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Long-term conditions and their concomitant management place considerable pressure on patients, communities, and health care systems worldwide. International clinical guidelines on the majority of long-term conditions recommend the inclusion of self-management programs in routine management. Self-management programs have been associated with improved health outcomes; however, the successful and sustainable transfer of research programs into clinical practice has been inconsistent. Recent developments in mobile technology, such as mobile phone and tablet computer apps, could help in developing a platform for the delivery of self-management interventions that are adaptable, of low cost, and easily accessible. We conducted a systematic review to assess the effectiveness of mobile phone and tablet apps in self-management of key symptoms of long-term conditions. We searched PubMed, Embase, EBSCO databases, the Cochrane Library, and The Joanna Briggs Institute Library for randomized controlled trials that assessed the effectiveness of mobile phone and tablet apps in self-management of diabetes mellitus, cardiovascular disease, and chronic lung diseases from 2005-2016. We searched registers of current and ongoing trials, as well as the gray literature. We then checked the reference lists of all primary studies and review papers for additional references. The last search was run in February 2016. Of the 9 papers we reviewed, 6 of the interventions demonstrated a statistically significant improvement in the primary measure of clinical outcome. Where the intervention comprised an app only, 3 studies demonstrated a statistically significant improvement. Interventions to address diabetes mellitus (5/9) were the most common, followed by chronic lung disease (3/9) and cardiovascular disease (1/9). A total of 3 studies included multiple intervention groups using permutations of an intervention involving an app. The duration of the intervention ranged from 6 weeks to 1 year, and final follow-up data ranged from 3 months to 1 year. Sample size ranged from 48 to 288 participants. The evidence indicates the potential of apps in improving symptom management through self-management interventions. The use of apps in mHealth has the potential to improve health outcomes among those living with chronic diseases through enhanced symptom control. Further innovation, optimization, and rigorous research around the potential of apps in mHealth technology will move the field toward the reality of improved health care delivery and outcomes.

Although the benefits of engaging in cardiac rehabilitation are well established, patient perceptions of the changes in their health-related quality of life are poorly documented. This systematic review synthesized qualitative studies on patients' perspectives of change in their health-related quality of life after attending cardiac rehabilitation. To identify and synthesize the best available evidence on the perspective of patients living with heart disease about the changes in their health-related quality of life after attending cardiac rehabilitation. Eight databases were used to identify relevant papers published in English and peer-reviewed, and no date restrictions were considered for the search. This systematic review followed the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. The Joanna Briggs Institute (JBI) Critical Appraisal Checklist was used to appraise the quality of each paper, and two independent reviewers conducted it. A meta-aggregation approach was used to synthesize the findings of the included studies. The search identified 10813 titles. Thirty-five full-text papers were reviewed after duplicates were removed, and the titles and abstracts were reviewed. Thirteen papers were retained for data synthesis. The synthesized findings were divided into three categories: building healthier habits, peer interaction, and improving mental health. This review demonstrates the positive changes in health-related quality of life for those patients engaged in cardiac rehabilitation. Peer interaction with other patients improved both mental and physical health. This review indicated that adopting healthier habits, including healthy eating and regular physical activity, had substantial benefits in formulating healthy behavior. The role of peers in supporting the development of a healthy lifestyle appears to be an understudied avenue and has potential for development.

Parental health literacy is associated with child health outcomes. Parents are increasingly turning to the internet to obtain health information. In response, health care providers are using digital interventions to communicate information to assist parents in managing their child's health conditions. Despite the emergence of interventions to improve parental health literacy, to date, no systematic evaluation of the effectiveness of the interventions has been undertaken. The aim of this review is to examine the effect of digital health interventions on health literacy among parents of children aged 0-12 years with a health condition. This includes evaluating parents' engagement (use and satisfaction) with digital health interventions, the effect of these interventions on parental health knowledge and health behavior, and the subsequent impact on child health outcomes. This systematic review was registered a priori on PROSPERO (International Prospective Register of Systematic Reviews) and developed according to the Joanna Briggs Institute methodology for systematic reviews. The databases CINAHL, MEDLINE, and PsycINFO were searched for relevant literature published between January 2010 and April 2021. Studies were included if they were written in English. A total of 2 authors independently assessed the search results and performed a critical appraisal of the studies. Following the review of 1351 abstracts, 31 (2.29%) studies were selected for full-text review. Of the 31 studies, 6 (19%) studies met the inclusion criteria. Of the 6 studies, 1 (17%) was excluded following the critical appraisal, and the 5 (83%) remaining studies were quantitative in design and included digital health interventions using web-based portals to improve parents' health knowledge and health behavior. Owing to heterogeneity in the reported outcomes, meta-analysis was not possible, and the findings were presented in narrative form. Of the 5 studies, satisfaction was measured in 3 (60%) studies, and all the studies reported high satisfaction with the digital intervention. All the studies reported improvement in parental health literacy at postintervention as either increase in disease-specific knowledge or changes in health behavior. Of the 5 studies, only 1 (20%) study included child health outcomes, and this study reported significant improvements related to increased parental health knowledge. In response to a pandemic such as COVID-19, there is an increased need for evidence-based digital health interventions for families of children living with health conditions. This review has shown the potential of digital health interventions to improve health knowledge and behavior among parents of young children with a health condition. However, few digital health interventions have been developed and evaluated for this population. Future studies with robust research designs are needed and should include the potential benefits of increased parent health literacy for the child. PROSPERO International Prospective Register of Systematic Reviews CRD42020192386; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=192386.

The majority of Internet-mediated studies use measures developed as paper-and-pencil measures or face-to-face-delivered material. Previous research suggests that the equivalence between online and offline measures must be demonstrated rather than assumed. The objective of this study was to explore the equivalence 4 measures completed in an online or offline setting. A sample (n = 1969) were randomly assigned to complete 4 popular scales (the SF-12v2, the Hospital Anxiety and Depression Scale (HADS), the Fatigue Symptom Inventory, and a single-item fatigue measure) either online or by mail survey (pencil and paper). The response rate was 52.51% (n = 1034) and comparable between the online and offline groups. Significant differences were noted in fatigue levels between the online and offline group (P = .01) as measured by the Fatigue Symptom Inventory, with the online sample demonstrating higher levels of fatigue. Equivalency was noted for the SF-12v2, the Hospital Anxiety and Depression Scale, and the single-item fatigue measure. Internal consistency was high except for the SF-12v2. The SF-12v2 may not be an ideal measure to use for remote administration. Equivalency of the Hospital Anxiety and Depression Scale (HADS) and the Physical Component Score and Mental Component Score of the SF-12v2 for online and offline data were demonstrated. Equivalency was not demonstrated for the Fatigue Symptom Inventory. Explanations for the difference in fatigue score between the online and offline samples are unclear. Research that seeks to match samples and control for extraneous online and offline variables is called for, along with exploration of factors that may mediate the completion of questionnaires or alter the respondents' relationship with the same, to enhance progress in this area.

ObjectiveTo systematically review and synthesise evidence on the experiences of older immigrants living with dementia and their carers.DesignA systematic review and meta-synthesis of qualitative studies.MethodsStudies exploring the experiences of older immigrants living with dementia and their carers were eligible. Databases were searched including CINAHL, MEDLINE, PsycINFO, PubMed, Embase, Web of Science and Cochrane Library from January 2000 to April 2021. Quality assessment was undertaken using the Critical Appraisal Skills Programme checklist for qualitative studies. Data were then synthesised using the thematic synthesis approach.ResultsThe results of this meta-synthesis were reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement and Enhancing transparency in reporting the synthesis of qualitative research statement. A total of 3857 studies were returned from the database search. Eighteen studies were included for meta-synthesis. Five synthesised findings were identified: living with dementia and caregiving; family relationships; barriers to dementia care services; stigma and discrimination; and legal and financial issues. The experiences of living with dementia and caregiving presented multiple challenges for older immigrants living with dementia and their families. However, there seems to be very little difference between the experiences of those who have migrated to a new country and those who were born and aged in the same country, but the ability to access and use the available services is different.ConclusionA lack of culturally appropriate dementia services, language barriers and dementia stigma can impede access to dementia care for older immigrants. Strategies to mitigate these barriers are urgently needed to ensure people from culturally and linguistically diverse backgrounds with dementia and their families have the information, education and support to access dementia services, in addition to research that explores the experiences of culturally and linguistically diverse populations.PROSPERO registration numberCRD42021277913.

Emerging evidence has identified sleep as a significant, but modifiable, risk factor for metabolic syndrome, diabetes, and obesity. Leptin, an adipocyte-derived peptide and a regulator of food intake and energy expenditure, has been shown to be associated with a short sleep duration in the pathophysiology of obesity and consequently type 2 diabetes. This review focuses on the current evidence indicating the effects of a short sleep duration on the regulation of leptin concentration in association with obesity and diabetes mellitus. In summary, the evidence suggests that sleep deprivation, by affecting leptin regulation, may lead to obesity and consequently development of type 2 diabetes through increased appetite and food intake. However, findings on the role of leptin in diabetes due to sleep deprivation are contradictory, and further studies with larger sample sizes are needed to confirm previous findings.

Introduction Pelvic floor exercises are effective in the treatment of urinary incontinence (UI) and are routinely prescribed, along with bladder training, by primary healthcare providers as first line conservative management. Mobile phone applications are increasingly popular within the healthcare setting and can provide opportunities for patients to complete treatments at home. To date, there has not been a systematic review examining outcomes from randomised controlled trials on the effectiveness of mobile applications to improve UI. Methods A systematic review of randomized controlled trials evaluating the effectiveness of mobile applications to improve UI was carried out according to the PRISMA reporting guidelines. The online databases MEDLINE, Embase, PsychINFO, CINAHL, Web of Science, Scopus, The Cochrane Library, Joanna Briggs Institute (JBI), Google Scholar were searched for papers published between 2007 to 2020. Keywords and MeSH terms were used to identify relevant English language studies. The quality and risk of bias within included studies was assessed by two independent reviewers, RCT JBI critical appraisal tool. Due to heterogeneity in the outcome of studies, a meta-analysis of the data could not be conducted. Findings Four studies reported an improvement in the outcome assessed post-intervention, suggesting that using mobile phone applications for pelvic floor muscle training (PFMT) was an acceptable and valid intervention to improve UI. Conclusion Mobile applications for PFMT indicated that increase adherence to treatment and decrease UI. The integration of this treatment modality into current practice is recommended. Mobile phone applications for PFMT show promise in the conservative management of UI. Further research is required to support the use of this technology in the conservative management of UI.

To understand motivators, facilitators and challenges to dietary change amongst a diverse sample of New Zealanders with prediabetes participating in a primary care nurse-led individualised dietary intervention. A qualitative study involving semi-structured, face-to-face interviews with a stratified sample of adults with prediabetes and BMI ≥ 25 kg/m2, purposefully selected from a larger 2-year primary care-based prediabetes dietary intervention study. Thematic analysis was undertaken. A socio-ecological model guided interpretation. Hawke's Bay, Aotearoa/New Zealand, April 2018-March 2020. Fifty-eight people aged 28-69 years, with similar numbers of men and women, indigenous Māori and non-Māori, and those who had and had not regressed to normoglycaemia at 6 months. Motivators for wanting to make dietary changes were determination not to progress to diabetes; wanting to be healthy and contribute to others and encouragement by others. Facilitators for adopting and maintaining changes were a strong desire to be healthy; personal determination and feeling supported. Challenges were compromised control over life and environmental factors; feeling unsupported by others; social occasions; financial constraints and living with other health conditions. Developing their own strategies to overcome challenges was empowering, enabling a sense of control. These factors were similar across demographic and glycaemic outcome groups. Influences on dietary change involved personal, interpersonal, organisational, environmental and policy factors. Although findings appeared similar across groups, dietary interventions need to address the specific ways motivators, facilitators and challenges manifest for individuals and social groups and be tailored accordingly within the context of the wider obesogenic and socio-economic environment.

Background Culturally and linguistically diverse (CaLD) consumers and carers have been identified as experiencing high levels of unmet needs relating to information and support across the cancer journey. This review identified and evaluated the effectiveness of strategies to meet the cancer information needs of consumers and carers from CaLD backgrounds. Methods This review followed Joanna Briggs Institute (JBI) methodology for systematic reviews. Databases searched included MEDLINE, CINAHL Ultimate, PsycINFO and AMED, ProQuest Dissertations and Theses, and GreyNet. Published and unpublished studies between 2013 - May 2024 on interventions, programmes or resources developed for adults (aged 18 years and over) from CaLD communities in relation to cancer prevention, cancer treatment or life after cancer were reviewed for inclusion. The review protocol was registered in PROSPERO (CRD42023451557). Results One hundred and twenty papers were included in the review. The majority were quasi-experimental studies ( n  = 52), followed by randomised controlled trials ( n  = 38) and qualitative studies ( n  = 25). The populations represented in the review included Latino ( n  = 47), Chinese ( n  = 28), Asian ( n  = 19), Korean ( n  = 16), and Vietnamese communities ( n  = 7). Most studies focused on prevention activities ( n  = 89) with a smaller number focused on active treatment ( n  = 6) and life after cancer ( n  = 20). Most studies focused on breast cancer ( n  = 37), followed by cervical cancer ( n  = 21). Engagement with community members was identified as an important requirement to develop and adapt interventions that were culturally acceptable, feasible and relevant to meet the communities’ needs. The majority of interventions demonstrated a positive impact on the primary outcome measured. No studies reported on the experiences of consumers and carers from CaLD backgrounds in the development of interventions, programmes and resources to address their cancer information needs. Conclusions This review supports a tailored approach to develop information, resources and interventions that leverage community resources and expertise to ensure that they are accessible and relevant to CaLD communities. The onus for researchers and clinicians is the creation of information, resources and interventions that are both accessible in terms of language and comprehension and are culturally relevant.

Adults who experience homelessness for an extended period of time also experience accelerated ageing and other negative impacts on their general health and wellbeing. Homelessness amongst older adults is on the rise, yet there are few systematic reviews investigating their experiences. Thus, this review classifies and synthesises qualitative research findings of studies published between 1990 to 2020 that have examined the needs and challenges of homeless older adults to elucidate their journey of homelessness. Seven papers met the requirements for inclusion. Three main themes were identified in the review: - (1) Pathways to homelessness, (2) Impact of homelessness, and (3) Outcomes and resolutions. This review collates current evidence on what is known about the experience of homelessness among older adults. In this study, homeless older adults identified a wide range of challenges associated with the experience of homelessness.