Worldviews on Evidence-Based Nursing最新文献

{"title":"The Effectiveness of Instant Messaging-Based Interventions on Health Behavior Change: A Systematic Review and Meta-Analysis.","authors":"Tianxue Hou, Mu-Hsing Ho, Huangqianyu Li, Chia-Chin Lin","doi":"10.1111/wvn.70066","DOIUrl":"10.1111/wvn.70066","url":null,"abstract":"<p><strong>Background: </strong>Instant messaging-based applications are increasingly used to deliver interventions designed to promote health behavior change. However, the effectiveness of these interventions has not been evaluated.</p><p><strong>Aims: </strong>This systematic review and meta-analysis aimed to evaluate the effectiveness of instant messaging-based interventions on health behavior change, addressing a gap in the literature regarding the impact of instant messaging on various health behaviors.</p><p><strong>Methods: </strong>We conducted comprehensive searches of six electronic databases (PubMed, EMBASE, Cochrane Library, PsycINFO, CINAHL Plus, and Web of Science) from their inception until July 2024, utilizing terms related to health behavior and instant messaging. Two authors independently screened studies and extracted data. Randomized controlled trials published in English that investigated the effects of instant messaging-based interventions on health behavior change, including physical activity, sedentary behavior, sleep, diet/nutrition, cancer screening, smoking cessation, and alcohol consumption were included. We used the revised Cochrane Risk-of-Bias Tool to assess the quality of the studies.</p><p><strong>Results: </strong>Fifty-seven randomized controlled trials published between 2014 and 2024 were included. The results showed that compared with the control groups, instant messaging-based interventions had statistically significant differences in physical activity (SMD = 0.52, 95% CI [0.21, 0.83], p < 0.001) and sleep (SMD = -0.93, 95% CI [-1.44, -0.42], p < 0.001). It also significantly impacted smoking cessation (OR = 1.88, 95% CI [1.28, 2.7], p < 0.001). However, it did not influence sedentary behavior (SMD = 0.25, 95% CI [-0.24, 0.74], p = 0.01) or diet/nutrition (SMD = 0.01, 95% CI [-0.31, 0.34], p < 0.001).</p><p><strong>Linking evidence to action: </strong>Instant messaging-based interventions are promising in enhancing health behavior change, including physical activity, sleep, and smoking cessation. Leveraging real-time communication and multimedia content can improve patient engagement and intervention effectiveness.</p>","PeriodicalId":49355,"journal":{"name":"Worldviews on Evidence-Based Nursing","volume":"22 4","pages":"e70066"},"PeriodicalIF":5.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12301180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144734857","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":"Defining and Measuring Opiophobia: A Systematic Review.","authors":"Karen E Alsbrook, Eileen Danaher Hacker","doi":"10.1111/wvn.70065","DOIUrl":"10.1111/wvn.70065","url":null,"abstract":"<p><strong>Background: </strong>\"Opiophobia\" lacks a clear definition and measurement, but it is commonly used by researchers and healthcare professionals in pain management to describe the underutilization of opioids by patients, caregivers, prescribers, and other healthcare professionals. This inconsistency complicates research and clinical interventions.</p><p><strong>Objective: </strong>This systematic review aimed to comprehensively evaluate the conceptualization and operationalization of opiophobia across quantitative studies involving adult populations.</p><p><strong>Methods: </strong>Peer-reviewed articles published before July 2024 were retrieved from four bibliographic databases (CINAHL, Embase, MEDLINE, and Scopus) and systematically reviewed. Included studies defined and/or measured opiophobia or opioid stigma among adult patients, family caregivers, and healthcare professionals. The review was conducted in two phases: the first phase provided a comprehensive understanding of study characteristics, while the second phase evaluated the conceptualization and measurement of opiophobia.</p><p><strong>Results: </strong>Thirty-six articles met inclusion criteria. Studies focused on healthcare professionals (n = 23, 64%); adult patients (n = 13, 33%), including 7 studies involving patients with cancer (19%); healthcare professionals and patients (n = 2, 5%); and family caregivers (n = 1, 3%). Among the studies that defined opiophobia (n = 20, 67%), common definitions included fear, prejudice, reluctance, addiction, exaggeration, underutilization, and inappropriate attitudes/beliefs, respectively. Limitations included the predominance of observational designs (n = 32, 89%) and the use of investigator-developed instruments (n = 27, 73%).</p><p><strong>Linking evidence to action: </strong>Instruments measuring opiophobia focused on opioid-related fears and behaviors. Instrument items that measured opiophobia primarily focused on fears and behaviors resulting from these fears. It remains unclear whether opiophobia is solely fear-based or also includes poor adherence to prescribed opioids. The wide variations in definitions and the use of mostly investigator-developed measures led to inconsistencies among studies. Further research is needed to design specific interventions and determine delivery times.</p>","PeriodicalId":49355,"journal":{"name":"Worldviews on Evidence-Based Nursing","volume":"22 4","pages":"e70065"},"PeriodicalIF":3.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754992","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":"Chatbot-Delivered Interventions for Improving Mental Health Among Young People: A Systematic Review and Meta-Analysis.","authors":"Jiaying Li, Yan Li, Yule Hu, Dennis Chak Fai Ma, Xiaoxiao Mei, Engle Angela Chan, Janelle Yorke","doi":"10.1111/wvn.70059","DOIUrl":"10.1111/wvn.70059","url":null,"abstract":"<p><strong>Background: </strong>The characteristics, application, and effectiveness of chatbots in improving the mental health of young people have yet to be confirmed through systematic review and meta-analysis.</p><p><strong>Aim: </strong>This systematic review aims to evaluate the effectiveness of chatbot-delivered interventions for improving mental health among young people, identify factors influencing effectiveness, and examine feasibility and acceptability.</p><p><strong>Methods: </strong>To identify eligible interventional studies, we systematically searched 11 databases and search engines covering a publication period of January 2014 to September 2024. Meta-analyses and subgroup analyses were performed on randomized controlled trials to investigate the effectiveness of chatbot-delivered interventions and potential influencing factors. Narrative syntheses were conducted to summarize the feasibility and acceptability of these interventions in all the included studies.</p><p><strong>Results: </strong>We identified 29 eligible interventional studies, 13 of which were randomized controlled trials. The meta-analysis indicated that chatbot-delivered interventions significantly reduced distress (Hedge's g = -0.28, 95% CI [-0.46, -0.10]), but did not have a significant effect on psychological well-being (Hedge's g = 0.13, 95% CI [-0.16, 0.41]). The observed treatment effects were influenced by factors including sample type, delivery platform, interaction mode, and response generation approach. Overall, this review demonstrates that chatbot-delivered interventions were feasible and acceptable.</p><p><strong>Linking evidence to action: </strong>This review demonstrated that chatbot-delivered interventions had positive effects on psychological distress among young people. Chatbot-delivered interventions have the potential to supplement existing mental health services provided by multidisciplinary healthcare professionals. Future recommendations include using instant messenger platforms for delivery, enhancing chatbots with multiple communication methods to improve interaction quality, and refining language processing, accuracy, privacy, and security measures.</p>","PeriodicalId":49355,"journal":{"name":"Worldviews on Evidence-Based Nursing","volume":"22 4","pages":"e70059"},"PeriodicalIF":5.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12261465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638570","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 Effectiveness of Patient-Centered Digital Empowerment Programs in Hematological Cancer Care: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Merve Gozde Sezgin, Hicran Bektas","doi":"10.1111/wvn.70064","DOIUrl":"10.1111/wvn.70064","url":null,"abstract":"<p><strong>Background: </strong>Hematological cancers impair patients' quality of life (QoL) due to prolonged and complex treatments. Digital empowerment programs enhance patient engagement by supporting symptom management and psychosocial well-being.</p><p><strong>Aims: </strong>This study was conducted to examine the effects of patient-centered digital empowerment programs on hematological cancer care.</p><p><strong>Methods: </strong>As part of this study, a comprehensive search was conducted in nine databases and the gray literature in March 2025. The screening included randomized controlled trials without any time restrictions. This study adhered to the guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Fixed-effect and random-effect models were used in the meta-analysis. Cochran's Q chi-square test and I² statistic were applied to assess heterogeneity. Data analysis was performed using the Comprehensive Meta-Analysis (CMA) 3 software.</p><p><strong>Results: </strong>A total of seven studies were included in this meta-analysis. Patient-centered digital empowerment programs were found to have moderate and positive effects on depression (Hedges' g = 0.27, p < 0.001), distress (Hedges' g = 0.28, p < 0.001), self-efficacy, and QoL (Hedges' g = 0.22, p < 0.001). There was no significant effect on fatigue levels in patients with hematological cancers (p = 0.27), suggesting that digital empowerment programs may not be effective in managing fatigue. The results of the sensitivity analysis support the robustness and reliability of the study findings.</p><p><strong>Linking evidence to action: </strong>Digital empowerment programs may serve as a moderately effective tool in improving depression, distress, self-efficacy, and QoL among patients with hematological cancers. However, they exhibit limited effects on physical symptoms, particularly in fatigue management. Therefore, more comprehensive and multidisciplinary interventions are needed to address the management of physical symptoms effectively. Patient-centered digital empowerment programs enable early intervention by assisting healthcare professionals in symptom tracking. Digital solutions enhance care processes by improving patient education, psychosocial support, and self-management skills.</p>","PeriodicalId":49355,"journal":{"name":"Worldviews on Evidence-Based Nursing","volume":"22 4","pages":"e70064"},"PeriodicalIF":3.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12290137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144709638","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":"Home-Based Exercise for Improving Balance Ability in Post-Stroke Patients: A Systematic Review and Meta-Analysis.","authors":"Xiaofang Li, Chengcheng Wu, Jiayu Zhang, Qunmei Zeng, Yinhua Wang","doi":"10.1111/wvn.70057","DOIUrl":"10.1111/wvn.70057","url":null,"abstract":"<p><strong>Background: </strong>Home-based exercise offers a cost-effective way to receive thorough rehabilitation without the requirement of costly supervised treatment.</p><p><strong>Aim: </strong>To investigate the effects of home-based exercise on the balance ability in post-stroke patients.</p><p><strong>Methods: </strong>A thorough search was carried out on various databases, such as Cochrane Library, Web of Science, PubMed, Embase, and China National Knowledge Infrastructure Library, until October 2024. The inclusion criteria were limited to randomized controlled trials that evaluated the impact of home-based exercise interventions.</p><p><strong>Results: </strong>The meta-analysis indicated that home-based exercise significantly improved static balance ability (Berg Balance Scale [BBS]: MD = 3.45, 95% CI [1.43, 5.47], I² = 71%, p = 0.0008, random-effects model). Conversely, the analysis revealed that the home-based exercise group did not exhibit a statistically significant improvement in the Time up and Go Test (TUG) when compared to the control group (TUG: MD = -0.34, 95% CI [-4.30, 3.61], I² = 96%, p = 0.86, random effects model). The subgroup analysis revealed that home-based exercise significantly enhanced balance ability in patients with subacute stroke (BBS: p < 0.0001; TUG: Overall effect p = 0.02). However, no significant improvement was observed in patients with chronic stroke (BBS: p = 0.39). Regarding the duration of intervention, both short-term and long-term interventions were effective on the BBS (p < 0.0001 and p = 0.0008, respectively), although no significant difference was found for the TUG. Participants engaging in exercise for more than 90 min per week demonstrated greater improvements in balance ability (BBS: p < 0.0001; TUG: p = 0.02). When considering national economic levels, significant effects on the BBS were observed in both developed and developing countries (p = 0.0001 and p < 0.0001, respectively), while significant effects on the TUG were noted only in developing countries (p = 0.04).</p><p><strong>Linking evidence to action: </strong>Home-based exercise interventions showed significant results in improving static balance in patients with subacute stroke, especially home-based exercise that lasted longer than 12 weeks and lasted at least 90 min per week. However, more methodologically rigorous randomized controlled trials are needed to validate these results. In addition, the optimal exercise program and type to optimize the balance ability of stroke patients also need further research.</p>","PeriodicalId":49355,"journal":{"name":"Worldviews on Evidence-Based Nursing","volume":"22 4","pages":"e70057"},"PeriodicalIF":3.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785791","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":"The Effect of Discharge Training Based on Teach-Back Method on Discharge Readiness and Satisfaction: A Randomized Controlled Trial.","authors":"Ayse Gullet, Sevinc Tastan","doi":"10.1111/wvn.70062","DOIUrl":"10.1111/wvn.70062","url":null,"abstract":"<p><strong>Background: </strong>The teach-back method is an effective approach for reinforcing patient education by clarifying and reviewing misunderstood concepts.</p><p><strong>Aim: </strong>To examine the effect of discharge training based on the teach-back method on discharge readiness and satisfaction in patients undergoing lumbar disc herniation surgery.</p><p><strong>Methods: </strong>A randomized controlled trial using a pre-test-post-test design was conducted at two state hospitals in Northern Cyprus from November 2022 to December 2023. A total of 64 patients were randomly assigned to either the intervention group (n = 32) or the control group (n = 32). Data were collected using the Discharge Education Satisfaction Scale, the Readiness for Hospital Discharge Scale, and the Discharge Education Knowledge Test. The CONSORT 2010 flow diagram was followed.</p><p><strong>Results: </strong>The mean ages of the intervention and control groups were 51.26 ± 11.92 years and 46.50 ± 11.73 years, respectively. Following the intervention, patients who underwent lumbar disc herniation surgery in the intervention group showed significantly higher scores compared to the control group (p < 0.05). These improvements were observed in overall discharge education satisfaction, discharge education knowledge, and all subdimensions of discharge readiness-including personal status, knowledge, and coping ability.</p><p><strong>Linking evidence to action: </strong>Discharge education delivered using the teach-back method enhances satisfaction, knowledge, and discharge readiness in patients undergoing lumbar disc herniation surgery.</p><p><strong>Trial registration: </strong>The full research protocol is available at ClinicalTrials.gov (NCT05695014).</p>","PeriodicalId":49355,"journal":{"name":"Worldviews on Evidence-Based Nursing","volume":"22 4","pages":"e70062"},"PeriodicalIF":5.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12285212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692140","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":"Needs and Experiences of Older Adults With Multiple Morbidities Using Health Technologies for Self-Management: A Systematic Review and Meta-Synthesis.","authors":"Chunlei Wang, Wenzhong Zhang, Fengyi Zhao, Qingxiang Sun, Danyang Li, Xue Li, Junjie Yang, Hong Ji","doi":"10.1111/wvn.70030","DOIUrl":"10.1111/wvn.70030","url":null,"abstract":"<p><strong>Background: </strong>The global population is aging, and it is becoming increasingly common for older people to suffer from multiple diseases. The development of digital health technologies has assisted the self-management of multimorbid older patients. Currently, there is a lack of qualitative review that synthesizes the needs and experiences of multimorbid older patients using digital health technologies for self-management.</p><p><strong>Aims: </strong>To synthesize the needs and experiences of multimorbid older adults using digital health technologies for self-management.</p><p><strong>Methods: </strong>The following six electronic databases were searched: PubMed, Embase, Web of Science, Scopus, Cochrane Library, and CINAHL. The search timeframe was from construction to November 4, 2024. Thematic synthesis by Thomas and Harden was used for meta-synthesis. Study selection and data extraction were conducted independently by two researchers, and quality was evaluated using the 10-item Critical Appraisal Skills Programme tool.</p><p><strong>Results: </strong>Ten studies were included. Three themes and seven subthemes were synthesized: (1) different impressions and perceptions, (2) challenges of use, and (3) conveniences and benefits. Older adults with multiple medical conditions have positive or negative impressions and perceptions of digital health technologies and experience multiple challenges in their use (lack of expertise, technical and equipment barriers, need support), while at the same time, digital health technologies offer huge benefits for their self-management (improved communication with healthcare professionals, enhanced self-management skills).</p><p><strong>Linking evidence to action: </strong>This review provides support for healthcare professionals to understand the experiences of multimorbid older adults using digital health technologies for self-management. Healthcare professionals and technology developers should establish collaborative relationships to design comprehensive, usable, and less burdensome digital health technologies for older adults with multiple morbidities. Additionally, comprehensive technical support services should be provided to ensure the effective utilization of these technologies by older adults.</p><p><strong>Trial registration: </strong>PROSPERO number: CRD42024599433.</p>","PeriodicalId":49355,"journal":{"name":"Worldviews on Evidence-Based Nursing","volume":"22 3","pages":"e70030"},"PeriodicalIF":3.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095176","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":"Mortality Risk Following Delirium in Older Inpatients: A Systematic Review and Meta-Analysis.","authors":"Pilar Pérez-Ros, Noelia Plaza-Ortega, Francisco Miguel Martínez-Arnau","doi":"10.1111/wvn.70027","DOIUrl":"10.1111/wvn.70027","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The onset of delirium in older inpatients is associated with worse outcomes, including longer length of hospital stay, loss of functionality, loss of cognitive function, sleep disorders, increased polypharmacy, higher rates of adverse effects, and mortality. Previous studies have analyzed mortality after delirium, but without discriminating between settings, time, or critical conditions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aims: &lt;/strong&gt;To assess the pooled incidence of delirium and risk of mortality at different times after hospital admission in older people and its association with mortality and length of stay in hospitalized people aged 65 years or older.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This systematic review and meta-analysis included studies analyzing the incidence of delirium and mortality. MEDLINE, Scopus, and the Web of Science were searched from inception to December 2023. PRISMA guidelines were followed. Inclusion criteria were original peer-reviewed studies in medical hospital areas using validated screening or diagnostic methods and quantifying mortality at admission or after excluding surgical patients. Exclusion criteria were studies that included only participants with a single condition at baseline, such as cancer, pneumonia, or frailty, or who were admitted to a specific unit such as the intensive care unit, as well as studies that assessed delirium in surgical areas. Study quality was assessed with Joanna Briggs Institute Critical Appraisal tools. The statistical analysis was performed in RevMan v5.4.0 (Cochrane Collaboration, Oxford, UK), using a random-effects model to calculate incidence, mortality, and length of hospital stay along with their 95% confidence intervals (CIs). The PROSPERO registration number for the review was CRD42023491604.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In the 32 included studies, the pooled cumulative incidence of delirium was 28.79% (95% confidence interval [CI] 24.06%, 33.51%). The mortality risk was higher in patients who had delirium during admission (odds ratio [OR] 5.23, 95% CI [3.45, 7.93]). This varied by time point: 1 month, OR 3.80 (95% CI 2.40, 6.00); 6 months, OR 3.48 (95% CI [2.01, 6.01]); 12 months, OR 2.73 (95% CI [2.07, 3.60]); 2 years, OR 2.09 (95% CI [1.57, 2.78]); and 5 years, OR 3.34 (95% CI [2.40, 4.64]). In the pooled analysis, mean length of hospital stay was 2.26 days (95% CI [0.54, 3.99]) longer in patients with delirium.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Linking evidence to action: &lt;/strong&gt;This study shows the markedly increased risk of mortality in older people with delirium during hospital admission and over the first month, in addition to an increased length of stay. The onset of delirium leads to increased use of healthcare resources. These data help to quantify the impact that delirium has on the health of older people, with implications for health system management. The evidence highlights the need to implement preventive pharmacological treatment or multicomponent strategies that ","PeriodicalId":49355,"journal":{"name":"Worldviews on Evidence-Based Nursing","volume":"22 3","pages":"e70027"},"PeriodicalIF":3.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081584","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":"Burnout, Mental Health, and Workplace Characteristics: Contributors and Protective Factors Associated With Suicidal Ideation in High-Risk Nurses.","authors":"Bernadette Mazurek Melnyk, Judy E Davidson, Sharon Tucker, Alai Tan, Andreanna Pavan Hsieh, Andrea Cooper, Cora Mayfield, Jacqueline Hoying","doi":"10.1111/wvn.70042","DOIUrl":"10.1111/wvn.70042","url":null,"abstract":"<p><strong>Background: </strong>A call for action has been issued nationwide to prevent suicide among nurses. An increased understanding of contributing and protective factors associated with suicidal ideation in nurses is needed to implement preventive measures. Factors needing exploration include nurses' burnout, mental well-being, physical health, and workplace characteristics.</p><p><strong>Aims: </strong>This study aimed to determine factors associated with suicidal ideation in 501 moderate-to-high-risk nurses, including their mental health, level of burnout, health-related personal beliefs, healthy lifestyle behaviors, and workplace characteristics.</p><p><strong>Methods: </strong>A descriptive, cross-sectional correlational study was conducted on baseline survey data that was completed before the nurses were randomized to one of two interventions as part of their participation in a randomized controlled trial investigating the efficacy of a combined mental health screening program and cognitive-behavioral skills building intervention versus a screening program alone. Nurses were recruited from across the United States via email. Only nurses identified with moderate-to-high-risk adverse mental health outcomes, including suicidal ideation, were included. The survey used valid and reliable measures to assess burnout, anxiety, depression, suicidal ideation, post-traumatic stress, healthy lifestyle behaviors, health-related personal beliefs, resilience, job satisfaction, self-perceived mattering to the workplace, and intent to leave. Bivariate tests were performed.</p><p><strong>Results: </strong>Burnout, anxiety, depression, and post-traumatic stress were individually correlated with increased odds of suicidal ideation, as were nurses working 12-h shifts and those who reported an intent to leave their jobs. Protective factors against suicidal ideation included resilience, positive health-related personal beliefs, healthy lifestyle behaviors, job satisfaction, and workplace mattering.</p><p><strong>Linking action to evidence: </strong>There is an urgent need for policies and implementation of evidence-based interventions to address mental health issues in nurses to ultimately prevent suicide. Burnout should be considered as a possible precursor to serious adverse mental health problems and not just an operational retention issue. Leaders need to invest in resources to enhance nurses' mental health, fix system problems that are at the root cause of burnout, routinely recognize employees for their excellent work, and communicate that they matter. Leaders should listen carefully to their nurses, prioritize their ideas for impactful change, and appreciate those who contribute to improving culture and caring practices.</p>","PeriodicalId":49355,"journal":{"name":"Worldviews on Evidence-Based Nursing","volume":"22 3","pages":"e70042"},"PeriodicalIF":3.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235723","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":"Effectiveness of Interventions Based on Social Cognitive Theory in Patients With Cardiovascular Disease: A Systematic Review and Meta-Analysis.","authors":"Mengdie Liu, Xiaoyun Xiong, Dan Xiao, Hua Chen, Si Liu","doi":"10.1111/wvn.70026","DOIUrl":"10.1111/wvn.70026","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular disease (CVD) is a leading cause of mortality and disability worldwide, posing significant challenges to the quality of healthcare services. Social Cognitive Theory (SCT) provides a framework for understanding individual behaviors and guides the development of intervention programs aimed at promoting health-enhancing behaviors.</p><p><strong>Aims: </strong>To evaluate the effectiveness of interventions based on SCT in improving health outcomes among patients with CVD.</p><p><strong>Methods: </strong>From the creation of the databases until September 2024, we searched six databases and manually searched the references included in the study. The outcomes included cardiovascular risk factors (weight, blood pressure, blood lipids), physical capacity (6-min walk test, physical activity, daily steps, exercise self-efficacy), psychological states (anxiety, depression), and health behaviors (self-management, self-efficacy, quality of life). The quality of randomized controlled trials was evaluated with the Cochrane RoB 2 tool, and quasi-experimental studies were assessed using the JBI critical appraisal tool.</p><p><strong>Results: </strong>A total of 10 studies, involving 1140 participants, were included in the review. Compared to conventional cardiovascular care, interventions based on SCT were able to lower systolic blood pressure (MD = -6.36; 95% CI [-11.30, -1.41]; p = 0.012), total cholesterol (MD = -0.29; 95% CI [-0.49, -0.09]; p = 0.004), and low-density lipoprotein levels (MD = -0.21; 95% CI [-0.38, -0.04]; p = 0.015) in CVD patients. They also increased the 6-min walk test distance (MD = 33.87, 95% CI [5.40, 62.34], p = 0.02) and daily steps (SMD = 0.77; 95% CI [0.46, 1.09]; p < 0.001), improved physical activity (SMD = 0.65; 95% CI [0.25, 1.06]; p = 0.002) and exercise self-efficacy (SMD = 1.23, 95% CI [0.23, 2.23], p = 0.016), and enhanced quality of life (SMD = 0.75, 95% CI [0.06, 1.43], p = 0.032).</p><p><strong>Link evidence to action: </strong>Social cognitive theory-based interventions hold promise for improving health outcomes in patients with cardiovascular disease. This study provides further insights into the application of SCT in clinical practice. However, given the limited number of included studies and the potential risk of bias, further high-quality research is required to validate these findings.</p>","PeriodicalId":49355,"journal":{"name":"Worldviews on Evidence-Based Nursing","volume":"22 3","pages":"e70026"},"PeriodicalIF":3.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040027","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}