteen studies involving 2146 participants were included in this meta-analysis. mCBT-I interventions were associated with significantly reduced insomnia symptoms and improved sleep quality at post intervention, at 1–3-month follow-up, and at 4–6-month follow-up. Interventions that included five components of CBT-I, were delivered for 6 weeks or longer, and were conducted in a group format were linked to better treatment outcomes; the differences in other subgroup categories were not statistically significant. Studies involving participants with comorbid conditions showed a greater effect in reducing insomnia symptoms than those without such participants. In addition, mCBT-I interventions delivered by healthcare professionals resulted in statistically larger effect sizes for improving sleep quality than self-help regimens.
The systematic review and meta-analysis identified the effectiveness of mCBT-I in reducing insomnia symptoms and improving sleep quality and offered practical implications for the development of effective mCBT-I interventions in clinical practice. However, future robust studies are needed to explore the long-term effects of mCBT-I interventions.
No patient or public contribution.
PROSPERO CRD: 42023454647
To explore the effects of telehealth-based exercise interventions on balance, motor function, walking ability and activities of daily living (ADLs) in patients with stroke.
Meta-analysis of randomised controlled trials.
This meta-analysis of randomised controlled trials was reported to follow the PRISMA statement and the Cochrane Handbook guidelines. The study employed either a fixed-effects model or a random-effects model according to the statistical heterogeneity observed.
The literature search was performed in six databases including PubMed, Embase, the Cochrane Central Register of Controlled Trials, Web of Science, PsycINFO and CINAHL from inception to December 2023.
A total of 15 randomised controlled trials were included in this meta-analysis. Most of the studies were evaluated for some concerns. The quality of the evidence in this analysis ranged from low to moderate in terms of the outcome. Meta-analysis revealed that telehealth-based exercise interventions presented significant effects on walking ability, motor function and ADLs in patients with stroke. Nonetheless, the balance remained unaffected by statistical significance.
Telehealth-based exercise interventions could effectively improve walking ability, motor function and ADLs in patients with stroke; however, the impact on balance was not significant. Telehealth-based exercise interventions are recommended for stroke survivors residing in remote areas or facing economic constraints.
This meta-analysis showed that telehealth-based exercise interventions could bring benefits to the rehabilitation of patients with stroke. Telehealth-based exercise interventions should be considered effective to better promote the rehabilitation of patients.
The study was reported in compliance with the PRISMA statement.
None.
PROSPERO (https://www.crd.york.ac.uk/PROSPERO): CRD42024501015
To examine the effectiveness of acupressure on sleep quality in cancer patients and to identify the population-level and intervention-level characteristics associated with the intervention outcome of sleep quality.
Systematic review and meta-analysis.
PubMed, EMBASE, APA PsycInfo, Web of Science, CINAHL, Cochrane Library, China National Knowledge Infrastructure and WanFang were searched for eligible randomised controlled trials from inception to April 2024.
Methodological quality was assessed using the Cochrane Risk of Bias Tool for Randomised Trials 2.0. A random-effects model was used for the meta-analysis. Subgroup analyses and the meta-regression aimed to investigate potential heterogeneity and identify characteristics that may be associated with more favourable acupressure outcomes.
In total, 22 randomised controlled trials involving 2113 participants were included in this meta-analysis. Compared with various control groups, acupressure exhibited a significant beneficial effect on sleep quality in cancer patients at post-intervention (SMD = −1.38, 95% CI [−1.81, −0.95], p < 0.001) and at 4-week follow-up (SMD = −0.33, 95% CI [−0.56, −0.10], p = 0.004). Acupressure also showed statistically significant improvements in sleep efficiency (SMD = 0.77, 95% CI [0.27, 1.26], p = 0.002) and total sleep time (SMD = 0.68, 95% CI [0.15, 1.22], p = 0.010) at post-intervention. None of the characteristics significantly affected the overall effect size on sleep quality.
Acupressure appears to be a promising intervention for enhancing sleep quality among cancer patients. Future studies should elucidate the long-term effects of acupressure on sleep quality, identify effective acupressure characteristics and determine which types of cancer patients benefit from this intervention.
This study provides a comprehensive summary of evidence supporting the use of acupressure to enhance sleep quality in cancer patients and demonstrates its effectiveness in clinical nursing practice.
PRISMA 2020 statement.
No Patient or Public Contribution.
Stroke incidence has increased recently, causing functional impairments in most patients. Augmented reality(AR) is frequently employed as an interactive and repetitive technology to facilitate functional rehabilitation. Therefore, this study aimed to examine the current evidence in the effect of AR for stroke rehabilitation.
Systematic review with meta-analysis.
Seven electronic databases including PubMed, Medline, CINAHL, Web of Science, Scopus, Embase and Cochrane were searched by MeSH terms and keywords such as ‘Stroke’ ‘Augmented reality’ up to December 1, 2024.
The Cochrane Risk of Bias tool was used to evaluate potential bias. Meta-analysis and Trial Sequence Analysis were used to analyse by the datastata15.0 software and TSA v0.9 software.
We searched 11 studies in a systematic review and 8 in a meta-analysis. The AR training group exhibited a significantly superior Berg Balance Scale scores(BBS) to those of the traditional training group. The Z-value curve of the sixth study crossed the traditional and TSA boundary values. Subgroup analysis revealed that BBS was significantly influenced in the hospital compared to the home intervention. The Timed Up and Go Test scores(TUG) and the 10-Meter Walk Test scores(10MWT) were similar in the AR and traditional training groups.
AR technology is beneficial for the lower limb balance functional rehabilitation of stroke patients. However, further exploration and verification are necessary due to an insufficient number of trials.
The findings provide clinical references for implementing AR in rehabilitation interventions for stroke patients.
This paper is helpful for nurses in the rehabilitation training process of stroke patients, to make personalised plans for their rehabilitation, implement rehabilitation, provide health education and address other aspects of efforts, to provide patients with comprehensive support and help, to promote the functional recovery of patients and improve the quality of life.
PRISMA guidelines.
PROSPERO number: CRD42024533761.
MJEditor (www.mjeditor.com) provided English editing services during the preparation of this manuscript.
Children experience significant psychological and physical stress during medical procedures. Picture books can help reduce anxiety by familiarising children with their upcoming procedures.
To synthesise and evaluate the effectiveness of picture books on reducing preoperative anxiety in children and their parents.
A systematic review and meta-analysis of randomised controlled trials reported following the PRISMA guidelines.
PubMed, CINAHL, EMBASE, Cochrane Library, China National Knowledge Infrastructure (CNKI) and Wanfang databases were searched from inception to January 1, 2024. This review includes randomised controlled trials published in Chinese or English that evaluate the efficacy of picture book interventions in reducing preoperative anxiety among children undergoing elective surgery. Studies were excluded if: (1) they were conference abstracts, protocols or repetitive publications; (2) they were not available in full text; (3) the data reported in the study could not be obtained from the authors; and (4) they were not published in Chinese or English. The Cochrane Risk of Bias Tool version 2.0 was used to assess the risk of bias of the included studies. Meta-analysis was conducted using Review Manager 5.4.
Five studies with a total of 418 patients were included in the analysis. Picture books can significantly reduce children's preoperative anxiety (SMD = −0.57, 95% CI = −0.76 to −0.37; p < 0.001). The certainty of the evidence for the effectiveness of picture books on preoperative anxiety was considered moderate.
Picture books can effectively reduce preoperative anxiety in children by familiarising them with the unknown. It has shown the potential to serve as preoperative educational material for paediatric patients.
Not applicable.
This meta-analysis highlights the effectiveness of picture books in reducing preoperative anxiety in children undergoing medical procedures. Healthcare professionals should consider integrating these interventions into preoperative health education.
CRD42023435105 (https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023435105)
Cancer patients, at both early and advanced stages, face complex bio-psycho-social-spiritual problems impacting their quality of life (QoL). Managing Cancer and Living Meaningfully (CALM) therapy is a psychotherapeutic approach that helps cancer patients find hope and meaning in life, thereby improving QoL.
This study aimed to critically assess the effects of CALM therapy on the QoL in cancer patients.
This was a systematic review and meta-analysis of randomised controlled trials (RCTs).
The main outcome was QoL, and the secondary outcomes were anxiety, depression, spiritual well-being, fatigue and sleep quality. Five English databases (PubMed, Embase, Scopus, Cochrane Library and ProQuest) and one trial registry site (Clinicaltrial.gov) were searched from their inception until March 2024. The pooled effect sizes were calculated using random-effects models and expressed as standard mean difference (SMD) or weighted mean difference (WMD). Review Manager 5.4 was used for data analysis. A sensitivity analysis was done by excluding one trial at a time to check the consistency of the results on QoL. The study protocol was prospectively registered on PROSPERO (CRD42023398655).
Fifteen trials met the inclusion criteria for the systematic review and twelve for the meta-analysis, with a total of 1635 cancer patients. CALM therapy showed significant benefits on QoL (SMD = 1.97), spiritual well-being (WMD = 1.93) and sleep quality (SMD = −1.56) compared with usual care. It also reduced anxiety (SMD = −1.94), depression (SMD = −1.28) and fatigue (SMD = −5.86) significantly. The sensitivity analysis confirmed the stability of these results when each trial was removed one by one.
CALM therapy may improve QoL, spiritual well-being, sleep quality and relieve anxiety, depression and fatigue in cancer patients.
This therapy should be promoted clinically as a comprehensive psychotherapeutic approach in cancer care.
CRD42023398655.
FreshRSS 