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Retractions in nursing are often framed as isolated instances of author misconduct or editorial failure. Drawing on recent longitudinal analysis of retracted nursing articles and the Journal Systems Framework (JSF), this Commentary argues that retractions are better understood as system-level signals reflecting differences in editorial capacity, governance, and infrastructure across journal systems.
Between 1997 and 2022, 123 nursing articles were retracted, with persistent concerns related to ethical violations, variability in retraction notice quality, delayed corrective action, and continued post-retraction citation.
Applying the JSF highlights how corrective capacity varies across journal systems, shaping the timeliness, transparency, visibility, and downstream amplification of retraction practices. High-profile retractions in flagship journals may reflect greater corrective capacity rather than uniquely severe ethical failure. Interpreting retractions as indicators of system stress, rather than moral anomalies, shifts attention from individual blame toward strengthening editorial infrastructure.
A systems-aware approach positions nursing scholarship to improve transparency, resilience, and trust as publication volume and complexity continue to grow.
Because nursing scholarship informs clinical care, education, and policy, failures in the scholarly record have implications beyond publishing itself. Greater understanding of retractions and corrective editorial processes can help strengthen trust in evidence used to guide nursing and health care practice.
To develop a machine learning model for predicting Taiwanese adults' intention to sign an advance directive (AD) and to identify the psychosocial, demographic, and system-level predictors relevant to culturally sensitive nursing. This study distinguishes between the reflective process of advance care planning (ACP) and the formal legal act of AD completion, addressing the need to understand cultural and system-level influences.
This was a cross-sectional quantitative study.
A survey was conducted with 1412 Taiwanese adults by using validated instruments, such as the Knowledge of Advance Care Planning Questionnaire and Advance Care Planning Attitude Scale. Data were analyzed using linear regression, random forest, and extreme gradient boosting models to predict the intention to sign an AD. A SHapley Additive exPlanations analysis was performed to interpret the model and investigate the effects of personal values and system-level barriers.
The extreme gradient boosting model outperformed the other models, with mean absolute error and root mean squared error values of 1.68 and 2.13, respectively. The SHapley Additive exPlanations analysis highlighted attitude toward ACP as the strongest predictor of signing intention. In addition to psychosocial factors, system-level factors such as procedural unfamiliarity and high consultation costs emerged as key barriers. Furthermore, older age and a higher number of children were associated with a weaker intention to sign an AD, reflecting a preference for informal family consensus over formal legal documentation.
Machine learning models effectively identify the interplay between personal attitudes, family dynamics, and institutional conditions that shape AD-related decision-making. The transition from ACP dialogue to formal AD signing is determined by both cultural values and structural factors.
Nurses should adopt a dual-track strategy—supporting advance care planning through family-inclusive dialogues and serving as “system navigators” to help patients overcome legal and financial barriers to advance directive signing. Data-driven insights from the present study may inform precise, culturally responsive interventions that honor patient autonomy.
Spirituality is a crucial yet complex element of holistic nursing care, particularly when providing care for older adults with depression. In Thailand, depression poses a significant mental health challenge. Thai cultural values are deeply interwoven with individuals' beliefs, making spirituality a critical factor in addressing the care of older adults with depression. This study aimed to explore how older adults with depression experience spirituality and construct meaning from it in their daily lives.
An interpretative phenomenological study.
In-depth interviews of 30 older Thai adults living with depression (aged 60–85 years) from an outpatient psychiatric clinic in southern Thailand were conducted using semi-structured interview questionnaires. Interpretive phenomenological analysis was employed. Data were collected from June to August 2024.
Five themes emerged from the phenomenological data analysis: (1) elusiveness of spiritual meaning, (2) holding oneself together through inner power, (3) finding acceptance through faith in a higher power, (4) family ties shaping peace and despair, and (5) being guided and cared for.
This study highlights that older adults with depression perceive spirituality as essential for their well-being. Personal practices, such as meditation and chanting, played a key role in strengthening spirituality and reducing the risk of relapse in depressive symptoms, which are distinct for each older adult. Understanding spirituality's role in mental health guides nurses to develop strategies for providing more empathetic spiritual care.
Nurses must address depression in older adults through individualized practices to effectively empower their inner strength and coping mechanisms. Understanding each individual's spiritual practices is essential to help them harness their inner strength when coping with depression.
The multifaceted responsibilities borne by clinical facilitators can impose a significant strain on their mental and emotional health and well-being. Within nursing and other healthcare professions, the responsibilities of clinical facilitators extend beyond conventional clinical duties to encompass supervising, facilitating, assessing, and supporting students as they transition into professional nursing practice. There is a need for insights into the well-being of clinical facilitators in the face of demanding work conditions, limited resources, and the emotional toll of patient care. This article critically reviews the literature to determine the current state of mental well-being among clinical facilitators in undergraduate health professions education and how they should be supported.
A scoping review guided the study using the Population, Context, Concept framework with a search string incorporating associated Boolean operators. 233 records were retrieved from eight databases and reviewed according to the inclusion and exclusion criteria. A total of 13 full-text articles were found to be eligible for extraction and analysis.
Major findings resulted in thematising mental health issue characteristics according to high and low job demands and burnout. Literature outlined the causes of mental health issues, including lack of recognition and appreciation, work performance, teaching and learning practices, student characteristics, support structures, and the environment. Recommendations included training, appropriate support systems, workload, guidelines, monitoring, community of practice, and research-oriented support.
Educational institutions must move beyond ad hoc support and implement integrated, strategic initiatives grounded in the principles of the Job-Demand-Control model. Future research should focus on developing and rigorously evaluating multifaceted intervention programmes that address these systemic factors. By investing in the well-being of clinical facilitators, institutions ultimately invest in the quality of future healthcare providers and the safety of the patients they will serve.
This article sets the tone for factors to consider and provides recommendations for educational institutions to better support the mental well-being of clinical facilitators.
Doctoral research in nursing is central to advancing scientific knowledge, strengthening professional identity, and informing evidence-based practice, education, and health policy. Analyzing the thematic content of doctoral theses offers insight into research priorities and national variations in nursing scholarship. Yet, no systematic cross-country analysis has examined the thematic focus of such work.
To explore and describe the diversity and scope of doctoral nursing research themes across eight countries in the Sigma Europe Region, identifying key areas of scholarly focus and shared priorities.
A document-based qualitative study using reflexive thematic analysis, as outlined by Braun and Clarke, to examine patterns of meaning within thesis summaries.
The study included doctoral nursing thesis summaries defended between January 2020 and December 2023, sourced from national and institutional repositories in eight countries of the Sigma Europe Region. A total of 15 repositories (4 national, 11 institutional) were systematically searched, and additional summaries were obtained via direct contact with universities offering doctoral nursing programmes.
Data were collected between September 2024 and February 2025 using predefined inclusion and exclusion criteria. In total, 431 eligible thesis summaries were analyzed following Braun and Clarke's six-phase framework, supported by MAXQDA software for data management and coding.
Thematic analysis identified three overarching domains: (1) foundations of nursing practice and care philosophy, (2) systemic and organizational dimensions of nursing, and (3) clinical innovation and public health impact. Ten interrelated themes emerged, including holistic and patient-centred care; emotional, psychological, and quality-of-life dimensions; communication in healthcare; workforce challenges; transforming nursing practice; maternal, neonatal and pediatric health; digital and virtual health innovations; public health and chronic disease management; and disease management, caregiving, and outcomes. Cross-cutting elements such as cultural sensitivity and resilience spanned multiple themes.
This cross-national synthesis demonstrates the breadth and depth of doctoral nursing research in the Sigma Europe Region. Findings highlight nursing's pivotal role in addressing healthcare needs through innovative, person-centred, and evidence-informed solutions, and underscore the value of international collaboration in shaping resilient, equitable, and future-ready healthcare systems.
Falls among older adults represent a major public health challenge, yet research examining the role of social determinants of health (SDOH) in fall risk remains limited. This study aimed to identify factors associated with fall occurrence and fall frequency among community-dwelling older adults in Korea, with particular emphasis on SDOH.
A cross-sectional study design.
We used a large nationwide sample (n = 9746) from the 2023 National Survey of Older Koreans. The number of falls in the past year served as the dependent variable. Independent variables included a range of socioeconomic and environmental variables as SDOH, alongside biological and behavioral variables. A zero-inflated negative binomial (ZINB) regression analysis was employed to address excess zeros and overdispersion in fall count data.
Among participants, 94.8% experienced no falls, 3.2% reported a single fall, and 1.9% reported recurrent falls. In the logit model for fall occurrence, higher household income level, absence of age-friendly housing, higher access to parks, and lower access to welfare centers were associated with higher risk of fall occurrence. In the count model for fall frequency, higher education level, presence of age-friendly housing, and outdoor mobility barriers were associated with higher fall frequency within the at-risk group.
The findings provide empirical evidence on the critical roles of SDOH in falls among community-dwelling older adults. Specifically, a ZINB regression analysis identified distinct sets of SDOH associated with fall occurrence versus fall frequency, highlighting the complex and multifaceted nature of fall patterns among older adults.
Healthcare providers and policymakers seeking to reduce falls should implement tailored, SDOH-integrated strategies by addressing the different mechanisms underlying fall occurrence and fall frequency.
Parents of adolescents with a mental disorder describe having overwhelming feelings regarding the psychiatric diagnosis, which they respond to with grief. Existing research indicates that these parents face unique challenges, such as self-blame and stigma. Parents are crucial in adolescent care, and healthcare professionals should find interventions that educate parents about the disorder, treatment and symptom management. The aim of this study was to explore and describe parents' experiences in having an adolescent with a mental disorder admitted to the psychiatric unit of a public hospital in Gauteng, South Africa.
The study used Heidegger's interpretive phenomenological design.
A qualitative, exploratory, descriptive and contextual method was used. Data were collected through semi-structured telephonic interviews with 10 parents who had an adolescent with a mental disorder admitted to a public hospital in Gauteng, South Africa. Tesch's thematic coding steps were used for data analysis.
The themes arising from the findings reflected (1) parents experienced that their lives were stuck amid grief for the loss of what their adolescent child used to be, and anxiety about what the future holds, (2) parents experienced that when they reached out for professional help, the healthcare system failed them due to a lack of guidance, information and support, (3) parents experienced that they prayed for divine intervention as a coping strategy, and (4) parents experienced stigma from the community.
The findings illustrate the need for psychiatric nurses to facilitate the mental health of parents of adolescents with a mental disorder. Furthermore, positive attitudes among parents are improved once they are empowered and receive the necessary support, and stigmatization will also be reduced. It is recommended that further research be conducted to explore the effectiveness of emotional and professional support in addressing the challenges parents experience with an adolescent who has a mental disorder.
This paper contributes knowledge to nursing practice by exploring the experiences of parents who have an adolescent with a mental disorder in the South African context.
Stroke is a global health concern. A timely response to a stroke can help reduce morbidity and mortality. However, barriers to timely response include poor recognition of stroke symptoms. Stroke symptom messages are designed to increase stroke recognition and encourage individuals to seek urgent medical assistance. The Face, Arm, Speech, Time (FAST) and Balance, Eyes, Face, Arm, Speech, Time (BE FAST) are commonly used stroke symptom messages shown to improve stroke symptom recognition and response. However, cultural factors and language differences may limit the effectiveness of stroke symptom messages and their acceptability in different countries and contexts. There has not been a comprehensive examination of the stroke symptom messages used worldwide and how these messages have been adapted in various settings.
We explored what stroke response messages are being used globally, and the contextual factors that influence the adoption of a stroke response mnemonic in different settings.
A 14-item survey was disseminated by the World Stroke Organization to its networks. The survey contained open- and closed-ended questions and allowed uploading relevant stroke symptom campaign materials. The survey was analyzed using descriptive statistics and a content analysis.
All except one survey respondent used a stroke symptom message. Fifteen respondents (27%) reported they did not translate their stroke awareness messaging. Of these 15 respondents, they used the English versions of FAST (n = 8), BE FAST (n = 4), and both FAST and BE FAST (n = 3). Forty respondents (71%) reported that they/their organization used an acronym to raise public awareness of the signs/symptoms of stroke that was different from FAST or BE FAST (English), many of which were direct or indirect translations or influenced by FAST and BE FAST. Survey responses shared insights and recommendations related to the content, tailoring and dissemination of stroke symptom messages.
Study findings highlight the global use of stroke symptom messages and their contextual adaptations to fit diverse settings and contexts. The challenges in applying universal or commonly used stroke symptom messages to different contexts were highlighted.
Nurses could have a key role in raising awareness of stroke symptoms and the development of locally adapted stroke symptom messages.
Assess US registered nurse genomic competency.
Administered the Genetics and Genomics Nursing Practice Survey (GGNPS).
GGNPS assesses genomic knowledge, skills, attitudes, confidence, and utilization in nursing practice. Distributed by the American Nurses Association via email and online to US registered nurses. Results are analyzed using descriptive statistics and compared to 2010 data.
1065 registered nurses responded. Most (41%) were Master's prepared, actively seeing patients (51%) and 66% considered it very important to learn more about genomics. Most (55%) reported their genomic knowledge was poor yet 51% reported a patient initiated a genetic discussion with them in the past 3 months. 66% completed all knowledge score items with a median score of 9/12, no change from 2010. Only 26% had heard of the Essential Competencies. Most reported no genomic curricular content (64%); had not attended a genomic course since licensure (64%); intended to learn more about genomics (70%); and would attend a course on their own time (79%).
Nurses felt genomics was important but have capacity deficits. Despite genomic discoveries and evidence-based practice guidelines that impact healthcare quality and safety, 20 years after the Genomic Competencies were established (2005) nursing genomic practice capacity remains low.
Genomics is critical to the safe, quality nursing practice regardless of the level of academic training, clinical role, or specialty.
Randomized controlled trials (RCTs) are essential for evidence-based nursing care. However, the quality of reporting and adherence to methodological standards in Latin American nursing journals remains unclear. This study evaluates the characteristics, reporting quality, and potential risk of bias of RCTs published in Latin American nursing journals.
To assess the reporting compliance and risk of bias of RCTs published in Latin American nursing journals.
Meta-research study.
A comprehensive handsearch of 29 Latin American nursing journals was performed covering publications from 2000 to 2024. Identified RCTs were assessed for adherence to CONSORT reporting guidelines and evaluated for risk of bias. Outcomes were classified using the COMET taxonomy. A descriptive analysis was performed.
A total of 6377 references were screened, identifying 34 eligible RCTs, most published after 2018. The median CONSORT compliance was 19 reported items (IQR 16–22). High compliance (> 90%) was observed in abstract reporting items, study objectives, and participant selection criteria. However, critical methodological features such as randomization procedures, blinding, and protocol registration showed low adherence (< 40%). Risk of bias was mostly rated as having “some concerns”, largely due to insufficient reporting. According to the COMET taxonomy, the most frequently reported outcome domains were “Delivery of care” and “Physical functioning”.
Reporting compliance and risk of bias of RCTs published in Latin American nursing journals presents significant gaps, particularly in key methodological domains. These shortcomings hinder transparency, reproducibility, and integration into evidence synthesis. Strengthening editorial policies and enforcing reporting standards could enhance the quality and reliability of published research in Latin American nursing journals.
To identify the barriers and facilitators in the implementation of fertility preservation (FP) shared decision-making (SDM) in oncology care.
Qualitative descriptive study.
Qualitative interviews with 16 female patients with cancer and seven healthcare providers were conducted between July 2022 and April 2024. Data were analyzed using directed content analysis, guided by the implementation science framework.
We identified 22 categories comprising 38 codes as barriers to SDM implementation and 17 categories comprising 26 codes as facilitators. Findings revealed that, at the innovation level, accessibility, feasibility, interdisciplinary collaboration, and quality improvement efforts were decisive in the implementation of FP SDM. At the individual level, healthcare providers' awareness and attitudes towards FP and SDM, as well as patients' knowledge, attitudes, and capabilities in FP SDM, were crucial factors in the implementation of FP SDM. In social, economic, and organizational contexts, support from significant others, social awareness about FP, multidisciplinary care, financial assistance, and educational resources were determinants in implementing FP SDM.
Implementing FP SDM among female patients with cancer necessitates a strategic approach that considers barriers and facilitators. Educating and promoting FP SDM among the public and healthcare providers, combined with incentivizing policies, can enhance individual knowledge and awareness while achieving systemic improvements, facilitating its successful implementation.
This study provides insights into barriers and facilitators and proposes strategic approaches to enhancing FP SDM implementation, contributing to improved quality of life for cancer survivors and advancements in clinical practice.
The climate crisis impacts global health and is exacerbated by the healthcare sector's emissions. Nurses, as the largest professional group, are key to promoting climate-resilient, low-carbon health systems. Integrating climate change and sustainable development into nursing education is crucial, yet gaps remain in understanding their representation in curricula and practice. This review examines the role of nursing in addressing climate change and sustainable development, focusing on their integration into education and related recommendations.
A narrative literature review was conducted to synthesize existing recent research on nursing, climate change, and sustainable development. No restrictions were applied to study design; however, studies published before 2017 were excluded.
A search was conducted in PubMed, CINAHL, and Google Scholar (January 2023, and updated in August 2024). Relevant studies were screened and duplicates removed. Data extraction followed inductive content analysis, with coding and categorization being undertaken collaboratively. MAXQDA PLUS 2022 was used for analysis, and new findings from the follow-up search were incorporated into existing categories or new ones were developed.
The review analyzed 33 articles on nursing's role in addressing climate change. Findings highlight gaps in knowledge, delayed responses, and the need for nurses to take on leadership roles. Education is crucial, yet curricula integration remains limited. Nurses must engage in advocacy, interdisciplinary collaboration, and policy development. Barriers include a lack of faculty awareness and overloaded curricula. A collective call for action urges nurses to embrace sustainability, strengthen research, and lead in achieving climate resilience.
This review highlights the need to integrate climate change and sustainable development into nursing education and practice. Nurses are vital to public health and to addressing climate change, but education gaps hinder their potential. Future research should focus on improving curricula, exploring Advanced Practice Nursing leadership roles, and addressing healthcare system challenges.
Integrating Sustainable Development and the Climate Crisis into nursing education and practice is crucial to preparing nurses for the health challenges posed by environmental changes, as well as for ensuring effective patient care, disaster response, and policy advocacy. Their integration is a process and should be viewed as being a consequence of the delayed responses, as identified in this review. This process should specifically address the identified gaps, such as the lack of basic knowledge concerning climate change and sustainable development, as well as learning to take on leadership roles in practice. More specifically, taking a leadership role includes both acting as a knowledge multiplier and increasing the health literacy of the general population.
Socially assistive robots (SARs) have been used in group interventions for older adults; however, their effectiveness remains unclear. This systematic review aimed to synthesize evidence on the efficacy of group interventions with SARs on various outcomes (physical, cognitive, psychological, quality of life, therapeutic engagement, and sociality) for older adults, and the factors that influence their effectiveness.
A literature search was conducted using five databases (Web of Science, PubMed, Scopus, PsycINFO, and MEDLINE) in October 2024. The research team selected and analyzed the studies applying a narrative synthesis.
In all, 25 articles were identified, 15 of which were deemed of good quality. We found that companion robots are commonly used in group interventions for older adults that consist of physical, cognitive, and combined physical and cognitive activities. Insufficient evidence was identified on the effectiveness of physical interventions and groups with physical and cognitive activities on health outcomes (i.e., physical, cognitive, psychological, and quality of life). Regarding the cognitive group interventions, positive physical outcomes (i.e., improved sleep quality, decreased pulse rate, and increased pulse oximetry), improved cognitive function, positive psychological outcomes (i.e., decreased agitation, depression, anxiety, and loneliness, and increased positive emotions) were found; however, the positive effects in terms of cognitive level and certain psychological outcomes were comparable to the control groups. Mixed results were reported for quality of life in older adults. Across the three types of interventions, robots facilitated engagement and increased the sociality of most older adults. The effectiveness depended on the cognitive function of the older adults, the presence of staff, the type of robot, and the schedule of the interventions.
Research gaps have been identified, and more rigorous studies investigating the effectiveness of different types of group interventions in older adults are needed before applying SARs in group interventions on a large scale.
Given the importance of group interventions in nursing care of older adults, healthcare professionals can use socially assistive robots in such interventions to assist in caring for older adults.
The way communication is conducted directly influences the professional–patient relationship, how patients cope with their diagnosis, and their sense of hope throughout treatment. This study aims to map the literature on strategies that healthcare professionals can use to promote hope in communication with pediatric patients and their families in the context of chronic illness. Based on this objective, the study highlights an algorithm to assist healthcare professionals in instilling hope in this population through communication.
Scoping review.
This systematized review was conducted using the databases PubMed, LILACS, PsycInfo, Embase, CINAHL, and Scopus, employing the PCC framework and the Boolean operators AND and OR. The time frame was limited to the last 20 years (2004–2024). A total of 734 studies were identified across the databases, with an additional four retrieved through manual citation searches, resulting in 19 articles included in the final sample.
The findings highlight three key pillars for promoting hope in communication: (1) careful preparation for information delivery, which involves identifying the diverse needs of families and creating a physically comfortable and emotionally supportive environment; (2) providing information and emphasizing how it is presented—considering content, clarity, honesty, empathy, and adaptation to the recipient's specific needs; and (3) follow-up after information delivery, ensuring emotional support and active, skilled listening.
Interpersonal communication between the healthcare professional, the patient, and the family was mainly focused on the transmission of information about the disease and treatment in a clear and empathetic manner, considering who is receiving the information and how the information is interpreted.
This review provides guidance for healthcare professionals in implementing communication strategies that foster hope in the context of pediatric chronic illness. Additionally, this guide may serve as a model for training students and healthcare professionals. Further research is needed to implement and explore additional effective communication strategies for this population across diverse cultural settings.
To explore the association between psychological capital and psychological distress in stroke patient–spouse dyads and examine the mediating effect of relationship satisfaction in this association.
A population of 207 stroke patient-spouse dyads completed the Positive Psychological Capital Questionnaire, Quality of Relationship Index, and Kessler Psychological Distress Scale. A dyadic analysis was conducted using the actor-partner interdependence mediation model.
In stroke-affected couples, a noteworthy interaction exists between moderately elevated levels of psychological capital (p < 0.01). Patients exhibit significantly diminished psychological capital and heightened psychological distress compared to their spouses (t = −5.429, p < 0.001; t = 2.536, p < 0.05). Conversely, there is no significant variance in relationship satisfaction between patients and the partners (t = −0.920, p > 0.05). Patient relationship satisfaction acts as a mediator in the correlation between dyadic psychological capital and patient psychological distress (β = −0.020, p < 0.05; β = −0.011, p < 0.05). Similarly, spousal relationship satisfaction serves as a mediator in the connection between dyadic psychological capital and spousal psychological distress (β = −0.011, p < 0.05; β = −0.020, p < 0.05).
Psychological distress was reduced when psychological capital or relationship satisfaction in stroke dyads was promoted, and relationship satisfaction is an important mediator of the impact of psychological capital on psychological distress in the dyads. Healthcare providers should pay equal attention to spouses and implement dyadic psychological capital interventions centered on stroke couples to enhance relationship satisfaction and reduce psychological distress.
Gender equity and workplace bias are critical factors influencing job satisfaction and career progression in healthcare. Despite global initiatives promoting equity, disparities persist within nursing, impacting organizational commitment and workforce retention.
This study investigates registered nurses' perceptions of gender equity and workplace bias and their impact on job satisfaction at King Khaled Hospital, Saudi Arabia.
A cross-sectional quantitative study design was employed, involving 246 randomly selected registered nurses. Data were collected using the gender equity in the Workplace Scale (GEWS), Workplace Gender Bias Scale (WGBS), and Job Satisfaction Survey (JSS). Descriptive statistics and Pearson correlation analyses were conducted using SPSS to assess gender differences and relationships between perceptions of equity, bias, and job satisfaction.
The study revealed moderate agreement regarding gender equity in promotions (48.8%) and compensation (52%), indicating room for improvement in implementing equality policies. Workplace bias was perceived notably in stereotyping (50.8%) and differential treatment (60%), with female nurses reporting higher levels of bias. Job satisfaction was moderate, with 60% of participants expressing overall satisfaction and only 42% satisfied with promotional opportunities. Perceptions of gender equity positively correlated with job satisfaction (r = 0.65, p < 0.001), while workplace bias was inversely correlated (r = −0.54, p < 0.001).
Persistent gender inequities and workplace biases negatively affect job satisfaction and career progression in nursing. Addressing these disparities through equitable organizational policies, diversity training, and inclusive leadership can enhance job satisfaction, improve retention, and foster a supportive work environment. These findings highlight the need for systemic reforms to promote workplace equity and well-being in healthcare organizations.
Falls among older adults are a major public health concern, often leading to serious outcomes such as fractures, head trauma, and increased mortality. Virtual reality (VR) interventions have emerged as a promising strategy for fall prevention by improving balance, reducing fear of falling, and enhancing confidence. However, the impact of VR interventions on specific outcomes such as fear of falling, balance, and postural control in older adults remains insufficiently synthesized.
Systematic review and meta-analysis.
A comprehensive systematic search of six databases was conducted from inception to January 20, 2025. Randomized controlled trials (RCTs) evaluating VR interventions targeting fear of falling, balance, and postural control in older adults were included. Methodological quality was assessed using the Cochrane risk-of-bias tool (RoB-2). Pooled standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated using random-effects models for each outcome.
Seventeen RCTs involving 988 older adults, published between 2016 and 2025, met the inclusion criteria. VR interventions demonstrated significant effects in reducing fear of falling (SMD = −0.40; 95% CI: −0.72 to −0.08; I 2 = 45.10%; p = 0.02), improving balance (SMD = 0.45; 95% CI: 0.07–0.83; I 2 = 73.54%; p = 0.02), and enhancing postural control (SMD = 0.50; 95% CI: 0.13–0.86; I2 = 46.89%; p = 0.01).
This meta-analysis highlights the effectiveness of VR interventions in reducing fear of falling and improving balance and postural control among older adults.
VR represents a valuable tool in fall prevention strategies, addressing key outcomes essential for maintaining independence and mobility in this population.
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