Aim
This review aimed to elucidate the effectiveness of structured handovers in improving patient outcomes in the wards.
Background
Studies have reported that the lack of quality handovers is one of ...the main causes of adverse effects.
Evaluation
A search over six electronic databases: MEDLINE; CINAHL; Web of Science; EMBASE; Scopus; and CENTRAL via Ovid concluded nine studies and synthesized by two independent reviewers based on the Cochrane Handbook for Systematic Reviews of Interventions. The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses statement was used to guide the undertaking of this review and meta‐analysis. All studies published up to February 2019 were considered in this review.
Key issues
This review has demonstrated that structured handovers reduced the incidences of patient complications, medication errors and general adverse events. However, the results were not statistically significant.
Conclusion
Current structured handover formats were effective in reducing problematic handovers such as omission of information, inaccurate information and documentation errors.
Implications for Nursing Management
Although there is limited high‐quality and rigorous research conducted to gain a clearer understanding of the impacts on patient‐related outcomes in nursing care, structured handovers remained effective in reducing the number of mistakes in information transfer.
Aim
To evaluate the effectiveness of educational interventions in improving medication adherence among adult patients diagnosed with hypertension, hyperlipidaemia and/or diabetes.
Design
This review ...was conducted with reference to methods set out in the Cochrane Handbook for Systematic Reviews of Interventions (PROSPERO registration number: CRD42016053402).
Data Sources
A search from seven electronic databases (2003–2016).
Review Method
The quality of evidence and strength of the studies was evaluated systematically, followed by an assessment of risks of bias by two reviewers with the Cochrane Collaboration's tool.
Results
Eighteen randomized controlled trials demonstrated a low to moderate quality evidence on the improvements of medication adherence with educational interventions. Participants with type 2 diabetes benefited from education interventions but not those with hypertension. No randomized controlled trials (RCT) was found for participants with hyperlipidaemia. Education that was conducted at home showed better medication adherence than education conducted in clinics. Medication adherence was improved after two to three sessions but no significant differences found after three sessions.
Conclusion
Through education, health literacy is improved, thus improving medication adherence.
Impact
A plethora of educational interventions have been implemented in the clinical settings, but no reviews have hitherto been conducted on their effectiveness. This review suggested that education improves health literacy which is directly proportionate to optimal disease management including medication adherence. The suggestions proposed in this review may impact the individual in terms of their adherence to medication to tackle exacerbation and relapse of chronic diseases and also proposed suggestions for future implementation of an education intervention.
目的
在于评价,教育干预措施能有效提高高血压、高脂血症和/或糖尿病成年患者的服药依从性。
设计
通过参考《Cochrane 干预措施系统评价手册》(PROSPERO 登记号:CRD42016053402)中规定的方法进行审查。
资料来源
搜索了七个电子数据库(从2003年至2016年)。
综述方法
系统性地评估了证据质量和研究强度,然后由两位审查者使用Cochrane 协作组织的工具评估了偏倚风险。
结果
十八项随机对照试验展现了教育干预措施改善服药依从性的低至中等质量证据。2型糖尿病患者受益于教育干预措施,但高血压患者则没有。没有发现针对高脂血症参与者进行的随机对照试验(RCT)。在家进行的教育比在诊所进行的教育显示出更好的服药依从性。虽然两到三次疗程后的服药依从性有所改善,但三次疗程后却没有发现显著性差异。
结论
通过教育,提高了健康素养,从而改改善了服药依从性。
影响
在临床环境中采取了大量的教育干预措施,但迄今为止尚未对其有效性进行审查。这篇综述表明,教育可以提高健康素养,而健康素养与最佳疾病管理(包括服药依从性)成正比。本综述中提出的建议可能会对个体在坚持治疗慢性疾病恶化和复发方面产生影响,并对未来实施教育干预提供了建议。
Aim
To evaluate the effectiveness of psychological interventions in reducing fear of cancer recurrence in breast cancer survivors.
Design
A systematic review and meta‐analysis.
Data Sources
PubMed, ...Embase, Cochrane Central Register of Controlled Trials, CINAHL, Scopus, PsycINFO, Web of Science and ClinicalTrials.gov were searched for relevant studies published from 1 January 1976 to 28 November 2020.
Methods
Eligible randomized controlled trials on psychological interventions for reducing fear of cancer recurrence in breast cancer survivors were included in meta‐analysis. Review Manager 5.4 was used to conduct the meta‐analysis, and the fear of cancer recurrence score was calculated by using standardized mean differences and 95% confidence intervals. Risk of bias was assessed with the Cochrane risk‐of‐bias tool. Quality of evidence, sensitivity analyses, and subgroup analyses were also conducted.
Results
This systematic review included 16 randomized controlled trials. We found psychological interventions significantly reduced fear of cancer recurrence. Subgroup analyses indicated that mindfulness and acceptance therapy‐based interventions reduced fear of cancer recurrence, whereas cognitive‐behavioural therapy combined with psychoeducation did not. Interventions with three to eight sessions were effective, while interventions with nine or more sessions were not. Face‐to‐face interventions were effective, whereas online interventions were not. The quality of evidence for fear of cancer recurrence was evaluated as moderate due to moderate heterogeneity in the included studies.
Conclusions
Psychological interventions were effective in reducing fear of cancer recurrence in breast cancer survivors. Mindfulness and acceptance therapy‐based interventions and short‐term interventions are recommended. Future well‐designed randomized controlled trials aiming to examine the effectiveness of psychological interventions in reducing fear of cancer recurrence are needed.
Impact
The findings of this systematic review may guide the development of psychological interventions and encourage the use of psychological interventions for reducing fear of cancer recurrence in breast cancer survivors.
Aim
To elucidate the infrared thermal patterns and temperature readings of the surfaces of surgical wounds for detecting delayed wound healing within four days after surgery.
Background
The nursing ...assessment of surgical wounds within the first four days after surgery is commonly based on visual and physical examination. Surgical wounds with delayed healing may be not detected if they do not exhibit signs such as redness or exudate within four days after surgery.
Design
This study was conducted using prospective observational design with reference to the STROBE Statement (see Supporting Information Appendix S1) to examine the temperatures of surgical wounds in their natural settings.
Methods
Based on convenience sampling, 60 participants admitted to the colorectal surgical ward for enterostoma closure from January–November 2013 were recruited.
Results
Although both infected and noninfected surgical wounds exhibited a significant increase in wound temperature from Days 1–4, the infected wounds revealed a statistically significantly lower temperature than the noninfected ones. Within the infrared thermal images, the infected wounds presented with partial warming of the skin surrounding and along the incision, suggesting that delayed healing could be identified.
Conclusion
This study demonstrates that delayed wound healing can be detected within the first four days after surgery for early intervention of prevention and treatment before discharge.
Relevance to Clinical Practice
This paper provides evidence‐based information for healthcare professionals in assessing surgical wounds for delayed healing within the first four days after surgery. The findings herein enable the early detection of delayed wound healing, based on which early intervention of prevention and treatment may be instituted for affected patients before their discharge.
Objective
Fear of cancer recurrence (FCR) is common in breast cancer survivors (BCS). This study examined the mediating role of illness representations in the relationships between FCR and physical ...symptoms, social constraint and self‐care self‐efficacy.
Methods
In this cross‐sectional study, 385 women with breast cancer completed a series of questionnaires including the FCR Inventory, Social Constraints Scale‐15, Cancer Survivors Self‐Efficacy Scale, Illness Perception Questionnaire‐Revised and European Organization for Research and Treatment Quality of Life Questionnaire‐Breast Cancer. Structural equation modelling method was conduct by using a bootstrapping method.
Results
Physical symptoms (β = 0.272, p < 0.01), social constraints (β = 0.130, p < 0.01), self‐efficacy (β = −0.233, p < 0.01) and illness representation (β = 0.261, p < 0.01) have direct effects on FCR. The indirect effects of physical symptoms (β = 0.10, p < 0.01), social constraints (β = 0.076, p < 0.01) and self‐efficacy (β = −0.025, p < 0.05) on FCR were partially mediated by illness representations.
Conclusions
In this study, the effects of physical symptoms, social constraints and self‐efficacy on FCR were found to be mediated by illness representation. Reducing the impact of negative illness representations on FCR by reducing physical symptoms, increasing self‐efficacy, and promoting open disclosure of cancer‐related concerns may be effective in reducing FCR in BCS.
Aims
This study aimed to investigate the application of infrared thermal imaging and adopt deep learning to detect air leakage for determining the fitness of respirators during fit‐checks.
Background
...The outbreak of Covid‐19 virus constitutes a public health crisis with substantial resultant morbidities and mortalities; has exerted profound impacts.
Methods
This was a prospective observational study, employing a non‐probability sampling method on a convenience sample to recruit the participants and followed the Strengthening the Reporting of Observational Studies in Epidemiology statement guidelines.
Results
The use of infrared thermal imaging identified air leakage points as a disruption to the facial thermal pattern distribution at (a) front of face; (b) right lateral of the face; (c) left lateral of the face; (d) top of the facemask with the head facing down; and (e) bottom of the facemask with the head facing up. Results also indicated that artificial intelligence tools and the proliferation of deep learning have the potential to detect the location of air leakage locations.
Conclusion
The use of infrared thermal imaging provides evidence of the feasibility and applicability of infrared thermal imaging techniques in detecting air leakage for individuals wearing respirators.
Clinical relevance
The use of infrared thermal technology can serve a potential role in complement fit‐checking of respiratory protective devices and offers promising practical utility in determining the fitness of respirators for nurses at the frontline to protect against the air‐borne viruses.
Aim
Examined the evidence of low‐to‐moderate‐intensity physical activities to assess the effect in managing hypertension, diabetes mellitus and hyperlipidaemia conditions among community‐dwelling ...older adult.
Background
Physical activity is recommended for the maintenance and improvement of health. However, high‐intensity physical activity may adversely impact exercise adherence by older adults.
Design
This review was conducted with reference to methods set out in the Cochrane Handbook for Systematic Reviews of Interventions. The PRISMA statement was employed to guide the reporting of the systematic review and meta‐analyses.
Data Sources
Seven electronic databases were searched to identify relevant articles that were published in English from 1 January 2000 to 31 December 2020.
Review Method
This review included randomised controlled trials and cluster‐randomised controlled trials on interventions of physical activities with low‐to‐moderate intensities compared against usual care without physical activities. Two reviewers independently extracted data and assessed the risk of bias using the Cochrane Risk of Bias Tool. Meta‐analysis was performed using RevMan, with Cochran Q and I2 used for determining heterogeneity. The overall effect was reviewed with z scores.
Results
Fifteen randomised controlled trials with 940 total participants were evaluated. Low‐to‐moderate‐intensity physical activity significantly improved systolic blood pressure Z = 3.59, p = .0003, HbA1C Z = 2.10, p = .04 and high‐density lipoprotein (HDL) levels Z = 3.83, p = .0001, compared to usual care. A further subgroup analysis found no significant difference in systolic blood pressure level after three sessions a week as well as after three months. There were insufficient papers to evaluate for both HbA1C and HDL levels.
Conclusion
Regular physical activity ranging from low‐to‐moderate intensity should be encouraged among older adults with chronic diseases.
Relevance for clinical practice
This review suggested that low‐to‐moderate levels of physical activity could be encouraged among community‐dwelling older adults to improve their physical health.
To provide an update on insights into the effectiveness of the green environment and forest on the mental health of city dwellers; and the role of mental health professionals in advocating green ...restorative therapies.
The studies reviewed in this paper confirmed the mental health benefits on individuals who engaged in the green environment and forest. Results of studies showed that the participants reported significantly higher positive effects. However, it is difficult to compare studies because of marked differences in methodology and often lack of biological markers. With the recent global concern about climate warming, mental health professionals have a critical role to influence city planners on the importance of the green environment and the forest. In Singapore, the 'Therapeutic Garden' project and 'Therapeutic Rainforest' program are examples of mental health professionals working with government agencies for a 'city in nature'.
The benefits of the green environment and forest are emphasized especially on the psychological well being. In the light of the danger of climate warming, this review highlights the need for city planners to collaborate with mental health professionals to incorporate high-quality green spaces when planning the city of the future. There is an urgent need for better consultation between health agencies and local city government to create an appealing and diverse green environment within the city.
Online learning in nursing education has been demonstrated to exert positive effects on knowledge, skills, learning attitudes, and confidence in performance. However, a noteworthy caveat has been ...that such benefits could vary depending on the content of pedagogical materials.
To examine the impact of online-tutorials in place of face-to-face tutorials on knowledge level and understand the perspectives of learners who experience online-tutorials.
This study adopted a mixed method experiential design in which the perspectives of learners who experience online-tutorials are embedded within the trial. Two cohort of nursing students enrolled for the module on Psychology for Nurses were recruited to evaluate the impact of online-tutorials compared to face-to-face tutorials in terms of knowledge level. Apart from the dissimilar mode of delivery, both cohorts experienced the same teaching structure, content, and assessments. Examination results from these two cohorts were compared upon completion of the course. For the online group, additional one-to-one interviews were conducted to further understand the impacts exerted by online learning on the level of knowledge among them.
There was a significant difference between the knowledge level of the two cohorts. Responses elicited during the interviews revealed five themes: lack of motivation; limited teamwork; missed learning opportunities; decreased interactions; and differences between online and face-to-face learning.
Conclusion: Online-tutorials may be a feasible pedagogical approach but the motivation to learn, teamwork and quality of discussion may be compromised due to the lack of socialization and interactions between students and tutors.
•Socializing remains an important element in the learning process.•Teaching methods and lessons need to be re-design to enhance meaningful collaboration between students.•Group dynamics and students’ comfort level in technology-based communication should be considered when planning online lesson.
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