Conectar
To quantify how specific patient-level characteristics influence the actual amount of mobilisation received during ICU care, thereby identifying key predictors to support individualised mobilisation strategies.
A prospective observational study was conducted in four tertiary hospitals among a convenience sample of 141 critically ill patients from July to November 2023. Data on mobilisation and patient characteristics were collected using standardised data collection tools, including a mobilisation log and a demographic information sheet. Data were analysed using non-parametric tests, Spearman correlation analysis, and multivariate regression to examine associations between early mobilisation and patient-related factors.
Males and surgical patients engaged in more activity (p < 0.001). Muscle strength (r = 0.568, p < 0.001) and haemoglobin levels (r = 0.207, p = 0.014) were positively associated with mobilisation, while higher disease severity (r = −0.321, p < 0.001) and greater pain (r = −0.284, p < 0.001) were linked to reduced activity. Muscle strength, disease severity, surgical status, and sex were independent predictors, explaining 32.5% of the variance.
Early mobilisation in the ICU is influenced by various patient-related factors. Protocols should be tailored to individual patient profiles to enhance outcomes.
This study provides guidance for ICU clinicians to develop targeted mobilisation strategies that consider patients' specific clinical profiles. Tailored approaches may help optimise early mobilisation practices and patient outcomes.
To explore the latent categories and influencing factors of dyadic decision self-efficacy among stroke patients and their caregivers.
A cross-sectional survey involving 305 patient-caregiver pairs was conducted using standardised questionnaires. Latent profile analysis was used to identify dyadic self-efficacy categories and multinomial logistic regression was employed to analyse influencing factors.
The dyadic decision self-efficacy of stroke patients and their caregivers was classified into three categories: low common decision self-efficacy group (35.6%), patients' high decision self-efficacy and caregivers' moderate decision self-efficacy group (38.6%), and high common decision self-efficacy group (25.8%). Influencing factors included patients' education level, income and health literacy, as well as caregivers' education, caregiving duration and social support.
The levels of dyadic decision self-efficacy among stroke patients and their caregivers are heterogeneous. Clinicians can develop targeted interventions involving both patients and caregivers, based on the population's characteristics and influencing factors, to improve their dyadic decision self-efficacy.
This study was conducted and reported in accordance with the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines.
This study explored the multiple mediating roles of sense of coherence (SOC) and coping styles in the relationship between caregiver burden and family adaptation among family caregivers of patients with stroke.
A cross-sectional study of 347 family caregivers of patients with stroke was conducted in China. Data were collected using a general information questionnaire, Zarit Caregiver Burden Interview and other questionnaires, and were analysed using descriptive, Pearson's correlation and path analyses.
SOC–positive and SOC–negative coping styles played a fully parallel chain-mediating role in the relationship between caregiver burden and family adaptation among family caregivers of patients with stroke.
Improving caregivers' SOC and encouraging them to adopt positive coping styles are crucial for reducing the negative impact of caregiver burden on family adaptation.
This study provides a new perspective for medical staff to improve the family adaptation of family caregivers of patients with stroke. Targeted interventions aimed at improving the SOC level and enhancing positive coping styles of the family caregivers of patients with stroke are necessary to improve their family adaptation.
Our study provides insights into the potential influencing mechanism of caregiver burden on family adaptation in family caregivers of patients with stroke, providing a new perspective for developing effective and precise intervention strategies to maintain better family adaptation.
This study adhered to the STROBE checklist.
Promoting SOC and focusing on the transformation of negative coping styles into positive ones may be crucial in developing nursing programmes for family adaptation.
No patient or public contribution.
Many systematic reviews (SRs) and meta-analyses (MAs) have reported the potential advantages and risks of ICU diary psychotherapy in patients and relatives, but the results remain uncertain and their quality has not yet been adequately assessed. We summarise existing SRs/MAs and assess their quality and level of evidence.
This overview of SRs was conducted in accordance with the preferred reporting items for overviews of reviews statement.
We conducted a detailed and comprehensive search of eight Chinese and English electronic databases from inception until March 2025. The Assessment of Multiple Systematic Reviews 2 (AMSTAR 2), the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 (PRISMA 2020), and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) were used to assess methodological quality, reporting quality and evidence quality for inclusion in SRs/MAs, respectively.
Fifteen published SRs/MAs met the inclusion criteria and were included in the study. The results of the AMSTAR 2 assessment showed that the methodological quality of the included studies was critically low. In the PRISMA 2020 assessment, the response rate of “Yes” for items 7, 14, 15, 16, 21, 22, 24, 25 and 27 was less than 50%. The GRADE assessment showed that no results were high-quality evidence, 2 results were moderate-quality evidence, 26 results were low-quality evidence and 45 results were very low-quality evidence.
ICU diaries can improve patients' psychological outcomes and quality of life, and whether there are advantages for their relatives needs to be further explored. However, the methodological quality of the studies was low and the risk of migration was high, reducing its reliability. Therefore, these conclusions should be treated with caution. High-quality studies with large sample sizes are needed to provide stronger and more scientific evidence.
Our paper presents an overview of systematic reviews, and therefore, such specific details may not be relevant to our study.
PROSPERO: CRD42023448359
Digital Creative Art Interventions (DCAIs) are innovative approaches to art interventions using digital technology, which can improve older adults' health. However, a comprehensive summary of the implementation of this intervention among older adults is lacking.
To summarise the deliveries and categories of DCAIs, review their feasibility and roles in older adults' healthcare, and explore the barriers and facilitators to implementing DCAIs in older adults.
Scoping review.
This scoping review followed Arksey and O'Malley's framework, and PRISMA-ScR was used to guide the report.
PubMed, Embase, EBSCOhost, Web of Science and Cochrane Library on 26 February 2024.
Thirty-one studies were selected in this review. We summarised the deliveries and categories of DCAIs in older adults. Besides, we cleared DCAIs to offer music, dance, museum, photo collage, drama, visual art interaction and mixed art intervention to older adults, primarily through videoconferencing or mobile applications. The five health promotion roles were physiological health enhancer, psychological caregiver, socialisation supporter, cognitive promoter and life optimiser. Most older adults believed DCAIs were not only feasible and acceptable, but they also met some barriers such as technological problems, problems brought about by older adults' decline in functioning, experience and privacy.
Despite the unique advantages of DCAIs, continuous improvements are needed. In the future, researchers and healthcare workers should focus on platform improvements, increasing interactivity, diversifying formats and ensuring security and privacy.
This review found that DCAIs offered new approaches to treatment options for older adults' physical and mental health. Therefore, it is recommended that they be continuously optimised and put into clinical practice.
No patient or public contribution.
This study summarised the DCAIs and provides the new approach for health promotion in older adults.
OSF (https://osf.io/m62x9/, registration DOI: https://doi.org/10.17605/OSF.IO/4ZGE6)
This study aims to investigate the levels of emotional intelligence, nurses' perceived professional benefits, and spiritual care competency among ICU nurses, explore the correlations among these three variables, and further analyse the mediating role of perceived professional benefits between emotional intelligence and spiritual care competency.
A multicenter cross-sectional study was conducted following the STROBE guidelines.
From January to March 2024, 568 ICU nurses from seven tertiary hospitals in China completed an online questionnaire including demographic items, the Wong and Law Emotional Intelligence Scale, the Nurses' Perceived Professional Benefits Questionnaire, and the Spiritual Care Competency Scale. Data were analysed using SPSS 27.0 and Amos 27.0. Pearson correlation, structural equation modelling (SEM), and bootstrap analysis (5000 samples) were used to test associations and mediation effects.
ICU nurses reported above-average scores in EI, NPPB, and SCC. EI was positively associated with both NPPB and SCC, and NPPB partially mediated the relationship between EI and SCC.
EI significantly contributes to ICU nurses' SCC both directly and indirectly through NPPB. These findings highlight the psychological mechanisms that support competency in spiritual care.
Nursing managers are encouraged to implement structured training programmes focusing on emotional regulation and professional value reinforcement, which may effectively enhance SCC and improve holistic care quality in ICU settings.
Not applicable.
To explore frail older adults' preferences and needs regarding mobile health (mHealth) exercise interventions in China. Additionally, it sought to identify the nudge strategies necessary for initiating and sustaining exercise behaviours among frail older adults.
A qualitative study.
The semi-structured interviews were conducted between April and May 2024 from two communities in Changsha, China. The data were analysed using a deductive framework analysis aligned to nudge theory, and an inductive thematic analysis to gather relevant needs and preferences.
This study involved 14 participants with pre-frailty or frailty, aged 60–82 years (median age of 64 years). While participants were generally receptive to new technologies, lower levels of health literacy and competing priorities often hindered their participation. Three primary functionality requirements were as follows. (1) Profession engagement: tailored exercise prescription, professional and timely feedback and guidance; (2) personalised knowledge encompassing pain management, successful cases and inspiration; (3) beneficial, tailored, dynamic, fragmented, challenging exercise courses. Participants showed positive attitudes towards simplification nudges, gamification nudges, social nudges, trustworthy nudges, reminder nudges, economic nudges, feedback nudges and pre-commitment nudges. Addressing privacy concerns was essential to build trust and acceptance among older adults.
These findings emphasised the importance of designing mHealth interventions that address frail older adults' specific needs and preferences while incorporating effective nudge strategies to promote engagement and adherence. Future researchers should explore wearables, ChatGPT language models, virtual coaching assistants, exercise snack to further optimise the experience and analyse the effects of nudges in mHealth exercise interventions among older adults.
Exercise systems or app development for frail older adults should meet three basic functionality and essential nudge strategies.
The consolidated criteria for reporting qualitative research (COREQ) guidelines were used for reporting.
Older adults' engagement and interview data contribute a lot.
To explore the current status of self-perceived burden in patients with newly diagnosed diabetes mellitus and the effects of social support and self-efficacy on their self-perceived burden, and to establish a model of the relationship among the three.
The prevalence of diabetes is rising year by year, and the population of newly diagnosed diabetes mellitus is growing, with a high incidence of self-perceived burden, and the related psychological problems of patients with newly diagnosed diabetes mellitus are receiving more and more attention.
A cross-sectional and quantitative study.
This study adhered to the EQUATOR guidelines. In total, 203 patients with newly diagnosed diabetes mellitus were selected using convenient sampling from the outpatients of diabetes and the ward of metabolic endocrinology in the hospital. Questionnaires were conducted using the Social Support Revalued Scale, Chronic Disease Self-Efficacy Scale and Self-Perceived Burden Scale. Structural equation modelling was applied to analyse the effects and pathways of influence among them.
The self-perceived burden score of patients with newly diagnosed diabetes mellitus was (33.84 ± 9.55) and moderate self-perceived burden was present. Social support and self-efficacy significantly affected self-perceived burden, with a direct effect of 0.273 and an indirect effect of 0.466 mediated by self-efficacy, totalling 0.739. The indirect effect via self-efficacy accounted for 63.06% of the impact.
Social support and self-efficacy have an essential effect on the self-perceived burden of patients with newly diagnosed diabetes mellitus. In addition, self-efficacy has a mediating effect on the influence of social support on self-perceived burden.
The self-perceived burden is common in patients with newly diagnosed diabetes mellitus. To reduce the self-perceived burden of these patients, it is important to focus on their self-efficacy and provide comprehensive social support.
Deep vein thrombosis (DVT) is a frequent complication following endovascular thrombectomy (EVT) in patients with acute ischaemic stroke (AIS), potentially leading to fatal pulmonary embolism (PE). Identifying patients early at high risk for DVT is clinically important. This study developed and validated a nomogram combining laboratory findings and clinical characteristics to predict the risk of lower-extremity DVT after EVT in patients with AIS.
This retrospective multicentre observational study was conducted in two tertiary hospitals in China, enrolling 640 patients who underwent ultrasonography for DVT diagnosis within 10 days following EVT. Data on medical history, examination and laboratory results were collected for logistic regression analyses to develop a DVT risk nomogram.
Logistic regression analyses identified critical predictors of DVT: lower limb National Institutes of Health Stroke Scale (NIHSS) score ≥ 2, elevated D-dimer levels (≥ 1.62 mg/L) and prolonged puncture-to-recanalization time (PRT ≥ 66 min). The nomogram demonstrated good discriminative ability (AUC 0.741–0.822) and clinical utility across internal and external validation cohorts. Additionally, the presence of DVT was significantly associated with reduced functional independence at 90 days post-EVT, highlighting the negative impact of DVT on patient recovery (OR = 3.85; 95% CI: 2.18–6.78; p < 0.001).
The study provides a practical clinical tool for early detection and intervention in patients with AIS at high risk for DVT following EVT. Early identification and intervention may help improve outcomes in patients with AIS undergoing EVT.
This nomogram helps in the early detection and proactive management of DVT in AIS patients, which can reduce severe complications and improve patient recovery outcomes.
No patient or public contributions were involved in this study due to its retrospective design, where data were utilised from existing medical records without direct patient interaction.
Stroke incidence has increased recently, causing functional impairments in most patients. Augmented reality(AR) is frequently employed as an interactive and repetitive technology to facilitate functional rehabilitation. Therefore, this study aimed to examine the current evidence in the effect of AR for stroke rehabilitation.
Systematic review with meta-analysis.
Seven electronic databases including PubMed, Medline, CINAHL, Web of Science, Scopus, Embase and Cochrane were searched by MeSH terms and keywords such as ‘Stroke’ ‘Augmented reality’ up to December 1, 2024.
The Cochrane Risk of Bias tool was used to evaluate potential bias. Meta-analysis and Trial Sequence Analysis were used to analyse by the datastata15.0 software and TSA v0.9 software.
We searched 11 studies in a systematic review and 8 in a meta-analysis. The AR training group exhibited a significantly superior Berg Balance Scale scores(BBS) to those of the traditional training group. The Z-value curve of the sixth study crossed the traditional and TSA boundary values. Subgroup analysis revealed that BBS was significantly influenced in the hospital compared to the home intervention. The Timed Up and Go Test scores(TUG) and the 10-Meter Walk Test scores(10MWT) were similar in the AR and traditional training groups.
AR technology is beneficial for the lower limb balance functional rehabilitation of stroke patients. However, further exploration and verification are necessary due to an insufficient number of trials.
The findings provide clinical references for implementing AR in rehabilitation interventions for stroke patients.
This paper is helpful for nurses in the rehabilitation training process of stroke patients, to make personalised plans for their rehabilitation, implement rehabilitation, provide health education and address other aspects of efforts, to provide patients with comprehensive support and help, to promote the functional recovery of patients and improve the quality of life.
PRISMA guidelines.
PROSPERO number: CRD42024533761.
MJEditor (www.mjeditor.com) provided English editing services during the preparation of this manuscript.
To examine the effects of depression on dyadic self-care in stroke patients and their caregivers, as well as the potential mediating role of self-efficacy in this relationship.
A multi-centre cross-sectional study design was employed.
From May to September 2022, stroke patients and their caregivers were recruited from China using a multi-centre stratified sampling method. Data analysis was conducted using a structural equation model based on the Actor-Partner Interdependence Model extended to include mediation. Depression in patients and caregivers was assessed using the Patient Health Questionnaire-9. The self-care self-efficacy scale was utilised to measure patient self-efficacy, while the caregiver self-efficacy in contributing to patient self-care scale was used for caregivers. Patient self-care was evaluated with the Self-Care of Stroke Inventory and caregiver contributions to self-care were assessed using the Caregiver Contributions to Self-Care of Stroke Inventory.
This study followed the STROBE checklist.
306 patient-caregiver dyads were enrolled. The direct effect between depression and dyadic self-care was not confirmed in stroke patients and their caregivers (p > 0.05). Patient self-efficacy had significant indirect actor effects on self-care maintenance (β = −0.173, p < 0.001), monitoring (β = −0.146, p < 0.001) and management (β = −0.186, p < 0.001). Caregiver self-efficacy had an indirect actor effect on caregiver contributions to self-care maintenance (β = −0.096, p < 0.001), monitoring (β = −0.073, p < 0.001) and management (β = −0.106, p < 0.001). The partner effect analysis showed caregiver self-efficacy plays a potential mediating role in the relationship between patient depression and caregiver contributions to self-care maintenance (β = −0.037, p = 0.036), monitoring (β = −0.028, p = 0.032) and management (β = −0.040, p = 0.036). Caregiver depression reduced caregiver self-efficacy, lowering patient self-care monitoring (β = −0.040, p = 0.004) and management (β = −0.047, p = 0.002) levels.
The findings indicate interactive effects between depression, self-efficacy and dyadic self-care among stroke patients and their caregivers. Therefore, the development of targeted dyadic interventions to address depression and enhance self-efficacy in both patients and caregivers should be considered.
To investigate evidence-based practices and examine rates of adherence to bundles on maintenance of central venous catheters among intensive care unit nurses in 22 selected hospitals.
Although there has been an overwhelming increase in the use of evidence-based practices to reduce Central Line-Associated Bloodstream Infections, also known as bundles, there continues to be a considerable gap between clinical practice and evidence.
This study employs a multi-center cross-sectional design.
Registered nurses who worked in the ICUs of 22 selected hospitals were included. Evidence-based procedures were developed based on Central Line Bundles, which include an 11-area and 35-item checklist. Rates of adherence to bundles were calculated and analysed after reaching 22,000 central line days in 22 units. The study was reported using the STROBE checklist.
The average adherence rate to evidence-based procedures for CVC maintenance among ICU nurses in the 22 units was 87.40%. The adherence rate of five areas of the evidence-based procedure based on the Central Line bundle was above 90%, including ‘Selection of regulated skin disinfectants’, ‘Tube sealing’, ‘Tube flushing’, ‘Dressing and catheter fixation’ and ‘Sterilized skin and catheter’. The three lowest-achieving areas of bundles were ‘Catheter and insertion site assessment,’ ‘Hand hygiene’ and ‘Sterilized catheter access hubs’. The lowest-achieving item of bundles is ‘Assess during multidisciplinary patient care rounds with signature confirmation’. The adherence rates in hospitals where CLABSI occurred were all less than 90%.
ICU nurses' adherence to maintenance bundles for CVC is moderate, implying that boosting adherence rates is critical for improved results. As a result, comparable studies should be done in ICUs where the bundle has been deployed to assess and improve adherence rates through effective interventions. To minimise CLABSI in future practice, novel strategies must be developed and implemented via continued education and regular evaluation.
We registered the trial with the US Clinical Trials Registry (ID: NCT06085690, Name: Multicenter Clinical Translational Study of ‘ICU-NO CRBSI’ Based on Improvement Science, https://ichgcp.net/clinical-trials-registry/NCT06085690)
Nurse administrators and policymakers can develop strategies and interventions for improving the quality of CVC care toward evidence-based practice. Minimising the gaps between evidence and practice will reduce the incidence of CLABSI to enhance the survival of critically ill patients.
In addressing the status of evidence-based practices among ICU nurses, this study enhances healthcare quality and outcomes.
There was no patient or public contribution.
To explore the effectiveness of dyadic intervention on the psychological distress of cancer patients and their partners.
Cancer patients and their partners demonstrated high levels of psychological distress. However, the effects of dyadic intervention on psychological distress were unclear.
A systematic review and meta-analysis of randomised controlled trials was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement.
A systematic search on couple-based dyadic intervention for cancer patients and their partners was carried out across eight databases. Our review adhered to the Cochrane risk-of-bias tool as its foundational framework, and data extraction and analysis followed standardised checklists for quantitative research studies.
No statistically significant effects were reported on patients' anxiety, depressive symptoms, or cancer-related distress. However, subgroup analysis revealed that interventions lasting 6 or 12 weeks had positive effects on patients' cancer-related distress. Significant reductions in cancer-related distress scores were only observed when interventions included communication and support (CS) and skill building (SB) components, however. Additionally, patients experienced higher distress levels with less than six interventions or session durations shorter than 6 h. For partners, couple-based dyadic interventions significantly reduced their anxiety and depressive symptom levels.
Couple-based dyadic interventions, with either 6- or 12-week durations, or encompassing both CS and SB components, demonstrated significantly positive effectiveness on patients' psychological distress. Couple-based dyadic interventions also exhibited a propensity for alleviating psychological distress in both cancer patients and their partners, with a more pronounced impact observed among partners.
This meta-analysis highlights the effectiveness of dyadic interventions in reducing psychological distress in cancer patients and their partners. Healthcare professionals should incorporate these interventions into their care practices.
Direct contributions from patients or the public were not included in this review.
PROSPERO number: CRD42023418978; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=418978
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.
FreshRSS 