ABSTRACT
Although meta-analyses have examined the association between patient education and health, the validity and quality of this evidence have not been comprehensively assessed. This second order meta-analysis combined previous meta-analyses that examined the effectiveness of patient education on health outcomes as an overall weighted grand mean d¯¯. Further, measures of methodological quality, meaningful variability across first order meta-analyses, and evidence for publication bias were examined. Forty meta-analyses were identified, investigating 156 associations between patient education and health summarizing data from over 776 studies including more than 74.947 patients. Quantitative analyses showed that patient education positively affects health outcomes with d¯¯ = 0.316 (95% CI [0.304, 0.329]). Summarizing data exclusively from randomized controlled trials indicated a causal effect. Patient education was effective for patients with neoplasms, diabetes, mental and behavioral disorders, diseases of the circulatory system, the respiratory system, and the musculoskeletal system. Patient education was effective in the reduction of medication use, pain, and visits to medical facilities, and significantly improved physiological, physical, psychological outcomes, and patients' general function. Overall, the findings reveal firm evidence for the effectiveness of patient education on health outcomes. However, theory-based interventions are lacking and need to be implemented to enable a successful transfer from theory to practice.
Subject(s)
Diabetes Mellitus , Neoplasms , Humans , Patient Education as TopicABSTRACT
Longstanding research suggests a positive relation between physical activity and health. However, when investigating this relation most studies focused on the absence of disease or infirmity as health indicators. The relation between physical activity and positive health-related constructs such as subjective well-being (SWB) remains oftentimes unexplored. The present meta-analysis offers a rigorous test of the relation between physical activity and SWB in healthy individuals, by including all different kinds of physical activity and SWB facets from childhood to old age. Random-effects meta-analysis using robust variance estimation revealed a positive relation (d = 0.360, 95% CI [0.301, 0.420]). Our results demonstrate a small beneficial main effect of physical activity on SWB, independent of the prior fitness level of the participants and various characteristics of the physical activity intervention. This effect was found in experimental studies as well as in correlational and quasi-experimental studies. Physical activity was more strongly related to positive affect compared to cognitive well-being and was unrelated to negative affect. Our results provide evidence for the importance of physical activity in the context of well-being. Further, we also systematically review and discuss the large heterogeneity of studies published on this relation and warrant further research regarding underlying mechanisms.
Subject(s)
Exercise , Health Status , Child , HumansABSTRACT
Researchers have recently started evaluating whether stimulating the brain noninvasively with a weak and painless electrical current (transcranial Electrical Stimulation, tES) enhances physiological and cognitive processes. Some studies found that tES has weak but positive effects on brain physiology, cognition, or assessment performance, which has attracted massive public interest. We present the first meta-analytic test of the hypothesis that tES in a learning phase is more effective than tES in an assessment phase. The meta-analysis included 246 effect sizes from studies on language or mathematical competence. The effect of tES was stronger when stimulation was administered during a learning phase (d=0.712) as compared to stimulation administered during test performance (d=0.207). The overall effect was stimulation-dosage specific and, as found in a previous meta-analysis, significant only for anodal stimulation and not for cathodal. The results provide evidence for the modulation of long-term synaptic plasticity by tES in the context of practically relevant learning tasks and highlight the need for more systematic evaluations of tES in educational settings.
