Effectiveness of telehealth on the glycemic control of patients with type 2 diabetes mellitus during the COVID-19 pandemic: A systematic review and meta-analysis of randomised controlled trials.

Background: During the COVID-19 pandemic, telehealth was employed to enhance clinical outcomes for patients with type 2 diabetes mellitus. However, the effectiveness of telehealth remains inconclusive. Objective: This study aimed to examine the impact of telehealth on the glycemic control of individuals with type 2 diabetes mellitus during the pandemic. Design: A systematic review and meta-analysis of randomized controlled trials. Setting: N/A. Participants: A total of 669 studies was sourced from electronic databases, including EMBASE, PubMed, and Scopus. Among these, twelve randomized controlled trials, comprising 1498 participants, were included. Methods: A comprehensive search was performed in electronic databases. The quality of the included studies was assessed using the Cochrane Risk of Bias tool, and statistical heterogeneity was assessed using I² and Cochran's Q tests. A random-effects model was utilized to combine the outcomes. Grading of Recommendations, Assessment, Development, and Evaluations was used to evaluate the certainty of the evidence. Results: The meta-analysis showed that participants receiving a telehealth intervention achieved a greater reduction in the glycated haemoglobin (HbA1C) compared to those receiving usual care, with a weighted-mean difference of -0.59 (95 % CI -0.84 to -0.35, p < .001, I² = 74.1 %, high certainty of evidence). Additionally, participants receiving telehealth interventions experienced better secondary outcomes, including a reduction in fasting blood sugar (16.06 %, 95 %CI -29.64 to -2.48, p = .02, high certainty of evidence), a decrease in body mass index (1.5 %, 95 %CI -1.98 to -1.02, p < .001, high certainty of evidence), and a decrease in low-density lipoprotein (7.8 %, 95 %CI -14.69 to -0.88, p = .027, low certainty of evidence). Conclusions: In our review, we showed telehealth's positive impact on glycaemic control in type 2 diabetes mellitus patients. Healthcare professionals can use telehealth in diabetes care. Caution is needed due to heterogeneity of the results. Further research should explore the long-term impacts of telehealth interventions. Registration: The study was registered with PROSPERO, CRD42022381879.

Lived Experience of Breast Cancer Survivors: A Phenomenological Study.

BACKGROUND: Breast cancer (BrCa) is the most common cancer worldwide. Five-year survival rates among individuals with BrCa are the highest of all types of cancer, yet there is a paucity of knowledge about the experiences of survivors regarding living through their diagnosis and treatment. In-depth interviews and the systematic analysis of self-reported experiences may provide in-depth information about the BrCa survivorship experience. PURPOSE: This qualitative study was designed to identify and elucidate the lived experiences of Thai women with BrCa who successfully completed their treatment program for BrCa and/or treatment with chemotherapy for over 5 years and are currently cancer-free. METHODS: A phenomenological method was employed. Survivors of BrCa who met the inclusion criteria were purposively selected and invited to take part in the study. Study data were collected between January and March 2019. An open-ended, in-depth interview guide was used to direct the conversation concerning the participants' experiences and perceptions. Thematic analysis was used for data analysis. RESULTS: Data saturation was reached after 12 interviews. The five themes derived from the data include (a) being distressed, (b) accepting treatments and seeking alternative treatments, (c) going through difficult times, (d) becoming a stronger person, and (e) becoming thankful. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The experiences and themes identified enhance scholarly understanding regarding the experience of survivors of BrCa. A true understanding of this experience enables healthcare providers to craft and deliver appropriate interventions that provide quality care and improve women's health, thereby enhancing their quality of life. The results of this study may contribute to the development of new theories by using different qualitative approaches such as grounded theory.

Older people living with chronic illness.

This study aimed to gain a better understanding of what it is like for older people to live with chronic illness. A Phenomenological method was used. A purposive sampling strategy was used to recruit older people with chronic illness from one community in Nakhonratchasima province, Thailand. Semi-structured interview guides were used to explore the participants' experiences and perceptions. Data saturation was reached after 30 interviews were completed. The data was analyzed using thematic analysis. Four themes emerged from the data: 1) living a restricted life, 2) feeling overwhelmed, 3) understanding and accepting loss, and 4) being kind to oneself and learning to live with the disease. The findings may increase understanding about what older people with chronic illness experience. Health care providers can use this understanding to relate health care and guidance to their patients by incorporating cultural influences and religious/spiritual beliefs into the standardized care for this population.