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International Journal of Nursing Studies Feb 2021Extensive surgery and chemo/radiation therapy (C/RT) to manage head and neck cancer (HNC) patients affects their ability to swallow food and liquids, risk of aspiration... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Extensive surgery and chemo/radiation therapy (C/RT) to manage head and neck cancer (HNC) patients affects their ability to swallow food and liquids, risk of aspiration and greatly influences their quality of life (QOL).
OBJECTIVES
Ascertain the effectiveness of swallowing exercises on improving swallowing function, performance status, mouth opening, risk of aspiration/penetration and QOL in HNC patients.
DESIGN
Systematic review and meta-analysis of randomized controlled trials DATA SOURCES: PubMed, Ovid-Medline, Embase, Cochrane Library, CINAHL and Web of Science and included all available RCTs.
REVIEW METHODS
We followed the PRISMA guidelines and standard methods for conducting a systematic review and meta-analysis. Comprehensive Meta-analysis 3.0 using the random effects model was used for data analysis.
RESULTS
In total, 19 RCTs with 1100 participants were identified and included in the current review. Swallowing exercises had significant small effect on swallowing function 0.33 (95%CI = 0.00-0.65) and moderate effect on mouth opening 0.60 (95%CI = 0.21-0.99) immediately after intervention and small effect at 6-month follow-up 0.46 (95%CI = 0.11-0.81). However, non-significant effects were observed on risk of aspiration/penetration, performance status and all domains of QOL.
CONCLUSION
Swallowing exercises demonstrated effectiveness in improving swallowing function and mouth opening in HNC patients undergoing multimodal treatment. This is the first comprehensive systematic review and meta-analysis of RCTs to assess the effect of swallowing exercises in HNC patients undergoing multimodal treatment. Nurses can play an important role in assisting the delivery of oropharyngeal swallowing exercises including jaw exercises, tongue exercises and swallowing maneuvers with assistance and guidance from speech pathologists to help improve HNC complications and QOL for HNC survivors.
Topics: Deglutition; Deglutition Disorders; Exercise Therapy; Head and Neck Neoplasms; Humans; Quality of Life
PubMed: 33352439
DOI: 10.1016/j.ijnurstu.2020.103827 -
The International Journal of Behavioral... Oct 2016With technological developments and modernised sedentary lifestyles has come an increase in diseases associated with inactivity such as obesity and other... (Review)
Review
BACKGROUND
With technological developments and modernised sedentary lifestyles has come an increase in diseases associated with inactivity such as obesity and other non-communicable diseases. Emerging evidence suggests that time spent sedentary may also interact with mental health. This systematic review examined the associations between sedentary behaviour and mental health problems among adolescents.
METHODS
This systematic review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses, and applied a quality assessment tool for quantitative studies to identity best available evidence. Following stringent search strategy of the databases; Cumulative Index to Nursing and Allied Health Literature, Global Health, Health Source: Nursing and Academic Edition, MEDLINE, PsychARTICLES and PsycINFO, we identified 32 articles eligible for review.
RESULTS
All studies reported leisure screen time among adolescents, and two thirds of identified studies examined depressive symptomatology. Other mental health measures were; anxiety symptoms, self-esteem, suicide ideation, loneliness, stress, and psychological distress. Strong consistent evidence was found for the relationship between both depressive symptomatology and psychological distress, and time spent using screens for leisure. Moderate evidence supported the relationship between low self-esteem and screen use. Poorer mental health status was found among adolescents using screen time more than 2-3 h per day, and gender differences exist. Essential information was missing for quality of evidence including heterogeneity in mental health and screen time-based measures, and self-report data collection methods.
CONCLUSIONS
The findings are of particular significance given the global public health concern of lifestyle-attributed diseases and the possibility for novel approaches to mental health. Future research should examine the psychological impact of reducing time spent using screens for leisure among adolescents, whilst accounting for possible confounding factors such as physical activity and dietary behaviours. It is critical that the reciprocal relationship between lifestyle behaviours and mental health is represented in both the psychiatric and public health forum.
Topics: Adolescent; Computers; Depression; Exercise; Female; Humans; Internet; Leisure Activities; Male; Mental Health; Sedentary Behavior; Self Concept; Stress, Psychological; Television; Video Games
PubMed: 27717387
DOI: 10.1186/s12966-016-0432-4 -
Scandinavian Journal of Caring Sciences Dec 2021This literature study describes caring science research on human dignity in different clinical practice. We already know a good deal about human dignity in nursing care... (Review)
Review
BACKGROUND
This literature study describes caring science research on human dignity in different clinical practice. We already know a good deal about human dignity in nursing care but how do patients, nurses, healthcare professionals and next of kin experience human dignity in clinical practice?
AIM
To summarise studies on human dignity to gain a deeper understanding of how it can be achieved in caring science research and to gain a broader understanding of the differences and similarities across caring contexts. The aim was also to gain a broader understanding of the differences and similarities of human dignity across different clinical practice.
METHOD
The literature review re-analysed 28 empirical studies on human dignity are experienced from acute, psychiatric, elderly and rehabilitation care. The data analysis strategy was conducted in a systematic and critical way and consisted of a five-step method.
RESULT
Maintaining dignity was described when caregivers had the time and the will to see and listen to patient and had the courage to see what they did not want to see, allowing their inner powers to act with the purpose of doing good. In elderly care, it was important that elderly persons are involved as members of society and experience respect, confidence, security and charity. Indignity was described when caregivers did not allow patients to have their will and when they had unethical attitudes, ignoring patients and creating powerlessness. The feeling of being abandoned and not being taken seriously are also described in elderly care.
CONCLUSION
Findings show how caregivers fulfil their ethical responsibility by seeing, listening and being a part of the time and place. The will to do good includes the courage to preserve dignity and human value rests on being created as a human being. More research is needed about ethical and moral responsibility in clinical practice.
Topics: Aged; Humans; Nursing Care; Personhood; Qualitative Research; Respect
PubMed: 33104271
DOI: 10.1111/scs.12922 -
Computers in Biology and Medicine Mar 2023Natural Language Processing (NLP) is widely used to extract clinical insights from Electronic Health Records (EHRs). However, the lack of annotated data, automated... (Review)
Review
BACKGROUND
Natural Language Processing (NLP) is widely used to extract clinical insights from Electronic Health Records (EHRs). However, the lack of annotated data, automated tools, and other challenges hinder the full utilisation of NLP for EHRs. Various Machine Learning (ML), Deep Learning (DL) and NLP techniques are studied and compared to understand the limitations and opportunities in this space comprehensively.
METHODOLOGY
After screening 261 articles from 11 databases, we included 127 papers for full-text review covering seven categories of articles: (1) medical note classification, (2) clinical entity recognition, (3) text summarisation, (4) deep learning (DL) and transfer learning architecture, (5) information extraction, (6) Medical language translation and (7) other NLP applications. This study follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
RESULT AND DISCUSSION
EHR was the most commonly used data type among the selected articles, and the datasets were primarily unstructured. Various ML and DL methods were used, with prediction or classification being the most common application of ML or DL. The most common use cases were: the International Classification of Diseases, Ninth Revision (ICD-9) classification, clinical note analysis, and named entity recognition (NER) for clinical descriptions and research on psychiatric disorders.
CONCLUSION
We find that the adopted ML models were not adequately assessed. In addition, the data imbalance problem is quite important, yet we must find techniques to address this underlining problem. Future studies should address key limitations in studies, primarily identifying Lupus Nephritis, Suicide Attempts, perinatal self-harmed and ICD-9 classification.
Topics: Humans; Natural Language Processing; Electronic Health Records; Machine Learning; Information Storage and Retrieval; Delivery of Health Care
PubMed: 36805219
DOI: 10.1016/j.compbiomed.2023.106649 -
International Journal of Nursing Studies Feb 2020Therapeutic alliance is a core part of the nursing role and key to the attainment of positive outcomes for people utilising mental health care services. However, these...
BACKGROUND
Therapeutic alliance is a core part of the nursing role and key to the attainment of positive outcomes for people utilising mental health care services. However, these relationships are sometimes difficult to develop and sustain, and nursing staff would arguably benefit from evidence-based support to foster more positive relationships.
OBJECTIVES
We aimed to collate and critique papers reporting on interventions targeted at improving the nurse-patient therapeutic alliance in mental health care settings.
DESIGN
Systematic literature review.
DATA SOURCES
The online databases of Excerpta Medica database (Embase), PsycINFO, Medical Literature Analysis and Retrieval System Online (MEDLINE) and Cumulative Index of Nursing and Allied Health Literature (CINAHL) were searched, eligible full text paper references lists reviewed for additional works and a forward citation search conducted.
REVIEW METHODS
Original journal articles in English language were included where they reported on interventions targeting the nurse-patient therapeutic relationship and included a measure of alliance. Data were extracted using a pre-determined extraction form and inter-rater reliability evaluations were conducted. Information pertaining to design, participants, interventions and findings was collated. The papers were subject to quality assessment.
RESULTS
Relatively few eligible papers (n = 8) were identified, highlighting the limitations of the evidence base in this area. A range of interventions were tested, drawing on diverse theoretical and procedural underpinnings. Only half of the studies reported statistically significant results and were largely weak in methodological quality.
CONCLUSIONS
The evidence base for methods to support nursing staff to develop and maintain good therapeutic relationships is poor, despite this being a key aspect of the nursing role and a major contributor to positive outcomes for service users. We reflect on why this might be and make specific recommendations for the development of a stronger evidence base, with the hope that this paper serves as a catalyst for a renewed research agenda into interventions that support good therapeutic relationships that serve both staff and patients.
Topics: Humans; Mental Health Services; Nurse-Patient Relations; Therapeutic Alliance
PubMed: 31862531
DOI: 10.1016/j.ijnurstu.2019.103490 -
International Journal of Mental Health... Oct 2019The aim of this study was to determine the prevalence of burnout in mental health nurses and to identify its predictors. A systematic review was conducted of studies... (Meta-Analysis)
Meta-Analysis Review
The aim of this study was to determine the prevalence of burnout in mental health nurses and to identify its predictors. A systematic review was conducted of studies published in the following databases: CINAHL, Dialnet, LILACS, ProQuest, PsycINFO, PubMed, SciELO, and Scopus. The search equation used was "Nurs * AND Burnout AND mental health". Subsequently, three fixed-effects meta-analyses were performed, one for each dimension of burnout, to calculate its prevalence and the corresponding confidence intervals. The data were analysed using StatsDirect meta-analysis software. Eleven studies were finally included (n = 11). In most cases, the literature informs about moderate levels of emotional exhaustion, depersonalization, and personal accomplishment. The studies inform that variables such as work overload, work-related stress, professional seniority, male gender, being single, and aggression at work, among other factors, contribute to burnout development. The meta-analytic prevalence estimations of burnout with a sample of n = 868 mental health nurses are 25% for high emotional exhaustion, 15% for depersonalization, and 22% for low personal accomplishment. From a workforce development and safety perspective, it is important for managers to address the emotional exhaustion and low personal accomplishment aspects of burnout reported in the workplace by mental health nurses.
Topics: Burnout, Professional; Humans; Prevalence; Psychiatric Nursing; Risk Factors
PubMed: 31132216
DOI: 10.1111/inm.12606 -
Iranian Journal of Nursing and... 2023Autism Spectrum Disorder (ASD) is a pervasive developmental disorder, which affects various multiple areas of a child's development. The objective of this study was to... (Review)
Review
BACKGROUND
Autism Spectrum Disorder (ASD) is a pervasive developmental disorder, which affects various multiple areas of a child's development. The objective of this study was to systematically review the available literature and appraise the effect of floortime in engaging autism disorder among children.
MATERIALS AND METHODS
A systematic review was performed using PubMed, PsycINFO, Science Direct, Scopus, Google Scholar, and Medline. The search terms used were DIR/floor time, ASD, floortime and autism, relationship therapy and autism, floortime, and ASDs. The studies, which described floortime in engaging children with ASD, full-text available in English, the sample had no comorbid psychiatric diagnosis, and the articles published in English from 2010 to 2020 were included in the review. Twelve studies meeting the inclusion criteria were included in the review.
RESULTS
The results showed substantial progress in different levels of functioning of autistic children with floortime. Home-based floortime improved emotive functioning, communication, and daily living skills, the parent-child interactions were improved as expressed by mothers, and also certain demographic factors of the parents have significantly influenced the floortime outcome. There were no adverse events to children or parents during floortime.
CONCLUSIONS
In general, we concluded that floortime is a cost-effective, completely child-led approach, which could be initiated as early as possible. If started early by healthcare professionals, it can be vital in improving social and emotional development among children.
PubMed: 37332371
DOI: 10.4103/ijnmr.ijnmr_272_21 -
Current Opinion in Psychiatry Sep 2020Social media's role in a user's life has increased dramatically over the past decade. It is used increasingly as a leisure activity amongst young adults. The types of...
PURPOSE OF REVIEW
Social media's role in a user's life has increased dramatically over the past decade. It is used increasingly as a leisure activity amongst young adults. The types of social media have also diversified with time and the ease of access is worrying. Aim of the current review is to find the effect of social media use on mental health.
RECENT FINDINGS
Systematic search of articles was carried out from different database from 1991 to February 2020 across five databases. The PICO guidelines, PRISMA flow diagram and Rayyan software were used in identifying relevant studies which were assessed using the risk of bias. Cross-referencing was done with the co-authors. A total of 16 studies was finally included in the review. Social media role is far reaching both in terms of an individual's self-perception and mood but also on their social relationships. It is interesting to find its effect also in politics, organizations and even psychiatric illnesses. The 16 studies were divided into the positive, negative and neutral effects of social media.
SUMMARY
Debate over social media's role on mental health will continue till a greater number of RCTs are conducted. Various variables amongst different age groups should be measured. It would also be beneficial if longitudinal research can be done.
Topics: Anxiety; Depression; Humans; Mental Disorders; Mental Health; Social Media
PubMed: 32639362
DOI: 10.1097/YCO.0000000000000631 -
European Journal of Nutrition Sep 2020Apple vinegar (AV) has been proclaimed to have different health benefits, such as a weight loss, the ability to lower blood glucose levels, and reducing the risk of...
INTRODUCTION
Apple vinegar (AV) has been proclaimed to have different health benefits, such as a weight loss, the ability to lower blood glucose levels, and reducing the risk of heart diseases. Studies on animals have demonstrated effects of AV consumption, deepening our knowledge of the beneficial effects and side effects.
AIM
The aims of this study were to evaluate the evidence of the effect of AV on metabolic parameters and body weight in humans, furthermore, to evaluate the safety and side effects of ingesting AV, and additionally to evaluate the evidence of the effect of AV on metabolic parameters, safety, and side effects of AV from studies performed on animals (mammals).
METHODS
A systematic literature search was performed. The databases PubMed (MEDLINE), PsycInfo (Ebsco), CINAHL (Ebsco), and Embase (Ovid) were searched for relevant articles. Primary outcomes were glycated hemoglobin, postprandial glucose, and synonyms for blood glucose. Secondary outcomes were waist circumference, visceral fat, high-density lipoprotein, low-density lipoprotein, triglycerides, and total cholesterol. Studies performed on humans and animals were included. The included studies performed on humans were quality assessed for risk of bias using a version of the Cochrane Collaboration's tool.
RESULTS
A total of 487 papers were identified in the literature search. Of these, 13 studies performed on humans and 12 studies performed on animals were included. There may be beneficial health effects from the consumption of AV. The risk of side effects when ingested in recommended quantities and in recommended ways seems inconsiderable.
CONCLUSION
Due to inadequate research of high quality, the evidence for the health effects of AV is insufficient. Therefore, more large-scale, long-term clinical studies with a low risk of bias are needed before definitive conclusions can be made.
Topics: Acetic Acid; Animals; Body Weight; Humans; Intra-Abdominal Fat; Lipids; Malus; Reproducibility of Results; Uncertainty; Waist Circumference
PubMed: 32170375
DOI: 10.1007/s00394-020-02214-3 -
International Nursing Review Mar 2023This study aimed to clarify the value of caring programs developed according to Orem's Self-Care Deficit Nursing Theory regarding quality of life and self-care as the... (Review)
Review
AIM
This study aimed to clarify the value of caring programs developed according to Orem's Self-Care Deficit Nursing Theory regarding quality of life and self-care as the primary outcomes and self-efficacy, anxiety, depression, and stress as the secondary outcomes among individuals aged 18-70 years with chronic diseases.
BACKGROUND
Chronically ill patients need to receive appropriate self-care training, counseling, and support. In this regard, the use of caring programs developed based on theories is highly suggested. Orem's Nursing Theory is the most well-known theory that provides a structure to involve patients in their self-care activities.
INTRODUCTION
Orem's Nursing Theory has been increasingly applied to guide practice for patients with chronic health conditions. However, recent trials have reported conflicting findings on the value of its application.
METHODS
Eight information sources (e.g., Web of Science Core Collection, PubMed, and Scopus) and the International Clinical Trials Registry Platform were searched up to 30 March 2022.
RESULTS
A total of 46 studies and 11 study register entries were eligible. Orem's theory-based interventions significantly improved the quality of life, self-care, and self-efficacy as well as significantly reduced anxiety and depression. However, the value of the interventions on stress was uncertain, as performing the meta-analysis was not possible.
DISCUSSION
Orem's Nursing Theory can help nurses in different fields to dynamically and carefully evaluate patients' self-care ability and implement appropriate nursing measures tailored to their needs, interests, and problems. Considering the inconsistent evidence to support the empirical adequacy of this theory, high-quality reviews are essential.
CONCLUSION
Orem's theory-based programs had a favorable effect on taking care of adults with chronic diseases.
IMPLICATIONS
This study augments the previous reviews related to the applicability of Orem's Nursing Theory. Considering the undesirable evidence quality and the high between-study heterogeneity, further well-designed trials are required to draw an evidence-based conclusion.
Topics: Humans; Adult; Quality of Life; Nursing Theory; Self Care; Chronic Disease; Self Efficacy
PubMed: 36418147
DOI: 10.1111/inr.12808