Conectar
The global prevalence of chronic kidney disease (CKD) has continued to rise over time. Pharmacological therapy is the mainstay of conventional CKD treatment; however, many CKD patients find it difficult to adhere to their medication regimen.
To systematically evaluate and compare the effects of various self-management support strategies for patients with CKD.
We searched PubMed, Embase, The Cochrane Library, Web of Science, and Scopus to identify quasi-randomized and RCTs comparing the effectiveness of different self-management support strategies in CKD patients, The search spanned from database inception to June 24, 2025. Two reviewers independently screened the literature, extracted information, assessed the quality of studies, and we performed analysis using RevMan 5.0 and STATA 14.0 software.
Eighty-one studies were included, examining 10 strategies. Compared to conventional interventions, face-to-face combined tele-guidance, group visits, tele-guidance, and multi-component structured interventions significantly improved patients' self-efficacy. Surface under the cumulative ranking curve (SUCRA) of different self-management support strategies influencing self-efficacy ranked in the top three were face-to-face combined tele-guidance, group visits and tele-guidance. Empowerment interventions, cognitive behavioral therapy (CBT) and tele-guidance enhanced quality of life compared to conventional interventions. The SUCRA for quality of life ranked highest for empowerment, CBT and face-to-face combined tele-guidance. Additionally, we found that these strategies were beneficial in improving patients' blood pressure, IDWG, renal disease knowledge, and self-management.
The study offers evidence on effective self-management support strategies for CKD patients, highlighting face-to-face combined tele-guidance might be the most effective intervention for increasing self-efficacy, while empowerment might be the most effective intervention for increasing quality of life in CKD patients. These findings can help healthcare providers design better programs to improve patient outcomes. However, more high-quality RCTs are needed to confirm findings.
PROSPERO: CRD42024596581
To synthesise literature about horizontal violence or workplace bullying among Intensive Care Unit nurses, exploring its awareness, factors, impacts, and strategies.
Following PRISMA standards, a mixed systematic review using a narrative synthesis approach and thematic analysis design of the Joanna Briggs Institute.
Four electronic databases from 2013 to 2023 studies published were searched.
Eight studies were included: three qualitative and five quantitative. Four key themes emerged: (i) awareness and understanding of horizontal violence or workplace bullying, (ii) factors affecting horizontal violence or workplace bullying, (iii) impacts of horizontal violence or workplace bullying, and (iv) strategies to address horizontal violence or workplace bullying.
Addressing horizontal violence or workplace bullying requires hospitals should adopt conflict resolution policies, stress management programs, and supportive supervision to improve nurse retention. Nurse management should establish confidential reporting mechanisms, provide training on interpersonal respect, and implement supportive structures to promote psychological safety. Intensive care unit nurses are encouraged to take proactive steps to address workplace bullying, ensuring improved staff well-being and care quality.
This paper addresses a significant gap in the literature regarding horizontal violence or workplace bullying among Intensive Care Unit nurses.
The findings will impact on healthcare administrators, policymakers, and educators. By understanding horizontal violence or workplace bullying, strategies can be implemented to improve workplace environment, support nurses' well-being, increase nurse retention, and improve the quality of patient care.
This systematic review adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The review methodology, including data selection, extraction, and synthesis, follows PRISMA standards to ensure clarity, transparency, and reproducibility.
This study did not include patient or public involvement in its design, conduct, or reporting.
There is a protocol that does not require registration, it made accessible at: https://doi.org/10.17605/OSF.IO/CFNEJ.
This study aims to develop dynamic networks and examine the longitudinal relationships of mental health symptoms among persons living with HIV (PLWH).
A longitudinal study.
We collected data between October 2022 and December 2022 using Wenjuanxing (Questionnaire Star), an online survey platform. The study tracked weekly data across 10 sessions, involving 123 PLWH in Beijing, China. A total of 40 mental health symptoms with six dimensions (somatization symptoms, negative affect, cognitive processes, cognitive function, interpersonal communication and social adaptation) were included in the symptom network, which consists of temporal, contemporaneous and between-person networks.
In the temporal network, ‘feeling inferior to others’ had the largest in-strength value, whereas ‘suicidal ideation’ exhibited the largest out-strength value. In the contemporaneous network, ‘feeling inferior to others’ showed the highest bridge strength, indicating it had the most connections to other mental health symptoms.
We found that ‘feeling inferior to others’ had the highest number of predictors, with up to seven mental health symptoms potentially triggering this particular symptom. Additionally, ‘suicidal ideation’ emerged as a powerful predictor, influencing the greatest number of mental health symptoms across five dimensions.
Our study enhances the understanding of the sequential development and consequences of mental health symptoms among PLWH, which may provide an important basis for designing precise mental health symptom management interventions.
This study was reported according to the STROBE checklist.
No patient or public contribution.
To evaluate bioecology and environmental influences of patients presenting with alopecia regarding decisions made for hair camouflage.
A descriptive qualitative design was used.
Sixteen adult patients with alopecia were purposefully recruited from two specialised trichology clinics across the Jiangsu Province, China. Surveys and in-depth semi-structured interviews were conducted between October 2024 and December 2024. Practical thematic analysis of transcribed data was informed through Bronfenbrenner's ecological systems theory.
Five major facilitators (camouflaged demands drive, camouflaged psychological resilience, habituation and dependence, family resilience and cross-border support, social acceptance) and four major barriers (limited future orientation, perceived coordination barriers, marginalisation of camouflage-related information, runaway costs) to hair camouflage were identified. These themes align with different levels of the ecological systems theory.
This study captures the complex ecological and intersectional nature of choice, experience and decision-making in patients' views on hair camouflage amid alopecia. Nursing professionals must understand these complexities to provide informed support and evidence-based interventions throughout patients' experiences with alopecia.
This study uses patient voices to offer ecological insights for a holistic understanding of their experiences. It provides knowledge relevant to nursing practice and alopecia patient support. Understanding patient-identified barriers and facilitators in alopecia camouflage is essential to inform more patient-centred approaches to choice, decision-making and psychological adaptation. Nurses are pivotal in this process, making enhanced understanding crucial for improving patients' psychological wellbeing and quality of life.
Our research reveals factors that equip nurses and the broader healthcare team to develop targeted counselling strategies, educational programs and resources related to camouflage for patients with alopecia. The hair-camouflage industry can use these insights to create more personalised and accessible products, better addressing patients' concealment needs and preferences.
Standards for Reporting Qualitative Research.
No patient or public contribution.
This study aims to assess the extent of organisational silence among new nurses, analyse how structural empowerment and role ambiguity influence this silence, and determine whether role ambiguity mediates the relationship between structural empowerment and organisational silence. The findings intend to offer practical guidance for nursing managers in supporting new nurses by minimising role ambiguity and fostering open communication during the transition into clinical practice.
New nurses commonly exhibit organisational silence during their transition process. Although research indicates that structural empowerment, role ambiguity and organisational silence are interrelated, the underlying mechanisms among these three factors remain unclear.
A cross-sectional design.
A convenience sampling approach was adopted between September 2024 and March 2025. The study recruited 680 new nurses from 15 tertiary A-level hospitals located in Guangzhou, Changsha and Hangzhou. Data collection instruments included a demographic information form, the Chinese version of the Nursing Role Conflict and Role Ambiguity Scale, the Employee Silence Behaviour Questionnaire and the Job Efficiency Conditions Scale. To examine the mediating role of role ambiguity in the relationship between structural empowerment and organisational silence, structural equation modelling (SEM) was applied.
A total of 628 new nurses participated in the survey. Structural empowerment was negatively correlated with role ambiguity (p < 0.01) and organisational silence (p < 0.01). The mediation analysis indicated that role ambiguity partially mediated the relationship between structural empowerment and organisational silence. Specifically, the mediating effect of role ambiguity was –0.14, accounting for 31.11% of the total effect.
This research indicated that new nurses exhibited a below-average level of structural empowerment, while their levels of role ambiguity and organisational silence were above average. Specifically, structural empowerment had a negative impact on both role ambiguity and organisational silence; role ambiguity positively predicted organisational silence. Furthermore, role ambiguity played a significant mediating role in the relationship between structural empowerment and organisational silence.
The findings indicate that nursing managers should not only focus on enhancing the structural empowerment of new nurses but also strengthen their role awareness, ensuring it plays a key role in reducing levels of organisational silence.
This study did not involve patients, service users, caregivers, or members of the public.
The aim of this study was to explore the follow-up needs of patients with diabetic foot ulcers.
A qualitative descriptive study was conducted, guided by Engel's biopsychosocial model.
Purposive sampling was used to recruit 17 patients with diabetic foot ulcers of Wagner grade ≥ 1. These patients had received care in the Endocrinology and Metabolism Department or the Wound Clinic of a tertiary hospital in Xi'an, China. Guided by the biopsychosocial model, individual face-to-face semi-structured interviews were conducted between April and July 2024. Data were analysed using thematic analysis.
Nine themes were identified. In the biological domain, patients reported needs for disease care and lifestyle modification. In the psychological domain, they highlighted the importance of emotional coping support and building trust with healthcare providers. In the social domain, patients expressed needs for personalised follow-up, equitable access to healthcare, financial support, community assistance, and management of family caregiving role conflicts.
This study identified biological, psychological, and social follow-up needs among patients with diabetic foot ulcers, highlighting the importance of holistic follow-up to promote recovery and improve quality of life after discharge.
Nurses should assess and address the biological, psychological, and social follow-up needs of patients with diabetic foot ulcers after discharge, providing tailored care to promote ulcer healing and prevent recurrence.
This study was reported in accordance with the Consolidated Criteria for Reporting Qualitative Research checklist.
None.
To estimate the longitudinal predictive relationships between anxiety, depression and post-traumatic stress disorder symptoms in nurses exposed to horizontal violence and identify the most influential symptom using cross-lagged panel network analysis.
A longitudinal cross-lagged panel network analysis study.
Data were obtained from a short longitudinal survey conducted at four tertiary hospitals in Shandong Province, China. Two follow-up surveys spaced 7 weeks apart were conducted on 298 nurses with horizontal violence exposure using the General Information Scale, the Negative Acts Questionnaire, the seven-item Generalised Anxiety Disorder scale, the nine-item Patient Health Questionnaire and the four-item SPAN. Unique longitudinal relationships between symptoms were estimated using cross-lagged panel network analysis.
The results showed that the out-expected influence of A2 (Uncontrollable worry) and P2 (Physiological arousal) was highest and they were the most predictive symptoms in the network. The bridge out-expected influence of A2 (Uncontrollable worry) was also highest and it was the key bridge symptom within the network.
A2 (Uncontrollable worry) and P2 (Physiological arousal) were the top risk factors contributing to mental health deterioration in nurses with horizontal violence exposure.
This study precisely identified the predictive mechanisms and core symptoms among psychological symptoms in nurses exposed to horizontal violence, which is expected to play a significant role in improving the mental health of this group. The results showed that “Uncontrollable worry” and “Physiological arousal” were the core symptoms with the strongest predictive effects on other symptoms. Additionally, “Uncontrollable worry” was also the bridge symptom driving the mutual transmission and development of anxiety, depression and post-traumatic stress disorder. Nursing managers should prioritise “Uncontrollable worry” and “Physiological arousal” as intervention targets, optimising mental health interventions to effectively enhance the psychological well-being of nurses exposed to horizontal violence.
No patient or public contribution.
To assess the competence level and latent profiles of nursing interns regarding their management of workplace violence (WPV).
Workplace violence may have adverse effects on the physical and mental health, clinical practice behaviours and career plan of nursing interns. Besides, the competence of WPV management contributed to a sense of career security for nursing interns. However, few studies have focused on the current status of the competence of WPV management for nursing interns.
A cross-sectional self-report design that followed STROBE guidelines.
A total of 379 Chinese nursing interns were invited from three tertiary hospitals in Chengdu city by convenience sampling in this cross-sectional study. Data were collected using the Sociodemographic Characteristics Questionnaire, the Management of Workplace Violence Competence Scale (MWVCS) and the Chinese version of the 10-item Connor-Davidson Resilience Scale (CD-RISC-10). Latent profile analysis and logistic regression were performed.
The mean score of nursing interns' management competence of WPV was 152.87 (SD = 25.67). The best latent profile model was identified as three profiles, namely the ‘low management competence of WPV subgroup’ (19.5%), ‘medium management competence of WPV subgroup’ (64.1%) and ‘high management competence of WPV subgroup’ (16.4%), respectively. Multiple logistic regression showed that attending the violence prevention training, interest in the nursing profession and resilience were protective factors of management competence of WPV for nursing interns.
The majority of nursing interns perform at a medium level with noted heterogeneous characteristics, which contribute to identifying different nursing interns' perceptions of competence to manage WPV. Therefore, nursing managers can provide targeted intervention strategies to further promote the competence of WPV management for nursing interns.
Nursing educators and managers could conduct systematic training on the competence of WPV management based on individual different characteristics, which can be used as pre-internship training programmes for nursing interns, and provide resilience support plans.
No patients or public contribution.
In China, more than 30% of patients have not initiated treatment within 30 days of HIV diagnosis. Delayed initiation has a detrimental influence on disease outcomes and increases HIV transmission. The study aims to evaluate the effectiveness of a nurse-led antiretroviral therapy initiation nudging intervention for people newly diagnosed with HIV in China to find the optimal intervention implementation strategy.
A Hybrid Type II sequential multiple assignment randomized trial will be conducted at four Centers for Disease Control and Prevention in Hunan, China. This study will recruit 447 people newly diagnosed with HIV aged ≥18 years and randomly assign them into two intervention groups and one control group. On top of the regular counselling services and referrals, intervention groups will receive a 4-week, 2-phase intervention based on the dual-system theory and the nudge theory. The control group will follow the currently recommended referral procedures. The primary outcomes are whether treatment is initiated, as well as the length of time it takes. The study outcomes will be measured at the baseline, day 15, day 30, week 12, week 24 and week 48. Generalized estimating equations and survival analysis will be used to compare effectiveness and explore factors associated with antiretroviral therapy initiation. Both qualitative and quantitative information will be collected to assess implementation outcomes.
Existing strategies mostly target institutional-level factors, with little consideration given to patients' decision-making. To close this gap, we aim to develop an effective theory-driven nudging strategy to improve early ART initiation.
This nurse-led study will help to prevent delayed initiation by employing implementation science strategies for people newly diagnosed with HIV. This study contributes to the United Nations' objective of ending the AIDS pandemic by 2030.
Chinese Clinical Trial Registry ChiCTR2300070140. The trial was prospectively registered before the first participant was recruited.
The nudging intervention was finalized through the Nominal Group Technique where we invited five experts in the related field and five people living with HIV to participate.
This study aims to investigate the impact of challenge-hindrance stressors on novice nurses' safety behaviour, the mediating effect of regulatory focus, and the moderating effect of workplace spirituality.
The relationship between challenge-hindrance stressors and novice nurses' safety behaviour has rarely been investigated, despite the global concern for patient safety in healthcare systems. Previous research suggests that regulatory focus and workplace spirituality matter for nurse safety behaviour, but the relationship between them remains unclear.
An on-site cross-sectional survey. The STROBE guidelines were followed to report this study. Stratified sampling was used to recruit participants, and 471 novice nurses completed the Nurse Safety Behaviour Questionnaire, the Challenge-Hindrance Stressors Scale, the Regulatory Focus Scale, and the Workplace Spirituality Scale between January 2024 and May 2024. SPSS 24.0 and SPSS PROCESS 3.5 macros were used to test research hypotheses.
Challenge stressors positively affect novice nurses' safety behaviour, and promotion focus mediates this relationship. Hindrance stressors negatively affect novice nurses' safety behaviour, and prevention focus partially masks this relationship. Workplace spirituality positively moderates the relationship between challenge stressors and novice nurses' safety behaviour.
Challenge-hindrance stressors have a double-edged sword effect on novice nurses' safety behaviours. Regulatory focus and workplace spirituality play significant roles in the relationship between challenge-hindrance stressors and novice nurses' safety behaviour.
Managers should leverage challenge stressors to boost novice nurses' safety behaviours and enhance their intrinsic motivation through regulatory focus. Additionally, managers should highlight workplace spirituality's importance in coping with work stress. This approach can effectively improve safety behaviours and ensure patient safety.
Patients and the public were not involved in the design and implementation of this study. Clinical novice nurses completed a questionnaire for this study.
To explore how, why and under what circumstances transitional care can be normalised as a routine care practice for adult patients with enterostomy after discharge from hospitals.
Realist review.
This review was conducted in three iterative phases: (1) constructing an initial programme theory to identify the scope of the study; (2) retrieving and evaluating the evidence, extracting data and integrating the evidence; and (3) analysing and integrating the evidence to refine the programme theory.
Five bibliographic databases and the grey literature were searched from 1947 to 2024 to identify the studies of two core concepts: enterostomy and transitional care.
A total of 36 papers were included, identifying nine context-mechanism-outcome configurations that explain how, why and under what circumstances transitional care can be normalised as routine care for adult patients with enterostomy after discharge: (1) Responsibilities of individual roles; (2) Interdisciplinary team collaboration; (3) Support from upper management; (4) Communication and interaction; (5) Multiple linkage; (6) Professional training; (7) External support and policy formulation; (8) Personalised measures; and (9) Evaluation and feedback.
The normalised implementation of transitional care is essential to help enterostomal patients better adapt to stoma life and improve their quality of life. An effective transitional care model not only relies on the support of professional caregivers, but requires the close cooperation of patients, family members, communities and healthcare organisations.
Reporting was adhered to the RAMESES publication standards: realist syntheses.
Patients and members of the public were involved in study design. Their contributions were participating in advisory groups, ensuring the research was addressed.
This study provides theoretical guidance for clinical stoma transitional care, translating the research findings into routine healthcare practices, constantly optimising and improving the stoma care system, and offering patients higher-quality and more efficient services.
This research, through the realist review approach in combination with the Normalisation Process Theory (NPT) and the Consolidated Framework for Implementation Research (CFIR), systematically elucidates for the first time how, why and under what circumstances transitional care can be regularised as a routine post-discharge care measure for adult enterostomy patients. The research findings will: Improve the quality of life of patients: Through personalised care plans and multidisciplinary team cooperation, help patients better adapt to life with an ostomy, reduce complications and improve self-management ability. Optimise clinical practice: Provide theoretical guidance for medical staff, promote the regular implementation of transitional care and improve the quality and efficiency of care. Promote education and training: Emphasise the importance of professional training and communication skills, and provide new ideas for nursing education. Support policy formulation: Call on the government and medical institutions to improve relevant policies, provide more resources and support and promote the rational allocation of medical resources.
Thirst is the most common self-reported symptom in intensive care unit (ICU) patients. There is evidence that oral cooling interventions may alleviate thirst symptoms in ICU patients. However, the evidence needs to be critically evaluated.
To investigate the effect of oral cooling interventions on alleviating thirst symptoms of ICU patients and explore the effectiveness of different types of oral cooling by subgroup analysis.
The PubMed, Ovid Embase, the Cochrane Library, Wanfang Data and China National Knowledge Infrastructure databases were searched from inception to 29 October 2023. Randomised controlled trials (RCTs) that reported thirst intensity or thirst distress as outcomes were included. The certainty of the evidence was evaluated by the GRADE approach.
The meta-analysis comprised eight RCTs that included 813 ICU patients. The pooled analysis from eight RCTs showed that oral cooling interventions had significant beneficial effects on thirst intensity (weighted mean difference [WMD] = −2.73, 95% confidence interval [CI] = −3.62 to −1.85, p < 0.01; moderate certainty). The pooled analysis from four RCTs showed that oral cooling interventions could significantly lower the thirst distress scores (standardised mean difference = −0.80, 95% CI = −1.13 to −0.47, p < 0.01; low certainty). Subgroup analysis indicated that cold stimulation (WMD = −3.12) and cold combined with menthol stimulation (WMD = −1.72) could significantly lower the thirst intensity scores.
Oral cooling interventions including cold and menthol had beneficial effects on thirst intensity and thirst distress in ICU patients. The high heterogeneity in methods should be considered when interpreting the results.
This study provides references for the application of oral care strategy in the ICU care field, and encourages nurses to apply the oral cooling plan to improve patients' comfort.
This was a meta-analysis based on data from previous studies.
PROSPERO: CRD42023416059
To develop a structured intervention aimed at enhancing family communication to reduce relapse in adolescents with depression.
This study follows a multi-stage process guided by the Intervention Mapping procedure with the Medical Research Council framework, assessing the layers of complexity. Its design comprises four interrelated stages to construct a family communication intervention, culminating in a pilot randomised controlled trial.
The program has four stages: (1) Identifying family interaction gaps through literature review and expert input; (2) Investigating communication needs of depressed adolescents and their families via a mixed methods study to develop a model intervention; (3) Refining the intervention with focus groups and expert e-Delphi; and (4) Finalising the intervention based on pilot randomised controlled trial outcomes. The research will be conducted in Greater Accra, Ghana.
The process will result in a family communication intervention tailored to the needs of adolescents with depression and their families. It will be pilot tested, and the results will inform a nationwide efficacy trial.
This research integrates qualitative and quantitative data to inform the development of an evidence-based family communication intervention. The program will carefully examine data integration and contextual challenges encountered during its implementation.
The intervention has the potential to enhance family communication, thus playing a crucial role in adolescent depression recovery by reducing relapse rates. Healthcare professionals will benefit from a structured, evidence-based communication tool that can be used in clinical settings.
The study focuses on improving communication between families of adolescents with depression, aiming to develop a family communication package for clinical and community use. This intervention may enhance recovery outcomes and reduce relapse risk for adolescents.
This study adhered to the GUIDED guideline for reporting intervention development studies.
No Patient or Public Contribution.
To develop and validate a machine learning-based risk prediction model for delirium in older inpatients.
A prospective cohort study.
A prospective cohort study was conducted. Eighteen clinical features were prospectively collected from electronic medical records during hospitalisation to inform the model. Four machine learning algorithms were employed to develop and validate risk prediction models. The performance of all models in the training and test sets was evaluated using a combination of the area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, Brier score, and other metrics before selecting the best model for SHAP interpretation.
A total of 973 older inpatient data were utilised for model construction and validation. The AUC of four machine learning models in the training and test sets ranged from 0.869 to 0.992; the accuracy ranged from 0.931 to 0.962; and the sensitivity ranged from 0.564 to 0.997. Compared to other models, the Random Forest model exhibited the best overall performance with an AUC of 0.908 (95% CI, 0.848, 0.968), an accuracy of 0.935, a sensitivity of 0.992, and a Brier score of 0.053.
The machine learning model we developed and validated for predicting delirium in older inpatients demonstrated excellent predictive performance. This model has the potential to assist healthcare professionals in early diagnosis and support informed clinical decision-making.
By identifying patients at risk of delirium early, healthcare professionals can implement preventive measures and timely interventions, potentially reducing the incidence and severity of delirium. The model's ability to support informed clinical decision-making can lead to more personalised and effective care strategies, ultimately benefiting both patients and healthcare providers.
This study was reported in accordance with the TRIPOD statement.
No patient or public contribution.
This study aims to explore the trajectories and co-occurrence of perceived control and caregiver self-efficacy among patients with heart failure (HF) and their caregivers within 3 months post-discharge and identify associated risk factors.
A prospective cohort design.
A prospective cohort study was conducted from March to June 2024 in Tianjin, China. Information on perceived control and caregiver self-efficacy was collected 24 h before discharge, 2 weeks, 1 month, and 3 months after discharge. Group-Based Dual Trajectory Modelling (GBDTM) and logistic regression were used for analysis.
The study included 203 dyads of patients with HF and their caregivers (HF dyads). Perceived control identified three trajectories: low curve (15.3%), middle curve (57.1%) and high curve (27.6%). Caregiver self-efficacy demonstrated three trajectories: low curve (17.2%), middle curve (56.7%) and high stable (26.1%). GBDTM revealed nine co-occurrence patterns, with the highest proportion (36.7%) being ‘middle-curve group for perceived control and middle-curve group for caregiver self-efficacy’, and 16.7% being ‘high-curve group for perceived control and high-stable group for caregiver self-efficacy’. Age, gender, household income, NYHA class, symptom burden and psychological resilience were identified as risk factors for perceived control trajectories; marital status, regular exercise and psychological resilience were identified as risk factors for caregiver self-efficacy trajectories.
We identified distinct trajectories, co-occurrence patterns and risk factors of perceived control and caregiver self-efficacy among HF dyads. These findings help clinical nurses to better design and implement interventions, strengthening the comprehensive management and care outcomes for HF dyads.
These findings highlighted the interactive relationship between perceived control and caregiver self-efficacy trajectories, suggesting that interventions should boost both to improve personalised treatment plans and outcomes for HF dyads.
This study adhered to the STROBE checklist.
Patients and their caregivers contributed by participating in the study and completing the questionnaire.
Cognitive decline, including subjective cognitive decline (SCD), mild cognitive impairment (MCI), and dementia, significantly affects social participation, leading to social isolation and reduced quality of life. Enhancing social participation through interventions may mitigate these effects, yet evidence on intervention effectiveness and mechanisms remains inconsistent.
To evaluate the effectiveness of social participation interventions for individuals with cognitive decline and identify effective behavior change techniques (BCTs) supporting social participation.
Our search using the following databases—PubMed, Web of Science, Embase, Cochrane Library, CINAHL, Scopus, CNKI, and Wanfang—was conducted until October 2024. The quality of the included studies was assessed using the Cochrane risk of bias tool for randomized trials. Meta-analyses were conducted using Review Manager 5.4 and Stata18, and the certainty of evidence was rated using the Grading of Recommendations Assessment, Development, and Evaluation approach.
Sixteen RCTs involving 2190 participants were included. Music therapy (SMD = 0.62, 95% CI [0.15, 1.10]) and reminiscence therapy (SMD = 0.34, 95% CI [0.02, 0.66]) demonstrated significant positive effects on social participation. Group-based interventions were particularly effective (SMD = 0.23, 95% CI [0.04, 0.43]). Commonly used BCTs included goal setting, behavioral practice/rehearsal, and social support. However, substantial heterogeneity and limited data on SCD and MCI restricted generalizability.
Interventions promoting social participation may enhance engagement for individuals with cognitive decline, particularly through music therapy, reminiscence therapy, and group-based formats. The complexity and dynamic nature of social interaction require individuals to engage and integrate various cognitive functions and skills, which can present significant challenges for older adults with cognitive impairments in their daily social participation. Further research is needed to optimize intervention components and address gaps in targeting early cognitive decline stages.
To identify modifiable caregiver factors influencing abuse tendency in Chinese nursing homes and delineate pathways for intervention.
Discerning the risk factors associated with elder abuse is paramount for enhancing prevention and intervention strategies.
Cross sectional study.
Using validated tools (Caregiver Abuse Screen, Maslach Burnout Inventory, Fatigue Scale-14, Barthel Index), 241 caregivers from 24 nursing homes in Wenzhou City, Zhejiang Province, China were surveyed. Structural equation modelling analysed the direct/indirect pathways linking caregiving stress, caregiving difficulty, job burnout and abuse tendency.
The prevalence of abuse tendency amongst caregivers in the previous year was 40.7%. The model explained 83% of the total variance in abuse tendency. The best-fitting model indicated that abuse tendency was directly affected by job burnout. Caregiving difficulty and stress indirectly affected abuse tendency through job burnout.
This study identified job burnout as a modifiable mediator linking caregiving difficulties, caregiving stress, and abuse tendency amongst nursing home caregivers. To disrupt the pathways to abuse tendency, clinical administrators should prioritise routine burnout screening coupled with structured resilience-building programmes. Simultaneously, optimising staffing ratios and enhancing caregiving competencies may foster safer care environments for caregivers and residents.
This study identified job burnout as a direct driver of abuse tendency, providing information for clinical managers and targeted interventions to mitigate elder abuse risk. Additionally, it revealed the indirect effects of caregiving difficulty and stress via job burnout, emphasising the need to optimise staffing allocation and workflow design to foster system-level improvements in caregiver mental health and service quality.
The study adhered to the STROBE checklist of observational surveys.
Caregivers voluntarily completed questionnaires.
This study identifies job burnout, caregiving difficulty, and caregiving stress as key risk factors for abuse tendency amongst nursing home caregivers. The validated model demonstrates the direct and indirect effects of these factors on abuse tendency, emphasising the need for targeted interventions to prevent and mitigate abuse.
This study aims to examine the chain-mediating effects of affective reactions and burnout on the relationship between workplace violence and work performance among nurses while distinguishing between physical and psychological violence.
A longitudinal study was conducted between October 2020 and October 2022. The study took place in four tertiary hospitals of Shandong Province, China. A total of 1086 nurses were recruited.
Workplace psychological violence, workplace physical violence, work performance, affective reactions (including anxiety and depressive symptoms) and burnout were assessed using self-report questionnaires. Data were analysed using multiple linear regressions and structural equation modelling on SPSS and AMOS.
The STROBE checklist was used for this study.
Workplace psychological violence, but not physical violence, was associated with nurses' work performance. Burnout mediates the relationship between workplace psychological violence and work performance. Affective reactions and burnout play serial intermediary roles in the relationship between workplace psychological violence and work performance.
Interventions aimed at reducing anxiety, depressive symptoms, and burnout among nurses who have experienced psychological violence may enhance their work performance.
Hospital administrators should prioritise the development of strategies to prevent psychological violence (e.g., anti-bullying training and counselling support) and enhance nurse performance through burnout screening and targeted interventions.
This study was conducted in Shandong Province, China, and relied on self-reported data, which may be subject to social desirability bias.
No patient or public contribution.
To investigate the physical activity levels of lung cancer survivors, analyse the influencing factors, and construct a predictive model for the physical activity levels of lung cancer survivors based on machine learning algorithms.
This was a cross-sectional study.
Convenience sampling was used to survey lung cancer survivors across 14 hospitals in eastern, central, and western China. Data on demographic, disease-related, health-related, physical, and psychosocial factors were also collected. Descriptive analyses were performed using SPSS 25.0, and predictors were identified through multiple logistic regression analyses. Four machine learning models—random forest, gradient boosting tree, support vector machine, and logistic regression—were developed and evaluated based on the Area Under the Curve of the Receiver Operating Characteristic (AUC-ROC), accuracy, precision, recall, and F1 score. The best model was used to create an online computational tool using Python 3.11 and Flask 3.0.3. This study was conducted and reported in accordance with the TRIPOD guidelines and checklist.
Among the 2231 participants, 670 (30%), 1185 (53.1%), and 376 (16.9%) exhibited low, moderate, and high physical activity levels, respectively. Multivariate logistic regression identified 15 independent influencing factors: residential location, geographical region, religious beliefs, histological type, treatment modality, regional lymph node stage, grip strength, 6-min walking distance, globulin, white blood cells, aspartate aminotransferase, blood urea, MDASI score, depression score, and SRAHP score. The random forest model performed best among the four algorithms, achieving AUC-ROC values of 0.86, 0.70, 0.72, and 0.67, respectively, and was used to develop an online predictive tool (URL: http://10.60.32.178:5000).
This study developed a machine learning model to predict physical activity levels in lung cancer survivors, with the random forest model demonstrating the highest accuracy and clinical utility. This tool enables the early identification of low-activity survivors, facilitating timely, personalised rehabilitation and health management.
The development of a predictive model for physical activity levels in lung cancer survivors can help clinical medical staff identify survivors with relatively low physical activity levels as early as possible. Thus, personalised rehabilitation plans can be formulated to optimise quality of life during their survival period.
Physical activity has been used as a nonpharmacological intervention in cancer patient rehabilitation plans. However, a review of past studies has shown that lung cancer survivors generally have low physical activity levels. In this study, we identified the key factors influencing physical activity among lung cancer survivors through a literature review. We constructed a prediction model for their physical activity levels using machine learning algorithms. Clinical medical staff can use this model to identify patients with low physical activity levels early and to develop personalised intervention plans to improve their quality of life during survival.
The study adhered to the relevant EQUATOR reporting guidelines, the TRIPOD Checklist for Prediction Model Development and Validation.
During the data collection phase, participants were recruited to complete the questionnaires.
FreshRSS 