Comparative insomnia prevalence between geriatrics lived in urban and rural areas: a multicenter nationwide study analysis.

AIMS: Insomnia is a common complaint among older adults. However, the comparative prevalence between older adults living in urban versus rural areas remains under-researched. This study aims to validate the overall prevalence of insomnia among older adults in Indonesia and investigate the comparative prevalence between older adults living in urban and rural areas. METHODS: The data were derived from the 2018 Indonesian Basic Health Research Study. We included a total of 93,830 older participants aged > 60 years old who completed the insomnia questions. The prevalence and regression models were analyzed using the SPSS software. RESULTS: The insomnia group has a higher age compared to the non-insomnia group (P < 0.05). Insomnia is more prevalent in females compared to males (P < 0.05). When classified by age groups (60-64, 65-69, 70-74, and > 75 years old), the prevalence of insomnia was 20%, 21%, 23%, and 24%, respectively. The prevalence of insomnia among older individuals living in rural areas was higher compared to those living in urban areas. In addition, increasing age, being female, unemployed, having comorbidities, being less active, and drinking alcohol are associated with insomnia symptoms. CONCLUSION: The findings of this study indicated that the prevalence of insomnia is high among older adults in Indonesia, with older adults living in rural areas exhibiting a higher prevalence compared to those living in urban areas. Our findings strengthen the importance of sleep management in clinical or community settings.

Association Between Social Jetlag and Components of Metabolic Syndrome: A Systematic Review and Meta-Analysis.

BACKGROUND: A mismatch between biological and social time, often referred to as social jetlag (SJL), can lead to inadequate sleep and activities or taking meals at times that do not align with our biological rhythms, increasing the risk of metabolic abnormalities. Although the association between sleep and metabolic syndrome (MetS) is well established, the effects of SJL on MetS and the components of MetS in adults remain unclear. PURPOSE: This study was designed to explore the relationship between SJL and MetS components in adults. METHODS: A systematic review and meta-analysis was conducted on studies registered in PubMed, Cochrane, Web of Science, and Embase between the inception of each database until November 15, 2023. We focused on studies designed to evaluate the relationship between SJL and either MetS or its components. Only studies using cross-sectional, prospective, or retrospective designs were considered for inclusion. The relationship between SJL and MetS was depicted as an odds ratio with a corresponding 95% confidence interval (CI). We determined the mean differences and 95% CIs to estimate the associations between SJL and MetS components. The Joanna Briggs Institute Critical Appraisal Checklist was used to evaluate the methodological rigor of the selected studies. Data were analyzed using RevMan software Version 5.4. RESULTS: The systematic review included 16 studies, with five analyzed via a meta-analysis covering four outcomes, each based on two to three studies. When comparing SJL of less than 1 hour with SJL of 2 hours or more, the latter showed a higher likelihood of MetS (pooled odds ratio: 1.52). Although a significant decrease in systolic blood pressure (pooled mean differences = -3.52 mmHg, 95% CI [-6.41, -0.64]) and a significant increase in waist circumference (pooled mean differences = 2.17 cm, 95% CI [0.61, 3.73]) were observed, the correlation between SJL and diastolic blood pressure failed to reach statistical significance. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The meta-analysis conducted in this study found an association between SJL and MetS. Healthcare practitioners should prioritize the management of sleep quality and duration, especially for individuals exhibiting substantial SJL. Improving sleep can aid in controlling blood pressure and managing weight and should form part of MetS management strategies.

Pain Catastrophizing as a Mediator Between Pain Self-Efficacy and Disease Severity in Patients with Fibromyalgia.

BACKGROUND: Fibromyalgia (FM) is characterized by chronic widespread pain, fatigue, sleep disturbances, cognitive impairment, and mood disturbance. Both pain catastrophizing and pain self-efficacy have been found to be mediators of pain treatment effectiveness. However, whether pain catastrophizing mediates the association between pain self-efficacy and FM severity remains unclear. AIM: To examine whether pain catastrophizing mediates the association between pain self-efficacy and disease severity in patients with FM. METHODS: This cross-sectional study included the baseline data of 105 people with FM from a randomized controlled trial. Hierarchical linear regression analysis was performed to examine the predictive ability of pain catastrophizing for FM severity. Furthermore, we examined the mediating effect of pain catastrophizing on the association between pain self-efficacy and FM severity. RESULTS: Pain self-efficacy was negatively associated with pain catastrophizing (ß = -.4043, p < .001). FM severity was positively associated with pain catastrophizing (ß = .8290, p < .001) and negatively associated with pain self-efficacy (ß = -.3486, p = .014). Pain self-efficacy had a direct effect on FM severity (ß = -.6837, p < .001) and an indirect effect on FM severity through the effect of pain catastrophizing (ß = -.3352, 95% CI bootstrapping -.5008 to -.1858). CONCLUSION: Pain catastrophizing independently predicts FM severity and mediates the association between pain self-efficacy and FM severity. Pain catastrophizing should be monitored through interventions aimed at improving pain self-efficacy to reduce symptom burden in patients with FM.

The effect of virtual reality on cognitive, affective, and psychomotor outcomes in nursing staffs: systematic review and meta-analysis.

BACKGROUND: In the healthcare systems of the world, reinforcing the competence and professionalism of nurses has become a concern. Gaining clinical nursing competence in the healthcare system requires more effort, and additional training is required. Medical education and training have begun using digital technologies, such as virtual reality (VR). The purpose of this research was to examine the efficacy of VR in terms of cognitive, emotional, and psychomotor outcomes and learning satisfaction in nurses. METHOD: The study searched eight databases (Cochrane library, EBSCOHost, Embase, OVID MEDLINE, ProQuest, PubMed, Scopus, and Web of Science) for articles that met these criteria: (i) nursing staff, (ii) any virtual reality technology intervention for education, all levels of immersion, [1] randomized control trial and quasi-experiment study, and (iv) published articles and unpublished theses. The standardized mean difference was measured. The random effect model was applied to measure the main outcome of the study with a significance level of p < .05. The I2 statistic assessment was applied to identify the level of heterogeneity of the study. RESULTS: A total of 6740 studies were identified, of which 12 studies with 1470 participants met the criteria for inclusion. The meta-analysis showed a significant improvement in the cognitive aspect (standardized mean difference [SMD] = 1.48; 95% CI = 0.33-2.63; p = .011, I2 = 94.88%), the affective aspect (SMD = 0.59; 95% CI = 0.34-0.86; p < .001, I2 = 34.33%), the psychomotor aspect (SMD = 0.901; 95% CI = 0.49-1.31; p < .001, I2 = 80.33%), and learning satisfaction (SMD = 0.47; 95% CI = 0.17-0.77; p = .002, I2 = 0%) aspects of the groups that received the VR intervention compared to the control groups. Subgroup analysis found that dependent variables (e.g., level of immersion) did not improve study outcomes. The quality of evidence was low which is affected by major methodological issues. CONCLUSIONS: VR may favorable as alternative method to increase nurse competencies. Randomized controlled trials (RCTs) on larger samples are needed to strengthen the evidence for the effect of VR in various clinical nurse settings. ROSPERO registration number: CRD42022301260.

Physical activity and depression in Indonesian adults with stroke: A nationwide survey.

PURPOSE: To examine the associations between physical activity and depressive symptoms in adults with stroke. DESIGN: We conducted a cross-sectional study involving the data of 3234 adults with stroke obtained from the 2018 Basic Health Research (Riset Kesehatan Dasar, RISKESDAS). METHODS: Physical activity level in metabolic equivalents-minutes per week were determined using the Global Physical Activity Questionnaire according to the World Health Organization (WHO) guidelines on physical activity and sedentary behavior recommendations. Depression was assessed using the Mini-International Neuropsychiatric Interview. Multivariate binomial logistic regression analysis was performed to examine the predictive role of physical activity for depression after adjusting for confounders. RESULTS: Adults with stroke who met the WHO recommendation of physical activity were independently and significantly associated with lower odds of depression after adjustment for confounders (adjusted OR = 0.757, p = 0.017). CONCLUSIONS: Performing physical activity according to the WHO recommendation is associated with a lower likelihood of depression among Indonesian adults with stroke. CLINICAL RELEVANCE: Clinicians should be informed by the findings of this study and prescribe exercise interventions or plan physical activities to optimize recovery and prevent poststroke depression.

Effects of proprioceptive training for people with stroke: A meta-analysis of randomized controlled trials.

OBJECTIVE: To evaluate the effectiveness of proprioceptive training on balance performance, trunk control, and gait speed in people with stroke. METHODS: We searched PubMed, Science Direct, Cochrane, Embase, and Medline for randomized controlled trials that evaluated the effects of proprioceptive training for patients with stroke from the date of each database's inception to July 26, 2021. Two reviewers independently screened the titles and abstracts of potentially eligible articles that were identified on the basis of the search criteria. Methodological quality was determined using version 2 of the Cochrane risk of bias tool for randomized trials. Data were analyzed using Comprehensive Meta-Analysis software. The treatment effect was estimated by calculating Hedges' g and 95% confidence intervals (CIs) using a random-effects model. Statistical heterogeneity was assessed according to the I2 value. The primary outcome was balance performance and secondary outcomes were trunk control, gait speed, and basic functional mobility. RESULTS: In total, 17 trials involving 447 people with stroke were included. Proprioceptive training had a significant effect on balance performance (Hedges' g = 0.69, 95% CI = 0.36-1.01), gait speed (Hedges' g = 0.57, 95% CI = 0.19-0.94), trunk control (Hedges' g = 0.75, 95% CI = 0.33-1.17), and basic functional mobility (Hedges' g = 0.63, 95% CI = 0.31-0.94) among people with stroke. CONCLUSION: Proprioceptive training may be effective in improving balance performance, gait speed, trunk control, and basic functional mobility among people with stroke.

Effects of Patient Activation Intervention on Chronic Diseases: A Meta-Analysis.

BACKGROUND: Patient activation has been described as a potential strategy to improve chronic disease self-management. However, the effects of patient activation interventions on psychological and behavioral outcomes have not been systematically evaluated. PURPOSE: This study was designed to evaluate the effects of patient activation interventions on physiological, psychological, behavioral, and health-related quality of life outcomes in patients with chronic diseases. METHODS: We systematically searched four databases (PubMed, Cochrane, CINAHL, and Embase) from inception to September 1, 2017. We identified English- and Chinese-language published reports of randomized controlled trials that evaluated the effects of patient activation interventions for adults with chronic diseases. Study selection, data extraction, and quality assessment were performed by two reviewers independently. We summarized the intervention effects with Hedges's g values and 95% confidence intervals using a random-effects model. We used the Cochrane Handbook to assess the methodological quality of the randomized controlled trials. RESULTS: Twenty-six randomized controlled trials were included in the qualitative synthesis and meta-analysis. In terms of overall study quality, most of the included studies were affected by performance and detection bias. Patient activation interventions produced significant effects on outcomes related to physiological, psychological, behavioral, and health-related quality of life in the context of chronic diseases. The following effect sizes were obtained: (a) physiological, namely, glycated hemoglobin = -0.31 (p < .01), systolic blood pressure = -0.20 (p < .01), diastolic blood pressure = -0.80 (p = .02), body weight = -0.12 (p = .03), and low-density lipoprotein = -0.21 (p = .01); (b) psychological, namely, depression = -0.16 (p < .01) and anxiety = -0.25 (p = .01); (c) behavioral, namely, patient activation = 0.33 (p < .01) and self-efficacy = 0.57 (p < .01); and (d) health-related quality of life = 0.25 (p = .01). CONCLUSIONS: Patient activation interventions significantly improve patients' physiological, psychosocial, and behavioral health statuses. Healthcare providers should implement patient activation interventions that tailor support to the individual patients' level of patient activation and strengthen the patients' role in managing their healthcare to improve chronic-disease-related health outcomes.