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Pregnancy is a special time for women that involves substantial emotional, physical, social, and family changes, which can lead to physical and psychological harm. The rapid development of e-health has provided a favourable platform for managing health-related outcomes in pregnant women, and nurses are the professional group that is most likely to provide e-health services. Nurse-led e-health interventions have attracted increasing attention, but their effects are uncertain.
To identify the effectiveness of nurse-led e-health interventions in improving health-related outcomes in pregnant women.
A systematic review.
The PubMed, PsycINFO, EMBASE, CINAHL, ProQuest, MEDLINE, Scopus, Web of Science and Cochrane Library databases were searched from inception to March 2023.
Two reviewers independently assessed study eligibility and extracted data. The Cochrane risk of bias tool was used for quality assessment. The findings of this review are presented using a narrative synthesis.
This review included 14 studies involving 2016 participants. Three out of five studies reported that nurse-led e-health interventions significantly reduced depressive symptoms. Four studies reported significant improvements in stress and self-efficacy after the intervention. Two studies reported significant improvements in anxiety symptoms, self-management ability, and quality of life after the intervention. One study showed that weight gain and physical activity significantly improved after the intervention. Due to the heterogeneity in the included studies, no meta-analysis was conducted.
Nurse-led e-health interventions may be beneficial for improving anxiety symptoms, depressive symptoms, stress, self-efficacy, weight gain, self-management ability, physical activity, and quality of life in pregnant women.
Nurse-led e-health interventions could provide individualised, economic, interactive, and convenient nursing modes for pregnant women. Rigorous and high-quality evidence confirming the long-term effects of these interventions on pregnant women is necessary.
The patients had no direct involvement in the present study.
PROSPERO registration ID: CRD42023401973
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.
by Wensi Ouyang, Guimei Guo, Jie Xia, Changwei Zhao, Xiaoling Zhou
BackgroundMinimally invasive treatment options for osteonecrosis of the femoral head (ONFH) have been a prominent area of research in recent years. Arthroscopic-assisted treatments have been applied in the clinical management of ONFH; however, high-quality evidence verifying their effectiveness and safety is still lacking.
ObjectiveTo systematically assess the clinical efficacy and safety of arthroscopic-assisted core decompression (AACD) in treating ONFH.
MethodsA comprehensive literature search was conducted in PubMed, Web of Science, EMBASE, Cochrane Library, Chinese National Knowledge Infrastructure, China Science and Technology Journal Database, WanFang, and the Chinese BioMedical Literature Database, from inception to June 25, 2024. We identified randomized controlled trials and non-randomized controlled studies on AACD for the treatment of ONFH based on predefined inclusion and exclusion criteria. A meta-analysis was performed using Review Manager 5.4.1 and Stata 17.0 software. The analyzed outcomes included operative time, intraoperative blood loss, length of hospital stay, postoperative femoral head collapse rate, Harris hip score, and postoperative complication rate. The Grades of Recommendations, Assessment, Development, and Evaluations (GRADE) system was used to assess the quality of evidence for the outcome indicators.
ResultsA total of fourteen studies were included in this meta-analysis, comprising 1,063 patients-541 in the core decompression (CD) group and 522 in the AACD group. The meta-analysis revealed no significant differences between the two groups in terms of intraoperative blood loss, length of hospital stay, 12-month postoperative Harris hip score, or overall postoperative complication rate (P > 0.05). However, the AACD group had a longer operative time (MD = 31.19, 95% Cl: 5.32 to 57.07, P = 0.02) and a lower overall postoperative femoral head collapse rate (RR = 0.49, 95% Cl: 0.27 to 0.89, P = 0.02) compared with the CD group. Additionally, the AACD group showed significant improvements in Harris hip scores at 3 months (MD = 6.39, 95% Cl: 5.44 to 7.33, P P P P Conclusion
This meta-analysis suggests that AACD is an effective and safe treatment for patients with ONFH. However, due to the limited quantity and quality of the included studies, these results should be interpreted with caution. Further high-quality studies are recommended to confirm these findings.
To examine the effectiveness of family-centred interventions among family caregivers.
Family-centred interventions are an emerging form of intervention that can be effective at improving physical and mental health outcomes for patients and family caregivers. To date, no reviews have examined the effectiveness of family-centred interventions for family caregivers.
A systematic review, including a meta-analysis, was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA 2020) checklist.
Seven English and two Chinese electronic databases were compressively searched from the outset to March 2023. Two researchers independently reviewed the abstracts and full texts, extracted the data and assessed the risk of bias independently by using the Cochrane ‘Risk of bias assessment tool’.
This systematic review and meta-analysis included 20 articles. The results of the meta-analysis showed that family-centred interventions could significantly improve caregiver burden (p=0.003), quality of life (p = 0.007), depression (p = 0.0002), and stress (p < 0.0001) but not anxiety or family functioning. According to our subgroup analysis, the family-centred empowerment model (p = 0.009) was superior to the other family intervention (p=0.004) in reducing caregiver burden. Family-centred interventions are more effective at reducing the burden of caregiving on family caregivers of adolescent patients (SMD=−0.79, 95% CI[−1.22,−0.36], p = 0.0003) than on adult patients (SMD=−0.37, 95% CI [−0.61,−0.12], p = 0.004).
Family-centred interventions could enhance family caregivers’ burden, quality of life, stress and depression but had no significant impact on anxiety or family functioning.
Family-centred interventions have the potential to improve the health status and caregiving burden of family caregivers. Rigorous and high-quality evidence is needed to confirm the long-term effects of these interventions on family caregivers.
The protocol has been registered in the PROSPERO international prospective register of systematic reviews (Protocol registration ID: CRD42023453607).
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