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To examine and map the available literature on outcomes associated with interventions carried out by advanced practice nurses in chronic wound care.
The role of the advanced practice nurses in wound care is identified as a key element in the management of patients with chronic wounds. However, the literature offers fragmented knowledge of the outcomes associated with their practice.
Scoping review.
This scoping review was conducted following the methodological framework proposed by Arskey and O'Malley, following the Preferred Reporting Item for Systematic Review and Meta-analysis for Scoping Review. PRISMA-ScR Checklist is included in the manuscript. Observational or experimental studies related to patients affected by chronic wounds and cared for by advanced practice nurses in wound care were included.
The following databases were queried: PubMed, CINAHL, Cochrane Library, and Scopus from 01 May 2025 to 31 October 2025.
The search strategy in the consulted databases identified 1956 studies; 31 met the inclusion criteria. Different types of chronic wounds were investigated: diabetic foot ulcers, venous leg ulcers, and pressure injuries. The most frequently measured outcomes were clinical responses (healing, recurrence, complications), organizational efficiency (referrals, resource utilization), and patient-reported outcomes.
Evidence from the included studies suggests that Advanced practice nurses led wound care models may be associated with faster healing, lower recurrence and complication rates, and more efficient care pathways, across different settings. This review highlights the global applicability of APN-led models, showing consistent improvements in clinical, organizational, and patient-reported outcomes through core interventions.
This scoping review follows Arskey and O'Malley's methodological framework and the Preferred Reporting Item for Systematic Review and Meta-analysis for Scoping Review.
No Patient or Public Contribution.
The revision protocol was registered on the OSF (https://doi.org/10.17605/OSF.IO/P9TA4).
To describe the prevalence and determinants of workplace violence against nurses in the Italian home care setting.
Secondary cross-sectional analysis of data from the multicentre study AIDOMUS-IT.
Nurses employed in home care services provided by Italian Local Health Authorities were interviewed using a variety of instruments. A multivariable binary logistic regression model was performed to model the risk of workplace violence against nurses in the last 12 months. Variables related to violence were selected among sociodemographic characteristics (such as age and gender), work-related factors (including years of experience, team composition, overtime working, previous experience in mental health care, burnout) and organisational elements (including leadership and support, workload, staffing and resources adequacy, and time to reach the patients' homes). Adjusted odds ratios (aOR) were used to present the results.
A total of 3949 nurses participated in the study and 20.49% of them reported to have experienced an episode of violence in the last 12 months. Determinants of higher risk of violence episodes were younger age (aOR = 1.02, p = 0.002), higher workload (aOR = 1.01, p = 0.002), working in a multiprofessional team (aOR = 1.24, p = 0.018), perception of inadequate managerial leadership and support (aOR = 1.38, p = 0.003), and higher burnout levels (aOR = 1.01, p < 0.001).
The prevalence of workplace violence against Italian home care nurses is high. Several modifiable determinants were found to be associated with a higher risk of violence, which can potentially be mitigated with tailored interventions.
Effective preventive strategies must be developed to lessen workplace violence against nurses in the home care setting. These strategies should focus on strengthening nursing managers' leadership and support skills, enhancing team-building strategies, avoiding inadequate workload, monitoring nurses' burnout, estimating optimum staffing levels, and assigning advanced-career nurses to home care services. These measures are imperative to guarantee the quality and safety of home care organisations and to attain favourable outcomes in the provision of care.
This study aimed to explore the prevalence and determinants of workplace violence against nurses in the Italian home care settings. We found that out of the 3949 nurses surveyed, 20% of the sample reported one episode of violence during the last 12 months. Determinants of this violence included younger age, higher workload and burnout, being in a multiprofessional team, and perception of lack of leadership and support by the nurse manager. The results of this study can be used to tailor interventions aimed at mitigating the risk factors of violence, particularly those that can be modified (e.g., workload, burnout, and leadership).
The study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.
No patient or public contribution.
To estimate the proportion of Italian nurse managers (NMs) intending to leave (ITL) their positions and to identify associated socio-demographic, job-related, and psychosocial factors.
Cross-sectional study.
Between September and November 2023, 464 NMs from 19 public hospitals completed a case-report form and the short version of the Copenhagen Psychosocial Questionnaire II (COPSOQ II). Latent Class Analysis (LCA) identified ITL profiles, and multiple logistic regression assessed factors associated with ITL.
284 NMs (61.2%; 95% CI 57–66) reported an intention to leave within 12 months. LCA identified two classes: (1) Low-ITL (54%)—mainly outpatient NMs from Central regions with strong relationships with management, good support, work–life balance, and autonomy (55.9% probability of being unlikely to leave). (2) High-ITL (46%)—mainly surgical or critical-care NMs, often from Northern regions, marked by poor management relations, low support and high work–family conflict (80.9% probability of being likely to leave). Multiple regression confirmed that stronger management relations reduced ITL (OR 0.60, 95% CI 0.46–0.79) whereas high job demands and work–health conflict increased it (OR 1.56, 95% CI 1.19–2.04). Northern location also predicted higher ITL (OR 1.58, 95% CI 1.03–2.44). Demographics, education, and clinical setting were not significantly associated.
These findings suggest that healthcare organizations should prioritize managerial and organizational strategies targeting modifiable work-related factors to reduce nurse managers' intention to leave. Interventions aimed at improving organizational support, work environment, and job satisfaction may contribute to workforce retention at the managerial level. Future research should evaluate the effectiveness of targeted organizational interventions in sustaining nurse manager retention.
Evidence-Based Practice (EBP) is essential to healthcare quality and safety, integrating scientific evidence with clinical expertise and patient preferences. Despite its importance, EBP implementation still faces major challenges. Educational interventions have proven effective in strengthening EBP competencies among healthcare.
To evaluate the impact of a personalized educational intervention on EBP competencies among healthcare professionals. Working at a private tertiary general hospital, comparing performance before and after the intervention.
A randomized controlled trial involving healthcare professionals was conducted. Eligible and consented participants were randomly assigned to either an Intervention Group (IG) receiving an Evidence-Based Practice (EBP) course or a Control Group (CG) not receiving the course, stratified by job level, role, and work shift. From the completers, 18 participants were randomly selected for the IG, and all 7 available CG participants were included in the final sample for analysis. All study participants completed two validated instruments: the Assessing Competencies in Evidence-Based Medicine (ACE) and the Fresno Test. The educational intervention consisted of a seven-week course with weekly three-hour sessions, for a total of 21 h. Comparative analyses were conducted using a Linear Mixed Model, adjusted for educational level, job level, time working at the hospital, and weekly workload.
A statistically significant increase in general EBP knowledge was observed in the IG following the intervention, with a mean gain of 19.1%. Separate analysis showed improvements of 10.8% in ACE and 24.2% in Fresno Test scores. No statistically significant changes were observed in the CG. Furthermore, after the intervention, the IG outperformed the CG for both general EBP knowledge and Fresno Test scores on both pre- and post-intervention comparisons.
The educational intervention had a positive statistically significant impact on EBP knowledge and skills among healthcare professionals in the IG compared to the CG. These findings underscore the potential of structured educational initiatives to enhance the quality of clinical practice through improved EBP competencies.
UTN U1111-1322-8443
To critically examine the policy logic of the EU-funded WHO Nursing Action Initiative and assess its capacity to address the structural drivers of Europe's nursing workforce instability, with a specific focus on retention governance as the missing determinant of sustainability.
Although Europe reports high aggregate numbers of nurses, persistent workforce shortages are driven not by insufficient supply but by systemic governance weaknesses that undermine retention. The Nursing Action Initiative provides the first coordinated, multi-country framework aligned with the WHO's 2023–2030 strategic priorities, yet several structural gaps, including the absence of binding retention metrics, enforceable safe staffing standards, harmonized advanced practice pathways, interoperable workforce intelligence, and mandatory accountability, limit its transformative potential. A shift from production-centric policies to a retention-driven governance architecture is therefore essential.
The Nursing Action Initiative represents an important step toward strengthening European nursing workforce policy, but its success will depend on Member States' willingness to implement structural reforms that ensure safe staffing, protect nurses' well-being, expand autonomous practice roles, and stabilize workforce distribution. Without a robust architecture of retention governance, neither the sustainability of Europe's nursing workforce nor the resilience of its health systems can be assured.
This commentary advances the policy debate by framing retention as the central determinant of workforce sustainability. It calls for urgent political commitment to move the Nursing Action Initiative beyond aspirational coordination and toward enforceable, system-level reform capable of delivering lasting improvements in workforce stability and quality of care across the European Union.
This study examines the relationships between wage satisfaction, union perceptions, expectations, and union membership among Turkish nurses, identifying factors associated with union participation.
Sequential explanatory mixed-methods design.
This two-phase study (January–July 2023) included: (1) a quantitative survey of 210 nurses assessing wage satisfaction, union perceptions, and expectations, analysed using regression and PROCESS Macro (Model 4); and (2) qualitative interviews with 22 nurses, including 15 with union leadership experience, analysed through thematic analysis using MAXQDA.
Quantitative findings indicated that wage satisfaction was associated with nurses' perceptions of unions but did not independently predict union expectations. The study hypothesises that union perception functions as a key mediating mechanism, translating wage dissatisfaction into expectations for union action. Qualitative findings supported this pattern, showing that although wage dissatisfaction was widespread, nurses' expectations were primarily shaped by perceptions of unions' transparency, political independence, democratic participation, and representational capacity rather than by wages alone.
Union participation among nurses is influenced by both economic conditions and normative evaluations of unions. While wage dissatisfaction provides an important contextual background, expectations and engagement are mainly driven by perceptions of union credibility, fairness, and representational effectiveness.
Nursing unions should prioritise transparent governance, democratic participation, and political independence to enhance trust, member engagement, workforce stability, and quality of care.
This study addresses persistent wage dissatisfaction alongside declining union membership and trust. The findings demonstrate that union engagement depends not only on economic dissatisfaction but also on perceived representational fairness. The results are particularly relevant for nursing unions, professional organisations, and policymakers aiming to strengthen union legitimacy and workforce engagement in healthcare systems.
Compliant with COREQ guidelines and mixed-methods reporting standards.
No patient or public contribution.
To explore the topics and themes covered in published research studies in nursing about neurodegenerative disease, synthesise the available evidence, and discuss future directions.
Scoping review following the Joanna Briggs Institute guidelines.
A multi-step search strategy was applied across different databases to identify studies published in English or Italian up to September 2023. Data were analysed using a Nursing Data Matrix based on the nursing meta-paradigm and the Child Health and Nutrition Research Initiative (CHNRI) 4D-framework. Screening and data extraction were performed independently by pairs of reviewers; data were extracted and thematically analysed to identify existing research questions and potential priorities.
Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, and Embase databases were searched for studies published from 2013 to 2023.
A total of 351 studies met inclusion criteria. The majority of studies originated from the United States (35%). Parkinson's disease and Alzheimer's disease were the most studied conditions, while rare diseases were scarcely represented. Most studies focused on nursing care (39%), with limited attention to rehabilitation (0.8%) and cost-effectiveness (1%). Although 70% of articles included at least one nurse author, 22% lacked any nursing authorship despite addressing nursing-related topics. Thematic and matrix analyses revealed an uneven distribution of research, with a predominance of descriptive studies and limited work in discovery-oriented research.
This review provides a comprehensive overview of nursing research in neurodegenerative diseases, highlighting key themes and gaps. The findings informed the preliminary identification of new nursing research priorities in neurodegenerative diseases to guide future studies and enhance evidence-based nursing care.
The study highlights key trends and gaps in nursing research on neurodegenerative diseases, calling for a more inclusive, equitable, and comprehensive research agenda.
PRISMA-ScR guidelines.
This study did not include patient or public involvement in its design, conduct or reporting.
Review registration was done on Open Science Framework, and can be viewed at https://osf.io/tn5v9 (https://doi.org/10.17605/OSF.IO/TN5V9)
Evidence-based practice (EBP) is widely endorsed as a cornerstone for high-quality, patient-centered care. However, its integration into daily clinical routines remains inconsistent, particularly in settings where cultural, educational, and organizational challenges persist. Reliable, contextually adapted tools are essential to measure EBP implementation and guide improvement efforts.
This study aimed to validate the Italian versions of the EBP Implementation Scale and its short-form (3-item) version.
A cross-sectional survey design was adopted. Both versions of the EBP Implementation Scale were translated and culturally adapted in accordance with internationally recognized guidelines. Data were gathered from a national sample of 405 nurses through a combination of convenience and snowball sampling. Psychometric assessment encompassed confirmatory and Bayesian factor analyses, evaluation of internal consistency and test–retest reliability, and measurement invariance testing. All analyses were performed in R Studio.
Confirmatory factor analyses confirmed that both versions (long and short) of the scale measure a single underlying construct. The instruments demonstrated high reliability (ω = 0.96 and 0.87 respectively). Measurement invariance across educational groups was partially established, as the partial scalar invariance model demonstrated acceptable fit (CFI = 0.991, RMSEA = 0.045), suggesting consistent interpretation of the scale across different levels of EBP training. Latent profile analysis revealed distinct subgroups of EBP implementers, with notable differences in latent means (p < 0.001) associated with previous education in evidence-based practice.
The Italian EBP Implementation Scales are valid and reliable tools for assessing EBP implementation behaviors. They can support education planning, monitor practice changes over time, and inform interventions aimed at enhancing evidence-based care.
To explore the impact of Doctor of Nursing Practice (DNP) education on career advancement, job satisfaction, leadership competencies and contributions to healthcare systems.
The study utilised a scoping review methodology based on Arksey and O'Malley's (2005) framework.
The search strategy was developed with an academic librarian to ensure thoroughness and relevance. Seven databases were searched using MesH terms. Inclusion criteria focused on peer-reviewed studies examining DNP education's influence on career advancement, job satisfaction and leadership. Thematic analysis was used to identify patterns and themes.
Studies were selected based on their focus on DNP-prepared nurses, nursing faculty or advanced practice nursing students in healthcare or academic settings, published between 2004 and 2024.
Twenty-one studies met the inclusion criteria, highlighting DNP education's role in fostering leadership, professional development and evidence-based practice. Thematic analysis revealed the benefits of being a DNP graduate include contribution to professional development, contribution to leadership and contribution to the practice environment. The challenges to DNP graduates include underrecognition of competencies, high educational costs and limited academic opportunities that were also identified.
DNP education contributes to individual and professional growth, leadership development and healthcare system improvements. However, barriers such as financial constraints and inadequate recognition of DNP competencies must be addressed to maximise the impact of this educational model.
DNP education empowers nurses to lead healthcare innovations, enhance patient care quality and reduce disparities in health outcomes. Strengthening financial and systemic support for DNP graduates is essential for sustaining these contributions.
DNP education is a transformative force in nursing, offering significant opportunities for leadership development and healthcare advancements. Aligning DNP programmes with evolving global healthcare challenges can further strengthen their impact on the profession and patient care.
PRISMA-ScR guidelines were followed.
To investigate factors predictive of antibiotic use behaviour in the community.
A cross-sectional study was conducted from May to November 2023.
Standardised instruments were administered to patients who had received services from nurses in sub-district health-promoting hospitals in Thailand for at least one of the three diseases: (1) upper respiratory infection, (2) acute diarrhoea or (3) fresh traumatic wounds. Antibiotic use behaviour was modelled using the generalised estimating equation with an independent error component to account for the clustering of the hospitals.
Five hundred and eighty-five participants (556 patients and 29 nurses) met the inclusion criteria in this study. Of the 556 adult patients who were surveyed, the majority had upper respiratory infections, reported an appropriate level of antibiotic use, a moderate level of awareness of appropriate antibiotic use and antibiotic resistance, and an inadequate literacy level of Rational Drug Use. The generalised estimating equation analysis revealed that factors predictive of antibiotic use behaviour were rational drug use literacy, awareness, process of care, nurses' experience and rate of rational antibiotic prescribing for acute diarrhoea.
The nurses and healthcare providers should focus on enhancing the quality of care by educating and collaborating with the community to ensure appropriate antibiotic use behaviour.
This study indicated that healthcare policymakers should prioritise patient education on antibiotic use behaviour while also ensuring that healthcare workers adhere to strict caregiving protocols.
Providing services by monitoring symptoms and home visits can help patients gain confidence in the treatment approach and lead to a rational change in antibiotic use.
We adhere to the STROBE checklist.
No patient or public involvement.
To examine the association between nurse–patient mutuality (i.e., a good quality of the relationship between the nurse and the patient) and nurse professional quality of life.
A cross-sectional, multi-centre study was conducted across four tertiary hospitals in Italy.
Data collection took place from November 2023 to June 2024, enrolling 517 nurses. Both medical and surgical departments, as well as inpatients and outpatients departments were included. Data were collected on nurses caring for patients with chronic illness. Mutuality was measured with the Nurse–Patient Mutuality in Chronic Illness scale, which includes three dimensions: Developing and Going Beyond, Being a Point of Reference, Deciding and Sharing Care; Professional Quality of Life was measured with the Professional Quality of Life version 5, which includes three dimensions: Compassion Satisfaction, Secondary Traumatic Stress, Burnout. A Bayesian path analysis was employed to evaluate the contribution of mutuality dimensions to the dimensions of professional quality of life.
Nurses' sample consisted of 517 participants. The three dimensions of mutuality showed different associations with the three dimensions of professional quality of life. Specifically, Being a Point of Reference, along with Deciding and Sharing Care, was significantly associated with Compassion Satisfaction. The dimensions Developing and Going Beyond and Deciding and Sharing Care were significantly and negatively associated with Secondary Traumatic Stress. Additionally, Deciding and Sharing Care was significantly and negatively associated with Burnout.
As all the dimensions of mutuality were significantly associated with different aspects of professional quality of life, future interventions to improve nurses' professional quality of life may also consider nurse–patient mutuality.
Nurse–patient mutuality may be a novel area of research to enhance nurses' professional quality of life, with implications for clinical practice and organisational development.
Nurse–patient mutuality is a key indicator of a high-quality relationship, enabling shared goals and shared decision-making. Nurses' professional quality of life is one of the most important factors that influence their intention to leave. Little is known about the association between nurse–patient mutuality and nurses' professional quality of life. Mutuality influences nurses' and patients' outcomes. Understanding mutuality could enhance the professional quality of life for nurses, improving their compassion satisfaction and reducing their burnout.
We adhered to STROBE guidelines.
Patients were not included in the sample. Health workers were involved in the study.
To explore how neonatal nurse leaders sustain human-centred care while implementing digital technologies in neonatal intensive care units (NICUs).
Qualitative descriptive multi-site study across four NICUs in the Eastern Region of Saudi Arabia (November 2024–May 2025), reported in accordance with COREQ.
Purposive maximum-variation sampling recruited 24 neonatal nurse leaders across leadership levels, hospital types and digital maturity stages. Semi-structured interviews were conducted in Arabic or English, transcribed, translated as needed and thematically analysed in NVivo 14 using a hybrid inductive–deductive approach. Directed content analysis of key organisational documents enabled triangulation. Trustworthiness was supported through member checking, peer debriefing, audit trail, external review and double coding of a subset of transcripts.
Four interrelated strategies were identified: (1) embedding a values-based human-centred vision; (2) selecting and customising digital tools to strengthen, not replace, nurse–family connection; (3) redesigning workflows (e.g., device-free openings, protected presence time, family-inclusive portals) to preserve presence and partnership; and (4) fostering team capability and psychological safety for digital–human integration.
Human-centred care in digital NICUs is intentionally led and structurally engineered. The study offers a practice-ready framework that translates values into reproducible routines within complex sociotechnical systems.
The framework supports nurse leaders in aligning digital transformation with family-centred care, protecting nurse–family presence, and enhancing safety, trust and partnership for high-risk neonates.
Addresses risks of relational erosion in digital and AI-enabled NICUs and provides transferable nurse-led strategies to sustain ethical, family-centred practice.
COREQ-compliant qualitative study.
No Patient or Public Contribution.
To describe parents' experiences of family-centred care in home-based paediatric care of their child with a life-limiting illness.
A qualitative descriptive study with semi-structured interviews.
The purposive sample of parents (n = 11) of children diagnosed with life-limiting illnesses and receiving home-based paediatric care was recruited from a university hospital in Finland. The semi-structured interviews were conducted between December 2020 and December 2021. The data were analysed using deductive–inductive content analysis.
Under the five themes of family-centred care, 11 main categories and 31 subcategories were identified. The main categories were (1) uniqueness of all family members as care recipients, (2) incorporating family's background into care, (3) emotional support, (4) practical support, (5) information sharing, (6) negotiation, (7) parental involvement in care, (8) home care by parents, (9) collaboration with the hospital, (10) collaboration with local authorities and (11) collaboration with the home care team.
Individually tailored interventions and carefully integrated services based on the needs of parents and all family members best support families in challenging life situations and contribute to the implementation of family-centred care in the home-based care of children with life-limiting illnesses.
The results increase the understanding of parents' experiences, wishes and needs to support further development of a home-based paediatric care model for children with life-limiting illnesses.
The results impact individual families caring for seriously ill children at home, professionals delivering the care and healthcare authorities and policymakers designing the services.
The reporting of the study is based on the Consolidated Criteria for Reporting Qualitative Research (COREQ).
No patient or public contribution.
This study aimed to test the psychometric properties of the Self-Care of Chronic Illness Inventory and the Self-Care Self-Efficacy scale in patients with cancer.
A multisite cross-sectional validation study was conducted.
Between November 2022 and July 2023, a convenience sample of 318 patients with cancer were enrolled in five Italian inpatient and outpatient facilities. Confirmatory factor analysis was performed on the three scales of the Self-Care of Chronic Illness Inventory and the Self-Care Self-Efficacy scale. Internal consistency was tested using Cronbach's alpha for unidimensional scales and McDonald's Omega for multidimensional scales. Construct validity was assessed with the global health status by Pearson's correlation. The COnsensus-based Standards for the selection of health Measurement INstruments reporting guidelines were followed for the reporting process.
Three hundred fourteen patients were included (median age: 55.5 years; male: 53.82%). Confirmatory factor analysis showed supportive fit indices for the three Self-Care of Chronic Illness Inventory scales (CFI: 0.977–1.000; SRMR: 0.004–0.78) and the Self-Care Self-Efficacy scale (CFI: 1.000; SRMR: 0.014). All scales demonstrated adequate internal consistency (0.89–0.99) and test–retest reliability (0.85–0.95). Construct validity was confirmed through correlations between Self-Care Self-Efficacy, each Self-Care of Chronic Illness Inventory scale, and global health status.
The Self-Care of Chronic Illness Inventory and Self-Care Self-Efficacy scales demonstrated excellent psychometric qualities and construct validity when administered to patients with cancer. Future research should explore self-care behaviours across different diseases and cultural contexts.
These tools can help develop targeted educational programs, improving patient outcomes.
Currently, there is a lack of knowledge regarding self-care behaviours in patients with cancer. These tools enable healthcare professionals to identify patient needs, design personalised interventions, and monitor their effectiveness over time.
No patient or public contribution.
To identify interventions and strategies to prevent patient- and visitor-perpetrated violence against nurses working in acute hospital Emergency Departments. Design Scoping review following the Joanna Briggs Institute guidelines.
A comprehensive literature search was conducted in PubMed and CINAHL to identify relevant studies published up to June 2024. The review included primary research studies employing quantitative, qualitative, and mixed-method approaches. Eligibility criteria focused on interventions aimed at preventing physical and verbal violence in acute hospital emergency settings, explicitly targeting nurses. The selection process followed PRISMA-ScR guidelines, with independent screening and data extraction by two reviewer pairs. Data Sources PubMed and CINAHL databases were searched for studies published up to June 2024.
A total of 40 studies were included, covering interventions across 11 countries, mostly from the United States. Interventions were categorised as organisational, environmental, or individual-focused. Training programs were the most common strategy, followed by risk assessment tools, defense strategies, multidisciplinary briefings, and technology-assisted interventions. Most interventions (73%) were implemented before violent incidents, 23% during, and 5% after. Healthcare workers, particularly nurses, were the primary target group, highlighting the need for effective preventive strategies.
Violence prevention interventions in Emergency Departments focus on pre-incident strategies, mainly organisational and individual-focused. Limited attention has been given to environmental interventions despite their role in mitigating workplace violence. Further research is needed to assess the long-term effectiveness of these strategies.
Addressing workplace violence in EDs ensures a safer work environment, improves staff retention, and enhances patient care quality.
This study did not include patient or public involvement in its design, conduct, or reporting.
Smoking is a major global health problem. It kills more than half of the users. At least 1.18 billion people smoked cigarettes every day as of 2020. Although many interventions for tobacco smoking cessation have been implemented, their effectiveness remains unclear. This study aimed to assess the long-term effectiveness of various smoking cessation interventions in adults.
We conducted a systematic review and meta-analysis of randomized controlled trials reporting long-term outcomes.
Evidence searches were conducted in the Cochrane Library, Embase, Medline-OVID, PubMed, Web of Science, and Clinicaltrials.gov. Two researchers searched until August 2023 without restrictions on country, language, or year of publication. The risk ratio (RR) for continuous abstinence was obtained through biochemical verification at measurements ≥ 6 months post-intervention. Data were extracted and assessed for quality using Risk of Bias 2. Meta-analysis was carried out using a random effects model. Subgroup analyses and meta-regression were performed to explore moderator variables. Sensitivity and publication bias analyses were also performed.
Twenty-two effect sizes from 13 studies showed that tobacco smoking cessation interventions increased continuous abstinence by 2.5 times (RR 3.52; 95% CI; 2.19–5.65). The highest ratio was in the behavioral intervention (RR 7.83) with more than 6 months of therapy (RR 10.57). The tobacco smoking cessation intervention worked better in 55–64 years (RR 7.29), especially in Asia (RR 10.08). The intervention was more effective for female respondents (RR 4.21) and combination therapy format (RR 3.82). However, meta-regression showed that differences in gender and therapy format did not significantly influence the effectiveness of tobacco smoking cessation interventions in adults (p values 0.2748 and 0.8769). Sensitivity analysis (p-value 0.0025) further strengthens the evidence of the conclusions and credibility of the findings.
Behavioral therapy lasting more than 6 months was the most successful tobacco smoking cessation intervention in respondents aged 55–64 years, especially when implemented in Asia. Although not significant, therapies delivered in combination formats, especially in women, have the potential to increase continuous abstinence for adults. These findings provide important evidence for developing effective prevention and treatment strategies for long-term smoking cessation concerning the type, format, and total of therapy.
FreshRSS 