Quasi-experimental Research Articles

A quasi-experimental study of general practices' referral to mammography in the post-trials treatment era.

Improvements in breast cancer therapy since the randomized controlled trials of mammography screening might have reduced the screening benefit. Most observational studies of mammography effectiveness would be confounded by these improvements and other factors. Using a design resistant to this confounding, we evaluated whether mammography in asymptomatic women reduces breast cancer mortality during the treatment era succeeding the trials. We designed a quasi-experimental cohort study in regions of Denmark without organized screening. We predicted the number of expected mammograms for each general practice based on observed numbers of mammograms and individual risk factors. Regardless of a woman's individual exposure to mammography, we assigned her the ratio of observed to expected mammograms of her general practice as her instrumental variable. We employed this potential instrumental variable as mammography exposure status and followed women from January 1, 2006 until death, emigration, or December 31, 2014, whichever came first. We included 169,197 women aged 50-66 from 738 general practices and without previous breast cancer as of January 1, 2006. Women affiliated with a practice referring more women than expected, compared with less, had a lower hazard of breast cancer death (hazard ratio 0.80, 95% confidence interval 0.68, 0.95). Negative control associations were near null, suggesting no confounding bias. This quasi-experimental study estimated a continued protective effect of mammography in women where most were presumably asymptomatic. In contrast to conventional observational studies, the use of practice referral ratio as an instrumental variable may avoid bias from uncontrolled confounding.

The Effects of Exergaming on the Depressive Symptoms of People With Dementia: A Systematic Review and Meta-Analysis.

Depressive symptoms are common among people with dementia (PWD). Exergaming consisting of combined cognitive and physical training in gaming is increasingly used to alleviate their depressive symptoms in research. With its potential synergistic neurobiological and psychosocial effects on reducing depressive symptoms among PWD, this review aimed to understand its effectiveness and contents. This is a systematic review of the effectiveness of exergames on depressive symptoms among older adults with dementia. A search was conducted on 7 May 2024 of the online databases CINAHL, Embase, PsycINFO, PubMed and the China Academic Journal Network Publishing Database (CNKI). The methodological quality of randomised controlled trials (RCT) and quasi-experimental studies was assessed with RoB2 and ROBINS-I, respectively. A meta-analysis of the included RCTs was conducted. Six studies consisting of four RCTs and two quasi-experimental studies involving 235 participants with various stages of dementia were included. The meta-analysis showed a significant overall improvement in depression with a large effect size (SMD = 1.46, 95% CI = -2.50, -0.43; p = 0.006). Despite high heterogeneity (I2 = 91%), all studies demonstrated a trend of improvement in depression after the intervention. The exergames adopted in the included trials had the following elements: simultaneous motor-cognitive training, a scoring mechanism and a social play. The dose of exergames ranged from 15 to 60 min per session for at least 8 weeks, with a minimum of two sessions weekly. However, the included studies had a moderate-to-serious risk of bias. The certainty of the evidence was very low. Exergames could be effective at improving the depressive symptoms of older adults with dementia. Yet, a moderate-to-severe risk of bias shows a rigorous study should be conducted in the future. This study provides evidence for healthcare professionals and informal caregivers to use exergames to address depressive symptoms in PWD. The review was registered on PROSPERO with the reference CRD42022372762.

Evaluation of an updated educational intervention on nutritional care to prevent undernutrition among older adults in primary health care.

The aim of this study was to evaluate district nurses' perceived and factual knowledge about nutritional care after an updated and expanded educational intervention. Furthermore, we aimed to compare the outcomes of the revised and the original educational intervention. In-depth knowledge of nutritional care is a prerequisite to supporting older adults' well-being and health. District nurses' actual knowledge of the nutrition care process, older adults' need for food, and palliative care in diverse phases of disease is therefore of utmost importance. An updated and expanded educational intervention meeting these needs was evaluated. A study-specific questionnaire about nutritional care was used before and after the educational intervention. Participants (n = 118) were district nurses working in primary health care in Region Stockholm. Additionally, a pre- and post-test quasi-experimental design was used to assess differences in learning outcomes of the revised intervention compared with the original intervention. District nurses who completed the questionnaire had worked in health care for about 18 years and as district nurses for 5 years after their specialist examination. After the revised educational intervention, significant improvements were found in all statements concerning perceived challenges and actions related to nutritional care, while questions about factual knowledge showed significant improvements in three of the four questions.Comparison between the revised and the original intervention revealed no differences in most areas of perceived challenges and actions related to nutritional care. Additionally, in half of the areas assessed, factual knowledge improved more after the revision than after the original educational intervention, including the maximum length of overnight fast and the type of oral nutritional supplements (ONS) that should be prescribed. The intervention was successful in increasing knowledge about nutritional care, nutritional counselling, food adaptation, and prescribing ONS in an individually tailored way. In-depth knowledge supports usability in clinical practice. Nevertheless, we need to follow-up and understand how increased knowledge about undernutrition and ONS prescription are implemented in primary health care when caring for older adults' desires and needs.

Evaluation of an online Cardiometabolic and Weight Loss Program. A mixed methods study.

Risk factors contributing to cardiovascular diseases (CVD) can be addressed through behavior modification, including changes in diet and physical activity. In 2021, The Wellness Institute (WI), located at Seven Oaks General Hospital, created a virtual cardiometabolic risk reduction program in response to COVID-19 pandemic public health restrictions, encompassing virtual health coaching and lifestyle education. The objective was to evaluate the acceptability, adherence, efficacy and engagement of the WI online cardiometabolic and weight loss program. The study followed a mixed methods quasi-experimental design. A total of 93 participants enrolled. Quantitative measures including anthropometrics, blood chemistry, and lifestyle were assessed for changes via paired t-tests at baseline and 16 weeks. Qualitatively, short answer questionnaires and three focus groups were completed to understand participants' experiences and program acceptability. We combined qualitative and quantitative data for analysis. Seventy-three participants (64 female, 87.7%) completed the final study visit (age 58 ± 11 years, weight 98 ± 20.9 kg). Of those, 98% attended all coaching sessions, would recommend the program, and reported the coaching sessions helped them stay motivated. A reduction in weight (5 ± 9 kg, p<0.001), systolic blood pressure (6 ± 10 mmHg, p<0.001) and diastolic blood pressure (4 ± 8 mmHg, p<0.001) were observed. Lifestyle factors also improved, including increases in physical activity (p<0.05). Most participants adhered to the program and found it acceptable. Completion was associated with an improvement in weight and blood pressure. These findings highlight the potential of virtual programming to contribute to improving lifestyle and health. Clinicaltrials.gov (ID# NCT04784624CT).

Higher Levels of Dispositional Mindfulness Are Associated With More Effective Ecological Momentary Intervention Outcomes in Reducing the Frequency of Awake Bruxism Behaviours.

Previous research has highlighted the multifactorial nature of awake bruxism (AB), including its associations with stress, anxiety and other psychological factors. Dispositional mindfulness, known for its benefits in enhancing emotional regulation and reducing stress, has not yet been thoroughly investigated in association with AB. This study aimed to investigate whether levels of dispositional mindfulness predict the efficacy of ecological momentary intervention (EMI) in reducing the frequency of AB behaviours. This study employed a quasi-experimental design with a correlational component and involved 83 undergraduate dental students categorised into high and low mindfulness groups based on the Mindfulness Attention and Awareness Scale (MAAS). An EMI was implemented using the No Clenching mobile app, which sent 12 alerts per day over 1 month. The primary outcome measure was a 50% reduction in the frequency of AB behaviours. A significant positive relationship was found between dispositional mindfulness levels and the reduction in AB behaviours. Participants with higher mindfulness levels experienced a greater reduction in AB frequency compared to those with lower mindfulness levels. Mixed-effects regression analysis revealed that mindfulness levels were a significant predictor of bruxism reduction (β = 0.45, p < 0.01). The coefficient for MAAS was positive and significant (coefficient = 1.5305, p < 0.001), indicating that higher mindfulness levels are associated with greater reductions in AB frequency. Additionally, a significantly higher percentage of participants in the high mindfulness group (97.5%) achieved a 50% reduction in AB behaviours compared to the low mindfulness group (62%). Higher levels of dispositional mindfulness are associated with more effective EMI outcomes in reducing AB behaviours. Incorporating mindfulness-based approaches into intervention strategies for AB could lead to more personalised and effective treatments.

Bullying Behaviors in Clinical Settings: Potentially Harmful Distractions.

Nursing students exposed to bullying behaviors are at risk for making medication errors. For a quasi-experimental study, 15 prelicensure nursing students at a Midwestern university were exposed to simulated bullying behaviors or common distractions while administering medications in a laboratory setting. Data were analyzed using Kruskal-Wallis tests. There was no significant difference in medication administration rubric score (H[2] = 1.489, p = .475) or time spent in room (H[2] = 1.778, p = .411) between groups. Bullying behaviors and other interruptions distracted nursing students from successfully completing the medication administration simulation.

Funeral support services for socio-economically deprived bereaved people in Hong Kong: An exploratory study of their effectiveness

This study aimed to explore the effectiveness of funeral support services for socio-economically deprived bereaved people in Hong Kong. Via a questionnaire, service users were asked to report their psychosocial status in different domains before and after the services. A quasi-experimental design was also used to compare service users with non-service users in different psychosocial domains after the funerals had taken place. Findings showed that service users indicated positive changes after the use of the services, such as reduced negative emotions and enhanced understanding of how post-death matters/funerals could be handled. This study provides preliminary evidence of the benefits of funeral support services and suggests the importance of funeral support for socio-economically deprived bereaved people. Findings may help reflect on the provision and accessibility of funeral support services in the community and give insights into the way formal bereavement service providers may better support bereaved people in the community.

The role of patterning skills in early mathematical development: an analysis of all dimensions of visual perception

ABSTRACT In the early stages of mathematical development, the primary objective is to develop pattern recognition skills by mastering fundamental techniques like sorting and comparison. Numerous pattern structures, such as visual, auditory and spatial patterns, can be created. In this study, we examined the effects of PO-MEP, a pattern-focused mathematics education program for preschool children, on children’s visual perception. The “Pattern-Oriented Mathematics Education Program (PO-MEP)” was developed, and compatible original materials were designed. The program is structured around repeating and growing patterns. Its impact was assessed using a quasi-experimental design, including a pretest, posttest and follow-up test, and a control group. The results show that it had a statistically significant impact on the development of all sub-dimensions of visual perception: hand-eye coordination, figure-ground perception, form constancy, position in space, and spatial relationships. In sum, the program developed the children’s visual perception. Further research may be conducted using different methodologies and age groups to strengthen these findings.

Looking under the hood of a hybrid two-way texting intervention to improve early retention on antiretroviral therapy in Malawi: an implementation fidelity evaluation

BackgroundWhile key to interpreting findings and assessing generalizability, implementation fidelity is underreported in mobile health (mHealth) literature. We evaluated implementation fidelity of an opt-in, hybrid, two-way texting (2wT) intervention previously demonstrated to improve 12-month retention on antiretroviral therapy (ART) among people living with HIV (PLHIV) in a quasi-experimental study in Lilongwe, Malawi.MethodsShort message service (SMS) data and ART refill visit records were used to evaluate adherence to 2wT content, frequency and duration through the lens of the Conceptual Framework for Implementation Fidelity. Message delivery and 2wT participant interactions were considered across four core 2wT components: 1) weekly motivational SMS messages; 2) proactive SMS appointment reminders; 3) SMS reminders after missed appointments; and 4) interactive messaging with 2wT staff about transfers and appointment rescheduling. Using mixed-effects logistic regression models adjusted for participant demographics, we examined the effect of core 2wT component fidelity on a) on-time appointment attendance and b) timely return to care after a missed appointment, presenting adjusted odds ratios (aORs) and 95% confidence intervals (CIs).ResultsThe 468 2wT participants had a median of 52 study weeks (interquartile range [IQR] 34 – 52) with 6 ART appointments (IQR 4—7) of which 2 (IQR 1 – 3) were missed. On average, participants received a motivation message for 75% (IQR 56%—83%) of enrolled weeks, a reminder before 83% (IQR 67%—100%) of appointments, and after 67% (IQR 0%—100%) of missed appointments. Participants reported 9 transfers and rescheduled 46 appointments through 2wT prompts; 196 appointments were changed via unprompted interaction. Participants with 10% higher expected motivation message delivery were more likely to attend clinic appointments on time (aOR: 1.08; 95%CI: 1.01 – 1.16, p = 0.03). Receiving and responding to an appointment reminder in any way were also associated with increased on-time appointment attendance (aOR: 1.35; 95%CI: 1.03 – 1.79, p = 0.03 and aOR: 1.47, 95%CI: 1.16 – 1.87, p = 0.001, respectively). No associations were found for 2wT messages and timely return to care following a missed appointment.ConclusionGreater 2wT implementation fidelity was associated with improved care outcomes. Although implementation fidelity monitoring of mHealth interventions is complex, it should be integrated into study design.

Medication reconciliation: impact of an educational intervention on the knowledge, attitude and practices of healthcare professionals - a prospective quasi-experimental study in a Saudi referral hospital

BackgroundMedication reconciliation has been acknowledged as a key intervention against medication errors. More than half of the medication errors that happen during care transitions are caused by unjustified medication discrepancies and up to one-third of these mistakes may be harmful. The study aimed to evaluate the knowledge, attitude and practices (KAP) of health care providers in on medication reconciliation process, pre and post educational intervention.MethodsA hospital-based prospective quasi-experimental pre-post intervention study was conducted from November 2023 to February 2024 among 346 healthcare professionals (medical doctors, pharmacists and nurses) practicing in King Saud Hospital (KSH), Unayzah, Saudi Arabia. The subjects were recruited using the convenience sampling method.An educational intervention workshop was conducted among the healthcare professionals. The KAP was assessed before and after the educational intervention using a content and face validated self-administered questionnaire. The statistical analyses were conducted using the Statistical Package for Social Sciences (SPSS). Wilcoxon Signed Rank Test was used to differentiate the mean response scores for knowledge, attitude, and practice domains, between pre and post intervention. Kruskal Wallis Test followed by Dunn’s post hoc test was used to compare the mean response scores for knowledge, attitude and practice domains based on educational qualification and practicing experience for the pre and post-test period. The level of significance is determined at P < 0.05.ResultsThere was a significant improvement in the participants’ knowledge, attitude and practice after the educational intervention with mean scores of 0.72 (SD = 1.67, p < 0.0001*), 0.76 (SD = 1.97, p < 0.0001*), and 0.56 (SD = 2.05, p = 0.001*) respectively. The overall KAP scores showed a statistically significant enhancement after the education intervention with a mean score difference of 2.04 (SD = 4.76, p < 0.0001*).Our study upholds that MedRec is highly valued by the participants due to its significant role in reducing medication errors and enhancing patient safety, and that it has the ability to recognize medication discrepancies and reduce adverse drug events.ConclusionThe education intervention effectively influenced the knowledge, attitude and practice of healthcare professionals regarding medication reconciliation. This study underscores the importance of continuous education and training for healthcare professionals to minimize medication discrepancies and improve patient care.

Effects of empathy mapping and mini-simulation on second-year nursing students’ empathy and communication self-confidence: a quasi-experimental study

BackgroundEmpathy and communication are critical abilities for nursing students, and in recent years, scenario-based teaching has played a crucial role in fostering empathy and professional skill development. However, novice nursing students in basic nursing education often lack prior experience in patient communication, making it challenging for them to prepare adequately for scenarios and effectively handle difficulties in real-life situations. This deficiency also hampers participants’ or observers’ ability to engage in deep reflection, feedback, and learning. Consequently, students frequently experience anxiety in patient communication, and the effectiveness of empathy building remains limited. The aim of the study was to use empathy mapping and mini-simulation in learning to enhance nursing students’ empathy and self-confidence in communication.MethodsA prospective quasi-experimental research design was employed, targeting second-year students in the four-year nursing program at our institution, specifically in the Basic Nursing and Experimentation II class. The students were randomly divided into two groups: an experimental group and a control group, with a total of 98 students (52 in the experimental group and 46 in the control group). The experimental group received instruction using empathic communication digital materials and engaged in empathy mapping exercises, while the control group underwent conventional scenario-based teaching. Pre-test and post-test data were collected from both groups.ResultsA total of 98 students participated in the study, with 46 students in the control group and 52 students in the experimental group. The average age of the participants was 19.19 ± 0.53 years, with a predominance of females (82.7%). At the end of the semester, there was no significant difference in the average empathy levels between the two groups. However, the communication confidence levels of students in the control group (40.20 ± 6.54) were significantly lower than those in the experimental group (43.88 ± 6.35) (P = 0.006).ConclusionsThis teaching approach facilitated deeper and broader student learning, enhancing both empathy and communication confidence. The teaching materials developed in this study can be employed in future courses to teach empathy and patient communication effectively.

Impact of the WHO safe childbirth checklist on birth attendant behavior and maternal-newborn outcomes: A systematic review and meta-analysis.

The intrapartum period is critical for reducing maternal and perinatal morbidity and mortality. The WHO's Safe Childbirth Checklist (SCC) was designed as a reminder of the most critical, evidence-based practices (EBPs) to improve quality care and reduce preventable complications and deaths. To assess the impact of SCC on birth attendant behavior and maternal and newborn health outcomes. A systematic review and meta-analysis was performed searching across five databases from 2009 to 2023. We included randomized controlled trials, quasi-experimental studies, and pre/post studies. A meta-analysis yielded a pooled estimate ofrelative risk (RR) for adherence to and effectiveness of the SCC. Of 1070 articles identified, 16 were included. Use of the SCC increased adherence to EBPs by 65% (RR 1.65; 95% confidence interval [CI]1.34-2.02). The behaviors that improved the most were danger sign counseling (RR 12.37; 95% CI 1.95-78.52; P = 0.008) and pre-eclampsia management (RR 3.43; 95% CI 1.33-8.88; P = 0.011). There was moderate evidence for stillbirth reduction (RR 0.89; 95% CI 0.80-0.99; P = 0.034). There is moderate evidence demonstrating the effectiveness of the SCC in reducing stillbirths and improving adherence to EBPs.

Environmental shocks and migration among a climate-vulnerable population in Bangladesh

Various studies predict large migration flows due to climatic and other environmental changes, yet the ex post empirical evidence for such migration is inconclusive. To examine the causal link between environmental changes and migration for a population residing along the Jamuna River in Bangladesh, an area heavily affected by floods and riverbank erosion, I relate the respondents’ self-reported affectedness by environmental changes, their migration aspirations, and their capability to move to their migration likelihood. The analysis relies on a unique quasi-experimental research design based on original survey panel data of 1604 household heads. I find that erosion significantly and substantively increases the likelihood to migrate, leading to more than a doubling of the migration likelihood compared to the unaffected control group. Flooding has a significant effect only if it causes severe and irreversible impacts. Moreover, erosion affectedness increases the likelihood of moving permanently, with the whole household, and to a rural location. Individual, temporary moves to urban locations, by contrast, are primarily driven by low socio-economic status. Those who move with the whole household migrate mostly less than five kilometers. These findings call for a more nuanced understanding of the complex environment-migration nexus.

Portfolio assessment in AI-enhanced learning environments: a pathway to emotion regulation, mindfulness, and language learning attitudes

In recent years, the incorporation of artificial intelligence (AI) into instructional settings has sparked important interest in how it can develop different aspects of language learning, principally in the realm of assessment. While traditional assessment methods have long been central to evaluating learners’ progress, the rise of AI tools presents an opportunity to revolutionize assessment practices by providing more personalized and adaptive feedback. This study explored the significance of portfolio assessment in AI-assisted environments, focusing on its impact on academic emotion regulation (AER), mindfulness, and attitudes toward language learning. A total of 69 students (38 in the experimental group (EG) and 31 in the control group (CG) from Bahir Dar University, Bahir Dar, Ethiopia, aged 22–34 years, participated in this quasi-experimental study. The participants, enrolled in the final term of their Bachelor’s program in English Teaching, were randomly assigned to either the EG or CG. The EG engaged in a portfolio assessment approach where AI was employed by the course instructor to review the portfolios and provide continuous, individualized feedback. Conversely, the CG also followed a portfolio assessment approach but relied on traditional teacher-led feedback without AI integration. The study employed pretests and posttests to measure AER and mindfulness levels before and after the intervention. Additionally, an attitude questionnaire was administered to the EG to assess their perceptions of AI-based portfolio assessment. Data analysis included analysis of covariance (ANCOVA), independent sample t-test, and one-sample t-test to determine the effects of the intervention. The findings indicated the potential of AI-assisted portfolio assessment in enhancing AER and mindfulness while fostering positive attitudes toward language learning. By comparing AI-integrated and traditional approaches, this study provides valuable insights into the role of AI in promoting effective and engaging learning experiences in EFL contexts.

Evaluating palliative care's role in symptom management for CKD patients in Egypt: A quasi-experimental approach.

Chronic kidney disease (CKD) is a global health challenge that affects patients' symptom burden and quality of life. Palliative care interventions show promise in addressing the multiple needs of CKD patients, focusing on symptom management, psychosocial support, and advance care planning. This study aimed to evaluate the effectiveness of palliative care interventions in improving symptom management in patients with CKD. The study used a quasi-experimental research design with a sample size of 128 participants diagnosed with CKD. Participants were selected based on strict criteria to ensure consistency of palliative care interventions. Non-probability purposive sampling was used to select participants. Data were collected using validated instruments such as the Edmonton Symptom Assessment System, Kidney Disease Quality of Life-Short Form, Palliative Performance Scale, Dialysis Symptom Index and Functional Assessment of Chronic Illness Therapy-Fatigue. These instruments provided robust measures of symptom severity, quality of life, performance status, symptom burden, and fatigue. The intervention consisted of 4 sessions designed to address symptom management, psychosocial support, and advance care planning strategies. Post-intervention, CKD patients showed significant improvements across multiple measures. Pain decreased from 6.2 to 4.8 (p = 0.002, 23% improvement), and fatigue decreased from 7.5 to 6.1 (p = 0.001, 19% reduction). Depression improved from 5.6 to 4.2 (p = 0.001, 25% reduction) and anxiety decreased from 4.9 to 3.8 (p = 0.004, 22% reduction). Physical functioning increased from 65.3 to 72.1 (p = 0.002, 10% improvement), cognitive function from 72.8 to 78.5 (p = 0.003, 8% increase), and emotional well-being from 60.2 to 65.7 (p = 0.004, 9% improvement). Ambulation improved from 75.2 to 81.5 (p = 0.001, 8% increase), activity from 68.7 to 74.3 (p = 0.004, 8% increase), and self-care from 82.4 to 88.1 (p = 0.003, 7% improvement). Nutritional status improved from 79.6 to 85.2 (p = 0.002, 7% increase) and level of consciousness from 70.3 to 75.8 (p = 0.005, 8% increase). Fatigue scores decreased significantly from 53.2 to 48.6 (p = 0.001, 9% decrease), activities of daily living from 50.1 to 45.8 (p = 0.001, 9% decrease), and well-being from 55.6 to 50.2 (p = 0.001, 10% improvement). The results highlight the potential of palliative care interventions to improve outcomes and well-being for people with CKD. By addressing their complex needs, these interventions offer valuable lessons for nephrology and palliative care practice, emphasizing holistic approaches to patient care. The findings add to the evidence supporting the integration of palliative care into CKD management, highlighting its value in improving patient outcomes and quality of life.

Attendance of Underserved Populations at Field-Based Health Services Events: Application of Quasi-Experimental Methods that Accommodate the COVID-19 Pandemic.

The COVID-19 pandemic disrupted the ability to receive health care services. Field-based health services became a logistically feasible alternative to medical center-based care. We compared two different field-based approaches to the delivery of SARS-CoV-2 testing and health education services for Latine communities using a quasi-experimental design that included propensity score matching to accommodate the challenges posed to research by the pandemic. From September 2021 through October 2022, we held 434 testing events, of which 234 used a geolocation approach and 200 used a partner-located approach to determine the location of the health services (n = 68 field sites in Oregon). We hypothesized that partner-located sites would obtain higher numbers of tests collected relative to geolocated sites, and that longer drive times to testing sites would be associated with lower testing rates. There were no differences in the number of tests collected by geolocated versus partner-located sites, controlling for population size and time-varying pandemic vulnerabilities measured as COVID-19 cases and deaths. Prior to propensity score weighting, a longer drive time to the testing site (both site types) was associated with a lower likelihood of total tests (IRR = .87, p < .01, CI [0.54, 0.92]), of Latine tests (IRR = .69, p < .001, CI [0.56, 0.84]), and of male tests collected (IRR = .67, p < .05, CI [0.47, 0.94]). The site's number of prior tests was associated with a significant 2% increase in tests collected and the prior week's number of county deaths was associated with a roughly 30% decrease in the likelihood of tests collected. However, the reduced testing rate when the death rate was higher was less likely in geolocated sites (IRR = 1.55, p < .001, CI [1.20, 2.01]). Implications for the utility of propensity score matching and time-varying covariates to accommodate pandemic challenges posed to research are discussed. Clinicaltrials.gov registration number: NCT05082935. Date of registration: 10/15/2021.

Nurse-Led/Involved Home-Based Interventions for Older Adults With Chronic Obstructive Pulmonary Disease (COPD): A Mixed-Methods Systematic Review.

To determine the effectiveness of nurse-led/involved home-based interventions for older people with COPD and to explore the experiences of older people and nurses with the interventions. A mixed-methods systematic review following the JBI methodology for mixed-methods systematic reviews. The search included relevant and peer-reviewed studies published from January 2010 to December 2023 in CINAHL, MEDLINE, Cochrane Central Register of Controlled Trials, PsycINFO, EMBASE, JBI, EMCARE and ProQuest. English-language reports of nurse-led/involved home-based interventions for people with COPD were included based on authors' consensus. Three reviewers performed independent quality appraisal using JBI tools. A convergent segregated approach was used for data synthesis and integration. Seven interventions were identified in two mixed-methods, two qualitative, two quasi-experimental studies, and one secondary analysis from a randomised control trial. The effectiveness of the interventions was measured with various outcomes and was effective to some extent, with reduced hospitalisation, hospitalisation days, hospitalisation cost and all-paid claims. However, the outcomes were not statistically significant, and the effectiveness was inconclusive. While patients appreciated support and resources, some perceived them as a double-edged sword. Patients preferred more holistic interventions over extended periods. The inconclusive findings and limitations warrant further research with larger sample sizes and comparable measurement tools and outcomes. This is the first mixed-methods systematic review on the effectiveness of home interventions for people with COPD with a clear definition of 'nurse-led'. Nurses felt highly valued by patients and other health professionals; however, they reported a lack of support from management. The lack of interventions led by nurses challenges them to lead, deliver and evaluate what matters to people with COPD. This systematic review was reported in accordance with the Referred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Not applicable.

Comparison of the effect of quick response code-based training and traditional methods on the knowledge, skill, and satisfaction of the nursing students in using medical device

Nurses acknowledge that their understanding of the shortcomings in the utilization of medical devices stems from insufficient knowledge about their correct usage. The use of Quick Response (QR) technology has paved a new gateway for accessing information and resources. The available evidence confirmed the usefulness of QR codes for use in clinical settings as a tool for training. The present research performed a quasi-experimental research design to compare the effect of QR code-based training and traditional methods on the knowledge, skill, and satisfaction of the nursing students in using medical device. For the control group, textual Persian manuals, visual aids in the form of pictures, and URLs were available to the students. For the intervention group, the training approach based on QR codes was explained on the first day of their presence at the heart center. The knowledge, skill and satisfaction evaluations were conducted at the end of the clinical course on day 10. The group of nursing students who used the QR code-based training method had a statistically significant higher mean knowledge and skill score compared to the traditional training method group. The level of satisfaction among students who received training using QR codes was non-significantly higher than traditional method group. Nursing managers and educators can enhance the delivery of high-quality nursing care by using QR code.

Effects of Mindfulness-Based Therapy and Counseling Group on Emotional Intelligence and Mindfulness of Clinical Psychology Students

This study assessed the impact of mindfulness-based group therapy and counseling on emotional intelligence, mindfulness, stress, happiness, self-compassion, and compassion for others among clinical psychology students. A quasi-experimental design was employed involving fourth-year undergraduate students in a clinical psychology program at a university in northeastern Thailand. Fourteen participants were purposefully selected based on slightly elevated stress levels and received therapy and counseling utilizing mindfulness techniques. Data collected through various assessment tools revealed that immediately after the intervention and three months later, participants demonstrated significantly higher levels of emotional intelligence, mindfulness, happiness, self-compassion, and compassion for others compared to pre-intervention levels. Moreover, stress levels significantly decreased post-intervention and remained lower three months later. These findings suggest that incorporating mindfulness-based therapy and counseling can effectively enhance emotional well-being and mitigate stress among clinical psychology students.

Evaluating the Anxiolytic Efficacy of Oral Alprazolam in Modulating Vital Parameters During Minor Oral Surgical Procedures: A Quasi-experimental Study

Evaluating the Anxiolytic Efficacy of Oral Alprazolam in Modulating Vital Parameters During Minor Oral Surgical Procedures: A Quasi-experimental Study