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Nurse-led education programs in childcare settings are critical for improving early childhood health outcomes and caregiver practices. Despite their potential, a systematic synthesis of their effectiveness is lacking.
To summarize the characteristics and evaluate the effectiveness of existing nurse-led education programs in childcare settings through a systematic review of experimental studies.
This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive search was conducted in five databases from inception to December 9, 2024. Two reviewers independently screened articles, extracted data, and assessed study quality. Due to methodological heterogeneity, a narrative synthesis was performed. The review was registered with PROSPERO (CRD42024618983).
Twelve studies met the inclusion criteria, involving 900 childcare workers and 920 families. The programs targeted two main areas: prevention of child health issues and management of child health issues. Lectures and group discussions were the most frequently used strategies. Nurses assumed diverse roles, including educators, consultants, and facilitators. The findings revealed several benefits, including reduced rates of upper respiratory illness, improved family health practices—such as appropriate medication use—and enhanced childcare worker competencies in first aid knowledge.
Nurses play a critical role in implementing education programs in childcare settings. Their contributions should be fully integrated into program planning and delivery. Future research should adopt rigorous methodologies to strengthen evidence-based practices and improve child health outcomes and caregiver competencies.
Pressure injuries (PIs) remain a problem for patient safety and the sustainability of healthcare systems. Difficulties persist in their assessment, prevention and monitoring by multidisciplinary teams. International recommendations point to this problem as a priority area for resolution in terms of patient safety. Research on the subject has been positive, resulting in several guidelines for clinical practice, but professionals' adherence remains below what is expected for their implementation. This scoping review aimed to identify interventions that increase multidisciplinary teams' adherence to the prevention and management of PIs between hospitals and the communities. The search was carried out in the MEDLINE (via PubMed), CINAHL, Scopus, Web of Science, JBI, Cochrane and grey literature databases by two independent reviewers, and led to the identification of 16 articles that met the eligibility criteria and made it possible to answer the research question. Strategies to improve adherence by health professionals include the creation and training of multidisciplinary teams, the implementation of new risk assessment models, Wound Boards, injury prevention reminders, video consultation apps, multidisciplinary rounds, documentation and recording. No studies were identified that assessed staff adherence to interventions aimed at preventing and managing PIs in the continuum between hospitals and communities, which is suggestive of the need for further research in this area.
The climate crisis impacts global health and is exacerbated by the healthcare sector's emissions. Nurses, as the largest professional group, are key to promoting climate-resilient, low-carbon health systems. Integrating climate change and sustainable development into nursing education is crucial, yet gaps remain in understanding their representation in curricula and practice. This review examines the role of nursing in addressing climate change and sustainable development, focusing on their integration into education and related recommendations.
A narrative literature review was conducted to synthesize existing recent research on nursing, climate change, and sustainable development. No restrictions were applied to study design; however, studies published before 2017 were excluded.
A search was conducted in PubMed, CINAHL, and Google Scholar (January 2023, and updated in August 2024). Relevant studies were screened and duplicates removed. Data extraction followed inductive content analysis, with coding and categorization being undertaken collaboratively. MAXQDA PLUS 2022 was used for analysis, and new findings from the follow-up search were incorporated into existing categories or new ones were developed.
The review analyzed 33 articles on nursing's role in addressing climate change. Findings highlight gaps in knowledge, delayed responses, and the need for nurses to take on leadership roles. Education is crucial, yet curricula integration remains limited. Nurses must engage in advocacy, interdisciplinary collaboration, and policy development. Barriers include a lack of faculty awareness and overloaded curricula. A collective call for action urges nurses to embrace sustainability, strengthen research, and lead in achieving climate resilience.
This review highlights the need to integrate climate change and sustainable development into nursing education and practice. Nurses are vital to public health and to addressing climate change, but education gaps hinder their potential. Future research should focus on improving curricula, exploring Advanced Practice Nursing leadership roles, and addressing healthcare system challenges.
Integrating Sustainable Development and the Climate Crisis into nursing education and practice is crucial to preparing nurses for the health challenges posed by environmental changes, as well as for ensuring effective patient care, disaster response, and policy advocacy. Their integration is a process and should be viewed as being a consequence of the delayed responses, as identified in this review. This process should specifically address the identified gaps, such as the lack of basic knowledge concerning climate change and sustainable development, as well as learning to take on leadership roles in practice. More specifically, taking a leadership role includes both acting as a knowledge multiplier and increasing the health literacy of the general population.
Physiological, psychological, and social changes may make older adults more vulnerable to stressors and lead to adverse health outcomes. It remains unclear whether interventions targeting coping strategies in older adults are effective.
This study aimed to systematically review and summarize existing interventions aimed at improving coping strategies in older adults and analyze intervention effectiveness.
A systematic search was conducted using PubMed, EMBASE, Web of Science, Cochrane, CINAHL, PsycINFO, CNKI, SinoMed, VIP, and WanFang databases for randomized controlled trials (RCTs) and quasi-experimental studies. Two researchers independently performed literature screening, quality assessment, and data extraction.
A total of 9 studies were included, comprising 7 RCTs and 2 quasi-experimental studies. Meta-analysis revealed that the interventions significantly enhanced the use of problem-focused coping strategies among older adults (SMD = 0.37, 95% CI: 0.12 ~ 0.63, p = 0.005, I 2 = 39%). However, there was no significant effect on emotion-focused coping strategies (SMD = −0.07, 95% CI [−0.62, 0.48], p = 0.80, I 2 = 76%). Moreover, no significant statistical differences were observed between the intervention group and the control group in terms of positive (SMD = 1.49, 95% CI [−0.23, 3.21], p = 0.09, I 2 = 98%) or negative coping strategies (SMD = −0.76, 95% CI [−1.79, 0.28], p = 0.15, I 2 = 96%).
Interventions targeting coping strategies can significantly improve the problem-focused coping strategies of older adults. It is crucial to help older adults accurately recognize daily stressors, acquire emotional regulation strategies, and enhance coping skills. More large-scale RCTs are needed to draw more robust conclusions.
Chronic heart failure (CHF) is a progressive life-limiting condition that necessitates early implementation of advance care planning (ACP). However, patients and caregivers encounter emotional, informational, and cultural barriers to effective ACP engagement. This meta-synthesis consolidates qualitative evidence to deepen our understanding of ACP practices in CHF care.
This study aimed to explore experiences of CHF patients and their caregivers in ACP, which is defined as a proactive decision-making process to establish future treatment plans based on patients' values. The study also aimed to identify barriers and facilitators influencing ACP decisions and assess the impact of flexible, personalized ACP approaches on care quality.
Using qualitative meta-synthesis, we analyzed 10 qualitative studies on CHF patients' and caregivers' ACP experiences. Data were thematically synthesized to identify emotional, relational, and practical factors that influence engagement in ACP.
Three themes emerged: (1) heart failure patients and caregivers face difficulties in ACP (difficulties from patients, difficulties from the family, and difficulties from the society), (2) multidimensional drivers and impacts of ACP (advance care planning drivers, acceptance and implementation of ACP, emotions and effects of ACP), (3) flexible, personalized ACP delivers tangible benefits (timing and effectiveness of ACP discussions, patients and caregivers have personalized needs for ACP, and patients and caregivers affirm ACP benefits).
ACP plays a critical role in improving end-of-life care quality and reducing emotional and decision-making burdens on caregivers. Flexible and personalized ACP strategies supported by trained healthcare professionals more effectively meet the unique needs of patients and families. To overcome persistent barriers and promote broader ACP adoption, healthcare systems should prioritize provider communication training, ACP education, and support systems tailored to diverse cultural contexts.
Wound care education is underrepresented in medical students' curricula. This scoping review aims to provide an overview of the published literature on educational methods and interventions used for chronic wound care education, specifically for medical students. A five-step framework for scoping reviews was used and includes a specific research question, identification of relevant literature, selection of studies, extraction of data and synthesis of the results. In total, six electronic databases (PubMed, Cochrane Library, Embase (Ovid), Web of Science, Scopus and APA PsychInfo) were searched with pre-defined search terms. The selection and evaluation of studies were conducted in a blinded review by three independent reviewers. The review was carried out in accordance with the PRISMA-ScR checklist for scoping reviews. We identified nine suitable studies regarding educational interventions for medical students in wound care. The included papers showed a broad variety of educational approaches, such as online learning tools or hands-on skills training. The implemented interventions had a positive effect on the students' wound care knowledge and their ability to perform wound care-related clinical skills. There is no comparison of the effectiveness of the different interventions, and it is not evaluated how effective they are compared to traditional lectures. There remains a need for more wound care education with a focus on the needs of medical students.
Artificial Intelligence is revolutionizing healthcare by addressing complex challenges and enhancing patient care. AI technologies, such as machine learning, natural language processing, and predictive analytics, offer significant potential to impact nursing practice and patient outcomes.
This systematic review aims to assess the impact of Artificial Intelligence applications in healthcare on nursing practice and patient outcomes. The goal is to evaluate the effectiveness of these technologies in improving nursing efficiency and patient care and to identify areas requiring further research.
This review, conducted in August 2024, followed PRISMA guidelines. We searched PubMed, GOOGLE SCHOLAR, and Web of Science for studies published up to August 2024. The inclusion criteria were original research on AI in nursing and healthcare practice published in English. A two-stage screening process was used to select relevant studies, which were then analyzed for their impact on nursing practice and patient outcomes.
A total of 5975 studies were surveyed from the previously mentioned databases, which met the inclusion criteria. Findings show that AI applications, including machine learning, robotic process automation, and natural language processing, have improved diagnostic accuracy, patient management, and operational efficiency. Machine learning enhanced disease detection, reduced administrative tasks for nurses, NLP improved documentation accuracy, and physical robots increased patient safety and comfort. Challenges identified include data privacy concerns, integration into existing workflows, and methodological variability.
AI technologies have substantially improved nursing practice and patient outcomes. Addressing challenges related to data privacy and integration, as well as standardizing methodologies, is essential for optimizing AI's potential in healthcare. Further research is needed to explore the long-term impacts, cost-effectiveness, and ethical implications of Artificial Intelligence in this field.
Artificial Intelligence (AI) is revolutionizing healthcare by enhancing nursing practices and improving patient outcomes. Tools such as Clinical Decision Support Systems (CDSS), predictive analytics, robotic process automation (RPA), and remote monitoring empower nurses to make informed decisions, optimize workflows, and monitor patients more effectively. AI enhances decision-making, boosts efficiency, and facilitates personalized care, while aiding in early detection and real-time data analysis. It also contributes to better nurse education and patient safety by minimizing errors and enabling remote consultations. However, for AI to be successfully integrated into healthcare, it is essential to tackle challenges related to training, ethical considerations, and data privacy to guarantee its effective implementation and positive impact on the quality and safety of healthcare.
Chronic and non-healing wounds are a global health issue with limited effective treatments. Wound care costs continue to rise, highlighting the need for new therapies. Medicinal plants, particularly African species, show promise for enhancing wound healing. This review analysed 93 studies and identified 37 relevant to wound healing, covering 39 plant species. Ten species were identified for their rich phytochemical content, specifically flavonoids, terpenoids, and alkaloids (plant-derived compounds). These compounds act synergistically, enhancing the wound healing process at each stage. Flavonoids reduce inflammation and support tissue turnover, while terpenoids enhance collagen production and wound closure. Alkaloids offer antimicrobial benefits and support wound contraction. Notable plants include Ageratum conyzoides and Aspilia africana (Asteraceae family); promoting haemostasis by lowering plasma fibrinogen and enhancing platelet-derived growth factors; Withania somnifera (Solanaceae); and Entada africana (Fabaceae), effectively regulating inflammation. In the proliferative phase, Ocimum gratissimum (Lamiaceae), Calendula officinalis (Asteraceae), and Centella asiatica (Apiaceae) although C. officinalis is native to Southern Europe, and C. asiatica an Asian-native; they are widely used in African traditional medicine and included here for their relevance in African wound healing practices; Justicia flava (Acanthaceae), Alternanthera sessilis (Amaranthaceae), and Acalypha indica (Euphorbiaceae); play key roles in enhancing collagen production, angiogenesis, and re-epithelialisation. This comprehensive analysis highlights the role of African medicinal plants in wound healing and their potential to improve wound care therapy.
This scoping review investigates the use of point-of-care infrared thermography devices for assessing various wound types. A comprehensive search across four databases yielded 76 studies published between 2010 and 2024 that met the inclusion criteria. The review highlights thermography applications in burns, surgical wounds, diabetic foot ulcers, pressure injuries, and other lower limb wounds. Key findings indicate its effectiveness in detecting early signs of inflammation and healing delays, facilitating timely interventions. The technology shows promise in accurately predicting wound healing trajectories and assessing treatment outcomes. Recent advancements have made thermographic devices more affordable and user-friendly, expanding their clinical potential. However, challenges persist, including reimbursement, training requirements, and integration with electronic medical records (EMRs), with EMR integration identified as a critical barrier to widespread adoption. While preliminary findings are promising, the current evidence base is constrained by small sample sizes, retrospective study designs, and limited consideration of skin tone variability. Large, prospective studies are essential to validate the clinical utility of thermography in wound care and to inform the development of standardised protocols that support equitable, bias-reduced assessment across diverse populations. Addressing these gaps is critical for advancing research, enhancing clinician training, and improving patient outcomes in wound care. Overall, point-of-care thermography demonstrates significant potential to enhance wound assessment and monitoring, thereby elevating care quality and patient outcomes.
Chronic wounds represent a substantial socioeconomic, financial, and psychological burden. We examine preclinical and clinical evidence assessing the impact of chronic wounds on negative affect, cognition, and quality of life and discuss potential mechanisms underlying the link between chronic wounds and negative affect and cognition. There is limited preclinical evidence examining negative affect and wounds, but anxiety-related behaviour has been reported in a rat incisional wound model. The incidence of anxiety and depression in people with chronic wounds varies considerably. Potential mechanisms underlying the link between chronic wounds and negative affect include the immune system, pain, metabolic dysfunction, inflammation, and vascular damage. There is a paucity of both preclinical and clinical studies examining the effect of chronic wounds on cognition, highlighting a need for more studies in this area. Research suggests that there are deficiencies in the management of anxiety, depression, and cognitive impairment in people with chronic wounds, but developing and administering therapies that target these comorbidities may have a positive impact on quality of life and wound healing. Integration of mental health and cognition screening into wound care protocols would provide substantial benefits both socioeconomically and to individuals with chronic wounds.
Home-based exercise offers a cost-effective way to receive thorough rehabilitation without the requirement of costly supervised treatment.
To investigate the effects of home-based exercise on the balance ability in post-stroke patients.
A thorough search was carried out on various databases, such as Cochrane Library, Web of Science, PubMed, Embase, and China National Knowledge Infrastructure Library, until October 2024. The inclusion criteria were limited to randomized controlled trials that evaluated the impact of home-based exercise interventions.
The meta-analysis indicated that home-based exercise significantly improved static balance ability (Berg Balance Scale [BBS]: MD = 3.45, 95% CI [1.43, 5.47], I 2 = 71%, p = 0.0008, random-effects model). Conversely, the analysis revealed that the home-based exercise group did not exhibit a statistically significant improvement in the Time up and Go Test (TUG) when compared to the control group (TUG: MD = −0.34, 95% CI [−4.30, 3.61], I 2 = 96%, p = 0.86, random effects model). The subgroup analysis revealed that home-based exercise significantly enhanced balance ability in patients with subacute stroke (BBS: p < 0.0001; TUG: Overall effect p = 0.02). However, no significant improvement was observed in patients with chronic stroke (BBS: p = 0.39). Regarding the duration of intervention, both short-term and long-term interventions were effective on the BBS (p < 0.0001 and p = 0.0008, respectively), although no significant difference was found for the TUG. Participants engaging in exercise for more than 90 min per week demonstrated greater improvements in balance ability (BBS: p < 0.0001; TUG: p = 0.02). When considering national economic levels, significant effects on the BBS were observed in both developed and developing countries (p = 0.0001 and p < 0.0001, respectively), while significant effects on the TUG were noted only in developing countries (p = 0.04).
Home-based exercise interventions showed significant results in improving static balance in patients with subacute stroke, especially home-based exercise that lasted longer than 12 weeks and lasted at least 90 min per week. However, more methodologically rigorous randomized controlled trials are needed to validate these results. In addition, the optimal exercise program and type to optimize the balance ability of stroke patients also need further research.
Patients with advanced cancer can suffer from serious distress like death anxiety and depression, in addition to facing a reduced quality of life. Death education interventions have been shown to improve these outcomes, but their effectiveness remains unclear, especially in the advanced stages.
This meta-analysis aimed to examine the efficacy of death education interventions on death anxiety, depression, and quality of life in advanced cancer sufferers, and to explore the influence of the intervention site, duration, the age of participants, and dyadic relationships with caregivers on the effectiveness of these interventions.
A meta-analysis of randomized controlled trials was performed.
A systematic search of 10 electronic databases identified 19 eligible RCTs with 1531 participants. Data were extracted and analyzed via Review Manager 5.4. Subgroup analyses were performed on the basis of the intervention site, duration, age of participants, and presence of caregivers.
In comparison to the control intervention, the death education intervention notably alleviated death anxiety (SMD = −2.11, 95% CI: −5.91 to −0.89, p = 0.008) and depression (SMD = −0.45, 95% CI: −0.72 to −0.18, p = 0.001). Quality of life (SMD = 0.86, 95% CI: 0.39–1.33, p = 0.0003) was also significantly improved. Subgroup analyses revealed that interventions with longer durations, conducted in professional settings, and targeting younger patients were more likely to be effective in reducing depression and enhancing the quality of life. Interventions without family companionship were more effective in improving depression, while interventions with family companionship were more effective in improving quality of life.
Death education interventions are effective at improving death anxiety, depression, and quality of life in patients with advanced cancer. Tailoring interventions to individual features and cultural backgrounds is crucial to achieving the best effect.
Death education is an effective and important intervention measure that can help patients with advanced cancer better cope with death anxiety and depressive emotions and improve their quality of life. Clinical medical workers should select appropriate death education programs based on the specific conditions of patients and provide necessary support and guidance.
CRD42024565376
“Opiophobia” lacks a clear definition and measurement, but it is commonly used by researchers and healthcare professionals in pain management to describe the underutilization of opioids by patients, caregivers, prescribers, and other healthcare professionals. This inconsistency complicates research and clinical interventions.
This systematic review aimed to comprehensively evaluate the conceptualization and operationalization of opiophobia across quantitative studies involving adult populations.
Peer-reviewed articles published before July 2024 were retrieved from four bibliographic databases (CINAHL, Embase, MEDLINE, and Scopus) and systematically reviewed. Included studies defined and/or measured opiophobia or opioid stigma among adult patients, family caregivers, and healthcare professionals. The review was conducted in two phases: the first phase provided a comprehensive understanding of study characteristics, while the second phase evaluated the conceptualization and measurement of opiophobia.
Thirty-six articles met inclusion criteria. Studies focused on healthcare professionals (n = 23, 64%); adult patients (n = 13, 33%), including 7 studies involving patients with cancer (19%); healthcare professionals and patients (n = 2, 5%); and family caregivers (n = 1, 3%). Among the studies that defined opiophobia (n = 20, 67%), common definitions included fear, prejudice, reluctance, addiction, exaggeration, underutilization, and inappropriate attitudes/beliefs, respectively. Limitations included the predominance of observational designs (n = 32, 89%) and the use of investigator-developed instruments (n = 27, 73%).
Instruments measuring opiophobia focused on opioid-related fears and behaviors. Instrument items that measured opiophobia primarily focused on fears and behaviors resulting from these fears. It remains unclear whether opiophobia is solely fear-based or also includes poor adherence to prescribed opioids. The wide variations in definitions and the use of mostly investigator-developed measures led to inconsistencies among studies. Further research is needed to design specific interventions and determine delivery times.
Pyoderma gangrenosum (PG) is a neutrophilic dermatosis associated with significant morbidity and mortality, with no consensus treatment to date. To review all clinical trials of treatments for PG to synthesise clinical evidence regarding the efficacy and safety of different treatments. After PROSPERO (CRD42023459180) registration, we systematically searched five databases (clinicaltrials.gov, CENTRAL, Embase, PubMed and Scopus) up until 18th May 2024 for PG treatments. Of 10 579 identified articles, 5853 deduplicated abstracts were screened. Twenty studies met the screening criteria after a full text review of 60 articles. We assessed the risk of bias using ROBIN-I for non-randomised and ROB-2 for randomised trials. Two reviewers independently performed article screening and quality assessments. Two reviewers independently extracted and recorded data on study characteristics, participants' demographics, disease characteristics, treatment regimens, and outcomes for the selected studies. A single-arm meta-analysis of available RCTs and non-randomised studies was conducted to analyse the outcomes of different systemic immunomodulators. The primary outcome was the complete healing of PG. Secondary outcomes included rates of recurrence, treatment failure, adverse events and time to complete healing. A total of twenty (20) interventional studies were included in the data synthesis: nine (9) prospective open-label studies, six (6) prospective cohort studies, three (3) open-label clinical trials, and two (2) randomised controlled trials evaluating multiple biological, systemic, and topical interventions. On random effects meta-analysis of systemic therapies including adalimumab, canakinumab, infliximab, chlorambucil, cyclosporine, cyclophosphamide and prednisolone, the pooled proportion of complete healing across 11 studies was 0.59 (95% confidence interval [CI]: 0.41–0.74; Χ 2 = 26.66, p < 0.01; I 2 = 66%); the pooled proportion of PG recurrence across 6 studies was 0.30 (95% CI: 0.20–0.41; Χ 2 = 1.14, p = 0.95; I 2 = 0%); the pooled proportion of serious adverse effects from 4 studies was 0.10 (95% CI: 0.05–0.19; Χ 2 = 5.01, p = 0.17; I 2 = 40%); and the pooled proportion of PG treatment failure across seven studies was 0.36 (95% CI: 0.24–0.49; Χ 2 = 12.78, p = 0.03; I 2 = 61%). The proportion of complete wound healing varies significantly across treatments and recurrence is common even in a limited follow-up period. Heterogeneity of study methods and low numbers hamper disease research. There remains a significant unmet need for better outcome measures than just complete healing as well as better treatment options to improve patient outcomes.
Instant messaging-based applications are increasingly used to deliver interventions designed to promote health behavior change. However, the effectiveness of these interventions has not been evaluated.
This systematic review and meta-analysis aimed to evaluate the effectiveness of instant messaging-based interventions on health behavior change, addressing a gap in the literature regarding the impact of instant messaging on various health behaviors.
We conducted comprehensive searches of six electronic databases (PubMed, EMBASE, Cochrane Library, PsycINFO, CINAHL Plus, and Web of Science) from their inception until July 2024, utilizing terms related to health behavior and instant messaging. Two authors independently screened studies and extracted data. Randomized controlled trials published in English that investigated the effects of instant messaging-based interventions on health behavior change, including physical activity, sedentary behavior, sleep, diet/nutrition, cancer screening, smoking cessation, and alcohol consumption were included. We used the revised Cochrane Risk-of-Bias Tool to assess the quality of the studies.
Fifty-seven randomized controlled trials published between 2014 and 2024 were included. The results showed that compared with the control groups, instant messaging-based interventions had statistically significant differences in physical activity (SMD = 0.52, 95% CI [0.21, 0.83], p < 0.001) and sleep (SMD = −0.93, 95% CI [−1.44, −0.42], p < 0.001). It also significantly impacted smoking cessation (OR = 1.88, 95% CI [1.28, 2.7], p < 0.001). However, it did not influence sedentary behavior (SMD = 0.25, 95% CI [−0.24, 0.74], p = 0.01) or diet/nutrition (SMD = 0.01, 95% CI [−0.31, 0.34], p < 0.001).
Instant messaging-based interventions are promising in enhancing health behavior change, including physical activity, sleep, and smoking cessation. Leveraging real-time communication and multimedia content can improve patient engagement and intervention effectiveness.
Medication errors, particularly during administration, are a major threat to patient safety, with interruptions being a key contributor. Nurses are the most affected by these disruptions, and various interventions have been proposed to reduce interruptions.
This review evaluates the effectiveness of preventive and responsive interventions aimed at reducing interruptions during medication administration.
A systematic search of multiple databases identified 14 eligible studies on interventions targeting nurse interruptions. The review includes randomized controlled trials and quasi-experimental studies, focusing on interruption and medication error rates. Significant heterogeneity prevented meta-analysis.
Preventive strategies, like no-interruption vests and awareness campaigns, may reduce interruptions from external sources, but nurse-to-nurse interruptions remained common. Responsive strategies showed limited success in reducing interruptions but improved nurses' ability to manage them. The impact on medication errors was inconclusive.
Preventive strategies help reduce interruptions, but more targeted interventions are needed for nurse-to-nurse disruptions. A combined approach of preventive and responsive strategies can enhance medication safety.
Hematological cancers impair patients' quality of life (QoL) due to prolonged and complex treatments. Digital empowerment programs enhance patient engagement by supporting symptom management and psychosocial well-being.
This study was conducted to examine the effects of patient-centered digital empowerment programs on hematological cancer care.
As part of this study, a comprehensive search was conducted in nine databases and the gray literature in March 2025. The screening included randomized controlled trials without any time restrictions. This study adhered to the guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Fixed-effect and random-effect models were used in the meta-analysis. Cochran's Q chi-square test and I 2 statistic were applied to assess heterogeneity. Data analysis was performed using the Comprehensive Meta-Analysis (CMA) 3 software.
A total of seven studies were included in this meta-analysis. Patient-centered digital empowerment programs were found to have moderate and positive effects on depression (Hedges' g = 0.27, p < 0.001), distress (Hedges' g = 0.28, p < 0.001), self-efficacy, and QoL (Hedges' g = 0.22, p < 0.001). There was no significant effect on fatigue levels in patients with hematological cancers (p = 0.27), suggesting that digital empowerment programs may not be effective in managing fatigue. The results of the sensitivity analysis support the robustness and reliability of the study findings.
Digital empowerment programs may serve as a moderately effective tool in improving depression, distress, self-efficacy, and QoL among patients with hematological cancers. However, they exhibit limited effects on physical symptoms, particularly in fatigue management. Therefore, more comprehensive and multidisciplinary interventions are needed to address the management of physical symptoms effectively. Patient-centered digital empowerment programs enable early intervention by assisting healthcare professionals in symptom tracking. Digital solutions enhance care processes by improving patient education, psychosocial support, and self-management skills.
Cognitive decline, including subjective cognitive decline (SCD), mild cognitive impairment (MCI), and dementia, significantly affects social participation, leading to social isolation and reduced quality of life. Enhancing social participation through interventions may mitigate these effects, yet evidence on intervention effectiveness and mechanisms remains inconsistent.
To evaluate the effectiveness of social participation interventions for individuals with cognitive decline and identify effective behavior change techniques (BCTs) supporting social participation.
Our search using the following databases—PubMed, Web of Science, Embase, Cochrane Library, CINAHL, Scopus, CNKI, and Wanfang—was conducted until October 2024. The quality of the included studies was assessed using the Cochrane risk of bias tool for randomized trials. Meta-analyses were conducted using Review Manager 5.4 and Stata18, and the certainty of evidence was rated using the Grading of Recommendations Assessment, Development, and Evaluation approach.
Sixteen RCTs involving 2190 participants were included. Music therapy (SMD = 0.62, 95% CI [0.15, 1.10]) and reminiscence therapy (SMD = 0.34, 95% CI [0.02, 0.66]) demonstrated significant positive effects on social participation. Group-based interventions were particularly effective (SMD = 0.23, 95% CI [0.04, 0.43]). Commonly used BCTs included goal setting, behavioral practice/rehearsal, and social support. However, substantial heterogeneity and limited data on SCD and MCI restricted generalizability.
Interventions promoting social participation may enhance engagement for individuals with cognitive decline, particularly through music therapy, reminiscence therapy, and group-based formats. The complexity and dynamic nature of social interaction require individuals to engage and integrate various cognitive functions and skills, which can present significant challenges for older adults with cognitive impairments in their daily social participation. Further research is needed to optimize intervention components and address gaps in targeting early cognitive decline stages.
Socially assistive robots (SARs) have been used in group interventions for older adults; however, their effectiveness remains unclear. This systematic review aimed to synthesize evidence on the efficacy of group interventions with SARs on various outcomes (physical, cognitive, psychological, quality of life, therapeutic engagement, and sociality) for older adults, and the factors that influence their effectiveness.
A literature search was conducted using five databases (Web of Science, PubMed, Scopus, PsycINFO, and MEDLINE) in October 2024. The research team selected and analyzed the studies applying a narrative synthesis.
In all, 25 articles were identified, 15 of which were deemed of good quality. We found that companion robots are commonly used in group interventions for older adults that consist of physical, cognitive, and combined physical and cognitive activities. Insufficient evidence was identified on the effectiveness of physical interventions and groups with physical and cognitive activities on health outcomes (i.e., physical, cognitive, psychological, and quality of life). Regarding the cognitive group interventions, positive physical outcomes (i.e., improved sleep quality, decreased pulse rate, and increased pulse oximetry), improved cognitive function, positive psychological outcomes (i.e., decreased agitation, depression, anxiety, and loneliness, and increased positive emotions) were found; however, the positive effects in terms of cognitive level and certain psychological outcomes were comparable to the control groups. Mixed results were reported for quality of life in older adults. Across the three types of interventions, robots facilitated engagement and increased the sociality of most older adults. The effectiveness depended on the cognitive function of the older adults, the presence of staff, the type of robot, and the schedule of the interventions.
Research gaps have been identified, and more rigorous studies investigating the effectiveness of different types of group interventions in older adults are needed before applying SARs in group interventions on a large scale.
Given the importance of group interventions in nursing care of older adults, healthcare professionals can use socially assistive robots in such interventions to assist in caring for older adults.
The characteristics, application, and effectiveness of chatbots in improving the mental health of young people have yet to be confirmed through systematic review and meta-analysis.
This systematic review aims to evaluate the effectiveness of chatbot-delivered interventions for improving mental health among young people, identify factors influencing effectiveness, and examine feasibility and acceptability.
To identify eligible interventional studies, we systematically searched 11 databases and search engines covering a publication period of January 2014 to September 2024. Meta-analyses and subgroup analyses were performed on randomized controlled trials to investigate the effectiveness of chatbot-delivered interventions and potential influencing factors. Narrative syntheses were conducted to summarize the feasibility and acceptability of these interventions in all the included studies.
We identified 29 eligible interventional studies, 13 of which were randomized controlled trials. The meta-analysis indicated that chatbot-delivered interventions significantly reduced distress (Hedge's g = −0.28, 95% CI [−0.46, −0.10]), but did not have a significant effect on psychological well-being (Hedge's g = 0.13, 95% CI [−0.16, 0.41]). The observed treatment effects were influenced by factors including sample type, delivery platform, interaction mode, and response generation approach. Overall, this review demonstrates that chatbot-delivered interventions were feasible and acceptable.
This review demonstrated that chatbot-delivered interventions had positive effects on psychological distress among young people. Chatbot-delivered interventions have the potential to supplement existing mental health services provided by multidisciplinary healthcare professionals. Future recommendations include using instant messenger platforms for delivery, enhancing chatbots with multiple communication methods to improve interaction quality, and refining language processing, accuracy, privacy, and security measures.
FreshRSS 