Systematic Reviews最新文献

{"title":"The efficacy and safety of ketorolac for postoperative pain management in lumbar spine surgery: a meta-analysis of randomized controlled trials.","authors":"Jianbin Guan, Ningning Feng, Kaitan Yang, Haimiti Abudouaini, Peng Liu","doi":"10.1186/s13643-024-02685-z","DOIUrl":"10.1186/s13643-024-02685-z","url":null,"abstract":"<p><strong>Background: </strong>Ketorolac is widely utilized for postoperative pain management, including back pain after lumbar spinal surgery. Several trials have assessed the efficacy of Ketorolac alone and in combination with other analgesics such as bupivacaine, morphine, epinephrine, paracetamol, and pregabalin. However, the effects and safety profile of ketorolac in these contexts remain controversial.</p><p><strong>Objective: </strong>We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the efficacy and safety of Ketorolac administration, both as a monotherapy and in combination with other analgesics, for managing postoperative pain in adults undergoing lumbar spinal surgery.</p><p><strong>Methods: </strong>We searched PubMed, EMbase, Web of Science, EBSCO, CNKI, WanFang, VIP, and Cochrane library databases through July 2024 for randomized controlled trials (RCTs) assessing the analgesic efficacy of Ketorolac administration for postoperative pain of lumbar surgery. The meta-analysis was conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statements. Data were extracted and analyzed using open-source meta-analysis software OpenMeta-Analyst, focusing on outcomes such as VAS pain scores, postoperative morphine requirements (PMR), length of hospital stay (LOS), and adverse effects, such as nausea, vomiting, pruritus, and constipation. The quality of evidence was assessed using the Jada scale.</p><p><strong>Results: </strong>Thirteen RCTs comprising a total of 938 patients were included. The methodological quality of the studies was high, with three studies scoring 5, six studies scoring 4, and four studies scoring 3 on the Jadad scale. Ketorolac significantly reduced pain compared to controls at 0-6 h, with a mean difference (MD) of - 1.42 (95% CI: - 2.03 to - 0.80; P < 0.0001), exceeding the Minimal Clinically Important Difference (MCID) of 1.2 to 2.0 points on the Visual Analog Scale (VAS), indicating clinically meaningful pain relief. During the 6-12-h period, the pain reduction was significant (MD =  - 0.58; 95% CI: - 0.80 to - 0.35; P < 0.0001), though below the MCID threshold. In the 12-24-h period, Ketorolac continued to show significant pain reduction (MD =  - 0.48; 95% CI: - 0.68 to - 0.28; P < 0.0001), but this reduction was also below the MCID. Heterogeneity was low in the 12-24-h period (I<sup>2</sup> = 13%), indicating consistent results across studies. There was a significant reduction in PMR (SMD =  - 1.83; 95% CI =  - 3.42 to - 0.23; P < 0.0001), although with considerable heterogeneity among the studies (I<sup>2</sup> = 93%, heterogeneity P < 0.01). Ketorolac administration also significantly reduced the LOS compared to controls (MD =  - 0.45 days; 95% CI =  - 0.74 to - 0.16; P = 0.0001), though this reduction, which is less than a full day (0.45 days), may have limited clinical significance. The findings suggest that Ketorolac ef","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11536961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Semi-automated title-abstract screening using natural language processing and machine learning.","authors":"Maximilian Pilz, Samuel Zimmermann, Juliane Friedrichs, Enrica Wördehoff, Ulrich Ronellenfitsch, Meinhard Kieser, Johannes A Vey","doi":"10.1186/s13643-024-02688-w","DOIUrl":"10.1186/s13643-024-02688-w","url":null,"abstract":"<p><strong>Background: </strong>Title-abstract screening in the preparation of a systematic review is a time-consuming task. Modern techniques of natural language processing and machine learning might allow partly automatization of title-abstract screening. In particular, clear guidance on how to proceed with these techniques in practice is of high relevance.</p><p><strong>Methods: </strong>This paper presents an entire pipeline how to use natural language processing techniques to make the titles and abstracts usable for machine learning and how to apply machine learning algorithms to adequately predict whether or not a publication should be forwarded to full text screening. Guidance for the practical use of the methodology is given.</p><p><strong>Results: </strong>The appealing performance of the approach is demonstrated by means of two real-world systematic reviews with meta analysis.</p><p><strong>Conclusions: </strong>Natural language processing and machine learning can help to semi-automatize title-abstract screening. Different project-specific considerations have to be made for applying them in practice.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11529237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142565210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stroke patient and stakeholder engagement (SPSE): concepts, definitions, models, implementation strategies, indicators, and frameworks-a systematic scoping review.","authors":"Hamidreza Khankeh, Gordon Guyatt, Shima Shirozhan, Juliet Roudini, Torsten Rackoll, Ulrich Dirnagl","doi":"10.1186/s13643-024-02686-y","DOIUrl":"10.1186/s13643-024-02686-y","url":null,"abstract":"<p><strong>Background: </strong>Involving stroke patients in clinical research through patient engagement aims to ensure that studies are patient-centered, and may help ensure they are feasible, ethical, and credible, ultimately leading to enhanced trust and communication between researchers and the patient community. In this study, we have conducted a scoping review to identify existing evidence and gaps in SPSE.</p><p><strong>Methods: </strong>The five-step approach outlined by Arksey and O'Malley, in conjunction with the Preferred Reporting Items for Scoping Reviews (PRISMA-ScR) guidelines, provided the structure for this review. To find relevant articles, we searched PubMed, Web of Science, and Embase databases up to February 2024. Additionally, the review team conducted a hand search using Google Scholar, key journals, and references of highly relevant articles. Reviewers screened articles, selecting eligible English-language ones with available full texts, and extracted data from them into a pre-designed table tested by the research team.</p><p><strong>Result: </strong>Of the 1002 articles initially identified, 21 proved eligible. Stakeholder engagement primarily occurred during the design phase of studies and within the studies using qualitative methodologies. Although the engagement of stakeholders in the research process is increasing, practice regarding terminology and principles of implementation remains variable. Researchers have recognized the benefits of stakeholder engagement, but have also faced numerous challenges that often arise during the research process.</p><p><strong>Conclusion: </strong>The current study identifies stakeholder groups and the benefits and challenges researchers face in implementing their engagement. Given existing challenges and limited specific models or frameworks, it is suggested to explore applied recommendations for stakeholder engagement in future studies, that may enhance stakeholder engagement, overcome obstacles, and unify researchers' understanding of engagement and implementation.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11526530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Toward a whole-of-virtual school framework for promoting student physical activity: a scoping review protocol.","authors":"Chad M Killian, Eugenia Opuda, Collin A Webster, Taemin Ha, Brian Dauenhauer, Jennifer M Krause","doi":"10.1186/s13643-024-02689-9","DOIUrl":"10.1186/s13643-024-02689-9","url":null,"abstract":"<p><strong>Background: </strong>The advent of full-time virtual schooling presents unique challenges and opportunities for the promotion of physical activity (PA) among children and adolescents. Despite the recognized benefits of PA as an essential component for combating non-communicable diseases and ensuring holistic development, there is a notable gap in understanding how to effectively integrate PA within the digital learning environments of full-time virtual schools. Current efforts to promote student PA are targeted for implementation exclusively in contexts characterized by physical school campuses that are bound to their surrounding local communities. This is problematic given the digital, widely distributed, and contextually unmoored nature of virtual schooling. Our aim in this scoping review is to advance research on whole-of-school physical activity promotion within full-time virtual schools by examining the published literature on whole-of-school PA promotion within full-time virtual schools. Specifically, this review will map the literature, consolidate knowledge claims and practical implications, and identify evidence gaps that merit further investigation.</p><p><strong>Methods/design: </strong>This review will be conducted using evidence-informed scoping review methodology and reporting guidelines. Articles will be included if they are peer-reviewed English-language research, commentary, practical, or grey literature and relate to the participation, support, design, development, and/or provision of remote online PA interventions delivered through primary/elementary and/or secondary/middle school/high schools. Searches will be conducted in PsycInfo, ERIC, SportDiscus, and Web of Science. Additional hand-searching, reference scans, and grey literature searches will also be performed. Two trained research assistants will independently complete study screening and selection and data charting with guidance from a senior author. Charted data will be displayed in table form, and depending on the results, data will also be synthesized through qualitative content analysis using the Active Schools guiding framework as an analytical and interpretive lens.</p><p><strong>Discussion: </strong>This scoping review will serve as a guidepost for the application and advancement of research on whole-of-school PA promotion through full-time virtual schools. The results will address the increased importance of equitable online learning and PA promotion due to the expanding virtual education landscape, with implications for public health and education policy.</p><p><strong>Systematic review registration: </strong>Open Science Framework:  https://osf.io/f6wau/ .</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11526610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The distribution of work-related musculoskeletal disorders among nurses in sub-Saharan Africa: a scoping review.","authors":"Kagiso Kgakge, Mbuzeleni Hlongwa, Ugochinyere Ijeoma Nwagbara, Themba Ginindza","doi":"10.1186/s13643-024-02687-x","DOIUrl":"10.1186/s13643-024-02687-x","url":null,"abstract":"<p><strong>Background: </strong>Musculoskeletal injuries are noticeably high among the nursing fraternity, with lower back pain (LBP) being the most prevalent. Therefore, this study aimed to map evidence on the burden of occupational musculoskeletal disorders (MSD) among nurses in sub-Saharan Africa (SSA).</p><p><strong>Methods: </strong>This scoping review was guided by Arksey and O'Malley's framework. We conducted a comprehensive literature search with no date limit from the following databases: Science Direct, PubMed, Sabinet (SA ePublications), EBSCOhost platform, World Health Organization (WHO) Library, Google Scholar, SCOPUS, Taylor and Francis, and WorldCat Academic Search with full text for published studies. The search took place from May 2022 to December 2022. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was used for reporting the search results, and a thematic content analysis was used to present the emerging themes from the included studies.</p><p><strong>Results: </strong>A total of 16,714 studies were identified after the database search. Only 29 studies met the inclusion criteria after full-article screening and were included for data extraction. The studies reported a total of 6343 participants from different regions in SSA. The 29 included studies showed evidence on the prevalence of MSD, associated risk factors of MSD and LBP among nurses in SSA with some recommendations on how to reduce the prevalence of MSD among nurses.</p><p><strong>Conclusion: </strong>The study findings reveal that there is a high prevalence of MSD among nurses, especially LBP. The etiology of MSD among nurses is multifactorial, and multifaceted strategies to address MSD are recommended. Further research is recommended to explore strategies that can be used to curb the high prevalence of MSD among nurses.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11526634/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of physical therapy modalities for motor function, functional recovery, and post-stroke complications in patients with severe stroke: a systematic review update.","authors":"Katrin Roesner, Bettina Scheffler, Martina Kaehler, Bianca Schmidt-Maciejewski, Tabea Boettger, Susanne Saal","doi":"10.1186/s13643-024-02676-0","DOIUrl":"10.1186/s13643-024-02676-0","url":null,"abstract":"<p><strong>Background: </strong>Physical therapy interventions play a crucial role in the daily care of patients recovering from severe stroke. However, the efficacy of these interventions and associated modalities, including duration, intensity, and frequency, have not been fully elucidated. In 2020, a systematic review reported the beneficial effects of physical therapy for patients with severe stroke but did not assess therapeutic modalities. We aim to update the current evidence on the effects of physical therapy interventions and their modalities in relation to the recovery phase in people with severe stroke in a hospital or inpatient rehabilitation facility.</p><p><strong>Methods: </strong>We searched CENTRAL, MEDLINE, Web of Science, and three other relevant databases between December 2018 and March 2021 and updated the search between April 2021 and March 2023.</p><p><strong>Clinicaltrials: </strong>gov and ICTRP for searching trial registries helped to identify ongoing RCTs since 2023. We included individual and cluster randomized controlled trials in the English and German languages that compared physical therapy interventions to similar or other interventions, usual care, or no intervention in a hospital or rehabilitation inpatient setting. We screened the studies from this recent review for eligibility criteria, especially according to the setting. Critical appraisal was performed according to the Cochrane risk-of-bias tool 2.0. The data were synthesized narratively.</p><p><strong>Results: </strong>The update identified 15 new studies, cumulating in a total of 30 studies (n = 2545 participants) meeting the eligibility criteria. These studies reported 54 outcomes and 20 physical therapy interventions. Two studies included participants during the hyperacute phase, 4 during the acute phase,18 during the early subacute phase, and 3 in the late subacute phase. Three studies started in the chronic phase. Summarised evidence has revealed an uncertain effect of physical therapy on patient outcomes (with moderate to low-quality evidence). Most studies showed a high risk of bias and did not reach the optimal sample size. Little was stated about the standard care and their therapy modalities.</p><p><strong>Discussion: </strong>There is conflicting evidence for the effectiveness of physical therapy interventions in patients with severe stroke. There is a need for additional high-quality studies that also systematically report therapeutic modalities from a multidimensional perspective in motor stroke recovery. Due to the high risk of bias and the generally small sample size of the included studies, the generalizability of the findings to large and heterogeneous volumes of outcome data is limited.</p><p><strong>Systematic review registration: </strong>PROSPERO CRD42021244285.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11520505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leveraging artificial intelligence to enhance systematic reviews in health research: advanced tools and challenges.","authors":"Lixia Ge, Rupesh Agrawal, Maxwell Singer, Palvannan Kannapiran, Joseph Antonio De Castro Molina, Kiok Liang Teow, Chun Wei Yap, John Arputhan Abisheganaden","doi":"10.1186/s13643-024-02682-2","DOIUrl":"https://doi.org/10.1186/s13643-024-02682-2","url":null,"abstract":"<p><p>Artificial Intelligence (AI) is transforming systematic reviews (SRs) in health research by automating processes such as study screening, data extraction, and quality assessment. This perspective highlights recent advancements in AI tools that enhance efficiency and accuracy in SRs. It discusses the benefits, challenges, and future directions of AI integration, emphasising the need for human oversight to ensure the reliability of AI outputs in evidence synthesis and decision-making in healthcare.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11504244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic point-of-care ultrasound in obstetric anesthesia and critical care: a scoping review protocol.","authors":"Ana Sjaus, Laura V Young","doi":"10.1186/s13643-024-02673-3","DOIUrl":"10.1186/s13643-024-02673-3","url":null,"abstract":"<p><strong>Background: </strong>Point-of-care ultrasound (POCUS) has gained popularity as a bedside diagnostic imaging modality. In obstetrical populations, particularly in acute care settings, POCUS serves as a valuable complement to clinical assessment. Despite its many applications, only a few have been defined and validated in the obstetric population. This scoping review aims to delineate literature on the diagnostic applications of POCUS in obstetric anesthesia and critical care.</p><p><strong>Methods: </strong>This review will adhere to the Joanna Briggs Institute methodology for scoping reviews, as updated by Arksey and O'Malley and in stages elaborated by Levac et al. Relevant literature will be identified using Medical Subject Headings (MeSH), keyword, and proximity searches and combined using Boolean operators in PubMed, Embase, and Web of Science from January 1, 2000, to the present. Two independent reviewers will screen literature against predefined eligibility criteria in abstract and full-text forms. A third reviewer will be consulted if consensus cannot be reached. Data extraction will be systematic, focusing on pre-specified variables aligned with the review's aims. Descriptive statistical and thematic analysis will follow data extraction, with findings presented in graphical and tabular forms. The reporting will follow Preferred Reporting Items for Systematic reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR).</p><p><strong>Conclusion: </strong>This review will present the scope of the current literature on diagnostic POCUS in obstetric anesthesia and critical care, highlighting both strengths and gaps in existing knowledge. The insights gained will support future research, knowledge synthesis, and development of educational programs. The findings will be disseminated through peer-reviewed journal publications, conferences, and social media platforms.</p><p><strong>Systematic review registration: </strong>Not applicable.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11515486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Geospatial analysis of environmental atmospheric risk factors in neurodegenerative diseases: a systematic review update.","authors":"Mariana Oliveira, André Padrão, Ana Cláudia Teodoro, Alberto Freitas, Hernâni Gonçalves","doi":"10.1186/s13643-024-02637-7","DOIUrl":"10.1186/s13643-024-02637-7","url":null,"abstract":"<p><p>Following up the previously published systematic review on the same topic and realizing that new studies and evidence had emerged on the matter, we conducted an update on the same research terms. With the objective of updating the information relating environmental risk factors on neurodegenerative diseases and the geographic approaches used to address them, we searched PubMed, Web of Science and Scopus for all scientific studies considering the following three domains: neurodegenerative disease, environmental atmospheric factor and geographical analysis, using the same keywords as in the previously published systematic review. From February 2020 to February 2023, 35 papers were included versus 34 in the previous period, with dementia (including Alzheimer's disease) being the most focused disease (60.0%) in this update, opposed to multiple sclerosis on the last review (55.9%). Also, environmental pollutants such as PM_2.5 and NO₂ have gained prominence, being represented in 65.7% and 42.9% of the new studies, opposed to 9.8% and 12.2% in the previous review, compared to environmental factors such as sun exposure (5.7% in the update vs 15.9% in the original). The mostly used geographic approach remained the patient's residence (82.9% in the update vs 21.2% in the original and 62.3% in total), and remote sensing was used in 45.7% of the new studies versus 19.7% in the original review, with 42.0% of studies using it globally, being the second most common approach, usually to compute the environmental variable. This review has been registered in PROSPERO with the number CRD42020196188.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11515500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adult day programs and their effects on individuals with dementia and their caregivers (ADAPT-DemCare): a realist synthesis to develop program theories on the how and why.","authors":"Hung Nguyen, Atiqur Rahman, Andrea Ubell, Zahra Goodarzi, Colleen J Maxwell, Saleema Allana, Kaitlyn Tate, Holly Symonds-Brown, Lori Weeks, Sienna Caspar, Jim Mann, Matthias Hoben","doi":"10.1186/s13643-024-02683-1","DOIUrl":"10.1186/s13643-024-02683-1","url":null,"abstract":"<p><strong>Background: </strong>Adult day programs aim to facilitate aging in place by supporting the health and well-being of persons with dementia and providing respite to their caregivers. However, studies on the effects of day programs are inconclusive, and we especially lack insights into the context conditions and mechanisms of day programs that may produce different outcomes for different groups of persons with dementia and their caregivers. Our objective was to conduct a realist review, synthesizing research on day programs to develop program theories explaining how and why day programs do or do not produce positive or negative outcomes for different groups of persons with dementia, and caregivers.</p><p><strong>Methods: </strong>We identified 14 literature reviews (including 329 references published between 1975 and 2021) on adult day programs. From this initial pool of studies, we will include those that focused on day program attendees with dementia or meaningful cognitive impairment, and/or their caregivers, and that report how day program contexts (C) and mechanisms (M) bring about outcomes (O) for attendees and caregivers. We will extract CMO statements (i.e., narratives that explain how and why day programs do or do not bring about certain outcomes for whom and under what circumstances). Using additional focused searches, citation mapping, citation tracking, and discussions with our researcher and expert team members, we will identify additional references. CMO statements will be synthesized, transformed into hypotheses, and linked and visualized to form program theories. Using focus groups and the James Lind Alliance Priority Setting Partnership method, we will discuss and prioritize our CMO statements and refine our program theories with 32 experts (older adults, caregivers, Alzheimer societies, caregiver organizations, day program staff and managers, and health system and policy decision makers).</p><p><strong>Discussion: </strong>By identifying essential elements and processes of day programs and related knowledge gaps, this study will generate much-needed knowledge to leverage the full potential of day programs so they can provide appropriate care, preventing premature institutionalization, and unnecessary acute and primary care use. This will ultimately improve the quality of life of persons with dementia and their caregivers, alleviate caregiver burden, and reduce social costs.</p><p><strong>Systematic review registration: </strong>PROSPERO CRD42024504030.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11515670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}