Nursing Research最新文献

{"title":"Cognitive Function, Physical Activity, and Sweat Cytokines in Older Adults With Dementia.","authors":"Jo Woon Seok, Ae Young Cho, Ji Yeon Lee, Hyangkyu Lee, Kyung Hee Lee","doi":"10.1097/NNR.0000000000000850","DOIUrl":"https://doi.org/10.1097/NNR.0000000000000850","url":null,"abstract":"<p><strong>Background: </strong>Inflammatory cytokines are linked to cognitive function in older adults with dementia; however, their associations with physical activity (PA) and noninvasive biomarkers, such as sweat, remain unclear.</p><p><strong>Objectives: </strong>This study aimed to examine the relationships among cognitive function, PA, and sweat cytokines, as well as the moderating effect of cognitive function on the association between PA and cytokine levels.</p><p><strong>Methods: </strong>Data from 40 older adults with dementia were analyzed to assess correlations between cognitive function, PA measured via wearable devices and sweat cytokine levels. Pearson's correlation, multiple linear regression, and the Johnson-Neyman method were employed to evaluate these associations. Interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) levels were measured from sweat samples, and cognitive function was assessed using standardized cognitive tests.</p><p><strong>Results: </strong>PA was positively associated with IL-6 and TNF-α, while lower cognitive function was linked to higher TNF-α levels. Cognitive function moderated the association between PA and TNF-α; specifically, higher PA was associated with lower TNF-α levels among participants with moderate-to-severe levels of dementia.</p><p><strong>Discussion: </strong>These findings suggest that sweat cytokine measurement is a viable noninvasive biomarker for inflammatory responses in dementia and that the effect of PA on inflammation may be influenced by cognitive function. Nurses should consider patients' cognitive function when interpreting the association between PA and cytokine levels.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144664102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Creating a Community of Safety in Black Maternal Health Research.","authors":"Alexis Dunn Amore, Abby J Britt, Renee Byfield, Kareena Cumberbatch, Oluwatomisin Faith-Tomi Wilson, Kamisha Milton, Raquibah Raheem, Shelley Gutierrez, Tietra Jones, Amanda Mullen, Nicole S Carlson","doi":"10.1097/NNR.0000000000000849","DOIUrl":"https://doi.org/10.1097/NNR.0000000000000849","url":null,"abstract":"<p><strong>Background: </strong>Health disparities in maternal health outcomes persist among Black birthing populations in the United States. Given the historical harms experienced by Black populations in research, culturally tailored approaches to ensure ethical research are needed. Community-engaged research strategies have been found to be effective in a variety of investigations; however, little has been documented regarding their use within biologically focused research among pregnant populations.</p><p><strong>Objective: </strong>The purpose of this paper is to describe the process of engaging with a community advisory board of a biologically focused research study focused on reducing perinatal health disparities and promoting health equity. Specifically, we outline the methods followed to meaningfully involve the community in each step of the research process.</p><p><strong>Methods: </strong>The research team utilized intentional team-building activities and feedback methods to relay information between the community and research partners regarding study protocols and community-led dissemination strategies. Online sessions with community partners were created utilizing community-engaged research principles to guide the sessions. Information obtained from the community advisory board (CAB) during these sessions was used to modify and optimize this study's data collection protocol, recruitment strategies, and dissemination efforts. A quantitative and qualitative survey was conducted during the process to gather feedback from CAB members about their experiences.</p><p><strong>Results: </strong>The CAB (n = 8 community members) shared in the operation of the project and collaborated on everything from study onset, recruitment/retention strategies, informed consent processes, and dissemination to data sharing. Scores from the quantitative questionnaire (n = 5) about their experiences demonstrated that members overall reported good or excellent experiences as participants in the CAB. Additionally, feedback from community members about how they felt working within a research team included feeling that they were (a) making the research study better, (b) learning about research, (c) providing voice for the community, and (d) building a community of trust. Detailed feedback on each session resulted in changes in study protocols, recruitment practices, and dissemination activities.</p><p><strong>Discussion: </strong>Safety is a crucial tenant of all research investigations. When research focuses on populations who have experienced perpetual harm, utilization of community expertise is necessary to ensure just and equitable research experiences.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144664104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceived Need and Utilization of Mental Health Services by Registered Nurses.","authors":"Shira Winter, Robert H Pietrzak, Celestine He, Jonathan M DePierro, Bevin Cohen, Chi Chan, Sydney Starkweather, Cara Faherty, Emma Benn, Uraina Clark, Nihal Mohamed, Lauren Peccoralo, Jonathan Ripp","doi":"10.1097/NNR.0000000000000852","DOIUrl":"https://doi.org/10.1097/NNR.0000000000000852","url":null,"abstract":"<p><strong>Background: </strong>Nurses experience high rates of mental health stressors. Mental health support services can mitigate the burden of these stressors and mental health sequelae, but nurses may not access them due to stigma, unavailability, or concerns regarding professional standing.</p><p><strong>Objective: </strong>To examine the association between nurse characteristics and perceived need for and utilization of mental health services and identify barriers to nurses accessing mental health services.</p><p><strong>Methods: </strong>Cross-sectional survey data were analyzed from 367 nurses in one large urban health system. Descriptive statistics and multinomial logistic regression were used to examine demographic, workplace, and mental health characteristics that were independently associated with perceived need for and utilization of mental health services.</p><p><strong>Results: </strong>Nurses who reported experiences of verbal abuse, anxiety, or burnout and who were younger and partnered were more likely to have utilized mental health services and have perceived they would benefit from these services. The most prevalent barriers to care included not knowing how to find a provider, inconvenient hours, and embarrassment or concerns about judgment from others.</p><p><strong>Discussion: </strong>Several barriers prevent nurses who perceive a need for mental health services from accessing them. Interventions targeting these barriers may help mitigate the burden of mental health conditions in this population.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144664106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breast Cancer Barriers to Education and Screening in People Experiencing Homelessness.","authors":"Vicki L Brzoza, Elyse Ryan","doi":"10.1097/NNR.0000000000000853","DOIUrl":"https://doi.org/10.1097/NNR.0000000000000853","url":null,"abstract":"<p><strong>Background: </strong>Each year in the United States, approximately 42,211 women and men die from breast cancer. Individuals experiencing homelessness are disproportionately affected, facing a higher incidence of the disease. People experiencing homelessness (PEH) have a higher incidence of breast cancer and mortality than domiciled individuals. Across all 50 states, the Centers for Disease Control and Prevention (CDC) provides free breast cancer screenings for eligible individuals with limited financial resources. However, people experiencing homelessness have screening rates that remain below the national average. Early detection is critical to identifying breast cancer. When detected in the earliest local stages, there is a 90% or better survival rate.</p><p><strong>Objective: </strong>The objective of the study was to examine the perspective of PEH regarding perceived challenges of obtaining breast cancer screenings, education, and care.</p><p><strong>Methods: </strong>We used a qualitative hermeneutic phenomenology design. Data were gathered using a focus group consisting of PEH in the state of New Jersey. This approach allowed the researchers to access multiple viewpoints of the phenomenon through robust discussions while prioritizing individual contributions and shared experiences. This qualitative hermeneutic phenomenology design used trustworthiness to establish rigor, using essential details in credibility, dependability, transferability, and confirmability.</p><p><strong>Results: </strong>Eighteen individuals participated. Major considerations for this PEH focus group were finances, family, time, accessibility, emotions, and education.</p><p><strong>Discussion: </strong>The results may be used to assist health care practitioners in becoming more informed about barriers to breast cancer education, screenings, and care. Identifying needs about finances, obligations, accessibility, and education may assist healthcare practitioners in discussing these key factors with patients, which may lead patients to become more open to breast cancer screenings. More dialogue about breast cancer screenings with PEH may lead to more screening participation.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144664101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Computable Phenotyping: Disease-Agnostic Translational Methods to Puberty and Diabetes in Adolescent Males.","authors":"David J Dj Schnabel, Lorah Dorn","doi":"10.1097/NNR.0000000000000848","DOIUrl":"https://doi.org/10.1097/NNR.0000000000000848","url":null,"abstract":"<p><strong>Background: </strong>Computable phenotyping is a data science method that systematically synthesizes clinical attributes, such as a disease, condition, or patient cohort, enabling a database to be queried for entries matching these characteristics. Developing computable phenotypes will enhance current clinical and research efforts and is foundational for effective nurse scholar participation in future data science endeavors, such as artificial intelligence (AI) and machine learning (ML) research.</p><p><strong>Objective: </strong>(a) Present a foundational, disease-agnostic framework for systematic computable phenotype construction; (b) demonstrate the framework used by exploring the following question: \"Does early pubertal timing increase the risk of developing type II diabetes in males?\"; and (c) outline the methodologic utility and limitations of computable phenotyping for nursing research.</p><p><strong>Methods: </strong>A proof-of-concept pilot project explored computable phenotype research utility by querying the TriNetX© de-identified health record database. Various computable phenotypes were constructed to retrieve complete case frequency counts of specific health records for children experiencing puberty. These retrieved records allowed for quantifying type 2 diabetes (T2D) risk by comparing children diagnosed with precocious puberty (medically diagnosed early puberty) to those without an abnormal puberty diagnosis. A translational science lens informed the extraction and synthesis of the underlying scientific and operational principles relevant to systematic computable phenotyping.</p><p><strong>Results: </strong>A six-step, disease-agnostic, computable phenotyping framework is synthesized for nurse researchers and clinicians to leverage \"big data\" applications in their work. The puberty case example-illustrating foundational use of the framework-suggests that males with precocious puberty may be six times more likely to develop T2D when 14-18 years old than those without diagnosed early puberty. The framework provides a foundation for sophisticated statistical analyses, such as leveraging computable phenotypes in multivariate modeling and machine learning algorithms.</p><p><strong>Discussion: </strong>The six-step, computable phenotype framework will introduce nurse scholars and clinicians to leverage data science principles in real-world interfaces. Applications using the framework can include generating and testing epidemiologic hypotheses, identifying participants for research with specific clinical attributes, deploying statistical models for health care monitoring and decision-making, and participating in future research on AI and ML algorithms. The puberty case example generates foundational evidence to justify future puberty research.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144664103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interpersonal Processes of Care Disparities, Symptom Distress, and Chemotherapy Dosing in Women With Early-Stage Breast Cancer.","authors":"Hiba Abujaradeh, Susan R Mazanec, Catherine M Bender, Mary C Connolly, Jill B Hamilton, Rachel L Brazee, Julia A O'Brien, Margaret Rosenzweig","doi":"10.1097/NNR.0000000000000847","DOIUrl":"https://doi.org/10.1097/NNR.0000000000000847","url":null,"abstract":"<p><strong>Background: </strong>Communication is an important tool in combatting racial and economic health care disparities in cancer care. The ability to communicate treatment-related distress and troubling symptoms can allow proactive symptom mitigation and adherence to a prescribed cancer treatment. Few studies have explored how racial and economic differences in patient-clinician interactions in cancer care influence symptom distress and chemotherapy adherence.</p><p><strong>Objectives: </strong>This study aimed to examine racial differences in interpersonal processes of care and their association with symptom distress and optimal chemotherapy dose among women diagnosed with early-stage breast cancer (ESBC).</p><p><strong>Methods: </strong>Black and White women newly diagnosed with ESBC and prescribed chemotherapy for a diagnosis of invasive breast cancer were recruited. Interpersonal Processes of Care and Symptom Distress Scale were included in this analysis. Ratios of prescribed chemotherapy to received chemotherapy were recorded as total chemotherapy percentage.</p><p><strong>Results: </strong>Persons who were Black perceived worse scores in communication, including \"lack of clarity,\" \"discrimination due to race/ethnicity,\" and \"disrespectful office staff.\" Participants who lived in areas of greater deprivation perceived worse levels of \"discrimination due to race/ethnicity\" compared to those living in areas of less deprivation. Participants who perceived higher \"discrimination due to race/ethnicity\" were less likely to achieve optimal chemotherapy doses. Those who perceived worse scores for \"lack of clarity,\" \"discrimination due to race/ethnicity,\" \"disrespectful office staff,\" and \"compassion\" had significantly higher levels of symptom distress.</p><p><strong>Discussion: </strong>Symptom distress during ESBC chemotherapy must be communicated via patient-provider interaction. Patients' perceptions of discrimination and bias may inhibit this process. This interaction requires further interrogation to develop an inclusive symptom communication protocol.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144664105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Related to Stroke Awareness and Severity in an Underserved Urban Community.","authors":"Joanna M Marmo, Benjamin Bass, Vincenza Coughlin, Kathleen Evanovich Zavotsky","doi":"10.1097/NNR.0000000000000829","DOIUrl":"10.1097/NNR.0000000000000829","url":null,"abstract":"<p><strong>Background: </strong>Despite experiencing an increased incidence in stroke, minority groups have the lowest reported knowledge of stroke signs and symptoms and are less likely to receive time-sensitive interventions. There is a need to explore the relationship between social determinants of health and stroke awareness and severity within at-risk communities.</p><p><strong>Objectives: </strong>The aim of this study was to explore relationships between social determinants of health and stroke awareness and severity in an underserved area located in a city borough in Northeastern United States.</p><p><strong>Methods: </strong>We used an exploratory descriptive retrospective design and existing data. Data from 1,162 patients discharged with a principal diagnosis of stroke (ischemic stroke, subarachnoid hemorrhage, or intracerebral hemorrhage) were analyzed to explore the relationship between social determinants of health (age, sex, race, ethnicity, payer status, zip code) and stroke awareness and severity.</p><p><strong>Results: </strong>Age group, race, and hospital arrival method were all significant indicators of time to arrival at the hospital. When holding all other factors in the model constant, being 65 years of age or older was associated with a decrease in time to reach the hospital compared to those under 65 years of age. Those who traveled by private transport had longer discovery to arrival times when holding all other factors constant, as compared to those who arrived by emergency medical services. Compared to persons who were White, persons who were Black or Asian saw increased times to hospital arrival.</p><p><strong>Discussion: </strong>This study found that social determinants of health including age, race, sex, and insurance type significantly influenced stroke awareness and/or severity. These study findings can be used by stroke program leadership and community nurses to direct community-centered stroke awareness outreach.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":"294-298"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hair Sampling for Physiological Stress Among Early Childhood Educators.","authors":"Randi A Bates, Walaa R Almallah, Bailey E Martin, Tharaa I Ananzeh, Christopher W Collen, Jaclyn M Dynia","doi":"10.1097/NNR.0000000000000815","DOIUrl":"10.1097/NNR.0000000000000815","url":null,"abstract":"<p><strong>Background: </strong>Despite expanding investigations of chronic physiological stress as measured by hair cortisol concentration among adults, there is little research examining chronic physiological stress among early childhood educators. Despite the \"calling\" of the career, these educators are at a unique increased risk for chronic stress due to earning stagnant, unlivable wages as compared to their K-12 educator colleagues and often being primary care providers to children and families experiencing intergenerational trauma. Because physiological stress may be linked to chronic disease later in life and may present differently than psychological stress, it is important to understand the feasibility of measuring chronic physiological stress, as commonly measured with hair cortisol, in this essential and unique population.</p><p><strong>Objectives: </strong>The aim of the study was to examine the feasibility of collecting hair to measure cortisol concentration as an estimate of chronic physiological stress among early childhood educators by understanding variations in their participation.</p><p><strong>Methods: </strong>Analyses of hair sampling participation of center-based educators by sociodemographic characteristics occurred across two pilot studies: one longitudinal ( n = 67) conducted during the COVID-19 pandemic (2021) and one cross-sectional ( n = 31) occurring postpandemic (2024). Educators were asked to provide hair samples for cortisol analysis to measure physiological stress and complete surveys on reasons for nonparticipation and their sociodemographic characteristics, including age, race, ethnicity, gender, and highest level of education.</p><p><strong>Results: </strong>Educators' sociodemographic characteristics generally reflected nationally representative samples. Across the studies, 75.3% of educators participated in initial hair sampling. Collectively, the most common reason for nonparticipation was related to hairstyle or hair characteristics. Educators who were Black/African American or had less than a bachelor's degree in education were least likely to participate in hair sampling.</p><p><strong>Discussion: </strong>Collecting hair for cortisol as a measure of physiological stress among early childhood educators is feasible. However, researchers may want to consider alternative measures of chronic physiological stress to promote equitable research practices among educators who are Black/African American or who have lower than a bachelor's degree in education. Given the importance of chronic physiological stress for health, avenues for future research are discussed.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":"313-317"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Qualitative Evaluation of Financial Toxicity and Supportive Care Needs of Women Living With Metastatic Breast Cancer.","authors":"Victoria K Marshall, Cindy Tofthagen, Pooja Advani, Dawn Mussallem, Cheryl Zambroski, Constance Visovsky","doi":"10.1097/NNR.0000000000000831","DOIUrl":"10.1097/NNR.0000000000000831","url":null,"abstract":"<p><strong>Background: </strong>The cost of cancer treatment is higher for breast cancer than any other cancer diagnosis, leaving women with metastatic breast cancer (MBC) vulnerable to challenges given the extended length of cancer treatment, including financial, physical, and psychological burdens.</p><p><strong>Objective: </strong>The purpose of this study was to examine the lived experiences of women diagnosed with MBC in the realm of financial concerns and unmet support needs specific to their cancer treatment.</p><p><strong>Methods: </strong>This qualitative, phenomenological study included individual interviews that were audio-recorded and transcribed verbatim. Applied thematic analysis was completed using Atlas.ti. Interrater reliability using Cohen's kappa was established at 0.80. Participants were recruited from a National Cancer Institute-designated cancer center in the United States.</p><p><strong>Results: </strong>Sixteen participants were interviewed. A majority were White, non-Hispanic, married, unemployed, and had obtained at least a bachelor's degree level of education. Nearly 19% of participants reported a gross household income of below $50,000. The mean age of participants was 55.6 years. Two major themes were identified, with each having three corresponding subthemes, including: 1) financial toxicities (cost of cancer treatments and medications, limitations of health insurance, and effect on employment); and 2) unmet support needs (managing usual responsibilities, emotional support, community and organizational support).</p><p><strong>Discussion: </strong>The results highlight the financial and psychosocial needs of women with MBC. Treatment costs take a huge financial toll on patients and their families, including insured women with higher household incomes. Participants expressed a desire for specific MBC resources and support.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":"266-271"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic Review of Effects of Medication Dispenser Use by Home-Dwelling Older Adults.","authors":"Olli Salmensuu, Virva Hyttinen-Huotari, Jenni Isotalo, Mieke Rijken, Ismo Linnosmaa, Minna Kaarakainen","doi":"10.1097/NNR.0000000000000824","DOIUrl":"10.1097/NNR.0000000000000824","url":null,"abstract":"<p><strong>Background: </strong>Population aging has increased the need for solutions that help older adults live independently in their own homes, where medication management is a major challenge.</p><p><strong>Objectives: </strong>In this systematic review, we assessed the effects of medication dispensers among home-dwelling older adults on outcomes within the five domains of the Quintuple Aim framework: user experiences, health and well-being outcomes, health service utilization and costs, care professional experiences, and equity.</p><p><strong>Methods: </strong>We identified relevant studies by searching databases (Scopus, CENTRAL, PubMed, Web of Science, CINAHL, PsycINFO, and Cochrane Reviews) from January 2017 to April 2022 with a predefined search strategy and two-person abstract and full-text screening. Two authors extracted the most relevant data and assessed quality for each included study. We assessed the evidence using a four-level quality rating measure: strong, moderate, limited, or no evidence.</p><p><strong>Results: </strong>We included five original studies and three systematic reviews, which provided information on 20 additional original studies. Data were extracted from these 25 original studies. We found significant results in 16 of them, mostly pointing to the beneficial effects of dispenser devices. Significant results for health and well-being outcomes were found in 13 out of 21 studies in which these were assessed, for service utilization in two out of five studies, for costs in two out of three studies, and for patient/carer experiences in one out of five studies. No study evaluated professional experiences or equity outcomes. Overall, strong evidence of a beneficial effect of dispenser devices in any outcome is lacking, but they can improve health outcomes (moderate evidence of beneficial effects of using dispenser devices on systolic and diastolic blood pressure, and hemoglobin A1c levels). For other outcome domains, there is no or only limited evidence for beneficial effects of dispenser devices.</p><p><strong>Discussion: </strong>We found that the use of dispenser devices by home-dwelling older adults can improve clinical health outcomes and may reduce health service utilization and costs. More high-quality research is needed to get a better insight into their effects on service utilization and costs. Future studies should also examine the effects on care professionals' experiences and equity.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":"305-312"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}