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To synthesise and appraise the evidence of the efficacy of serious games in reducing chronic pain among older adults.
Chronic pain in older adults generally results in a substantial handicap due to decreased mobility, exercise avoidance and various concerns that affect their overall quality of life. While serious games have been widely used as a pain management approach, no reviews have thoroughly examined their efficacy for chronic pain management in older adult populations.
A systematic review and meta-analysis.
The CINAHL, the Cochrane Library, Embase, Medline, PubMed and Web of Science databases were comprehensively searched to find articles published from their inception until 17 April 2023. RoB-2 was used to assess the risk of bias in the included studies. The efficacy of serious games for pain management in older individuals was investigated using pooled standardised mean differences (SMDs) in pain reduction using a random effect model.
The meta-analysis comprised nine randomised controlled trials that included 350 older adult patients with pain. Serious games effectively alleviated pain in this group (pooled SMD = −0.62; 95% confidence interval: −1.15 to −0.10), although pain-related disability and fear require further investigation.
Serious games tended to effectively reduce pain in this older adult group; however, due to a lack of randomised controlled trials, the analysis found lower effectiveness in reducing pain-related disability and fear. Further studies are accordingly required to confirm these findings.
The findings of the study emphasise the importance of serious games to increase the motivation of older adults to exercise as one of the safe and extensively used pain management strategies. Serious games that effectively reduce chronic pain in older adults are characterised as consisting of diverse physical activities delivered through consoles, computer-based activities and other technologies.
Serious games are recommended as being potentially useful and practical for reducing pain in older adults.
Mindfulness-based interventions are becoming increasingly popular and are effective in lowering depressive symptoms and caregiver burden. However, the overall efficacy of therapies in stress and anxiety management is unreported, and no study to date has performed a subgroup analysis to investigate the intervention dose response of outcomes.
To quantitatively identify the effectiveness of mindfulness-based interventions for caregivers of persons living with dementia.
A comprehensive literature search of six databases was undertaken from the date of inception to June 18, 2023. The DerSimonian–Laird model with random effects was used to examine the overall effect and its heterogeneity in the studies. Version 2 of the risk of bias (RoB 2) tool was employed to analyze the publication bias of each randomized study. Funnel and forest plots were created to represent the findings.
Thirteen randomized trials were included in the meta-analysis. Mindfulness-based interventions significantly reduced stress and anxiety of caregivers of persons living with dementia. In addition, interventions provided for ≥8 weeks were beneficial in reducing depression in caregivers. However, mindfulness-based interventions did not offer significant benefits in reducing depression or caregiver burden immediately after the intervention.
Mindfulness-based interventions have the potential to help caregivers of people living with dementia. This study could be used as a model for future research into and implementation of mindfulness-based therapies for caregivers.
Mindfulness-based therapies appear to alleviate stress and anxiety but are ineffective in reducing depression and burden in caregivers of persons living with dementia. Well-designed RCTs with more rigorous methodology and a larger sample size should be conducted to firm the conclusion of the effectiveness of mindfulness-based interventions for caregivers of persons living with dementia.
Nurses increasingly use mindfulness as an effective mental health intervention to reduce psychological distress. The effectiveness of mindfulness-based interventions remains inconclusive, which may lead to implementation of interventions in an inefficient or ineffective manner. This study aimed to examine the effects of mindfulness-based interventions on reducing stress, anxiety, and depression among nurses.
Systematic review and meta-analysis.
Randomized controlled trials (RCTs) were searched using six databases published through May 20, 2023, which evaluated the effects of mindfulness-based interventions on reducing psychological distress among nurses. To assess the quality of methodology included in the RCTs, version 2 of the Cochrane risk-of-bias instrument for RCTs with five domains was used. Standardized mean difference (SMD) with 95% confidence interval (CI) were calculated using the random–effects model in the meta-analyses. Publication bias was assessed using Egger's regression test. Further, the robustness effect size of the pooled analysis was assessed using leave-one-out sensitivity analysis.
A total of 16 RCTs were included in the final analysis. Overall, the modalities appeared to alleviate stress (pooled SMD: −0.50 [95% CI: −0.82 to −0.18]; p < 0.001) and depression (pooled SMD: −0.42 [95% CI: −0.78 to −0.06]; p = 0.02) among nurses.
Mindfulness-based interventions appear to alleviate stress and depression in nurses. Future research evaluating mindfulness-based interventions among working nurses with more rigorous methodological and larger sample size.
Support for nurses' mental health must be included while implementing personal and professional development plans.
Transitional care interventions have emerged as a promising method of ensuring treatment continuity and health care coordination when patients are discharged from hospital to home. However, few studies have investigated the frequency and duration of interventions and the effects of interventions on physical function. Therefore, this study aimed to determine the efficacy of transitional care for patients with stroke.
Six databases and the grey literature were searched to obtain relevant articles from October 1, 2022 to March 10, 2023. The primary outcomes studied were motor performance, walking speed, activities of daily living (ADLs) and caregiver burden following hospital-to-home transitional care. The quality of the studies was assessed with Cochrane risk of bias version 2. The quality and sensitivity of the evidence were assessed to ensure rigour of the findings. Meta-analyses were performed using stata 17.0.
A total of 2966 patients were identified from 23 studies. Transitional care improved post-stroke motor performance, walking speed and ADLs, and reduced caregiver burden.
The findings suggest that provision of transitional care model implementation in patients with stroke is important because it reduces disability in stroke patients and helps to decrease caregivers' burden.
The findings of the study emphasize the importance of transitional care programmes for stroke patients after they are discharged from the hospital and returned to their homes. To meet the needs of patients, all levels of health professionals including nurses should be aware of the discharge process and care plan.
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