Worldviews on Evidence-Based Nursing最新文献

{"title":"The Evidence-Based Practice Mentor: Findings From a Role Delineation Study to Support the Role's Needed Knowledge and Skills.","authors":"Cindy Beckett, Lee Ann Strait, Bindu Thomas, Jeff Messinger, Lynn Gallagher-Ford, Bernadette Mazurek Melnyk","doi":"10.1111/wvn.70088","DOIUrl":"https://doi.org/10.1111/wvn.70088","url":null,"abstract":"<p><strong>Background: </strong>The role of the interprofessional evidence-based practice (EBP) mentor is critical to integrate best practices into healthcare and academic environments to improve outcomes and reduce costs for patients, families, providers, students, and faculty. This study aimed to validate the knowledge, skills, and attitudes/beliefs (KSAs) needed for the EBP mentor. This role delineation study (RDS) assessed knowledge about the EBP mentor role and tasks as related to the steps and competencies of EBP.</p><p><strong>Methods: </strong>Interprofessional EBP experts participated in an advisory panel. Focus groups were conducted with the advisory panel members to identify the KSAs needed for expert EBP mentors. The steps of EBP were broken into 11 domains to align with the processes and strategies needed for EBP methodology. The focus group data were analyzed to identify the KSAs for each domain. A role delineation survey was developed. Interprofessional experts were invited to complete the survey to validate the KSAs needed for the EBP mentor role. The online survey included demographic information and 11 sections that aligned with the steps of EBP and the 107 KSA items needing to be validated.</p><p><strong>Results: </strong>A total of 251 interprofessional EBP experts completed the survey (232 nurses, 19 interprofessionals). Healthcare providers comprised 82.5% of the sample, academic/researchers 15.5%, and \"worked in both settings\" 2%. The results reported strong inter-rater reliability (ranging from 0.836 to 0.955) and strong validity for each of the 11 domains and KSAs.</p><p><strong>Linking evidence to action: </strong>Findings from this study support the EBP mentor role and will guide interprofessional EBP education and EBP mentor positions in healthcare systems. The study showed that the tasks of the EBP mentor were consistent across settings, educational degrees, and professional roles. Validity for the tasks/role for an interprofessional Evidence-based Practice Certification was clear and outlined expectations for the EBP mentor role.</p>","PeriodicalId":49355,"journal":{"name":"Worldviews on Evidence-Based Nursing","volume":"22 6","pages":"e70088"},"PeriodicalIF":3.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745388","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":"Community Cardiac Rehabilitation Program: Lessons Learned for Long-Term Outcomes.","authors":"Cheryl Monturo, Carol Smith, William M Bannon, Cindy Brockway","doi":"10.1111/wvn.70089","DOIUrl":"10.1111/wvn.70089","url":null,"abstract":"<p><strong>Background: </strong>Although some research supports the maintenance of positive outcomes from cardiac rehabilitation Phase II (CR II) up to 12 months, the barriers to maintaining physical activity and risk factor management during CR maintenance (CR III) are well known.</p><p><strong>Aim: </strong>To investigate participants' ability to sustain clinical, quality-of-life (QOL), and behavioral outcomes and share their experiences 6 months after CR II completion.</p><p><strong>Methods: </strong>Longitudinal explanatory sequential pre-CR/post-CR study in a community hospital within a large health system. A convenience sample of 155 participants completed a reassessment of health outcomes. Participants also completed an online survey about barriers and facilitators during and after CR II. Analysis methods included MANOVA and summative content analysis.</p><p><strong>Results: </strong>The sample was mostly male, white, non-Hispanic, and college educated, with a mean age of 67.9 years. CR II participants sustained most behavioral outcomes, but not all clinical outcomes. Outcomes that improved/maintained were physical activity, tobacco status, diet, and QOL. Outcomes that worsened/returned to pre-CR II were weight, blood pressure, and depression. Participants described their motivation for staying healthy, top concerns, goals, barriers, and strengths/resources. Common responses included exercise, weight, diet, quality of life, family, and friends.</p><p><strong>Linking evidence to action: </strong>Our findings suggest the need for the implementation of innovative strategies during CR II that may extend past discharge into CR III. These include the introduction of digital technology and eHealth to provide value-added service to patients and a solid foundation for future maintenance and a structured, behavioral weight loss intervention. Establishing these tools, in addition to developing a support system will help patients to initiate maintenance care before program completion.</p>","PeriodicalId":49355,"journal":{"name":"Worldviews on Evidence-Based Nursing","volume":"22 6","pages":"e70089"},"PeriodicalIF":3.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12676506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670722","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":"Psychosocial Support Interventions After Perinatal Loss: A Network Meta-Analysis of RCTs Indicates What Works Best for Women's Mental Health?","authors":"Wenshan Huang, Wei Zhao, Yitong Han, Ziqi Wang, Yujie Han, Wei Zhang","doi":"10.1111/wvn.70085","DOIUrl":"10.1111/wvn.70085","url":null,"abstract":"<p><strong>Background: </strong>Psychosocial interventions are recognized as effective nonpharmacological treatments that can enhance the mental well-being of women dealing with perinatal loss. However, as these interventions vary widely, there is currently no review that systematically evaluates and ranks their effects on the mental health of women affected by perinatal loss.</p><p><strong>Objective: </strong>The aim of this study is to integrate the existing evidence, assess and compare the effects of psychosocial interventions on negative emotions among women experiencing perinatal loss, rank the effect sizes of various interventions, and identify the most effective intervention on the basis of different outcome measures.</p><p><strong>Methods: </strong>Seven English-language databases were systematically searched for randomized controlled trials (RCTs) focusing on women experiencing perinatal loss, with publications up to August 20, 2024. Traditional pairwise meta-analyses were performed using Review Manager 5.4.1, while Stata 18.0 was employed for network meta-analysis and evidence synthesis. The surface under the cumulative ranking curve (SUCRA) was used to assess the efficacy of the interventions. The protocol was registered with PROSPERO under number CRD42024530312.</p><p><strong>Results: </strong>A total of 30 RCTs encompassing 6181 participants were included in the analysis. On the basis of the SUCRA rankings, problem-solving therapy was identified as an effective treatment for alleviating depression and anxiety among women experiencing perinatal loss (depression: SUCRA = 82.55%, SMD = -1.34, 95% CI [-2.41, -0.27]; anxiety: SUCRA = 97.7%, SMD = -2.83, 95% CI [-4.26, -1.40]). Additionally, bereavement intervention emerged as the most effective approach for improving grief symptoms (SUCRA = 81.60%, SMD = -1.11, 95% CI [-2.14, -0.09]).</p><p><strong>Linking evidence to action: </strong>Compared with traditional treatment, psychosocial intervention can improve the psychological state of women with perinatal loss, and the differences in the effects of face-to-face and technology-assisted interventions should be further explored. Moreover, problem-solving therapy has proven to be effective and appears to be the most effective method for alleviating depressive and anxiety symptoms among women experiencing perinatal loss, while bereavement support is the most effective method for grief due to perinatal loss. Nursing and health policymakers can develop various intervention strategies according to the varied psychological states of women experiencing perinatal loss.</p>","PeriodicalId":49355,"journal":{"name":"Worldviews on Evidence-Based Nursing","volume":"22 6","pages":"e70085"},"PeriodicalIF":3.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145606891","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 Effects of a Technology-Assisted Hybrid Cardiac Rehabilitation (TecHCR) Program for Adults With Coronary Heart Disease: A Randomized Controlled Trial.","authors":"Mei Sin Chong, Janet Wing Hung Sit, Kai Chow Choi, Anwar Suhaimi, Ying Jiang, Sek Ying Chair","doi":"10.1111/wvn.70092","DOIUrl":"10.1111/wvn.70092","url":null,"abstract":"<p><strong>Background: </strong>Technology-assisted interventions offer a promising alternative to conventional cardiac rehabilitation. However, there is limited evidence on their effectiveness, particularly in non-Western settings with emphasis on exercise self-efficacy.</p><p><strong>Aims: </strong>To evaluate the effects of a 12-week, technology-assisted hybrid cardiac rehabilitation (TecHCR) program on physical, physiological, and psychological outcomes of patients with coronary heart disease.</p><p><strong>Methods: </strong>A two-arm parallel randomized controlled trial including 160 participants was randomly assigned to either TecHCR or usual care. TecHCR was underpinned by the Health Belief Model, consisting of three supervised exercise training and occupational therapy sessions, a fitness watch for exercise self-monitoring, six audio-visual educational videos, and a weekly video call follow-up. Data were collected at baseline, immediately post-intervention, and at 24 weeks post-intervention.</p><p><strong>Results: </strong>Participants in TecHCR demonstrated significantly greater improvement in exercise self-efficacy (β = 5.909, 95% CI [3.146, 8.672]; p < 0.001), health-promoting behaviors (β = 9.058, 95% CI [5.524, 12.591]; p < 0.001), and perceived anxiety levels (β = -1.255, 95% CI [-1.893, -0.616]; p < 0.001) at immediate post-intervention and (β = 8.506, 95% CI [4.951, 12.061]; p < 0.001, β = 14.563, 95% CI [8.809, 20.317]; p < 0.001, β = -1.145, 95% CI [-1.975, -0.315]; p = 0.007, respectively) 24 weeks post-intervention when compared with the control group. No statistically significant improvements were observed in perceived depression and cardiovascular risk factors.</p><p><strong>Linking evidence to action: </strong>The TecHCR program, combining supervised sessions with technology-assisted components, is an effective approach for significantly improving exercise self-efficacy, health-promoting behaviors, and anxiety in patients with coronary heart disease. Healthcare institutions should consider implementing hybrid programs to overcome barriers to traditional cardiac rehabilitation, leveraging technology to extend support and maintain patient engagement beyond supervised sessions.</p><p><strong>Trial registration: </strong>clinicaltrials.gov identifier: NCT04862351.</p>","PeriodicalId":49355,"journal":{"name":"Worldviews on Evidence-Based Nursing","volume":"22 6","pages":"e70092"},"PeriodicalIF":3.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12745914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145850882","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 Association Between Nursing Work Environment and Evidence-Based Practice.","authors":"Alberto Lana, Lucía Fernández-Arce, María González-García, Rocío Fernández-Iglesias, Elena Andina-Díaz, Ana Fernández Feito","doi":"10.1111/wvn.70082","DOIUrl":"10.1111/wvn.70082","url":null,"abstract":"<p><strong>Introduction: </strong>Evidence-based practice (EBP) is essential for improving the quality of care and health outcomes in healthcare organizations. This study aimed to analyze the association between the nursing work environment and EBP elements, including attitude, training, implementation and quality of care.</p><p><strong>Methods: </strong>A multicenter, cross-sectional study was conducted with 1022 registered nurses from 57 primary care centers and four public hospitals in northern Spain. The Practice Environment Scale of the Nursing Work Index (PES-NWI) was used to assess the nursing work environment. Data collection also included the Health Sciences Evidence-Based Practice (HS-EBP) questionnaire to evaluate attitudes toward EBP, and self-reported measures of EBP training, EBP implementation, and overall quality of care. Odds ratios (OR) and 95% confidence intervals for the association between the nursing work environment and EBP elements were calculated using logistic regression adjusted for sociodemographic and occupational characteristics.</p><p><strong>Results: </strong>Compared to nurses who reported working in unfavorable environments (n = 220; 21.5%), those working in favorable environments (n = 437; 42.8%) exhibited a positive attitude toward EBP (OR = 2.89; 95% CI [2.00, 4.18]), EBP implementation (OR = 2.30; 95% CI [1.52, 3.39]) and higher quality of care (OR = 2.35; 95% CI [1.61, 3.44]). Using a composite measure that considered all EBP elements, favorable environments were associated with overall EBP engagement (OR = 3.47; 95% CI [2.38, 5.07]). The most influential environmental dimensions were adequate staffing and strong nursing foundations.</p><p><strong>Linking evidence to action: </strong>A favorable nursing work environment was strongly associated with a positive attitude toward EBP, the implementation of EBP, and a commitment to providing high-quality care. Key strategies to promote EBP should involve healthcare and academic institutions working together to establish a healthy work environment with appropriate staffing and care foundations rooted in nursing theory.</p>","PeriodicalId":49355,"journal":{"name":"Worldviews on Evidence-Based Nursing","volume":"22 6","pages":"e70082"},"PeriodicalIF":3.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12595286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145472342","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":"Nurses' Handover Satisfaction: Development and Validation of the Handover Quality Questionnaire.","authors":"Mayra Veronese, Elisabetta Cesaro, Lucia Stivanello, Chiara Daicampi","doi":"10.1111/wvn.70098","DOIUrl":"10.1111/wvn.70098","url":null,"abstract":"<p><strong>Background: </strong>The handover process is a critical component of patient safety, enabling effective communication and the transfer of responsibility among nurses. However, despite their critical role, it is often compromised by interruptions, lack of standardization, and variability in practice, which may reduce quality and nurse satisfaction. Existing tools primarily measure information transfer and efficiency but rarely incorporate nurses' perspectives on safety and satisfaction. This gap underscores the need for a validated instrument that comprehensively assesses handover quality from both a professional and safety perspective.</p><p><strong>Objectives: </strong>To develop and validate the Handover Quality Questionnaire (HAND-Q), a tool assessing nurses' satisfaction with handovers and their perceived impact on patient safety.</p><p><strong>Methods: </strong>HAND-Q development included a conceptualization phase (literature review, expert discussions) and a validation phase (pilot and large-scale testing). Exploratory and Confirmatory Factor Analyses (EFA, CFA) assessed psychometric properties.</p><p><strong>Results: </strong>EFA revealed four factors: Satisfaction, Patient Safety, Care Pathway Safety, and Handover Content. CFA confirmed good model fit. Inter-factor correlations showed strong links between handover quality and safety, alongside discrepancies between satisfaction and objective standards.</p><p><strong>Linking evidence to practice: </strong>The HAND-Q offers a practical tool to assess handover quality, support standardization, enhance patient safety, and inform training and digital solutions.</p>","PeriodicalId":49355,"journal":{"name":"Worldviews on Evidence-Based Nursing","volume":"22 6","pages":"e70098"},"PeriodicalIF":3.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12745061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145850654","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 Effect of Nurse-Led Telephone Patient Education and Counseling on Disease Management, Quality of Life, and Self-Care Behaviors in Hemodialysis Patients.","authors":"İlker Tutur, Emine Kir Bicer","doi":"10.1111/wvn.70074","DOIUrl":"10.1111/wvn.70074","url":null,"abstract":"<p><strong>Background: </strong>Hemodialysis can lead to complications that negatively impact patients' quality of life. Managing hemodialysis effectively requires patient adherence to complex regimens.</p><p><strong>Aim: </strong>This randomized controlled experimental study aimed to assess the impact of nurse-led telephone-based patient education and counseling on disease management, quality of life, and self-care behaviors in hemodialysis patients.</p><p><strong>Methods: </strong>Conducted between September 2022 and June 2023 at State Hospital's Hemodialysis Unit, the study included an intervention and a control group. Data were collected using tools such as the Scale for Dietary Knowledge in Hemodialysis Patients (SDKHP), Attitude Scale for the Dietary Therapy of Hemodialysis Patients (ASDTHP), Dialysis Symptom Index (DSI), Fluid Control in Hemodialysis Patients Scale (FCHPS), the Scale for the Assessment of Self-Care Behaviors with Arteriovenous Fistula (AVF), and the Kidney Disease Quality of Life-36 (KDQOL-36).</p><p><strong>Results: </strong>Pre- and posttest comparisons showed significant improvements in the intervention group's mean scores for SDKHP, ASDTHP, and FCHPS, with the control group experiencing declines. DSI scores indicated reduced symptoms in the intervention group and an increase in the control group. The AVF Self-Care Scale results demonstrated increased self-care behaviors in the intervention group, while a decrease was observed in the control group. KDQOL-36 subscales, including physical and mental functioning, disease burden, and symptom management, also improved in the intervention group, while scores declined in the control group. These findings confirm the effectiveness of telephone-based patient education and counseling on multiple outcome measures.</p><p><strong>Linking evidence to action: </strong>Nurse-led, telephone-based patient education and counseling improved dietary adherence and disease management. Telephone-based patient interventions enhanced patients' self-care skills regarding AVF maintenance. Quality of life improved across multiple dimensions in the intervention group. Telephone counseling ensured continued monitoring and individual support, even after discharge. Nurses should integrate telephone-based counseling into routine care, especially for chronic disease management.</p>","PeriodicalId":49355,"journal":{"name":"Worldviews on Evidence-Based Nursing","volume":"22 6","pages":"e70074"},"PeriodicalIF":3.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145423419","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":"Integrating Evidence-Based Practice With PDSA Methodology for the Reduction of Central Line Associated Blood Stream Infection in Intensive Care Unit.","authors":"Ebtisam Elhihi, Khadija Lafi, Maha Alahmadi, Mohamed Al-Theiba, Asma Abdul Rahman, Nouf Maghrabi, Shaima Mizi, Haneen Alsulami, Mada Altambkti, Thuraya Rumbo","doi":"10.1111/wvn.70096","DOIUrl":"https://doi.org/10.1111/wvn.70096","url":null,"abstract":"<p><strong>Background: </strong>Preventing central line associated bloodstream infections is feasible; although numerous hospitals continue to face challenges in achieving this important patient safety goal.</p><p><strong>Aim: </strong>The aim of this project was to reduce the incidence of central line associated bloodstream infections in the intensive care unit.</p><p><strong>Methods: </strong>This evidence-based practice quality improvement project was conducted in the general intensive care unit with 35 beds in King Abdullah Medical City in response to an increase in reported central line associated bloodstream infections cases. A searchable clinical question was formulated, and the relevant literature was reviewed and critically appraised to identify effective prevention strategies. Multimodal Interventions were then implemented and evaluated. The Plan, Do, Study, Act methodology was integrated with an evidence-based practice model to enhance the effectiveness, sustainability, and overall quality of the initiatives.</p><p><strong>Results: </strong>Central line associated bloodstream infection rates decreased from 1.37 to 0.62 per 1000 central line days in the intensive care unit following implementation of the interventions. Moreover, the project generated a total cost savings of $244,201 USD (915,756 SAR), reflecting reduced costs associated with central line associated bloodstream infection cases over the subsequent 18 months.</p><p><strong>Linking evidence to action: </strong>Implementation of multimodal interventions is essential to decrease central line associated bloodstream infection rate in intensive care units.</p>","PeriodicalId":49355,"journal":{"name":"Worldviews on Evidence-Based Nursing","volume":"22 6","pages":"e70096"},"PeriodicalIF":3.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145851537","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":"Comparative Efficacy of Brief Behavioral Therapy for Insomnia: A Systematic Review and Network Meta-Analysis.","authors":"Faizul Hasan, Christopher James Gordon, Lia Taurussia Yuliana, Debby Syahru Romadlon, Hsiao-Yean Chiu","doi":"10.1111/wvn.70075","DOIUrl":"10.1111/wvn.70075","url":null,"abstract":"<p><strong>Background: </strong>The comparative efficacy of brief behavioral therapy for insomnia (BBTI) remains unclear.</p><p><strong>Aims: </strong>This systematic review and network meta-analysis examined the effectiveness of different BBTI approaches and compared BBTI with other nonpharmacological interventions, such as cognitive behavioral therapy for insomnia (CBT-I).</p><p><strong>Methods: </strong>Three databases were searched from inception to December 27, 2024. Primary outcomes were insomnia severity and sleep quality. Secondary outcomes included total sleep time, sleep onset latency, wake after sleep onset, sleep efficiency, and daytime sleepiness. A frequentist network meta-analysis with random-effects modeling was conducted. Heterogeneity was assessed using the I² statistic.</p><p><strong>Results: </strong>Eighteen randomized controlled trials involving 1104 participants (mean age: 52.6 years) were included. Compared with usual care, BBTI significantly reduced insomnia severity (mean difference [MD] = -4.79; 95% confidence interval [CI = -6.05, -3.53]; I² = 0%) and improved sleep quality (MD = -3.45; 95% CI [-4.97, -1.94]; I² = 0%). BBTI also shortened sleep onset latency (MD = -19.81 min; 95% CI = -30.64, -8.98; I² = 17%) and wake after sleep onset (MD = -15.51 min; 95% CI [-22.75, -8.27]; I² = 47%) and increased sleep efficiency (MD = 10.78%; 95% CI [7.67%, 13.89%]; I² = 8%). No significant differences were found in total sleep time or daytime sleepiness. Face-to-face BBTI and CBT-I demonstrated similar outcomes. Face-to-face BBTI ranked as the most effective approach based on the surface under the cumulative ranking curve.</p><p><strong>Linking evidence to action: </strong>Face-to-face BBTI is an optimal nonpharmacological option for improving sleep quality and efficiency and reducing insomnia severity, sleep onset latency, and wake after sleep onset.</p><p><strong>Trial registration: </strong>PROSPERO number: CRD42021242589.</p>","PeriodicalId":49355,"journal":{"name":"Worldviews on Evidence-Based Nursing","volume":"22 5","pages":"e70075"},"PeriodicalIF":3.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145349545","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":"Effects of Shift Work on Cognitive and Motor Performance in Nurses: A Systematic Review and Meta-Analysis.","authors":"Fadime Ulupınar, Süleyman Ulupınar","doi":"10.1111/wvn.70078","DOIUrl":"10.1111/wvn.70078","url":null,"abstract":"<p><strong>Background: </strong>Shift work-especially during night hours-adversely affects nurses' cognitive and motor performance, potentially compromising patient safety. Variations in shift duration and rotation patterns contribute to these effects. Implementing evidence-based strategies such as optimized scheduling, structured rest breaks, and supportive work environments may mitigate performance declines. These findings highlight the importance of organizational policies aimed at protecting both healthcare workers and patient outcomes.</p><p><strong>Methods: </strong>A comprehensive search across PubMed, Cochrane Library, and Web of Science identified 22 studies with 224 comparison data points for inclusion. Study quality was assessed using the ROBINS-I tool across seven bias domains. Analyses were performed using Python, applying random-effects models to account for heterogeneity (Cochran's Q, I²), with Egger's test used for publication bias assessment.</p><p><strong>Results: </strong>Day shifts led to a small performance decline (Hedges' g = 0.238, 95% CI [0.155, 0.321]), while night shifts caused a more substantial decline (Hedges' g = 0.386, 95% CI: 0.320 to 0.451). Motor performance across all shift types showed a moderate effect size (Hedges' g = 0.326, 95% CI [0.210, 0.442]). Comparing day shifts to nonstandard shifts, a small effect size (Hedges' g = 0.220, 95% CI [0.171, 0.269]) highlighted reduced performance under irregular shift conditions. High heterogeneity in night shifts (I² = 86.8%) suggested variability in study designs and methodologies.</p><p><strong>Linking evidence to action: </strong>Shift work, particularly night shifts, negatively impacts cognitive and motor performance, posing risks to clinical safety. The variability in shift durations (6-17 h) and different shift rotation strategies contributed to heterogeneity. Targeted interventions, including optimized scheduling, adequate rest breaks, and supportive workplace practices, are needed to mitigate negative effects. This meta-analysis provides evidence-based insights into the detrimental effects of shift work on nurses' performance, supporting the development of policies and strategies to promote safer clinical environments and enhance healthcare quality.</p><p><strong>Trial registration: </strong>PROSPERO.</p>","PeriodicalId":49355,"journal":{"name":"Worldviews on Evidence-Based Nursing","volume":"22 5","pages":"e70078"},"PeriodicalIF":3.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145373280","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}