Worldviews on Evidence-Based Nursing最新文献

{"title":"Respiratory support in the emergency department: A systematic review and meta-analysis.","authors":"Jane O'Donnell, Alison Pirret, Karen Hoare, Rebecca Fenn, Elissa McDonald","doi":"10.1111/wvn.12718","DOIUrl":"10.1111/wvn.12718","url":null,"abstract":"<p><strong>Background: </strong>An estimated 20% of emergency department (ED) patients require respiratory support (RS). Evidence suggests that nasal high flow (NHF) reduces RS need.</p><p><strong>Aims: </strong>This review compared NHF to conventional oxygen therapy (COT) or noninvasive ventilation (NIV) in adult ED patients.</p><p><strong>Method: </strong>The systematic review (SR) and meta-analysis (MA) methods reflect the Cochrane Collaboration methodology. Six databases were searched for randomized controlled trials (RCTs) comparing NHF to COT or NIV use in the ED. Three summary estimates were reported: (1) need to escalate care, (2) mortality, and (3) adverse events (AEs).</p><p><strong>Results: </strong>This SR and MA included 18 RCTs (n = 1874 participants). Two of the five MA conclusions were statistically significant. Compared with COT, NHF reduced the risk of escalation by 45% (RR 0.55; 95% CI [0.33, 0.92], p = .02, NNT = 32); however, no statistically significant differences in risk of mortality (RR 1.02; 95% CI [0.68, 1.54]; p = .91) and AE (RR 0.98; 95% CI [0.61, 1.59]; p = .94) outcomes were found. Compared with NIV, NHF increased the risk of escalation by 60% (RR 1.60; 95% CI [1.10, 2.33]; p = .01); mortality risk was not statistically significant (RR 1.23, 95% CI [0.78, 1.95]; p = .37).</p><p><strong>Linking evidence to action: </strong>Evidence-based decision-making regarding RS in the ED is challenging. ED clinicians have at times had to rely on non-ED evidence to support their practice. Compared with COT, NHF was seen to be superior and reduced the risk of escalation. Conversely, for this same outcome, NIV was superior to NHF. However, substantial clinical heterogeneity was seen in the NIV delivered. Research considering NHF versus NIV is needed. COVID-19 has exposed the research gaps and slowed the progress of ED research.</p>","PeriodicalId":49355,"journal":{"name":"Worldviews on Evidence-Based Nursing","volume":" ","pages":"415-428"},"PeriodicalIF":3.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140186076","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":"Changes in fatigue among cancer patients before, during, and after radiation therapy: A meta-analysis.","authors":"Chia-Ling Li, Pei-Ying Chen, Tsui-Yun Yang, Joseph Tung-Chieh Chang, Woung-Ru Tang, Mei-Ling Chen","doi":"10.1111/wvn.12672","DOIUrl":"10.1111/wvn.12672","url":null,"abstract":"<p><strong>Background: </strong>Fatigue is a common symptom in cancer patients receiving radiotherapy. However, previous studies report inconsistent patterns of fatigue change.</p><p><strong>Aim: </strong>The aim of this study was to estimate changes in fatigue among patients with cancer before, during, and after radiotherapy.</p><p><strong>Methods: </strong>Five databases (PubMed, SDOL, CINAHL Plus with Full Text, Medline [ProQuest], and ProQuest Dissertations) were searched for studies published from January 2006 to May 2021. Three effect sizes of fatigue change (immediate, short-term, and long-term) were calculated for each primary study using standardized mean difference. A random-effect model was used to combine effect sizes across studies. Subgroup analyses and meta-regression were performed to identify potential categorical and continuous moderators, respectively.</p><p><strong>Results: </strong>Sixty-five studies were included in this meta-analysis. The weighted mean effect size for immediate, short-term, and long-term effects was 0.409 (p < .001; 95% CI [0.280, 0.537]), 0.303 (p < .001; 95% CI [0.189, 0.417]), and 0.201 (p = .05; 95% CI [-0.001, 0.404]), respectively. Studies with prostate cancer patients had a significantly higher short-term (0.588) and long-term weight mean effect size (0.531) than studies with breast (0.128, -0.072) or other cancers (0.287, 0.215). Higher radiotherapy dosage was significantly associated with a higher effect size for both immediate (β = .0002, p < .05) and short-term (β = .0002, p < .05) effect.</p><p><strong>Linking evidence to action: </strong>Findings from this meta-analysis indicated that radiotherapy-induced fatigue (RIF) exist for more than 3 months after the completion of treatment. Assessment of radiation-induced fatigue in cancer patients should extend long after treatment completion, especially for patients with prostate cancer and patients receiving a higher radiation dose. Interventions to reduce fatigue tailored for different treatment phases may be developed.</p>","PeriodicalId":49355,"journal":{"name":"Worldviews on Evidence-Based Nursing","volume":" ","pages":"234-244"},"PeriodicalIF":4.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9993224","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":"Effectiveness of motivational strategies on physical activity behavior and associated outcomes in patients with cancer: A systematic review and meta-analysis.","authors":"Naomi Takemura, Mu-Hsing Ho, Denise Shuk Ting Cheung, Chia-Chin Lin","doi":"10.1111/wvn.12691","DOIUrl":"10.1111/wvn.12691","url":null,"abstract":"<p><strong>Background: </strong>Motivational interviewing is a client-centered counseling technique widely applied as a behavior change strategy. It has been adopted to help cancer patients modify health behaviors. The effectiveness of motivational interviewing on physical activity behavior and its associated outcomes in cancer patients is unclear.</p><p><strong>Aim: </strong>The aim of this review was to determine the effect of motivational interviewing with other motivational strategies on physical activity behavior and associated outcomes in cancer patients.</p><p><strong>Methods: </strong>This is a systematic review and meta-analysis of randomized controlled trials, following PRISMA guidelines. Eight English databases were searched from inception to October 2022. The outcomes were evaluated using standardized mean differences (SMDs) with fixed- and random-effects models. Methodological quality of the studies was assessed by Cochrane Risk of Bias Tool 2.0.</p><p><strong>Results: </strong>Eight trials with 450 participants were identified, with sample sizes ranging from 25 to 87. The number of motivational interviewing sessions ranged from one to 12. The types of motivational strategy intervention varied. Apart from motivational interviewing, pedometers were frequently used as a strategy. The quality of the included studies differed, with one out of eight scoring low in the overall risk of bias. Our meta-analysis indicated that motivational interviewing with other motivational strategies significantly promoted the total physical activity level (SMD = 0.34, 95% confidence interval [0.10, 0.58], p = .005; low certainty), but not did not affect other physical and psychosocial outcomes.</p><p><strong>Conclusion: </strong>The combination of motivational interviewing with other motivational strategies was beneficial in increasing the total physical activity level of cancer patients.</p><p><strong>Linking evidence to action: </strong>Motivational interviewing can be a clinical communication skill that healthcare professionals, especially nurses, can acquire to motivate patients to change their behaviors to promote health. Future studies adopting motivational interviewing interventions could consider additional motivational strategies, such as pedometers, to maximize the benefits on physical activity behaviors.</p>","PeriodicalId":49355,"journal":{"name":"Worldviews on Evidence-Based Nursing","volume":" ","pages":"253-262"},"PeriodicalIF":4.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71523109","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":"Serial mediation roles of empowerment and self-care activities connecting health literacy, quality of life, and glycemic control in people with type 2 diabetes.","authors":"Xiaoyan Zhao, Qiao Liu, Xiaodi Guo, Xiling Hu, Li Cheng","doi":"10.1111/wvn.12684","DOIUrl":"10.1111/wvn.12684","url":null,"abstract":"<p><strong>Background: </strong>Health literacy, empowerment, and self-care activities are likely the crucial concepts affecting the quality of life and glycemic control in people with type 2 diabetes (T2D). However, evidence demonstrating the mechanisms underlying these concepts is scarce.</p><p><strong>Aims: </strong>The aim of this study was to test the serial mediation roles of empowerment and self-care activities on the relationships between health literacy and quality of life and between health literacy and hemoglobin A1c (HbA1c) in people with T2D.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among 319 people with T2D in Guangzhou, China, from July 2019 to January 2020. Data were collected using the Health Literacy Scale, the Diabetes Empowerment Scale-Short Form, the Summary of Diabetes Self-Care Activities Measure, and the Adjusted Diabetes-Specific Quality of Life Scale. RStudio 4.2.1 was used for serial mediation analysis.</p><p><strong>Results: </strong>The dimension of communicative health literacy accounted for the most total variance (β = 0.810, p < .001) in the construct of health literacy. The serial multiple mediation of empowerment and self-care activities in the associations between health literacy and quality of life (β = -.046, p = .019) and between health literacy and HbA1c (β = -.045, p = .005) were statistically significant.</p><p><strong>Linking evidence to action: </strong>This study emphasized the vital role of communicative health literacy when improving health literacy in people with T2D. Diabetes care and education specialists could implement empowerment approaches and flexible self-care strategies to improve the quality of life and glycemic control in people with T2D. Enhancing health literacy was suggested as a favorable strategy for promoting empowerment and self-care activities in people with T2D.</p>","PeriodicalId":49355,"journal":{"name":"Worldviews on Evidence-Based Nursing","volume":" ","pages":"330-337"},"PeriodicalIF":4.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49684171","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":"Facilitators and barriers to implementation of telemedicine in nursing homes: A qualitative systematic review and meta-aggregation.","authors":"Min Chua, Xue Kee Lau, Jeanette Ignacio","doi":"10.1111/wvn.12711","DOIUrl":"10.1111/wvn.12711","url":null,"abstract":"<p><strong>Background: </strong>Telemedicine is an effective way to provide nursing home residents ease of access to consultations with healthcare professionals. It is safe, effective, and time- and cost-efficient, and can be used when there are movement restrictions, such as during the COVID-19 pandemic. This literature focuses only on healthcare professionals' experiences and perspectives on the use of telemedicine in long-term care facilities.</p><p><strong>Objectives: </strong>This review concentrated on telemedicine programs that did not involve remote monitoring. It aimed to comprehensively appraise existing literature examining the facilitators and barriers in implementing telemedicine services in nursing homes.</p><p><strong>Methods: </strong>A systematic qualitative review was conducted with content analysis. Database searching was conducted in PubMed, Embase, Cochrane, Scopus, and CINAHL. Hand searching for gray literature and reference lists of included papers was also performed. Qualitative studies or mixed-method studies with a qualitative analysis addressing implementation of telemedicine in any long-term care facilities were included. The Critical Appraisal Skills Programme qualitative checklist was used to assess the quality of the included studies. The data were extracted and cross-checked between two reviewers. A third reviewer was consulted for any disagreements. Meta-aggregation was used to synthesize the results.</p><p><strong>Results: </strong>Eighty-one findings were extracted, which informed 16 categories and 13 synthesized findings. The synthesized findings were related to the innovation domain, infrastructure, work processes, individuals, and implementation processes.</p><p><strong>Linking evidence to action: </strong>This review highlighted factors that affect the successful implementation of a telemedicine service in nursing homes. These findings provide evidence to support the future utilization of this service in the nursing home setting. Further research should explore the best approach to address these barriers and facilitators.</p>","PeriodicalId":49355,"journal":{"name":"Worldviews on Evidence-Based Nursing","volume":" ","pages":"318-329"},"PeriodicalIF":3.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139716555","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 cognitive behavioral therapy in patients with chronic obstructive pulmonary disease: A systematic review and meta-analysis.","authors":"Xinming Chen, Yating Guo, Tuoxin Zhang, Jiamin Lin, Xintong Ding","doi":"10.1111/wvn.12705","DOIUrl":"10.1111/wvn.12705","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) causes airflow blockage and breathing-related issues. This chronic disease impacts people worldwide. Substantial evidence supports the use of cognitive behavioral therapy (CBT) to help patients with chronic illnesses cope with worrisome and painful symptoms. However, the impact of CBT on COPD outcomes is less understood.</p><p><strong>Objective: </strong>In this study, we systematically summarized the effects of CBT on lung function, anxiety and depressive symptoms, and quality of life of patients with COPD.</p><p><strong>Methods: </strong>Six English-language and four Chinese-language databases were systematically searched for relevant randomized controlled trials published through April 15, 2023. Studies in which CBT was the only difference in treatment administered to experimental and control groups were included in the review. The studies' risk of bias was evaluated using the Cochrane Criteria.</p><p><strong>Results: </strong>Sixteen studies (1887 participants) were included. The meta-analysis showed that CBT improved the percent-predicted forced expiratory volume in 1 second (FEV₁%), forced vital capacity (FVC), FEV₁/FVC ratio, maximal voluntary ventilation, peak expiratory flow, treatment compliance, and World Health Organization abbreviated quality of life, Self-rating Anxiety and Depression Scale, and St George's Respiratory Questionnaire scores compared with the control (all p < .05).</p><p><strong>Conclusion: </strong>This review demonstrated that CBT improves the lung function, anxiety and depressive symptoms, treatment compliance, and quality of life of patients with COPD and can be used widely in the clinical treatment of this disease.</p>","PeriodicalId":49355,"journal":{"name":"Worldviews on Evidence-Based Nursing","volume":" ","pages":"288-306"},"PeriodicalIF":3.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139089101","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":"Best practices for implementation of Kamishibai cards in the healthcare setting to improve nursing-sensitive indicator associated outcomes: An integrative review.","authors":"Elizabeth L Gabriel, Kimberly Clark, Victoria May, Rachel Meltzer, Jennifer Moreland, Nadine Rosenblum, Linh Truong, Emily J Weiss, Vicki Yfantis, Alexandra Johnson, Madeleine Whalen","doi":"10.1111/wvn.12713","DOIUrl":"10.1111/wvn.12713","url":null,"abstract":"<p><strong>Background: </strong>Many adverse events are identified as nursing-sensitive indicators (NSIs) and have evidence-based care bundles known to reduce risk of occurrence. Kamishibai cards are a tool from the manufacturing industry used for practice auditing and improvements. Use of Kamishibai cards is believed to be common in the healthcare setting, but true evidence-based guidelines do not yet exist to guide their implementation.</p><p><strong>Aims: </strong>The aim of this integrative review was to identify best practices around the implementation of Kamishibai cards in the healthcare setting for improvement in NSI-associated outcomes.</p><p><strong>Methods: </strong>Eleven nurses at three facilities worked through the evidence using the Johns Hopkins Evidence-Based Practice Model.</p><p><strong>Results: </strong>Ten articles were included for this review. Broad themes included direct observation with non-punitive and timely feedback, clearly visualized results, use of evidence-based care bundles, pre-implementation education, and both leadership and frontline-staff involvement. All facilities showed improvement in NSI-associated outcomes after the implementation of K-cards.</p><p><strong>Linking action to action: </strong>In health care, K-cards can be implemented and designed with additional focus on the bundles of care they are intended to audit and staff support, but further evidence would better define guidelines around implementation.</p>","PeriodicalId":49355,"journal":{"name":"Worldviews on Evidence-Based Nursing","volume":" ","pages":"271-278"},"PeriodicalIF":4.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139742462","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 weight management on heart failure: A systematic review and meta-analysis of randomized controlled trials.","authors":"Qiuge Zhao, Yilin Zhang, Xiaoyu Dong, Xiuting Zhang, Xiuzhen Fan","doi":"10.1111/wvn.12665","DOIUrl":"10.1111/wvn.12665","url":null,"abstract":"<p><strong>Background: </strong>Weight management is an important part of disease management in patients with heart failure. However, the effectiveness of reported weight management interventions is inconclusive.</p><p><strong>Aims: </strong>The aim of this systematic review and meta-analysis was to assess the effects of weight management on functional status, heart failure-related hospitalizations, and all-cause mortality in patients with heart failure.</p><p><strong>Methods: </strong>PubMed, Web of Science, Embase, and the Cochrane Library were searched on April 3, 2022. This study was registered with PROSPERO (CRD42021283817). Eligible studies assessed functional status, heart failure-related hospitalizations, and all-cause mortality in patients with heart failure. Two researchers independently screened the articles, extracted data, and evaluated the risk bias of each study. Dichotomous variables were presented as OR with a 95% confidence interval (CI). The data were analyzed using a fixed effect or random effect model, and heterogeneity was determined using I² statistics. All statistical analyses were conducted using RevMan 5.3.</p><p><strong>Results: </strong>Among 4279 studies screened, seven randomized controlled trials were included in this study. The results showed that weight management significantly improved functional status (OR = 0.15, 95% CI [0.07, 0.35], I² = 52%) and reduced the risk of all-cause mortality (OR = 0.54, 95% CI [0.34, 0.85], I² = 0%), but had no significant effect on heart failure-related hospitalizations (OR = 0.72, 95% CI [0.20, 2.66]).</p><p><strong>Linking evidence to action: </strong>Weight management has effects on improved functional status and reduced all-cause mortality in patients with heart failure. It is necessary to strengthen the weight management interventions of patients with heart failure to improve patients' functional status and reduce all-cause mortality.</p>","PeriodicalId":49355,"journal":{"name":"Worldviews on Evidence-Based Nursing","volume":" ","pages":"279-287"},"PeriodicalIF":4.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10045929","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":"Sustained delirium reduction in an inpatient neuroscience unit.","authors":"Elizabeth Kozub, Katie Hedquist, Lisa Tu, Ruth Bryant","doi":"10.1111/wvn.12704","DOIUrl":"10.1111/wvn.12704","url":null,"abstract":"<p><strong>Background: </strong>Delirium is described as acute brain dysfunction that often fluctuates throughout the day and is highly prevalent in hospitalized adults. Delirium negatively affects patient outcomes with consequences including decreased cognitive functioning and increased mortality and healthcare costs. Furthermore, neurological patients are at increased risk for developing delirium due to their underlying diagnoses.</p><p><strong>Purpose: </strong>The purpose of this evidence-based practice project was to evaluate the long-term impact of nursing education and use of trained volunteers to prevent the development of delirium in an inpatient neuroscience unit.</p><p><strong>Implementation plan: </strong>This was a pre-post designed evidence-based practice project to educate and prioritize nursing care interventions for delirium prevention compared to a delirium management framework. The interventions included delirium education for nurses and nursing assistants along with the development of a specialized volunteer program to implement non-pharmacological, multi-component delirium prevention interventions. Long-term sustainment and enculturation occurred over the subsequent year.</p><p><strong>Outcomes: </strong>The baseline data collection period included 2520 patients. The intervention period included 4515 patients, with both groups being similar in age, race, gender, and length of stay. The total number of patients with a discharge diagnosis of delirium decreased from 29.2% to 19.8% (p < .001). Fewer patients in the intervention group were discharged to a skilled nursing facility (p < .001) and other post-acute facility (p = .008), along with more patients being discharged to home care (p < .001).</p><p><strong>Linking evidence to action: </strong>This evidence-based practice project demonstrates long-term sustained reduction of delirium in the neuroscience population. Despite the challenges during the COVID-19 pandemic, delirium prevention strategies were found to be effective in decreasing the rate at which patients develop delirium.</p>","PeriodicalId":49355,"journal":{"name":"Worldviews on Evidence-Based Nursing","volume":" ","pages":"263-270"},"PeriodicalIF":4.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139099042","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":"Factors affecting colonoscopy screening among first-degree relatives of colorectal cancer patients: A mixed-method systematic review.","authors":"Rujin Li, Caixia Li, Li Liu, Weicong Chen, Yang Bai","doi":"10.1111/wvn.12689","DOIUrl":"10.1111/wvn.12689","url":null,"abstract":"<p><strong>Background: </strong>First-degree relatives (FDRs) of colorectal cancer (CRC) patients have a higher risk of developing CRC than the general population. Ensuring that these at-risk populations receive colonoscopy screening is an effective strategy for reducing the increased risk, but the rates remain low. Colonoscopy screening behavior is influenced by factors at multiple levels. However, most previous reviews failed to review them and their interactions systematically.</p><p><strong>Aims: </strong>To explore factors influencing FDRs' colonoscopy screening behavior according to the ecological model.</p><p><strong>Method: </strong>A mixed-method systematic review was performed in accordance with The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guideline. A comprehensive literature search was conducted using eight bibliographic databases (Medline, EMBASE, PubMed, the Cochrane Library, Scopus, China National Knowledge Infrastructure, Wan Fang Data, and China Biology Medicine) for the period from January 1995 to February 2023. The Joanna Briggs Institute critical appraisal checklists were applied to assess studies qualities. A convergent integrated approach was used for data synthesis and integration.</p><p><strong>Results: </strong>In total, 24 articles reporting on 23 studies were included. Only one study was rated low quality, and the other 22 studies were rated moderate to high quality. The findings revealed that certain factors and their interactions affected FDRs' colonoscopy screening behaviors according to the ecological model, including misconceptions about CRC and colonoscopy, concerns about the procedure, perceived susceptibility to developing CRC, health motivation, fear of CRC, fatalism, the recommendation from CRC patients, and recommendations from physicians, colonoscopy schedules, cancer taboo, health insurance and cost of colonoscopy.</p><p><strong>Link evidence to action: </strong>Family communication-centered multilevel interventions are recommended to promote colonoscopy screening behavior among FDRs of CRC patients.</p>","PeriodicalId":49355,"journal":{"name":"Worldviews on Evidence-Based Nursing","volume":" ","pages":"245-252"},"PeriodicalIF":4.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72211596","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}