Effectiveness of interventions to prevent abuse in people living with dementia in community settings: A systematic review.

OBJECTIVES: This review examined the evidence for interventions to prevent the abuse of people living with dementia in the community. METHODS: The articles were retrieved from 2000 to 2023 from six databases, including MEDLINE via PubMed, CINAHL Plus via EBSCO, EMBASE, ProQuest Medical Library, Web of Science, and Scopus. The research articles that focused on finding the effectiveness of interventions for preventing abuse of people living with dementia in community settings were included in this review. The review included randomized controlled trials and pre-test post-test trials only. The quality appraisal of the eligible studies was done using ROB 2 and ROBINS II. The findings were tabulated and narratively synthesised. RESULTS: Out of 1831 articles, only three were included in this review. Only two RCTs were included in this efficacy review. Both the studies showed that the interventions were not effective in reducing abuse. The studies utilised family caregiver interventions like psychological interventions and online supportive education. The review identified psychological interventions with some evidence. Another study was a quasi-experimental study that used dialectical behaviour therapy as an intervention to reduce abuse occurrence. The study showed low evidence and focused only on reporting of elder abuse as an outcome. CONCLUSION: This review found very few studies and was not able to draw a conclusion on the effectiveness of interventions for abuse in people living with dementia. Given the paucity of research, there is a clear need to identify how to overcome the challenges faced in elder abuse research and further refine the development of approaches to reduce elder abuse among people living with dementia in community settings.

Caring burden and quality of life among the caregivers of people living with dementia - a cross-sectional study in Udupi district of Karnataka.

Dementia is a chronic disorder of the brain that affects cognitive performance. The caregivers of individuals with dementia experience a greater burden that affects their Quality of Life (QoL). This cross-sectional study conducted in India was designed to assess the caring burden and QoL among the caregivers of people with dementia, as well as to ascertain the relationship between QoL scores and burden. Our sample included 80 caregivers of people with dementia. Most of the caregivers (n = 59, 73.8%) had a higher level of caregiver burden. There was a negative correlation between caregiver burden scores and QoL. A higher level of caregiver stress and low QoL were experienced by caregivers of dementia patients. In developing countries like India, counseling, and education on home health care for people with dementia should be provided to reduce the burden and enhance the QoL of caregivers.

The Attitude of Young Adults on Child Abuse- A Community Based Cross-Sectional Survey.

BACKGROUND: Identifying the attitude of young adults towardschild abuse has a significant role in sensitizing them to theissue, which would bring about a positive change in our society at large. This study aims to assess young adults' attitudes towards child abuse and find the association between their attitudes and the selected socio-demographic variables. METHODS: This cross-sectional survey was carried out in the community of Udupi district, Karnataka, among 200 young adults. They were assessed by a self-report attitude scale and a socio-economic status scale. RESULTS: The majority of the respondents (98.0%) had a negative attitude towards child abuse. 59% believed that most of the abuse was perpetrated by people known to the children, and 72.5% strongly agreed that disciplining children can be achieved through dialogue. 44.5% of the respondents believed that society is not taking an active role in child protection. CONCLUSION: Studying people's attitudes on a social issue creates awareness. This study provided insight into young adults' awareness of the importance of child protection, as expressed by their negative outlook towards child abuse.

Determinants of Adherence to Antihypertensives Among Elderly: A Multifactorial Concern.

Purpose: The aim of the study was to assess the predictors of adherence among elderly on antihypertensives and to examine the difference in adherence among males and females. Patients and Methods: Cross-sectional survey design was adopted for the study. The data were collected from 800 patients of age 60 years and above using demographic proforma, clinical proforma and Morisky Medication Adherence Scale (MMAS-8) with due approval from the institutional ethical clearance committee and written informed consent from the participants. Results: The findings revealed no significant difference in the non-adherence rates among males and females. Number of medications was identified as the major predictor of adherence. Conclusion: Awareness of factors influencing medication adherence is crucial for health professionals to provide appropriate advice for patients to maintain quality health. The findings of the study highlight the importance of nurses' role towards imparting knowledge on hypertension and emphasizing on the importance of adherence to antihypertensives among elderly.

Effectiveness of Extended Infection Control Measures on Methicillin-Resistant Staphylococcus aureus Infection Among Orthopaedic Patients.

Purpose: The purpose of the study was to find the effectiveness of Extended Infection Control Measures (EICM) in reducing the rate of methicillin-resistant Staphylococcus aureus (MRSA) infection among orthopaedic surgery patients. Methods: The study adopted a quasi-experimental design and was conducted in the orthopaedic units of a tertiary care hospital. This study recruited 168 orthopaedic patients and 154 healthcare professionals (HCPs). EICM included hand hygiene, decolonizing the patients and HCPS, staff education, feedback of surveillance data, treatment of high-risk and MRSA-infected patients, having separate equipment for MRSA-infected patients, and appropriate cleaning of patient's unit. Results: The EICM effectively reduced MRSA infection from 21.2 to 6% (p < 0.001). It also resulted in improving the knowledge of HCPs in the prevention and management of MRSA infection (p < 0.001), and all colonized HCPs were successfully (100%) decolonized. Conclusion: EICM is a promising intervention to combat MRSA infection among orthopaedic wards. Hence, it can be executed in orthopaedic wards, thereby improving the treatment quality and reducing the infection-related consequences. Supplementary Information: The online version contains supplementary material available at 10.1007/s43465-022-00713-5.

Psychosocial Distress of Head Neck Cancer (HNC) Patients Receiving Radiotherapy: A Systematic Review.

BACKGROUND: Head and Neck Cancer (HNC) patients are at increased risk of psychosocial distress compared with patients with other forms of cancer. Various symptoms of the disease and side effects of treatment are attributing factors for distress. This systematic review aimed to identify the prevalence of psychosocial distress among HNC patients receiving radiotherapy. METHODS: The following search engines from 2000-2021 were searched: PubMed, CINAHL, Cochrane, Web of Science, ProQuest, Scopus, and Embase. Citation checking and extensive reference checking were also conducted. Cross-sectional, longitudinal, cohort, exploratory and prospective, repeated measure studies published in English were included. Newcastle Ottawa Scale assessed the quality, and the data were extracted on a validated data extraction form. RESULTS: Out of 782 articles, eleven records met the eligibility criteria, including 776 HNC patients receiving radiotherapy. Data were synthesized and summarized descriptively as measurements were not homogenous. Prevalence estimates of depression or depressive symptoms were calculated. Outcomes were measured with various measuring tools and reported in frequency, percentage, mean, and standard deviation in various studies. All studies reported depression ranging from 9.8% to 83.8%, and pooled estimated prevalence of depression among HNC patients receiving radiotherapy is 63% (95% CI 42-83) with significant heterogeneity (I2= 97.66%; p<0.001). An increase in the trend is observed along with treatment progression. Another three studies reported anxiety along with depression. Physical symptoms, body image, low social support, fatigue specific radiotherapy regimens were the predictive factors of depression. CONCLUSION: HNC patients are psychosocially distressed during radiotherapy, and the distress is steadily increased during the therapy. The predictive factors could serve as potential areas of intervention and supportive therapy during radiotherapy.

Mobile applications in medical education: A systematic review and meta-analysis.

OBJECTIVE: This review evaluates the effectiveness of smartphone applications in improving academic performance and clinical practice among healthcare professionals and students. METHODS: This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Articles were retrieved from PubMed, Scopus, and Cochrane library through a comprehensive search strategy. Studies that included medical, dental, nursing, allied healthcare professional, undergraduates, postgraduates, and interns from the same disciplines who used mobile applications for their academic learning and/or daily clinical practice were considered. RESULTS: 52 studies with a total of 4057 learner participants were included in this review. 33 studies (15 RCTs, 1 cluster RCT, 7 quasi-experimental studies, 9 interventional cohort studies and 1 cross-sectional study) reported that mobile applications were an effective tool that contributed to a significant improvement in the knowledge level of the participants. The pooled effect of 15 studies with 962 participants showed that the knowledge score improved significantly in the group using mobile applications when compared to the group who did not use mobile applications (SMD = 0.94, 95% CI = 0.57 to1.31, P<0.00001). 19 studies (11 RCTs, 3 quasi-experimental studies and 5 interventional cohort studies) reported that mobile applications were effective in significantly improving skills among the participants. CONCLUSION: Mobile applications are effective tools in enhancing knowledge and skills. They can be considered as effective adjunct tools in medical education by considering their low expense, high versatility, reduced dependency on regional or site boundaries, online and offline, simulation, and flexible learning features of mobile apps.

Structure, staffing, and factors affecting infection control nurses: Hospital based exploratory survey- A study protocol.

AIM: The overall aim of the study is to develop a module for the structure, staffing, job responsibilities, training and workflow for the hospital Infection Control Department. DESIGN: An exploratory research design in two phases. Phase 1: Hospital based exploratory survey design. Phase 2: Delphi technique with Focus Group Discussion. METHOD: Data will be collected through interviewing Infection Control Nurses (ICNs) or infection control in-charge using Infection Prevention and Control Assessment Framework (IPCAF) released by World Health Organization (WHO) in the first phase and Delphi technique in the second phase to determine the problems and solutions for the concerns pertaining to the ICNs. The study is funded by Indian Council of Medical Research from 15 October 2019 for 3 years duration. DISCUSSION: Healthcare Associated Infection (HAI) affects the care quality of millions of people around the globe. Many researchers have explored the evidence for causes and measures to contain infection. However, there are hardly few researches from the perspective to structure, staffing pattern and factors affecting ICNs. As staffing is considered as a vital component in infection prevention, there is a necessity for optimization to reduce the global burden related to HAI. IMPACT: This protocol on Structure, staffing, and factors affecting ICN will provide insight into developing strategy, policy or educational module for the ICNs across the country. TRIAL REGISTRATION: The trial is registered with Central Trial Registry of India (CTRI) with reference ID: CTRI/2020/07/026286.

Effects of foot massage and patient education in patients undergoing coronary artery bypass graft surgery: A randomized controlled trial.

BACKGROUND: Anxiety, pain, and fatigue are common postoperative problems that disturb the recovery and quality of life in patients undergoing coronary artery bypass graft (CABG) surgery. These postoperative problems are associated with prolonged recovery and decreased quality of life. This study was aimed at evaluating the combined effects of foot massage and patient education on anxiety, fatigue, pain, self-efficacy, and quality of life in patients undergoing CABG surgery. MATERIAL AND METHODS: In this randomized controlled trial (RCT), 130 participants were randomly allocated to experimental (n = 65) and control (n = 65) groups. The experimental group received a combination of foot massage and patient education as interventions and the control group received usual care of the hospital. RESULTS: The experimental group had a significant decrease in anxiety (p = 0.001), fatigue (p = 0.001), pain (p = 0.001), and increased self-efficacy (p = 0.001) and quality of life (p = 0.001). CONCLUSION: The combined form of foot massage and patient education is effective in decreasing anxiety, fatigue, pain, and increasing self-efficacy and the quality of life. These interventions will support the recovery of patients and reduce their suffering.

Specialist nurse initiated interventions in breast cancer care: A systematic review of randomised controlled trials.

AIMS AND OBJECTIVES: To evaluate the effectiveness of specialist nurse interventions in the care of women with breast cancer. BACKGROUND: Nurses perform a crucial role in physical and psychosocial support of women with breast cancer. However, only few reviews have explored and discussed the roles and interventions carried out by specialised nurses in breast cancer care. DESIGN: Systematic review based on PRISMA guidelines. METHODS: A comprehensive literature search was conducted in PubMed, CINAHL, Scopus, Web of Science, Science Direct, Cochrane Library, IndMed and Shodhganga databases for articles published in English language from 1980 to 2018. Only RCTs were included. Quality assessment, data extraction and analysis were completed on all included studies. RESULTS: Sixteen papers were assessed for methodological quality. Due to methodological heterogeneity of the papers, a meta-analysis was not performed. The reviewers categorised the main outcomes under different domains like physical problems, psychological problems, patient satisfaction, patient needs, quality of life and cost data. DISCUSSION: This review provides evidence on specialist nurses' role in breast cancer care. The methodological aspects of studies in this review vary in different aspects. More studies with rigorous scientific methods are needed to provide robust evidence on effectiveness of specialist nurses' role. CONCLUSION: Even though specialist nursing interventions can contribute to health outcomes of women with breast cancer, there is limited number of studies reported from developing countries. This warrants the need for specialist nurse interventions in breast cancer care from developing countries. RELEVANCE TO CLINICAL PRACTICE: Offering a specialist nurse service helps the patients to meet their informational and educational needs, supportive care and coordination of care. Specialist breast nurse services can be integrated into hospital setting to improve patient care and treatment adherence.

Randomized controlled trial on the effectiveness of a multicomponent intervention on migraine: A study protocol.

AIM: To describe a randomized controlled trial protocol that evaluates the effectiveness of a multicomponent intervention in improving the outcomes (quality of life, disability, intensity, frequency and duration) of patients with migraine. BACKGROUND: Migraine affects various facets of Quality of Life and results in moderate to high levels of disability among migraineurs. Migraine pain can be intense and unremitting that can interfere with the daily routine and reduce the ability to think and function normally. Many people can lower their risk of a migraine by simply avoiding stress, getting enough sleep, eating regularly and by avoiding triggers. Hence, the present study aims at evaluating the effectiveness of a multicomponent intervention in managing migraine headaches. The multicomponent intervention includes behavioural lifestyle modification program and sessions of pranayama (a form of yogic breathing exercise). DESIGN: The study is a prospective, randomized, controlled, single-blinded trial with parallel arms. METHODS: The study participants are randomized to intervention and control arms. The participants randomized to the intervention arm would receive the specific multicomponent intervention based on the protocol. The participants in the control arm would receive routine care. They are followed up for 24 weeks and the outcomes are assessed. DISCUSSION: Various studies report that non-pharmacological therapies and integrative therapies play a major role in the management of migraine headaches. The findings of the study are expected to open up new horizons in health care arena emphasizing the use of non-pharmacological therapy for less focused areas of primary care health problems such as migraine. TRIAL REGISTRATION: The trial is registered with the Clinical Trials Registry India (CTRI). The CTRI India is one of the primary registries in the WHO registry network (Ctri.nic.in, ). CTRI reference ID: CTRI/2015/10/006282.

Effect of Preoperative Education on Postoperative Outcomes Among Patients Undergoing Cardiac Surgery: A Systematic Review and Meta-Analysis.

PURPOSE: The objective of this review was to assess the effect of preoperative education on postoperative outcomes among patients undergoing cardiac surgery. DESIGN: Systematic review and meta-analysis. METHODS: A comprehensive literature search was made on PubMed, CINAHL, Ovid, ProQuest, ScienceDirect, Scopus, Web of Science, and the Cochrane database between 1995 and 2015. Fourteen randomized controlled trials were included. Data analysis was performed with RevMan software and created the Supplementary Appendix using the GRADE approach. FINDINGS: Meta-analysis showed that preoperative education reduced anxiety scores (standardized mean difference = -0.96, 95% confidence interval: -1.37, -0.54; P < .0001). However, there was no significant effect of preoperative education on pain, depression, and length of hospital stay. There is low-quality evidence, and reasons for downgrading are due to study design limitations, inconsistency, and imprecision of effect estimates. CONCLUSIONS: The results show that preoperative education can effectively decrease anxiety in patients undergoing cardiac surgery.

Effect of Complementary Therapies in Patients Following Cardiac Surgery: A Narrative Review.

Cardiovascular diseases are increasing rapidly and have become a major health problem worldwide. The incidence and prevalence of cardiovascular disease are increasing rapidly, predominantly in the developing countries. Patients with cardiovascular disease who do not respond to routine medical treatment will have to follow cardiac surgical procedures. The objective of this study was to apprise the evidence of the effect of various complementary therapies on postoperative outcomes among patients undergoing cardiac surgery. A comprehensive literature search was made on PubMed-Medline, CINAHL, Science Direct, Scopus, Web of Science, and the Cochrane Library databases for original research studies published between 2000 and 2015. Original articles that reported the effect of complementary therapies in patients undergoing cardiac surgery were included. Twenty-eight studies were analyzed, and they have produced conflicting results. Most of the studies (n = 25) have documented the effects of complementary therapies on improving postoperative outcomes of patients, whereas other studies (n = 3) found no evidence of improvement. Although methods varied considerably, most of the studies included in this review reported positive results. Therefore, there is some evidence that complementary therapies can lead to positive postoperative outcomes. Evidence of the efficacy of complementary therapies in cardiac surgical patients remains inconclusive. Additional research is needed to provide a strong evidence base for the use of complementary therapies to improve postoperative outcomes and recovery in patients undergoing cardiac surgery.

Effectiveness of self-management programmes in diabetes management: A systematic review.

BACKGROUND: Diabetes is a major noncommunicable disease, which is increasing, and approximately 415 million people are affected around the globe. Since diabetes is a lifelong disease, patients require better understanding and knowledge of the condition to become self-reliant in making diabetes-related decisions. AIMS: This systematic review was performed to assess the effectiveness of diabetes self-management programs in people with type 2 diabetes. METHODS: A comprehensive literature search was undertaken to identify all published English language articles through EBSCO discovery services in the following electronic database: Science Direct, CINAHL Plus with Full Text, MEDLINE, and Access Medicine. Studies were published from January 2000 to October 2015. The initial search retrieved 37 566 studies and based on the inclusion criteria, 14 studies were selected for review. RESULTS: Of 14 studies, most findings favoured diabetes self-management. But the overall effectiveness of individual interventions was not conclusive. A wide variety of interventions was used including diabetes education as a major component in self-management programs. CONCLUSION: Interventions used varied strategies in differing composition, and further work is needed to find out the effectiveness of individual interventions.

A Randomized controlled trial to evaluate the impact of a Nurse Navigator Programme on outcomes of people with breast cancer: study protocol.

AIM: To evaluate the effectiveness of a Nurse Navigator Programme on anxiety, psychological distress and quality of life in people with breast cancer. BACKGROUND: Breast cancer is the most frequently detected malignancy and a major cause of cancer death among women around the world. The lengthy course of illness from initial diagnosis to treatment and subsequent follow-up causes deterioration in physical, psychological and social status among patients. Nurses have a major role in cancer care. As women with breast cancer have to undergo various treatment modalities, continued care by a pivot nurse is thought to enhance treatment adherence. Limited studies have been reported from developing countries on Nurse Navigation Programmes. DESIGN: A Stratified Randomized controlled trial with repeated measures. METHODS: One hundred and twenty newly diagnosed women with breast cancer admitted to surgery wards of a tertiary care hospital in South India will be recruited. (Project funded in Octo"ber 2014). Women are randomly allocated to a control and intervention group. The outcome variables are anxiety, psychological distress and quality of life. Data on outcome measures will be collected at five different time points: before surgery, at discharge, beginning of adjuvant therapy, middle of adjuvant therapy and at the end of adjuvant therapy. DISCUSSION: This study may give evidence on the effectiveness of a Nurse Navigator Programme for women with breast cancer. If significant effects were detected, the programme could be integrated into hospital services to improve the patient care.

Neonatal sepsis, bacterial isolates and antibiotic susceptibility patterns among neonates.

Data from hospital records of 96 neonates hospitalised with sepsis were analysed using SPSS 11.5 version to identify sepsis--its signs and symptoms with which they were admitted, bacterial isolates and antibiotic susceptibility patterns among neonates admitted during 2007-2009. The retrospective data revealed that majority of the neonates 61 (63.5%) were males. Of the 96 neonates 52 (54.2%) were pre-term, and 44 (45.8%) were referred from various institutes after initial trial of management for the same. Majority ie. 66 (68.8%) had respiratory distress. Lethargy was noted in 56 (58.30%), fever among 10 (10.4%) and jaundice was reported among 6 (6.2%). Blood culture and sensitivity revealed that pseudomonas infection claimed to have triggered early signs and symptoms of sepsis among 11 (11.46%) neonates and Staphylococcus aureus was responsible for triggering late signs and symptoms ofsep is among 11 (11.46%) neonates.

Elderly and depression.

It is believed that it is 'normal' for the elderly per sons to become depressed and many cases aren't recognized and thus lead to untold misery for the sufferers and their families. We have found that majority of the clients under study were females belonging to low socio economic status, uneducated and unemployed. Majority of the clients had moderate depression (58%), And about 19% of them had severe depression. The problems related to subjective depressive feelings were investigated through a structured questionnaire surveyed among 100 elderly clients in Udhyava Village of Udupi district. We conclude that there is a significant relationship between family--friend relationships and depressive feelings of aged people.