-
Preventive Medicine Reports Jun 2024Emerging evidence suggests that dietary interventions hold promise for promoting cognitive function and mental well-being in aging populations. This systematic review... (Review)
Review
OBJECTIVE
Emerging evidence suggests that dietary interventions hold promise for promoting cognitive function and mental well-being in aging populations. This systematic review aimed to examine the potential relationship between Time-Restricted Eating (TRE) and Intermittent Fasting (IFA) with cognitive function and mental health in older adults.
METHODS
A thorough exploration was undertaken on electronic databases such as PubMed, Scopus, Web of Science, Science Direct, and Google Scholar, up to October 2023, following PRISMA standards. The evaluation of the quality and potential bias in the incorporated articles involved the use of the Newcastle-Ottawa Scale and Consolidated Standards of Reporting Trials (CONSORT).
RESULTS
From a total of 539 articles initially identified, eight studies met the eligibility criteria for inclusion in this review. Out of these eight studies, six focused on cognitive function, and 2 focused on mental health. The reviewed articles encompassed a wide range of population sizes, with the number of older adults studied varying from 10 to 1357, reflecting a diverse cohort of individuals. Conclusions.The findings suggest that TRE and IFA may have a positive impact on cognitive function and mental health in this population. However, additional research is needed to fully comprehend this relationship. Therefore, future research should specifically examine factors such as the duration and timing of the eating window in TRE, as well as the physical condition of older adults, to provide a more nuanced understanding of the cognitive and mental health benefits of TRE and IFA in older adults.
PubMed: 38774517
DOI: 10.1016/j.pmedr.2024.102757 -
Heart & Lung : the Journal of Critical... 2024Congenital heart disease (CHD) is the most common birth defect worldwide. Neurocognitive deficits and psychiatric disorders, which can impact daily life, have been... (Review)
Review
BACKGROUND
Congenital heart disease (CHD) is the most common birth defect worldwide. Neurocognitive deficits and psychiatric disorders, which can impact daily life, have been reported in over 50% of adolescents and young adults with moderate to complex CHD.
OBJECTIVE
Conduct a systematic review of sex, clinical, psychological and social determinants of health (SDoH) factors affecting neurocognition in adults with CHD post-cardiac surgery.
METHODS
PubMed, Cumulated Index to Nursing and Allied Health Literature, and Embase were searched for relevant studies over the past 5 years. Thirteen articles met inclusion criteria of: 1) CHD post-cardiac surgery, 2) age ≥ 18 years, and 3) used a validated measure of neurocognition.
RESULTS
A total of 507 articles were identified. After screening, 30 articles underwent full text review yielding 13 eligible articles. Twelve articles reported deficits in multiple domains including executive function, intellectual functioning, visuospatial ability, and verbal fluency in more complex CHD. Only three studies examined cognition based on sex, with female and lower parental SES associated with worse cognitive outcomes. Most studies were from Europe, predominantly sampled Caucasian participants, had heterogeneous samples of CHD complexity, and lacked standardized cognitive measures which limited generalizability of findings.
CONCLUSIONS
Adults with CHD present with a wide variety of cognitive deficits, with some associations with sex, clinical history, and SDoH factors. It remains unclear to what degree these factors affect cognition in adults with moderate to complex CHD. Future longitudinal studies should focus on age-related effects on cognition and potential health care disparities in diverse CHD samples.
Topics: Adolescent; Young Adult; Humans; Female; Heart Defects, Congenital; Cardiac Surgical Procedures; Cognition; Cognitive Dysfunction
PubMed: 38043432
DOI: 10.1016/j.hrtlng.2023.11.011 -
Journal of Plastic, Reconstructive &... Jan 2024Alopecia is a common and distressing medical condition that has been related to psychiatric disorders. Stem cell-derived conditioned medium (CM), a novel therapy for... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Alopecia is a common and distressing medical condition that has been related to psychiatric disorders. Stem cell-derived conditioned medium (CM), a novel therapy for hair regeneration, has shown effectiveness in several trials.
METHODS
This meta-analysis aims to explore the effectiveness of stem cell-derived CM in improving hair growth for patients of alopecia. We prospectively registered this systematic review and meta-analysis in PROSPERO (CRD42023410249). Clinical trials that the enrolled participants suffering from alopecia applied stem cell-derived CM were included. We calculated the mean and standard deviation for the hair density and thickness.
RESULTS
Ten clinical trials were included in our analysis. On the basis of eight clinical trials (n = 221), our pooled results indicate that stem cell-derived CM is effective in increasing hair density (mean difference [MD]: 14.93, confidence interval [95% CI]: 10.20-19.67, p < 0.0001) and thickness (MD: 18.67, 95% CI: 2.75-34.59, p < 0.0001) (μm) in patients with alopecia. Moreover, our findings suggest that longer treatment duration is associated with significantly greater improvement than shorter treatment duration (p = 0.02). Three of the included studies were randomized controlled trials (RCTs), and when we specifically analyzed these RCTs; statistical significance could also be observed in terms of hair density (MD: 9.23, 95% CI: 1.79-16.68, p < 0.00001).
KEY MESSAGES
Stem cell-derived conditioned medium can effectively increase hair density and thickness for alopecia, and there is no difference between each method (topical application, microneedling, or injection).
Topics: Humans; Culture Media, Conditioned; Alopecia; Hair; Stem Cells; Duration of Therapy
PubMed: 37983981
DOI: 10.1016/j.bjps.2023.10.060 -
Supportive Care in Cancer : Official... Mar 2024Cancer is one of the leading causes of mortality in the world which imposes numerous psychological burdens on the patients. Psycho-spiritual interventions such as... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Cancer is one of the leading causes of mortality in the world which imposes numerous psychological burdens on the patients. Psycho-spiritual interventions such as meaning-based therapies may help decrease these challenges. This systematic review and meta-analysis aim to investigate the effects of meaning-based psychotherapy on post-traumatic growth and death anxiety of patients with cancer.
METHODS
PubMed, Scopus, Proquest, Web of Science, and Google Scholar were searched until 30 September 2023. The Cochrane Collaboration's tool was used to assess the quality of the included studies. A random-effect model was preferred, and statistical analysis was performed by STATA software version 17.
RESULTS
A total of 17 studies were included in the systematic review. Eleven articles examined the impact of meaning-based interventions on death anxiety and six articles examined post-traumatic growth in cancer patients. Ten studies with a total of 555 participants were included for analysis of the effect of logotherapy versus routine care on death anxiety. Analysis showed a significant decrease effect of logotherapy versus routine care on death anxiety (SMD, - 4.05 (- 6.20, - 1.90); I, 98.38%). Three studies with a total of 364 participants were included for analysis of the effect of logotherapy versus routine care on post-traumatic growth in patients with cancer. Analysis showed a positive but non-significant effect of logotherapy versus routine care on post-traumatic growth (SMD, 2.05 (- 0.91, 5.01); I, 99.08%).
CONCLUSION
The qualitative analysis showed the positive impact of meaning-based psychotherapy interventions on death anxiety and post-traumatic growth in cancer patients, but the results of the meta-analysis on post-traumatic growth were not statistically significant. The review shows the need for more clinical trial studies in larger and more diverse samples in terms of cancer types and cultural background.
Topics: Humans; Posttraumatic Growth, Psychological; Stress Disorders, Post-Traumatic; Psychotherapy; Neoplasms; Anxiety
PubMed: 38532225
DOI: 10.1007/s00520-024-08448-9 -
Nursing Ethics Mar 2024Moral distress has been identified as an occupational hazard for clinicians caring for vulnerable populations. The aim of this systematic review was (i) to summarize the... (Review)
Review
Moral distress has been identified as an occupational hazard for clinicians caring for vulnerable populations. The aim of this systematic review was (i) to summarize the literature reporting on prevalence of, and factors related to, moral distress among nurses within acute mental health settings, and (ii) to examine the efficacy of interventions designed to address moral distress among nurses within this clinical setting. A comprehensive literature search was conducted in October 2022 utilizing Nursing & Allied Health, Embase, CINAHL, PsychInfo, and PubMed databases to identify eligible studies published in English from January 2000 to October 2022. Ten studies met inclusion criteria. Four quantitative studies assessed moral distress among nurses in acute mental health settings and examined relationships between moral distress and other psychological and work-related variables. Six qualitative studies explored the phenomenon of moral distress as experienced by nurses working in acute mental health settings. The quantitative studies assessed moral distress using the Moral Distress Scale for Psychiatric Nurses (MDS-P) or the Work-Related Moral Stress Questionnaire. These studies identified relationships between moral distress and emotional exhaustion, depersonalization, cynicism, poorer job satisfaction, less sense of coherence, poorer moral climate, and less experience of moral support. Qualitative studies revealed factors associated with moral distress, including lack of action, poor conduct by colleagues, time pressures, professional, policy and legal implications, aggression, and patient safety. No interventions targeting moral distress among nurses in acute mental health settings were identified. Overall, this review identified that moral distress is prevalent among nurses working in acute mental health settings and is associated with poorer outcomes for nurses, patients, and organizations. Research is urgently needed to develop and test evidence-based interventions to address moral distress among mental health nurses and to evaluate individual and system-level intervention effects on nurses, clinical care, and patient outcomes.
PubMed: 38490947
DOI: 10.1177/09697330241238337 -
Applied Nursing Research : ANR Dec 2023"Partnership Care Model (PCM)", which is the first partnership conceptual framework founded on the Iranian culture to control chronic diseases, has been recently used in... (Meta-Analysis)
Meta-Analysis
BACKGROUND
"Partnership Care Model (PCM)", which is the first partnership conceptual framework founded on the Iranian culture to control chronic diseases, has been recently used in different fields of nursing research with no levels of valid evidence to support its application. Therefore, this systematic review and meta-analysis sought to clarify the impacts of interventions developed based on PCM on quality of life (QoL), sleep quality, anxiety, and depression among adults and children with chronic diseases.
METHODS
International data sources (e.g., PubMed, Web of Science, Scopus) and national databases (e.g., SID, MagIran, IranDoc, IRCT) were searched from 2001 to September 23, 2023, to find Randomized Controlled Trials (RCTs) on PCM-driven interventions for the experimental groups versus no intervention or standard care groups. The studies' methodological quality and evidence quality were rated utilizing the Cochrane risk of bias instruction and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Data were pooled by a random-effects approach employing STATA (vers. 11.2).
RESULT
Eighteen RCTs, reported in 22 publications, were qualified. The PCM compared to the standard care significantly improved the QoL among both adults (10 effect sizes [ESs], mean difference [MD]: 3.17, P < 0.001) and children (4 ESs, MD: 4.45, P < 0.001). Likewise, the intervention enhanced adults' sleep quality (3 ESs, MD: 7.15, P < 0.001). The anxiety of adults and children was also significantly lower in the PCM group (4 ESs, MD: -4.52, P = 0.001; 2 ESs, MD: -4.04, P < 0.001, respectively). However, regarding depression, a significant effect of PCM was found only among children (3 ESs, MD: -7.99, P = 0.011). The methodological quality of the studies and the evidence quality were undesirable.
CONCLUSION
The PCM had a promising influence on the caring of adults and children suffering from chronic diseases. However, additional high-quality RCTs are needed to generate a higher quality of evidence concerning the clinical benefits of the PCM.
PROSPERO NO
CRD42021253790.
Topics: Humans; Adult; Child; Depression; Randomized Controlled Trials as Topic; Chronic Disease; Anxiety; Iran; Quality of Life
PubMed: 38007245
DOI: 10.1016/j.apnr.2023.151744 -
BMC Psychiatry Jan 2024In recent years, mobile psychological interventions have proven effective in reducing self-injury and suicide-related behaviors. Therefore, it is essential to...
BACKGROUND
In recent years, mobile psychological interventions have proven effective in reducing self-injury and suicide-related behaviors. Therefore, it is essential to continually enhance the user experience and address patients' needs to facilitate the development of mobile mental health interventions. Identifying patients with mobile mental health needs can be challenging for mental health professionals. To address this, we conducted a systematic review of qualitative research to synthesize the needs of patients engaged in self-injury and suicide-related behaviors for mobile and internet-based psychological interventions.
METHODS
This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (PRISMA) and the Enhancing Transparency in Reporting the Synthesis of Qualitative Research statement (ENTREQ). We explored 11 databases and synthesized the results using thematic analysis.
RESULTS
Sixteen qualitative and mixed-method studies were included. The study found that the needs of patients with self-injury and suicide-related behaviors for mobile psychological intervention included therapy, technology, culture, privacy, communication, emotional support, personalization, and self-management. Consistent with the Technology Acceptance Model (TAM), the needs of patients with self-injury and suicide-related behaviors are influenced by the perceived ease of use and perceived usefulness of the mobile intervention. However, the findings also highlight the importance and unmet needs of peer support, communication, self-management, and empowerment in using mobile psychological interventions for patients with self-injury and suicide-related behaviors.
CONCLUSIONS
Studies in this area have shown that the needs of patients with self-harm and suicide-related behaviors cover multiple stages, including basic therapeutic and technical needs and advanced emotional needs. This complexity makes it challenging to address the needs of patients engaged in self-injury and suicide-related behaviors through digital interventions. In the future, mental health professionals should be encouraged to participate in multidisciplinary collaborations to expand the use of digital interventions, enhancing remote self-management for patients and providing new strategies for the ongoing care of psychiatric patients. We registered the review protocol on PROSPERO (CRD42022324958).
Topics: Humans; Internet; Mental Health; Psychosocial Intervention; Self-Injurious Behavior; Suicidal Ideation; Qualitative Research
PubMed: 38178028
DOI: 10.1186/s12888-023-05477-2 -
Healthcare (Basel, Switzerland) Aug 2023The purpose of this systematic review was to explore factors affecting nurses' job satisfaction in Saudi Arabian hospitals by utilizing the social determinants of a... (Review)
Review
The purpose of this systematic review was to explore factors affecting nurses' job satisfaction in Saudi Arabian hospitals by utilizing the social determinants of a health model. We conducted a systematic review using three databases (PubMed, PsychINFO, and CINAHL) following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. A total of 235 studies were screened. Of these studies, nine met the inclusion criteria. The studies were appraised using the Joanna Briggs Institute checklist tool. The majority of studies reported that salary, years of experience, nationality, and marital status were factors affecting nurses' job satisfaction. Gender and educational level did not impact job satisfaction for male and female nurses. Overall, the review highlighted some knowledge gaps in the assessment of the impact of social determinants of health regarding gender and educational level on nurses' job satisfaction. Further research is needed to address this knowledge gap.
PubMed: 37685428
DOI: 10.3390/healthcare11172394 -
Health Technology Assessment... Jan 2024Containment (e.g. physical restraint and seclusion) is used frequently in mental health inpatient settings. Containment is associated with serious psychological and...
BACKGROUND
Containment (e.g. physical restraint and seclusion) is used frequently in mental health inpatient settings. Containment is associated with serious psychological and physical harms. De-escalation (psychosocial techniques to manage distress without containment) is recommended to manage aggression and other unsafe behaviours, for example self-harm. All National Health Service staff are trained in de-escalation but there is little to no evidence supporting training's effectiveness.
OBJECTIVES
Objectives were to: (1) qualitatively investigate de-escalation and identify barriers and facilitators to use across the range of adult acute and forensic mental health inpatient settings; (2) co-produce with relevant stakeholders an intervention to enhance de-escalation across these settings; (3) evaluate the intervention's preliminary effect on rates of conflict (e.g. violence, self-harm) and containment (e.g. seclusion and physical restraint) and understand barriers and facilitators to intervention effects.
DESIGN
Intervention development informed by Experience-based Co-design and uncontrolled pre and post feasibility evaluation. Systematic reviews and qualitative interviews investigated contextual variation in use and effects of de-escalation. Synthesis of this evidence informed co-design of an intervention to enhance de-escalation. An uncontrolled feasibility trial of the intervention followed. Clinical outcome data were collected over 24 weeks including an 8-week pre-intervention phase, an 8-week embedding and an 8-week post-intervention phase.
SETTING
Ten inpatient wards (including acute, psychiatric intensive care, low, medium and high secure forensic) in two United Kingdom mental health trusts.
PARTICIPANTS
In-patients, clinical staff, managers, carers/relatives and training staff in the target settings.
INTERVENTIONS
Enhancing de-escalation techniques in adult acute and forensic units: Development and evaluation of an evidence-based training intervention (EDITION) interventions included de-escalation training, two novel models of reflective practice, post-incident debriefing and feedback on clinical practice, collaborative prescribing and ward rounds, practice changes around admission, shift handovers and the social and physical environment, and sensory modulation and support planning to reduce patient distress.
MAIN OUTCOME MEASURES
Outcomes measured related to feasibility (recruitment and retention, completion of outcome measures), training outcomes and clinical and safety outcomes. Conflict and containment rates were measured via the Patient-Staff Conflict Checklist. Clinical outcomes were measured using the Attitudes to Containment Measures Questionnaire, Attitudes to Personality Disorder Questionnaire, Violence Prevention Climate Scale, Capabilities, Opportunities, and Motivation Scale, Coercion Experience Scale and Perceived Expressed Emotion in Staff Scale.
RESULTS
Completion rates of the proposed primary outcome were very good at 68% overall (excluding remote data collection), which increased to 76% (excluding remote data collection) in the post-intervention period. Secondary outcomes had high completion rates for both staff and patient respondents. Regression analyses indicated that reductions in conflict and containment were both predicted by study phase (pre, embedding, post intervention). There were no adverse events or serious adverse events related to the intervention.
CONCLUSIONS
Intervention and data-collection procedures were feasible, and there was a signal of an effect on the proposed primary outcome.
LIMITATIONS
Uncontrolled design and self-selecting sample.
FUTURE WORK
Definitive trial determining intervention effects.
TRIAL REGISTRATION
This trial is registered as ISRCTN12826685 (closed to recruitment).
FUNDING
This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: 16/101/02) and is published in full in ; Vol. 28, No. 3. See the NIHR Funding and Awards website for further award information.
CONTEXT
Conflict (a term used to describe a range of potentially unsafe events including violence, self-harm, rule-breaking, medication refusal, illicit drug and alcohol use and absconding) in mental health settings causes serious physical and psychological harm. Containment interventions which are intended to minimise harm from violence (and other conflict behaviours) such as restraint, seclusion and rapid tranquilisation can result in serious injuries to patients and, occasionally, death. Involvement in physical restraint is the most common cause of serious physical injury to National Health Service mental health staff in the United Kingdom. Violence to staff results in substantial costs to the health service in sickness and litigation payments. Containment interventions are also expensive (e.g. physical restraint costs mental health services £6.1 million and enhanced observations £88 million per annum). Despite these harms, recent findings indicate containment interventions such as seclusion and physical restraint continue to be used frequently in mental health settings. Clinical trials have demonstrated that interventions can reduce containment without increasing violence and other conflict behaviours (e.g. verbal aggression, self-harm). Substantial cost-savings result from reducing containment use. De-escalation, as an intervention to manage aggression and potential violence without restrictive practices, is a core intervention. 'De-escalation' is a collective term for a range of psychosocial techniques designed to reduce distress and anger without the need to use 'containment' interventions (measures to prevent harm through restricting a person's ability to act independently, such as physical restraint and seclusion). Evidence indicates that de-escalation involves ensuring conditions for safe intervention and effective communication are established, clarifying and attempting to resolve the patient's concern, conveyance of respect and empathy and regulating unhelpful emotions such as anxiety and anger. Despite featuring prominently in clinical guidelines and training policy domestically and internationally and being a component of mandatory National Health Service training, there is no evidence-based model on which to base training. A systematic review of de-escalation training effectiveness and acceptability conducted in 2015 concluded: (1) no model of training has demonstrated effectiveness in a sufficiently rigorous evaluation, (2) the theoretical underpinning of evaluated models was often unclear and (3) there has been inadequate investigation of the characteristics of training likely to enhance acceptability and uptake. Despite all National Health Service staff being trained in de-escalation there have been no high-quality trials evaluating the effectiveness and cost-effectiveness of training. Feasibility studies are needed to establish whether it is possible to conduct a definitive trial that can determine the clinical, safety and cost-effectiveness of this intervention.
Topics: Adult; Humans; State Medicine; Feasibility Studies; United Kingdom; Aggression; Surveys and Questionnaires
PubMed: 38343036
DOI: 10.3310/FGGW6874 -
Journal of Psychiatric and Mental... Aug 2023WHAT IS KNOWN ON THE SUBJECT?: Mental health recovery has become a more prevalent approach to empowering people with schizophrenia (PWS), especially in western... (Review)
Review
UNLABELLED
WHAT IS KNOWN ON THE SUBJECT?: Mental health recovery has become a more prevalent approach to empowering people with schizophrenia (PWS), especially in western countries. However, despite the benefits, there is a lack of evidence regarding its practice in developing countries such as Southeast Asian Countries. The optimal treatment for PWS has not yet been identified, since most mental health care is provided in hospital-based settings in Southeast Asia. Mental health treatment in Southeast Asia is highly influenced by cultural norms, values, and practices. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: The findings highlight the importance of integrating cultural aspects into the treatment of people with schizophrenia. The sample of unique elements in Southeast Asian mental health recovery include using a close neighbour/cadre as social support and using religious activity to increase hope. Lack of government support, high level of employment, and stigma are the biggest barriers in the PWS recovery process. WHAT IS THE IMPLICATION FOR PRACTICE?: There is a research gap regarding the awareness and implementation of mental health recovery in psychiatric programs across the Southeast Asian region which likely impacts the effectiveness of the treatment. The review shows that little research has explored the concept of personal recovery in Southeast Asian Countries.
ABSTRACT
INTRODUCTION: Recovery has become an important approach used by mental health services around the world. Many mental health systems have taken steps to move towards more recovery-oriented practices and service delivery. Therefore, establishing recovery-oriented services in developing countries like those in the Southeast Asian region requires a detailed understanding of the cultural norms, values, and current mental health practices.
AIMS
To investigate the mental health practices that promote recovery, its barrier in Southeast Asia, and to determine if they align with the CHIME recovery model.
METHOD
Electronic databases MEDLINE, EMBASE, CINAHL, PsycINFO and SCOPUS, were searched [PROSPERO] (CRD42021227962). Peer-reviewed English language articles from 2004 to January 2021 were included. Methodological quality was assessed using the CASP checklist, and thematic synthesis of included studies was conducted.
RESULTS
Thirty-one studies met inclusion criteria. Several themes illustrated mental health recovery services and the current obstacles identified in South-east Asian studies. Connection includes peer support and support groups, relationship status, and limited opportunities to become involved in the community. Hope is found in cultural concepts of hope, stimulating recovery through mental health programs, whilst lack of knowledge and education are the main barriers. Ethnicity is linked to a high level of stigma, but ethnicity also builds identity. Meaning and spirituality manifest in religious activities as the catalyst for recovery. Finally, the opposite of Empowerment is seen in the tendency of people with schizophrenia to remain in a passive position. Further barriers to empowerment are unemployment and a lack of social support.
DISCUSSION
In Southeast Asia, the elements of culture, religiosity, and communality are essential to mental health recovery. The obstacles to recovery are relate to human rights, social support, family involvement, and continuity of care.
IMPLICATIONS FOR PRACTICE
This review explores the concept of mental health recovery for people who are experiencing psychosis and living in Southeast Asian countries. The evidence may contribute to the further development of mental health programs in this region.
Topics: Humans; Schizophrenia; Mental Health Recovery; Psychotic Disorders; Mental Health; Asia, Southeastern
PubMed: 36681884
DOI: 10.1111/jpm.12902