Family Medicine and Community Health最新文献

{"title":"Acceptance and attitudes towards genetic cancer testing among German general practice patients: a cross-sectional survey.","authors":"Diana Guertler, Ann-Kristin Reinhard, Sabina Ulbricht, Jean-François Chenot, Ute Felbor, Susanne Wurm","doi":"10.1136/fmch-2025-003395","DOIUrl":"10.1136/fmch-2025-003395","url":null,"abstract":"<p><strong>Objective: </strong>This study describes acceptance and attitudes towards genetic cancer testing among German primary care patients.</p><p><strong>Design: </strong>Cross-sectional survey.</p><p><strong>Setting: </strong>Primary care.</p><p><strong>Participant: </strong>Systematically recruited patients aged ≥18 years from six general practices in Mecklenburg-Western Pomerania participated in an anonymous self-administered survey on familial cancer prevention (n=479 and 67.0% participation rate). Those with complete data were analysed (n=424; mean age 53.7, SD 16.6 years; men 34.4%). Linear regression analyses were used to examine potential disparities in general acceptance of genetic testing and attitudes towards genetic cancer testing according to sociodemographics and familial cancer knowledge.</p><p><strong>Result: </strong>General acceptance of genetic testing was high, particularly among younger, higher-educated individuals and those with a family history of cancer and higher familial cancer knowledge. For example, 83.3% either agreed or strongly agreed that it should be available to anybody. The most important benefits of genetic cancer testing were to guide check-up frequency (81.4%), to inform medical decision-making (80.2%) and to understand children's risk (75.2%). The most important concerns included the potential burden on the family (44.6%) and the belief that cancer cannot be prevented (39.2%). More favourable attitudes were found among younger, higher-educated individuals, those with a personal history of cancer and those with fewer children or no partner. For example, higher age was linked to lower benefit (regression coefficient (RC) -0.01, 95% CI -0.01 to -0.001) and higher concern ratings (RC 0.01, 95% CI 0.002 to 0.01). About a third (34.7%) rated not wanting to know about genetic alterations that increase their cancer risk as a (very) important reason against testing. Information avoidance was higher among older individuals (RC 0.02, 95% CI 0.01 to 0.02), women (RC 0.40, 95% CI 0.11 to 0.69), those with lower education (RC -0.64, 95% CI -0.91 to -0.36) and those with more children (RC 0.21, 95% CI 0.09 to 0.33).</p><p><strong>Conclusion: </strong>Acceptance of genetic testing was high, but barriers remain, particularly among older adults, women, the less educated and those with more children. Targeted educational efforts to improve health literacy, emphasise the preventive potential of genetic testing and emotional support through genetic counselling are essential to overcome these barriers and promote informed decision-making.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"13 3","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12314927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144761723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenge of long-term benzodiazepine use in primary care: insights from a real-world cohort study in Catalonia.","authors":"María Teresa Peñarrubia-María, Lucy Anne Parker, Marta Puig-García, Marina Fuente-Moreno, Blanca Lumbreras, Elsa Lopez-Pintor, Joan Domenech Abella, Marc Saez, Alexandra Lelia Dima, Adolfo Figueiras Guzmán, Elisa Chilet Rosell, Antoni Serrano-Blanco, Ignacio Aznar-Lou","doi":"10.1136/fmch-2024-003233","DOIUrl":"10.1136/fmch-2024-003233","url":null,"abstract":"<p><strong>Introduction: </strong>Long-term use of benzodiazepines (BZD) triggers health problems. Although Spain leads European use of BZD, the number of long-term users (LTUs) remains unknown.</p><p><strong>Objective: </strong>The aim of the study is to estimate the proportion of primary care (PC) patients who initiate a BDZ prescription that subsequently become LTU and to identify its associated factors.</p><p><strong>Design: </strong>Retrospective real-world data cohort.</p><p><strong>Setting and participant: </strong>It included the population over 15 years with a new prescription of BZD in PC in Catalonia. Users were considered LTU if they had been dispensed at least three prescriptions within 3 months. Sociodemographic characteristics of patients and prescribers, pathologies, previous BZD use, number and type of visits, and prescription quality standard were considered. We estimated the proportion of LTU among patients with a new prescription, stratified by age and sex, and estimated risk factors by multivariate generalised linear models.</p><p><strong>Result: </strong>100 638 users with a new BZD prescription were included. 27.1% were LTU at 3 months and 14.5% at 6 months. LTU increases with age and is higher in women. Predictors of LTU are Spanish nationality, living in rural areas, having a mental illness, having used BZD, having virtual visits or not meeting pharmacy-therapeutic quality standards.</p><p><strong>Conclusion: </strong>The number of patients who develop LTU is high, especially in the elderly. Exploring the causes of this phenomenon could contribute to the development of future interventions.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"13 3","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12315019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144761730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Educational and research utility of the registrar clinical encounters in training (ReCEnT) project: an exploration of mechanisms using the context, input, process and product (CIPP) framework.","authors":"Michael Tran, Susan Wearne, Andrew Davey, Parker Magin","doi":"10.1136/fmch-2025-003289","DOIUrl":"10.1136/fmch-2025-003289","url":null,"abstract":"<p><strong>Background: </strong>The Registrar Clinical Encounters in Training (ReCEnT) project is an Australian general practice vocational training programme with integrated and interdependent education and research functions. Trainees (registrars) contemporaneously document in-consultation clinical experience and actions.</p><p><strong>Objectives: </strong>Using a realist lens, we elucidate the mechanisms underpinning project outcomes to answer questions around programme effectiveness, impacts, sustainability and the lessons and findings that are translatable to other primary care training programmes.</p><p><strong>Methods: </strong>The context, input, process and product framework was used. As a means to understand the interactions between each of the interdependent components, it allows for inferences regarding causal mechanisms for specific outcomes.</p><p><strong>Results: </strong>Context: ReCEnT occurs within an apprenticeship-like model of general practice vocational training entailing a central supervisor/apprentice relationship. ReCEnT has demystified the content and characteristics of registrar consultations. Input: multiple stakeholder involvement is both advantageous and a logistical challenge, with the programme's success dependent on registrars, practices and training providers providing detailed and accurate data, with prompt subsequent processing.</p><p><strong>Process: </strong>contemporaneous consultation data collection in different stages of training constitutes a component of registrars' programmatic assessment. Product: individualised feedback provides educational benefit through reflection. Clinical and educational research questions can be addressed with resulting research translation feeding back into the programme model and government policy. Clinical behaviour change is also evaluated.</p><p><strong>Conclusion: </strong>ReCEnT is unique, globally, in its scope and longevity (2010-present). Creation of meaningful, individualised feedback facilitates reflection and provides both immediate educational benefits and the substrate for further research, programme and policy design and targeted formal teaching and learning.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"13 3","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12281318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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 age at first separation from parents on suicidal ideation, suicide planning and suicide attempts among left-behind children: the causal mediating effect of traumatic events.","authors":"Xian Wu, Xiaobing Zhai, Jiangxue Wang, Yudu Liu, Yuanyuan Wu, Yangxi Huang, Miao Zhou, Bing Xiang, Mei Yang, Xinyan Xie, Jing Zeng","doi":"10.1136/fmch-2025-003349","DOIUrl":"10.1136/fmch-2025-003349","url":null,"abstract":"<p><strong>Background: </strong>To investigate the relationship of age at first separation from parents (AFSP) with suicidal ideation (SI), suicide planning (SP) and suicide attempts (SA) among left-behind children (LBC) in China and the mediating effect of traumatic events (TEs).</p><p><strong>Methods: </strong>This cross-sectional study employed a multistage sampling method to conduct questionnaire surveys in six high-concentrated LBC provinces. Logistic regression and restricted cubic splines were performed to investigate the association of AFSP with SI, SP and SA, and meta-analysis (I²) was used to assess the heterogeneity. Causal mediation analysis (structural equation modelling) was used to evaluate the mediating effect of TEs, and bootstrap resampling was employed to assess the robustness of the causal mediation analysis.</p><p><strong>Results: </strong>A total of 12 162 (6269 LBC) participants were included in this study; the prevalence rates of SI, SP and SA among LBC were 30.7%, 18.6% and 11.9%; and LBC had a higher risk of SI (OR: 1.32), SP (OR: 1.40) and SA (OR: 1.25) than non-LBC, all p<0.001. AFSP was negatively associated with SI, SP and SA, particularly peaking before 2 years old. LBC with AFSP <2 years old had a higher risk of SI (OR 2.65; 95% CI 2.17 to 3.24; p<0.001), SP (OR 2.63; 95% CI 3.36 to 4.29; p<0.001) and SA (OR 2.04; 95% CI 2.73 to 3.63; p<0.001). TEs mediated the increased risk of SI (average causal mediation effect (ACME) 0.03-0.07; proportion (Prop) 40-54%; all p<0.001), SP (ACME 0.03-0.06; Prop 39-61%; all p<0.001) and SA (ACME 0.02-0.04; Prop 53-80%; all p<0.01).</p><p><strong>Conclusions: </strong>We found that AFSP was associated with SI, SP and SA, mediated by TEs. Our findings supported the necessity of reducing SI, SP and SA risks among LBC and highlighted the need to consider AFSPs and TEs in intervention strategies.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"13 3","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12265772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experiences, perceptions and attitudes on providing advice on physical activity to patients with chronic ischaemic heart disease: a qualitative study in general practitioners in Germany.","authors":"Alicia Prinz, Sabrina Hoppe, Verena Leve, Rik Crutzen, Norbert Donner-Banzhoff, Stefan Wilm, Sabrina Kastaun","doi":"10.1136/fmch-2024-003124","DOIUrl":"10.1136/fmch-2024-003124","url":null,"abstract":"<p><strong>Background and objective: </strong>The WHO emphasises the importance of integrating advice on physical activity (PA) into primary care of patients with chronic ischaemic heart disease (IHD). Similarly, the German treatment guideline 'Chronic Coronary Heart Disease' recommends that general practitioners (GPs) provide advice on PA to IHD patients. However, the provision of PA advice seems to be inadequately implemented in general practice. One reason is the lack of medical training in providing PA advice effectively and efficiently. International guidelines recommend such training for health professionals. This study aims to explore experiences, perceptions and attitudes, including barriers and facilitators of GPs towards the routine delivery of PA advice to IHD patients.</p><p><strong>Methods: </strong>Between March and June 2023, 12 face-to-face problem-centred interviews and six focus group discussions (n=37) with GPs were conducted. Interview and discussion guides were developed and pilot tested by the multi-professional study team. We used a purposive sampling strategy, and data were collected in an iterative process. Audio-recorded data were transcribed verbatim and analysed using a content structuring procedure (deductive and inductive approach). GPs were involved throughout the entire research process, for example, in multi-professional analysis groups.</p><p><strong>Results: </strong>Although GPs are mostly aware of the health benefits of PA for patients with IHD, PA advice is not routinely provided. Conversations on PA tend to be rather unstructured, and advice is often addressed more generally than customised to the patients' needs and preferences. Priority is given to other lifestyle issues, such as smoking cessation. PA advice is perceived as time-consuming and rather ineffective with regard to the target behaviour. GPs frequently express frustration in this context. GPs express a lack of and simultaneously a need for communication strategies (structure and tools) that can be integrated into everyday GP practice to motivate patients to PA.</p><p><strong>Conclusion: </strong>The results provide relevant insights into the current practice of GPs with regard to their attitudes on, experiences with, and requirements for the provision of PA advice to IHD patients. These results are helpful to inform the development of appropriate GP training in the provision of very brief PA advice to IHD patients.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"13 3","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12228453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ending nuclear weapons, before they end us.","authors":"Chris Zielinski","doi":"10.1136/fmch-2025-003434","DOIUrl":"10.1136/fmch-2025-003434","url":null,"abstract":"","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"13 2","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12086871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prescribing medications to patients living with a visual impairment: a qualitative study of physicians to explore their usual clinical practices.","authors":"Théodora Merenda, Zélie Sibilles, Jennifer Denis, Jean-Pierre Sabot, Stéphanie Patris","doi":"10.1136/fmch-2024-003253","DOIUrl":"https://doi.org/10.1136/fmch-2024-003253","url":null,"abstract":"<p><strong>Objectives: </strong>Visual impairment is a disability affecting a large number of people worldwide, who are more likely to experience difficulties in their daily lives, impacting on their quality of life, independence, mobility and state of health. However, there is a lack of progress in the field of healthcare for individuals living with a visual impairment. The objectives of this study were (1) to illustrate the usual clinical practices of physicians to support the care of individuals with a visual impairment and (2) to identify the components considered to reduce risks resulting from the prescription of medications to these individuals.</p><p><strong>Methods and analysis: </strong>Semi-structured interviews were conducted with French-speaking physicians via videoconference in Belgium. Participants were recruited voluntarily and using the snowball method. An interview guide was developed to meet the objectives of the study. Interviews were carried out until theoretical data saturation, recorded, transcribed <i>verbatim</i> and analysed in a double-blind fashion using thematic analysis. Data were organised using NVivo V.14 software.</p><p><strong>Results: </strong>Three themes were addressed in the 24 interviews: consultation with patients with a visual impairment, prescribing medications to patients with a visual impairment and medication risk management for patients with a visual impairment. Most participants reported that they had not received specific education in visual impairment. Some physicians reported that they did not differentiate between patients living with a visual impairment and other patients, while others reported taking some additional measures.</p><p><strong>Conclusions: </strong>This qualitative study highlighted a lack of knowledge and awareness among physicians regarding visual impairment and at-risk medications in these patients. The development of recommendations and tools is a solution to improve the quality of care for patients living with a visual impairment.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"13 2","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frailty reversal and its main determinants: a population-based observational and longitudinal study.","authors":"Mateu Serra-Prat, Aida Fortuny Borsot, Emili Burdoy, Àngel Lavado Cuevas, Laura Muñoz Ortiz, Mateu Cabré","doi":"10.1136/fmch-2024-003250","DOIUrl":"https://doi.org/10.1136/fmch-2024-003250","url":null,"abstract":"<p><strong>Background: </strong>Clinical guidelines recommend frailty screening for the aged population, given that frailty is frequently reversible. However, little is known about frailty and prefrailty reversal rates in the general population if no specific interventions have been implemented.</p><p><strong>Aim: </strong>To assess real-world frailty and prefrailty reversal rates in the general population aged ≥65 years, the main contributing clinical conditions and the main risk factors for reversing frailty and prefrailty.</p><p><strong>Methods: </strong>Observational longitudinal 12-month study (2019) of all 1·5 million persons aged ≥65 years in Catalonia. Data were retrospectively collected from various health databases through the Catalan Public Data Analysis for Health Research and Innovation (PADRIS) V.2022 programme. Frailty status according to the electronic Screening Index for Frailty (e-SIF) was determined for 31 December 2018 and for 31 December 2019.</p><p><strong>Results: </strong>The study included 1 465 312 Catalan inhabitants (mean age 75.8 years, 57.0% women). The annual frailty and pre-frailty reversal rates were 7.1% and 4.6%, respectively. Both rates were higher in men and decreased with age. The e-SIF components with the greatest impact on frailty reversal were non-planned hospitalisations, polypharmacy, orthostatic hypotension or syncope, anaemia and visual impairment. Female sex, age, dependency, ≥2 comorbidities and polypharmacy had an independent protective effect on 12-month frailty and pre-frailty reversals.</p><p><strong>Conclusions: </strong>Prefrailty and frailty are reversible, but reversal is unlikely in cases of multimorbidity, polypharmacy and functional dependency in older and severely frail individuals. Interventions that mainly target the avoidance of non-planned hospitalisations, polypharmacy and falls would have the greatest impact on reversing frailty and pre-frailty.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"13 2","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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 the COVID-19 pandemic on individuals with chemical intolerance.","authors":"Raymond F Palmer, David Kattari, Monica Verduzco-Gutierrez","doi":"10.1136/fmch-2024-003081","DOIUrl":"https://doi.org/10.1136/fmch-2024-003081","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to determine if the COVID-19 pandemic had differential effects on individuals with chemical intolerances (CI). CI is characterised by multisystem symptoms initiated by a one-time high dose or persistent low-dose exposure to environmental toxins including chemicals, foods and drugs. With an estimated 20% US prevalence, symptoms include fatigue, headache, weakness, rash, mood changes, musculoskeletal pain, gastrointestinal issues, difficulties with memory, concentration and respiratory problems, which are similar to COVID-19 and its sequelae.</p><p><strong>Design: </strong>A US population-based survey involving 7500 respondents was asked if they ever had COVID-19, what the severity was, and if they had long COVID-19. CI was assessed using the Quick Environmental Exposure and Sensitivity Inventory.</p><p><strong>Setting: </strong>The Center for Disease Control estimates that over 24 million have been infected with COVID-19 in the USA with over 6 700 000 being hospitalised and over 1 174 000 deaths. Other industrialised countries show similar numbers.</p><p><strong>Results: </strong>Those in the High CI class reported a greater COVID-19 prevalence, symptom severity and long COVID-19 than in the medium and low CI groups (p<0.0001). These associations were independent of race, ethnicity, income, age and sex. However, there were significantly increased odds of COVID-19 severity among women and those over 45 years old. Asian individuals were least likely to have severe symptoms compared with white individuals (OR=0.53; 95% CI 0.35 to 0.79). Black/African American individuals reported a lower prevalence of COVID-19 than non-Hispanic whites. However, one interaction between CI and race was significant, African Americans with high CI reported greater odds (OR=2.2; 95% CI 1.15 to 3.16) of reporting COVID-19 prevalence. Furthermore, African American individuals had significantly greater odds of increased symptom severity.</p><p><strong>Conclusion: </strong>Prior studies show higher risk for COVID-19 among older age groups, male sex, those with pre-existing comorbidities (eg, challenged immunities) and those from minoritised racial/ethnic groups. The results of this study suggest that those with CI be included in a high-risk group. Various risk subsets may exist and future investigations could identify different risk subsets. Understanding these subgroups would be helpful in mounting targeted prevention efforts.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"13 2","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035467/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144037692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of different types of physical exercise on sleep quality in older population with insomnia: a systematic review and network meta-analysis of randomised controlled trials.","authors":"Pakwan Bahalayothin, Kittiphon Nagaviroj, Thunyarat Anothaisintawee","doi":"10.1136/fmch-2024-003056","DOIUrl":"10.1136/fmch-2024-003056","url":null,"abstract":"<p><strong>Objective: </strong>To measure the impact of each type of exercise on sleep quality and identify the exercise that enhances sleep quality the most.</p><p><strong>Study selection: </strong>Eligible randomised controlled trials that compare physical exercise to routine activities, usual care, non-physical activity, or health education to measure the Pittsburgh Sleep Quality Index.</p><p><strong>Data source: </strong>Studies retrieved from Medline, Embase, CINAHL, Scopus, ClinicalTrial.gov and ThaiJo from the database's inception to October 2022.</p><p><strong>Data extraction and synthesis: </strong>Two reviewers independently identified studies, collected data and assessed bias. In the absence of heterogeneity, a fixed effect model was used for pairwise meta-analysis. Alternatively, a random effect model was used. A two-stage network meta-analysis used the surface under the cumulative ranking curve (SUCRA) to compare exercise efficacy.</p><p><strong>Main outcome: </strong>Global Pittsburgh Sleep Quality Index (GPSQI) and subdomain score.</p><p><strong>Results: </strong>This review comprised 2170 people from 25 trials. Direct meta-analysis revealed significant improvement in GPSQI with combined exercise (unstandardised mean difference (USMD) -2.35, 95% CI-3.13 to -1.57, p<0.001, I²=69.13%). GPSQI decreased considerably with aerobic activity (USMD -4.36, 95% CI -7.86 to -0.86, p=0.01, I²=97.83%). For the network meta-analysis, strengthening, aerobic and combination exercise significantly lowered GPSQI (USMD-5.75, -3.76 and -2.54, respectively). Strength training improved GPSQI scores most effectively (SUCRA 94.6%).</p><p><strong>Conclusion: </strong>Exercise that strengthens muscles, rather than aerobic or combination exercises, is the most effective way to enhance sleep quality.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"13 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11891529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}