{"title":"Publication Dynamics Where Evidence Is Missing: Mapping Empty Reviews in Nursing.","authors":"Chiara Moreal, Gaia Magro, Daniela D'Angela, Renzo Moreale, Gaia Dussi, Sara Dentice, Stefania Chiappinotto, Alvisa Palese","doi":"10.1111/wvn.70125","DOIUrl":"10.1111/wvn.70125","url":null,"abstract":"<p><strong>Introduction: </strong>The production of science is characterized by socio-political and technological forces that influence what knowledge is produced. In this context, empty reviews have received little attention, with debate ranging over the pros and cons of their publication. However, their dissemination may improve the ability to recognize and prioritize research gaps. The main aim of the study was to map empty reviews published in nursing science.</p><p><strong>Materials and methods: </strong>A scoping review in accordance with Arksey and O'Malley, Joanna Briggs Institute and Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews. The review protocol was registered in the Open Science Framework database in April 2025. Four databases and grey literature were searched; there were eligible scoping or systematic reviews defined as \"empty\" in the field of nursing. A modified framework of Patterns, Advances, Gaps, Evidence for practice, and Research recommendations was used to summarize the extracted data.</p><p><strong>Results: </strong>Fifteen empty reviews were identified. In terms of Patterns, the empty reviews were mainly published in high-income countries over the last 10 years and related to clinical practise and outcomes, education and training, organizational and human resources, and approaches to maternity care, mental health, and nursing education. In general, reporting guidelines were used, while funding was not documented. In terms of Recommendations, more primary studies, the development of tools and the strategic use of empty reviews to inform the funding and research agenda were suggested.</p><p><strong>Linking evidence to action: </strong>Empty reviews in nursing may indicate neglected or emerging areas that can help orient research agendas to ensure equity-oriented priorities and reduce the marginalization of under-investigated topics. Recognizing empty reviews as legitimate scholarly outputs supports transparent mapping of knowledge gaps, helping funders, institutions, and research programs direct resources to under-investigated areas. Dedicated registries that publicly report empty reviews, establish minimum reporting standards, and require explicit keywords in titles and abstracts would improve transparency and accessibility, and stimulate targeted primary research that can turn \"empty\" areas into active inquiry. From this perspective, empty reviews may attract research investment rather than be seen as methodological failures.</p>","PeriodicalId":49355,"journal":{"name":"Worldviews on Evidence-Based Nursing","volume":"23 1","pages":"e70125"},"PeriodicalIF":5.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12949488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147318740","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}
Jennifer Hayakawa, Paulina Schuhler, Rebecca DeAnda, John Schomberg, Melanie Patterson
{"title":"Our Stories, Our Strength: An Evidence-Based Practice Initiative to Enhance Healthcare Culture Through Storytelling.","authors":"Jennifer Hayakawa, Paulina Schuhler, Rebecca DeAnda, John Schomberg, Melanie Patterson","doi":"10.1111/wvn.70113","DOIUrl":"10.1111/wvn.70113","url":null,"abstract":"<p><strong>Background and/or rationale: </strong>The COVID-19 pandemic exacerbated burnout, isolation, and disconnection among healthcare workers, leading to national calls to address workplace mental health. Storytelling has emerged as an effective strategy to build belonging, resilience, and connection. In response, a pediatric healthcare system launched an evidence-based storytelling initiative rooted in narrative medicine and visual symbolism.</p><p><strong>Aim: </strong>To strengthen workplace culture by fostering connection, psychological safety, and meaning through structured storytelling.</p><p><strong>Implementation: </strong>Developed in partnership with Dear World, the intervention integrated guided reflection, peer sharing, and professional photography. Initially focused on staff, the initiative expanded to include adolescent and young adult patients. Implementation included phased rollout, train-the-trainer models, onboarding integration, and multimedia engagement. Evaluation methods included pre- and post-surveys and organizational metrics, with the Connection During Conversations Scale (CDCS) used to assess effectiveness across different session formats.</p><p><strong>Outcomes: </strong>Over 2 years, 1818 participants attended 60 events. Significant improvements in perceived connection and belonging were observed (p < 0.001), with 94% reporting stronger connections to colleagues and 93% to organizational values. CDCS analysis of Year 2 participants (n = 148) demonstrated comparable effectiveness between full and abbreviated session formats, with slightly stronger outcomes in full sessions. As part of broader workforce engagement efforts, nurse turnover declined from 21% to 13%, contributing to $2.3 million in projected cost avoidance.</p><p><strong>Linking evidence to action: </strong>This scalable, low-cost initiative offers a sustainable model for rehumanizing healthcare. Its integration into orientation, leadership development, and wellness programs underscores its value in fostering connection, resilience, and retention across high-stress care settings.</p>","PeriodicalId":49355,"journal":{"name":"Worldviews on Evidence-Based Nursing","volume":"23 1","pages":"e70113"},"PeriodicalIF":5.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145935779","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 Effectiveness of Acupoint Stimulation Therapies for Cancer-Related Fatigue: A Network Meta-Analysis.","authors":"Hui-Chuan Chou, Sriyani Padmalatha Konara Mudiyanselage, Chia-Chun Tang, Shu-Chuan Chen, Su-Ying Fang, Mei-Feng Lin","doi":"10.1111/wvn.70104","DOIUrl":"10.1111/wvn.70104","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to evaluate and rank the effectiveness of various acupoint stimulation therapies in alleviating cancer-related fatigue (CRF), a pervasive and distressing symptom among cancer patients.</p><p><strong>Background: </strong>CRF severely compromises patients' quality of life across treatment and survivorship stages. Despite growing interest in nonpharmacological interventions, comparative evidence on the efficacy of acupoint stimulation therapies remains limited.</p><p><strong>Methods: </strong>A systematic review and network meta-analysis of 28 randomized controlled trials (RCTs) involving 2370 participants was conducted. Databases searched included MEDLINE, CINAHL, Embase, Cochrane, Web of Science, and Airiti Library. Interventions included acupuncture, acupressure, oil acupressure, moxibustion, and transcutaneous electrical acupoint stimulation (TEAS). Standardized mean differences (SMDs) were calculated using a random-effects model. Surface Under the Cumulative Ranking Curve (SUCRA) was used to rank therapies.</p><p><strong>Findings: </strong>Oil acupressure (SUCRA: 73.6%), relaxing acupressure (73.4%), and acupuncture (72.7%) were the most effective interventions. Both professionally administered and self-administered therapies significantly reduced CRF, with no major differences in efficacy. Subgroup analyses revealed consistent effectiveness across cancer types, particularly breast and lung cancer, and treatment stages.</p><p><strong>Conclusions: </strong>Acupoint stimulation therapies, especially acupressure and acupuncture, effectively reduce CRF and are suitable for integration into routine cancer care. Self-administered acupressure offers a practical, low-cost alternative, especially in resource-limited settings. Standardization of protocols and long-term studies are warranted to guide clinical implementation.</p><p><strong>Trial registration: </strong>The review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO: CRD42024556455).</p>","PeriodicalId":49355,"journal":{"name":"Worldviews on Evidence-Based Nursing","volume":"23 1","pages":"e70104"},"PeriodicalIF":5.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146094699","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":"Team Strategies and Tools to Enhance Team Performance in Simulation Training on a Perinatal Unit.","authors":"Jenny Collins, Jamie Buchanan","doi":"10.1111/wvn.70121","DOIUrl":"10.1111/wvn.70121","url":null,"abstract":"<p><strong>Significance/background: </strong>The cause of medical errors and adverse events in healthcare is multifactorial and includes faulty systems, processes, and conditions that can lead individuals to make mistakes. These mistakes are estimated to cause between 210,000 and 400,000 preventable deaths each year in the United States and are often caused by ineffective communication and teamwork failures among interdisciplinary team members. Effective communication is crucial, especially during critical events as this impacts health care quality and patient safety.</p><p><strong>Aims: </strong>The project's aim was to implement the identified best practice of Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) 3.0 to improve communication and teamwork during critical events on a perinatal unit.</p><p><strong>Implementation plan: </strong>This was an evidence-based practice project consisting of 2 h of TeamSTEPPS didactic and interactive instruction followed by using the TeamSTEPPS concepts during 2 h of critical event simulation training to assess the perception of communication and teamwork of a multidisciplinary team on a perinatal unit. The multidisciplinary team members included labor and delivery nurses, mother/baby nurses, hospital aides, ward clerks, obstetrical technicians, obstetricians, and midwives.</p><p><strong>Outcomes: </strong>Using the TeamSTEPPS Teamwork Perception Questionnaire (T-TPQ), the perception of communication and teamwork was compared pre- and post-implementation. Communication and teamwork mean scores from pre to post increased by 61% and 56%, respectively. The mean posttest scores improved for each of the T-TPQ measures, indicating the intervention had an impact on each of the dimensions of the TeamSTEPPS approach, including team function, team leadership, situational monitoring, mutual support, and communication (p < 0.01) and Cohen's d<sub>z</sub>, of 0.82-1.32 provided evidence of a large effect.</p><p><strong>Linking evidence to action: </strong>This evidence-based practice project provided clear and specific guidance for communicating and strengthening teamwork during perinatal critical events. Implementing TeamSTEPPS strategies can provide a safe environment for patients and a positive work environment where teamwork and communication are encouraged.</p>","PeriodicalId":49355,"journal":{"name":"Worldviews on Evidence-Based Nursing","volume":"23 1","pages":"e70121"},"PeriodicalIF":5.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146107642","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}
Cara Gallegos, Trisha Saul, Rosemary A Timmerman, Frances Chu, Ross J Bindler, Crystal Billings
{"title":"EBP Beliefs, Competencies, Implementation Self-Efficacy, and Access to Mentors in a Large U.S. Healthcare System: An Updated Assessment of Where We Are Now.","authors":"Cara Gallegos, Trisha Saul, Rosemary A Timmerman, Frances Chu, Ross J Bindler, Crystal Billings","doi":"10.1111/wvn.70107","DOIUrl":"10.1111/wvn.70107","url":null,"abstract":"<p><strong>Background: </strong>Evidence-based practice (EBP) has been in existence for more than 30 years and is recognized as the standard to achieve high quality care.</p><p><strong>Purpose: </strong>To examine EBP beliefs, competence, implementation self-efficacy, organizational culture and readiness, access to mentors and assess relationships between nurse characteristics and EBP variables in a large healthcare system in six U.S. states.</p><p><strong>Methods: </strong>A cross-sectional descriptive correlational design was used to conduct a web-based anonymous survey of registered nurses in a large multistate healthcare system throughout the western US. Measures included: EBP Competency Self-Assessment Scale, the EBP Mentoring Scale, and the Short forms of the EBP Beliefs Scale, EBP Implementation Scale, the Organizational Culture and Readiness Scale for System-Wide Integration of Evidence-Based Practice.</p><p><strong>Results: </strong>A total of 1468 nurses completed the survey from 36 hospitals in six U.S. states. Overall, participants rated themselves competent in only one competency (asks clinical questions). EBP beliefs followed by implementation self-efficacy scores were highest. Total scores for EBP implementation showed the strongest positive correlation with EBP competency followed by beliefs and mentorship with culture and readiness, the least strong relationship. EBP competency, beliefs, and implementation increased with educational attainment. EBP mentorship scores were low across the system.</p><p><strong>Linking evidence to action: </strong>The study continues to demonstrate nurses' low perceptions of their EBP competency. Compared to previous studies, nurses in this sample reported their EBP competency higher; however, they still rated themselves above competence in only one statement. This underscores an urgent need for comprehensive education and robust support mechanisms. It is imperative that healthcare organizations establish access to experienced mentors and cultivate organizational structures to empower nurses to master EBP, thereby enhancing patient outcomes and advancing overall quality of care.</p>","PeriodicalId":49355,"journal":{"name":"Worldviews on Evidence-Based Nursing","volume":"23 1","pages":"e70107"},"PeriodicalIF":5.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146144407","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 Influencing HPV Vaccination Uptake in Adolescents: Evidence to Guide Clinical Practice.","authors":"Taylor Mullin, Diane Von Ah","doi":"10.1111/wvn.70120","DOIUrl":"10.1111/wvn.70120","url":null,"abstract":"<p><strong>Background: </strong>Human papillomavirus (HPV) is a major contributor to several preventable cancers. Although the HPV vaccine is recognized by the Centers for Disease Control and Prevention (CDC) as safe and effective, uptake among U.S. adolescents remains below optimal levels. Disparities in vaccination rates are shaped by both individual characteristics and social determinants of health (SDOH).</p><p><strong>Objective: </strong>To systematically review and synthesize the literature examining individual factors and social determinants of health associated with HPV vaccine initiation and completion among adolescents aged 9-18 years in the U.S.</p><p><strong>Methods: </strong>A systematic search was conducted in accordance with PRISMA guidelines, yielding 37 eligible studies from an initial pool of 2092 articles. The STROBE checklist was used to assess methodological quality, and the Levels of Evidence framework by Melnyk and Fineout-Overholt guided appraisal of study strength.</p><p><strong>Results: </strong>Across included studies, initiation and completion rates averaged 47% and 40%, respectively. Key predictors of higher vaccine uptake included provider recommendation, health insurance coverage, urban residence, older age, and higher parental education. Disparities were most evident among adolescents living in rural areas and those from minority or low-income backgrounds. Barriers reported in several studies included parental safety concerns and logistical challenges. Evidence regarding parental knowledge and attitudes was mixed: smaller studies suggested an influence, whereas the largest population-based study reported no significant effect.</p><p><strong>Conclusion: </strong>Addressing HPV vaccination disparities requires a multifaceted approach, including improving healthcare access in underserved regions, strengthening provider-parent communication, and implementing policy interventions such as school-based vaccination programs and state mandates. Normalizing HPV vaccination as part of routine adolescent care is essential for reducing HPV-related cancer morbidity and mortality. These findings also have implications for catch-up vaccination in young adults aged 15-26 and shared clinical decision-making up to age 45, which remain important strategies for increasing protection across the lifespan.</p>","PeriodicalId":49355,"journal":{"name":"Worldviews on Evidence-Based Nursing","volume":"23 1","pages":"e70120"},"PeriodicalIF":5.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12917299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146221733","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 Mindfulness-Based Interventions for Fear of Childbirth Among Pregnant Women Planned for Normal Birth: A Systematic Review and Meta-Analysis.","authors":"Ruohan Wang, Yinge Wang, Yue Huang, Ka Ming Chow","doi":"10.1111/wvn.70101","DOIUrl":"10.1111/wvn.70101","url":null,"abstract":"<p><strong>Background: </strong>Fear of childbirth is common among pregnant women. Mindfulness-based interventions have been used widely in obstetrics. However, the evidence of the effects on fear of childbirth is controversial.</p><p><strong>Aims: </strong>To evaluate the effects of mindfulness-based interventions on fear of childbirth, pain catastrophising, labour pain intensity, use of pain relief medication, mode of delivery and duration of labour among pregnant women planned for normal delivery.</p><p><strong>Methods: </strong>In this systematic review, 10 databases were searched from inception to 7 November 2024. Randomized controlled trials implementing mindfulness-based interventions for fear of childbirth or related outcomes were included. Two reviewers assessed the methodological quality and certainty of evidence independently. Standardized mean difference (SMD), risk ratio (RR), and 95% confidence intervals (CI) were used to evaluate effect sizes.</p><p><strong>Results: </strong>A total of 16 studies from 15 trials were included. Based on very low to moderate certainty of evidence, mindfulness-based interventions were effective in decreasing fear of childbirth both immediately post-intervention and within 6-week postpartum (SMD: -0.72; 95% CI -0.89, -0.55; SMD: -0.63; 95% CI -0.91, -0.35, respectively), labour pain intensity (SMD: -1.22; 95% CI -2.07, -0.37), caesarean section rate (RR: 0.58; 95% CI 0.36, 0.93), and total duration of labour (SMD: -1.03; 95% CI -1.34, -0.72), and improving mindfulness level both immediately post-intervention and within six-week postpartum (SMD: 0.48; 95% CI 0.31, 0.66; SMD: 0.50; 95% CI 0.27, 0.73, respectively), but had no significant effect on pain catastrophising (SMD: -0.36; 95% CI -0.72, 0.01) and epidural analgesia use rate (RR: 0.77; 95% CI 0.57, 1.03).</p><p><strong>Linking evidence to action: </strong>Mindfulness-based interventions have potential effects on reducing fear of childbirth and promoting labour-related outcomes. These interventions might be an effective approach in obstetrics clinical practice to enhance the pregnancy and labour experiences among pregnant women.</p><p><strong>Trial registration: </strong>PROSPERO registration number: CRD42024610793.</p>","PeriodicalId":49355,"journal":{"name":"Worldviews on Evidence-Based Nursing","volume":"23 1","pages":"e70101"},"PeriodicalIF":3.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12816443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146004783","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}
Ita Daryanti Saragih, Ira Suarilah, Hsun-Kuei Ko, Ice Septriani Saragih, Bih-O Lee
{"title":"Palliative Care Interventions for Caregivers of People With Advanced Dementia: A Meta-Analysis.","authors":"Ita Daryanti Saragih, Ira Suarilah, Hsun-Kuei Ko, Ice Septriani Saragih, Bih-O Lee","doi":"10.1111/wvn.70094","DOIUrl":"https://doi.org/10.1111/wvn.70094","url":null,"abstract":"<p><strong>Background: </strong>Palliative care reduces caregiver burden, alleviates patient symptoms, and supports treatment decision-making. However, despite these benefits, there is limited evidence on the effectiveness of palliative care interventions for caregivers of individuals with advanced dementia.</p><p><strong>Aims: </strong>To integrate and analyze data on the effectiveness of palliative care interventions in improving caregiver outcomes in order to ensure that both patients and caregivers receive the support necessary for optimal care experiences, quality of life management, and advanced care planning.</p><p><strong>Methods: </strong>A systematic search was conducted of six databases to identify relevant studies published from database inception to 12 December 2024. Randomized controlled trials (RCTs) investigating palliative care interventions for caregivers of people with advanced dementia were included. Version 2 of the Cochrane Risk of Bias tool was used to assess the risk of bias in the methodology of each study. Standardized mean differences (SMDs) between each intervention and control group were calculated. A random-effects DerSimonian and Laird model was applied to generate pooled SMD estimates for each outcome and assess its heterogeneity. A leave-one-out sensitivity analysis was performed to ensure the stability of the pooled effect sizes.</p><p><strong>Findings: </strong>Eight RCTs were included in the final analysis. Palliative care interventions appeared to reduce conflict in decision-making among caregivers of people with advanced dementia.</p><p><strong>Conclusion: </strong>Palliative care interventions were successful in reducing conflict in decision-making of caregivers of people with advanced dementia. However, the modality's effects on caregiver satisfaction and caregiver distress need further investigation.</p><p><strong>Linking evidence to action: </strong>Future palliative care interventions for caregivers of advanced dementia patients should focus on developing the contents of palliative care materials based on evidence-based evaluations and explore strategies to improve engagement between patients, caregivers, and healthcare professionals.</p>","PeriodicalId":49355,"journal":{"name":"Worldviews on Evidence-Based Nursing","volume":"22 6","pages":"e70094"},"PeriodicalIF":3.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745368","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":"Efficacy of Acceptance and Commitment Therapy for Smoking Cessation: A Systematic Review and Meta-Analysis.","authors":"Jia Fan, Xuexue Lei, Jiaxin Zhang, Yuyang Chang, Nan Jiang, Zhifei Qu, Bing Liang, Danhua Qu","doi":"10.1111/wvn.70086","DOIUrl":"10.1111/wvn.70086","url":null,"abstract":"<p><strong>Background: </strong>Smoking cessation is a pressing public health concern. Behavioral therapy has been widely promoted as a means to aid smoking cessation. Acceptance and commitment therapy (ACT), based on the principles of cognitive behavioral therapy, can help participants accept, rather than suppress, the physical and emotional experiences and thoughts associated with not smoking, identify experiential avoidance behaviors, strengthen the determination to quit, and ultimately commit to adaptive behavioral changes guided by smoking-cessation-related values, thereby achieving the goal of quitting smoking.</p><p><strong>Aims: </strong>To assess the effects of ACT compared with other smoking cessation interventions by examining three key outcomes: cessation rates, smoking behaviors, and psychological outcomes.</p><p><strong>Methods: </strong>We searched 8 databases and 2 registration platforms, covering the period from inception to March 26, 2025. We included only randomized controlled trials that recruited adult smokers and implemented ACT for smoking cessation, with the comparison group receiving either active treatment, no treatment, or any other intervention.</p><p><strong>Results: </strong>A total of 23 studies involving 8951 participants were included. The findings indicated that, compared with all types of control interventions, ACT significantly increased smoking cessation rates both immediately postintervention (RR = 1.48, 95% CI [1.03, 2.14], p = 0.04, I<sup>2</sup> = 81%) and at short-term follow-up (RR = 1.63, 95% CI = 1.31 to 2.01, p < 0.01, I<sup>2</sup> = 0%). Subgroup analyses showed that ACT significantly improved short-term cessation rates compared with behavioral support (RR = 1.60, 95% CI [1.27, 2.02], p < 0.01, I<sup>2</sup> = 0%), while, compared with the blank control, ACT significantly increased smoking cessation rates across three different time points (postintervention: RR = 3.11, 95% CI [2.13, 4.54], p < 0.01, I<sup>2</sup> = 0%; medium-term follow-up: RR = 2.55, 95% CI [1.32, 4.93], p < 0.01; long-term follow-up: RR = 3.33, 95% CI [1.66, 6.68], p < 0.01). Narrative synthesis suggested that compared with behavioral therapy, ACT may confer benefits in improving psychological outcomes, while compared with the blank control, it may also reduce daily cigarette consumption and nicotine dependence, and enhance psychological outcomes.</p><p><strong>Linking evidence to action: </strong>Acceptance and commitment therapy may be a beneficial approach for improving cessation rates, enhancing smoking cessation behaviors, and promoting psychological well-being among adult smokers. However, the quality of the included evidence was limited, thereby weakening the strength of these findings. Future rigorously designed trials with larger sample sizes, particularly those comparing ACT against other smoking cessation interventions, are warranted to further confirm its effects.</p>","PeriodicalId":49355,"journal":{"name":"Worldviews on Evidence-Based Nursing","volume":"22 6","pages":"e70086"},"PeriodicalIF":3.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145769664","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}
Wenzhong Zhang, Kangming Sun, Yan Wu, Jing Li, Zhenzhen Xu, Chunlei Wang, Fengyi Zhao, Qingxiang Sun, Ou Chen, Hong Ji
{"title":"Effectiveness of Nurse-Led Telephone-Based Follow-Up Interventions on Health Outcomes in People With Acute Coronary Syndromes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Wenzhong Zhang, Kangming Sun, Yan Wu, Jing Li, Zhenzhen Xu, Chunlei Wang, Fengyi Zhao, Qingxiang Sun, Ou Chen, Hong Ji","doi":"10.1111/wvn.70079","DOIUrl":"10.1111/wvn.70079","url":null,"abstract":"<p><strong>Background: </strong>Nurse-led telephone-based follow-up interventions play a role in patient follow-up, but at present, no meta-analysis has been found to assess the effectiveness of nurse-led, telephone follow-up interventions for patients with acute coronary syndrome.</p><p><strong>Objective: </strong>This systematic review and meta-analysis aimed to evaluate the effectiveness of nurse-led telephone-based follow-up interventions on health outcomes in people with acute coronary syndromes.</p><p><strong>Design: </strong>Systematic review and meta-analysis of randomized controlled trials.</p><p><strong>Methods: </strong>A comprehensive search of six databases: PubMed, Web of Science, Embase, Cochrane Library, CINAHL and Scopus was conducted from the inception of the databases to 30 September 2023. The Cochrane Risk of Bias Tool was used to assess the methodological quality of the included randomized controlled studies. Review Manager 5.4 and Stata 16.0 were used to conduct statistical analysis.</p><p><strong>Results: </strong>A total of 12 studies were included. Nurse-led telephone-based follow-up interventions may reduce systolic and diastolic blood pressure (MD = -2.55, 95% CI [-4.16, -0.94]) (MD = -2.15, 95% CI [-3.18, -1.12]) and low-density lipoprotein (MD = -9.06, 95% CI [-14.33, -3.79]) in patients with acute coronary syndrome. However, its effectiveness in controlling high-density lipoprotein (MD = 1.65, 95% CI [-4.30, 7.61]) and reducing total cholesterol (MD = -2.72, 95% CI [-7.57, 2.13]) was uncertain. In addition, the results showed that the nurse-led follow-up intervention did not play a role in improving anxiety (SMD = -0.20, 95% CI [-0.44, 0.04]) and depression (SMD = -0.07, 95% CI [-0.21, 0.06]) in patients with acute coronary syndrome, but it probably improved drug adherence (RR = 1.30, 95% CI [1.05, 1.60]) and smoking cessation (RR = 1.31, 95% CI [1.08, 1.60]).</p><p><strong>Linking evidence to action: </strong>The findings of this review suggest that nurse-led telephone-based follow-up interventions had a potentially positive effect on controlling blood pressure and low-density lipoprotein levels, as well as improving medication adherence and smoking cessation among patients with acute coronary syndrome, compared to usual care. However, the intervention did not appear to significantly impact high-density lipoprotein, total cholesterol, anxiety, and depression, indicating that further research in these areas will be necessary in the future.</p><p><strong>Trial registration: </strong>PROSPERO (International Prospective Register of Systematic Reviews): CRD42023465894.</p>","PeriodicalId":49355,"journal":{"name":"Worldviews on Evidence-Based Nursing","volume":"22 6","pages":"e70079"},"PeriodicalIF":3.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145423381","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}