The effectiveness of e-healthcare interventions for mental health of nurses: A PRISMA-compliant systematic review of randomized controlled trials.

BACKGROUND: Mental health problems, including burnout among nurses, are common and important. With the rapid development of information and communication technologies and the rise in use of smartphones, the use of e-mental health strategies is increasing in public and clinical settings, and initial clinical trials using this intervention have been conducted. This systematic review evaluated whether e-healthcare interventions improve burnout and other mental health aspects in nurses. METHODS: Six electronic databases including MEDLINE (via PubMed), EMBASE (via Elsevier), the Cochrane Library Central Register of Controlled Trials, the Cumulative Index of Nursing and Allied Health Literature, the Allied and Complementary Medicine Database, and PsycARTICLES were searched to collect relevant randomized controlled trials up to January 28, 2021, using e-healthcare interventions for mental health in nurses. The e-healthcare intervention was classified as web-based, smartphone-based, and real-time online interventions. The primary outcome was burnout in this population. Due to the heterogeneity of the interventions used in the included studies, quantitative synthesis was not performed, but included studies were analyzed qualitatively. Also, the details of e-healthcare for the mental health of nurses were analyzed. The methodological quality of included studies was assessed using Cochrane's Risk of Bias tool. RESULTS: Seven randomized controlled trials were included in this study. The 20-minute session of an online form of the emotional freedom technique was reported to significantly improve burnout severity compared to no intervention (P < .001). Other outcomes, such as career identity, quality of work life, workplace bullying, job stress, turnover intention, distress, anxiety, and resilience in nurses, were also reported to be improved by e-healthcare interventions. The methodological quality of the included studies was generally poor. CONCLUSIONS: In conclusion, there was some evidence that e-healthcare interventions may improve mental health outcomes, including burnout in nurses, compared with no intervention. However, due to the poor methodological quality and wide heterogeneity of the interventions and outcomes in the included studies, we were not able to reach sufficiently reliable conclusions. E-healthcare intervention for nurses in the new coronavirus disease era was discussed. High-quality clinical trials in this area should be conducted in the future.

Effectiveness and safety of acupuncture in treating sleep disturbance in dementia patients: A PRISMA-compliant systematic review and limitations of current evidence.

BACKGROUND: Dementia is of increasing importance, as it is a major public health problem worldwide. Sleep disturbance is common in dementia patients and may be associated with worse cognitive symptoms or behavioral and psychological symptoms of dementia. Non-pharmacological approaches, such as acupuncture, for treating this clinical condition are gaining importance. This study aimed to comprehensively search and analyze randomized controlled clinical trials (RCTs) of acupuncture in treating sleep disturbance or sleep disorders in dementia patients. METHODS: A comprehensive search was conducted from 12 electronic databases on December 2, 2020. We included RCTs reporting the effectiveness and safety of acupuncture in treating sleep disorders or disturbance in dementia patients. The methodological quality of the included studies was assessed using the Cochrane Collaboration's risk-of-bias tool. RESULTS: Five articles with four original RCTs met the inclusion criteria. These studies reported clinical data suggesting that adjuvant acupuncture for hypnotics, and ear acupressure in dementia patients with sleep disorders or sleep disturbance may have clinical benefits in certain sleep-related parameters and total effective rate (TER). Only 1 study reported the safety profile of the intervention, and no acupuncture-related adverse reactions were reported. Some studies compared 2 kinds of acupuncture methods, and found that specific acupuncture methods were superior to conventional acupuncture in improving sleep-related parameters, cognitive function and TER. The methodological quality of the included clinical studies was not high. CONCLUSIONS: There were limited acupuncture studies on this topic. Given the number of studies included and their sample size, methodological quality, and heterogeneities, clinically relevant conclusions could not be drawn. Further clinical studies are needed in this field considering its urgency and importance.

The Effectiveness and Safety of Mind-Body Modalities for Mental Health of Nurses in Hospital Setting: A Systematic Review.

The mental health of nurses including burnout is an important issue. The purpose of this systematic review was to evaluate whether mind-body modalities improve burnout and other mental health aspects of nurses. A comprehensive search was conducted using six electronic databases. Randomized controlled trials using mind-body modalities on the mental health of nurses, up to January 2021, were included. The methodological quality of the included studies was assessed using the Cochrane Risk of Bias tool. Seventeen studies were included in the review. Data on mindfulness-based interventions (MBIs) and yoga were available for burnout, and there was no evidence that multimodal resilience programs including MBIs statistically significantly improved burnout levels compared to no intervention or active control groups. However, one study reported that yoga could significantly improve emotional exhaustion and depersonalization, which are subscales of burnout, compared to usual care. In addition, the effects of MBIs, relaxation, yoga, and music on various mental health outcomes and stress-related symptoms have been reported. In conclusion, there was some evidence that yoga was helpful for improvement in burnout of nurses. However, due to the heterogeneity of interventions and outcomes of the studies included, further high-quality clinical trials are needed on this topic in the future.

Herbal medicine for behavioral and psychological symptoms of dementia: A protocol for systematic review.

BACKGROUND: Dementia is becoming a major public health problem worldwide with the aging of the world's population. Behavioral and psychological symptoms of dementia (BPSD), associated symptoms of dementia, not only predicts the poor prognosis of patients with dementia, but is also a major factor causing the care burden on caregivers, especially informal caregivers. For BPSD management, an alternative to existing psychotropic drugs is needed, given the benefit-harm ratio. Therefore, in this systematic review, we will evaluate the effectiveness and safety of herbal medicine for BPSD. METHODS AND ANALYSIS: Thirteen electronic databases will be comprehensively searched. Clinical studies reporting the efficacy (or effectiveness) and safety of herbal medicines in BSPD management published from their inception to December 2020 will be included. The primary outcome will be BPSD symptoms assessed by the validated tool. Moreover, total effective rate, daily living activities and quality of life of patients, burden and quality of life of caregiver, placement in a long-term care facility from home, and safety data will be regarded as the secondary outcome. Two independent researchers will perform the study selection, data extraction, and quality assessment process. To assess the methodological quality of the included studies, validated tools according to its design, such as the Cochrane Collaboration's risk of bias tool will be used. To perform meta-analysis, RevMan version 5.3 will be used, with mean differences for continuous outcomes and risk ratio for binary outcomes, and 95% confidence intervals. According to the heterogeneity and number of included studies, a fixed- or random-effects model will be used. REGISTRATION NUMBER: OSF (URL: https://osf.io/3u8ch), PROSPERO (CRD42020211000) (URL: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020211000).