Conectar
Chronic wounds present a significant challenge to society and have a negative impact on the quality of life and daily activities of patients. This review aimed to identify the cost-effectiveness of the currently used care alternatives for the treatment of chronic wounds. This study serves to identify cost-effectiveness boundaries and provide a basis for determining the cost-effectiveness of the proposed care alternatives. A systematic literature search was conducted in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Articles published on Web of Science and PubMed from June 2013 to June 2023 were included. A comparative analysis was performed using the data adjusted for inflation and transformed for the same time horizon. The median time to heal was approximately 2.5 months in the first quartile of studies ending at 1.3 months and the third quartile ending at 3.7 months. The average cost of complete chronic wound healing for all care alternatives in the study sample was $6435, with a median cost of $5814. This systematic review covers a diverse range of treatment alternatives, their health effects and costs and highlights the complex landscape of cost-effectiveness in the treatment of chronic wounds.
Trial Registration: PROSPERO database under registration number: CRD42023434074
Person-centred care (PCC) has been increasingly promoted in wound management, yet its theoretical foundations and practical application remain unclear. This scoping review aimed to map and synthesise how PCC frameworks, concepts and outcome measures have been used in wound care. Following the Joanna Briggs Institute methodology and PRISMA-ScR guidelines, a systematic search was conducted across major databases for studies published between 2020 and 2025. Eligible sources included empirical research, reviews and conceptual papers addressing PCC in adults with chronic wounds. Data were extracted and analysed descriptively across conceptual and evaluative domains. Fourteen publications met inclusion criteria. Only one explicit framework of person-centred wound care was identified. Most studies referred to patient-centred rather than person-centred approaches and applied principles such as empowerment, shared decision-making and communication without consistent theoretical grounding. Outcome assessment focuses mainly on clinical or functional indicators, with limited attention to relational or experience-based dimensions of care. Some studies used the term person-centred as an unreflected keyword. Person-centred wound management remains conceptually fragmented, methodologically heterogeneous and sometimes unreflected. Greater theoretical precision, consensus on terminology and development of validated frameworks and measurement tools are required to translate person-centred principles into consistent, evidence-based clinical practice.
The production of science is characterized by socio-political and technological forces that influence what knowledge is produced. In this context, empty reviews have received little attention, with debate ranging over the pros and cons of their publication. However, their dissemination may improve the ability to recognize and prioritize research gaps. The main aim of the study was to map empty reviews published in nursing science.
A scoping review in accordance with Arksey and O'Malley, Joanna Briggs Institute and Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews. The review protocol was registered in the Open Science Framework database in April 2025. Four databases and grey literature were searched; there were eligible scoping or systematic reviews defined as “empty” in the field of nursing. A modified framework of Patterns, Advances, Gaps, Evidence for practice, and Research recommendations was used to summarize the extracted data.
Fifteen empty reviews were identified. In terms of Patterns, the empty reviews were mainly published in high-income countries over the last 10 years and related to clinical practise and outcomes, education and training, organizational and human resources, and approaches to maternity care, mental health, and nursing education. In general, reporting guidelines were used, while funding was not documented. In terms of Recommendations, more primary studies, the development of tools and the strategic use of empty reviews to inform the funding and research agenda were suggested.
Empty reviews in nursing may indicate neglected or emerging areas that can help orient research agendas to ensure equity-oriented priorities and reduce the marginalization of under-investigated topics. Recognizing empty reviews as legitimate scholarly outputs supports transparent mapping of knowledge gaps, helping funders, institutions, and research programs direct resources to under-investigated areas. Dedicated registries that publicly report empty reviews, establish minimum reporting standards, and require explicit keywords in titles and abstracts would improve transparency and accessibility, and stimulate targeted primary research that can turn “empty” areas into active inquiry. From this perspective, empty reviews may attract research investment rather than be seen as methodological failures.
Patients undergoing abdominal surgeries have a chance to experience surgical-related anxiety. But the most effective non-pharmacological interventions in managing this anxiety have not yet been identified.
To examine the effectiveness of different types of non-pharmacological interventions, and identify the effective components on pre- and postoperative anxiety management among patients undergoing abdominal surgeries.
A systematic search of randomized control trials (RCTs) examined the effects of non-pharmacological interventions on preoperative and/or postoperative anxiety (Primary outcomes) among patients undergoing abdominal surgery was conducted across MEDLINE, Ovid Nursing, AMED, PsycINFO, CINAHL, EMBASE, Cochrane Library, HyRead, and WANFANG DATA from 1987 to March 1, 2024. Secondary outcomes including postoperative pain, postoperative analgesics consumption, resumption of postoperative bowel movements, and length of hospital stay were also examined. Cochrane Risk of Bias Tool (version 2.0) was used for quality assessment. Meta-analysis was performed to synthesize the findings. Narrative summaries were provided for the studies that could not be included in the meta-analysis.
This review included 35 RCTs. The interventions of included studies were categorized as prehabilitation, sensory stimulation, preoperative counseling, information provision, and psychological interventions. Meta-analysis revealed that preoperative counseling was beneficial in managing preoperative anxiety (SMD = −1.36; 95% CI = −1.96, −0.76), postoperative anxiety (SMD = −1.30; 95% CI = −1.62, −0.98), and postoperative pain (SMD = −0.84; 95% CI = −1.21, −0.47). Meanwhile, psychological interventions adopting relaxation exercises had potential effects in reducing postoperative opioid consumption and shortening time to postoperative bowel movement.
Adopting preoperative counseling is suggested for the management of pre- and postoperative anxiety and postoperative pain among patients undergoing elective abdominal surgeries. A one-off lasting for 20–45 min preoperative counseling including individualized information about the coming surgery and perioperative process, and a discussion addressing patients' concerns is recommended. Future research is needed to explore the effects of relaxation exercise on important patients' outcomes such as postoperative analgesics consumption and time to resume bowel movement among patients undergoing abdominal surgery.
PROSPERO registration number: CRD42023359484
To identify obstacles faced by nurses when using health technologies in Intensive Care Units (ICUs).
Systematic review following PRISMA and registered in PROSPERO.
Six databases were searched. Two reviewers independently screened studies and appraised methodological quality using the Joanna Briggs Institute tool. Data were synthesized narratively.
Eight studies met eligibility criteria. Barriers clustered around limited training and technical competence, shorter professional experience, increased workload with multiple devices, organizational culture, and reduced direct patient contact, which may undermine patient-centered care. Heterogeneity of study designs precluded meta-analysis.
Obstacles to technology use in ICUs arise from individual and organizational factors. Addressing these barriers requires structured education, mentoring for novice nurses, workload management, and supportive policies that integrate technology without displacing bedside care.
Nursing leaders and educators should implement ongoing, ICU-specific technology training and mentoring. Managers and policymakers must ensure adequate staffing and promote Health Technology Assessment to align device implementation with clinical needs, safeguarding patient safety and the human dimensions of care.
Human papillomavirus (HPV) is a major contributor to several preventable cancers. Although the HPV vaccine is recognized by the Centers for Disease Control and Prevention (CDC) as safe and effective, uptake among U.S. adolescents remains below optimal levels. Disparities in vaccination rates are shaped by both individual characteristics and social determinants of health (SDOH).
To systematically review and synthesize the literature examining individual factors and social determinants of health associated with HPV vaccine initiation and completion among adolescents aged 9–18 years in the U.S.
A systematic search was conducted in accordance with PRISMA guidelines, yielding 37 eligible studies from an initial pool of 2092 articles. The STROBE checklist was used to assess methodological quality, and the Levels of Evidence framework by Melnyk and Fineout-Overholt guided appraisal of study strength.
Across included studies, initiation and completion rates averaged 47% and 40%, respectively. Key predictors of higher vaccine uptake included provider recommendation, health insurance coverage, urban residence, older age, and higher parental education. Disparities were most evident among adolescents living in rural areas and those from minority or low-income backgrounds. Barriers reported in several studies included parental safety concerns and logistical challenges. Evidence regarding parental knowledge and attitudes was mixed: smaller studies suggested an influence, whereas the largest population-based study reported no significant effect.
Addressing HPV vaccination disparities requires a multifaceted approach, including improving healthcare access in underserved regions, strengthening provider–parent communication, and implementing policy interventions such as school-based vaccination programs and state mandates. Normalizing HPV vaccination as part of routine adolescent care is essential for reducing HPV-related cancer morbidity and mortality. These findings also have implications for catch-up vaccination in young adults aged 15–26 and shared clinical decision-making up to age 45, which remain important strategies for increasing protection across the lifespan.
Older adults face growing risks of depression and anxiety, yet stigma, comorbidities, cost, and limited access impede receipt of conventional care. Digital mental health interventions (DMHIs), including immersive virtual reality (VR), exergaming, and mobile apps, may reduce these barriers.
To evaluate the efficacy of DMHIs in reducing depressive and anxiety symptoms among adults aged ≥ 50 years.
We conducted a PRISMA adherent systematic review and meta-analysis of randomized controlled trials. Interventions included immersive VR, exergaming/physical digital platforms, mobile applications, and digital cognitive training. Standardized mean differences (SMDs) were pooled with random effects models; heterogeneity was assessed with I 2.
Nineteen RCTs (n = 718; mean ages 50.9–84.7 years) met inclusion criteria. Across studies, DMHIs significantly reduced depressive symptoms (SMD = −0.656, 95% CI = −0.932 to −0.380; p < 0.001) and anxiety symptoms (SMD = −0.559, 95% CI = −0.740 to −0.380; p < 0.0001). Immersive and physically engaging modalities (e.g., VR, exergaming) outperformed app-based approaches. Heterogeneity ranged from moderate to high (I 2 ≈ 69.6%–97%).
Offer DMHIs: especially VR or exergaming when access to in-person therapy is limited or as an adjunct to usual care. Provide brief onboarding and, when feasible, caregiver support to boost adherence and confidence with technology. Select or configure age-friendly interfaces (e.g., large fonts, simple navigation) to address common usability barriers. Integrate DMHIs into stepped-care or rehabilitation pathways and monitor outcomes with validated tools (e.g., GDS, STAI). Address equity by supplying devices/connectivity solutions and consider cost-effectiveness and long-term engagement in implementation plans.
Trial Registration: PROSPERO ID: CRD420250655153
Colon cancer (RC) patients holding an intestinal stoma recorded lower health-related quality of life (HRQOL) levels. Intestinal stoma leads to several difficulties, like travel, work, and sporting activities. Patients with an intestinal stoma frequently experienced changes in their HRQOL. The COH-QOL-Ostomy questionnaire comprehensively measured these changes across physical, psychological, social, and spiritual domains. We reviewed literature in order to assess any differences in HRQOL between females and males and between intestinal stoma permanence among these patients. We conducted a literature review from: British Nursing Collection, Embase, MEDLINE, Nursing & Allied Health Database, PubMed, Scopus and Web of Science databases, without any time limits. The protocol was registered with PROSPERO no. CRD420251040414. A total of 492 records were identified. Of these, 362 records were removed, obtaining 130 potential records. However, 126 of these were excluded as they did not meet the inclusion criteria including only 4 records for further analysis. The COH-QOL-Ostomy questionnaire has been considered to assess HRQOL total score and its related sub dimensions, specifically physical, psychological, social and spiritual well-being. For each item, a Likert scale has been associated raging from zero (worse outcome) to 10 (good outcome). A total of 915 observations were collected, specifically 401 related to females and 514 to males. Additionally, a total of 670 observations were recorded: 338 belonging to the temporary group and 332 to the permanent one. Data reported a significant difference in the Psychological Well Being dimensions between the two groups, in favour of the female group (t = −3.66; p = 0.035). Considering the ostomy permanence, the temporary group reported a significant and better total quality of life score (t = −7.53; p = 0.017), Psychological Well Being dimension (t = −5.24; p = 0.035), and in social dimension (t = −8.09; p = 0.015), too. Sex-related differences in HRQOL assessments could help patients to achieve the most appropriate interventions to ameliorate QOL perceptions. Permanence criteria for ostomy could better address healthcare professionals for a specific clinical pathway to improve, especially in social support, which could positively contribute to better self-care for these patients.
Skin failure is increasingly recognised across healthcare settings, yet its definition, diagnostic criteria and relationship to pressure injuries remain inconsistent with little interdisciplinary consensus. This lack of clarity complicates bedside assessment, documentation and quality reporting. Historically, pressure injuries were viewed as preventable events associated with inadequate care, but growing evidence shows that some wounds develop despite optimal preventive measures, particularly in patients with multimorbidity or limited physiological reserve. This article will review the historical development of skin failure and how it is intertwined with contrasting theories of pressure injury formation that began in the 19th century. We will track the proliferation of definitions and overlapping terms that muddle contemporary documentation and classification, and demonstrate why a unified definition is urgently needed. Skin failure represents the intersection of tissue deformation with systemic vulnerability including hypoperfusion, inflammation, vascular dysfunction, oedema, medication effects, immune compromise, nutritional depletion and age-related changes. A meaningful and practical definition must span all healthcare environments and patient populations, supporting accurate diagnosis and equitable evaluation of care quality. We outline a call to action that includes interdisciplinary consensus, standardised terminology and the development of predictive tools that integrate physiologic data, advanced analytics, and patient-centered outcomes across the healthcare continuum.
Health coaching has emerged as a promising intervention to improve health outcomes in older adults. However, its effectiveness has not been comprehensively synthesized.
To evaluate the effectiveness of health coaching interventions on anxiety, depression, quality of life, self-management behavior, and self-efficacy among older adults.
A systematic search of six English databases (PubMed, Scopus, CINAHL, Cochrane Library, APA PsycInfo, and ProQuest Dissertations & Theses Global) was conducted from inception to October 20, 2024. Standardized mean difference (SMD) and 95% confidence interval (CI) were calculated using meta-analysis with random or fixed effects. Sensitivity analyses, subgroup analyses, and publication bias tests were also performed.
Thirty-five randomized controlled trials (RCTs) involving 20,200 older adults were included in this review. Meta-analysis results indicated that health coaching interventions could significantly improve anxiety (SMD: −0.09; 95% CI: −0.15, −0.04; I 2: 0%), quality of life (SMD: 0.22; 95% CI: 0.05, 0.39; I 2: 76%), self-management behaviors (SMD: 1.15; 95% CI: 0.45, 1.86; I 2: 95%), and self-efficacy (SMD: 0.18; 95% CI: 0.02, 0.33; I 2: 69%) among older adults, but had no significant effects on depression (SMD: −0.26; 95% CI: −0.64, 0.12; I 2: 98%).
Health coaching interventions may enhance the well-being of older adults. However, the certainty of the current evidence was generally very low to moderate, and substantial heterogeneity existed across studies. Therefore, these findings should be interpreted with caution. More high-quality RCTs with extended follow-up, as well as analyses of differential effects across demographic information, are needed to provide more robust and generalizable evidence.
Loneliness and social isolation are prevalent and persistent in cancer patients, affecting their psychosocial adjustment. Non-pharmacological interventions have been shown to be effective in previous studies; however, the most effective types of non-pharmacological interventions for this population remain unclear.
The aim of this systematic review and network meta-analysis (NMA) was to synthesize the existing evidence and compare the effectiveness of different types of non-pharmacological interventions in treating loneliness and social isolation among cancer patients.
A systematic search was conducted in PubMed, Web of Science, Cochrane Library, Embase, CINAHL, PsycINFO, and MEDLINE databases from their inception to December 2024. Randomized controlled trials (RCTs) evaluating non-pharmacological interventions targeting loneliness and social isolation in cancer patients were included. NMA was performed using Stata 17.0 software under a frequentist framework.
A total of 13 RCTs were included, including 9 non-pharmacological interventions and 1151 cancer patients. In order of probability, group logotherapy (SUCRA: 99.9%, SMD: −1.62, 95% CI: −2.23 to −1.01) was the most effective intervention for alleviating loneliness and social isolation, followed by psychoeducational therapy (SUCRA: 76.9%, SMD: −0.62, 95% CI: −1.16 to −0.07) and supportive expressive group therapy (SUCRA: 65.7%, SMD: −0.40, 95% CI: −0.75 to −0.05).
The NMA suggests that, in terms of short-term efficacy, group logotherapy may be considered the optimal choice for reducing loneliness and social isolation levels in cancer patients. Healthcare professionals could regularly conduct group logotherapy among cancer patients to promote their psychosocial adaptation.
PROSPERO Registration Number: CRD42024616937
Cancer survivors often receive inadequate pain management, leading to impaired quality of life. Despite their importance, evidence on the global prevalence of chronic pain in cancer survivors remains insufficiently clear.
The systematic review and proportional meta-analysis aimed to estimate the pooled global prevalence of chronic pain among cancer survivors and to explore heterogeneity stratified by geographic region, cancer type, pain duration, and pain assessment tool.
Five databases (PubMed, Embase, Cochrane Library, CINAHL, and China National Knowledge Infrastructure) were searched up to September 2024 for studies in English or Chinese. The review followed MOOSE and PRISMA guidelines with PROSPERO registration (CRDxx). Studies were included if they reported chronic pain prevalence in cancer survivors using validated instruments or solely reported chronic pain. Two reviewers independently screened studies, extracted data, and assessed quality using the JBI Critical Appraisal Checklist for Analytical Cross-Sectional Studies. Pooled prevalence and 95% prediction intervals were calculated using a random-effects model with Freeman–Tukey double arcsine transformation. Subgroup analysis was used to explore heterogeneity. Leave-one-out analysis explored robustness. Funnel plot and Egger's test were used to examine publication bias.
In total, 36 studies involving 39,806 participants were included. The pooled prevalence of chronic pain among cancer survivors was 41% (95% CI: 34%–49%) after testing robustness, with significant heterogeneity (I 2 = 99.32%). Subgroup analysis indicated significant group differences in prevalence rates by geographic region, cancer type, and pain duration (all p < 0.001).
These findings stress the need for more extensive and tailored chronic pain management in current clinical practice. Additional research on chronic pain outcomes among pediatric cancer survivors, cancer populations within Africa and South America, and those with cancer types other than breast cancer is needed.
PROSPERO Registration: CRD42024597090.
This study aimed to evaluate and rank the effectiveness of various acupoint stimulation therapies in alleviating cancer-related fatigue (CRF), a pervasive and distressing symptom among cancer patients.
CRF severely compromises patients' quality of life across treatment and survivorship stages. Despite growing interest in nonpharmacological interventions, comparative evidence on the efficacy of acupoint stimulation therapies remains limited.
A systematic review and network meta-analysis of 28 randomized controlled trials (RCTs) involving 2370 participants was conducted. Databases searched included MEDLINE, CINAHL, Embase, Cochrane, Web of Science, and Airiti Library. Interventions included acupuncture, acupressure, oil acupressure, moxibustion, and transcutaneous electrical acupoint stimulation (TEAS). Standardized mean differences (SMDs) were calculated using a random-effects model. Surface Under the Cumulative Ranking Curve (SUCRA) was used to rank therapies.
Oil acupressure (SUCRA: 73.6%), relaxing acupressure (73.4%), and acupuncture (72.7%) were the most effective interventions. Both professionally administered and self-administered therapies significantly reduced CRF, with no major differences in efficacy. Subgroup analyses revealed consistent effectiveness across cancer types, particularly breast and lung cancer, and treatment stages.
Acupoint stimulation therapies, especially acupressure and acupuncture, effectively reduce CRF and are suitable for integration into routine cancer care. Self-administered acupressure offers a practical, low-cost alternative, especially in resource-limited settings. Standardization of protocols and long-term studies are warranted to guide clinical implementation.
The review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO: CRD42024556455)
Near infrared (NIR) therapy is increasingly used to enhance postoperative wound healing, yet clinical trial results remain inconsistent. To evaluate the effectiveness of NIR therapy on postoperative wound healing and identify treatment parameters associated with optimal outcomes: This systematic review and meta-analysis registered at PROSPERO (CRD420251163415) assessed evidence on comparing NIR therapy (630–1100 nm) with standard care or placebo on healing of surgical-induced wounds. A multilevel random-effects meta-analysis of standardised mean differences (SMDs) was conducted. Moderator analyses examined the wavelength, fluence, session number, application technique and anatomical site. Risk of bias was assessed using Cochrane RoB 2.0 and certainty of evidence was rated with GRADE. Fifty-six trials (N = 4920) were included for systematic review and 35 trials contributed 69 outcomes to meta-analysis. NIR significantly improved wound healing (0.78, [0.46–1.09], p < 0.01) and reduced postoperative pain (0.71, [0.24–1.17], p < 0.01), but heterogeneity was high and effects varied across studies. Optimal outcomes were associated with short NIR wavelengths (700–850 nm), 4–10 sessions and non-contact application. Effects on swelling, scarring and inflammatory markers were inconsistent. Overall, certainty of evidence was very low. This first systematic review and meta-analysis indicates that NIR therapy demonstrates promise for enhancing postoperative healing and reducing pain, though effects vary by protocols.
Needling therapy may be a novel alternative therapeutic intervention for burn injuries and related complications. This scoping review aimed to comprehensively evaluate the evidence status of needling therapy for burns and their complications. Studies on needling therapy for burns and related complications were retrieved from inception to 1st June 2024. Nine databases (MEDLINE, Embase, CENTRAL, CNKI, CiNii, RISS, KISS, DBpia and OASIS) were searched without any language or study-type restrictions. The study design, details of the needling therapy, and results of needling for burn injuries (or related complications) were evaluated. Of the 1475 articles screened, 46 studies (comprising 16 experimental studies, 12 case studies, four observational studies, 13 randomised controlled trials, and one systematic review) were included in the final analysis. Most studies (71.7%) investigated the acute-phase burn wound healing process, while the remaining studies (28.3%) focused on the modulation of burn-related complications. Experimental studies demonstrated that needling therapy activates phases of the wound healing process including the inflammation, proliferation, and remodelling phases and modulates the cholinergic anti-inflammatory response in burn-related acute symptoms. Clinical studies exhibited a significant heterogeneity regarding treatment period, patient population, and needling type across different study designs. Experimental studies have primarily focused on the wound healing process itself, whereas clinical studies have investigated short-term outcomes related to burn complications, with great heterogeneity observed in the methods of needling employed. Further studies are required to strengthen research gaps between experimental and clinical research, with proper treatment and evaluation periods to demonstrate the effectiveness of needling therapy for burns and associated complications.
Trial Registration: INPLASY202450102
Fear of childbirth is common among pregnant women. Mindfulness-based interventions have been used widely in obstetrics. However, the evidence of the effects on fear of childbirth is controversial.
To evaluate the effects of mindfulness-based interventions on fear of childbirth, pain catastrophising, labour pain intensity, use of pain relief medication, mode of delivery and duration of labour among pregnant women planned for normal delivery.
In this systematic review, 10 databases were searched from inception to 7 November 2024. Randomized controlled trials implementing mindfulness-based interventions for fear of childbirth or related outcomes were included. Two reviewers assessed the methodological quality and certainty of evidence independently. Standardized mean difference (SMD), risk ratio (RR), and 95% confidence intervals (CI) were used to evaluate effect sizes.
A total of 16 studies from 15 trials were included. Based on very low to moderate certainty of evidence, mindfulness-based interventions were effective in decreasing fear of childbirth both immediately post-intervention and within 6-week postpartum (SMD: −0.72; 95% CI −0.89, −0.55; SMD: −0.63; 95% CI −0.91, −0.35, respectively), labour pain intensity (SMD: −1.22; 95% CI −2.07, −0.37), caesarean section rate (RR: 0.58; 95% CI 0.36, 0.93), and total duration of labour (SMD: −1.03; 95% CI −1.34, −0.72), and improving mindfulness level both immediately post-intervention and within six-week postpartum (SMD: 0.48; 95% CI 0.31, 0.66; SMD: 0.50; 95% CI 0.27, 0.73, respectively), but had no significant effect on pain catastrophising (SMD: −0.36; 95% CI −0.72, 0.01) and epidural analgesia use rate (RR: 0.77; 95% CI 0.57, 1.03).
Mindfulness-based interventions have potential effects on reducing fear of childbirth and promoting labour-related outcomes. These interventions might be an effective approach in obstetrics clinical practice to enhance the pregnancy and labour experiences among pregnant women.
PROSPERO registration number: CRD42024610793
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
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.
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)
FreshRSS 