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Background Post-stroke dysphagia (PSD) has been associated with high risk of aspiration pneumonia and mortality. However, limited evidence on pooled prevalence of post-stroke dysphagia and influence of individual, disease and methodological factors reveals knowledge gap. Therefore, to extend previous evidence from systematic reviews, we performed the first meta-analysis to examine the pooled prevalence, risk of pneumonia and mortality and influence of prognostic factors for PSD in acute stroke. Methods Our search was conducted in CINAHL, Cochrane Library, EMBASE, Ovid-Medline, PubMed, and Web of Science an initial search in October 2020 and a follow-up search in May 2021. Data synthesis was conducted using the Freeman-Tukey double-arcsine transformation model for the pooled prevalence rate and the DerSimonian-Lard random-effects model for prognostic factors and outcomes of PSD. Results The pooled prevalence of PSD was 42% in 42 studies with 26,366 participants. PSD was associated with higher pooled odds ratio (OR) for risk of pneumonia 4.08 (95% CI, 2.13–7.79) and mortality 4.07 (95% CI, 2.17–7.63). Haemorrhagic stroke 1.52 (95% CI, 1.13–2.07), previous stroke 1.40 (95% CI, 1.18–1.67), severe stroke 1.38 (95% CI, 1.17–1.61), females 1.25 (95% CI, 1.09–1.43), and diabetes mellitus 1.24 (95% CI, 1.02–1.51) were associated with higher risk of PSD. Males 0.82 (95% CI, 0.70–0.95) and ischaemic stroke 0.54 (95% CI, 0.46–0.65) were associated with lower risk of PSD. Haemorrhagic stroke, use of instrumental assessment method, and high quality studies demonstrated to have higher prevalence of PSD in the moderator analysis. Conclusions Assessment of PSD in acute stroke with standardized valid and reliable instruments should take into account stroke type, previous stroke, severe stroke, diabetes mellitus and gender to aid in prevention and management of pneumonia and thereby, reduce the mortality rate. Trial registration https://osf.io/58bjk/?view_only=26c7c8df8b55418d9a414f6d6df68bdb .

Background Smoking is a major global health problem. It kills more than half of the users. At least 1.18 billion people smoked cigarettes every day as of 2020. Although many interventions for tobacco smoking cessation have been implemented, their effectiveness remains unclear. This study aimed to assess the long‐term effectiveness of various smoking cessation interventions in adults. Design We conducted a systematic review and meta‐analysis of randomized controlled trials reporting long‐term outcomes. Methods Evidence searches were conducted in the Cochrane Library, Embase, Medline‐OVID, PubMed, Web of Science, and Clinicaltrials.gov. Two researchers searched until August 2023 without restrictions on country, language, or year of publication. The risk ratio (RR) for continuous abstinence was obtained through biochemical verification at measurements ≥ 6 months post‐intervention. Data were extracted and assessed for quality using Risk of Bias 2. Meta‐analysis was carried out using a random effects model. Subgroup analyses and meta‐regression were performed to explore moderator variables. Sensitivity and publication bias analyses were also performed. Results Twenty‐two effect sizes from 13 studies showed that tobacco smoking cessation interventions increased continuous abstinence by 2.5 times (RR 3.52; 95% CI; 2.19–5.65). The highest ratio was in the behavioral intervention (RR 7.83) with more than 6 months of therapy (RR 10.57). The tobacco smoking cessation intervention worked better in 55–64 years (RR 7.29), especially in Asia (RR 10.08). The intervention was more effective for female respondents (RR 4.21) and combination therapy format (RR 3.82). However, meta‐regression showed that differences in gender and therapy format did not significantly influence the effectiveness of tobacco smoking cessation interventions in adults (p values 0.2748 and 0.8769). Sensitivity analysis (p‐value 0.0025) further strengthens the evidence of the conclusions and credibility of the findings. Conclusion Behavioral therapy lasting more than 6 months was the most successful tobacco smoking cessation intervention in respondents aged 55–64 years, especially when implemented in Asia. Although not significant, therapies delivered in combination formats, especially in women, have the potential to increase continuous abstinence for adults. These findings provide important evidence for developing effective prevention and treatment strategies for long‐term smoking cessation concerning the type, format, and total of therapy.

From the perspective of disease prevention, the enhancement of cognitive function among the healthy older people has become an important issue in many countries lately. This study aim to investigate the effect of cognitive-based training on the overall cognitive function, memory, attention, executive function, and visual-spatial ability of the healthy older people. Cochrane, PubMed, EMBASE, MEDLINE, PsycINFO, and CINAHL of selected randomized controlled trials (RCTs), and previous systematic reviews were searched for eligible studies. The population focused on this study were healthy older people who participated in randomized controlled trials that investigated the effectiveness of cognitive-based training. The outcomes including change in overall cognitive function, memory, attention, executive function, and visual-spatial ability. We collected a total of 31 RCTs, the results showed that cognitive-based training has a moderate effect on overall cognitive function (g = 0.419; 95%CI = 0.205-0.634) and executive function (g = 0.420; 95%CI = 0.239-0.602), and a small effect on the memory (g = 0.354; 95%CI = 0.244-0.465), attention (g = 0.218; 95%CI = 0.125-0.311), and visual-spatial ability (g = 0.183;95%CI = 0.015-0.352) in healthy older people. Subgroup analysis indicated the intervention characteristics of ≧3 times each week (p = 0.042), ≧8 total training weeks (p = 0.003) and ≧24 total training sessions (p = 0.040) yields a greater effect size. Cognitive-based training is effective for the healthy older people. This improvement can represent a clinically important benefit, provide information about the use of cognitive-based training in healthy older people, and help the healthy older people obtain the greatest possible benefit in health promotion and disease prevention.

Nurses who experience workplace violence exhibit compromised care quality and decreased work morale, which may increase their turnover rate. This study explored prevalence of workplace violence, the reaction of victims, and workplace strategies adopted to prevent violence among acute psychiatric settings in northern Taiwan. A cross-sectional study was conducted, which consisted of 429 nurses who completed the Chinese version of the Workplace Violence Survey Questionnaire developed by the International Labor Office, International Council of Nurses, World Health Organization, and Public Services International. The rates of physical and psychological violence were 55.7% and 82.1%, respectively. Most perpetrator of the workplace violence were patients. Most victims responded by instructing the perpetrator to stop, followed by narrating the incident to friends, family, and colleagues. Only 4.9%-12% of the victims completed an incident or accident form, and the main reason for not reporting these violent incidents was the belief that reporting such incidents was useless or unimportant. The major strategies adopted by workplaces to prevent violence were security measures, patient protocols, and training. Institutions should train staff to handle violence, provide a therapeutic environment, simplify the reporting process, and encourage reporting of all types of violence.

This is the first meta-analysis to compare the treatment effects and safety of administering donepezil alone versus a combination of memantine and donepezil to treat patients with moderate to severe Alzheimer Disease, particularly regarding cognitive functions, behavioral and psychological symptoms in dementia (BPSD), and global functions. PubMed, Medline, Embase, PsycINFO, and Cochrane databases were used to search for English and non-English articles for inclusion in the meta-analysis to evaluate the effect size and incidence of adverse drug reactions of different treatments. Compared with patients who received donepezil alone, those who received donepezil in combination with memantine exhibited limited improvements in cognitive functions (g = 0.378, p < .001), BPSD (g = -0.878, p < .001) and global functions (g = -0.585, p = .004). Gradual titration of memantine plus a fixed dose and gradual titration of donepezil as well as a fixed dose and gradual titration of memantine resulted in limited improvements in cognitive functions(g = 0.371, p = .005), BPSD(g = -0.913, p = .001), and global functions(g = -0.371, p = .001). Both in the 24th week and at the final evaluation point, the combination of donepezil and memantine led to greater improvement in cognitive functions, BPSD, and global functions than did donepezil alone in patients with moderate to severe Alzheimer Disease.

We performed the first meta-analysis of clinical studies by investigating the effects of eye-movement desensitization and reprocessing (EMDR) therapy on the symptoms of posttraumatic stress disorder (PTSD), depression, anxiety, and subjective distress in PTSD patients treated during the past 2 decades. We performed a quantitative meta-analysis on the findings of 26 randomized controlled trials of EMDR therapy for PTSD published between 1991 and 2013, which were identified through the ISI Web of Science, Embase, Cochrane Library, MEDLINE, PubMed, Scopus, PsycINFO, and the Cumulative Index to Nursing and Allied Health Literature electronic databases, among which 22, 20, 16, and 11 of the studies assessed the effects of EMDR on the symptoms of PTSD, depression, anxiety, and subjective distress, respectively, as the primary clinical outcome. The meta-analysis revealed that the EMDR treatments significantly reduced the symptoms of PTSD (g = -0.662; 95% confidence interval (CI): -0.887 to -0.436), depression (g = -0.643; 95% CI: -0.864 to -0.422), anxiety (g = -0.640; 95% CI: -0.890 to -0.390), and subjective distress (g = -0.956; 95% CI: -1.388 to -0.525) in PTSD patients. This study confirmed that EMDR therapy significantly reduces the symptoms of PTSD, depression, anxiety, and subjective distress in PTSD patients. The subgroup analysis indicated that a treatment duration of more than 60 min per session was a major contributing factor in the amelioration of anxiety and depression, and that a therapist with experience in conducting PTSD group therapy was a major contributing factor in the reduction of PTSD symptoms.

The adoption of information and communication technology (ICT) tools was accelerated by the COVID-19 pandemic to facilitate contactless interaction and reduce infection risk. However, there remains a lack of quantitative analysis regarding nurses' perceptions and experience with these ICT tools. This survey study aimed to assess nurses' experience and satisfaction with ICT tools during the COVID-19 pandemic. Registered nurses were recruited into this questionnaire-based cross-sectional study. Questions about organizational ICT training and support, impact on patient care, and ICT perception were asked. A total of 237 nurses completed and returned the questionnaire. The majority of nurses reported that ICT tools support instant consultation and communication with patients (62.0%). ICT tools' suitability and effectiveness of features were 6.40 ± 1.72 and 6.10 ± 1.73, respectively. Nurses' attitudes and perceived benefits of the ICT tools scored 3.59 ± 0.81 and 3.52 ± 0.87, respectively. The mean system usability score was 52.75 ± 11.75. Subgroup analyses highlighted the influence of ICT training, support, concerns about patient safety, and user anxiousness on the scores. Participants identified equipment, infrastructure, and workflow changes as major issues in ICT use, which require organizational efforts for improvement. Addressing data utility and security concerns through policy initiatives is also imperative. This study highlights the necessity of organizational initiatives to promote good use of ICT tools and to enhance nursing resilience, especially when facing a health emergency, more resources should be allocated to the IT department that aims to respond soon; strategies including integrating digital tools for emergencies into other established systems, expanding the size of IT team for maintenance and providing training course with multiple modules.

Declines in oral consumption and swallowing function are common reasons which may elevate the risk of malnutrition in the older adults. This study aimed to provide valuable information and contribute to the existing body of knowledge in this field as well as highlight the importance of a comprehensive assessment of oral health, swallowing function, and nutritional status in long-term care residents. This was a cross-sectional study. Thirty-nine participants were recruited from a nursing home. The comprehensive assessment was evaluated in participants, including oral health (Oral Health Assessment Tool (OHAT)), swallowing function (Functional Oral Intake Scale (FOIS) and Eating Assessment Tool (EAT)-10), and nutritional status (Mini Nutritional Assessment-Short Form (MNA-SF). The average age of participants was 80.4 ± 11.7 years, and 46% of these older adults were found to be at the risk of malnutrition. There was a negative correlation between the OHAT and MNA-SF scores. In addition, subjects with poor oral health (OHAT score = 5~8), oral consumption of a modified diet (FOIS score = 4~6), and reduced swallowing function (EAT-10 score ≥ 3) were more likely to be at risk of malnutrition. A comprehensive evaluation of oral health and swallowing function was closely connected with the nutritional status of older nursing home dwellers.

Purpose This meta‐analysis aimed to summarize and synthesize the effectiveness of bereavement support for adult family caregivers in palliative care. Methods Meta‐analysis was conducted. The databases of the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane, Embase, Medline, PubMed, Scopus, and Web of Science were comprehensively searched from inception until January 2020. This study followed the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines and standard methods for conducting a meta‐analysis. Data analysis was performed using Comprehensive Meta‐analysis version 3.0, and the random‐effects model was adopted. Findings In total, 19 randomized controlled trials with an overall sample size of 2,690 participants met the inclusion criteria. The study showed that bereavement support had a significant effect on reducing grief (Hedges’ g score = ‐0.198; 95% confidence interval [CI] ‐0.310 to ‐0.087), depression (Hedges’ g score = ‐0.252; 95% CI ‐0.406 to ‐0.098), and anxiety (Hedges’ g score = ‐0.153; 95% CI ‐0.283 to ‐0.023); however, high heterogeneity was present. No statistically significant difference was shown for traumatic feelings. Based on moderator analysis, a group format was more effective for grief, a combined individual and group format for depression, and an individual format for anxiety. Bereavement support was more effective when delivered by professionals, when delivered in more than six sessions, and need to be evaluated within 6 months. Conclusions Bereavement support was effective in reducing grief, depression, and anxiety. The majority of the included studies had moderate heterogeneity, which limited the comparability of the evidence. Therefore, more robust randomized controlled trials are needed to confirm these study results. Clinical Relevance This meta‐analysis provides evidence that bereavement support delivered in the palliative care setting is effective for reducing grief, depression, and anxiety. Nurses and other healthcare professionals can make recommendations for adult family caregivers based on this study in reducing psychological symptoms due to a loss in the palliative care domain.

Introduction Dementia notably increases fall risk in older adults, leading to major injuries and considerable concerns from health‐care professionals. However, comprehensive evidence regarding the prevalence, incidence rate, and moderating factors of falls in institutional settings is limited. This study aimed to evaluate the prevalence, incidence rates, and moderating factors of falls among older adults with dementia in nursing homes and dementia‐specialized care units. Design A meta‐analysis. Methods We searched CINAHL, PubMed, Embase, ProQuest, Scopus, Web of Science, and PsycINFO from database inception to April 30, 2024. Older adults with dementia in nursing homes or dementia‐specialized care units were included. The pooled prevalence was analyzed using a generalized linear mixed model with random effects using R software. Incidence rates were reported per person‐year using comprehensive meta‐analysis software. Study quality was assessed using Hoy's criteria. Variations in the pooled prevalence of falls were explored through moderator analyses. Results This meta‐analysis included 21 studies involving 35,449 participants. The pooled prevalence of falls was 45.6%, with subtypes showing 39.2%, 35.2%, and 29.0% among Alzheimer's dementia, vascular dementia, and mixed dementia subtypes, respectively. Falls were more prevalent in dementia‐specialized care units (53.0%) than in nursing homes (42.6%). The overall incidence rate was 3.61 per person‐year, higher in dementia‐specialized care units (5.80) than in nursing homes (3.17). Subgroup analyses revealed higher fall prevalence in women (70.0%) than in men (30.6%). Meta‐regression indicated that comorbidities, including delirium, visual impairment, and arthritis, increased fall risk. Conclusions This meta‐analysis revealed a high incidence of falls in nearly half of older adults with dementia, particularly among those in dementia specialized care units. Clinical Relevance Healthcare professionals should prioritize regular fall risk assessments, tailored interventions, and environmental safety modifications, particularly in dementia‐specialized care units, to reduce fall‐related injuries and improve patient outcomes.