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Physiological, psychological, and social changes may make older adults more vulnerable to stressors and lead to adverse health outcomes. It remains unclear whether interventions targeting coping strategies in older adults are effective.
This study aimed to systematically review and summarize existing interventions aimed at improving coping strategies in older adults and analyze intervention effectiveness.
A systematic search was conducted using PubMed, EMBASE, Web of Science, Cochrane, CINAHL, PsycINFO, CNKI, SinoMed, VIP, and WanFang databases for randomized controlled trials (RCTs) and quasi-experimental studies. Two researchers independently performed literature screening, quality assessment, and data extraction.
A total of 9 studies were included, comprising 7 RCTs and 2 quasi-experimental studies. Meta-analysis revealed that the interventions significantly enhanced the use of problem-focused coping strategies among older adults (SMD = 0.37, 95% CI: 0.12 ~ 0.63, p = 0.005, I 2 = 39%). However, there was no significant effect on emotion-focused coping strategies (SMD = −0.07, 95% CI [−0.62, 0.48], p = 0.80, I 2 = 76%). Moreover, no significant statistical differences were observed between the intervention group and the control group in terms of positive (SMD = 1.49, 95% CI [−0.23, 3.21], p = 0.09, I 2 = 98%) or negative coping strategies (SMD = −0.76, 95% CI [−1.79, 0.28], p = 0.15, I 2 = 96%).
Interventions targeting coping strategies can significantly improve the problem-focused coping strategies of older adults. It is crucial to help older adults accurately recognize daily stressors, acquire emotional regulation strategies, and enhance coping skills. More large-scale RCTs are needed to draw more robust conclusions.
Optimal glycemic control is known to be challenging for people with type 2 diabetes (T2D) due to the maintenance of long-term self-management behavior. Incorporating the transtheoretical model (TTM) components into motivational interviewing (MI) has been applied to promote self-management behaviors such as physical activity in T2D patients. However, the effectiveness of the TTM-based MI intervention in improving glycemic control, self-management, and self-efficacy in adults with T2D remains unclear.
This systematic review and meta-analysis of randomized controlled trials aimed to estimate the effect of a TTM-based MI intervention on glycemic control, self-management, and self-efficacy in adults with T2D patients.
We searched five electronic databases up to September 13, 2023. Two researchers independently screened records, extracted data, and assessed study quality using the Cochrane Risk of Bias Tool 2.0. Pooled effects were estimated in standardized mean differences (SMDs) or mean differences (MDs) using fixed- and random-effects models. Sensitivity analysis and meta-regression explored the reasons for heterogeneity.
Thirty trials with 4214 participants were identified. The TTM-based MI intervention significantly reduced HbA1c (MD = −0.92, 95% CI [−1.08, −0.75], p < 0.001, I 2 = 65%), FPG (SMD = −1.06, 95% CI [−1.38, −0.73], p < 0.001, I 2 = 93%), and 2hPG (MD = −1.42 mmol/L, 95% CI [−1.83, −1.00], p < 0.001, I 2 = 89%), with high, moderate, and low certainty of evidence, respectively. The intervention also improved self-management (SMD = 1.47, 95% CI [1.16, 1.78], p < 0.001, I 2 = 80%) and self-efficacy (SMD = 1.53, 95% CI [1.04, 2.02], p < 0.001, I 2 = 92%). Meta-analysis revealed that MI treatment dose and initial glycemic status contributed to the high heterogeneity.
The TTM-based MI intervention can be a promising intervention for understanding patients' stage of change with tailored strategies and MI techniques to facilitate behavior change, resulting in improved glycemic control, self-management, and self-efficacy in T2D patients. Nevertheless, given the moderate to high risk of bias in the included studies, further rigorous randomized controlled trials should be conducted to examine the effectiveness of TTM-based MI interventions. Short and multiple sessions that comply with the fidelity of MI in the intervention plans are suggested in daily nursing routine for diabetes self-management education.
Previous studies regarding mind–body exercise among people with breast cancer mostly focused on one type of mind–body exercise and provided conflicting results.
This paper aims to systematically synthesize the evidence hierarchy and examine the credibility of previous meta-analyses of different types of mind–body exercises.
We searched PubMed, Embase, Cochrane Library, Web of Science, and Epitemonikos from database inception to February 2nd, 2024, for meta-analyses of randomized controlled trials. Included meta-analyses examined the effects of mind–body exercises on at least one outcome of health-related quality of life, cancer-related fatigue, depression, anxiety, and sleep quality in breast cancer patients. The random effects estimates (Hedges'G), 95% prediction interval, small study effect, and excess significance bias were calculated. Furthermore, we categorized meta-analyses based on the evidence credibility criteria and assessed quality using A Measurement Tool to Assess Systematic Reviews 2.
The umbrella review included a re-analysis of 16 meta-analyses of 9 articles including 134 randomized controlled trials involving 9469 breast cancer patients and survivors. We identified 3 articles as “low” quality and 6 articles as “critically low” quality. Convincing evidence supported the effectiveness of Yoga intervention in reducing depression symptoms (G = −0.77, 95% Confidence Interval [−0.93, −0.61]). However, 11 meta-analyses were supported by weak evidence (1 for Qigong alleviated depression, 4 for Qigong, Baduanjin, Tai Chi Chuan, and Yoga improved health-related quality of life, 3 for multiple mind–body exercises, Tai Chi Chuan, and Yoga reduced cancer-related fatigue, 2 of Baduanjin and Yoga reduced anxiety, as well as 1 of Yoga improved sleep quality).
Mind–body exercises, especially yoga, may be beneficial for improving health-related quality of life and mental health for breast cancer patients. Further high-quality interventions investigating diverse mind–body exercise interventions are warranted to ascertain the effectiveness of health-related quality of life and mental health outcomes.
Previous research has demonstrated the effectiveness of virtual reality (VR) technology in many application areas. However, there is a clear gap in the literature regarding its effects on depression and anxiety in older adults with chronic diseases.
This review aimed to assess the effectiveness of VR interventions for depression and anxiety in older adults with chronic diseases.
Seven electronic databases were systematically searched from their inception to April 9, 2024. Two researchers evaluated methodological quality using RoB (version 2.0) and performed meta-analyses using RevMan (version 5.4) and Stata (version 16.0) software.
This review included 19 randomized controlled studies. Meta-analysis revealed that VR significantly improved depression (standard mean difference [SMD] = −0.67, 95% confidence interval [CI] [−0.90, −0.45], p < .00001) and anxiety (SMD = −0.76, 95% CI [−0.95, −0.57], p < .00001) in older adults with chronic diseases, improved their quality of life (SMD = 0.39, 95% CI [0.17, 0.61], p = .0006) and positive emotions (SMD = 5.65, 95% CI [3.61, 7.69], p < .00001), and relieved stress (SMD = −1.08, 95% CI [−1.52, −0.64], p < .00001). However, the difference in self-efficacy was statistically non-significant (SMD = 1.01, 95% CI [−0.48, 2.50], p = .19).
The results of this systematic review provide important evidence for developing interventions to improve the mental health of older adults with chronic diseases.
A common psychological problem among nurses is depression, potentially affecting their well-being and job performance. It is vital to explore how to alleviate nurses' depressive symptoms.
The current research explored the mediating impact of basic psychological needs satisfaction on the link of gratitude with depressive symptoms.
The nurses in this study were from mainland China. A total of 724 subjects completed an online questionnaire, which included measures of depressive symptoms, basic psychological needs satisfaction and gratitude.
Our research found that gratitude was negatively linked to depressive symptoms. Furthermore, basic psychological needs satisfaction had a partial mediation effect on the link of gratitude with depressive symptoms after controlling for five demographic variables. These results suggest that gratitude may influence depressive symptoms via basic psychological needs satisfaction.
Our study found that basic psychological need satisfaction partially mediates the gratitude-depression relationship in nurses. The result means that hospital administrators and nurse leaders should design gratitude interventions to alleviate nurses' depressive symptoms. They also help nurses decrease depressive symptoms by creating an environment that meets their basic psychological needs.
Non-pharmacological interventions have been used in the rehabilitation of stroke survivors, but their effects on stroke survivors' quality of life (QoL) are unknown.
This review aimed to summarize the existing evidence regarding non-pharmacological interventions for QoL in stroke survivors and to evaluate the effectiveness of different types of interventions.
We systematically searched databases including PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Chinese BioMedical Literature Database, China Science and Technology Journal Database, and Wanfang data from the earliest available records to March 2023. Randomized controlled trials which explored the effects of non-pharmacological interventions on QoL in stroke patients were included. The meta-analysis was conducted to evaluate the effectiveness of different interventions on QoL. The Review Manager 5.3 was used to conduct the meta-analysis and the revised Cochrane risk-of-bias tool was used to assess the methodological quality of trials.
A total of 93,245 records were identified, and 34 articles were reviewed and summarized, of which 20 articles were included in the meta-analysis. The summary of the findings of the included studies revealed fitness training, constraint-induced movement therapy (CIMT), physical exercise, music therapy (MT), and art-based interventions may have positive effects on QoL. The fitness training improved total QoL, especially in physical domains including physical functioning (mean difference [MD] = 10.90; 95% CI [7.20, 14.59]), role physical (MD = 10.63; 95% CI [6.71, 14.55]), and global health (MD = 8.76; 95% CI [5.14, 12.38]). The CIMT had a slight effect on general QoL (standardized mean difference [SMD] = 0.48, 95% CI [0.16, 0.80]), whereas significantly improved strength (MD = 8.84; 95% CI [1.31, 16.38]), activities of daily living/instrumental activities of daily living (ADL/IADL; MD = 10.42; 95% CI [2.98, 17.87]), and mobility (MD = 8.02; 95% CI [1.21, 14.83]). MT had a positive effect on the mental health domain (SMD = 0.54; 95% CI [0.14, 0.94]).
Our findings suggest that fitness training and CIMT have a significant effect on improving physical QoL, while MT has a positive effect on improving psychological QoL. Future studies may use comprehensive and multicomponent interventions to simultaneously improve the patients' physical, psychological, and social QoL.
Extensive literature has shown the effectiveness of cognitive behavioral therapy in treating perinatal depression, but little is known about the effectiveness of its technology-based version.
The aim of this review was to examine the effectiveness of technology-based cognitive behavioral therapy in reducing depressive and anxiety symptoms in women suffering from or at risk of experiencing perinatal depression.
Six electronic databases were searched until February 2023 for articles published in English. Random-effect meta-analyses were conducted. Heterogeneity was assessed using the I 2 statistics and Cochran's Q chi-squared test. Sensitivity analyses and subgroup analyses were also performed, and quality appraisals at the study and outcome levels were conducted.
A total of 16 randomized controlled trials were included in the review. Results from meta-analyses suggest that technology-based cognitive behavioral therapy has a medium effect in reducing perinatal depressive symptoms and a small effect in reducing perinatal anxiety symptoms. Overall, women suffering from or at risk of perinatal depression may benefit from technology-based cognitive behavioral therapy.
Future interventions can be improved by addressing both perinatal depression and anxiety, paying more attention to antenatal women to prevent postnatal mental health issues, and using self-guided mobile applications for accessibility.
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