The effect of mindfulness-based interventions on caregiver burden, quality of life and psychological distress in caregivers of adults with chronic diseases: Systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Chronic diseases requiring long-term treatment, care, and follow-up can negatively affect the health and well-being of caregivers. Mindfulness-based interventions (MBIs) are increasingly used as a mental health intervention to control the psychological problems experienced by caregivers and improve their quality of life. AIMS: This systematic review and meta-analysis aimed to provide evidence for a holistic evaluation and synthesis of the effects of MBIs applied to caregivers of adults with chronic disease on the burden, quality of life, and psychological distress. METHODS: Studies evaluating the effects of mindfulness-based interventions on caregivers of adults with chronic diseases and published through September 2023 were searched using PubMed, Web of Science, Scopus, and EBSCO. Methodological quality was assessed with the modified JADAD scale, and bias was assessed with the Cochrane risk-of-bias tool for randomized trials. Randomized controlled studies were included. The standardized mean difference with a 95% confidence interval was calculated. Heterogeneity was analyzed using the I2 test and Q statistic. Publication bias was assessed with the Egger regression test. RESULTS: This meta-analysis included 12 studies. Pooled evidence found that MBIs resulted in significant improvements in stress, anxiety, depression, and caregiver burden in caregivers of adults with chronic illness but had no significant effects on quality of life, resilience, and mindfulness. The Egger's test showed no evidence of publication bias. LINKING EVIDENCE TO ACTION: MBIs can be considered as a helpful method to increase psychological well-being and reduce caregiver burden in caregivers of adults with chronic diseases. These findings may direct clinicians to conduct mindfulness-based interventions for caregivers of adults with chronic diseases.

The Effectiveness of Telehealth Interventions on Medication Adherence Among Patients with Type 2 Diabetes: A Meta-Analysis.

Objective: Diabetes mellitus (DM) is a global health issue with an increasing frequency across the world and is an important disease in which medication adherence is a priority component for disease management. Several interventions are implemented to increase medication adherence in patients with type 2 DM, and telehealth interventions have become widespread thanks to technological advancements. This meta-analysis aims at reviewing the telehealth interventions applied to patients with type 2 DM and examining their effects on medication adherence. Methods: Relevant studies published in ScienceDirect, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL) and PubMed from 2000 to December 2022 were searched in this meta-analysis. Their methodological quality was assessed using the Modified Jadad scale. Total score for each study ranged from 0 (low quality) to 8 (high quality). Studies with four or more were of good quality. Standardized mean difference (SMD) and 95% confidence intervals (CI) were used for statistical analysis. Publication bias was assessed using the funnel plot and Egger regression test. Both subgroup analysis and meta-regression analysis were performed in the study. Results: A total of 18 studies were analyzed in this meta-analysis. All studies scored 4 or above in their methodological quality assessment and were of good quality. The combined results have shown that telehealth interventions significantly increased medication adherence in the intervention group (SMD = 0.501; 95% CI 0.231-0.771; Z = 3.63, p < 0.001). Our subgroup analysis has revealed that HbA1c value, mean age, and duration of intervention significantly affected the study results. Conclusion: Telehealth interventions are an effective method to increase medication adherence in patients with type 2 DM. It is recommended that telehealth interventions be expanded in clinical practices and included in disease management.

"Working in the emergency department is not a job; it's like a war" A narrative inquiry and interpretive phenomenology of the violence experienced by emergency nurses in Turkey.

AIMS: This study aims to reveal the violent experiences of nurses working in the emergency department and the meanings they attribute to them. METHODS: This research was conducted as narrative inquiry and interpretive phenomenology and recruited 15 nurses. Interviews with nurses actively working in the emergency department and who had been exposed to violence by patients or their relatives were conducted with a semi-structured interview form. The consolidated criteria for reporting qualitative research (COREQ) checklist was used. RESULTS: In the study, three themes were determined (1) Unpredictable event, (2) Interminable effects of violence, and (3) Like a bottomless pit. With seven sub-themes. CONCLUSIONS: This study underlined that violence applied to nurses by patients or relatives of patients in the emergency department is an unexpected situation that causes negative emotions. Violence affects all aspects of life and limits communication with the patient. Coping with a violent situation is challenging for nurses, and they demand support from the management.

A structural equation modeling analysis of the effects of nurses' spirituality and spiritual care on professional quality of life.

Spiritual care helps nurses establish a deeper connection with patients and meet their spiritual needs. Spiritual belief is thought to enable nurses to be more effective in their profession and positively affect their quality of life. This study aimed to investigate the effects of nurses' spirituality and spiritual care on quality of life. This study was designed as a descriptive cross-sectional study using structural equation modeling. A total of 221 nurses were included. Data were collected using the Professional Quality of Life Scale, and Spirituality and Spiritual Care Scale. The data were analyzed using descriptive statistics, correlational statistics, and structural equation modeling. Spirituality and spiritual care were negative predictors of burnout and positive predictors of compassion satisfaction. Spirituality and spiritual care decreased the level of burnout in nurses and significantly increased the level of compassion satisfaction. This study suggests raising nurse awareness of spirituality and spiritual care. Supporting nurses with professional training programs, including spiritual care, may benefit their quality of life.

Influence of technical, cognitive and socio-emotional factors on digital literacy in nursing students assessed using structural equation modeling.

BACKGROUND: Digital literacy is one of the 21st-century skills that nursing students should develop and acquire. Several factors influencing digital literacy have been identified, but the predictive role of technical, cognitive, and socio-emotional factors in digital literacy remains unexplored in nursing students. OBJECTIVE: This study aimed to explore the digital literacy level and determine the predictive role of technical, cognitive, and socio-emotional factors in digital literacy among nursing students in Turkey using a structural equation modeling (SEM)-based approach. DESIGN: A web-based, predictive, cross-sectional study. SETTINGS: This study was conducted among first-, second-, third- and fourth-year students in a nursing faculty located in the capital of Turkey in the academic year 2021-2022. PARTICIPANTS: Overall, 210 nursing students were recruited for this study. METHODS: The use of a digital literacy model guided data collection. Data were collected between 8 and 28 June 2022 using online Google Forms. The data were analyzed using descriptive statistics and SEM. RESULTS: Nursing students' digital literacy mean score was 67.29 (13.60). Internet self-efficacy (ß = 0.31, p < 0.001), online information search strategies (ß = 0.20, p = 0.003), and online privacy concerns (ß = 0.14, p = 0.024) were positive predictors, whereas social media use (ß = -0.13, p = 0.032) was a negative predictor of digital literacy. Among these variables, Internet self-efficacy had the most significant influence on the digital literacy level. The four variables contributed to 22 % of variance in the digital literacy level. CONCLUSIONS: This study shows nursing students' digital literacy level is above average. Our findings suggest that technical, cognitive, and socio-emotional factors influence digital literacy.

Effectiveness of Virtual Reality Simulation Among BSN Students: A Meta-analysis of Randomized Controlled Trials.

This study aimed to evaluate the effect of virtual reality simulation in nursing education in five domains: knowledge, skill performance, self-confidence, self-efficacy, and satisfaction. Randomized controlled trials were obtained from the databases SCOPUS, Web of Science, PubMed, and EBSCO from inception until September 2021. The standardized mean differences with 95% confidence intervals were determined for the main variables, and heterogeneity was analyzed using the I2 test. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) Checklist was used. Meta-analysis was performed using the Stata 15.0 software. Among the 2074 records identified, 18 trials were included. The meta-analysis of these trials indicated that virtual reality simulation caused a significant improvement in knowledge with a moderate effect, skill performance with a moderate effect, and satisfaction with a moderate effect compared with the control group. However, virtual reality simulation did not significantly influence self-confidence and self-efficiency. The findings of this study suggested that virtual reality simulation might significantly benefit knowledge, skill performance, and satisfaction but not self-confidence and self-efficiency. Further well-designed randomized controlled trials with a larger sample size are recommended to confirm these findings.

The Effect of Touch Therapy on Symptoms and Psychosocial Variables in Individuals Diagnosed With Cancer: A Systematic Review and Meta-analysis.

BACKGROUND: Touch therapy is used in the control of physical and psychological symptoms in cancer patients. However, its effectiveness has not been well studied. OBJECTIVES: The aim of this study was to examine the effectiveness of touch therapy intervention on symptoms and psychosocial factors for patients with cancer. METHOD: Four electronic databases were used to identify all experimental studies that examine the effects of touch therapy on symptoms and psychosocial factors for patients with cancer. The standardized mean differences between groups in levels of symptoms and psychosocial factors for postintervention were computed for each study. RESULT: The pooled results suggest that touch therapy intervention effectively reduces pain, fatigue, anxiety, and negative mood among patients with cancer postintervention. However, touch therapy intervention did not affect the quality of life and stress. CONCLUSION: A significant effect of touch therapy was the reduction of physical and psychological symptoms in cancer patients. IMPLICATIONS FOR PRACTICE: Touch therapy could be safely integrated into the clinical practice of patients with cancer.

Determining the predictors of nursing students' xenophobic tendency toward refugees.

BACKGROUND: Xenophobia is an important role in affecting the professional development of nursing students and the health of refugees. However, factors contributing to xenophobia levels in nursing students remain undetermined. AIM: To determine the predictors and levels of xenophobia in nursing students toward refugees. METHOD: Our cross-sectional descriptive study included nursing students (n = 265) from Turkey. Data were collected using the "Participant Information Form", "Xenophobia Scale", "Ethnocentrism Scale", and "Intergroup Social Contact Scale". Structural equation modeling and regression analysis were used for data analysis. RESULTS: 86.0 % of the participants were female and students' xenophobia scale mean score was 50.89 (SD = 9.59) at a high level. Nursing students living in the city center showed a higher level of xenophobia than those living in the village/town (ß = 3.327). Nursing students with an immigrant family member displayed a lower level of xenophobia than those who did not (ß = 3.461). Both ethnocentrism and intergroup social contact exerted a direct effect on xenophobia. Ethnocentrism (ß = 0.193, p < 0.001) was found to be a positive predictor of xenophobia levels in students. Intergroup social contact (ß = -0.400, p < 0.001) was found to be a negative predictor of xenophobic levels in students. CONCLUSION: This study showed that ethnocentrism and intergroup social contact exerted direct effects on the xenophobic levels in nursing students. Our study also revealed that living in the city center and having an immigrant family member affected the level of xenophobia in such a sample.

The Effects of Cooling Therapies on Fatigue, Physical Activity, and Quality of Life in Multiple Sclerosis: A Meta-Analysis.

PURPOSE: This meta-analysis examined the effects of the cooling therapies on fatigue, physical activity, and quality of life (QoL) in patients with multiple sclerosis (MS). METHODS: Articles published between 2000 and 2020 were searched in six databases. The standardized mean differences were determined by the upper and lower limits of 95% confidence intervals. Publication bias was assessed by conducting the Egger test, which uses linear regression. Publication bias was examined visually using a funnel plot. RESULTS: Nine studies were included in this meta-analysis. The types of cooling therapies included cooling garment ( n = 4), cooling device ( n = 2), cooling room ( n = 1), precooling ( n = 1), and cold water ingestion ( n = 1). The results indicated a significant decrease in fatigue and an increase in physical activity following cooling therapy. Cooling therapies improved the QoL of patients with MS. The Egger test indicated no significant publication bias. However, the funnel plot presented a slight asymmetry among studies. CONCLUSIONS AND CLINICAL RELEVANCE: Cooling therapies have a beneficial effect on fatigue, physical activity, and the QoL of patients with MS. Healthcare professionals can use cooling methods to manage thermosensitive symptoms in patients with MS.

Examination of family caregivers of advanced cancer patients within the scope of the cancer family caregiving experience model: An embedded mixed-methods design.

OBJECTIVE: This study aimed to examine the stressors and contextual factors that affect the quality of life (QoL) of caregivers of advanced cancer patients and to address their caregiving experiences. METHODS: The study had an embedded mixed-methods design and was conducted in the medical oncology unit of a training and research hospital in Turkey. In the quantitative phase, 125 patients with advanced cancer and their family caregivers were included. In the qualitative phase, 21 family caregivers were included. The analysis of quantitative data was carried out using SPSS 25.0 statistical program, and qualitative data were carried out using Collaizi's seven-step descriptive analysis approach. QoL was determined as the dependent variable and evaluated with Caregiver QoL Index-Cancer (CQOLC). RESULTS: The symptoms, care dependency of patients, and preparedness to the care of caregivers showed a direct impact on the CQOLC. Income level, employment status, and daily caregiving hours demonstrated a direct effect on the CQOLC. Four themes emerged from the interviews: Understanding the dynamics of the caregiving process, losing control of life during the caregiving process, limitation of socio-economic freedom in the caregiving process, and the effort to hold on to life in the caregiving process. CONCLUSION: The cancer family caregiving experience model is a useful model for evaluating the QoL of caregivers from a multidimensional perspective. Health care professionals should not forget that the QoL of family caregivers should be evaluated in multiple ways, and education programmes for family members should be structured.

The effect of motivational interviewing on metabolic control and psychosocial variables in individuals diagnosed with diabetes: Systematic review and meta-analysis.

OBJECTIVE: The current study aimed to analyze the effects of motivational interviewing (MI) on metabolic and psychosocial variables among individuals with diabetes. METHODS: Four databases were searched between 2000 and 2021 years. Randomized controlled studies were included. The standardized mean differences were determined. The heterogeneity was analyzed using the I2 test. The methodological quality was evaluated independently by three researchers. RESULTS: This meta-analysis included 16 studies. Glycated hemoglobin, postprandial plasma glucose (PG), systolic blood pressure (BP) significantly decreased after MI. There are no significant effects of MI on fasting PG, body mass index, diastolic BP, total cholesterol, high-density lipoprotein, low-density lipoprotein and triglyceride. MI had an overall significant impact on depression, emotional distress, and self-efficacy. Only four studies had 7 points based on the Modified Jadad Scale. The Egger's test showed no evidence of publication bias. CONCLUSION: MI effectively reduced glycated hemoglobin, postprandial plasma glucose, systolic blood pressure, depressive symptoms, emotional distress, and increased self-efficacy. PRACTICE IMPLICATIONS: This meta-analysis showed that MI was effective at improving metabolic control and psychosocial variables. MI should be considered a complementary treatment for people diagnosed with diabetes. Future studies should be structured as long-term studies with higher methodological quality.

Interventions to Improve the Preparedness to Care for Family Caregivers of Cancer Patients: A Systematic Review and Meta-analysis.

BACKGROUND: Preparedness for caregiving could balance the negative impacts of caregiving. The interventions aimed at increasing readiness among the caregivers are important during the illness period for both patients and their caregivers. OBJECTIVES: The aims of this study were to review the interventions applied to the caregivers of cancer patients and to examine the effects of these interventions on the preparedness to care. METHODS: The ScienceDirect, Scopus, CENTRAL, Web of Science, MEDLINE, and PubMed were searched for relevant studies published between 2000 and 2020. The methodological quality was assessed using the Quality Assessment Tool for Quantitative Studies. The statistical analyses were performed using the Comprehensive Meta-Analysis software version 3.0. The publication bias was assessed using the Egger test, for funnel plots. RESULTS: Eleven studies were selected for the meta-analysis, including those about psychoeducation programs (n = 5), education programs (n = 3), supportive programs (n = 2), and a self-care support program for the caregivers (n = 1). The methodological quality assessment revealed 2 studies as "strong." The results indicated an increase in the caregivers' preparedness to care after the interventions. The subgroup analysis revealed that the programs with higher ratios of female caregivers were more effective. CONCLUSION: The interventions applied to the family caregivers can exert beneficial effects on caregivers' preparedness to care. Nonetheless, future studies should focus on methodological issues, such as randomization and blinding. IMPLICATIONS FOR PRACTICE: Nurse-driven interventions may be used as a useful strategy to improve the preparedness to care among the caregivers of cancer patients. The male caregivers should be closely followed by healthcare professionals for knowledge and support needs.

Biopsychosocial Factors Predicting Pain Among Individuals Experiencing the Novel Coronavirus Disease (COVID-19).

BACKGROUND: Pain is one of the most common symptoms of novel coronavirus disease (COVID-19). Being both a physical and a psychological experience, pain is affected by many factors, including biological, psychological, and social rather than a single variable. AIMS: To determine the effects of biological, psychological, and social factors on pain level among participants experiencing with the COVID-19. DESIGN: A web-based, retrospective, and descriptive study SETTING: Social media sources such as Facebook, WhatsApp, Instagram, and E-mail PARTICIPANTS: One hundred forty-nine participants were included. METHODS: Data were collected based on the biopsychosocial model. Pain level was evaluated using the visual analog scale (VAS). The data were analyzed using descriptive, correlational statistics, and structural equation modeling. RESULTS: The mean age of participants was 32.87 (SD = 11.32) years. The VAS scores were associated with gender (Z = -2.103, p = .035), and chronic disease status (Z = 3.001, p = .003), and the Chalder Fatigue Scale total score (ß = 0.718, p < .001) associated with biological factors. The Coronavirus Anxiety Scale scores among psychological factors showed a direct impact on the VAS scores (ß = 0.583, p < .001). The Patterns of Activity Measure-Pain total score examined within social factors directly affected the VAS score. The VAS score did not correlate with age, smoking status, hospitalization status, respiratory support, marital status, education level, employment, and income status. CONCLUSIONS: The pain level in COVID-19 participants was determined by biological, psychological, and social factors. Females and participants with chronic illness, anxiety, fatigue, and low physical activity were found to experience high levels of pain. Education and counseling programs for pain management should be comprehensively structured and include anxiety reduction programs, and fatigue management.

'The body seems to have no life': The experiences and perceptions of fatigue among patients after COVID-19.

AIMS AND OBJECTIVES: This study aimed at determining the perception of fatigue among patients with a history of the coronavirus disease (COVID-19). BACKGROUND: Fatigue is a long-lasting distressing symptom. It is a multidimensional symptom consisting of several factors, including physiological, psychological, social and environmental. It is vital to examine and understand the perception of fatigue among post-COVID-19 participants. DESIGN: A descriptive phenomenological design. METHODS: The study sample consisted of 14 post-COVID-19 participants that were recruited using criterion sampling. The fatigue levels of the participants were determined using the Chalder Fatigue Scale (CFS), and those with a fatigue score above 12 were interviewed. All the interviews were conducted with a smartphone due to the COVID-19. The COnsolidated criteria for REporting Qualitative research (COREQ) checklist was used. RESULTS: The age of the participants varied from 24 to 67 years, with the majority of the participants being female (n = 8). The COVID-19 duration ranged from one to 11 months, and the CFS scores varied between 14 and 33. Four themes emerged following the qualitative data analysis: a new symptom beyond fatigue, fatigue increases dependency in daily life, fatigue impedes sociability and a way to hold on to life's regular rhythms. CONCLUSIONS: This study concluded that fatigue in post-COVID-19 participants is a new experience that is difficult to define and manage and overwhelmingly affects the physical and social aspects of life. Participants look for new ways to live with fatigue and turn to traditional methods and psychosocial strategies. RELEVANCE TO CLINICAL PRACTICE: This study revealed the miscellaneous aspects of fatigue in post-COVID-19 participants. Nurses should evaluate fatigue with a holistic approach that includes its physical, social, emotional and spiritual aspects. Nurses can play an active role in the management of fatigue, which is a very common symptom in the COVID-19 pandemic.