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The efficacy of mindfulness‐based programs in reducing anxiety among nurses in hospital settings: A systematic review

Abstract

Background

The increasing pressure of their professional duties has led to a notable concern regarding the mounting anxiety levels among nurses. The ongoing discussion revolves around the efficacy of mindfulness as a means to alleviate anxiety in nurses.

Aim

This systematic review evaluated the effectiveness of mindfulness in reducing anxiety among nurses.

Methods

The evaluation followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. An extensive and comprehensive search was conducted across eight databases to identify studies that utilized randomized controlled trials (RCTs) and were published in English between 2011 and 2022. Independently, two reviewers assessed the validity of the randomized controlled trials using the Consolidated Standards of Reporting Trials criteria. Additionally, two authors independently employed the Risk of Bias in Non-Randomized Studies of Interventions (ROBINS-2) method to evaluate the potential bias in the RCTs.

Results

Eight randomized controlled trial studies that were deemed eligible were included in the current analysis. Based on the literature review, it was determined that mindfulness-based training can assist nurses in reducing their anxiety levels. Furthermore, the effectiveness of mindfulness-based programs in enhancing nurses' mindfulness and self-compassion has been firmly established.

Conclusions

Based on existing literature, mindfulness-based interventions have proven to be effective in reducing anxiety levels among nurses. However, in order to enhance the overall quality of research, it is necessary to implement more rigorous controlled designs that include randomization. Additionally, larger sample sizes with a diverse range of participants are needed to establish and validate the effectiveness of mindfulness-based programs in alleviating anxiety among nurses.

Linking Evidence to Action

Implementing mindfulness-based training in healthcare organizations can offer numerous benefits. One such advantage is that it can help nurses in reducing anxiety and enhancing their ability to handle the pressures associated with their profession.

Study Registration

PROSPERO Protocol registration ID: CRD42023475157.

Brain health measurement: a scoping review

Por: Lee · A. · Shah · S. · Atha · K. · Indoe · P. · Mahmoud · N. · Niblett · G. · Pradhan · V. · Roberts · N. · Malouf · R. S. · Topiwala · A.
Objectives

Preservation of brain health is an urgent priority for the world’s ageing population. The evidence base for brain health optimisation strategies is rapidly expanding, but clear recommendations have been limited by heterogeneity in measurement of brain health outcomes. We performed a scoping review to systematically evaluate brain health measurement in the scientific literature to date, informing development of a core outcome set.

Design

Scoping review.

Data sources

Medline, APA PsycArticles and Embase were searched through until 25 January 2023.

Eligibility criteria for selecting studies

Studies were included if they described brain health evaluation methods in sufficient detail in human adults and were in English language.

Data extraction and synthesis

Two reviewers independently screened titles, abstracts and full texts for inclusion and extracted data using Covidence software.

Results

From 6987 articles identified by the search, 727 studies met inclusion criteria. Study publication increased by 22 times in the last decade. Cohort study was the most common study design (n=609, 84%). 479 unique methods of measuring brain health were identified, comprising imaging, cognitive, mental health, biological and clinical categories. Seven of the top 10 most frequently used brain health measurement methods were imaging based, including structural imaging of grey matter and hippocampal volumes and white matter hyperintensities. Cognitive tests such as the trail making test accounted for 286 (59.7%) of all brain health measurement methods.

Conclusions

The scientific literature surrounding brain health has increased exponentially, yet measurement methods are highly heterogeneous across studies which may explain the lack of clinical translation. Future studies should aim to develop a selected group of measures that should be included in all brain health studies to aid interstudy comparison (core outcome set), and broaden from the current focus on neuroimaging outcomes to include a range of outcomes.

Does a program‐based cognitive behavioral therapy affect insomnia and depression in menopausal women? A randomized controlled trial

Abstract

Background

Menopausal women often complain of a range of physical and psychological symptoms known as menopausal syndrome. These symptoms are associated with fluctuating hormone levels, sleep disturbances, and mood swings.

Aim

This study aimed to examine the efficacy of a program-based cognitive behavioral group therapy (CBT) for insomnia and depression among women experiencing menopause.

Methods

A randomized controlled trial of 88 women experiencing menopause was conducted in Egypt from June to September 2022 in outpatient clinics at Mansoura University Hospitals in Egypt. Participants were randomly assigned to a control group (45 women) and an intervention group (43 women). The intervention group received 7 weeks of CBT sessions. Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), and Beck Depression Inventory 2nd Edition (BDI-II) were administered before and after the intervention.

Results

In the intervention group, there was a significant difference in scores of the subdomains of PSQI, including sleep efficiency, daytime dysfunction, subjective sleep quality, and sleep disturbance (t = 8.911, 11.77, 7.638, and 11.054, respectively), while no significant difference in domains of using sleep medication, sleep duration, and sleep latency. Significant improvements were observed between pre-and-post-intervention in the intervention group for the total scores of PSQI, ISI, and BDII-II (t = 12.711, 16.272, and 12.384, respectively), indicating a large effect size for the three studied variables (r = .81, .87, .8, respectively).

Linking Evidence to Action

This study demonstrated the efficacy of group CBT for lowering insomnia and depression in women experiencing menopause. Thus, results indicated the need of considering prompt and appropriate interventions such as CBT as a safe treatment option to prevent the aggravation of sleep and emotional problems for menopausal women.

Trial Registration

ClinicalTrials.gov Identifier: NCT05920460.

Surgical site infection outcomes of two different closed incision negative pressure therapy systems in cardiac surgery: Systematic review and meta‐analysis

Abstract

Closed incision negative pressure therapy (ciNPT) system use compared with standard of care dressings (SOC) on surgical site infection (SSI) in cardiac surgery was assessed. A systematic literature review was conducted. Risk ratios (RR) and random effects models were used to assess ciNPT with foam dressing (ciNPT-F) or multilayer absorbent dressing (ciNPT-MLA) versus SOC. Health economic models were developed to assess potential per patient cost savings. Eight studies were included in the ciNPT-F analysis and four studies were included in the ciNPT-MLA analysis. For ciNPT-F, a significant reduction in SSI incidence was observed (RR: 0.507, 95% confidence interval [CI]: 0.362, 0.709; p < 0.001). High-risk study analysis reported significant SSI reduction with ciNPT-F use (RR: 0.390, 95% CI: 0.205, 0.741; p = 0.004). For ciNPT-MLA, no significant difference in SSI rates were reported (RR: 0.672, 95% CI: 0.276, 1.635; p = 0.381). Health economic modelling estimated a per patient cost savings of $554 for all patients and $3242 for the high-risk population with ciNPT-F use. Health economic modelling suggests ciNPT-F may provide a cost-effective solution for sternotomy incision management. However, limited high-quality literature exists. More high-quality evidence is needed to fully assess the impact of ciNPT use following cardiac surgery.

The effect of triclosan‐coated sutures on the incidence of surgical site infection in laparoscopic sleeve gastrectomy, laparoscopic appendicectomy or laparoscopic cholecystectomy: A multi‐centre, double‐blind, randomized, intra‐individual study

Abstract

Surgical site infection (SSI) is a common cause of post-operative morbidity. According to the latest report announced by CDC, the SSI accounts for 20% of healthcare-associated infection with a high risk of mortality up to twofold to 11-fold increase with high economic burden for the prolonged hospital stay. Port site infection (PSI) is a subgroup of SSI occurring at the ports of laparoscopy. We tried to determine the efficacy of polyglactin 910 suture coated with triclosan in lowering the rate of PSI in some of the clean-contaminated wound surgeries. This study included 480 individuals eligible for laparoscopic cholecystectomy, appendicectomy or sleeve operations. Polyglactin 910 sutures coated with triclosan were used in one port site incision while polyglactin 910 sutures were used in the other port sites incisions. In patients who underwent laparoscopic cholecystectomy and appendicectomy, the incidence of PSI was significantly lower in the triclosan-coated sutures. In sleeve gastrectomy patients, although a lower number of triclosan-coated sutures developed PSI, there was no statistically significant difference between triclosan and non-triclosan-coated sutures. This study showed that using sutures coated with antiseptics like triclosan has clinical benefits to prevent SSIs in most of the laparoscopic surgeries.

Nutritional analysis and characterization of carbapenemase producing-<i>Klebsiella pneumoniae</i> resistant genes associated with bovine mastitis infected cow’s milk

by Mr. Saddam, Muddasir Khan, Muhsin Jamal, Sadeeq Ur Rahman, Abdul Qadeer, Imad Khan, Mohamed H. Mahmoud, Gaber El-Saber Batiha, Syed Hussain Shah

The current study was designed to analyze nutritional parameters and to characterize carbapenemase producing-Klebsiella pneumoniae isolates from bovine mastitic cow’s milk. Out of 700 milk samples K. pneumoniae was identified by phenotypic and molecular techniques along with their antibiogram analysis and nutritional analysis was performed using the procedure of Association of Official Analytical Chemists. Carbapenemase-producing K. pneumoniae was detected by phenotypic CarbaNP test followed by molecular characterization of their associated resistant genes blaVIM, blaKPC, blaOXA-48, blaNDM, and blaIMP along with insertion sequence common region 1 (ISCR1) and integrons (Int1, Int2, and Int3) genes. Among nutritional parameters, fat content was observed (2.99%) followed by protein (2.78%), lactose (4.32%), and total solid (11.34%), respectively. The prevalence of K. pneumoniae among bovine mastitis was found 25.71%. Antibiogram analysis revealed that more effective antibiotics was ceftazidime (80%) followed by amikacin (72%), while highly resistant antibiotics was Fusidic acid (100%). Distribution of carbapenemase producer K. pneumoniae was found 44.4%. Among carbapenem resistant genes blaKPC was found 11.25%, blaVIM 2.75%, blaNDM 17.5%, and blaOXA-48 7.5%, while blaIMP gene was not detected. Furthermore, distribution of ISCR1 was found 40%, while integron 1 was found 61.2% followed by integron 2 (20%), and integron 3 (5%). In conclusion, the recent scenario of carbapenemase resistant K. pneumoniae isolates responsible for mastitis may affect not only the current treatment regime but also possess a serious threat to public health due to its food borne transmission and zoonotic potential.
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