Worldviews on Evidence-Based Nursing最新文献

{"title":"Effectiveness of Sensor-Based Fall Prevention Systems in Hospitals: A Systematic Review and Meta-Analysis.","authors":"Mingliang Zheng, Tingting Yan, Xingyanan Wang, Yan Yin, Ting Yu, Xiliang Li, Shuli Luo, Zhitian Xiao","doi":"10.1111/wvn.70184","DOIUrl":"10.1111/wvn.70184","url":null,"abstract":"<p><strong>Objective: </strong>To synthesize evidence on the effectiveness of hospital sensor-based fall prevention systems and examine whether technology type, patient risk, and implementation strategy modify their impact.</p><p><strong>Methods: </strong>We searched MEDLINE, Embase, CINAHL, CENTRAL, Web of Science, and trial registries through April 30, 2025. Interventional studies evaluating hospital sensor-based fall prevention systems were eligible, including randomized controlled trials and quasi-experimental designs. Two reviewers independently extracted data and assessed risk of bias using the Cochrane Risk of Bias tools. Random-effects meta-analyses applied the Paule-Mandel estimator with Hartung-Knapp-Sidik-Jonkman adjustment. Incidence rate ratios (IRR) were pooled for fall rates and fall-related injuries, and odds ratios (OR) for patients with at least one fall. Subgroup analyses examined technology generation and risk profile, with restricted analyses for mandated implementation. Certainty of evidence was rated with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.</p><p><strong>Results: </strong>Sixteen studies were included, seven in meta-analysis. No significant impact was found for fall rates (IRR 0.77, 95% CI 0.38-1.58; I² = 92%), fallers (OR 1.24, 95% CI 0.76-2.02; I² = 73%), or fall-related injuries (IRR 0.98, 95% CI 0.81-1.18; I² = 0%). Machine learning-based systems reduced fall rates (IRR 0.50, 95% CI 0.32-0.79), while rule-based systems did not. Mandatory implementation was associated with lower fall rates (IRR 0.51, 95% CI 0.37-0.70) but not fewer fallers. Certainty of evidence ranged from very low to low.</p><p><strong>Conclusion: </strong>Sensor-based systems showed no consistent benefit for preventing hospital falls or injuries, though machine learning and mandated use appeared more promising. Given the limited number of trials, heterogeneity, and low certainty, further research should focus on rigorous evaluation, workflow integration, and cost-effectiveness.</p><p><strong>Register: </strong>This review was registered with PROSPERO (CRD420251123960; registered on 11 August 2025).</p><p><strong>Clinical trial number: </strong>not applicable.</p>","PeriodicalId":49355,"journal":{"name":"Worldviews on Evidence-Based Nursing","volume":"23 5","pages":"e70184"},"PeriodicalIF":5.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149129012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Advance Care Planning and Place of Death: A Systematic Review and Meta-Analysis.","authors":"Minsung Kim, Minji Mun, Hana Lee, Kyungmi Woo","doi":"10.1111/wvn.70179","DOIUrl":"10.1111/wvn.70179","url":null,"abstract":"<p><strong>Background: </strong>Place of death is a key indicator of quality in end-of-life care, reflecting how well care aligns with patients' values and preferences. Advance care planning (ACP) has been proposed to support goal-concordant care, yet evidence regarding its association with actual place of death remains inconsistent.</p><p><strong>Objective: </strong>To examine the association between participation in ACP and place of death and to explore whether this association varies according to ACP implementation method.</p><p><strong>Methods: </strong>In this systematic review and meta-analysis, we searched five databases (PubMed, Embase, PsycInfo, CINAHL, and ProQuest) for studies published in English from inception to September 2025. Studies of adults engaged in ACP and reporting actual place of death were included. Random-effects meta-analyses were conducted, with subgroup analyses by documentation-based or discussion-based ACP implementation methods. Risk of bias and certainty were assessed using RoB 2, ROBINS-I V2, and GRADE.</p><p><strong>Results: </strong>Of 4216 records, 13 studies were included. ACP was associated with increased home death and reduced hospital death, with considerable heterogeneity. For home death, discussion-based implementation showed a significant association, whereas documentation-based implementation did not. For hospital death, both implementation methods were associated with reduced odds.</p><p><strong>Linking evidence to action: </strong>ACP is associated with place of death, but its impact appears to depend on how it is implemented. These findings suggest that ACP should be approached as a communication-centered process rather than solely as documentation. Clinicians should prioritize facilitated discussions that clarify patient values and preferences, and integrate them into care planning. Future implementation efforts should focus on strengthening communication processes and care coordination to support goal-concordant end-of-life care, particularly in enabling home-based death.</p><p><strong>Protocol registration: </strong>PROSPERO (CRD420251236312).</p>","PeriodicalId":49355,"journal":{"name":"Worldviews on Evidence-Based Nursing","volume":"23 5","pages":"e70179"},"PeriodicalIF":5.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing Clinical Nurses' and Nurse Leaders' Perceptions of a Healthy Work Environment: An Integrative Review.","authors":"Mildred Ortu Kowalski, Susan Heidenwolf Weaver, Kari A Mastro","doi":"10.1111/wvn.70181","DOIUrl":"https://doi.org/10.1111/wvn.70181","url":null,"abstract":"<p><strong>Background: </strong>Differences in perceptions of clinical nurses and nurse leaders have been observed and reported. Such differences can impact organizational outcomes and overall workplace environment.</p><p><strong>Objectives: </strong>The objective of this study was to provide an integrative global review and synthesis of published literature comparing perceptions of clinical nurses and nurse leaders of the work environment in acute care settings.</p><p><strong>Methods: </strong>Five databases were searched for quantitative, qualitative, and mixed methods studies published in English within the last 10 years; publications were peer reviewed. An appraisal of articles meeting review criteria was conducted using the Johns Hopkins method. Selected studies were reviewed both independently and collaboratively by the authors.</p><p><strong>Results: </strong>The final sample consisted of 23 publications from five countries. The sample included 16 quantitative studies, five qualitative studies, and two mixed method studies. In articles, findings identified some similarities (22%) in perspectives of clinical nurses and nurse leaders of the work environment, but more differences were reported (78%). Areas identified were classified using the American Association of Critical Care Nurses standards established for a healthy workplace environment.</p><p><strong>Discussion: </strong>A global phenomenon of differences in perceptions between clinical nurses and nurse leaders was supported by this integrative review. Such differences impact nurse satisfaction, turnover, and patient outcomes. Interventions to shrink the gap in perceptual differences between clinical nurses and nurse leaders warrant further research exploration. The value of leadership education, highlighting authentic leadership traits, is prioritized for consideration. To be effective globally, cultural practices must be taken into consideration. Importantly, objective outcomes following structured education must be reported.</p>","PeriodicalId":49355,"journal":{"name":"Worldviews on Evidence-Based Nursing","volume":"23 5","pages":"e70181"},"PeriodicalIF":5.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Virtual Reality to Reduce Procedural Anxiety During Breast Biopsy: A Randomized Controlled Trial.","authors":"Renee Trambert, Paul Friedman, Naveed Jan, Colleen Smorra, Diane Caruso, Jennifer Ribaudo, Mildred Ortu Kowalski, Beth Jameson, Lise Cooper, John Rutledge","doi":"10.1111/wvn.70183","DOIUrl":"https://doi.org/10.1111/wvn.70183","url":null,"abstract":"<p><strong>Background/significance: </strong>Breast biopsies are essential for cancer diagnoses and are often accompanied by heightened procedural anxiety. While local anesthesia addresses procedural pain, it does not lessen psychological distress. Virtual reality (VR) has been explored as a distraction-based intervention that may reduce procedural anxiety.</p><p><strong>Aims: </strong>This study evaluated the effects of standard care plus VR compared to standard care alone on patient anxiety, pain, and satisfaction during ultrasound-guided breast biopsy.</p><p><strong>Methods: </strong>A single-site, two-arm randomized controlled trial (n = 80) compared standard care to standard care plus the use of VR during the ultrasound-guided breast biopsy procedure. Data were collected between 9/2024 and 5/2025. Study participants were randomized 1:1 to receive either standard care (control group) or standard care plus VR use (intervention group). Anxiety and pain were assessed pre- and post-procedure using 11-point numeric rating scales; satisfaction was measured post-procedure. Open-ended responses from the intervention group were analyzed thematically.</p><p><strong>Results and findings: </strong>Study participants in the intervention group demonstrated significantly greater anxiety reduction compared to the control group (p < 0.001). Pain scores did not differ significantly between groups (p = 0.37). Satisfaction was uniformly high in both groups. Thematic analysis of open-ended responses from the intervention group identified themes related to anxiety reduction, distraction, and perceptions of VR use during the breast biopsy procedure.</p>","PeriodicalId":49355,"journal":{"name":"Worldviews on Evidence-Based Nursing","volume":"23 5","pages":"e70183"},"PeriodicalIF":5.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence Anxiety, Impostor Phenomenon, and Workplace Deviant Behavior Among Nurses: A Three Wave Longitudinal Study.","authors":"Hangna Qiu, Yongkang Fu, Dongrun Liu, Zhengyi Ma, Juntong Jing, Chaoran Chen, Enshe Jiang, Jiangong Ma","doi":"10.1111/wvn.70180","DOIUrl":"https://doi.org/10.1111/wvn.70180","url":null,"abstract":"<p><strong>Background: </strong>The widespread application of artificial intelligence technologies in healthcare has intensified nurses' perceptions of technological replacement and role uncertainty, making artificial intelligence anxiety an increasingly important occupational psychological risk factor. The impostor phenomenon may play a critical mediating role between anxiety and workplace deviant behavior; however, longitudinal evidence remains limited.</p><p><strong>Objective: </strong>To examine the dynamic relationship between artificial intelligence anxiety and workplace deviant behavior among nurses, and to test the longitudinal mediating role of the impostor phenomenon.</p><p><strong>Methods: </strong>A three wave longitudinal design was employed to conduct a 6-month longitudinal survey among 594 clinical nurses. Structural equation modeling was used to examine the longitudinal relationships among the study variables.</p><p><strong>Result: </strong>Across the three waves, artificial intelligence anxiety, impostor phenomenon, and workplace deviant behavior were significantly correlated. Longitudinal mediation analyses indicated that artificial intelligence anxiety had a significant direct effect on subsequent workplace deviant behavior and that the impostor phenomenon significantly mediated the relationship between artificial intelligence anxiety at T1 and workplace deviant behavior at T3.</p><p><strong>Linking evidence to action: </strong>Establishing routine monitoring and early-warning mechanisms for technology-related psychological stress, together with personalized support strategies that enhance perceived technological control and reinforce the core values of humanistic nursing care, may effectively reduce nurses' cognitive distortions and mitigate workplace deviant behavior.</p>","PeriodicalId":49355,"journal":{"name":"Worldviews on Evidence-Based Nursing","volume":"23 5","pages":"e70180"},"PeriodicalIF":5.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Nurse Specialists' Perceptions of Competency and Self-Efficacy in Evidence-Based Practice and Implementation Science.","authors":"Amy Shay, Molly McNett, Sharon Tucker, Janet S Fulton","doi":"10.1111/wvn.70174","DOIUrl":"10.1111/wvn.70174","url":null,"abstract":"<p><strong>Background: </strong>Research and demonstration projects have shown that the Clinical Nurse Specialist (CNS) role is uniquely suited to lead implementation of evidence-based clinical practice changes for improved outcomes and reduced costs to healthcare systems. CNS practice competencies closely align with the design, development, and implementation of evidence-based practice change. National data on CNS's knowledge and use of implementation science to guide EBP implementation is lacking.</p><p><strong>Aims: </strong>A CNS professional organization implementation science team and a university evidence-based practice center collaborated on this research to identify self-reported competencies, experiences, and strategies of CNSs when implementing evidence-based practices across healthcare settings.</p><p><strong>Methods: </strong>This cross-sectional observational study used a survey design with a sample of 167 CNS professional organization members. Survey instruments included the Evidence-Based Practice (EBP) Competency Tool, EBP Implementation Strategies Self-Efficacy Scale, and the Implementation Experience Survey to describe aggregate self-reported competencies and experiences with EBP and project implementation.</p><p><strong>Results: </strong>Demographics revealed most CNSs have no EBP training (54.5%) or implementation science training (74.3%) beyond degree preparation. The mean EBP Competency score was 79.3%. The mean EBP Implementation Strategies Self-Efficacy Scale score was 79.8%. Most participants reported using less than half the survey-identified EBP activities and implementation strategies. Implementation Experience Survey results showed participants rated maintaining EBP change as more difficult and less successful than starting or completing EBP implementation practice change.</p><p><strong>Linking evidence to action: </strong>CNSs reported confidence with EBP, but the majority are not guided by EBP models. This raises questions about the quality of evidence appraisal and synthesis. Results suggest a disconnect between self-perception of EBP and implementation science competence levels and real-world use of EBP models and implementation science methods. Educational support is needed to improve confidence in advanced EBP and implementation science competencies.</p>","PeriodicalId":49355,"journal":{"name":"Worldviews on Evidence-Based Nursing","volume":"23 5","pages":"e70174"},"PeriodicalIF":5.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13581206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148983834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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 Cognitive Behavioral Therapy on Fall Prevention for Older Adults: A Meta-Analysis.","authors":"Ita Daryanti Saragih, Ira Suarilah, Hsun-Kuei Ko, Karolus Wangi, Bih-O Lee","doi":"10.1111/wvn.70161","DOIUrl":"10.1111/wvn.70161","url":null,"abstract":"<p><strong>Background: </strong>Falls among older adults are a major public health issue and the leading cause of injury-related deaths. They affect older adults' physical, social, and psychological well-being. Although CBT-based interventions show promise for fall prevention, they have not yet been specifically applied to this population.</p><p><strong>Aims: </strong>To evaluate and synthesize the effects of cognitive behavioral therapy (CBT) on older adults' fear of falling, perceived consequences of falls, physical performance, and balance: METHODS: A systematic search of Academic Search Complete, CINAHL Plus with Full Text, Cochrane Library, Embase, Medline, PubMed, and Web of Science was performed, from database inception to March 8, 2025, to find randomized trials applying CBT to prevent falls among older adults. The Cochrane risk-of-bias tool for randomized trials was used to assess the risk of bias of the studies included. A random-effects DerSimonian-Laird model with a 95% confidence interval was used to estimate the pooled standardized mean differences (SMDs) of outcomes.</p><p><strong>Result: </strong>Seventeen studies were included in the final analysis. CBT in combination with exercise was found to reduce fear of falling (pooled SMD = -0.25; 95% CI = -0.41 to -0.09; I² = 22.22%) and improve balance (pooled SMD = 0.79; 95% CI = 0.56-1.01; I² = 0.00%; p < 0.001) in older adults. The findings of this study can guide future research on developing CBT-based interventions to maximize the benefits of this modality for preventing falls among older adults. This study suggests that CBT in combination with exercise is effective for preventing falls among older adults. CBT also appears to benefit older adults by reducing their fear of falling and improving balance. The intervention duration should be considered to achieve a meaningful effect on fall prevention for this population.</p>","PeriodicalId":49355,"journal":{"name":"Worldviews on Evidence-Based Nursing","volume":"23 4","pages":"e70161"},"PeriodicalIF":5.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13351814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148425667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Relationship Between Transition Shock and Maintaining Professional Membership Among Newly Graduated Nurses: The Mediating Role of Work Engagement.","authors":"Berra Yilmaz Kusakli, Hanife Tiryaki Sen","doi":"10.1111/wvn.70159","DOIUrl":"10.1111/wvn.70159","url":null,"abstract":"<p><strong>Background: </strong>The transition from student to professional nurse represents a significant challenge for Newly Graduated Nurses (NGNs). The first year of practice is often considered a critical period of adaptation, during which transition shock and the level of work engagement can significantly influence their intention to remain in the profession.</p><p><strong>Purpose: </strong>This study investigated the mediating role of work engagement in the relationship between transition shock and maintaining professional membership among NGNs.</p><p><strong>Methods: </strong>A total of 374 NGNs employed at a city hospital constituted the participants in this correlational and cross-sectional study. Three scales were used to collect data: the Nursing Transition Shock Scale, the Maintaining Professional Membership Scale, and the Utrecht Work Engagement Scale (UWES-3). Data were collected between April 2024 and May 2024.</p><p><strong>Results: </strong>The mean level of transition shock among NGNs was indicating moderate shock, while the mean scores for maintaining professional membership and work engagement were above average. Transition shock was found to have a negative effect on maintaining professional membership. In addition, work engagement had an indirect effect on the correlation between transition shock and maintaining professional membership.</p><p><strong>Linking evidence to action: </strong>Work engagement plays a vital mediating role in buffering the negative impact of transition shock on newly graduated nurses. Healthcare leaders can enhance nurses' ability to maintain their professional membership and reduce turnover by implementing targeted strategies that actively foster work engagement and ease the transition to practice.</p>","PeriodicalId":49355,"journal":{"name":"Worldviews on Evidence-Based Nursing","volume":"23 4","pages":"e70159"},"PeriodicalIF":5.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13350999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148425639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Qualitative Evaluation of Nurses' Perceptions of De-Escalation and Resilience Training for Workplace Violence Prevention.","authors":"Sayed Ibrahim Ali, Mostafa Shaban","doi":"10.1111/wvn.70170","DOIUrl":"10.1111/wvn.70170","url":null,"abstract":"<p><strong>Significance/background: </strong>Workplace violence is a persistent threat to nurses' safety, well-being, and retention, particularly in acute care settings where patient acuity, time pressure, and emotionally charged interactions can heighten the risk of aggression. De-escalation training is increasingly recommended as a workplace violence prevention strategy, while resilience-oriented support may help nurses cope with the psychological consequences of exposure. However, less is known about how nurses experience these forms of training in routine acute care practice and what contextual factors influence their uptake and usefulness.</p><p><strong>Aims: </strong>To explore nurses' experiences with de-escalation training and resilience support in the context of workplace violence prevention and to identify factors influencing their perceived usefulness and sustained application in acute care settings.</p><p><strong>Methods: </strong>A qualitative study guided by interpretive description and informed by the Consolidated Framework for Implementation Research was conducted in acute care facilities in the Al-Ahsa region, Saudi Arabia. Purposive sampling was used to recruit 20 registered nurses from emergency, medical-surgical, and critical care units who had participated in workplace violence-related training within the previous 12 months. Data were collected through semi-structured interviews and analyzed using reflexive thematic analysis.</p><p><strong>Results/findings: </strong>Four themes were identified: (1) training as a foundation for confidence and psychological preparedness, (2) organizational climate as a determinant of training usefulness, (3) barriers to translating training into practice, and (4) the need for system-level integration for sustainable workplace violence prevention. Participants viewed de-escalation training as strengthening communication and situational response skills, while resilience support was perceived as helping nurses manage stress reactions and recover after difficult incidents. However, staffing pressures, inconsistent reporting pathways, and variable leadership support limited sustained application.</p><p><strong>Linking evidence to action: </strong>Effective workplace violence prevention requires more than staff education alone. Healthcare organizations should embed de-escalation training within mandatory competency development, pair it with structured psychological support after incidents, and strengthen leadership engagement, reporting systems, and interdisciplinary coordination to promote safer acute care environments.</p>","PeriodicalId":49355,"journal":{"name":"Worldviews on Evidence-Based Nursing","volume":"23 4","pages":"e70170"},"PeriodicalIF":5.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13433968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Non-Pharmacological Interventions in Improving Health-Related Quality of Life in People Living With HIV: A Bayesian Network Meta-Analysis of Randomized Controlled Trials.","authors":"Mingyue Shi, Yunxian Zhou","doi":"10.1111/wvn.70167","DOIUrl":"10.1111/wvn.70167","url":null,"abstract":"<p><strong>Background: </strong>With antiretroviral therapy, HIV has become a manageable chronic condition, shifting focus to improving health-related quality of life (HRQoL). Non-pharmacological interventions offer distinct advantages for optimizing long-term health outcomes in people living with HIV.</p><p><strong>Objectives: </strong>To identify optimal non-pharmacological interventions for improving overall HRQoL and its domains (physical, psychological, social, environmental, independence, spiritual).</p><p><strong>Methods: </strong>Ten databases (Embase, MEDLINE, Web of Science Core Collection, CINAHL, PsycINFO, CENTRAL, CBM, CNKI, VIP Information, Wanfang Data) were searched from inception to August 2025. Bayesian network meta-analyzes were performed for direct and indirect comparisons. The Cochrane Rob-2 and the CINeMA tools were used to assess risk of bias and the certainty of evidence, respectively.</p><p><strong>Results: </strong>37 articles were included. Exercise was most effective for overall HRQoL (SMD = 1.00, 95% CI [0.43, 1.58]) and physical (SMD = 0.69, 95% CI [0.11, 1.27]), psychological (SMD = 0.93, 95% CI [0.37, 1.51]), and social (SMD = 0.57, 95% CI [0.06, 1.08]) domains. Mindfulness-based interventions ranked second for overall HRQoL (SMD = 0.82, 95% CI [0.24, 1.40]). Cognitive behavioral therapy ranked second in the psychological domain (SMD = 0.73, 95% CI [0.16, 1.29]). Insufficient data precluded network meta-analysis for environmental, independence, and spiritual domains.</p><p><strong>Linking evidence to action: </strong>Future research should explore how different exercise types affect specific HRQoL dimensions and conduct large-scale, head-to-head RCTs to confirm the efficacy of exercise, cognitive behavioral therapy, and mindfulness interventions, especially for the environmental, independence, and spiritual domains. Methodological improvements-including blinding of outcome assessors, intention-to-treat analysis, standardized measurement tools, and protocol transparent reporting-are needed.</p><p><strong>Trial registration: </strong>PROSPERO: CRD420251118087.</p>","PeriodicalId":49355,"journal":{"name":"Worldviews on Evidence-Based Nursing","volume":"23 4","pages":"e70167"},"PeriodicalIF":5.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148594046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}