Socially assistive robots (SARs) have been used in group interventions for older adults; however, their effectiveness remains unclear. This systematic review aimed to synthesize evidence on the efficacy of group interventions with SARs on various outcomes (physical, cognitive, psychological, quality of life, therapeutic engagement, and sociality) for older adults, and the factors that influence their effectiveness.
A literature search was conducted using five databases (Web of Science, PubMed, Scopus, PsycINFO, and MEDLINE) in October 2024. The research team selected and analyzed the studies applying a narrative synthesis.
In all, 25 articles were identified, 15 of which were deemed of good quality. We found that companion robots are commonly used in group interventions for older adults that consist of physical, cognitive, and combined physical and cognitive activities. Insufficient evidence was identified on the effectiveness of physical interventions and groups with physical and cognitive activities on health outcomes (i.e., physical, cognitive, psychological, and quality of life). Regarding the cognitive group interventions, positive physical outcomes (i.e., improved sleep quality, decreased pulse rate, and increased pulse oximetry), improved cognitive function, positive psychological outcomes (i.e., decreased agitation, depression, anxiety, and loneliness, and increased positive emotions) were found; however, the positive effects in terms of cognitive level and certain psychological outcomes were comparable to the control groups. Mixed results were reported for quality of life in older adults. Across the three types of interventions, robots facilitated engagement and increased the sociality of most older adults. The effectiveness depended on the cognitive function of the older adults, the presence of staff, the type of robot, and the schedule of the interventions.
Research gaps have been identified, and more rigorous studies investigating the effectiveness of different types of group interventions in older adults are needed before applying SARs in group interventions on a large scale.
Given the importance of group interventions in nursing care of older adults, healthcare professionals can use socially assistive robots in such interventions to assist in caring for older adults.
To explore the association between psychological capital and psychological distress in stroke patient–spouse dyads and examine the mediating effect of relationship satisfaction in this association.
A population of 207 stroke patient-spouse dyads completed the Positive Psychological Capital Questionnaire, Quality of Relationship Index, and Kessler Psychological Distress Scale. A dyadic analysis was conducted using the actor-partner interdependence mediation model.
In stroke-affected couples, a noteworthy interaction exists between moderately elevated levels of psychological capital (p < 0.01). Patients exhibit significantly diminished psychological capital and heightened psychological distress compared to their spouses (t = −5.429, p < 0.001; t = 2.536, p < 0.05). Conversely, there is no significant variance in relationship satisfaction between patients and the partners (t = −0.920, p > 0.05). Patient relationship satisfaction acts as a mediator in the correlation between dyadic psychological capital and patient psychological distress (β = −0.020, p < 0.05; β = −0.011, p < 0.05). Similarly, spousal relationship satisfaction serves as a mediator in the connection between dyadic psychological capital and spousal psychological distress (β = −0.011, p < 0.05; β = −0.020, p < 0.05).
Psychological distress was reduced when psychological capital or relationship satisfaction in stroke dyads was promoted, and relationship satisfaction is an important mediator of the impact of psychological capital on psychological distress in the dyads. Healthcare providers should pay equal attention to spouses and implement dyadic psychological capital interventions centered on stroke couples to enhance relationship satisfaction and reduce psychological distress.
Falls among older adults are a major public health concern, often leading to serious outcomes such as fractures, head trauma, and increased mortality. Virtual reality (VR) interventions have emerged as a promising strategy for fall prevention by improving balance, reducing fear of falling, and enhancing confidence. However, the impact of VR interventions on specific outcomes such as fear of falling, balance, and postural control in older adults remains insufficiently synthesized.
Systematic review and meta-analysis.
A comprehensive systematic search of six databases was conducted from inception to January 20, 2025. Randomized controlled trials (RCTs) evaluating VR interventions targeting fear of falling, balance, and postural control in older adults were included. Methodological quality was assessed using the Cochrane risk-of-bias tool (RoB-2). Pooled standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated using random-effects models for each outcome.
Seventeen RCTs involving 988 older adults, published between 2016 and 2025, met the inclusion criteria. VR interventions demonstrated significant effects in reducing fear of falling (SMD = −0.40; 95% CI: −0.72 to −0.08; I 2 = 45.10%; p = 0.02), improving balance (SMD = 0.45; 95% CI: 0.07–0.83; I 2 = 73.54%; p = 0.02), and enhancing postural control (SMD = 0.50; 95% CI: 0.13–0.86; I2 = 46.89%; p = 0.01).
This meta-analysis highlights the effectiveness of VR interventions in reducing fear of falling and improving balance and postural control among older adults.
VR represents a valuable tool in fall prevention strategies, addressing key outcomes essential for maintaining independence and mobility in this population.
Despite evidence supporting nurse-led digitalized diabetes interventions, gaps persist in understanding their specific impact on community-dwelling patients with type 2 diabetes mellitus (T2DM). Prior reviews lacked a quantitative synthesis of these interventions' effects on outcomes like self-care, HbA1c, and quality of life (QoL), limiting their applicability to clinical practice. This study aimed to systematically evaluate and quantify the effectiveness of nurse-led digitalized diabetes management programmes for community-dwelling adults with T2DM.
We searched six databases to identify relevant articles from their inception to June 2024. Randomized controlled trials that evaluate the effects of nurse-led digitalized diabetes management programs for community-dwelling patients with T2DM were included. The Cochrane Risk of Bias tool version 2.0 was used to appraise the included studies. The pairwise meta-analysis was performed through the software Comprehensive Meta-Analysis Version 3.0.
Eleven RCTs were included, encompassing 2943 participants from various regions. Nurse-led digitalized programs significantly improved self-care behaviors (SMD = 1.15; 95% CI: 0.49 to 1.81), and QoL (SMD = 0.65; 95% CI: 0.37 to 0.94). The interventions also demonstrated a clinically meaningful reduction in HbA1c levels (MD = -0.25%; 95% CI: −0.43 to −0.06), highlighting their potential in improving glycaemic control. Heterogeneity across studies was substantial for self-care but moderate for HbA1c and QoL.
Nurse-led digitalised diabetes management programmes effectively enhance self-care behavior, reduce HbA1c levels, and improve QoL among community-dwelling patients with T2DM. These findings underscore the potential of digitalised interventions as scalable and accessible alternatives to traditional diabetes management, particularly in non-institutionalized settings.
Nurse-led digitalised diabetes management programmes can empower community-dwelling patients with T2DM to achieve better health outcomes by enhancing self-care and glycaemic control while improving QoL. Their integration into routine clinical practice could address barriers to care, optimize diabetes management, and reduce the long-term burden of the disease.
The International Prospective Register of Systematic Reviews (PROSPERO) identifier: CRD42024594874
Dementia notably increases fall risk in older adults, leading to major injuries and considerable concerns from health-care professionals. However, comprehensive evidence regarding the prevalence, incidence rate, and moderating factors of falls in institutional settings is limited. This study aimed to evaluate the prevalence, incidence rates, and moderating factors of falls among older adults with dementia in nursing homes and dementia-specialized care units.
A meta-analysis.
We searched CINAHL, PubMed, Embase, ProQuest, Scopus, Web of Science, and PsycINFO from database inception to April 30, 2024. Older adults with dementia in nursing homes or dementia-specialized care units were included. The pooled prevalence was analyzed using a generalized linear mixed model with random effects using R software. Incidence rates were reported per person-year using comprehensive meta-analysis software. Study quality was assessed using Hoy's criteria. Variations in the pooled prevalence of falls were explored through moderator analyses.
This meta-analysis included 21 studies involving 35,449 participants. The pooled prevalence of falls was 45.6%, with subtypes showing 39.2%, 35.2%, and 29.0% among Alzheimer's dementia, vascular dementia, and mixed dementia subtypes, respectively. Falls were more prevalent in dementia-specialized care units (53.0%) than in nursing homes (42.6%). The overall incidence rate was 3.61 per person-year, higher in dementia-specialized care units (5.80) than in nursing homes (3.17). Subgroup analyses revealed higher fall prevalence in women (70.0%) than in men (30.6%). Meta-regression indicated that comorbidities, including delirium, visual impairment, and arthritis, increased fall risk.
This meta-analysis revealed a high incidence of falls in nearly half of older adults with dementia, particularly among those in dementia specialized care units.
Healthcare professionals should prioritize regular fall risk assessments, tailored interventions, and environmental safety modifications, particularly in dementia-specialized care units, to reduce fall-related injuries and improve patient outcomes.
To construct a symptom network of maintenance hemodialysis patients and identify the core symptoms and core symptom clusters. Finally, this study provides a reference for accurate symptom management.
A correlational cross-sectional design. A total of 368 patients who underwent maintenance hemodialysis were enrolled from two hemodialysis centers in Chengdu, Sichuan Province, China. A symptom network was constructed with the R coding language to analyze the centrality index. Symptom clusters were extracted by exploratory factor analysis, and core symptom clusters were preliminarily determined according to the centrality index of the symptom network.
The most common symptoms in maintenance hemodialysis patients were fatigue, dry skin, and pruritus. In the symptom network, headache had the highest mediation centrality (rB = 2.789) and closeness centrality (rC = 2.218) and the greatest intensity of numbness or tingling in the feet (rS = 1.952). A total of six symptom clusters were extracted, including pain and discomfort symptom clusters, emotional symptom clusters, gastrointestinal symptom clusters, sleep disorder symptom clusters, dry symptom clusters, and sexual dysfunction symptom clusters. The cumulative variance contribution rate was 69.269%.
Fatigue, dry skin, and pruritus are the sentinel symptoms of maintenance hemodialysis patients, headache is the core symptom and bridge symptom, and pain symptom clusters are the core symptom clusters of MHD patients. Nurses can develop interventions based on core symptoms and symptom clusters to improve the effectiveness of symptom management in maintenance hemodialysis patients.
Understanding the core symptoms and symptom groups that plague maintenance hemodialysis patients is critical to providing accurate symptom management. To ensure that maintenance hemodialysis patients receive effective support during treatment, reduce the adverse effects of symptoms, and improve the quality of life of patients.