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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.
Nurse job satisfaction is a critical area of study with far-reaching implications for healthcare organizations, patient care, and the retention of nursing staff.
This study aimed to investigate the association of gratitude with job satisfaction among Chinese nurses and examine the potential mediating roles of resilience and stress in this relationship.
Two separate studies were conducted to examine our research hypotheses. In Study 1, a total of 460 nurses completed the questionnaire related to gratitude, resilience, stress, and job satisfaction. A validation study was conducted in Study 2, which consisted of 709 nurses who also completed the same measures of gratitude, resilience, and stress to ensure the repeatability of the Study 1 results. Furthermore, a different scale was used to measure nurses' job satisfaction.
The two studies consistently found that both resilience and stress mediated gratitude–job satisfaction independently among Chinese nurses. Furthermore, resilience was found to be a significantly stronger mediator than stress in the association of gratitude with job satisfaction. Finally, we found that gratitude predicted nurses' job satisfaction via the serial mediating effects of resilience and stress.
These findings highlight the complex interplay between gratitude, resilience, stress, and job satisfaction by demonstrating that resilience and stress act as parallel and sequential mediators between nurses' gratitude and job satisfaction. The healthcare sector can improve nurses' job satisfaction by increasing gratitude, building resilience, and reducing feelings of stress.
Nurse managers have the potential to enhance job satisfaction among nurses by implementing measures that increase gratitude, build resilience, and reduce stress levels.
Chronic obstructive pulmonary disease (COPD) causes airflow blockage and breathing-related issues. This chronic disease impacts people worldwide. Substantial evidence supports the use of cognitive behavioral therapy (CBT) to help patients with chronic illnesses cope with worrisome and painful symptoms. However, the impact of CBT on COPD outcomes is less understood.
In this study, we systematically summarized the effects of CBT on lung function, anxiety and depressive symptoms, and quality of life of patients with COPD.
Six English-language and four Chinese-language databases were systematically searched for relevant randomized controlled trials published through April 15, 2023. Studies in which CBT was the only difference in treatment administered to experimental and control groups were included in the review. The studies' risk of bias was evaluated using the Cochrane Criteria.
Sixteen studies (1887 participants) were included. The meta-analysis showed that CBT improved the percent-predicted forced expiratory volume in 1 second (FEV1%), forced vital capacity (FVC), FEV1/FVC ratio, maximal voluntary ventilation, peak expiratory flow, treatment compliance, and World Health Organization abbreviated quality of life, Self-rating Anxiety and Depression Scale, and St George's Respiratory Questionnaire scores compared with the control (all p < .05).
This review demonstrated that CBT improves the lung function, anxiety and depressive symptoms, treatment compliance, and quality of life of patients with COPD and can be used widely in the clinical treatment of this disease.
Weight management is an important part of disease management in patients with heart failure. However, the effectiveness of reported weight management interventions is inconclusive.
The aim of this systematic review and meta-analysis was to assess the effects of weight management on functional status, heart failure-related hospitalizations, and all-cause mortality in patients with heart failure.
PubMed, Web of Science, Embase, and the Cochrane Library were searched on April 3, 2022. This study was registered with PROSPERO (CRD42021283817). Eligible studies assessed functional status, heart failure-related hospitalizations, and all-cause mortality in patients with heart failure. Two researchers independently screened the articles, extracted data, and evaluated the risk bias of each study. Dichotomous variables were presented as OR with a 95% confidence interval (CI). The data were analyzed using a fixed effect or random effect model, and heterogeneity was determined using I 2 statistics. All statistical analyses were conducted using RevMan 5.3.
Among 4279 studies screened, seven randomized controlled trials were included in this study. The results showed that weight management significantly improved functional status (OR = 0.15, 95% CI [0.07, 0.35], I 2 = 52%) and reduced the risk of all-cause mortality (OR = 0.54, 95% CI [0.34, 0.85], I 2 = 0%), but had no significant effect on heart failure-related hospitalizations (OR = 0.72, 95% CI [0.20, 2.66]).
Weight management has effects on improved functional status and reduced all-cause mortality in patients with heart failure. It is necessary to strengthen the weight management interventions of patients with heart failure to improve patients' functional status and reduce all-cause mortality.
As a devastating neurodegenerative disease, Alzheimer's disease (AD) imposes a considerable direct and indirect financial burden. However, effective drug treatment options are limited. In recent years, game therapy has become a research hotspot in this field.
The purpose of this study was to synthesize the conclusions of existing studies and integrate the data to evaluate the effects of game therapy on people living with dementia (PLWD).
We included randomized clinical trials and quasi-experimental studies which assessed the impacts of game therapy on PLWD and took cognitive function, quality of life, and depression as outcome indicators. Two trained researchers independently screened the studies, evaluated the quality, and extracted the data. Statistical analysis was performed by Review Manager (Revman) 5.3 and STATA16.0 software.
There were 12 studies involving 877 PLWD included, total. The results of the meta-analysis demonstrated that the Mini-Mental State Examination (MMSE) scores of the test group were significantly higher than that of the control group (SMD = 2.69, 95% CI [1.88, 3.51], p < .01), and the Cornell Scale for Depression in Dementia scores of the test group were significantly lower than those of the control group (SMD = −4.28, 95% CI [−6.96, −1.60], p < .01); but in terms of quality of life (SMD = 0.17, 95% CI [−0.82, 1.16], p = .74), the difference was not statistically significant.
Game therapy can improve cognitive function and depression in PLWD. The combination of different types of games can improve the different clinical symptoms of PLWD, and different intervention time also have different effects on the outcome, which shows that we can develop unique, systematic, safe, and scientific game intervention programs for PLWD to improve their cognitive function and depression.
Current studies have revealed that acceptance and commitment therapy (ACT) can alleviate the adverse effects of cancer; however, its effectiveness on the psychological flexibility, fatigue, sleep disturbance, and quality of life of patients with cancer remains unclear.
The aims of this study were to identify the effectiveness of ACT on psychological flexibility, fatigue, sleep disturbance, and quality of life of patients with cancer, and to explore moderators.
PubMed, Embase, Web of Science, CENTRAL, PsycINFO, CINAHL, CNKI, VIP, and Wanfang electronic databases were searched from inception to September 29, 2022. The Cochrane Collaboration's risk-of-bias assessment tool II and the Grading of Recommendations Assessment, Development, and Evaluation approach were used to evaluate evidence certainty. The data were analyzed using R Studio. The study protocol was registered with PROSPERO (CRD42022361185).
The study included 19 relevant studies (1643 patients) published between 2012 and 2022. The pooled results showed that ACT significantly improved psychological flexibility (mean difference [MD] = −4.22, 95% CI [−7.86, −0.58], p = .02) and quality of life (Hedges' g = 0.94, 95% CI [0.59, 1.29], Z = 5.31, p < .01) but did not significantly improve fatigue (Hedges' g = −0.03, 95% CI [−0.24, 0.18], p = .75) or sleep disturbance (Hedges' g = −0.26, 95% CI [−0.82, 0.30], p = .37) in patients with cancer. Additional analyses revealed a 3-month sustainable effect on psychological flexibility (MD = −4.36, 95% CI [−8.67, −0.05], p < .05), and moderation analysis showed that intervention duration (β = −1.39, p < .01) and age (β = 0.15, p = .04) moderated the effects of ACT on psychological flexibility and sleep disturbance, respectively.
Acceptance and commitment therapy demonstrates effectiveness for psychological flexibility and quality of life of patients with cancer, but there is a lack of evidence regarding its effects on fatigue and sleep disturbance. In clinical practice, ACT should be designed in more detail and rounded to achieve better results.
The inconsistencies between randomized clinical trials (RCTs) registrations and peer-reviewed publications may distort trial results and threaten the validity of evidence-based medicine. Previous studies have found many inconsistencies between RCTs registrations and peer-reviewed publications, and outcome reporting bias is prevalent.
The aims of this review were to assess whether the primary outcomes and other data reported in publications and registered records in RCTs of nursing journals were consistent and whether discrepancies in the reporting of primary outcomes favored statistically significant results. Moreover, we reviewed the proportion of RCTs for prospective registration.
We systematically searched PubMed for RCTs published in the top 10 nursing journals between March 5, 2020, and March 5, 2022. Registration numbers were extracted from the publications, and registered records were identified from the registration platforms. The publications and registered records were compared to identify consistency. Inconsistencies were subdivided into discrepancies and omissions.
A total of 70 RCTs published in seven journals were included. The inconsistencies involved sample size estimation (71.4%), random sequence generation (75.7%), allocation concealment (97.1%), blinding (82.9%), primary outcomes (60.0%) and secondary outcomes (84.3%). Among the inconsistencies in the primary outcomes, 21.4% were due to discrepancies and 38.6% resulted from omissions. Fifty-three percent (8/15) presented discrepancies in the primary outcomes that favored statistically significant results. Additionally, although only 40.0% of the studies were prospective registrations, the number of prospectively registered trials has trended upward over time.
While not including all RCTs in the nursing field, our sample reflected a general trend: inconsistencies between publications and trial registrations were prevalent in the included nursing journals. Our research helps to provide a way to improve the transparency of research reports. Ensuring that clinical practice has access to transparent and reliable research results are essential to achieve the best possible evidence-based medicine.
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