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Aim: To determine the effects of collaborative health management of congestive heart failure through the rigorous evaluation and extraction of evidence. Background: Over the past two decades, cardiovascular disease has been the leading cause of death worldwide. Multidisciplinary team intervention for congestive heart failure has increased with population ageing and congestive heart failure incidence rate as well as cost of care. However, the effectiveness and feasibility of collaborative health management need to be explored. Design: Systematic review and meta‐analysis. Methods: We conducted systematic literature searches in the Cochrane Library, PubMed, CINAHL and Medline for articles published between 2002 and 2022. After screening based on the inclusion and exclusion criteria, 13 articles were included in a rigorous review and evidence extraction process, evaluated methodological quality using the Jadad Quality Scale. Statistical heterogeneity was evaluated using Review Manager (RevMan Version 5.4) for the meta‐analysis. Results: In this study, a systematic review and meta‐analysis were performed on 13 studies regarding the collaborative health management of people with congestive heart failure. The common result is that the collaborative health management model enables the enhancement of self‐care and monitoring abilities, the strengthening of cardiac function, the alleviation of physiological and psychological symptoms and the improvement of readmission rates, mortality rate and quality of life. Conclusion: The congestive heart failure collaborative health management model could decrease the hospitalization rate related to congestive heart failure, all‐cause mortality rate, and all‐cause hospitalization rate, and improve the quality of life. Implications for Practice: The collaborative health management model could effectively coordinate interdisciplinary team cooperation and provide information, which decreases hospitalization and mortality risks and improves their quality of life. No patient or Public Contribution: Our paper is a systematic review and meta‐analysis, and such details do not apply to our work. What does this paper contribute to the wider global clinical community?: The Collaborative Health Management Model provides in‐depth insights, aiding in the design tailored to the specific circumstances of each country. Highlighting its critical role in the context of a global shortage of nursing staff, the model emphasizes the integration of multidisciplinary professional roles and the strengthening of collaboration as essential elements in addressing challenges posed by workforce shortages.Implementation of the Collaborative Health Management Model not only enhances patient care outcomes but also relieves pressure on healthcare systems, lowers medical costs, and addresses challenges arising from the shortage of nursing staff. Consequently, this model not only contributes to individual patient care improvement but also holds broader implications for enhancing the efficiency and sustainability of global healthcare systems. Trial and Protocol Registration: The detailed study protocol can be found on the PROSPERO website. [ABSTRACT FROM AUTHOR]

Aim: To systematically provide an overview of the qualitative evidence available on the motivations for nurses to leave the nursing profession. Design: A qualitative systematic review using the meta‐aggregation design of the Joanna Briggs Institute. Data Sources: Qualitative studies in English, dating from 2010 until January 2023, were obtained from CINAHL, PsycINFO and PubMed. Review Methods: Studies were selected using predetermined inclusion and exclusion criteria. Quality assessment was done using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research. The assessment of confidence in the review findings was done according to the ConQual approach. Results: Nine papers that investigated nurses' motivations to leave the profession were included. We developed four synthesized findings from 11 synthesized categories and 31 categories to reflect nurses' motivations to leave the profession, including (1) challenging work environment, (2) emotional distress, (3) disappointment about nursing reality, and (4) culture of hierarchy and discrimination. Conclusion: This review provides an in‐depth and meaningful understanding of motivations for nurses to leave the profession. Among others, poor working conditions, a lack of opportunities for career development, a lack of support from managers, work‐related stress, a discrepancy between nursing education and practice and bullying behaviour were motivations to leave the profession, which calls for targeted action to retain nurses in the profession. Impact: Findings of this study shine a light on reasons why nurses leave the profession, providing evidence to support nurse managers and policymakers to develop retention strategies to move out of current crisis into recovery of sustainable global healthcare. Patient or Public Contribution: There was no direct patient or caregiver contribution to this study because this study originated from the process of a Master study. However, two of the authors are still involved in clinical nursing practice and provided the necessary link between research and practice. [ABSTRACT FROM AUTHOR]

Aims: To synthesize existing qualitative research evidence on the supportive care needs of women with gynaecological cancer. Design: Qualitative systematic review. Data sources A comprehensive literature search was performed using nine databases (PubMed, Web of Science, PsycINFO, CINAHL, Embase, CBM, CNKI, VIP and WanFang) without restrictions regarding publication date; qualitative studies published in English or Chinese were included. Initial search in December 2021 and updated in October 2022. Review methods: This study was conducted according to the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) guidelines. The Critical Appraisal Skills Programme tool for qualitative research was used to assess the quality of all included papers. Finally, we adopted a thematic synthesis method, synthesized the main findings, and constructed themes. Results: Eleven studies published between 2010 and 2021 were included in the review. Based on the thematic synthesis method, 10 descriptive themes were generated and five analytical themes were derived: psychological support, information support, social support, disease‐specific symptom management and form of care. Women with gynaecological cancer expressed a desire for psychological support from empathetic healthcare professionals; information support included access to adequate and appropriate information, as well as communication and involvement; social support highlighted women's desire for peer support, family‐related support and financial support; disease‐specific symptom management described women's desire for support in coping with reproduction/sexual issues and form of care highlighted the need for continuity of care and holistic care. Conclusion: The supportive care needs of women with gynaecological cancer are multidimensional and complex. The future care practice should take women's needs as a starting point and provide ongoing holistic and individualized support. Healthcare providers' understanding and support of these needs are critical to improving women's clinical outcomes and quality of care. Impact The present findings can help further develop supportive care programmes and make nursing interventions more targeted and effective. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aim: To synthesize and present the currently available literature on the experiences of spousal and adult child caregivers of stroke patients in transitional care. Design: This is a qualitative systematic review. Data Sources: Eight electronic databases (PubMed, CINAHL, Cochrane, Embase, Web of Science, PsychINFO, ProQuest and Scopus) were searched from September 2020 to April 2022 for relevant literature and grey literature. Qualitative studies exploring the experiences of sspousal or adult child caregivers of stroke survivors up till 1 year after discharge were included. Review Methods: The selection of articles was done by two independent reviewers who screened the titles and the abstracts of studies, and the full texts of selected articles. Quality appraisal and data extraction of selected articles were undertaken by two independent reviewers using Joanna Briggs Institute (JBI) critical appraisal tools. Data synthesis was conducted using a meta‐aggregative approach recommended by JBI. Results: A total of 19 papers were included in this review. A total of three synthesized findings centred around caregivers' experience with healthcare professionals, changes in their life roles and needs, effects of caregiving and how they adapted to their changes were aggregated. Conclusion: Spousal and adult child caregivers faced multiple barriers during transitional care, such as the lack of resources and an inability to cope with changes in their lives. Support and adequate preparation were key facilitators in easing stroke caregivers into their role. Impact The findings from this review can be used to guide future implementations of caregiver education programmes and comprehensive discharge planning for stroke survivors. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to determine what kind of psychosocial interventions aimed at improving the well‐being of adult cancer patient caregivers were developed, and to describe the methodological characteristics and clinical effectiveness of the interventions which could be included in the nursing care plans. Design: Systematic review Data sources A systematic search of three databases (PubMed, CINAHL, and PsycINFO) was conducted to identify peer‐reviewed papers published between years 2004–2019. Review Methods: The review was guided by the Joanna Briggs Institute manual for systematic reviews. Data were extracted and appraised by three reviewers using standardized checklists. Narrative synthesis was used to analyse the data. Results: A total of 37 studies underwent analysis. Most of the studies described psychoeducational interventions, designed for patient‐caregiver dyads, delivered face‐to‐face. There was a great variety in caregiver outcomes and measurement tools used. Even though most studies used a randomized controlled design and standardized intervention protocols, many reported problems with recruitment and attrition. Most studies reported that the intervention improved caregiver outcomes, yet the majority of them failed to report effect sizes. Conclusion: There are currently a plethora of successful interventions available for cancer patient caregivers which can be included to the nursing care plan. Psychoeducational online interventions which include a social support component may have the best potential in supporting caregivers. It is important to address specific caregiver needs at different cancer stages rather than general needs of caregivers in future interventions. Impact This review suggests that despite a large number of different interventions which can be included in the nursing care plan to improve the support offered to caregivers, some issues should be addressed while designing an intervention study. The emphasis should be placed on reporting effect sizes, focusing on specific caregiver needs and improving recruitment, retention strategies and sustainability of caregiver interventions. [ABSTRACT FROM AUTHOR]

Aims: To examine the incidence of intraoperative peripheral nerve injury, symptoms, risk factors, functions, and quality of life in patients undergoing robotic‐assisted laparoscopic surgery to lithotomy positioning with steep Trendelenburg. Design: A systematic review. Data sources: The Cochrane Library catalogue, PubMed, EMBASE, CINHAL and SveMed + databases were searched from January 2000 ‐ February 2019. Review methods: Titles and abstracts were screened for inclusion. Full‐text assessments of each paper were conducted by two reviewers. The quality of the included papers was assessed using the Mixed Methods Appraisal Tool. Descriptive statistics and thematic analysis were used to synthesize the data. Results: Eleven quantitative studies were included with three themes: (a) incidence of intraoperative peripheral nerve injury; (b) upper extremity intraoperative peripheral nerve injury related to steep Trendelenburg positioning; and (c) lower extremity intraoperative peripheral nerve injury related to lithotomy positioning. The overall incidence of intraoperative peripheral nerve injury in robotic‐assisted laparoscopic urologic, gynaecologic and colorectal surgery was 0.16%–10.0% and the symptoms appeared immediately after surgical procedures. Risk factors for intraoperative peripheral injury were prolonged operative time, high American Society of Anesthesiologists scores, comorbidities and high body mass index. Conclusion: Intraoperative peripheral nerve injuries are rare, but occasionally serious when related to lithotomy positioning with steep Trendelenburg. Operating room nurses have a responsibility both for positioning patients and for being familiar with the technological developments that will influence the preoperative handling of patients. Impact: This systematic review emphasizes the need for operating room nurses together with surgical team to have knowledge about mechanisms for injury, positioning, anatomy/physiology, and evaluation of risk factors to ensure that patients are not exposed for intraoperative peripheral nerve injuries. Increased robotic‐assisted laparoscopic surgery necessitates further research examining the incidence of intraoperative peripheral nerve injury related to positioning and how these affect patients' function and the quality of life. [ABSTRACT FROM AUTHOR]

Aim: The aim of this was to identify and synthesize the evidence underpinning the health policymaking process to inform the development of a health‐related policy analysis framework. Design: A mixed methods review using "Best Fit" Framework synthesis. Data Sources: PUBMED and CINAHL+ databases for English language papers published between March 2013 – March 2017. Review Methods: Titles were screened, data abstracted and analysed by two authors at each stage. Findings from included studies were coded against six a priori categories which had been constructed through a preliminary literature review, consultation and consensus. Results: Sixty‐eight papers were included. There exists empirical support for six key domains which require to be addressed in the policymaking and analysis process: (1) Context; (2) Process; (3) Content; (4) Stakeholder Consultation; (5) Implementation; and (6) Evaluation. Failure to contextualize and integrate these six domains in problem identification, policy analysis, strategy and policy development, policy enactment and policy implementation is problematic. Conclusion: There is a need to test and refine the constructs linked to the policymaking cycle taking cognizance of the context where these are developed, implemented and evaluated. Impact: This review makes a novel contribution to the synthesis of evidence to inform the policymaking and analysis process. Findings illuminate the complexity of policymaking, the competing pressures involved and the importance of the local, national and international context. These findings have international relevance and provide empirical support for key criteria to guide those involved in context specific policymaking and/or the analysis of existing policy. [ABSTRACT FROM AUTHOR]

Aims: To examine the experiences of health transitions for young people with intellectual disabilities and their carers and identify the implications for nursing practice. Design: A systematic review and critical appraisal of qualitative, quantitative, and mixed methods studies. Data sources: A search of the relevant literature published 2007–2017 was carried out in AMED, ASSIA, CINAHL, MEDLINE, PsycINFO, PubMed, and Science Direct Sociological Abstracts databases. Review methods: A total of 12 of 637 papers identified in the search met the inclusion criteria for this review. A narrative review of the papers was undertaken by synthesizing the key findings and grouping them into concepts and emergent themes. Results: Four main themes were identified: (a) becoming an adult; (b) fragmented transition process and care; (c) parents as advocates in emotional turmoil; and (d) making transitions happen. Conclusion: The range of issues that have an impact on the transition from child to adult health services for young people with intellectual disabilities and their carers raise important implications for policy development, nursing practice, and education. [ABSTRACT FROM AUTHOR]

Aims: To synthesize and evaluate the effectiveness of interventions for nurses to improve the assessment and management of pain in people living with dementia. Design: Systematic review and meta‐analyses of randomized controlled trials. Data sources: CINAHL, Joanna Briggs Institute (JBI) EBP, Cochrane Library, PubMed, and Scopus databases were searched for all journal articles published between 2009 ‐2019. Review methods: Papers were included under population intervention comparator outcome (PICO) framework for: (a) people living with dementia aged 65 years and over; (b) interventions developed for nurses or other health professionals; (c) comparison group of standard care or control; and (d) outcome that measures the intervention effects on nurses and people living with dementia. Independent reviewers undertook critical appraisal, data abstraction, and synthesis. Meta‐analyses were performed to determine the effectiveness of interventions. Results: Of 2099 titles and abstracts screened, six interventions with low‐to‐moderate risk of bias met inclusion criteria. Studies that implemented a routine pain assessment tool showed no effect on nurses' analgesic management. Studies that developed a comprehensive pain model involving multidisciplinary health professionals showed overall effects on pain assessment and management in dementia care. Physician involvement had an impact on analgesic management. Conclusion: Comprehensive pain models improve nurses' pain assessment and management. A lack of balance between analgesia use and non‐pharmacological pain management in dementia care is evident. Multidisciplinary health professionals' involvement is essential for effective intervention design for pain management in dementia. Impact: Various pain assessment tools have been considered to assist identification and management of pain in people living with dementia. Nevertheless, challenges exist when caring for people living with dementia in pain. These findings support the development of a comprehensive pain model, which may be a more effective strategy than routine use of a pain tool alone for nurses to improve pain management in dementia care. [ABSTRACT FROM AUTHOR]

Aims To review systematically the psychometric properties of instruments used to measure intention to work with older people. Background Nursing students are part of the future healthcare workforce; thus, being aware of their intention to work with older people would give valuable insights to nursing education and practice. Despite a plethora of research on measuring intention to work with older people, a valid and reliable instrument has not been identified. Design A systematic literature review of evidence and psychometric properties. Data sources Eight database searches were conducted between 2006 - 2016. Review methods English articles were selected based on inclusion and exclusion criteria. The COSMIN checklist was used to assess instruments reporting a psychometric evaluation of validity and reliability. Results Of 41 studies identified for full text review, 36 met the inclusion criteria. Seven different types of instruments were identified for psychometric evaluation. Measures of reliability were reported in eight papers and validity in five papers. Evidence for each measurement property was limited, with each instrument demonstrating a lack of information on measurement properties. Based on the COSMIN checklist, the overall quality of the psychometric properties was rated as poor to good. Conclusion No single instrument was found to be optimal for use. Studies of high methodological quality are needed to properly assess the measurement properties of the instruments that are currently available. Until such studies are available, we recommend using existing instruments with caution. [ABSTRACT FROM AUTHOR]

Aims: To identify, appraise and describe the characteristics and measurement properties of instruments assessing nurses' attitudes towards the importance of involving families in their clinical practice. Design: Psychometric systematic review. Data Sources: The PubMed, CINAHL, PsycINFO, Web of Science, and Cochrane Library databases were searched from their time of inception to June 2018. Review Methods: Two reviewers independently assessed the eligibility of studies, extracted data, and appraised the methodological quality of the studies using the COSMIN checklist. Results: A total of 19 studies representing 5 instruments were included. Two instruments—a revised version of the Families' Importance in Nursing Care: Nurses' Attitudes scale (FINC‐NA‐R) and the Family Nurse Practice Scale (FNPS)—obtained higher scores for most of their properties. The instruments used in the remaining eight studies require further assessment of their psychometric properties. Conclusion: This psychometric review offers a synthesis of the quality of the available instruments and gives a better understanding of nursing theory‐based tools. The FNPS and FINC‐NA‐R instruments seem to be the most suitable measures of nurses' attitudes towards the importance of involving families in their clinical practice. Impact: The growing emphasis on improving nurse–family relationships and the quality of care provided makes it necessary to have valid and reliable instruments for assessing nurses' attitudes towards the importance of involving families in their clinical practice. This paper provides evidence that will help clinicians and researchers make decisions about the most suitable instrument based on a critical appraisal and comparison of the measurement properties according to a rigorous methodology. [ABSTRACT FROM AUTHOR]

Aim To produce a framework for the development of a qualitative semi-structured interview guide. Background Rigorous data collection procedures fundamentally influence the results of studies. The semi-structured interview is a common data collection method, but methodological research on the development of a semi-structured interview guide is sparse. Design Systematic methodological review. Data sources We searched PubMed, CINAHL, Scopus and Web of Science for methodological papers on semi-structured interview guides from October 2004-September 2014. Having examined 2,703 titles and abstracts and 21 full texts, we finally selected 10 papers. Review methods We analysed the data using the qualitative content analysis method. Results Our analysis resulted in new synthesized knowledge on the development of a semi-structured interview guide, including five phases: (1) identifying the prerequisites for using semi-structured interviews; (2) retrieving and using previous knowledge; (3) formulating the preliminary semi-structured interview guide; (4) pilot testing the guide; and (5) presenting the complete semi-structured interview guide. Conclusion Rigorous development of a qualitative semi-structured interview guide contributes to the objectivity and trustworthiness of studies and makes the results more plausible. Researchers should consider using this five-step process to develop a semi-structured interview guide and justify the decisions made during it. [ABSTRACT FROM AUTHOR]

Aim. To understand nurses' perceptions and experiences of work role transitions. Background. Globally an uncertain healthcare landscape exists and when changing work roles nurses experience periods of transition when they may not cope well. A greater understanding of work role transitions may help facilitate workforce retention and successful careers. Design. Mixed methods systematic review. Data sources. Six data bases were searched for peer reviewed primary empirical research, published in English language between January 1990 and December 2014, supplemented by hand and citation searching. Review methods. Evidence for Policy and Practice Information and Co-ordinating Centre methods for systematic reviews principles were followed. Analysis and synthesis of the qualitative and quantitative papers was conducted separately using thematic analysis. A third synthesis combined the narrative findings and a narrative synthesis of results is presented. Results. Twenty-six papers were included. Across nurses' work role transitions two pathways were found: Novice and Experienced. 'Novice' comprises pre-registration and newly qualified nurses. 'Experienced' comprises, Enrolled/Licensed Practical Nurse to Registered Nurse, experienced to specialist nurse and clinical role changes. Each pathway results in different emphasizes of two themes; 'Striving for a new professional self' includes emotional upheaval and identity while 'Know how' includes competence and boundaries. Novice nurses are more susceptible to the extremes of emotional upheaval while experienced nurses' competence eases aspects of transitions while boundary issues pervade. Conclusion. Informed work and educational environments are required for all groups of nurses. Using existing models of transition can facilitate successful individual transitions and develop the workplace. [ABSTRACT FROM AUTHOR]

Abstract: Aim: To synthesize evidence on the effectiveness of social media in nursing and midwifery education. Background: Social media are being explored to see if these online tools can support teaching, learning, and assessment. Design: A mixed study systematic review. Data sources: A systematic search of PubMed, MEDLINE, CINAHL, Scopus, and ERIC was run in January 2016. An updated search was run in June 2017. No date limits were applied. Methods: Titles, abstracts, and full papers were screened against inclusion criteria by two independent reviewers, who extracted and quality assessed data. Synthesis followed a sequential explanatory approach. Results: Twelve studies were included. Social media seemed to support students to acquire new knowledge and skills. The learning process centred on the interactive nature of the platforms which allow information to be dynamically shared and discussed in near real time. The characteristics of social media enabled social support and a more student‐centred setting, which appeared to enhance collaborative learning, although information quality was sometimes problematic. Learning via social media was underpinned by how well the educational interventions were organized, digital literacy and e‐Professionalism of students and faculty, the accessibility of the online applications, and personal motivation. Conclusion: This review provides the first rigorous synthesis of social media in nursing and midwifery education. A new Social Media Learning Model was conceptualized to aid our understanding of learning via this technology. Knowledge gaps are identified and recommendations on how to capitalize on social media to improve learning in higher and continuing education provided. [ABSTRACT FROM AUTHOR]

Abstract: Aim: To determine the effectiveness of non‐pharmacological therapies for sleep disturbances in people with Parkinson's disease (PD). Background: Sleep disturbances, which are common in people with PD, may diminish their quality of life. Non‐pharmacological therapies are preferred over pharmacological therapies for improving sleep quality, owing to fewer adverse effects. Design: Systematic literature review. Data sources: A systematic search of eight databases and hand searching was conducted for papers published between 1 January 2000 – 1 January 2016. Review methods: The Cochrane methods were followed. Risk of bias was assessed using the Cochrane Collaboration Risk of Bias Tool. Results: Eight studies were identified for data extraction. Therapeutic domains included physical exercise, cognitive behavioural and complementary interventions. Therapies in four of the eight studies significantly improved sleep quality and the unified PD rating scale score. Other studies showed no clear effects on sleep (N = 1), limited effects on sleep (N = 1) or effects in both the intervention and control groups, indicating that the intervention had no distinctive effects (N = 2). Conclusions: The non‐pharmacological intervention types and sleep‐related measured outcomes were heterogeneous. Most therapies had inconsistent effects on sleep. The insufficient evidence for non‐pharmacological treatments seems related to the unique motor‐associated clinical features of PD, which restrict the use of physical exercise therapy, or to individual “wearing‐off” periods, which limit group therapy. Further studies on non‐pharmacological therapies are required to identify the best interventions for improving sleep quality in people with PD. [ABSTRACT FROM AUTHOR]

Aims This systematic quantitative review identifies and summarizes the current knowledge and effects of training interventions for managing patients' challenging behaviour. Background Challenging behaviour is an acknowledged worldwide healthcare problem and its management can have a huge impact on quality of care. Evidence-based training interventions that focus on managing challenging behaviour are needed, but few tools for the systematic evaluation of these interventions are currently offered. Design A quantitative systematic review following the 2008 Centre for Reviews and Dissemination guidelines. Data Sources CINAHL, Scopus, PsycInfo, PubMed and Cochrane were searched using the same terms for papers published in English from 2005-2015. Review Methods Studies were assessed for quality and risk of bias, according to the Cochrane Effective Practice and Organisation of Care Group criteria. A narrative summary was conducted. Results We included 17 studies and evaluated 16 training interventions. Interventions were classified into four key themes: disengagements, communication, controlling behavioural symptoms and restrictive measures. Our review showed that interventions were more likely to decrease violent incident rates and increase staff confidence than change staff attitudes or increase knowledge. The elements of competence used to manage challenging behaviour were measured unilaterally. The evidence provided by studies was largely weak. Conclusion The variety of measurements used in the studies made comparing the effectiveness of the training interventions difficult. An individual's competence to manage challenging behaviour needs to be defined and a comprehensive scale for evaluating competence is also needed. Patient safety should be included in future evaluations. [ABSTRACT FROM AUTHOR]

Aim To evaluate the impact of multi-professional teamwork (MPTW) and leadership training interventions on patient outcomes in acute hospital settings. Background Although investigations of teamwork and leadership training in acute hospital settings indicate that such programs can optimize patient outcomes, evidence-based recommendations on the content, duration and frequency of training programs associated with clinical evidence are still absent. Design Quantitative systematic review. Data Sources A search was conducted for relevant papers published during the period from 2000-February 2014. Review Methods Twelve studies met the inclusion criteria and were appraised for quality and a risk-of-bias assessment was conducted. The review used a structured approach for literature search, data evaluation, analysis and presentation. A narrative summary was used to report results. Results Two MPTW and leadership interventions in stroke units have the greatest impact on patient outcomes in acute hospital settings. The interventions' impact on patient outcomes, explored in the ten remaining studies, is associated with great uncertainty due to several alternative explanations of the findings. Conclusion Research designs that test such interventions must be improved before recommendations on the ultimate program can be made. This can be achieved by strengthening the design, methodology and descriptions of interventions and the use of more consistent patient outcomes. Building a safety culture adjacent to implementing teamwork and leadership training interventions is essential for improving patient outcomes. [ABSTRACT FROM AUTHOR]

Aim To evaluate the effectiveness of interventions to support caregivers of people with selected chronic conditions. Background Informal caregivers provide millions of care hours each week contributing to significant healthcare savings. Despite much research evaluating a range of interventions for caregivers, their impact remains unclear. Design A systematic review of systematic reviews of interventions to support caregivers of people with selected chronic conditions. Data sources The electronic databases of PubMed, CINAHL, British Nursing Index, Psyc INFO, Social Science Index (January 1990-May 2014) and The Cochrane Library (Issue 6, June 2014), were searched using Medical Subject Heading and index term combinations of the keywords caregiver, systematic review, intervention and named chronic conditions. Review methods Papers were included if they reported a systematic review of interventions for caregivers of people with chronic conditions. The methodological quality of the included reviews was independently assessed by two reviewers using R- AMSTAR. Data were independently extracted by two reviewers using a pre-designed data extraction form. Narrative synthesis of review findings was used to present the results. Results Eight systematic reviews were included. There was evidence that education and support programme interventions improved caregiver quality of life. Information-giving interventions improved caregiver knowledge for stroke caregivers. Conclusion Education, support and information-giving interventions warrant further investigation across caregiver groups. A large-scale funded programme for caregiver research is required to ensure that studies are of high quality to inform service development across settings. [ABSTRACT FROM AUTHOR]

Aim To report a novel review to develop a health systems model of successful transition of children with complex healthcare needs from hospital to home. Background Children with complex healthcare needs commonly experience an expensive, ineffectual and prolonged nurse-led discharge process. Children gain no benefit from prolonged hospitalization and are exposed to significant harm. Research to enable intervention development and process evaluation across the entire health system is lacking. Design Novel mixed-method integrative review informed by health systems theory. Data sources CINAHL, PsychInfo, EMBASE, PubMed, citation searching, personal contact. Review methods Informed by consultation with experts. English language studies, opinion/discussion papers reporting research, best practice and experiences of children, parents and healthcare professionals and purposively selected policies/guidelines from 2002-December 2012 were abstracted using Framework synthesis, followed by iterative theory development. Results Seven critical factors derived from thirty-four sources across five health system levels explained successful discharge (new programme theory). All seven factors are required in an integrated care pathway, with a dynamic communication loop to facilitate effective discharge (new programme logic). Current health system responses were frequently static and critical success factors were commonly absent, thereby explaining ineffectual discharge. Conclusion The novel evidence-based model, which reconceptualizes 'discharge' as a highly complex longitudinal health system intervention, makes a significant contribution to global knowledge to drive practice development. Research is required to develop process and outcome measures at different time points in the discharge process and future trials are needed to determine the effectiveness of integrated health system discharge models. [ABSTRACT FROM AUTHOR]

Aims To examine the relationship between perioperative anxiety and postoperative pain in children and adolescents undergoing elective surgical procedures and the differences in children's perioperative anxiety and postoperative pain among subgroups of demographics. Background While anxiety and pain are regarded as two common problems experienced by children and adolescents perioperatively and the relationship between them has been reported in previous studies, there has been no review paper examining this phenomenon. Design A quantitative systematic review. Data sources Nine electronic databases were searched for studies published in English from the inception date of the databases to December 2010, using various combinations of search terms of 'adolescents', 'anxiety', 'child', 'pain', 'surgery' and 'correlation/relationship'. Review methods Using the Joanna Briggs Institute's comprehensive systematic review strategies, relevant studies were independently appraised and extracted by two reviewers using the standardized critical appraisal instruments and data extraction tool from Joanna Briggs Institute Meta Analysis of Statistics Assessment and Review Instrument. Results Ten studies were included in this review from 943 studies initially retrieved. Children and adolescents who had higher level of perioperative anxiety experienced a higher level of postoperative pain. Inconclusive evidence was found regarding differences of perioperative anxiety and postoperative pain between demographic subgroups of gender, age and past surgical experience. Conclusion Results of this review inform healthcare providers of the role perioperative anxiety plays on children's and adolescents' postoperative pain and indicate the need to use interventions to reduce perioperative anxiety and, therefore, optimize their postoperative pain management during the perioperative period. [ABSTRACT FROM AUTHOR]

Aim To provide a comprehensive integration of contemporary studies focusing on the relationship between obesity and asthma in paediatric populations. Background The simultaneous increase in asthma and obesity prevalence has been widely discussed over the past 20 years. Although studies have discovered a positive correlation between the two, evidence-based findings are needed to develop nursing interventions. Design A quantitative systematic review on the literature was conducted from June-December 2011. Data sources An electronic database search was conducted for studies published between January 1966-May 2011. Additional articles were identified through the reference lists of reviewed papers. Review methods Inclusion/exclusion criteria and quality appraisal were applied to ensure research primarily designed to study the relationship between obesity and asthma in children was included. Results The majority of studies support a positive association between obesity and asthma in children. Among correlates recognized as important effect modifiers, gender was the most prominent, with obese girls more likely to have asthma diagnoses than obese boys. Scrutinization of covariates in selected studies revealed that most related to children's demographic characteristics and were inconsistent across the studies. Conclusions This review was designed to integrate contemporary scientific findings on the association between obesity and asthma by including a large number of studies with variant research designs. To identify high-risk groups and develop nursing interventions to help children affected by both epidemics, more interdisciplinary and well-designed investigations focusing on an expanded spectrum of correlates including demographic and behavioural factors are warranted. [ABSTRACT FROM AUTHOR]