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To identify barriers and facilitators to nurse prescribing implementation through a synthesis of qualitative studies.
The roles of healthcare professionals are expanding in response to the growing demand for access to high-quality healthcare services. Advanced practice nurses are a global trend, and nurse prescribing is a crucial feature of advanced practice nurses that can meet the needs of growing healthcare services. The development and promotion of nurse prescribing varies significantly across countries, and it is essential to identify the factors influencing the implementation of nurse prescribing.
A systematic search of PubMed, Web of Science, Embase, Cochrane Library, CINAHL, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, Wan Fang and Weipu database was conducted to retrieve literature on barriers and facilitators related to the implementation of nurse prescribing. We searched records from inception to 29 March 2025. Two researchers independently performed literature screening, literature evaluation, data extraction and synthesis. Literature screening and data extraction adhered to the predefined inclusion and exclusion criteria. Literature quality was evaluated using the JBI Checklist for Qualitative Research. The results were synthesised using the thematic synthesis approach. Information was extracted using the Consolidated Framework for Implementation Research (CFIR) in a deductive way, and barriers and facilitators to the implementation were categorised based on the CFIR. Report rigour assessed via ENTREQ.
The synthesis of 14 included papers identified 18 thematic categories, yielding two key findings. The main barriers identified included failure to anticipate the cost of nurse prescribing, legal constraints, social pressures, poor organisational structure, insufficient prescribing education, lack of competence of nurses leading to psychological changes, opposition and lack of cooperation of team members, and insufficient planning of nurse prescribing. Facilitating factors included prescribing experience, resource and labor conservation, cost reduction, resources, nurses' prescribing training, leadership support, patients' needs, nursing professional development, nurses' competence, and team cooperation and support.
Identifying barriers and facilitators to nurse prescribing is critical for informing policy-making and clinical prescribing practices. The results offers practical guidance to develop strategic plans that enhance implementation and adoption of nurse prescribing.
Nurse prescribing improves patient access while mitigating healthcare strain. By streamlining medication delivery and optimising resource use in overburdened systems, this model strengthens patient-centered care while allowing physician specialisation in complex cases. This workforce innovation enhances team-based care and ensures continuity for vulnerable populations.
This paper identifies barriers and facilitators, offering policymakers, healthcare administrators, and educators actionable insights to enable nurse role expansion, reduce physician workload, and enhance outcomes through holistic care.
No patient or public contribution.
This study aimed to (1) evaluate the effectiveness of e-health interventions in improving physical activity and associated health outcomes during pregnancy, (2) compare the e-health functions employed across interventions and (3) systematically identify the behaviour change techniques (BCTs) used and examine their interrelationships.
A systematic review and meta-analysis following the PRISMA 2020 guidelines.
Randomised controlled trials were included. Meta-analyses and subgroup analyses were performed using RevMan 5.3. Social network analysis was conducted to determine the most central BCTs within the intervention landscape.
Ten databases were searched, including PubMed, Embase, Web of Science, Cochrane Library, ProQuest, Scopus, SinoMed, China National Knowledge Infrastructure, WanFang and the China Science and Technology Journal Database, from inception to April 22, 2024.
Thirty-five studies were included. Pooled analyses indicated that e-health interventions significantly improved both total (SMD: 0.19; 95% CI: 0.10 to 0.27; I 2 = 55%) and moderate-to-vigorous physical activity (SMD: 0.16, 95% CI: 0.06 to 0.26; I 2 = 53%) in pregnant women. Subgroup analyses revealed that interventions based on theoretical frameworks and those not specifically targeting overweight or obese women demonstrated greater effectiveness. Additionally, e-health interventions were associated with significant reductions in both total and weekly gestational weight gain. Six of the twelve e-health functions were utilised, with ‘client education and behaviour change communication’ being the most prevalent. Thirty unique BCTs were identified; among them, ‘instruction on how to perform the behaviour’, ‘self-monitoring’, ‘problem solving’, and ‘goal setting’ showed the highest degree of interconnectedness.
E-health interventions are effective in enhancing physical activity and reducing gestational weight gain during pregnancy. Incorporating theoretical frameworks and well-integrated BCTs is recommended to optimise intervention outcomes.
Integrating e-health interventions into existing perinatal care models holds promise for enhancing physical activity among pregnant women and improving maternal health outcomes.
This study adhered to the PRISMA checklist.
No patient or public involvement.
The study protocol was preregistered in the International Prospective Register of Systematic Reviews (CRD42024518740)
To examine the association between perceived quality of care and the level of coercion experienced by individuals hospitalised in acute mental health units.
National cross-sectional study.
Data were collected from 255 patients admitted to 12 acute mental health units across Spain. Standardised instruments assessed perceived quality of care and levels of coercion, humiliation and fear at discharge. Multiple linear regression analyses were used to explore associations between care quality dimensions and patients' experiences.
Perceived quality of care was significantly associated with lower levels of perceived coercion and humiliation. All dimensions of care quality showed inverse associations, with the “secluded” dimension showing the strongest association. The association between care quality and perceived fear was less consistent. These findings are particularly relevant for mental health nurses, who play a central role in delivering relational care and ensuring patients' emotional safety.
Higher perceived quality of care is associated with lower levels of coercion, humiliation, and fear during hospitalisation in acute mental health settings.
For mental health nursing, these results underscore the critical role of nurses in creating therapeutic environments that reduce coercive experiences. By fostering trust, promoting patient autonomy, and ensuring emotional and physical safety, nurses can significantly influence the quality of care and patient outcomes.
The study addresses the lack of evidence on how perceived quality of care influences experiences of coercion in acute mental health settings. Better perceived care quality is linked to reduced feelings of coercion, humiliation and fear. The research has direct implications for mental health nurses, clinical educators and healthcare managers aiming to improve patient experiences and reduce coercive practices in psychiatric care.
STROBE reporting guideline.
No patient or public contribution.
To investigate the physical activity levels of lung cancer survivors, analyse the influencing factors, and construct a predictive model for the physical activity levels of lung cancer survivors based on machine learning algorithms.
This was a cross-sectional study.
Convenience sampling was used to survey lung cancer survivors across 14 hospitals in eastern, central, and western China. Data on demographic, disease-related, health-related, physical, and psychosocial factors were also collected. Descriptive analyses were performed using SPSS 25.0, and predictors were identified through multiple logistic regression analyses. Four machine learning models—random forest, gradient boosting tree, support vector machine, and logistic regression—were developed and evaluated based on the Area Under the Curve of the Receiver Operating Characteristic (AUC-ROC), accuracy, precision, recall, and F1 score. The best model was used to create an online computational tool using Python 3.11 and Flask 3.0.3. This study was conducted and reported in accordance with the TRIPOD guidelines and checklist.
Among the 2231 participants, 670 (30%), 1185 (53.1%), and 376 (16.9%) exhibited low, moderate, and high physical activity levels, respectively. Multivariate logistic regression identified 15 independent influencing factors: residential location, geographical region, religious beliefs, histological type, treatment modality, regional lymph node stage, grip strength, 6-min walking distance, globulin, white blood cells, aspartate aminotransferase, blood urea, MDASI score, depression score, and SRAHP score. The random forest model performed best among the four algorithms, achieving AUC-ROC values of 0.86, 0.70, 0.72, and 0.67, respectively, and was used to develop an online predictive tool (URL: http://10.60.32.178:5000).
This study developed a machine learning model to predict physical activity levels in lung cancer survivors, with the random forest model demonstrating the highest accuracy and clinical utility. This tool enables the early identification of low-activity survivors, facilitating timely, personalised rehabilitation and health management.
The development of a predictive model for physical activity levels in lung cancer survivors can help clinical medical staff identify survivors with relatively low physical activity levels as early as possible. Thus, personalised rehabilitation plans can be formulated to optimise quality of life during their survival period.
Physical activity has been used as a nonpharmacological intervention in cancer patient rehabilitation plans. However, a review of past studies has shown that lung cancer survivors generally have low physical activity levels. In this study, we identified the key factors influencing physical activity among lung cancer survivors through a literature review. We constructed a prediction model for their physical activity levels using machine learning algorithms. Clinical medical staff can use this model to identify patients with low physical activity levels early and to develop personalised intervention plans to improve their quality of life during survival.
The study adhered to the relevant EQUATOR reporting guidelines, the TRIPOD Checklist for Prediction Model Development and Validation.
During the data collection phase, participants were recruited to complete the questionnaires.
To critically assess the impact of theory-guided positive psychological interventions on the quality of life of breast cancer patients and survivors.
Systematic review and meta-analysis.
A comprehensive literature search was conducted across seven electronic databases from inception to August 2024. Randomised controlled trials that examined the effects of theory-guided positive psychological interventions on adult breast cancer patients or survivors and reported quality of life outcomes were included. Screening, data extraction and critical appraisal were independently performed by the reviewers using the revised Cochrane risk-of-bias tool (RoB2). A meta-analysis was conducted using RevMan Web. The study was reported following the PRISMA 2020 Statement.
Five randomised controlled trials were included. Only two of these studies showed a low risk of bias across all quality measures. The meta-analysis demonstrated a significant improvement in quality of life following theory-guided positive psychological interventions, with low heterogeneity. Subgroup analyses revealed that interventions lasting either less than or longer than 3 weeks, and both group-based and individual-based formats, had positive effects on quality of life. Additional psychological benefits were observed including reductions in depressive symptoms, anxiety, perceived stress and improvements in post-traumatic growth, resilience, hope and perceived benefits. One study also reported improvements in sleep quality.
The findings demonstrate that theory-guided positive psychological interventions can potentially significantly improve quality of life in breast cancer patients. However, the limited number of studies underscores the need for further high-quality research to validate these findings and identify the most effective intervention characteristics.
Our systematic review highlights that theory-guided positive psychological interventions show promise as an effective strategy for improving the quality of life in breast cancer patients. These interventions can enhance psychosocial support strategies, paving the way for better-informed approaches that lead to improved patient outcomes.
No patient or public contribution.
The systematic review and meta-analysis had been registered with the International Prospective Register of Systematic Reviews (PROSPERO) under the registration ID number: CRD42024581382
The relationship between occupational stress and the quality of nursing care in the operating room (OR) is an area that has not been thoroughly explored in the literature. The present study was designed to examine the correlation between job-related stress and the quality of care delivered by nurses in the OR setting.
A cross-sectional survey was administered to OR nurses at our institution from 1 April to 30 April 2023. Participants were asked to complete a demographic questionnaire and several validated scales: the Good Perioperative Nursing Care Scale (GPNCS), the Operating Room Nurses' Job Stressor Scale (ORNJSS), the Self-rating Anxiety Scale (SAS), and the Self-rating Depression Scale (SDS).
A total of 171 OR nurses participated. The mean score for nursing quality was 143.01 (SD 19.44), job stressors scored an average of 94.12 (SD 22.57), anxiety scores averaged 54.13 (SD 15.76), and depression scores averaged 59.41 (SD 15.03). A robust inverse correlation was identified between the nursing quality score and the job stressor score (r = −0.641). Furthermore, the nursing quality score exhibited significant negative correlations with both anxiety (r = −0.658) and depression (r = −0.626) scores.
The findings of this study demonstrate a substantial inverse correlation between the quality of perioperative nursing care and the intensity of occupational stressors, as well as the prevalence of anxiety and depressive symptoms among OR nurses. It is imperative for hospital management to contemplate and implement interventions aimed at mitigating work-related stress and bolstering the psychological well-being of OR nursing staff.
To explore the mediating effects of psychological flexibility and anxiety between knowledge and health behaviour in stroke patients, and to provide a reference for improving the health behaviour of stroke patients.
A cross-sectional study.
A convenience sampling method was used to recruit 219 stroke patients from a tertiary hospital in China from July to November 2024. Patients were surveyed using an electronic questionnaire containing demographic questions and validated scales for stroke knowledge, psychological flexibility, anxiety and health behaviour. IBM SPSS v26.0 software and PROCESS Process macro were used for data analysis.
The health behaviour score of stroke patients was 54.2 ± 3.8, and health behaviour was positively correlated with stroke knowledge and negatively correlated with psychological flexibility and anxiety. There was a significant chain-mediated effect of psychological flexibility and anxiety in the relationship between stroke knowledge and health behaviour.
Stroke knowledge not only directly predicts health behaviour in stroke patients, but also indirectly influences the health behaviour of patients through the chain mediation of psychological flexibility and anxiety.
This study highlights the importance of caregivers focusing on the interactions between patient knowledge, psychological flexibility, anxiety and health behaviour when caring for stroke patients. Comprehensive interventions aimed at enhancing stroke patients' knowledge, improving patients' psychological flexibility and reducing anxiety have the potential to improve patient health behaviour.
Patients completed questionnaires.
The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for cross-sectional studies was applied to report the results.
To explore the effects of telehealth-based exercise interventions on balance, motor function, walking ability and activities of daily living (ADLs) in patients with stroke.
Meta-analysis of randomised controlled trials.
This meta-analysis of randomised controlled trials was reported to follow the PRISMA statement and the Cochrane Handbook guidelines. The study employed either a fixed-effects model or a random-effects model according to the statistical heterogeneity observed.
The literature search was performed in six databases including PubMed, Embase, the Cochrane Central Register of Controlled Trials, Web of Science, PsycINFO and CINAHL from inception to December 2023.
A total of 15 randomised controlled trials were included in this meta-analysis. Most of the studies were evaluated for some concerns. The quality of the evidence in this analysis ranged from low to moderate in terms of the outcome. Meta-analysis revealed that telehealth-based exercise interventions presented significant effects on walking ability, motor function and ADLs in patients with stroke. Nonetheless, the balance remained unaffected by statistical significance.
Telehealth-based exercise interventions could effectively improve walking ability, motor function and ADLs in patients with stroke; however, the impact on balance was not significant. Telehealth-based exercise interventions are recommended for stroke survivors residing in remote areas or facing economic constraints.
This meta-analysis showed that telehealth-based exercise interventions could bring benefits to the rehabilitation of patients with stroke. Telehealth-based exercise interventions should be considered effective to better promote the rehabilitation of patients.
The study was reported in compliance with the PRISMA statement.
None.
PROSPERO (https://www.crd.york.ac.uk/PROSPERO): CRD42024501015
To compare and rank the efficacy of different non-pharmacological interventions on anxiety, depression, sleep disorders, and the quality of life in liver transplantation patients.
In recent years, numerous non-pharmacological interventions have been developed to address anxiety, depression, sleep disorders, and the quality of life in liver transplantation patients. However, it remains unclear which non-pharmacological intervention serves as the most effective and preferred approach.
A systematic review and network meta-analysis in accordance with the PRISMA guidelines.
Relevant randomised controlled trials were extracted from eight electronic databases. A network meta-analysis was then performed to evaluate the relative efficacy of the non-pharmacological interventions for liver transplantation patients. The quality of the data was assessed using the Cochrane Risk of Bias tool. We registered this study in PROSPERO, number CRD42023450346.
A total of 25 randomised controlled trials were included. Spouse support education combined with mindfulness training, individualised psychological intervention, and cognitive behavioural therapy were found to be significantly effective for both anxiety and depression. The top three interventions against anxiety were spouse support education combined with mindfulness training, individualised psychological intervention, and exercise rehabilitation training. Meanwhile, individualised psychological intervention, spouse support education combined with mindfulness training, and cognitive behavioural therapy were the top-ranked three interventions for reducing depression. Sleep hygiene education was the most effective to improve sleep disorders. Continuous care based on a mobile medical platform emerged as the most effective intervention in improving the quality of life.
Several non-pharmacological interventions appeared to be effective in treating anxiety, depression, sleep disorders, and improving the quality of life among liver transplantation patients. More high-quality clinical trials should be incorporated in the future to investigate the reliability of existing findings.
Healthcare professionals should be encouraged to apply these promising non-pharmacological interventions during clinical care.
This study did not directly involve patients or public contributions to the manuscript.
To evaluate the accuracy of different pressure injury risk assessment tools in paediatrics and identify risk assessment tools with the best predictive performance.
A systematic review and network meta-analysis.
Eight electronic databases, including PubMed, Embase, Web of Science, Cochrane Library, China Knowledge Resource Integrated Database, Weipu Database, Wanfang Database and Chinese Biomedical Database were comprehensively searched. The study was conducted using the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines 2020. Two researchers independently conducted article screening, data extraction and quality assessment. Statistical analysis was performed using R 4.3.1 and Stata 14.0.
A total of 20 articles were included in this study, involving 4908 patients and 13 pressure injury risk assessment tools for children, of which 15 articles were included in the network meta-analysis. The results showed that the Paediatric Pressure Ulcer Prediction and Evaluation Tool (PPUPET) had the highest superiority index, with the relative sensitivity (0.7, 95% confidence interval, CI: 0.0–1.5) and the relative specificity (1.4, 95% CI: 0.7–1.8). The next was Braden-Q combined with the Glamorgan scale, with a superiority index of 7.08, a relative sensitivity of 1.1 (95% CI: 0.5–1.5) and a relative specificity of 1.3 (95% CI: 0.8–1.7).
This study suggested that the PPUPET can comprehensively evaluate medical device-related pressure injuries in children, the Braden-Q scale had a better predictive performance for children aged 21 days–8 years in general paediatric departments, and the Glamorgan scale was suitable in the Paediatric Intensive Care Unit.
This review highlights that clinical practitioners should select appropriate assessment tools based on different departments and the age of children to accurately assess the risk of pressure injuries in children.
No Patient or Public Contribution.
PROSPERO CRD42023470769. http://www.crd.york.ac.uk/PROSPERO/#recordDetails.
To synthesise existing evidence concerning the application of AI methods in detecting depression through behavioural cues among adults in healthcare and community settings.
This is a diagnostic accuracy systematic review.
This review included studies examining different AI methods in detecting depression among adults. Two independent reviewers screened, appraised and extracted data. Data were analysed by meta-analysis, narrative synthesis and subgroup analysis.
Published studies and grey literature were sought in 11 electronic databases. Hand search was conducted on reference lists and two journals.
In total, 30 studies were included in this review. Twenty of which demonstrated that AI models had the potential to detect depression. Speech and facial expression showed better sensitivity, reflecting the ability to detect people with depression. Text and movement had better specificity, indicating the ability to rule out non-depressed individuals. Heterogeneity was initially high. Less heterogeneity was observed within each modality subgroup.
This is the first systematic review examining AI models in detecting depression using all four behavioural cues: speech, texts, movement and facial expressions.
A collaborative effort among healthcare professionals can be initiated to develop an AI-assisted depression detection system in general healthcare or community settings.
It is challenging for general healthcare professionals to detect depressive symptoms among people in non-psychiatric settings. Our findings suggested the need for objective screening tools, such as an AI-assisted system, for screening depression. Therefore, people could receive accurate diagnosis and proper treatments for depression.
This review followed the PRISMA checklist.
No patients or public contribution.
To investigate the status and influencing factors of caring readiness among parents of children undergoing liver transplantation transitioning from the intensive care unit, and to explore the associations between caring readiness and other variables.
A cross-sectional study.
A total of 126 parents of children who underwent liver transplantation at a tertiary hospital in China took a questionnaire survey via convenience sampling. Independent t-test, ANOVA and correlation analysis were conducted to analyse the data. Multivariable stepwise linear regression was used to analyse the influencing factors of caring readiness. The PROCESS macro (Model 4) was used to verify the mediating effect of caregiver burden between social support and caring readiness.
The STROBE checklist was used as a guideline in this study.
The mean score of caring readiness among parents of children who had undergone liver transplantation and were transitioning from the intensive care unit was 23.62 ± 5.34. Multivariable stepwise linear regression analysis indicated that experience with caregiving, intensive care unit length of stay, social support and caregiver burden were the factors associated with caring readiness, explaining 18.6% of the variance in caring readiness among parents. Caregiver burden partially moderated the relationship between social support and caring readiness (20.93%).
The study shows caring readiness was moderate among parents of children who have undergone liver transplantation and are transitioning from the intensive care unit. It reveals that lack of caregiving experience and children's short intensive care unit length of stay should be emphasised, preventing inadequate readiness of parents. Furthermore, enhancing social support interventions and burden-reduction strategies are important for improving parents' caring readiness.
The findings demonstrate that health care professionals should provide timely and appropriate intervention strategies to enhance parents' caring readiness, which could potentially be achieved by increasing social support and reducing caregiver burden.
Parents of children who underwent liver transplantation participated in this study via a questionnaire survey.
To map the diabetes-related content exposure of older adults with Type 2 diabetes mellitus, and explore the association between the exposure and self-management and the mediation effects of self-efficacy.
Cross-sectional study.
This study was conducted among 257 eligible older adults with Type 2 diabetes mellitus from five communities in China. Diabetes self-management and self-efficacy were measured with standardised assessment tools. The variable of diabetes-related content exposure was generated by the collection of all content exposure and the transformation of Q-methodology. Descriptive statistics and the relative mediation effect model were used to do the analyses.
Among the participants, 61.1% had hyperbeneficial content exposure, 13.6% had hypobeneficial content exposure, 24.9% had irrelevant content exposure, and 0.4% had harmful content exposure. Compared with those with irrelevant content exposure, older adults with hyperbeneficial content exposure exhibited higher self-management scores (β = 0.448, 95% CI = 0.174–0.721); in the mediation model, the relative direct effect of hyperbeneficial content exposure on self-management remained significant (β = 0.377, 95% CI = 0.104–0.650), and self-efficacy significantly mediated this relationship (β = 0.071, 95% CI = 0.011–0.154). The relative mediation effect accounted for 15.8% of the relative total effect. Conversely, no significant effect of hypobeneficial content exposure on self-management was observed.
Social media can empower the self-management of older adults with Type 2 diabetes mellitus exposed to hyperbeneficial contents, with self-efficacy serving as a significant mediator. In contrast, exposure to hypobeneficial contents on social media did not lead to significant improvement in the self-management. This suggests that not all diabetes-related contents on social media are equally beneficial, and the relevance of information matters.
Healthcare providers should consider leveraging social media platforms in conjunction with traditional education programmes to enhance the self-management of older adults with Type 2 diabetes mellitus. Older adults with Type 2 diabetes mellitus may search positively diabetes-related hyperbeneficial contents on social media.
The report of this study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement guidelines.
No patient or public contribution.
Leukaemia children often encounter various social adaptation issues stemming from changes in their living environment. Identifying and optimising the factors associated with social adaptation is crucial in improving social adaptation in children with leukaemia.
To investigate social adaptation in children with leukaemia and to clarify the impact pathway of cognitive flexibility, problem behaviour, prosocial behaviour, parenting style and social support on social adaptation.
Using a convenience sampling method, 264 leukaemia children completed a cross-sectional survey. Data were collected using the Social Adaptation Assessment Scale for Children with Leukaemia, Strengths and Difficulties Questionnaire, Cognitive Flexibility Scale, Short-Egna Minnenav Barndoms Uppfostran and Multi-Dimensional Scale of Perceived Social Support. Structural equation modelling was used to test the influencing factors of social adaptation.
Social support directly influenced social adaptation (β = 0.19, p < 0.01) and indirectly influenced social adaptation through prosocial behaviour (β = 0.06, p < 0.01) and problem behaviour (β = 0.18, p < 0.01). Prosocial behaviour (β = 0.17, p < 0.01) and problem behaviour (β = −0.61, p < 0.01) directly influenced social adaptation. Negative parenting directly influenced social adaptation (β = 0.12, p < 0.01) and indirectly influenced social adaptation (β = −0.23, p < 0.01) through problem behaviour.
Our finding indicated that there are prominent social adjustment problems in the recovery process of children with leukaemia. These findings suggest that targeted education is needed to enhance social adaptation among children with leukaemia.
The final model should serve as a framework to guide intervention research targeting social support and negative parenting to improve the social adaptation of children with leukaemia. During the recovery process, nurses need to regularly follow up on the children's social adaptation and encourage them to participate in social activities to increase social support while providing family guidance based on improving parenting styles.
The subjects of this study were children with leukaemia aged 8–18 years. All authors read and approved the final manuscript.
To study the effects of virtual reality (VR) on pain perception among a paediatric population while being vaccinated. We will also investigate the effects of VR on the fear experienced by children during the vaccination procedure, as well as parental satisfaction levels.
Many studies, for example, in the fields of oncology, dermatology or plastic surgery, have described the benefits of using VR to reduce the perception of pain among paediatric populations. These results are encouraging, but their main limitations were the small sample sizes they included or their methodological design.
This will be a randomised clinical trial.
SPIRIT guidelines were followed to report this protocol, and we will use the CONSORT and CONSORT-EHEALTH guidelines to report the randomised clinical trial. The sample will comprise 148 children aged 3–14 years who will come for vaccination at the Tres Forques Health Center. The participants will be randomly allocated into intervention group (VR; n = 74) or (the control group standard-of-care; n = 74) at a 1:1 ratio. The intervention group will view experiences with a VR headset as a distraction measure. The study variables will be the level of pain and fear perceived by the child during vaccination, parental satisfaction with the vaccination procedure, and sociodemographic and vaccination variables.
The start of the study is planned for September 2020, and the results will be expected in September 2021.
This study aims to identify what measures reduce pain and fear in children during vaccination, which in turn, can help to improve the degree of parental satisfaction with these procedures.
Vaccination is an independent function of the nursing profession. Identifying which distraction measures reduce the perception of pain and fear in the paediatric population will not only improve children's experiences but will also improve the satisfaction of both parents and children, thus increasing the degree of compliance with the vaccination schedule.
To evaluate the effectiveness and safety of nutritional interventions (i.e. nutritional support, dietary patterns and dietary supplements) on cognitive function in cancer survivors.
Systematic review.
A systematic and comprehensive search of PubMed, Web of Science, the Cochrane Library, Embase, and CINAHL was conducted from the inception until March 10, 2023. The last search was conducted on December 10, 2023.
PRISMA.
A total of 59 randomized controlled trials were included for analysis. Nutritional support, dietary patterns and dietary supplements improved cognitive function in cancer survivors with no apparent safety concerns. The anti-inflammatory diet, the fasting-mimicking diet and the web-based diet significantly improved cognitive function. Whereas the ketogenic diet or dietary advice to consume more soluble dietary fibres and less insoluble dietary fibres and lactose could not. There was evidence from dietary supplements to support the beneficial effects of polyunsaturated fatty acid supplements, traditional herbal medicines and other supplements.
Nutritional interventions have great promise for improving cognitive function in adult cancer survivors. Further validation of the nutritional interventions supported in this study in other survivors and exploration of more effective nutritional interventions are needed.
This work can support the construction of nutritional support interventions and dietary guidance programs to prevent cancer-related cognitive decline.
This work filled a gap in preventive strategies for cancer-related cognitive decline from a nutritional perspective. Nutritional support, dietary patterns, and dietary supplements can prevent cancer-related cognitive decline without serious safety concerns. This work highlighted nutritional interventions that have the potential to improve cognitive function in cancer survivors, benefiting the further construction of evidence-based nutritional intervention programs.
PROSPERO.
No patient or public contribution.
To determine the effect of immersive virtual reality (VR) on perceived pain and fear in children during vaccination and parental satisfaction with the procedure.
Virtual reality can reduce the perception of pain by children but only three studies have analysed its use during vaccination to date; these had small sample sizes and imperfect methodological designs.
A randomised controlled clinical trial.
One hundred and sixty participants from the Tres Forques Health Center were randomly assigned to the intervention group (IG) (n = 82) in which distraction with immersive VR was used during the vaccination, while standard distraction techniques were used for the control group (n = 80). The primary outcome was pain (Wong–Baker FACES). Secondary outcomes included (Children's Fear Scale) and parental satisfaction with the vaccination procedure. Chi-squared tests were used for qualitative variables, relationships between quantitative variables were tested with Spearman correlations, and Mann–Whitney U- or Student t-tests were employed to assess the relationship between quantitative and qualitative variables.
Compared to the controls, the children in the IG reported significantly less pain and fear, while parental satisfaction was significantly higher. Reported pain and fear did not differ according to the sex of the patient. Child age was not linked to fear but was related to pain: the younger the patient, the greater the pain they described.
Immersive VR effectively controlled pain and fear in children during vaccination and increased parent satisfaction with the vaccination process. Patient sex did not influence the level of pain and fear but age did.
Improving vaccination experiences can reduce perceived pain and fear in children and increase parent satisfaction, thereby enhancing vaccination schedule adherence and improving group immunity.
The CONSORT Statement for non-pharmacological randomised clinical trials were followed.
This study explored the impact of different care modes on the outcome of hospitalized patients with acute ischaemic stroke (AIS) during hospitalization and 3 months after discharge.
This was a prospective cohort study comparing the outcomes at hospitalization, at discharge, and at 3 months post discharge among AIS patients with different caregiving arrangements from 9, December 2022 to 20, August 2023. The general information questionnaire, Modified Barthel Index, Shortened General Comfort Questionnaire, Perceived Social Support scale, Herth Hope Index, modified Rankin scale and EQ-5D-5L were utilized for the investigation.
The psychological evaluation scores during hospitalization, including comfort, perceived social support, and hope, did not significantly differ between the two groups of AIS patients (p > .05). Moreover, there were no significant impacts observed in terms of length of stay (LOS) at the hospital or hospitalization expense (p > .05). The proportion of patients with intact functionality was greater in the family caregiver group 3 months after discharge (16.5%). However, when stratified based on prognosis, the difference in outcomes between the two groups of patients did not reach statistical significance (p > .05). The analysis of ADL, quality of life and stroke recurrence in 276 surviving ischaemic stroke patients 3 months post discharge indicated no differences between the two groups across all three aspects (p > .05).
Older and divorced or widowed AIS patients tend to prefer professional caregivers. The psychological state during hospitalization, length of hospital stay and hospitalization expenses are not influenced by the caregiving model. Three months post discharge, a greater proportion of patients in the family caregiving group had intact mRS functionality, but this choice did not impact patient prognosis, stroke recurrence, quality of life or independence in ADL.
FreshRSS 