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Relationship Between Sleep and Cognitive Frailty in Older Adults: A Systematic Review and Meta‐Analysis

ABSTRACT

Aim

To explore the relationship between sleep and cognitive frailty in older adults.

Design

A systematic review and meta-analysis.

Data Sources

The Web of Science, Cochrane Library, CINAHL, Embase, PsycINFO and PubMed databases were searched from inception to October 28, 2024.

Methods

Two investigators independently conducted literature screening, data extraction and quality assessment. The Joanna Briggs Institute Critical Appraisal Tool and Newcastle–Ottawa Scale were used to evaluate methodological quality. This review followed PRISMA guidelines.

Results

This review included 13 articles involving 14,223 individuals, and 10 studies included in the meta-analysis. Across 13 studies, the overall prevalence of cognitive frailty was 25%. Sleep problems were categorised into four categories; the results reported that poor sleep quality, long sleep time and insomnia were correlated with the presence of cognitive frailty. However, the relationship between short sleep time and cognitive frailty was not significant.

Conclusions

This review quantitatively suggested that sleep parameters such as long sleep time, insomnia and poor sleep quality were correlated with the presence of cognitive frailty. Future research should adopt longitudinal designs and use validated instruments to measure both quantitative and qualitative aspects of sleep, thereby facilitating a thorough examination of the strength of the relationship between sleep and cognitive frailty, as well as the direction of causality.

Impact

The review highlights the need to integrate comprehensive sleep assessments and targeted interventions into nursing care plans for older adults to enhance their sleep health. The findings will provide support for the development of effective interventions to prevent and manage cognitive frailty in the older population.

Patient or Public Contribution

No patient or public contribution.

The Relationship Between Nurse Leadership and Structural Empowerment With Clinical Teaching Competencies: A Cross‐Sectional Study

ABSTRACT

Aims

To examine the relationship among leadership, clinical teaching competencies, and structural empowerment of nursing clinical instructors in China.

Design

A cross-sectional study.

Methods

A total of 152 nurses who come from three Grade A tertiary hospitals located in Beijing, Kunming, and Liaoning Province, China, completed an online questionnaire that included general information, clinical teaching information, the Conditions of Work Effectiveness Questionnaire-II, nurse leadership, and structural empowerment. SPSS 26.0 and AMOS 26.0 were used for normality test, descriptive statistics, correlation analysis, regression analysis, and structural equation model.

Results

The study revealed that nurse leadership (r = 0.402) and structural empowerment (r = 0.568) both positively correlated with clinical teaching competencies. Specifically, the level of nurse leadership exhibited a low but direct positive effect on these competencies (β = 0.22), while the level of structural empowerment demonstrated a moderate direct positive effect (β = 0.56).

Conclusion

Enhancing nurse leadership and structural empowerment positively influence the clinical teaching competencies of nursing instructors.

Impact

Constructing a structural equation model to describe the relationship between leadership, structural empowerment, and teaching ability can provide the most intuitive direction for future research, so as to better improve the teaching ability of clinical nursing teachers.

Patient or Public Contribution

No patient or public contribution.

Checklist of Paediatric Advance Care Planning: A Delphi Study

ABSTRACT

Aim

To develop a comprehensive decision-making checklist for paediatric advance care planning tailored to the needs of terminally ill children and their families.

Design

A Delphi Study.

Methods

Underpinned by Delphi methodology, a four-phase procedure was adopted: (1) drafting items by the working group, (2) refining items based on an experts' survey, (3) further refining based on the same experts, and (4) final adaptations and approval. This study was initiated by the Paediatric Palliative Care Subspecialty Group of the Paediatrics Society of the Chinese Medical Association. The process involved 60 healthcare providers (physicians, nurses, and social workers) from 14 paediatric palliative care teams.

Results

The developed checklist included 5 topics, 24 subtopics, and 45 items. Five topics were (1) medical and nursing decision-making, (2) social support planning, (3) psychological support planning, (4) spiritual support planning, and (5) posthumous affairs planning. This checklist addresses symptom management for terminally ill children, integrating support for their psychological, social, and spiritual well-being, and addresses the care needs of their family members.

Conclusions

The study provided a paediatric advance care planning checklist derived from the expert consensus that includes key elements and items.

Implications

This checklist provides healthcare providers with a structured framework to set paediatric advance care planning and ensure that all aspects of children's well-being and their families' needs are considered. This study also lays an evidence-based foundation for the design of related documents.

Impact

This study developed a comprehensive paediatric advance care planning checklist with 5 topics, 24 subtopics, and 45 items. This study provides a comprehensive decision-making checklist for healthcare providers and families, ensuring that critical decisions are addressed timely.

Reporting Method

This article is presented in accordance with the CREDES guidelines.

Patient or Public Contribution

Limited patient and public involvement was incorporated, focusing on reviewing the initial checklist draft.

Concentration-dependent effects of fermented spent coffee grounds and contrasting effects of earthworms on growth and phytochemicals in medicinal plant <i>Glechoma longituba</i>

by Bing-Nan Zhao, Zi-Yang Xie, Jia-Ning Liu, Xiao-Ran Chen, Xin-Xin Wang, Jia-Yi Li, Rui Zhang, Chao Si

Fermented spent coffee grounds (FSCG) serve as a valuable soil amendment to improve soil structure and fertility, while earthworms play a well-established role in enhancing soil processes and plant growth. However, their combined effects on bioactive compound accumulation in medicinal plants remain unclear. This study investigated the individual and interactive effects of FSCG (0%, 10%, and 20%, v/v) and earthworms (with and without Pheretima guillelmi) on the growth and phytochemical content of Glechoma longituba, a common medicinal herb, under greenhouse conditions. Results showed that 10% FSCG generally promoted plant growth, whereas 20% FSCG generally enhanced the accumulation of total flavonoids, chlorogenic acid, and soluble protein. Earthworms enhanced aboveground biomass and node number but significantly reduced chlorogenic acid content. These findings highlight the potential of FSCG as a sustainable soil amendment in medicinal plant cultivation and underscore the need to consider earthworm activity when optimizing both plant biomass and phytochemical quality.
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