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Total knee arthroplasty (TKA) is considered a common surgical option in patients with end-stage osteoarthritis of the knee. This systematic review and meta-analysis aimed to determine the effectiveness of cognitive behavioral therapy (CBT) for patients after TKA. PubMed, EMBASE, the Cochrane Library, Web of Science and CINAHL were searched for randomized controlled trials (RCTs) from inception to 20 August 2021. Included studies were evaluated with the Cochrane risk-of-bias tool. Six RCTs were included. Our study results demonstrated that a significant reduction in pain catastrophing was seen in patients receiving CBT at post-intervention (SMD −0.48, 95% CI = −0.72 to −0.23, I2 17.2%, p = 0.00) but not in 3-month or 12-month follow-up. There were no significant differences between CBT and usual-care patients regarding pain intensity or knee function at different time-points. This is the first time that meta-analysis has been conducted to determine the effectiveness of CBT for patients after TKA. It is necessary to conduct longer follow-ups, include larger samples and conduct rigorous RCTs to further explore this issue. [ABSTRACT FROM AUTHOR]

Background: Several factors are associated with the incidence of burnout, including alexithymia, social support, and depression. The relative importance of these three key parameters as mediators of burnout, however, is not well understood. In addition, there have been few studies to date specifically examining the association between alexithymia and burnout among nurses in China. Purpose: To evaluate the relationship of burnout with alexithymia, social support, and depression across emergency department nurses in China. Methods: This descriptive, cross-sectional survey was conducted using a convenience sampling methodology to survey nurses responsible for direct emergency care (n = 413) from 18 tertiary hospitals in Western, Eastern, Northern, and Southern China between May 2020 and June 2020. A structural equation modeling approach was then used to assess a hypothetical model wherein alexithymia both directly and indirectly affects burnout among emergency nurses via impacting the incidence of depression and perceived social support. Results: Results supported all driving hypotheses. Alexithymia was positive direct correlated with burnout (β = 0.35; P < 0.001) and depression (β = 0.50; P < 0.001), and exhibited a negative direct effect on social support (β = − 0.14; P = 0.041). Depression was associated with burnout, both directly (β = 0.24; P < 0.001) and indirectly (β = 0.15; P < 0.001) through its relationship with social support. Alexithymia was the factor most strongly associated with burnout, and it was able to affect burnout indirectly through depression and social support. Conclusions: We found that among emergency nurses in China, alexithymia was correlated with burnout, depression, and social support. Alexithymia was the factor most strongly associated with burnout. These data suggest that providing better social support and alleviating alexithymia may decrease rates of burnout among emergency nurses. [ABSTRACT FROM AUTHOR]

Aims and Objectives: This study aimed to understand the risk factors that contribute to medical device‐related (MDR) nasal mucosal membrane pressure injuries (MM PI) in ICU patients. Background: ICU patients require substantial tube‐based life support such as oxygen tubes, tracheal intubation and indwelling gastric tubes. As a result, there is an increased risk of PI occurrence; however, few studies have assessed the risk factors associated with nasal mucosal MDR‐MMPI in ICU patients. Design: A cross‐sectional study design was performed. Methods: From January 2019 to June 2020, data from 912 patients treated in the ICU of a tertiary first‐class a hospital in China were collected. The occurrence of PI of the nasal mucosa was obtained by nasopharyngoscope when replacing the nasal catheter fixation patch every day. The study methods were followed by the STROBE guidelines. Results: The incidence of nasal mucosal MDR‐MM PI was 10.9%. The degree of nasal mucosal MM PI was mainly grade 1 (62cases, 62.6%), and no grade 4 were observed. The columella (58 cases, 58.6%) was the most common site of nasal mucosal MM PI followed by the anterior septum (18 cases, 18.2%). A high patient APACHE‐Ⅱ score, the disturbance of consciousness, a history of diabetes, days of gastric tube indwelling, hypoproteinemia, fever (T > 37.5℃) and the use of vasoconstrictors were identified as significant influencing factors of nasal MM PI in ICU patients (p <.05). Conclusions: A high APACHE‐Ⅱ score, disturbance of consciousness, history of diabetes, days of gastric tube indwelling, hypoproteinemia, fever (T > 37.5℃) and use of vasoconstrictive drugs were risk factors for nasal mucosal MDR‐MM PI in ICU patients. This study informs on the risk factors of nasal mucosal MM PI that will allow medical support staff to carry out key interventional measures to prevent nasal mucosal MM PI. Relevance to clinical practice: This study illustrates the characteristics and risk factors of nasal mucosal pressure injury in intensive care units, potentially contributing to the prevention of the incidence of nasal mucosal MDR‐PI in ICU patients. [ABSTRACT FROM AUTHOR]

Background: The first step in preventing pressure injuries (PIs), which represent a significant burden on intensive care unit (ICU) patients and the health care system, is to assess the risk for developing PIs. A valid risk assessment scale is essential to evaluate the risk and avoid PIs. Objectives: To compare the predictive validity of the Braden scale and Waterlow scale in ICUs. Design: A multicentre, prospective and cross‐sectional study. Methods: We conducted this study among 6416 patients admitted to ICUs in Gansu province of China from April 2021 to October 2022. The incidence and characteristics of PIs were collected. The risk assessment of PIs was determined using the Braden and Waterlow scale. The sensitivity, specificity, positive and negative predictive values, and the area under the receiver operating characteristic curve of the two scales were compared. Results: Out of 5903 patients, 72 (1.2%) developed PIs. The sensitivity, specificity, positive and negative predictive, and the area under the curve of the Braden scale were 77.8%, 50.9%, 0.014 and 0.996, and 0.689, respectively. These values for the Waterlow scale were 54.2%, 71.1%, 0.017, 0.994 and 0.651. Conclusions: Both scales could be used for risk assessment of PIs in ICU patients. However, the accuracy of visual inspection for assessment of skin colour, nursing preventive measures for patients and scales inter‐rater inconsistency may limited the predictive validity statistics. Relevance to Clinical Practice: Both scales could be used for PIs risk assessment. The low specificity of the Braden scale and low sensitivity of the Waterlow scale remind medical staff to use them in combination with clinical judgement and other objective indicators. Patient or Public Contribution: This study was designed to enhance the management of PIs. Patients and the general public were not involved in the study design, analysis, and interpretation of the data or manuscript preparation. [ABSTRACT FROM AUTHOR]

• This study provides the latest evidence on the level of life space mobility of community elderly people. • The life space mobility of community elderly people is at a moderate level globally, with 42% of them living in a state of restricted life space. • The level of life space mobility among community elderly people gradually achieved stability after 2017. • South America, females and earlier survey years have a lower level of LSM. Multiple countries have conducted surveys on the level of life space mobility for community-dwelling elderly through the Life-Space Assessment, the results vary greatly, from 41.7 to 88.6. However, there is no meta-analysis on the current situation of community-dwelling elderly life space mobility. To systematically assess the global level of life space mobility for community-dwelling elderly, to identify potential covariates such as geographical regions, survey years, gender, and age that contribute to the heterogeneity between the studies, and to identify the dynamic trend based on survey years. Systematic review and meta-analysis. Two reviewers searched the following 8 electronic bibliographic databases from inception until May 28, 2023: PubMed, The Cochrane Library, Web of Science, Embase, Chinese Biomedical Database, China Knowledge Resource Integrated Database, WanFang, and Weipu Database. This review was conducted using the Stata 14.1 and R 4.3.1. The Cochrane's Q statistical and I2 index were used to test for heterogenicity and assess the degree of heterogenicity, respectively. Studies were appraised using the Agency for Healthcare Research and Quality tool, the Newcastle-Ottawa Scale for the quality of cross-sectional studies, cohort studies, respectively. A total of 29 studies were selected from databases and reference lists. The pooled score of Life-Space Assessment was 66.84 (95% CI: 63.30–70.39) and the prevalence of restricted life space was 42% (95% CI: 0.27–0.57). The geographical regions, survey years, gender were found to be a significant covariate of the pooled score of life space mobility estimate in the subgroup analysis. The mean score of Life-Space Assessment gradually achieved stability after 2017. The life space mobility of community-dwelling elderly in the global is at a moderate level, with 42% of them experiencing restricted life space. South America, females and earlier survey years have a lower level of life space mobility. In the future, the government should identify vulnerable groups for targeted intervention to promote the level of LSM in the community-dwelling elderly. PROSPERO [CRD42023443054]. [ABSTRACT FROM AUTHOR]