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Healthcare (Basel, Switzerland) Jun 2024According to the World Health Organization, social isolation, particularly of older adults, is a public health issue endangering the well-being of individuals,... (Review)
Review
According to the World Health Organization, social isolation, particularly of older adults, is a public health issue endangering the well-being of individuals, families, and communities. Social isolation affects health through biological, behavioral, and psychological pathways and is associated with physical and psychological/emotional well-being, increases morbidity and mortality rates, and lowers quality of life. This systematic review examined the relationship between social isolation and physical health, including subjective and objective dimensions, and factors that influence this relationship in adults. : This systematic review examined six electronic databases covering the field of health and human services and included results from 1 January 2017 to 10 March 2023 with key terms including adult social connection or social isolation coupled with health, physical, psychological, emotional, mental, or behavioral. The initial search yielded 925 research articles across all databases and was narrowed to 710 when the decision was made to focus on social isolation and physical health. Covidence was used throughout the retrieval and appraisal process, as provided in a PRISMA flow diagram. Twenty-four studies that scored 90 or above in the appraisal process were included in the systematic review. : The studies represented included seven studies conducted in the United States and seventeen studies conducted internationally. Regarding study design, twenty-three studies were quantitative, one was qualitative, and one was mixed methods. The majority of quantitative studies were correlational in design with nine being longitudinal. The majority of studies were based on large national data sets representing in total 298,653 participants aged 50 and older. The results indicate that social isolation is related to increases in inflammatory biomarkers associated with diseases, all-cause mortality, lower expectations of longevity, and frailty. In addition, social isolation was associated with cognitive decline and disruptions in sleep. Poor oral health increased social isolation. The results further indicated that decreased physical performance/function and a decline in physical activity were associated with social isolation, as well as decreased overall physical health, poor health behaviors, and self-care, and decreased health-related quality of life. Further research is warranted to examine the possible bidirectionality of these relationships and possible mediating, moderating, or confounding variables. : Future research is needed to explore the biological and behavioral pathways in which social isolation negatively impacts physical health. Going forward, studies are needed that move beyond descriptive, exploratory methods and integrate data from qualitative and mixed-method designs that will inform the development and testing of a conceptual framework related to social isolation and health. By advancing the science behind social isolation, comprehensive interventions can be identified and tested with implications at the individual, family, community, and societal levels to reduce social isolation, particularly among adults, and improve health and quality of life.
PubMed: 38891210
DOI: 10.3390/healthcare12111135 -
BMC Medical Ethics Jun 2024The nursing profession considers conscience as the foundation and cornerstone of clinical practice, which significantly influences professional decision-making and...
BACKGROUND
The nursing profession considers conscience as the foundation and cornerstone of clinical practice, which significantly influences professional decision-making and elevates the level of patient care. However, a precise definition of conscience in the nursing field is lacking, making it challenging to measure. To address this issue, this study employed the hybrid approach of Schwartz Barcott and Kim to analyze the concept of conscience-based nursing care.
METHODS
This approach involves a three-phase process; theoretical, fieldwork, and analytical. A systematic literature review was conducted using electronic databases during the first phase to find relevant papers. The content of 42 articles that met the inclusion criteria was extracted to determine the attributes, antecedents, and consequences of consciousness care using thematic analysis. Based on the working definition as a product of this phase, the plan of doing the fieldwork phase was designed. During this phase, data were collected through interviews with nurses all of whom were responsible for patient care in hospitals. In this phase, 5 participants were chosen for in-depth interviewing by purposeful sampling. Data were analyzed using directed content analysis. The findings of the theoretical and fieldwork phases were integrated and the final definition was derived.
RESULTS
The integration of the theoretical and fieldwork phases resulted in identifying four key characteristics of conscience-based nursing care. Firstly, it involves providing professional care with a conscientious approach. Secondly, ethics is at the core of conscience-based care. Thirdly, external spirituality plays a significant role in shaping one's conscience in this context. Finally, conscience-based nursing care is both endogenous and exogenous, with professional commitment being the central focus of care.
CONCLUSION
Conscience-based nursing care is an essential component of ethical care, which elevates clinical practice to professional care. It requires the integration of individual and social values, influenced by personal beliefs and cultural backgrounds, and supported by professional competence, resources, and a conducive organizational atmosphere in the healthcare field. This approach leads to the provision of responsive care, moral integrity, and individual excellence, ultimately culminating in the development of professionalism in nursing.
Topics: Humans; Conscience; Nursing Care; Attitude of Health Personnel; Ethics, Nursing; Concept Formation
PubMed: 38890687
DOI: 10.1186/s12910-024-01070-8 -
PloS One 2024The most dominant model of hope is cognitive, in which hope is defined as goal-directed thinking, comprising self-agency and goal route identification. Nonetheless,... (Meta-Analysis)
Meta-Analysis
The most dominant model of hope is cognitive, in which hope is defined as goal-directed thinking, comprising self-agency and goal route identification. Nonetheless, competing theories about the fundamental nature of hope remain and further exploration of the construct is warranted. Little is known about whether the cognitive model aligns with how higher education students themselves think about hope. Understanding how "lay" populations conceptualise and experience psychological phenomena is as important as applying scientific theory. Personal beliefs impact on how people make sense of their life experiences and on their wellbeing. Research is specifically needed to explore the conceptualisation and experience of hope within diverse student populations. A systematic review was conducted to identify published scientific research and grey literature presenting qualitative accounts of hope from higher education students. A qualitative meta-synthesis of the eight eligible reports was conducted using thematic analysis and synthesis approaches to identify conceptualisations of hope and its associations with mental health and well-being. Nine themes were identified, reflecting that hope is: fundamental; self-construal over time; goal-directed; cognitive-emotional-behavioural; connection; resilience; dynamic and reciprocal; the inverse of depression; positive. These findings were identified as reflecting conclusions in which at least a moderate level of confidence may be placed. These findings clearly align with the cognitive model of hope, but emphasise the additional facets of fundamentality, self-construal, and negative origins. The implications for higher education institutions include to promote growth mindsets, to support students to learn skills for identifying and pursuing goals, and to provide hope-enhancing interventions as part of their student support provision.
Topics: Humans; Hope; Students; Goals; Cognition; Mental Health; Universities
PubMed: 38885226
DOI: 10.1371/journal.pone.0304596 -
The Lancet. Psychiatry Jul 2024Many patients with schizophrenia have symptoms that do not respond to antipsychotics. This condition is called treatment-resistant schizophrenia and has not received... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Many patients with schizophrenia have symptoms that do not respond to antipsychotics. This condition is called treatment-resistant schizophrenia and has not received specific attention as opposed to general schizophrenia. Psychological and psychosocial interventions as an add-on treatment to pharmacotherapy could be useful, but their role and comparative efficacy to each other and to standard care in this population are not known. We investigated the efficacy, acceptability, and tolerability of psychological and psychosocial interventions for patients with treatment-resistant schizophrenia.
METHODS
In this systematic review and network meta-analysis (NMA), we searched for published and unpublished randomised controlled trials (RCTs) through a systematic database search in BIOSIS, CINAHL, Embase, LILACS, MEDLINE, PsychInfo, ClinicalTrials.gov, and the WHO International Clinical Trials Registry Platform for articles published from inception up to Jan 31, 2020. We also searched the Cochrane Schizophrenia Group registry for studies published from inception up to March 31, 2022, and PubMed and Cochrane CENTRAL for studies published from inception up to July 31, 2023. We included RCTs that included patients with treatment-resistant schizophrenia. The primary outcome was overall symptoms. We did random-effects pairwise meta-analyses and NMAs to calculate standardised mean differences (SMDs) or risk ratios with 95% CIs. No people with lived experience were involved throughout the research process. The study protocol was registered in PROSPERO, CRD42022358696.
FINDINGS
We identified 30 326 records, excluding 24 526 by title and abstract screening. 5762 full-text articles were assessed for eligibility, of which 5540 were excluded for not meeting the eligibility criteria, and 222 reports corresponding to 60 studies were included in the qualitative synthesis. Of these, 52 RCTs with 5034 participants (1654 [33·2%] females and 3325 [66·8%] males with sex indicated) comparing 20 psychological and psychosocial interventions provided data for the NMA. Mean age of participants was 38·05 years (range 23·10-48·50). We aimed to collect ethnicity data, but they were scarcely reported. According to the quality of evidence, cognitive behavioural therapy for psychosis (CBTp; SMD -0·22, 95% CI -0·35 to -0·09, 35 trials), virtual reality intervention (SMD -0·41, -0·79 to -0·02, four trials), integrated intervention (SMD -0·70, -1·18 to -0·22, three trials), and music therapy (SMD -1·27, -1·83 to -0·70, one study) were more efficacious than standard care in reducing overall symptoms. No indication of publication bias was identified.
INTERPRETATION
We provide robust findings that CBTp can reduce the overall symptoms of patients with treatment-resistant schizophrenia, and therefore clinicians can prioritise this intervention in their clinical practice. Other psychological and psychosocial interventions showed promising results but need further investigation.
FUNDING
DAAD-ASFE.
Topics: Humans; Network Meta-Analysis; Psychosocial Intervention; Schizophrenia, Treatment-Resistant; Randomized Controlled Trials as Topic; Psychotherapy; Antipsychotic Agents; Treatment Outcome; Schizophrenia
PubMed: 38879276
DOI: 10.1016/S2215-0366(24)00136-6 -
Medicine Jun 2024Many randomized controlled trials have demonstrated that exercise benefits cognitive function in patients with mild cognitive impairment (MCI), but less attention has... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Many randomized controlled trials have demonstrated that exercise benefits cognitive function in patients with mild cognitive impairment (MCI), but less attention has been paid to the development of exercise programs in this population.
OBJECTIVE
This study aimed to assess the effect of exercise intervention for elderly with MCI and provide the most effective exercise intervention plan.
METHODS
We searched 4 international databases (PubMed, EMBASE, Web of Science, Cochrane Library) and 4 Chinese databases (Chinese National Knowledge Infrastructure, VIP database and Wanfang database) for studies on exercises associated with MCI up to September 25, 2022. The resulting standardized mean differences (SMD) and 95% confidence intervals were statistically analyzed using Review Manager 5.3 software.
RESULTS
A total of 20 RCTs were comprised in this meta-analysis, including 1393 participants. The results of the meta-analysis revealed that exercise had positive effects on cognitive function in elderly with MCI and was statistically significant (SMD = 1.25, 95%CI: [0.88,1.62], P < .00001). Subgroup analysis showed that the most significant factor was the Peterson 2004 criteria, multi-exercise, 35 to 50 minutes/times, <3 times/3 to 5 times per week, >16 weeks and medium intensity.
CONCLUSION
Exercise intervention can significantly alleviate cognition in elderly with MCI. The best exercise program for exercise intervention for MCI is: multi-exercise, 35 to 50 minutes/times, 3 to 5 times/week, and exercise cycle for more than 16 weeks with medium intensity, has the best effect. Plus, more RCTs with larger sample sizes will be required in the future to demonstrate the link between exercise duration, intensity, and cognitive function.
Topics: Humans; Cognitive Dysfunction; Exercise Therapy; Aged; Randomized Controlled Trials as Topic; Cognition; Exercise; Female; Male
PubMed: 38875404
DOI: 10.1097/MD.0000000000038025 -
PloS One 2024The COVID-19 pandemic drastically affected many areas and contexts of today's society, including school and family. Several studies focused on the worldwide effects of...
The COVID-19 pandemic drastically affected many areas and contexts of today's society, including school and family. Several studies focused on the worldwide effects of school closures on students' learning outcomes, context, and well-being. However, the data emerging from these studies are often inconsistent and fragmentary, highlighting the need of a comprehensive analysis of the phenomenon. This need is especially urgent for the countries with the most severe school closure, like Italy. This systematic review aims to collect the opinions of parents, teachers, and students on: other dimensions of Italian primary school students affected by school closures, beyond academic performance; hypothetical agreement between the opinions of parents, teachers, and students regarding the different effects of school closures on Italian primary school students; possible differences between the effects of school closures on Italian primary school students and the students in other countries. Our search was conducted using PRISMA 2020 guidelines on Web of Science, Pubmed, Scopus, and EBSCOHost. The results obtained from 34 articles revealed a strong concern on the part of all stakeholders involved in learning during the pandemic, with evident negative effects for Italian school students. The constraint on distance learning led to a drastic change in everyone's routine, and a negative emotional change on the part of young students. Parents and teachers generally considered distance learning to be ineffective for the education of their children and students; they encountered technical-practical difficulties in the use of electronic devices for participation in school activities; overall learning deficits on the part of students, especially in mathematics, as confirmed by INVALSI results were also found. The investigation reveals a condition of shared emotional and academic performance difficulty, and a further challenging circumstance for students previously at risk of marginalization. Further research in this field is paramount to identify new and adequate recovery strategies.
Topics: COVID-19; Humans; Italy; Child; Schools; Students; Pandemics; Learning; Education, Distance; SARS-CoV-2; Parents; School Teachers
PubMed: 38875255
DOI: 10.1371/journal.pone.0303991 -
Breast Disease 2024Research investigating the quality of life (QOL) of breast cancer patients undergoing chemotherapy has yielded useful knowledge regarding the effects of cancer treatment...
OBJECTIVES
Research investigating the quality of life (QOL) of breast cancer patients undergoing chemotherapy has yielded useful knowledge regarding the effects of cancer treatment on the quality of life of patients. This study reviews the assessment of the quality of life for those diagnosed with breast cancer.
DESIGN
A systematic review was conducted.
DATA SOURCES
This systematic review utilized online databases, including PubMed, Web of Science, Scopus, and Google Scholar. A search ranging from 2018 to 2024 was carried out.
REVIEW METHOD
Medical Subject Headings (MESH) were used for keyword selection along with other target keywords, such as "Quality of life", "Breast cancer", "Chemotherapy", "Treatment side effects", "Patient experience", "Psychosocial well-being", "Physical functioning", "Emotional distress", and "Supportive care". We reviewed and included all English-language publications. A narrative synthesis was conducted to present the results of the studies.
RESULTS
A total of 300 studies were obtained from the search using the specified keywords. Each result underwent another filtering round after applying the inclusion and exclusion criteria. This process led to a final selection of 20 papers that met the requirements and were included in the systematic review.
CONCLUSION
The use of instruments to measure the quality of life (QoL) of breast cancer patients is crucial in understanding the impact of breast cancer on patients' lives, from physical and mental health to social aspects.
Topics: Humans; Quality of Life; Breast Neoplasms; Female; Surveys and Questionnaires
PubMed: 38875026
DOI: 10.3233/BD-249008 -
European Journal of Sport Science Jun 2024To assess the evidence for the effect of strength and conditioning on physical qualities and aesthetic competence in dance populations, three electronic databases... (Meta-Analysis)
Meta-Analysis Review
To assess the evidence for the effect of strength and conditioning on physical qualities and aesthetic competence in dance populations, three electronic databases (PubMed, Scopus, SPORTDiscus) were searched (until September 2022) for studies that met the following criteria: (i) dancers aged >16 years; (ii) structured strength and conditioning intervention; and (iii) with physical qualities and aesthetic competence as outcome measures. Methodological quality and risk of bias of the included studies were assessed through the systematic review tool "QualSyst". Meta-analyses of effect sizes (Hedges' g) with forest plots explored the effects of the strength and conditioning interventions. Thirty-six studies met the inclusion criteria and were included in this review. Meta-analysis indicated strength and conditioning significantly (p < 0.05) improved lower body power (g = 0.90, 95% CI: 0.53-1.27), upper body strength (g = 0.98, 95% CI: 0.39-1.57), lower body strength (g = 1.59, 95% CI: 0.97-2.22), and flexibility (g = 0.86, 95% CI: 0.05-1.66). Strength and conditioning interventions were found to be effective at improving physical qualities in dancers, recommending their participation in additional sessions to enhance overall fitness and ultimately dance performance. It is recommended that future strength and conditioning intervention research should include sample size calculations, with participants recruited from a specific dance genre and skill level in order to evaluate how strength and conditioning influences dance performance.
Topics: Humans; Dancing; Muscle Strength; Resistance Training; Esthetics
PubMed: 38874993
DOI: 10.1002/ejsc.12111 -
Journal of Psychosomatic Research Aug 2024Research shows that people with a history of mental health conditions were at increased risk of COVID-19 infection, hospitalisation, and mortality. However, the... (Review)
Review
OBJECTIVE
Research shows that people with a history of mental health conditions were at increased risk of COVID-19 infection, hospitalisation, and mortality. However, the relationship between mental health conditions and COVID-19 vaccine outcomes such as vaccine intention, uptake and vaccine breakthrough is not yet well-understood.
METHODS
We conducted a systematic search on the topics of COVID-19 vaccine intentions, vaccine uptake, and vaccine breakthrough, in relation to mental health conditions (e.g., depression, schizophrenia), in four databases: PubMed, MEDLINE, SCOPUS, and PsychINFO, and the publication lists of Clinical Practice Research Datalink (CPRD), The Health Improvement Network (THIN), OpenSAFELY, and QResearch. Inclusion criteria focussed on studies reporting any of the aforementioned COVID-19 vaccine outcomes among people with mental health conditions.
RESULTS
Of 251 publications initially identified, 32 met our inclusion criteria. Overall, the evidence is inconclusive regarding the levels of intention to accept COVID-19 vaccines among people with mental health conditions. People with mental health conditions were more likely to have lower uptake of COVID-19 vaccines, compared to people without. Common barriers to COVID-19 vaccine uptake included concerns about the safety, effectiveness, and side effects of the vaccines. Limited evidence also suggests that vaccine breakthrough may be a particular risk for those with substance use disorder.
CONCLUSIONS
Evidence for the association between COVID-19 vaccine intentions and mental health conditions is mixed. Vaccine uptake might be lower in people with mental health conditions compared to people without, yielding interventions to encourage vaccine uptake in this population. Our understanding of COVID-19 vaccine breakthrough in this population also needs enhancing.
Topics: Humans; COVID-19 Vaccines; COVID-19; Mental Disorders; Mental Health; SARS-CoV-2; Vaccination; Intention
PubMed: 38870550
DOI: 10.1016/j.jpsychores.2024.111826 -
BMC Health Services Research Jun 2024Limited Health Literacy (HL) is an obstacle to accessing and receiving optimal health care and negatively impacts patients' quality of life, thus making it an urgent... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Limited Health Literacy (HL) is an obstacle to accessing and receiving optimal health care and negatively impacts patients' quality of life, thus making it an urgent issue in the health care system. Visual-based interventions are a promising strategy to improve HL through the use of visual aids and pictorial materials to explain health-related concepts. However, a comprehensive summary of the literature on the topic is still scarce.
METHODS
To fill this gap, we carried out a systematic review and meta-analysis with the aim to determine the effectiveness of visual-based interventions in improving comprehension of health related material in the clinical population. Independent studies evaluating the effectiveness of visual-based interventions on adults (> 18 years) and whose primary outcome was either health literacy (HL) or comprehension were eligible for the review. After a systematic literature search was carried out in five databases, 28 studies met the inclusion criteria and thus were included. Most of the studies were randomized controlled trials and they focused on HL and health knowledge as outcomes.
RESULTS
The review and meta-analysis showed that visual-based interventions were most effective in enhancing the comprehension of health-related material compared to traditional methods. According to meta-analytic results, videos are more effective than traditional methods (Z = 5.45, 95% CI [0.35, 0.75], p < 0.00001) and than the employment of written material (Z = 7.59, 95% CI [0.48, 0.82], p < 0.00001). Despite this, no significant difference was found between video and oral discussion (Z = 1.70, 95% CI [-0.46, 0.53], p = 0.09).
CONCLUSIONS
We conclude that visual-based interventions, particularly the ones using videos, are effective for improving HL and the comprehension of health-related material.
Topics: Humans; Health Literacy; Audiovisual Aids; Comprehension; Patient Education as Topic
PubMed: 38862966
DOI: 10.1186/s12913-024-11138-1