International Journal of Nursing Studies最新文献

{"title":"Effects of advanced practice nurses on health-care costs, quality of care, and patient well-being: A meta-analysis of randomized controlled trials","authors":"Melati Fajarini , Agus Setiawan , Chien-Mei Sung , Ruey Chen , Doresses Liu , Chiu-Kuei Lee , Shu-Fen Niu , Kuei-Ru Chou","doi":"10.1016/j.ijnurstu.2024.104953","DOIUrl":"10.1016/j.ijnurstu.2024.104953","url":null,"abstract":"<div><h3>Background</h3><div>The growing recognition of advanced practice nurses' role has been challenged by the need for decreased health-care costs while ensuring quality of care and patient well-being. However, limited evidence exists from previous reviews evaluating the effectiveness of advanced practice nurses.</div></div><div><h3>Objectives</h3><div>To investigate the effects of advanced practice nurses on health-care costs, quality of care, and patient well-being.</div></div><div><h3>Design</h3><div>A meta-analysis of randomized controlled trials.</div></div><div><h3>Methods</h3><div>A literature search was conducted in CINAHL, Cochrane Library, Embase, Ovid-Medline, PubMed, Scopus, and Web of Science from their inception to June 2023. The primary outcome was health-care costs, including total cost with direct (hospitalization, medication, and diagnostic costs) and indirect costs. The secondary outcomes were quality of care (hospitalization, readmission, length of stay, mortality and patient satisfaction) and well-being [mental (anxiety, depression), physical (pain, fatigue), and quality of life]. Hedges' <em>g</em> and odds ratio with corresponding 95 % confidence intervals were calculated using a random-effects model to obtain pooled effect estimates for the primary and secondary outcomes. Heterogeneity was determined using <em>I</em><sup>2</sup> and <em>Q</em> statistics, and moderator analysis was performed to determine the sources of heterogeneity. Publication bias was evaluated using the Begg and Mazumdar rank correlation and Egger's test and through the visual inspection of a funnel plot.</div></div><div><h3>Results</h3><div>In this review, we included 22 studies involving 7764 participants, mostly women (56.4 %). Compared with other health professionals, advanced practice nurses significantly reduced patients' total costs (<em>g</em>, −<!--> <!-->0.21; 95 % confidence interval, −<!--> <!-->0.30 to −<!--> <!-->0.12), lowered direct costs (<em>g</em>, −<!--> <!-->0.15; 95 % confidence interval, −<!--> <!-->0.22 to −<!--> <!-->0.08), and decreased hospitalization costs (<em>g</em>, −<!--> <!-->0.19; 95 % confidence interval, −<!--> <!-->0.34 to −<!--> <!-->0.04). As well, advanced practice nurses significantly lowered hospital readmissions (odds ratio, 0.25; 95 % confidence interval, 0.11 to 0.57), increased patient satisfaction (<em>g</em>, 0.54; 95 % confidence interval, 0.31 to 0.77), reduced anxiety (<em>g</em>, −<!--> <!-->0.36; 95 % confidence interval, −<!--> <!-->0.71 to −<!--> <!-->0.00), depression (<em>g</em>, −<!--> <!-->0.28, 95 % confidence interval, −<!--> <!-->0.46 to −<!--> <!-->0.10), pain (<em>g</em>, −<!--> <!-->0.20; 95 % confidence interval, −<!--> <!-->0.35 to −<!--> <!-->0.04), and fatigue (<em>g</em>, −<!--> <!-->0.24; 95 % confidence interval, −<!--> <!-->0.41 to −<!--> <!-->0.07). Patient satisfaction improved in disease management, follow-up care, and blended intervention, although did not reach statistica","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"162 ","pages":"Article 104953"},"PeriodicalIF":7.5,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142696556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Benefits of an educational intervention on functional capacity in community-dwelling older adults with frailty phenotype: A randomized controlled trial","authors":"Andrea González-Mariscal , Juan Corral-Pérez , María Ángeles Vázquez-Sánchez , Laura Ávila-Cabeza-de-Vaca , Manuel Costilla , Cristina Casals","doi":"10.1016/j.ijnurstu.2024.104955","DOIUrl":"10.1016/j.ijnurstu.2024.104955","url":null,"abstract":"<div><h3>Background</h3><div>There is an urgent demand for nurses to expand their knowledge and skills in managing frailty in primary care. Frailty is a multifaceted condition that is prevalent among older adults and often leads to reduced functional capacity. Currently, there is a limited understanding of the effectiveness of educational interventions aimed at improving functional capacity among community-dwelling frail older adults in a primary care setting.</div></div><div><h3>Objective</h3><div>This study aimed to evaluate the impact of an educational program on functional capacity among pre-frail and frail older adults living in the community.</div></div><div><h3>Design</h3><div>A 12-month, multicenter, randomized controlled trial.</div></div><div><h3>Settings</h3><div>The FRAGSALUD study was conducted across 14 healthcare centers situated within the regions of Cadiz and Malaga, Spain.</div></div><div><h3>Participants</h3><div>A total of 199 frail/pre-frail community-dwelling older adults (74.2 ± 6.4 years).</div></div><div><h3>Methods</h3><div>Participants who met at least one Fried's criteria were assigned to either the control group (n = 90), which received usual healthcare assistance, or the intervention group (n = 109). The 6-month intervention comprised four group sessions and six telephone calls conducted by professional nurses, sport scientists, and nutritionists. This educational program focused on guidelines for physical activity, nutritional habits, cognition, and psychosocial well-being. Functional capacity was assessed using questionnaires for basic (Barthel Index) and instrumental (Lawton and Brody Scale) activities of daily living. All outcome measures were evaluated at baseline, immediately after the intervention (6-month), and six months after the intervention as a follow-up (12-month). Differences in functional capacity (Barthel Index and Lawton and Brody Scale scores) across the three time points were analyzed using Friedman's ANOVA, with Wilcoxon signed-rank test for pairwise comparisons.</div></div><div><h3>Results</h3><div>At both 6-month and 12-month assessments, the control group showed a statistically significant decline in basic and instrumental activities of daily living compared to the intervention group, which maintained similar levels, preventing this age-related decline.</div></div><div><h3>Conclusions</h3><div>The educational intervention, designed for easy implementation within healthcare systems, especially for nurses, successfully maintained levels of functional capacity in basic and instrumental activities of daily living, while the control group experienced a decline in functional capacity during the 12-month follow-up. Thus, educational interventions are encouraged for preserving the functional independence of frail/pre-frail older adults living in the community.</div></div><div><h3>Registration</h3><div>This trial was registered at <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> (Id","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"162 ","pages":"Article 104955"},"PeriodicalIF":7.5,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics and influencing factors of serious fall injuries among older inpatients: A secondary analysis of multicenter cross-sectional administrative data","authors":"Jingcan Xu ,&nbsp;Shuyi Peng ,&nbsp;Li Yao ,&nbsp;Minhui Liu ,&nbsp;Liqing Yue","doi":"10.1016/j.ijnurstu.2024.104956","DOIUrl":"10.1016/j.ijnurstu.2024.104956","url":null,"abstract":"<div><h3>Background</h3><div>Inpatient falls are common adverse events in hospitals, particularly among older adults. However, current research on falls in the older population is limited by small sample sizes and reliance on single-center designs without distinguishing the different levels of fall injuries.</div></div><div><h3>Objective</h3><div>To examine the circumstances of falls in older inpatients and investigate the factors influencing serious fall injuries.</div></div><div><h3>Design</h3><div>A secondary analysis of multicenter cross-sectional administrative data from the China National Database of Nursing Quality (CNDNQ).</div></div><div><h3>Setting(s)</h3><div>67 hospitals in Hunan, China.</div></div><div><h3>Participants</h3><div>5143 fall incidents from 5048 older inpatients were included from January 2019 to December 2022.</div></div><div><h3>Methods</h3><div>Descriptive statistics (means, standard deviations, frequencies, and percentages) were used to describe fall characteristics. Given the multilevel data structure, a Generalized Linear Mixed Model (GLMM) with a Logistic link function was employed, treating hospitals and wards as random effects. Univariate and multivariate analyses were conducted.</div></div><div><h3>Results</h3><div>The prevalences of fall-related injuries and serious fall injuries in this study were 63.3 % and 25.0 %, respectively. Nurse-to-patient ratio at the time of fall ≤<!--> <!-->0.05 (<em>aOR</em> = 1.522, <em>95</em> <em>% CI:</em> 1.297–1.785), female gender (<em>aOR</em> = 1.304, <em>95</em> <em>% CI:</em> 1.137–1.497), a lengthy hospital stay (<em>aOR</em> = 1.009, <em>95</em> <em>% CI:</em> 1.001–1.018) were associated with an increased risk of serious fall injuries. Surgical (<em>aOR</em> = 0.655, <em>95</em> <em>% CI:</em> 0.482–0.889) and orthopedic wards (<em>aOR</em> = 0.649, <em>95</em> <em>% CI:</em> 0.449–0.939) exhibited lower risks of serious fall injuries than internal medicine wards. The period from 8:00 to 15:59 was associated with a higher risk of serious fall injuries compared to the period from 0:00 to 7:59 (<em>aOR</em> = 1.416, <em>95</em> <em>% CI:</em> 1.171–1.713). Compared to lying, standing (<em>aOR</em> = 2.594, <em>95</em> <em>% CI:</em> 1.733–3.883), getting in/out of bed (<em>aOR</em> = 1.403, <em>95</em> <em>% CI:</em> 1.009–1.951), walking or rehabilitating (<em>aOR</em> = 3.039, <em>95</em> <em>% CI:</em> 2.194–4.208), toileting (<em>aOR</em> = 1.411, <em>95</em> <em>% CI:</em> 1.038–1.917), and showering (<em>aOR</em> = 2.170, <em>95</em> <em>% CI:</em> 1.391–3.385) were associated with an increased risk of serious fall injuries.</div></div><div><h3>Conclusions</h3><div>Fall-related injuries and serious fall injuries are highly prevalent among older inpatients. The study provides insights for targeted fall prevention strategies, improving nursing management and patient safety.</div></div><div><h3>Registration</h3><div>Not registered.</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"161 ","pages":"Article 104956"},"PeriodicalIF":7.5,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on Tan et al. (2024) 'Interventions to promote readiness for advance care planning: A systematic review and meta-analysis'","authors":"Dongpo Song","doi":"10.1016/j.ijnurstu.2024.104957","DOIUrl":"10.1016/j.ijnurstu.2024.104957","url":null,"abstract":"","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"161 ","pages":"Article 104957"},"PeriodicalIF":7.5,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on Raya-Benítez et al. (2024) 'Effectiveness of non-instrumental early mobilization to reduce the incidence of deep vein thrombosis in hospitalized patients'","authors":"Xuerong Zhang,&nbsp;Xiaoping Wang","doi":"10.1016/j.ijnurstu.2024.104954","DOIUrl":"10.1016/j.ijnurstu.2024.104954","url":null,"abstract":"","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"161 ","pages":"Article 104954"},"PeriodicalIF":7.5,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Who gets the bed: Factors influencing the intensive care exit block: A qualitative study","authors":"Frances Fengzhi Lin ,&nbsp;Jacqueline Peet ,&nbsp;Lauren Murray ,&nbsp;Mahesh Ramanan ,&nbsp;Kylie Jacobs ,&nbsp;Jane Brailsford ,&nbsp;Amelia Osmond ,&nbsp;Moreblessing Kajevu ,&nbsp;Peter Garrett ,&nbsp;Alexis Tabah ,&nbsp;Carol Mock ,&nbsp;Yingyan Chen","doi":"10.1016/j.ijnurstu.2024.104949","DOIUrl":"10.1016/j.ijnurstu.2024.104949","url":null,"abstract":"<div><h3>Background</h3><div>Patient flow problems, including discharge delay and after-hours discharge, have been a consistently major issue, especially for intensive care units (ICUs). Evidence suggests that discharge delay and after-hours discharge are associated with increased ICU and hospital length of stay, leading to worsened patient outcomes and increased healthcare costs. They can also increase ICU readmission and post-ICU mortality. The factors influencing discharge processes are not well elucidated.</div></div><div><h3>Objective</h3><div>This study aimed to explore the barriers and facilitators to the ICU patient discharge processes in adult ICUs.</div></div><div><h3>Methods</h3><div>This qualitative exploratory multisite observational study was conducted in three regional adult ICUs in Queensland, Australia. We used staff interviews, fieldnotes, and document analysis as data collection techniques. Data analysis commenced with a deductive content analysis using the Structure, Process, and Outcomes framework. Following this, an inductive process was taken using the Theoretical Domains Framework.</div></div><div><h3>Findings</h3><div>We conducted 59 staff interviews and analysed the discharge documents across three sites. Four domains, including context and resources, beliefs about consequences, social/professional role and identity, and behaviour regulation, were strongly related to the factors that influenced the discharge processes. The findings revealed barriers to discharge, including finding the right bed, disconnected and ineffective information systems, ineffective communication and coordination within and across teams and departments, and uncertainty and inconsistency in discharge decision making. Facilitators included clarity on professional roles in ICU discharge, effective communication within the ICU team, and context specific strategies to support the discharge processes.</div></div><div><h3>Conclusions</h3><div>The findings provide an in-depth understanding of the barriers and facilitators to the ICU discharge processes. Multifaceted strategies should be considered to facilitate and manage ICU discharge safely and efficiently, including the use of clearer discharge criteria and guidelines, digital systems that aid communication and coordination, and early planning of ICU patient discharge.</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"161 ","pages":"Article 104949"},"PeriodicalIF":7.5,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital technologies in nursing: An umbrella review","authors":"Larissa Schlicht ,&nbsp;Johannes Wendsche ,&nbsp;Marlen Melzer ,&nbsp;Letizia Tschetsche ,&nbsp;Ulrike Rösler","doi":"10.1016/j.ijnurstu.2024.104950","DOIUrl":"10.1016/j.ijnurstu.2024.104950","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Digital technologies promise to reduce nurses' workload and increase quality of care. However, considering the plethora of single and review studies published to date, maintaining a comprehensive overview of digital technologies' impact on nursing and effectively utilizing available evidence is challenging.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;This review aims (i) to map published reviews on digital nursing technologies, based on their aims and the specific technologies investigated, to synthesize evidence on how these technologies' uses is associated with (ii) nurses' work-related and organizational factors, professional behavior, and health and work safety and (iii) ethically relevant outcomes for people in need of care.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;div&gt;Preregistered overview of reviews (PROSPERO-ID: CRD42023389751).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Setting(s)&lt;/h3&gt;&lt;div&gt;We searched for systematic reviews in eight databases, five key journals, and reference lists of included reviews published in English until May 21, 2024.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We used the AMSTAR 2 checklist to assess the methodological quality of included reviews reporting associations with nursing outcomes. The extracted data were analyzed by their frequency and narratively synthesized.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;We identified 213 reviews on digital technologies' uses in the nursing sector. Most of these focused on information and communication technologies. The most frequently reported research objectives encompass technology usage and/or general experiences with it and technology-related consequences for care recipients. Regarding work-related and organizational factors, beneficial impacts were found for the execution of nursing tasks, information management and job control. Depending on the technology type, reviews reported mixed effects for documentation activities, communication/collaboration and mainly negative effects on nurses' workload. Concerning occupational safety and health-related and further nurse outcomes, reviews reported mostly positive effects on nurses' job satisfaction and professional competence. Adverse effects related to mental and physical strain, such as increased frustration, fatigue, and burnout. Regarding ethically relevant outcomes, robotic and telecare technologies had the most reported findings. Most evidence concerned effects on the principles of beneficence/non-maleficence and respect for autonomy.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Digital nursing technologies' legitimacy hinges on their impact on patient outcomes and nurses' work, safety, and health. This review identifies a diverse array of these technologies, with both positive and negative effects. However, due to narrative limitations, meta-analysis was impractical. Future research should quantitatively assess the effects of various digital nursing technologies on work, safety, health, and ethical outcomes.&lt;/div&gt;&lt;div&gt;&lt;strong&gt;Tweetable ab","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"161 ","pages":"Article 104950"},"PeriodicalIF":7.5,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142720194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dyadic interventions for cancer patient-caregiver dyads: A systematic review and network meta-analysis","authors":"Xiaoxu Wang ,&nbsp;Lili Zang ,&nbsp;Xueyuan Hui ,&nbsp;Xiaoxuan Meng ,&nbsp;Shuo Qiao ,&nbsp;Liping Fan ,&nbsp;Qinghui Meng","doi":"10.1016/j.ijnurstu.2024.104948","DOIUrl":"10.1016/j.ijnurstu.2024.104948","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Cancer imposes significant psychological distress on both patients and caregivers. Dyadic interventions are designed to concurrently address the health problems of both, yet there remains limited evidence as to which specific dyadic interventions yield the most effective outcomes for both partners.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objectives&lt;/h3&gt;&lt;div&gt;To systematically synthesize and evaluate the comparative efficacy of various dyadic interventions on a wide range of outcomes within cancer patient-caregiver dyads.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Searches of eight electronic databases from inception to July 2, 2023, were performed. Data extraction and quality assessment were independently conducted by two reviewers utilizing the Cochrane risk of bias tool and the Jadad score. Stata 17.0 was used for network meta-analysis, with the Surface Under the Cumulative Ranking (SUCRA) curve employed to rank interventions based on efficacy for each outcome. Effect sizes were reported using standardized mean difference (SMD) with a 95 % confidence interval (CI), and publication bias was assessed via Egger’s test. The study protocol was registered in PROSPERO under CRD42023467172.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Result&lt;/h3&gt;&lt;div&gt;A total of 37 studies, spanning 8 countries, were included. According to SUCRA rankings, WeChat couple-based psychosocial support and the eHealth symptom and complication management program were identified as the most effective interventions for improving quality of life in both patients and caregivers (SUCRA = 82.1 %, SMD = 7.30, 95 % CI: 1.02, 13.58; SUCRA = 86.6 %, SMD =&lt;!--&gt; &lt;!--&gt;1.17, 95 % CI: 0.04, 2.31, respectively). Emotionally focused therapy was ranked as the most effective intervention for enhancing dyadic adjustment (SUCRA = 100 %, SMD = 1.63, 95 % CI: 0.91, 2.36; SUCRA = 99.9 %, SMD = 2.04, 95 % CI: 1.26, 2.82, respectively). Couple-based intimacy enhancement and telephone-based dyadic psychosocial interventions were deemed most effective interventions in alleviating anxiety (SUCRA = 88.2 %, SMD = −&lt;!--&gt; &lt;!--&gt;0.83, 95 % CI: −&lt;!--&gt; &lt;!--&gt;1.65, −&lt;!--&gt; &lt;!--&gt;0.00; SUCRA = 95.6 %, SMD = −&lt;!--&gt; &lt;!--&gt;1.08, 95 % CI: −&lt;!--&gt; &lt;!--&gt;1.76, −&lt;!--&gt; &lt;!--&gt;0.41, respectively), while telephone-based dyadic psychosocial intervention and coping skills training were the most efficacious interventions for reducing depression in both partners (SUCRA = 95.2 %, SMD = −&lt;!--&gt; &lt;!--&gt;0.89, 95 % CI: −&lt;!--&gt; &lt;!--&gt;1.55, −&lt;!--&gt; &lt;!--&gt;0.23; SUCRA = 99.8 %, SMD = −&lt;!--&gt; &lt;!--&gt;2.31, 95 % CI: −&lt;!--&gt; &lt;!--&gt;3.27, −&lt;!--&gt; &lt;!--&gt;1.35, respectively). Additionally, caregiver educational program was ranked highest for reducing caregivers burden (SUCRA = 95.6 %, SMD = −&lt;!--&gt; &lt;!--&gt;1.20, 95 % CI: −&lt;!--&gt; &lt;!--&gt;1.55, −&lt;!--&gt; &lt;!--&gt;0.23).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;The highest-ranked dyadic interventions identified in this analysis offer valuable insights for clinical practice, providing strategies to enhance the quality of life, strengthen dyadic relationships, a","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"161 ","pages":"Article 104948"},"PeriodicalIF":7.5,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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 multi-sensory interventions for reducing pain among premature infants: A systematic review and network meta-analysis","authors":"Mei-di Shen ,&nbsp;Xiang-dong Ding ,&nbsp;Li Fu ,&nbsp;Hong-xiao He ,&nbsp;Si-bing Chen ,&nbsp;Yin-chu Hu ,&nbsp;Chong-kun Wang ,&nbsp;Li-hua Ren","doi":"10.1016/j.ijnurstu.2024.104947","DOIUrl":"10.1016/j.ijnurstu.2024.104947","url":null,"abstract":"<div><h3>Background</h3><div>A series of multi-sensory interventions are proved to be effective in reducing pain among premature infants. Nevertheless, there lacks a comparison of these interventions to find the most suitable and optimal one for clinical decision-making.</div></div><div><h3>Objective</h3><div>This systematic review and network meta-analysis aims to compare the effectiveness of various multi-sensory interventions, and to identify the optimal intervention for alleviating pain in premature infants.</div></div><div><h3>Methods</h3><div>A comprehensive literature search was performed on August 19, 2024 to identify pertinent clinical trials. The Cochrane Risk of Bias (version 2) was used to assess the quality and potential bias of each included study. Network meta-analysis was used to assess the effectiveness of various interventions and to identify the optimal ones.</div></div><div><h3>Results</h3><div>A total of 18 clinical trials involving 1408 premature infants were included. Three multi-sensory interventions were shown to be superior to routine practice in reducing pain among premature infants, including tactile-kinesthetic intervention, tactile-auditory intervention and tactile-visual-gustatory-olfactory intervention (all, <em>P</em> &lt; 0.05). Among these interventions, tactile-kinesthetic intervention ranks the best for its effectiveness in alleviating procedural pain among premature infants. Subgroup network meta-analysis demonstrated that the tactile-visual-gustatory-auditory-olfactory intervention ranked the best for its effectiveness in reducing pain from invasive procedures, with the tactile-auditory intervention best for non-invasive procedures.</div></div><div><h3>Conclusions</h3><div>Our study suggests that cautious assessment and identification should be prioritized to select appropriate multi-sensory interventions based on pain procedures, thus to effectively reduce pain in premature infants. Subsequent studies are needed to refine and optimize these strategies for broader application.</div></div><div><h3>PROSPERO registry</h3><div>CRD42024510352.</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"161 ","pages":"Article 104947"},"PeriodicalIF":7.5,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142578686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Family involvement in preventing delirium in critically ill patients: A systematic review and meta-analysis","authors":"Jiaqi Li ,&nbsp;Yingying Fan ,&nbsp;Ruoyu Luo ,&nbsp;Yangyang Wang ,&nbsp;Na Yin ,&nbsp;Wenhao Qi ,&nbsp;Tiancha Huang ,&nbsp;Ju Zhang ,&nbsp;Jiyong Jing","doi":"10.1016/j.ijnurstu.2024.104937","DOIUrl":"10.1016/j.ijnurstu.2024.104937","url":null,"abstract":"<div><h3>Background</h3><div>Humanized care is a novel concept in the prevention of delirium, with family involvement being a crucial component. Currently, there is controversy regarding the effectiveness of family involvement in preventing delirium among critically ill patients, and the impact of varying levels of family involvement on delirium prevention remains unclear.</div></div><div><h3>Objective</h3><div>The purpose of this study is twofold: (a) to investigate the influence of family involvement on delirium among critically ill patients, and (b) to explore the effectiveness of different levels of family involvement in preventing delirium in these patients.</div></div><div><h3>Design</h3><div>A systematic review and meta-analysis.</div></div><div><h3>Methods</h3><div>From database inception to July 2024, a comprehensive search was conducted across PubMed, EMBASE, CINAHL, Web of Science, and the Cochrane CENTRAL database. Randomized controlled trials that examined family involvement were included in the review.</div></div><div><h3>Results</h3><div>This review included a total of 11 randomized controlled trials, encompassing 3113 critically ill patients. Family involvement was found to significantly reduce the incidence of delirium among critically ill patients (RR = 0.46, 95%CI = 0.31 to 0.69), decrease the duration of delirium (WMD = −<!--> <!-->2.18, 95 % CI = −<!--> <!-->4.14 to −<!--> <!-->0.22), and shorten the length of Intensive Care Unit (ICU) stay (WMD = −<!--> <!-->1.46, 95%CI = −<!--> <!-->2.43 to −<!--> <!-->0.50). Three different levels of family involvement—direct participation in care (RR = 0.37, 95%CI = 0.26 to 0.51), family visits and companionship (RR = 0.56, 95 % CI = 0.25 to 1.25), and indirect participation (RR = 0.77, 95 % CI = 0.29 to 2.07)—varies in their effectiveness for delirium prevention.</div></div><div><h3>Conclusions</h3><div>Family involvement significantly impacts delirium prevention in critically ill patients. The effectiveness of delirium prevention varies depending on the level of family involvement, with direct participation of family members in caregiving demonstrating a more pronounced effect in reducing delirium incidence among critically ill patients.</div></div><div><h3>Registration</h3><div>The review protocol has been registered in the PROSPERO International prospective register of systematic reviews (CRD42024563095).</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"161 ","pages":"Article 104937"},"PeriodicalIF":7.5,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142561414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}