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Impact of spiritual interventions in individuals with cancer: A systematic review and meta-analysis.European Journal of Oncology Nursing :... Jun 2024This meta-analysis aimed to determine how spiritual interventions affect cancer patients' physical, emotional, and spiritual outcomes and quality of life.
PURPOSE
This meta-analysis aimed to determine how spiritual interventions affect cancer patients' physical, emotional, and spiritual outcomes and quality of life.
METHODS
Between 2012 and May 2024, the Cochrane Library, Scopus, PubMed, and Web of Science were searched considering the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Twenty-six randomized controlled trials were included, and 16 were synthesized in the meta-analysis. Bias risk was evaluated using the Cochrane risk-of-bias methodology for randomized studies. The Grading of Recommendations, Assessment, Development, and Evaluations tool was employed for evidence certainty. Heterogeneity was expressed through I and Q statistics. Hedge's g was calculated for effect sizes. Egger's and Kendall's Tau were used for publication bias.
RESULTS
Spiritual interventions yielded beneficial effects on fatigue (Hedges's g = 0.900, p < 0.001) and pain (Hedges's g = 0.670, p < 0.001) but not for overall symptom burden (Hedges's g = 0.208, p = 0.176). Significant effects were found for anxiety (Hedges's g = 0.301, p < 0.001), depression (Hedges's g = 0.175, p = 0.016), and psychological distress (Hedges's g = 0.178, p = 0.024), except for hopelessness (Hedges's g = 0.144, p = 0.091). Spiritual interventions enhanced faith (Hedges's g = 0.232, p = 0.035), the meaning of life (Hedges's g = 0.259, p = 0.002), spiritual well-being (Hedges's g = 0.268, p < 0.001), and quality of life (Hedges's g = 245, p < 0.001). Moderator analysis pointed out that cancer stage, total duration, delivery format, providers' qualification, content, and conceptual base of spiritual interventions significantly affect physical, emotional, and spiritual outcomes and quality of life.
CONCLUSION
This meta-analysis highlighted the benefits of spiritual interventions with varying effect sizes on patients' outcomes, as well as quality of life in cancer, and shed on how to incorporate these approaches into clinical practice.
PubMed: 38943773
DOI: 10.1016/j.ejon.2024.102646 -
Journal of Evaluation in Clinical... Jun 2024Nomophobia becoming widespread can have negative effects on the psychology of nursing students, who are the nurses of the future. Yet, the psychological well-being of...
RATIONALE
Nomophobia becoming widespread can have negative effects on the psychology of nursing students, who are the nurses of the future. Yet, the psychological well-being of the nursing group dealing with human health is essential for psychologically supporting the individuals they care for and reducing the potential for errors in nursing care. Therefore, it is necessary to determine nomophobia in nursing students and examine its relationship with psychological states.
AIMS
This research was conducted to determine the effect of nomophobia levels on depression, anxiety and stress levels of nursing students.
METHOD
The descriptive and correlational research was completed with 544 nursing students. Data were collected using the Data Collection Form, Nomophobia Scale, Depression, Anxiety and Stress Scale (DASS-21) and analysed using descriptive statistics, Kolmogorov-Smirnov, Shapiro-Wilk, Spearman, Mann-Whitney U and Kruskal-Wallis tests. p < 0.05 was considered statistically significant.
RESULTS
The students' mean age was 21.10 ± 1.32. Their mean nomophobia score was 102.51 ± 27.06. 65.6% had depression, 66.2% had anxiety, and 35.8% had stress at different levels. A relationship was found between the students' nomophobia mean scores and their depression, anxiety and stress subscale scores (p < 0.001).
CONCLUSION
The students' nomophobia levels were high. As students' nomophobia levels increased, their depression, anxiety and stress levels increased. Our recommendation is to inform nurses about nomophobia, support conscious phone use, and direct students affected by nomophobia to relevant units. Our recommendation is to inform nursing students about nomophobia, direct students affected by nomophobia to relevant units, and support their participation in activities that will raise awareness among students.
PubMed: 38943492
DOI: 10.1111/jep.14071 -
Journal of the American Board of Family... Jun 2024Interest is growing in clinic-based programs that screen for and intervene on patients' social risk factors, including housing, food, and transportation. Though several...
BACKGROUND
Interest is growing in clinic-based programs that screen for and intervene on patients' social risk factors, including housing, food, and transportation. Though several studies suggest these programs can positively impact health, few examine the mechanisms underlying these effects. This study explores pathways through which identifying and intervening on social risks can impact families' health.
METHODS
This qualitative study was embedded in a randomized clinical trial that examined the health impacts of participation in a social services navigation program. We conducted semi-structured interviews with 27 English or Spanish-speaking caregivers of pediatric patients who had participated in the navigation program. Interviews were analyzed using thematic analysis.
RESULTS
Caregivers described 3 pathways through which the navigation program affected overall child and/or caregiver health: 1) increasing families' knowledge of and access to social services; 2) helping families connect with health care services; and 3) providing emotional support that reduced caregiver isolation and anxiety. Participants suggested that navigation programs can influence health even when they do not directly impact resource access.
DISCUSSION
Social care programs may impact health through multiple potential pathways. Program impacts seem to be mediated by the extent to which programs increase knowledge of and access to social and health care services and support positive relationships between families and program personnel.
PubMed: 38942446
DOI: 10.3122/jabfm.2023.230232R2 -
Journal of Pain and Symptom Management Jun 2024Home-based pediatric palliative and hospice care (PPHC) supports the hundreds of thousands of children with serious illness and complex care needs and their families in...
CONTEXT
Home-based pediatric palliative and hospice care (PPHC) supports the hundreds of thousands of children with serious illness and complex care needs and their families in the home setting. Considerable variation, however, exists in the provision and quality of home-based PPHC in the U.S. Ensuring equitable, high-quality home-based PPHC for all children requires the evaluation of families' care experiences and assessment of whether these experiences are aligned with their needs and priorities.
OBJECTIVES
To evaluate the psychometric properties of the previously developed 23-item home-based PPHC EXPERIENCE Measure for use with families of children receiving home-based PPHC in the U.S.
METHODS
Participants included families recruited from the Children's Hospital of Philadelphia, Courageous Parents Network, and several other hospital- and community-based PPHC programs across the U.S. who provide home-based PPHC services. Participants completed the EXPERIENCE Measure at baseline and again at retest. We evaluated the factor structure of the EXPERIENCE Measure, as well as evidence regarding score reliability and validity.
RESULTS
82 family participants completed the baseline and 53 completed the retest questionnaire from 15 states across the U.S. We found evidence for the score reliability and validity of a four-domain EXPERIENCE measure.
CONCLUSION
The EXPERIENCE Measure is a tool with evidence for reliable and valid scores to evaluate family-reported home-based PPHC experiences at the time care is being received. Future work will evaluate the usability (i.e., acceptability, feasibility, and clinical actionability) of EXPERIENCE, including the sensitivity of the instrument to change over time and its impact on real-time clinical actions.
PubMed: 38942094
DOI: 10.1016/j.jpainsymman.2024.06.018 -
PloS One 2024Body mass index (BMI) is inversely proportional with adiponectin levels among adults, while insulin, C-reactive protein (CRP), interleukin 6 (IL-6), resistin and tumor...
BACKGROUND AND OBJECTIVES
Body mass index (BMI) is inversely proportional with adiponectin levels among adults, while insulin, C-reactive protein (CRP), interleukin 6 (IL-6), resistin and tumor necrosis factor-alpha (TNF-α) have been linked with elevated BMI. The role and relation of these biomarkers with BMI among a Hispanic pediatric population are less known. Thus, the objective of this study was to examine the association of inflammatory markers with the odds of overweight/obesity while controlling for several sociodemographic factors among a Hispanic youth population in Northeast Tennessee.
METHODS
Height, weight, demographic information, and blood samples were collected from 107 Hispanic children aged 2 to 10 years recruited at a large community health center in 2015-2016 in Northeast Tennessee. Data for this research were accessed and analyzed in 2022. Multivariable logistic regression was conducted to assess the relations between adiponectin, insulin, resistin, CRP, TNF-α, and IL-6, and overweight/obesity vs. having a healthy (normal) weight.
RESULTS
Adiponectin levels were significantly lower among overweight/obese Hispanic children (p = 0.0144) compared to healthy weight children. The odds of overweight/obesity decreased by 4% for every one-unit increase in serum adiponectin. Insulin levels were significantly higher among overweight/obese Hispanic children compared to healthy weight children (p = 0.0048). The odds of overweight/obesity increased by 7% for every one-unit increase in serum insulin. Resistin, IL-6, TNF-α, and CRP were not significantly associated with overweight/obesity in this population.
CONCLUSION
Adiponectin behaves similarly in Hispanic youth as it does in other pediatric populations, possibly making it a valuable marker when examining metabolic health status in this population.
Topics: Humans; Child; Body Mass Index; Male; Female; Hispanic or Latino; Child, Preschool; Biomarkers; Adiponectin; C-Reactive Protein; Interleukin-6; Resistin; Insulin; Tumor Necrosis Factor-alpha; Inflammation; Pediatric Obesity; Overweight; Tennessee
PubMed: 38941300
DOI: 10.1371/journal.pone.0289523 -
Cancer Nursing Jun 2024Interventions to foster resilience may promote mental health recovery after exposure to stressors. However, comprehensive systematic syntheses of such evidence in family...
BACKGROUND
Interventions to foster resilience may promote mental health recovery after exposure to stressors. However, comprehensive systematic syntheses of such evidence in family members of pediatric cancer patients are lacking.
OBJECTIVE
To systematically review and meta-analyze the evidence for the effects of psychological interventions at fostering resilience in family members of pediatric cancer patients.
METHODS
PubMed, Cumulative Index to Nursing and Allied Health Literature, and 9 other databases were searched for articles published until March 2023. Empirical studies on psychological interventions to improve resilience in family members of pediatric cancer patients were included. Full-text and quality appraisals were performed independently by 2 reviewers. Pooled effect sizes were calculated using random-effects meta-analyses.
RESULTS
Seventeen studies were included, of which 10 were included in the meta-analyses. There was a positive effect of interventions on resilience at postintervention time points, but no effects on depressive symptoms, stress, or well-being. The improvement in resilience was sustained in the short term (≤3 months) and medium term (>3 to ≤6 months), with delayed effects on depressive symptoms and stress. In the 6 studies that reported moderate effect sizes, the interventions comprised problem-solving skills, cognitive strategies, promotion of personal strength, and social resources.
CONCLUSION
The findings indicated that psychological interventions targeting resilience have the potential to positively affect the resilience and mental health outcomes of family members, particularly parents.
IMPLICATIONS FOR PRACTICE
Psychological interventions targeting resilience hold promise in improving the mental health of family members. Future interventions should clearly specify the characteristics of the intervention, such as mode of delivery, format, and duration.
PubMed: 38941110
DOI: 10.1097/NCC.0000000000001368 -
The Nurse Practitioner Jun 2024Atopic dermatitis (AD), a chronic inflammatory, pruritic skin disorder, is seen primarily in the pediatric population but can be found among all age groups. The symptoms...
Atopic dermatitis (AD), a chronic inflammatory, pruritic skin disorder, is seen primarily in the pediatric population but can be found among all age groups. The symptoms of AD can cause embarrassment in patients and can interrupt daily activities and productivity, potentially resulting in avoidance of social situations. In addition to nonpharmacologic management, mainstay pharmacologic treatments for AD are topical medications including corticosteroids, calcineurin inhibitors, phosphodiesterase-4 inhibitors, and topical Janus kinase (JAK) inhibitors. Promising new drugs-oral JAK inhibitors and monoclonal antibodies-have emerged as new treatment options for moderate-to-severe AD.
Topics: Dermatitis, Atopic; Humans; Janus Kinase Inhibitors; Phosphodiesterase 4 Inhibitors; Adrenal Cortex Hormones; Calcineurin Inhibitors; Dermatologic Agents; Nurse Practitioners
PubMed: 38941080
DOI: 10.1097/01.NPR.0000000000000183 -
Pediatric Cardiology Jun 2024By comparison with adults, cardiopulmonary exercise testing in children with Tetralogy of Fallot is limited, and its clinical application less clarified. This study...
By comparison with adults, cardiopulmonary exercise testing in children with Tetralogy of Fallot is limited, and its clinical application less clarified. This study provides a comprehensive CPET profile in a child-adolescent population with repaired TOF, explores mechanisms underpinning exercise intolerance and associations with clinical outcome. Seventy-four CPETs were completed in 58 child-adolescents with rTOF (age 13.8 SD 2.4 years). CPET parameters were corrected for age, sex and body size. At follow-up (4.9 years, IQR 3.5-7.9) clinical status and re-intervention was evaluated and CPET indices predicting these outcomes determined. Cohort peak V̇O was within low-normal limits (% pred: 74.1% SD 15.4) with 15 patients (26%) displaying moderately severe reduction in V̇O (< 65% pred). Oxygen uptake efficiency slope highly correlated with V̇O (r = 0.94, p < 0.001) and was insensitive to exercise intensity. No significant change in CPET occurred in patients who underwent interval testing at 24 SD 14.5 months, although there was a variable response in V̇O between individuals. Chronotropic response, lung vital capacity, heart rate-V̇O slope (indicator of stroke volume) predicted oxygen consumption: V̇O (R = 50.91%, p < 0.001) and workload (R = 58.39%, p < 0.001). Adverse clinical status was associated with reduced workload (OR 0.97, p = 0.011). V̇/V̇ slope was steeper in those that died ((%pred:137.8 SD 60.5 vs. 108.4 SD 17.0, p < 0.019). RVOT reintervention post-CPET (24 patients, 43.8%) was associated with an increased gradient of HR-VO slope (OR 1.042, p = 0.004). In child-adolescents with TOF important reductions in cardiopulmonary functioning were apparent in 25% of patients. Exercise intolerance was related to reduced vital capacity, impaired chronotropic response and deficient stroke volume increment.
PubMed: 38940827
DOI: 10.1007/s00246-024-03524-7 -
Journal of Interprofessional Care Jun 2024Collaboration among healthcare providers is regarded as a promising method to improve care quality and patient outcomes with limited human and financial resources. In...
Collaboration between professionals in primary and secondary healthcare services about hospital-at-home for children: A focus group study from the perspectives of stakeholders.
Collaboration among healthcare providers is regarded as a promising method to improve care quality and patient outcomes with limited human and financial resources. In Norway, "hospital-at-home" refers to care given by teams from the hospital pediatric wards who provide treatment and care in the family's home. When children need home visits multiple times daily, the hospital-at-home often reaches out to municipality healthcare providers, asking them to share this task. We aimed to explore the collaboration between stakeholders to gain knowledge on matters concerning the transfer of pediatric competence between hospital and home-based care, and to gain insight into how to set up the service for children in the future. We conducted three focus group interviews. The results showed that managing hospital-at-home collaboratively came with various challenges concerning unclear responsibilities between hospitals and homecare services and several obstacles to setting up cooperation across service levels. Thus, positive collaboration experiences between hospital and homecare settings were shared. Formalizing this collaboration was considered important for future collaboration. Building competence and learning from and with each other ensures better conditions for success if the collaboration is organized and facilitated through agreements between the hospital and the municipalities.
PubMed: 38940630
DOI: 10.1080/13561820.2024.2371353 -
Clinical Otolaryngology : Official... Jun 2024As patients nowadays tend to have multiple diseases and complex medical histories, our aim was to identify high-quality, non-instrumental dysphagia screening tools used... (Review)
Review
INTRODUCTION
As patients nowadays tend to have multiple diseases and complex medical histories, our aim was to identify high-quality, non-instrumental dysphagia screening tools used for the detection of adult dysphagia cases in all disease categories in acute-care settings.
METHOD
A literature search was conducted in five databases from each database's earliest inception to 31 July 2021 and guided by five keywords: 'dysphagia', 'deglutition', 'screening', 'test' and 'measure'. Without limiting the search in any specific disease category, reviewers assessed original studies and identified tools if they had been validated against instrumental evaluations and if they had been designed as a pass-fail procedure to screen whether dysphagia is absent or present. We further excluded any tool if it was (1) for pediatric focus, or (2) a patient self-report questionnaire. All final tool candidates underwent a methodological quality appraisal using the Revised Tool for the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2).
RESULT
Out of 195 studies with 165 tools identified, 20 tool candidates underwent QUADAS-2 review. We found six high-quality, non-instrumental screening tools for detecting adult dysphagia cases in acute-care settings, including the Yale Swallow Protocol, Gugging Swallowing Screen, Toronto Bedside Swallowing Screening Test (both English and Portuguese versions), Sapienza Global Bedside Evaluation of Swallowing and Two-Step Thickened Water Test. These high-quality tools were developed primarily for patients with stroke. Only Yale Swallow Protocol was originally tested for heterogeneous populations with stroke, multiple sclerosis, traumatic brain injury, oesophageal surgery, neurosurgery and head-and-neck cancer.
CONCLUSIONS
The results highlight the gap in the unavailability of high-quality dysphagia screening tool in several emerged high-risk populations including elderly inpatients, or patients following endotracheal extubation. Further research is needed to determine whether these six tools can be effectively applied across different high-risk populations in acute-care settings to screen for cases finding.
PubMed: 38940226
DOI: 10.1111/coa.14194