Prevalence of sleep disturbances in people with mild cognitive impairment: A systematic review and meta-analysis.

This review was performed to determine sleep disturbance prevalence in individuals with mild cognitive impairment (MCI). The MEDLINE, Embase, Cochrane Library, CINAHL, PsycINFO, and Web of Science databases were systematically searched from inception to January 20, 2024. Fifty-two studies fulfilling the eligibility criteria were included. However, six of these studies were excluded from data synthesis due to poor methodological quality. The subjective sleep disturbance prevalence among all individuals with MCI was 35.8 % (95 % CI: 31.9-39.7) across 44 studies, and the objective sleep disturbance prevalence was 46.3 % (95 % CI: 36.3-56.3) across 6 studies. Five studies examined TST and WASO, while three assessed SE. Among all potential objective assessments of sleep disturbance prevalence, only TST, WASO, and SE could be meta-analyzed in MCI because of the limited number of studies available. The estimated sleep disturbance prevalence differed significantly according to measurement method, geographical region, and research design. However, the data source did not significantly influence prevalence estimates. In meta-regression analysis, publication year, participant age, percentage of females, and study quality did not predict prevalence. As subjective and objective sleep disturbances are common in people with MCI, effective intervention strategies should be developed to alleviate them.

Expressed Emotion in Families of People With Dementia: A Review of Scale-Based Measures.

PURPOSE: Research on the concept of expressed emotion (EE) has expanded in recent years but its role in dementia still requires elucidation. Understanding the role of EE in the dementia context could help in the development of appropriate interventions. METHOD: The current review synthesized relevant literature to investigate the prevalence and correlates of EE status in families of people with dementia. A comprehensive search of four databases from inception to 2022 produced 2,683 papers; 18 studies met inclusion criteria. RESULTS: The use of EE criteria differed not only across cultural contexts, but even within the same cultural context. Overall, the prevalence of EE in families with dementia compared with other psychiatric conditions was not high. CONCLUSION: Specific changes in EE over time remain to be explored, and findings emphasize the need to carefully discriminate High EE status based on the cultural background of family members with dementia. [Journal of Gerontological Nursing, 50(2), 17-25.].

Why do nurses miss nursing care? A qualitative meta-synthesis.

AIM: The aim of this qualitative meta-synthesis was to discover the factors impacting on missed nursing care of nurses through systematic thinking. BACKGROUND: Although nurses are responsible for high-quality care, missed nursing care is common, endangering patient safety. Understanding of the causes related to missed nursing care could help nursing managers improve the quality of nursing care. DESIGN: A qualitative meta-synthesis guided by the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). METHODS: As a method designed to contribute to knowledge development, meta-synthesis allows for integration of qualitative study findings using thematic synthesis. Six databases were searched up to October 2021; nine studies met the inclusion and quality assessment criteria and meta-synthesis were conducted. RESULTS: Three themes related to the causes why nurses missed nursing care were found. The themes included intrinsic resources (professional and ethical values, ambiguous nurse role, prioritization, education system, and knowledge), system structure (staff and resources shortage, heavy workload but limited time, and organizational management failure), and social environment (communication, working relationship and skill mix, and inappropriate ward layout). CONCLUSION: The phenomenon of missed nursing care is a global tissue, with variations in its elements but also notable similarities. Meta-synthesis provides evidence of intrinsic and extrinsic factors that contribute to missed nursing care. RELEVANCE TO CLINICAL PRACTICE: Recognizing and understanding the causes of missed nursing care is essential for nursing managers to ensure patient safety and the provision of high-quality care.

Prevalence of sleep disturbances in people with mild cognitive impairment: a systematic review protocol.

OBJECTIVE: This review will determine the prevalence of sleep disturbances in individuals with mild cognitive impairment. INTRODUCTION: Mild cognitive impairment is regarded as a transitional state between normal functioning and dementia, and has a high likelihood of conversion to dementia. Individuals with mild cognitive impairment may suffer more severe sleep disturbances compared with normal older people. In some studies, sleep disturbances were associated with significantly higher odds of mild cognitive impairment. There is a need for prevalence estimates of sleep disturbances in people with mild cognitive impairment based on the currently available literature to guide clinical health care professionals and public health policies. INCLUSION CRITERIA: The review will consider studies reporting on the prevalence of sleep disturbances in individuals with mild cognitive impairment, using validated instruments, including subjective and/or objective measures. Studies will be excluded if the participants report sleep-related breathing or movement disorders. Studies using only the Mini-Mental State Examination to diagnose mild cognitive impairment will also be excluded. METHODS: The review will follow the JBI methodology for systematic reviews of prevalence and incidence. The MEDLINE (Ovid), Embase, Cochrane Library (CDSR and CENTRAL), CINAHL (EBSCOhost), PsycINFO (EBSCOhost), Scopus, and Web of Science Core Collection databases will be systematically searched from inception to the present with no language limitations. Analytical observational studies, including prospective and retrospective cohort, case-control, and cross-sectional studies, will be considered. Two reviewers will independently conduct the study selection, critical appraisal, and data extraction. Methodological quality will be evaluated using the JBI critical appraisal checklist for studies reporting prevalence data. A meta-analysis will be conducted to synthesize the prevalence data, where possible. REVIEW REGISTRATION: PROSPERO CRD42022366108.

Effect of sleep report feedback using information and communication technology combined with health guidance on improving sleep indicators in community-dwelling older people: a pilot trial.

BACKGROUND: This study evaluated the preliminary effect of an integrated novel intervention comprising visualised sleep report feedback using information and communication technology and periodic health guidance on improving sleep indicators among community-dwelling older people. METHODS: The intervention was implemented among 29 older people in Sakai City, Japan, in a 3 months pilot trial. Non-worn actigraph devices were placed under participants' bedding to continuously measure their sleep state, and they received monthly sleep reports in writing. Sleep efficiency, total sleep time, sleep latency, and the number of times away from bed were recorded. A trained nurse expertly interpreted participants' sleep data and provided telephone health guidance. The first month's data were used as the baseline (T1), the second month provided data for the first intervention (T2), and the third month provided data for the second intervention (T3). Friedman tests and Wilcoxon signed-rank tests were used to examine differences in sleep outcomes between different time points. RESULTS: Participants' mean age was 78.97 ± 5.15 years, and 51.72% (15/29) were female. Comparison of T2 and T1 showed the intervention decreased participants' sleep latency at T2 (P = 0.038). Compared with T1, the intervention significantly decreased sleep latency (P = 0.004), increased total sleep time (P < 0.001), and improved sleep efficiency (P < 0.001) at T3. When T3 was compared with T2, only total sleep time was significantly increased (P < 0.001). There were no significant differences in the number of times away from bed across the three time points (P > 0.05). CONCLUSIONS: This visualised sleep report feedback and periodic health guidance intervention for community-dwelling older people showed promising, albeit small preliminary effects on sleep. A fully powered randomised controlled trial is required to verify the significance of this effect.