Critical Appraisal Checklist Research Articles

Patient Experience with Health Technology in Saudi Arabia: A Systematic Review

Objective: This systematic review aimed to investigate the impact of health technology on patient experience in Saudi Arabia. Methods: The PubMed database was searched for relevant studies published between January 2000 and December 2022 using certain eligibility criteria. The quality of studies was assessed using the Joanna Briggs Institute critical appraisal checklist. Results: A total of 30 studies were included in this systematic review. Of the 30 studies, 25 were cross-sectional in design. Most of the studies focused on patient satisfaction as a primary indicator of patient experience with health technology. Notably, 93.3% of the included studies reported high patient satisfaction. Conclusion: The findings of this systematic review highlight the growing adoption of health technology in Saudi Arabia, indicating a commitment to improving access to healthcare and evaluating patient perspectives. Patient satisfaction with health technology was confirmed. Thus, investing in and endorsing health technologies can significantly improve patient experience.

Risk of Early Childhood Dental Caries Associated With Prolonged Breastfeeding: A Systematic Review and Meta-Analysis.

Breastfeeding provides essential nutrients and benefits for newborns. However, its prolonged duration has raised concerns about potential risks for early childhood caries (ECC). To determine if prolonged breastfeeding increases the risk of dental caries in children under 71 months. Eligibility criteria included observational studies comparing ECC risk in children breastfed for over 12 months, with no language restrictions. Databases searched included PubMed, Scopus, and others, up to May 17, 2024. Risk of bias was assessed using the JBI Critical Appraisal Checklist. Meta-analyses were performed using a random-effects model. Twenty-five studies involving 19 681 participants were included. Studies showed an increased risk of ECC in children breastfed for more than 24 months (RR = 2.44; 95% CI, 1.97 to 3.02). For the 12-24 months period, no significant risk increase was found. Meta-analyses also indicated higher ECC prevalence with breastfeeding beyond 12 months (OR = 1.86; 95% CI, 1.48 to 2.35). Prolonged breastfeeding beyond 24 months is associated with an increased risk of ECC. This review highlights the need for future studies to address current research limitations and better understand the relationship between prolonged breastfeeding and ECC. International Prospective Register of Systematic Reviews (PROSPERO): CRD42024509212.

Caregiving experience of family caregivers for people with colorectal cancer: a qualitative systematic review protocol.

This review aims to synthesize the most robust evidence regarding family caregivers' experiences of caring for people with colorectal cancer (CRC). Caring for people with CRC places a significant burden on caregivers that can affect their physical and psychological well-being. Understanding the unique experiences of family caregivers is essential for developing effective support systems that enhance their well-being. This review will consider studies exploring the experiences of family caregivers caring for people with primary CRC. The studies will focus on qualitative data, including designs such as phenomenology, grounded theory, ethnography, qualitative descriptive studies, action research, feminist research, mixed methods studies, and program evaluations with embedded qualitative data. The review will follow the JBI methodology for systematic reviews of qualitative evidence. The search strategy will aim to locate published and unpublished studies, with no date or language restrictions. PubMed, CINAHL (EBSCOhost), Web of Science Core Collection, PsycINFO (EBSCOhost), Scopus, China National Knowledge Infrastructure, and Wanfang databases will be searched. The search for gray literature will include Google Scholar and ProQuest Dissertations and Theses. Two reviewers will independently select the studies, extract data, and critically appraise the methodological quality of the studies using the JBI critical appraisal checklist for qualitative research. The findings will be pooled using the meta-aggregation approach or presented in narrative format. The final synthesized findings will be graded for certainty according to the ConQual approach. PROSPERO CRD42024517472. PROSPERO CRD 42024517472.

Systematic review and critical appraisal of predictive models for diabetic peripheral neuropathy: Existing challenges and proposed enhancements.

The trend of risk prediction models for diabetic peripheral neuropathy (DPN) is increasing, but few studies focus on the quality of the model and its practical application. To conduct a comprehensive systematic review and rigorous evaluation of prediction models for DPN. A meticulous search was conducted in PubMed, EMBASE, Cochrane, CNKI, Wang Fang DATA, and VIP Database to identify studies published until October 2023. The included and excluded criteria were applied by the researchers to screen the literature. Two investigators independently extracted data and assessed the quality using a data extraction form and a bias risk assessment tool. Disagreements were resolved through consultation with a third investigator. Data from the included studies were extracted utilizing the Checklist for Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies. Additionally, the bias risk and applicability of the models were evaluated by the Prediction Model Risk of Bias Assessment Tool. The systematic review included 14 studies with a total of 26 models. The area under the receiver operating characteristic curve of the 26 models was 0.629-0.938. All studies had high risks of bias, mainly due to participants, outcomes, and analysis. The most common predictors included glycated hemoglobin, age, duration of diabetes, lipid abnormalities, and fasting blood glucose. The predictor model presented good differentiation, calibration, but there were significant methodological flaws and high risk of bias. Future studies should focus on improving the study design and study report, updating the model and verifying its adaptability and feasibility in clinical practice.

Dietary Pattern and Depressive Outcomes in Children and Adolescents: Systematic Review and Meta-analysis of Observational Studies.

Research suggests that dietary pattern plays an important role in mental health and constitutes a modifiable risk factor for depression. The aim of this systematic review and meta-analysis was to evaluate the association between dietary patterns and depressive outcomes in adolescents. Medline/PubMed, Lilacs, EMBASE, PsycINFO, and PsycARTICLES, gray literature up to March 2024 were searched; the reference lists were also verified. Observational studies in participants with a mean age ⩽19 years reporting associations between dietary patterns and clinical depression or depressive symptoms were searched. Overall, 21 studies were included in this systematic review. Data from eligible articles were extracted by 2 reviewers. Odds ratios (ORs) and confidence intervals (CIs) were determined under a random-effects model. The risk of bias assessment was conducted by 2 independent researchers using the Joanna Briggs Institute Critical Appraisal Checklist tool. The qualitative results revealed that a higher unhealthy diet score was positively associated with depressive symptoms, while a healthy diet was negatively associated with depressive symptoms. In the study that included adolescents with a clinical diagnosis of depression, the relationship between inflammatory dietary pattern tertiles and depression was attenuated after all covariates were adjusted for. The meta-analysis to evaluate the association between depressive symptoms and a posteriori dietary patterns found that the "healthy" dietary pattern decreased depressive symptoms in adolescents (OR: 0.69; 95% CI: 0.44, 0.95). There was no statistically significant association between depressive symptoms and "unhealthy" and "snacks" patterns (OR: 1.20 [95% CI: 0.95, 1.46]; OR: 1.20 [95% CI: 0.70, 1.48]) dietary patterns. The results identified that a healthy dietary pattern decreased depressive symptoms in adolescents. However, considering the high heterogeneity and the low level of certainty of the evidence, these results should be interpreted with caution. PROSPERO registration no. CRD42020159921.

Maternity providers' moral experiences addressing maternal drug use.

BackgroundAddressing drug use among pregnant and postpartum women is complicated by the social, ethical, and legal interplay between maternal and child needs. The moral experiences of providers as they care for this population are poorly understood. The purpose of this review is to synthesize the qualitative literature on the moral experiences of prescribing maternity providers managing the care of pregnant and postpartum women who use drugs (PPWUD), specifically focused on drug testing and child welfare reporting decisions.MethodsThe Hunt and Carnevale (2011) bioethics framework was used to define moral experience as "a person's sense that values that he or she deem important are being realized or thwarted in everyday life." A systematic search of PubMed, PsycINFO, and CINAHL resulted in 31 eligible articles. Study quality was assessed using the Critical Appraisal Checklist for Qualitative Research from the Joanna Briggs Institute (2015). Thematic narrative analysis was used to synthesize results and identify themes.FindingsOverall, maternity providers' experiences were characterized by ethical conflicts influenced by provider-level and policy-level factors. Even when endorsing patient autonomy and parental rights, no maternity providers endorsed continued maternal substance use that placed the fetus or child at significant risk. Structural constraints within healthcare systems and punitive laws were cited as significant barriers to providing optimal care to PPWUD. Biased drug testing protocols and some child welfare reporting policies created ethical conflict by placing maternity providers' relationship with their patients in opposition to their legal and ethical responsibility to report child maltreatment.ImplicationsMore rigorous characterization of these moral experiences is needed to support the development of provider-level interventions and policy-level changes as maternity providers care for both mothers and children impacted by drug use.

The Effect of Foot Reflexology on Postpartum Comfort and Breastfeeding Outcomes in Postpartum Women: A Meta-Analysis Study.

Introduction: In recent years, foot reflexology has been frequently used as a method to solve problems such as stress, pain, and depression. It has been observed that the studies focused on the effect of foot reflexology on the pregnancy and birth process. Research Aim: A meta-analysis of experimental trials evaluating the effectiveness of foot reflexology applied in the postpartum period on comfort and breastfeeding outcomes was conducted in the present study. Materials and Methods: A comprehensive electronic search was done through the PubMed, WoS, Wiley, ScienceDirect, Scopus, and Google Scholar databases to identify experimental articles. There was no time restriction when searching the database. The risk of bias was assessed using the Joanna Briggs Institute (JBI) critical appraisal checklist for quasi-experimental studies and the Cochrane risk of bias tool for randomized trials. The meta-analysis was conducted using Comprehensive Meta-Analysis. Cochran's Q test and Higgins' I2 were used to assess study heterogeneity. Results: Three studies, two randomized controlled trials and one quasi-experimental trial (n = 260), were included in the analysis. Foot reflexology applied to postpartum women was found to have positive effects on the LATCH (standardized mean difference [SMD]: 1.010, confidence interval [CI]: 0.752/1.269, Z = 7.664, p = 0.000), Visual Analogue Scale (VAS)-breast tension (SMD: 2.240, CI: 1.928/2.552, Z = 14.086, p = 0.000), VAS-breast heat (SMD: 0.500, CI: 0.289/0.710, Z = 4.659, p = 0.000), VAS-breast pain (SMD: 2.302, CI: 1.836/2.768, Z = 9.686, p = 0.000), postpartum comfort (SMD: 3.578, CI: 3.131/4.025, Z = 15.689, p = 0.000), and breastfeeding satisfaction (SMD: 1.492, CI: 1.178/1.806, Z = 9.318, p = 0.000) scores. Conclusions: This meta-analysis determined that the foot reflexology intervention increased breastfeeding success, satisfaction, and postpartum comfort levels and statistically significantly reduced the signs of breastfeeding onset.

Life experiences after kidney transplantation in adolescents: A qualitative meta-synthesis.

To systematically evaluate the life experience of adolescents after kidney transplantation. We use computer search Web of Science, PubMed, Cochrane Library, Embase, EBSCO, CNKI, Wanfang, VIP database, search database to October 2024, screening after kidney transplant adolescents life experience of qualitative study. We used the Australian Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research to quality evaluation, and using the thematic analysis method to integrate the results. 7 articles were included, and 31 research results were integrated into 8 new categories and combined results are 3 integration results: complex emotional experience; eager for multifaceted support; self-adjustment. Nursing staff should pay attention to the psychological experience and needs of adolescents, to eliminate their stigma, to promote positive cognition, and to improve their quality of life.

Predictors of survival among breast cancer patients in Ethiopia: a systematic review and meta-analysis.

Breast cancer remains a significant public health issue, with delayed medical attention often leading to advanced stages and poorer survival rates. In East Africa, evidence on the prevalence and factors contributing to the delayed presentation of breast cancer is limited. As a result, this study aims to assess the pooled prevalence of delayed breast cancer presentation and identify contributing factors in East Africa. We conducted a systematic review of observational studies from East Africa using PubMed, Google Scholar, Embase, Cochrane Library, Hinari, and Mednar databases. The Newcastle Ottawa 2016 Critical Appraisal Checklist assessed methodological quality. Publication bias was evaluated using a funnel plot and Egger's test, and heterogeneity was examined with the I-squared test. Data were extracted with Microsoft Excel and analyzed using Stata 11. The pooled prevalence of delayed presentation among breast cancer patients in East Africa was 61.85% (95% confidence interval, 48.83%-74.88%). Significant factors contributing to delayed presentation included visiting traditional healers (adjusted odds ratio, 3.52; 95% CI, 1.43-5.59), low educational levels (adjusted odds ratio, 3.61; 95% CI, 2.39-4.82), age > 40 years (adjusted odds ratio, 1.87; 1.03, 2.71), absence of breast pain (adjusted odds ratio, 2.42; 1.09, 3.74), distance >5 km away from home to health institution (adjusted odds ratio, 2.89; 1.54, 4.24), and rural residence (adjusted odds ratio, 3.33; 95% CI, 2.16-4.49). This meta-analysis' findings demonstrated that over half of breast cancer patients in East Africa delayed detection. Significant factors associated with delayed presentation include age over 40 years, illiteracy, rural residence, use of traditional healers, distance >5 km from a health facility, and absence of breast pain. Healthcare stakeholders and policymakers must be focused on raising awareness and educating people to encourage early detection and prompt therapy.

The Cost and Cost-Effectiveness of Childbirth Settings: A Systematic Review.

To sustain positive progress toward sustainable development goals as envisioned in goal 3 and beyond, safe and affordable care during pregnancy and birth for women, their families, and health facilities and professionals is essential. In this systematic review, we report the best available evidence regarding the cost and cost-effectiveness of birth in various settings, including hospitals, birth centres, and homes for women at low risk of complications from high-, middle-, and low-income countries. We conducted a systematic review of cost and economic evaluation papers, following the comprehensive search of online databases, including Medline, CINAHL, Embase, Scopus, and Google Scholar, and grey literature, using predetermined search strategies. Both partial and full economic evaluation studies were included, and we appraised them using Joanna Briggs Institute's (JBI's) critical appraisal checklists for economic evaluation studies. Although we attempted to pool total incremental net benefit, the results were synthesised narratively without a meta-analysis due to the high heterogeneity between primary studies. From 2307 identified studies, 11 studies (13 country level records from 11 countries) were included. Both direct and indirect costs of childbirth at home, midwife-led birth units (MLBUs), and hospitals were reported. Ten studies showed that births in MLBUs were less costly than hospital births, while home births were also reported to be less costly than hospital births in seven studies. Regarding cost-effectiveness, in Bangladesh, MLBUs generally showed better outcomes at lower costs than hospital births, while one site had higher costs. In Pakistan and Uganda, MLBUs displayed mixed results, with some being cost-effective and others more costly with poorer outcomes. In the Netherlands, MLBUs were less costly but had poorer outcomes, whereas home births were less costly and more effective. In Belgium, MLBUs were less costly but less effective in reducing caesarean and instrumental births, though they did reduce epidural analgesia use cost-effectively. Most studies found that births in MLBUs and at home were less costly than births in hospital. There is the potential for these settings to provide a cost-effective option for women through reduced intervention rates and favourable outcomes in high-income countries and could offer birthing options to women in low- and middle-income countries that includes care by skilled maternity practitioners in potentially more affordable settings.

Preoperative Factors Associated With In-Hospital Major Bleeding After Percutaneous Coronary Intervention: ASystematic Review.

Preoperative Factors Associated With In-Hospital Major Bleeding After Percutaneous Coronary Intervention: ASystematic Review.

Usability questionnaire for standalone or interactive mobile health applications: a systematic review

BackgroundMobile health apps (mHealth apps) play important roles in various aspects of disease management, health monitoring, behavioural change, education, and medication adherence. The usability and satisfaction of the app indicate whether the app is favoured and used for its optimal potential. Surveys are among the most commonly used methods and are simple to conduct, and data analysis is easily quantifiable. We aimed to synthesize the evidence from questionnaires available to assess the usability and satisfaction of mHealth apps, both standalone and interactive apps, and to evaluate the validation status of the questionnaire.MethodsAn extensive search of the literature published from 2000 to June 2023 was conducted via PubMed, Scopus and Google Scholar. The keywords, MeSH terms, truncation and text words used for the search included “mobile health” or “health” or “mobile app*” or “mhealth” and “patient satisfaction” or “user” or “usability” or “feasibility” and “survey” or “questionnaire”. Eligibility was independently assessed by two investigators on the basis of the inclusion and exclusion criteria. Human studies published in English that reported the usability and/or satisfaction of patients or users with mHealth apps with published questionnaires were included. Studies that did not include questions or assessed the usability and/or satisfaction of healthcare providers or experts were excluded. Studies such as questionnaire development and validation, translation studies, qualitative studies, reviews, editorials, brief reports, comments, conference proceedings, letters and wrong outcomes were excluded. The first author, year and country of publication; sample size; demographics of the study population; name and type of mobile health application; assessment tool; validation status; and number of questions, domains and scores were collected from each study. The quality assessment was independently performed by two reviewers via the Joanna Briggs Institute (JBI) critical appraisal checklist for cross-sectional studies.ResultsElectronic database searches identified 5703 potentially relevant studies, and 40 studies with a total of 1552 respondents were included. The majority of the studies assessed the usability of standalone apps (62.5%). Half of the studies (50.0%) utilized researcher-developed questionnaires, whereas only 25% of the researcher-developed questionnaires were validated. Nine studies used the System Usability Survey (SUS). The majority of the studies (70.0%) used questionnaires that were not validated. When the JBI critical appraisal checklist was used to assess quality, 14 (35.0%) studies were assessed to be poor quality.ConclusionResearchers have developed questionnaires, and the SUS is the most commonly used method to assess the usability and satisfaction of mobile health applications. Although most questionnaires have not been validated, ensuring the optimal use of mHealth apps via adapted and customized questionnaires is crucial.

Artificial Intelligence Performance in Image-Based Cancer Identification: Umbrella Review of Systematic Reviews.

Artificial intelligence (AI) has the potential to transform cancer diagnosis, ultimately leading to better patient outcomes. We performed an umbrella review to summarize and critically evaluate the evidence for the AI-based imaging diagnosis of cancers. PubMed, Embase, Web of Science, Cochrane, and IEEE databases were searched for relevant systematic reviews from inception to June 19, 2024. Two independent investigators abstracted data and assessed the quality of evidence, using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Systematic Reviews and Research Syntheses. We further assessed the quality of evidence in each meta-analysis by applying the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) criteria. Diagnostic performance data were synthesized narratively. In a comprehensive analysis of 158 included studies evaluating the performance of AI algorithms in noninvasive imaging diagnosis across 8 major human system cancers, the accuracy of the classifiers for central nervous system cancers varied widely (ranging from 48% to 100%). Similarities were observed in the diagnostic performance for cancers of the head and neck, respiratory system, digestive system, urinary system, female-related systems, skin, and other sites. Most meta-analyses demonstrated positive summary performance. For instance, 9 reviews meta-analyzed sensitivity and specificity for esophageal cancer, showing ranges of 90%-95% and 80%-93.8%, respectively. In the case of breast cancer detection, 8 reviews calculated the pooled sensitivity and specificity within the ranges of 75.4%-92% and 83%-90.6%, respectively. Four meta-analyses reported the ranges of sensitivity and specificity in ovarian cancer, and both were 75%-94%. Notably, in lung cancer, the pooled specificity was relatively low, primarily distributed between 65% and 80%. Furthermore, 80.4% (127/158) of the included studies were of high quality according to the JBI Critical Appraisal Checklist, with the remaining studies classified as medium quality. The GRADE assessment indicated that the overall quality of the evidence was moderate to low. Although AI shows great potential for achieving accelerated, accurate, and more objective diagnoses of multiple cancers, there are still hurdles to overcome before its implementation in clinical settings. The present findings highlight that a concerted effort from the research community, clinicians, and policymakers is required to overcome existing hurdles and translate this potential into improved patient outcomes and health care delivery. PROSPERO CRD42022364278; https://www.crd.york.ac.uk/PROSPERO/view/CRD42022364278.

A holistic focus on the psychophysiology of reinvestment: A systematic review on reinvestment-related neural, cardiac vagal and oculomotor activity.

A holistic focus on the psychophysiology of reinvestment: A systematic review on reinvestment-related neural, cardiac vagal and oculomotor activity.

Nurse-Led Models of Service Delivery for Skin Cancer Detection: A Systematic Review.

To consolidate evidence on nurse-led models for skin cancer detection by focusing on their roles, comparing their effectiveness to physician-led care and highlighting any value-added benefits. Systematic review methodology with narrative synthesis. MEDLINE Complete, PubMed, Embase, CINAHL Complete, ScienceDirect, Scopus, BNI, LILACS, PsycINFO, Trip Medical Database, ERIC, EThOS, CDSR, WoS, Google Scholar, ClinicalTrials.gov, ICTRP, CENTRAL and the website 'Getting It Right First Time'. This review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Studies between January 1992 and September 2024 were evaluated using the Joanna Briggs Institute Critical Appraisal Checklists. The search encompassed both peer-reviewed and grey literature; however, no grey literature met the inclusion criteria. Of the 6680 records screened, six studies met the inclusion criteria, involving 3325 patients across England, New Zealand and the United States. These studies focused on nurse-led models of care for skin cancer, assessing outcomes such as diagnostic accuracy, treatment effectiveness, cost savings, waiting times, access to care and patient satisfaction. While none directly compared nurse-led to dermatologist-led models, one study demonstrated comparable diagnostic accuracy between nurses and ophthalmologists. Nurse-led models were shown to effectively substitute for or complement physician-led care, though only one study was authored by a nurse consultant, highlighting a gap in nursing-led research. Service users favoured community-based, nurse-led care for its accessibility, convenience and cost-effectiveness, with health education noted as an added benefit in one study. Nurse-led models demonstrate potential for high diagnostic accuracy in skin cancer, effective treatment delivery and enhanced patient education on skin self-examination. While role delineation remains a challenge, nurses play a critical role in supporting dermatologists in addressing the increasing referral demands associated with skin cancer care. The systematic review protocol (registration number: CRD42023448950) was developed in collaboration with a patient representative with lived experience of melanoma, alongside academic experts in dermatology nursing and specialist; dermatology clinicians. A patient representative with lived experience of melanoma contributed to the review protocol. Training and Competency Development: Completing nationally recognised dermatology nursing qualifications beyond the Advanced Clinical Practice pathway and practical training to extend assessment, diagnostic and treatment skills are essential for autonomous practice in dermatology. Specific skills in nurse-led skin cancer care are vital to ensure clinical competency. Dermatology Nurse Consultant Training Programme: Policies should prioritise nationally recognised Advanced Nurse Practitioner to Dermatology Nurse Consultant Training Programmes focusing on assessment, diagnostic and treatment skills. A structured, portfolio-based approach to training is crucial for achieving competency and enabling autonomous practice in dermatology, supporting the delivery of high-quality care. Support for Community-Based Care: Policy-level support for community-based care is critical, particularly in rural or underserved regions. These models reduce patient travel, improve timely care access and provide training opportunities for rural clinicians, offering a viable alternative to hospital-based services. Standardising Nurse-Led Models: Developing national or international guidelines is essential for scaling nurse-led models. Standardisation allows these models to adapt to the specific needs of local services while maintaining high standards of care. Delivering Comprehensive Care: Nurse-led models show promise in delivering standard care comparable to physician-led services for specific components of the skin cancer care pathway. They also provide value-added care benefits, such as tailored patient education, enhancing outcomes and satisfaction. Nurse-led models demonstrate diagnostic accuracy in identifying skin lesions, including skin cancer, while contributing to treatment, patient education and follow-up care. Despite their growing role in skin cancer management, greater dissemination and publication of their outcomes are needed to inform clinical practice. This review highlights the importance of standardising nurse-led approaches into scalable frameworks to support dermatologists, enhance patient outcomes and ensure consistent care standards in skin cancer. Further evaluation is required to assess their efficiency, cost-effectiveness and implementation across diverse healthcare settings.

Experience of Nurses Providing Care at Shelters After Natural Hazards and Disasters: A Qualitative Systematic Review.

Nurses are frequently called upon to serve as first responders and care providers after natural hazards and disasters. As disaster relief nurses protect the health of and provide support to survivors who are forced to live in shelters, their experiences deserve to be analyzed. However, there is a paucity of research and systematic reviews (SRs) on this topic. This research was designed to systematically analyze the experiences of nurses providing care to people in shelters following natural hazards and disasters. The authors searched CINAHL, PubMed, Scopus, Web of Science, and ProQuest Dissertations and Theses on July 2nd 2023 for qualitative studies published in English and Japanese since 1995 (the first year articles on this topic were published). After evaluating the methodological quality of the five included studies using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research and conducting a critical appraisal, the relevant qualitative data were extracted. The findings were categorized according to their quality and meaning. Based on these categories, a meta-synthesis was performed to produce a set of synthesized findings. The five qualitative studies included in this review covered the post-natural disaster care experiences of 45 participants. The meta-synthesis resulted in 25 findings, seven categories, and two synthesized findings, including (a) nurses play multiple roles for evacuees from affected communities and (b) nurses managing shelters to ensure the health and living conditions of evacuees. The synthesized findings explain the disaster relief experience of nurses comprehensively. This qualitative SR included five moderate-quality studies designed to explore the experiences of disaster relief nurses following natural hazards and disasters. Nurses worked with and managed several teams, including those involved in rescue, resource management, organization, and record management, in a flexible manner, thus involving them in the management of all events within and involving evacuee shelters. These nurses are responsible for providing medical and nursing care and protecting evacuees from danger, while respecting the pace of each individual in the disaster-stricken community. Notably, the nurses leveraged their personal and disaster nursing experiences to learn and develop nursing care strategies and techniques unique to shelters.

Factors associated with good death for end-of-life patients in the intensive care unit based on nurses' perspectives: A systematic review.

Factors associated with good death for end-of-life patients in the intensive care unit based on nurses' perspectives: A systematic review.

Nationwide insights into frailty: Systematic review and meta-analysis of community-based prevalence studies from India.

Frailty, a biologic syndrome of decreased reserve and resistance to stressors, affects 5 % to 17 % of older adults and is linked to factors like low BMI, female sex, and low exercise levels. With India's older population expected to double by 2050, frailty presents major public health and economic challenges. This study summarizes the prevalence of frailty among community-dwelling Indians. This systematic review and meta-analysis followed PRISMA guidelines to determine the prevalence of frailty among adults in India. We conducted a comprehensive search across multiple databases, including PubMed, Scopus, EMBASE, and Web of Science, up to January 16, 2024, excluding hospital-based studies and reviews. Data were analyzed using STATA software with a random-effects model, and quality was assessed using the JBI Critical Appraisal Checklist. The meta-analysis revealed a pooled frailty prevalence of 36 % (95 % CI: 29 % to 44 %) among 330,007 community-dwelling adults in India, with significant heterogeneity across studies (I² = 99.95 %). Frailty prevalence varied by assessment method, with 48 % using the frailty index and 31 % using the Fried phenotype. Subgroup analyses indicated significant variability in frailty prevalence by gender, data source, and assessment tool, with no significant publication bias detected. This meta-analysis found a pooled frailty prevalence of 36 % and pre-frailty prevalence of 48 % among adults in India, with higher frailty in women (45 %) than men (35 %) and variation across assessment tools. Future research should focus on longitudinal studies and developing tailored frailty assessment tools.

Incidence and predisposing factors associated with peri-intubation cardiac arrest: A systematic review and meta-analysis.

Various studies have delved into its incidence and risk factors, but a comprehensive meta-analysis exploring this life-threatening complication during emergent endotracheal intubation has been lacking. This study quantitatively assesses the global incidence and associated risk factors of peri-intubation cardiac arrest (PICA). We conducted a systematic literature search on PubMed, Embase, Web of Science, and Cochrane Library from inception to October 28, 2024. Two independent authors searched, reviewed, and evaluated selected studies. Any peer-reviewed published studies reporting the incidence of PICA among adults (≥18 years) outside of the operating theater were included. Studies reporting incidence within heterogeneous populations or from overlapping groups were excluded. The primary outcome focused on determining the global incidence of PICA, while the secondary outcome addressed associated risk factors. A random-effects model was used to aggregate overall incidence rates. Subgroup analysis and meta-regression were conducted to examine PICA incidence in different locations and with the study's sample size. The publication bias was assessed via Egger's test and visualization of the funnel plot. The risk of bias was evaluated using the Joanna Briggs Institute Critical Appraisal Checklist. Fifteen articles met the inclusion criteria for the meta-analysis. PICA incidence varied from 0.5% to 23.3%. The estimated pooled incidence was 2.7% (95% confidence interval [CI]: 1.9-3.6) across PICA in the emergency department (ED) (2.5%, 95% CI: 1.4-3.7) and outside of the ED (2.9%, 95% CI: 2.2-3.6). Egger's test yielded P = 0.009, indicating potential publication bias due to small-study effects, as suggested by the funnel plot. Meta-regression analysis revealed higher incidence in studies with smaller populations. Notably, preintubation hypotension, hypoxemia, and body mass index were found to be the most associated risk factors for PICA. Additionally, there was significant variability in PICA definitions, ranging from immediate to occurrences within 60 min after intubation. PICA occurrences during emergent endotracheal intubation reached up to 3%, showing a similar rate both within and outside the ED. While limitations such as heterogeneity and potential bias exist, these findings underscore the imperative for prospective research. Prospective studies are warranted to further delineate this critical aspect of emergent intubation.

Effects of Mindfulness-Based Practices in the Perinatal and Postpartum Periods on Women's Health: A Systematic Review

The aim of this systematic review was to evaluate the effects of mindfulness interventions on women's mental health in the perinatal and postpartum period. In the study, randomized controlled studies published in the last five years, from January 2018 to September 2023, were searched in CINAHL, PubMed, Cochrane Library, Science Direct, and Springer Link databases. The keywords "Pregnancy", "Pregnant", "Prenatal", "Perinatal", "Postpartum", "Mindfulness", "Meditation", "Self-compassion" and "Randomized controlled trial" were used while searching the databases. The assessed articles were subjected to quality assessment using the PRISMA checklist and the Joanna Briggs Institute's Critical Appraisal Checklist for Randomized Controlled Trials. As a result of the search, 26 studies were found. The studies revealed that the most commonly applied mindfulness intervention among intervention groups was self-help programs in an online setting. Mindfulness-based practices significantly impacted women's mental health, reducing fear of childbirth, depression, anxiety, and stress levels, while enhancing psychological well-being, self-efficacy, self-compassion, and mindfulness. Furthermore, these practices also benefited women’s physical health, contributing to higher rates of normal vaginal births and increased maternal-fetal attachment. They were found to lessen birth pain, reduce the need for medication or anesthesia, and support the adoption of healthy lifestyle behaviors. These findings suggest that mindfulness interventions, which positively influence the mental health of both mothers and infants, should be widely applied to women, and the results of this study should be disseminated.