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Children experience significant psychological and physical stress during medical procedures. Picture books can help reduce anxiety by familiarising children with their upcoming procedures.
To synthesise and evaluate the effectiveness of picture books on reducing preoperative anxiety in children and their parents.
A systematic review and meta-analysis of randomised controlled trials reported following the PRISMA guidelines.
PubMed, CINAHL, EMBASE, Cochrane Library, China National Knowledge Infrastructure (CNKI) and Wanfang databases were searched from inception to January 1, 2024. This review includes randomised controlled trials published in Chinese or English that evaluate the efficacy of picture book interventions in reducing preoperative anxiety among children undergoing elective surgery. Studies were excluded if: (1) they were conference abstracts, protocols or repetitive publications; (2) they were not available in full text; (3) the data reported in the study could not be obtained from the authors; and (4) they were not published in Chinese or English. The Cochrane Risk of Bias Tool version 2.0 was used to assess the risk of bias of the included studies. Meta-analysis was conducted using Review Manager 5.4.
Five studies with a total of 418 patients were included in the analysis. Picture books can significantly reduce children's preoperative anxiety (SMD = −0.57, 95% CI = −0.76 to −0.37; p < 0.001). The certainty of the evidence for the effectiveness of picture books on preoperative anxiety was considered moderate.
Picture books can effectively reduce preoperative anxiety in children by familiarising them with the unknown. It has shown the potential to serve as preoperative educational material for paediatric patients.
Not applicable.
This meta-analysis highlights the effectiveness of picture books in reducing preoperative anxiety in children undergoing medical procedures. Healthcare professionals should consider integrating these interventions into preoperative health education.
CRD42023435105 (https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023435105)
To systematically review and integrate qualitative-research results pertaining to psychological distress in patients with breast cancer and to clarify its causes and drivers.
Patients with breast cancer experience psychological distress in the stages of diagnosis, treatment, and rehabilitation, which seriously affects their quality of life. Through comprehensive qualitative research, the study comprehensively describes the experiences of patients with breast cancer to guide medical personnel in taking better care of them.
A systematic review and synthesis of qualitative studies.
Qualitative studies were included if they were related to the psychological-distress experiences of patients with breast cancer. The Joanna Briggs Institute Qualitative Assessment and Review Instrument was used to appraise study quality. Data were synthesised using the Thomas and Harden method of thematic and content analysis.
Nine electronic databases (PubMed, Embase, Cochrane Library, CINAL [via EBSCO], and PsycINFO, China Knowledge Resource Integrated Database, Wanfang, Chinese Biomedical, and Weipu) were searched from inception until February 2024.
Thirteen studies were included in the meta-synthesis. Four analytical themes were identified: diagnostic and therapeutic, individual, environmental, and interpersonal factors.
Psychological distress is a subjective feeling influenced by interactions among individual, therapeutic, environmental, and interpersonal factors, and it is commonly encountered among patients with breast cancer. Therefore, to optimise the management of psychological distress, the characteristics and external environment of patients with breast cancer should be carefully considered when delivering routine nursing care.
Patients experience psychological distress at different stages of breast cancer; however, the causes of psychological distress at different stages differ. Medical staff should implement targeted psychological-distress intervention measures based on factors relevant to different stages.
The Enhancing Transparency in Reporting the Synthesis of Qualitative Research statement.
The protocol of this study has been registered in the database PROSPERO (registration ID: CRD42023417364).
Delirium is a common complication among adults. It is essential to improve the outcomes of delirium.
To systematically synthesize the evidence on the effectiveness of the nurse-led non-pharmacological interventions on outcomes of delirium in adults.
Electronic databases including CINAHL, Cochrane Library, MEDLINE, EMBASE, PubMed, Web of Science, PsycINFO, and Clinical Trial Registration were searched comprehensively by the authors. The authors reviewed the full text and assessed the risk of bias using the Cochrane Risk of Bias Tool 2.0. The meta-analysis was performed using RevMan and Stata software. The forest plots showed the overall effect of the included study and the I 2 test was used to assess the degree of heterogeneity between studies. Random effects models were used to analyze studies with significant heterogeneity.
A total of 32 studies (10,122 participants) were included in the meta-analysis. Nurse-led non-pharmacological interventions resulted in a significantly lower incidence of delirium compared with the usual care/control group (risk ratio = 0.74, p < .001) and reduced mortality in the hospital compared with usual care (risk ratio = 0.81, p = .04). However, the implementation of nurse-led, non-pharmacological interventions had no significant effect on the duration, severity of delirium, or length of hospital stay.
Our findings suggest that the nurse-led, non-pharmacological strategy was effective in reducing the incidence of delirium and mortality in the hospital. Multicomponent interventions were the most effective strategy for reducing the incidence of delirium in adults.
To explore the actual experience of psychological distress of adult women of reproductive age at different stages after breast cancer diagnosis.
Qualitative.
Eighty-one patients with breast cancer-related distress thermometer scores >4 were selected using a purposive sampling method. Patients were divided into newly diagnosed and 1-, 3-, 6-, 9- and 12-month groups according to time since diagnosis and then interviewed. A phenomenological approach was adopted to analyse interview content, and different themes were extracted.
Women exhibited different levels of psychological distress depending on the time since diagnosis, with newly diagnosed patients showing the highest distress. Within 1 year post-diagnosis, different events caused patients distress. Themes extracted at new diagnosis and 1-, 3-, 6-, 9- and 12 months post-diagnosis included sadness and disbelief, loss of control, optimistic but concerned, physical and mental exhaustion, difficulties returning to society and limited sexual intimacy, respectively; all groups expressed reproductive concerns.
Clinical nurses should focus on different psychologically distressing events to provide targeted interventions at distinct phases. For women of childbearing age, clinical nurses should pay particular attention to patients' marriage and reproductive concerns.
During the year after a breast cancer diagnosis, patients of childbearing age experience events that cause psychological distress that differ depending on time since diagnosis. Nurses should focus on core stressful events and perform specific nursing interventions.
To provide holistic care, nurses should consider the psychological and emotional changes patients may undergo. For women of childbearing age, clinical nurses should pay particular attention to patients' marriage and fertility concerns, and be able to provide evidence-based professional guidance on reproductive preservation techniques.
The study was reported using the consolidated criteria for reporting qualitative research guidelines.
Patients contributed to data collection through interviews.
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