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Physiological, psychological, and social changes may make older adults more vulnerable to stressors and lead to adverse health outcomes. It remains unclear whether interventions targeting coping strategies in older adults are effective.
This study aimed to systematically review and summarize existing interventions aimed at improving coping strategies in older adults and analyze intervention effectiveness.
A systematic search was conducted using PubMed, EMBASE, Web of Science, Cochrane, CINAHL, PsycINFO, CNKI, SinoMed, VIP, and WanFang databases for randomized controlled trials (RCTs) and quasi-experimental studies. Two researchers independently performed literature screening, quality assessment, and data extraction.
A total of 9 studies were included, comprising 7 RCTs and 2 quasi-experimental studies. Meta-analysis revealed that the interventions significantly enhanced the use of problem-focused coping strategies among older adults (SMD = 0.37, 95% CI: 0.12 ~ 0.63, p = 0.005, I 2 = 39%). However, there was no significant effect on emotion-focused coping strategies (SMD = −0.07, 95% CI [−0.62, 0.48], p = 0.80, I 2 = 76%). Moreover, no significant statistical differences were observed between the intervention group and the control group in terms of positive (SMD = 1.49, 95% CI [−0.23, 3.21], p = 0.09, I 2 = 98%) or negative coping strategies (SMD = −0.76, 95% CI [−1.79, 0.28], p = 0.15, I 2 = 96%).
Interventions targeting coping strategies can significantly improve the problem-focused coping strategies of older adults. It is crucial to help older adults accurately recognize daily stressors, acquire emotional regulation strategies, and enhance coping skills. More large-scale RCTs are needed to draw more robust conclusions.
Home-based exercise offers a cost-effective way to receive thorough rehabilitation without the requirement of costly supervised treatment.
To investigate the effects of home-based exercise on the balance ability in post-stroke patients.
A thorough search was carried out on various databases, such as Cochrane Library, Web of Science, PubMed, Embase, and China National Knowledge Infrastructure Library, until October 2024. The inclusion criteria were limited to randomized controlled trials that evaluated the impact of home-based exercise interventions.
The meta-analysis indicated that home-based exercise significantly improved static balance ability (Berg Balance Scale [BBS]: MD = 3.45, 95% CI [1.43, 5.47], I 2 = 71%, p = 0.0008, random-effects model). Conversely, the analysis revealed that the home-based exercise group did not exhibit a statistically significant improvement in the Time up and Go Test (TUG) when compared to the control group (TUG: MD = −0.34, 95% CI [−4.30, 3.61], I 2 = 96%, p = 0.86, random effects model). The subgroup analysis revealed that home-based exercise significantly enhanced balance ability in patients with subacute stroke (BBS: p < 0.0001; TUG: Overall effect p = 0.02). However, no significant improvement was observed in patients with chronic stroke (BBS: p = 0.39). Regarding the duration of intervention, both short-term and long-term interventions were effective on the BBS (p < 0.0001 and p = 0.0008, respectively), although no significant difference was found for the TUG. Participants engaging in exercise for more than 90 min per week demonstrated greater improvements in balance ability (BBS: p < 0.0001; TUG: p = 0.02). When considering national economic levels, significant effects on the BBS were observed in both developed and developing countries (p = 0.0001 and p < 0.0001, respectively), while significant effects on the TUG were noted only in developing countries (p = 0.04).
Home-based exercise interventions showed significant results in improving static balance in patients with subacute stroke, especially home-based exercise that lasted longer than 12 weeks and lasted at least 90 min per week. However, more methodologically rigorous randomized controlled trials are needed to validate these results. In addition, the optimal exercise program and type to optimize the balance ability of stroke patients also need further research.
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.
Patients with chronic kidney disease on hemodialysis experience complex symptom clusters that impact their quality of life. Simplifying symptom management is essential to improve patient care and outcomes. However, there is no comprehensive evaluation of these simplification methods in current literature.
To evaluate and synthesize strategies for simplifying the symptomatology associated with hemodialysis to improve patient outcomes and management practices.
We conducted a systematic review. We performed a comprehensive literature search across Pubmed, CINAHL, Embase, Web of Science, Scopus, CNKI, VIP database, and Wanfang in April 2024. Data synthesis was narrative due to the heterogeneity of the methodologies. Studies were selected based on predefined criteria focused on symptom simplification strategies among adult hemodialysis patients. Articles were retrieved and assessed for relevance and quality through April 2024.
We identified 18 eligible studies from an initial pool of 18,324 records, focusing on variable-centered, person-centered approaches and approaches to identifying the main symptoms to symptom simplification. The studies varied significantly in their methodological quality and findings but commonly reported symptom clusters that correlated with poor patient outcomes.
This review underlines critical areas for advancement in hemodialysis patient care through strategic symptom management integration. Our findings emphasize the necessity of implementing simplified symptom assessment protocols in routine clinical practice, thereby enhancing patient engagement and outcomes. Additionally, the results advocate for ongoing research into personalized care approaches, underscoring the potential for these strategies to decrease symptom burden significantly. These insights should inform both policy and educational programs, encouraging the adoption of standardized practices across healthcare systems. Moreover, the study highlights the need for management strategies that align with patient-reported outcomes, fostering a more patient-centered approach in healthcare settings. Ultimately, this evidence should guide educational efforts to better equip healthcare providers with the tools necessary for effective symptom management in hemodialysis care.
PROSPERO: CRD42023473789
Cancer is a global public health concern that causes psychosocial and spiritual challenges in those who suffer from it and their family caregivers. Meaning-centered interventions have a positive impact on improving anxiety and depression in patients with advanced cancer. However, the impact of meaning-centered interventions on existential distress of patients with cancer and family caregivers' mental health is still unclear.
To examine the efficacy of meaning-centered interventions in alleviating existential distress, enhancing quality of life, and fostering a sense of meaning among cancer survivors and their family caregivers.
This systematic review and meta-analysis were conducted according to the Preferred Reporting Item for Systematic Reviews and Meta-analysis 2020 statement. A comprehensive search was conducted from inception until September 2023 across nine databases: PubMed, Embase, Web of Science, PsycINFO, The Cochrane Library, CINAHL, Scopus, WANFANG, and CNKI. Heterogeneity testing and meta-analyses were conducted using Review Manger 5.3. We calculated standard mean deviations and 95% confidence intervals and presented forest plots for assessing intervention effects. Two reviewers independently evaluated the risk of bias of all included articles. STATA 17.0 was used for publication bias analysis.
The review included 25 studies with 2399 participants, and 22 were included in the meta-analysis. Meaning-centered interventions enhanced quality of life, alleviated existential distress, and reduced depressive symptoms and cancer-related fatigue. They did not affect spiritual well-being. The subgroup analysis showed that the individual form and long-term intervention (≥3 months) enhanced the quality of life in cancer survivors. Meaning-centered interventions reduce depression in advanced cancer survivors more than in mixed-stage cancer survivors. Meaning-centered interventions significantly enhanced benefit finding for family caregivers.
Meaning-centered interventions may improve mental health for patients with cancer and their family caregivers. Future research must include diverse cultural perspectives to understand the impact of meaning-centered interventions on various groups.
Managing medication interruptions is considered one of the biggest dilemmas for nurses in clinical settings. To improve medication safety, it was imperative to conduct a systematic review to get a deeper understanding of nurses' experiences with medication interruptions.
A systematic review and qualitative meta-synthesis aimed to explore clinical nurses' experiences of interruption during medication in hospitals.
Systematic searches were conducted in PubMed, CINAHL, Ovid Medline, Embase, Web of Science, and The Cochrane Library from inception to January 2024. The search strategy included four groups of keywords: (1) qualitative research, (2) nurses, (3) medication interruption, and (4) experience. Critical Appraisal Skills Programme was used to assess the quality of the studies. Meta-ethnography was utilized to synthesize the findings of the included studies.
Nine articles published between 2012 and 2023 were included; the number of participants varied from 5 to 40, aged 20–68 years, and the majority were female. Four synthesized findings were identified as follows: (1) an inevitable part of the routine, (2) a decision-making process, (3) working in a minefield, and (4) coping with interruption.
Nurses embraced interruptions as an inherent component of clinical care. Previous experience and nursing culture, encompassing personal and professional aspects, significantly influence nurses' attitudes toward medication interruptions. It is crucial to incorporate the distinctive work experiences of nurses into techniques aimed at efficiently handling interruptions in future research. The registration number in PROSPERO is CRD42023470276.
Long COVID is prevalent in the general population. Exercise is a promising component of rehabilitation for long COVID patients.
This study examined the effects of exercise interventions on managing long COVID symptoms.
In this systematic review and meta-analysis, a systematic search was conducted through June 2023 using keywords such as “long COVID” and “post-acute COVID-19 syndrome” among major electronic databases. Randomized controlled trials that examined the effect of exercise on patients suffering from long COVID were included. Nine studies involving 672 individuals were included in this study.
The main outcomes for exercise interventions in patients with long COVID were fatigue, dyspnea, anxiety, depression, and cognitive impairment. The exercise interventions comprised aerobic exercise, multimodal exercise, breathing exercise, and Taichi. Most of the included studies (6/9) were at high risk of bias. According to the meta-analyses, exercise significantly improved long COVID fatigue (ES = 0.89, 95% CI: 0.27 to 1.50) and dyspnea (ES = 1.21, 95% CI [0.33, 2.09]), whereas no significant effect was identified on long COVID anxiety, depression, and cognitive impairment. According to subgroup analyses, multimodal exercise had the broadest spectrum of benefits on long COVID symptoms (including fatigue, dyspnea, and depression), and supervised exercise, intervention frequency ≤4 times a week, the passive control group also showed a positive effect on some long COVID symptoms.
A common psychological problem among nurses is depression, potentially affecting their well-being and job performance. It is vital to explore how to alleviate nurses' depressive symptoms.
The current research explored the mediating impact of basic psychological needs satisfaction on the link of gratitude with depressive symptoms.
The nurses in this study were from mainland China. A total of 724 subjects completed an online questionnaire, which included measures of depressive symptoms, basic psychological needs satisfaction and gratitude.
Our research found that gratitude was negatively linked to depressive symptoms. Furthermore, basic psychological needs satisfaction had a partial mediation effect on the link of gratitude with depressive symptoms after controlling for five demographic variables. These results suggest that gratitude may influence depressive symptoms via basic psychological needs satisfaction.
Our study found that basic psychological need satisfaction partially mediates the gratitude-depression relationship in nurses. The result means that hospital administrators and nurse leaders should design gratitude interventions to alleviate nurses' depressive symptoms. They also help nurses decrease depressive symptoms by creating an environment that meets their basic psychological needs.
Acceptance and commitment therapy (ACT) is a psychotherapy technique, which promotes psychological flexibility and enables patients to change behaviors based on value-directed goals. However, the beneficial effects of ACT on glycemic control, self-care behaviors, acceptance of diabetes, self-efficacy, and psychological burden are still unclear among patients with type 2 diabetes mellitus (T2DM).
This study aimed to systematically synthesize scientific evidence to determine the effectiveness of ACT among patients with T2DM on glycemic control, self-care behaviors, acceptance of diabetes, self-efficacy, and psychological burden and identify the optimal characteristics of effective interventions.
Nine electronic databases were searched to identify eligible studies of randomized controlled trials from inception to June 2023. Two reviewers independently assessed the study eligibility, extracted the data, and performed the quality appraisal using the Cochrane Risk of Bias 2 Tool. The meta-analysis was conducted using Review Manager 5.3. The certainty of the evidence was rated using the Grading of Recommendations Assessment, Development, and Evaluation system.
Ten studies involving 712 participants were included. ACT demonstrated significant improvements on patients' glycemic control (mean difference [MD]: 0.95%; p < .001), self-care behaviors (MD: 1.86; p = .03), diabetes acceptance (MD: 7.80; p < .001), self-efficacy (standardized mean difference [SMD]: 1.04; p < .001), anxiety (SMD: −1.15; p = .006), and depression (SMD: −1.10; p = .04). However, favorable but nonsignificant improvements were found in diabetes distress. Subgroup analyses demonstrated that ACT offered more than five sessions using individualized format, with theoretical underpinnings and professional input from multidisciplinary therapists are recommended to yield better results on glycemic control and self-care behaviors.
Acceptance and commitment therapy could generate beneficial effectiveness on glycemic control, self-care behaviors, acceptance of diabetes, self-efficacy, anxiety, and depression among patients with T2DM. Large-scale trials with rigorous design and representative samples are warranted to strengthen the current evidence.
Nurse job satisfaction is a critical area of study with far-reaching implications for healthcare organizations, patient care, and the retention of nursing staff.
This study aimed to investigate the association of gratitude with job satisfaction among Chinese nurses and examine the potential mediating roles of resilience and stress in this relationship.
Two separate studies were conducted to examine our research hypotheses. In Study 1, a total of 460 nurses completed the questionnaire related to gratitude, resilience, stress, and job satisfaction. A validation study was conducted in Study 2, which consisted of 709 nurses who also completed the same measures of gratitude, resilience, and stress to ensure the repeatability of the Study 1 results. Furthermore, a different scale was used to measure nurses' job satisfaction.
The two studies consistently found that both resilience and stress mediated gratitude–job satisfaction independently among Chinese nurses. Furthermore, resilience was found to be a significantly stronger mediator than stress in the association of gratitude with job satisfaction. Finally, we found that gratitude predicted nurses' job satisfaction via the serial mediating effects of resilience and stress.
These findings highlight the complex interplay between gratitude, resilience, stress, and job satisfaction by demonstrating that resilience and stress act as parallel and sequential mediators between nurses' gratitude and job satisfaction. The healthcare sector can improve nurses' job satisfaction by increasing gratitude, building resilience, and reducing feelings of stress.
Nurse managers have the potential to enhance job satisfaction among nurses by implementing measures that increase gratitude, build resilience, and reduce stress levels.
Health literacy, empowerment, and self-care activities are likely the crucial concepts affecting the quality of life and glycemic control in people with type 2 diabetes (T2D). However, evidence demonstrating the mechanisms underlying these concepts is scarce.
The aim of this study was to test the serial mediation roles of empowerment and self-care activities on the relationships between health literacy and quality of life and between health literacy and hemoglobin A1c (HbA1c) in people with T2D.
A cross-sectional study was conducted among 319 people with T2D in Guangzhou, China, from July 2019 to January 2020. Data were collected using the Health Literacy Scale, the Diabetes Empowerment Scale—Short Form, the Summary of Diabetes Self-Care Activities Measure, and the Adjusted Diabetes—Specific Quality of Life Scale. RStudio 4.2.1 was used for serial mediation analysis.
The dimension of communicative health literacy accounted for the most total variance (β = 0.810, p < .001) in the construct of health literacy. The serial multiple mediation of empowerment and self-care activities in the associations between health literacy and quality of life (β = −.046, p = .019) and between health literacy and HbA1c (β = −.045, p = .005) were statistically significant.
This study emphasized the vital role of communicative health literacy when improving health literacy in people with T2D. Diabetes care and education specialists could implement empowerment approaches and flexible self-care strategies to improve the quality of life and glycemic control in people with T2D. Enhancing health literacy was suggested as a favorable strategy for promoting empowerment and self-care activities in people with T2D.
The inconsistencies between randomized clinical trials (RCTs) registrations and peer-reviewed publications may distort trial results and threaten the validity of evidence-based medicine. Previous studies have found many inconsistencies between RCTs registrations and peer-reviewed publications, and outcome reporting bias is prevalent.
The aims of this review were to assess whether the primary outcomes and other data reported in publications and registered records in RCTs of nursing journals were consistent and whether discrepancies in the reporting of primary outcomes favored statistically significant results. Moreover, we reviewed the proportion of RCTs for prospective registration.
We systematically searched PubMed for RCTs published in the top 10 nursing journals between March 5, 2020, and March 5, 2022. Registration numbers were extracted from the publications, and registered records were identified from the registration platforms. The publications and registered records were compared to identify consistency. Inconsistencies were subdivided into discrepancies and omissions.
A total of 70 RCTs published in seven journals were included. The inconsistencies involved sample size estimation (71.4%), random sequence generation (75.7%), allocation concealment (97.1%), blinding (82.9%), primary outcomes (60.0%) and secondary outcomes (84.3%). Among the inconsistencies in the primary outcomes, 21.4% were due to discrepancies and 38.6% resulted from omissions. Fifty-three percent (8/15) presented discrepancies in the primary outcomes that favored statistically significant results. Additionally, although only 40.0% of the studies were prospective registrations, the number of prospectively registered trials has trended upward over time.
While not including all RCTs in the nursing field, our sample reflected a general trend: inconsistencies between publications and trial registrations were prevalent in the included nursing journals. Our research helps to provide a way to improve the transparency of research reports. Ensuring that clinical practice has access to transparent and reliable research results are essential to achieve the best possible evidence-based medicine.
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