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Objectives: This systematic review and meta‐analysis aimed to determine the prevalence of loneliness and social isolation among informal carers of individuals with dementia and to identify potential influencing factors. Methods: We conducted a comprehensive search across 10 electronic databases, including PubMed, Cochrane, Embase, Web of Science, PsycINFO, CINAHL, Scopus, Chinese Biomedical, China National Knowledge Internet, and WANFANG. Our search strategy covered the inception of the databases up to September 16, 2023, with an updated search conducted on March 8, 2024. Prevalence estimates of loneliness and social isolation, presented with 95% confidence intervals, were synthesized through meta‐analysis. Subgroup analyses and meta‐regression were employed to explore potential moderating variables and heterogeneity. Results: The study encompassed 27 research papers involving 11,134 informal carers from 17 different countries. The pooled prevalence of loneliness among informal carers of individuals with dementia was 50.8% (95% CI: 41.8%–59.8%), while the pooled prevalence of social isolation was 37.1% (95% CI: 26.7%–47.6%). Subgroup analyses and meta‐regression indicated that various factors significantly influenced the prevalence of loneliness and social isolation. These factors included the caregiving setting, study design, the intensity of loneliness, geographical location (continent), data collection time, and the choice of assessment tools. Conclusions: This study underscores the substantial prevalence of loneliness and social isolation among informal carers of individuals with dementia. It suggests that policymakers and healthcare providers should prioritize the development of targeted interventions and support systems to alleviate loneliness and social isolation within this vulnerable population. Key points: Informal carers of people with dementia contend with unique circumstances that render them susceptible to both loneliness and social isolation.There is a significant prevalence of loneliness and social isolation in informal carers of individuals with dementia.Several significant moderators influence the prevalence of loneliness and social isolation among informal carers of individuals with dementia.Moderator analysis can guide targeted interventions and support systems for at‐risk informal carers of people with dementia to alleviate loneliness and social isolation. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to clarify the concept of perceived health from the perspective of rural adults in China. Methods: Walker and Avant's concept analysis was applied. Findings: Perceived health from rural adults in China is a subjective assessment of their health status, which is deeply affected by Chinese traditional culture and being in a rural environment. Conclusions: Most rural adults in China could perceive their health as good or poor, however, rural areas have disadvantages in health care, geographical location, and educational resources compared with urban counterparts, which may lead to some unscientific health attitudes and lifestyles and hinder their healthcare‐seeking behaviors. Implication for Nursing Practice: To help nurses understand better the concept of perceived health with the rural background, which is different from urban areas. Perceived health provides rich information resources for nurses to carry out holistic care, and to lead rural adults in China to form a correct and positive attitude and lifestyle as possible. [ABSTRACT FROM AUTHOR]

Background: Stroke survivors might perceive their quality of life (QoL) as being affected even years after onset. The purpose of this review was to go through the literature to identify factors related to QoL for persons with stroke in China and Western countries for possible similarities and differences in their respective cultural views. Method: A narrative literature review was conducted on the papers identified by searching PubMed, EBSCO/CINAHL, EMBASE, PsycINFO, China National Knowledge Infrastructure and Wanfang Data that published up to November 2016. Factors predicting QoL after stroke were extracted, and comparisons were made between Chinese and Western studies respecting cultural aspects. Results: A total of 43 articles were included in this review, with 31 conducted in Western countries and 12 in China. Predictors of QoL included Demographic factors: age, gender, marital status, education level, socioeconomic status; Clinically related factors: severity of stroke, physical function, depression/anxiety, cognitive impairment, incontinence and other comorbidities; Environmental factors: residential status, social support, social participation; and Individual factors: coping strategies and self‐perception. Being married and resident at home might be associated with the perception of QoL differently between Chinese and Western survivors. Conclusions: Most predictors of QoL in stroke survivors were the same in China and the Western countries. However, their QoL might be predicted differently regarding to the individualistic and collectivistic cultural differences. [ABSTRACT FROM AUTHOR]

The World Health Organization recommends that women exclusively breastfeed until their babies are 6 months old and continue to breastfeed while introducing complementary foods. A meta‐aggregation methodology was used to systematically review and synthesise the qualitative studies on factors influencing breastfeeding practices of healthy Chinese women in Greater China. English and Chinese databases were searched to identify peer‐reviewed qualitative studies (published 2008–2019). Relevant data were extracted, and key themes related to factors influencing breastfeeding practices were identified. Of 7587 articles identified, 22 qualitative studies met inclusion criteria for the review, 10 of which were published in Chinese. A total of 87 themes were extracted from all included studies and classified into 9 subcategories: government enactment of policies, implementation of policies in workplaces, social expectations, social support, medical and health services, services with Chinese characteristics, breastfeeding and pumping facilities, maternal perceptions of breastfeeding and self‐efficacy to breastfeed. The nine subcategories were then grouped into four categories. Potential effect associations among these influence factors of breastfeeding practices emerged from categories and subcategories. Family members' influence on breastfeeding motivation and self‐efficacy suggest a potential benefit of breastfeeding promotion interventions targeting the whole family. The role of primary care should be fully exploited in breastfeeding promotion, including both prenatal education and post‐partum visits. Standardising the training and qualifications of maternity matrons (yuesao) and folk breastfeeding specialists (cuirushi) can promote evidence‐based approaches to facilitating breastfeeding during the confinement period. Increased availability of breastfeeding and pumping facilities in the workplace would facilitate continuing breastfeeding after returning to work. [ABSTRACT FROM AUTHOR]

Aim: To critically assess the effects of white noise on the pain level, weight gain and vital signs (heart rate, respiratory rate and oxygen saturation) of preterm infants in neonatal intensive care units (NICUs). Design: A systematic review and meta‐analysis of randomised controlled trials (RCTs). Methods: Ten databases (PubMed, Cochrane Library, Embase, Web of Science, CINAHL, PsycINFO, SinoMed, China National Knowledge Infrastructure, VIP and Wanfang Data) were systematically reviewed from inception to July 2022. Two reviewers evaluated the risk of bias separately using the Cochrane Collaboration criteria and extracted data using a predesigned information form. Results: The meta‐analysis included eight eligible RCTs. According to statistical analysis, white noise significantly affected the pain level, weight gain, heart rate, respiratory rate and oxygen saturation in preterm infants. Regardless of the outcome measurement timing, gestational age and birth weight of preterm infants, subgroup analysis demonstrated that white noise reduced the pain level, heart rate and respiratory rate and promoted weight gain in preterm infants in NICUs. Conclusion: White noise is a practical and potentially useful therapy for premature neonates in NICUs. No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

Aims: To identify the incidence, prevalence and risk factors of exposure keratopathy (EK) among critically ill patients. Design: Systematic review and meta‐analysis, in accordance with the PRISMA 2020 Statement. Methods: The Cochrane Library, PubMed, Embase, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), China Knowledge Resource Integrated Database (CNKI), Chinese Biomedical Database (CBM), Weipu Database (VIP) and WanFang Database were systematically searched from inception to June 2022. Observational studies that reported EK among paediatric and adult critically ill patients were screened and included original articles based on the inclusion criteria. Two reviewers independently completed data extraction and quality assessments. Subgroup analysis investigated potential causes of heterogeneity. Results: Of the 4508 studies identified, 23 studies involving 3519 subjects were included. The pooled prevalence of EK was 34.0%, and the pooled incidence rate of EK was 23.0%. Risk factors associated with EK in critically ill patients included lagophthalmos, chemosis, eye blinks <5 times per minute, mechanical ventilation, sedation, lower Glasgow Coma Scale (GCS) score and higher Acute Physiology and Chronic Health Evaluation (APACHE) II score. Conclusion: This review shows that EK rates are high in critically ill patients and are influenced by multiple factors. Medical staff should pay more attention to EK in critically ill patients, conduct professional evaluations and implement targeted eye care protocols to reduce its occurrence. Implications for Practice: This study shows the frequency of and multiple risk factors for EK in critically ill patients, which provides evidence‐based guidance for nurses to evaluate the risk of EK in critically ill patients and take appropriate precautions to reduce the risk. Protocol Registration: The protocol was registered in PROSPERO (https://www.crd.york.ac.uk/prospero/) (CRD42022346964). Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aim: To review the literature related to symptom management, clinical significance and related theoretical framework systems in adult patients with brain tumours. Background: As understanding of symptoms or symptom clusters and underlying biologic mechanisms has grown, it is apparent that symptom science is moving forward. Although some progress has been made in the symptom science of solid tumours such as breast and lung neoplasms, insufficient attention has been paid to symptom management for patients suffering from brain tumours. Further research is needed to achieve effective symptom management for these patients. Design: A literature review with a systematic search of symptom management in adult brain tumours. Methods: Electronic data bases were searched to obtain relevant published literature on symptom management in adults with brain tumours. This was then analysed and a synthesis of relevant findings is presented. Findings: Four significant general themes relating to symptom management of brain tumours in adults were identified: (1) The potential theoretical foundation related to symptom management was revealed. (2) Widely accepted validated scales or questionnaires for the assessment of single symptoms or symptom clusters were recommended. (3) Several symptom clusters and the underlying biologic mechanisms have been reported. (4) Specific symptom interventions for adults with brain tumours were collected and classified as evidence‐based or insufficient evidence. Conclusion: There are still many challenges in the effective management of symptoms in adults with brain tumours. The guiding role of theoretical frameworks or models related to symptom management should be utilized in future research. Using the concept of symptom clustering for research into symptoms found in patients with brain tumours, exploring common biological mechanisms for specific symptom clusters and making full use of modern big data resources to build a strong evidence base for an effective intervention or management program may inform the management of symptoms among these patients leading to better results. No Patient or Public Contribution: This is a literature review. Implications for Symptom Management: The ultimate goal is obviously not only improving the survival rate of patients with brain tumours, but also enhancing their quality of life. Several important findings from our review include the theoretical foundations, validated assessment tools, the assessment of symptom clusters and the underlying biologic mechanism, and the identification of the evidence base for symptom interventions. These are of relevance for managers, researchers and practitioners and may function as a reference to help the effective symptom management for adults with brain tumours. [ABSTRACT FROM AUTHOR]

Physical distancing and contact restrictions have been implemented in most countries and territories due to the rapid spread of SARS‐CoV‐2. This has caused physical, emotional, and psychological distress for adults living in the community. Diversified telehealth interventions have been widely applied in health care and have proven to be cost‐effective and well accepted by patients and health professionals. Currently, the effectiveness of telehealth interventions on psychological outcomes and quality of life among community adults during the COVID‐19 pandemic remains unclear. A literature search was conducted using PubMed, PsycINFO, CINAHL, EMBASE, MEDLINE, and the Cochrane Library from 2019 to October 2022. Twenty‐five randomized controlled trials with 3228 subjects were finally included in this review. Two independent reviewers performed the screening, extraction of key data points, and appraisal of the methodological quality. There were positive effects of telehealth interventions on anxiety, stress, loneliness, and well‐being among community adults. Participants who were women or older adults were more likely to recover from negative emotions, increase well‐being, and improve quality of life. The real‐time and interactive interventions and remote cognitive‐behavioural therapy (CBT) may be better choices during the COVID‐19 pandemic. Based on the findings of this review, health professionals have more options and alternatives for delivering telehealth interventions in the future. Rigorously designed randomized controlled trials (RCTs) with higher statistical power and long‐term follow‐up should be conducted in the future to strengthen the currently weak evidence. [ABSTRACT FROM AUTHOR]

Objectives: More people with dementia live in low‐ and middle‐income countries (LMICs) than in high‐income countries, but best‐practice care recommendations are often based on studies from high‐income countries. We aimed to map the available evidence on dementia interventions in LMICs. Methods: We systematically mapped available evidence on interventions that aimed to improve the lives of people with dementia or mild cognitive impairment (MCI) and/or their carers in LMICs (registered on PROSPERO: CRD42018106206). We included randomised controlled trials (RCTs) published between 2008 and 2018. We searched 11 electronic academic and grey literature databases (MEDLINE, EMBASE, PsycINFO, CINAHL Plus, Global Health, World Health Organization Global Index Medicus, Virtual Health Library, Cochrane CENTRAL, Social Care Online, BASE, MODEM Toolkit) and examined the number and characteristics of RCTs according to intervention type. We used the Cochrane risk of bias 2.0 tool to assess the risk of bias. Results: We included 340 RCTs with 29,882 (median, 68) participants, published 2008–2018. Over two‐thirds of the studies were conducted in China (n = 237, 69.7%). Ten LMICs accounted for 95.9% of included RCTs. The largest category of interventions was Traditional Chinese Medicine (n = 149, 43.8%), followed by Western medicine pharmaceuticals (n = 109, 32.1%), supplements (n = 43, 12.6%), and structured therapeutic psychosocial interventions (n = 37, 10.9%). Overall risk of bias was judged to be high for 201 RCTs (59.1%), moderate for 136 (40.0%), and low for 3 (0.9%). Conclusions: Evidence‐generation on interventions for people with dementia or MCI and/or their carers in LMICs is concentrated in just a few countries, with no RCTs reported in the vast majority of LMICs. The body of evidence is skewed towards selected interventions and overall subject to high risk of bias. There is a need for a more coordinated approach to robust evidence‐generation for LMICs. Key points: While the majority of people with dementia reside in low‐ and middle‐income countries (LMICs), it is not known what types of interventions have been studied in these settings and how effective they are.We conducted the first comprehensive mapping study of interventions for people with dementia or mild cognitive impairment (MCI) and/or their carers in LMICs.This high‐level overview of dementia intervention research in LMICs identified the following gaps: dementia intervention research is highly concentrated in just a few LMICs, and skewed towards Traditional Chinese Medicine, Western pharmaceuticals, and supplements, with comparatively little evidence generated on interventions for carers.Lack of robust and locally relevant evidence on effective interventions presents a substantial challenge to designing evidence‐based treatment and care systems that help people with dementia or MCI and their carers to live better lives. [ABSTRACT FROM AUTHOR]

Introduction: Maintaining care for elderly individuals in rural areas is heavily dependent on support from informal caregivers. Many informal caregivers of the elderly in rural areas feel burdened and urgently require professional support. Interests in telehealth that can provide support irrespective of geographical location have been increasing. Objective: To identify the benefits of and barriers in telehealth engagement for rural caregivers to provide evidence for service improvement. Design: A scoping review method was used following PRISMA‐ScR guidelines and Arksey and O'Malley's five‐stage framework. Five databases were searched. The search terms were chosen based on the target intervention (i.e. telehealth), target population (caregivers of elderly individuals) and target context (rural areas). Two authors independently assessed the eligibility of studies and extracted data from eligible studies. Findings: Of 4220 retrieved studies, 19 articles met the inclusion criteria. This study identified four benefits of and two barriers to telehealth for rural caregivers. Four subthemes were identified as the key benefits in using telehealth for caregivers: decrease in psychological distress, increase in care efficiency, increase in social support and increase in access to resources, while inadequate telehealth infrastructures and caregivers' own reasons were the primary barriers in using telehealth for those populations. Conclusions: Telehealth was shown to significantly benefit rural caregivers. Future research can be designed and conducted for overcoming the barriers to telehealth. Additionally, the benefits identified by this review need to be translated from research into practice for rural caregivers' care. [ABSTRACT FROM AUTHOR]

Background: Recently, the attempts to promote advance care planning (ACP) and advance directives (ADs) have appeared in mainland China. However, anecdotal evidence suggests that the concept of ACP and ADs is not widely known to the public and healthcare professionals. Aim: To examine and synthesise currently available research about ACP and ADs for older people in mainland China, and to discuss implications for future nursing practice and research. Design: An integrative literature review. Methods: A systematic search was conducted in seven English electronic databases (CINAHL, MEDLINE, ProQuest, Cochrane, JBI, Scopus and Wiley) and four Chinese electronic databases (CNKI, Wanfang, VIP and CBM). Eligible articles were critically appraised using the Mixed Methods Appraisal Tool (MMAT). Findings: From various groups including older people, families and healthcare professionals, low levels of knowledge and awareness about ACP and ADs are reported. Demographic characteristics such as age, gender, education and clinical conditions were related to positive or negative attitude towards ACP. The main reason people cited for being 'reluctant/fairly reluctant' to make an AD was that they were 'Not familiar with it'. Conclusions: Given that older people showed positive attitudes towards ACP, policy support and practice guidelines about ADs and ACP are necessary to respect their wishes and to guide healthcare professionals in mainland China. [ABSTRACT FROM AUTHOR]

With the increase in our older adult population, there is a need for dementia training for informal and formal dementia caregivers. The objective of this scoping study is to assess dementia knowledge instruments utilized in educational programs and interventions intended for formal and informal dementia caregivers. Scoping review methodology was used to search PubMed, PsycInfo, CINAHL and Web of Science with tailored database search terms. The search yielded 8101 results, with 35 studies meeting inclusion. Studies were conducted in eight countries, had varying study designs (randomized controlled trials [RCTs] = 9, non‐RCTs = 6, one‐group study design = 20) and utilized previously published (19) and author developed (16) instruments. Furthermore, the studies were internationally diverse, conducted in the United States (n = 18), Australia (n = 7), UK (n = 3), China (n = 2), Canada (n = 2), Taiwan (n = 1), Brazil (n = 1) and multi‐country (n = 1). Only two studies focused on minority populations. While author‐developed instruments may be more relevant and timesaving, studies should strive to validate instruments or use previously published instruments to help standardize findings across studies and understand better the effects of educational programs on caregiver knowledge. Geriatr Gerontol Int 2020; 20: 397–413. [ABSTRACT FROM AUTHOR]

Aim: Ethnic Chinese women are one of the populations at high risk of gestational diabetes mellitus (GDM) internationally. This systematic review aimed to determine which dietary intervention strategies were found to be effective in improving glycaemic control and pregnancy outcomes among ethnic Chinese women with GDM. Methods: The review protocol was registered with PROSPERO (CRD42016043585). Eight English and four Chinese language databases were searched for randomised controlled trials and cohort studies of dietary intervention among ethnic Chinese women with GDM. Review Manager 5.3 and GRADE criteria were used in meta‐analysis and assessment of quality of evidence. Results: Included studies comprised 3944 women in 29 eligible studies. Compared to standard treatment, low glycaemic index (GI) diets, low glycaemic load (GL) diets and fibre‐enriched diets were associated with a reduction in fasting plasma glucose, 2‐hour plasma glucose and HbA1c, and improved neonatal outcomes. Low GL diets were associated with reduced caesarean section risk. Conclusions: In ethnic Chinese women with GDM, low GI diets, low GL diets and fibre‐enriched diets were associated with improved glycaemic control and pregnancy outcomes. Given the lack of direct comparison of these three diets, future direct comparison trials are necessary to determine optimal dietary intervention strategies. [ABSTRACT FROM AUTHOR]

Abstract: Background and purpose: Over the last 500 years, the most earthquakes with 10,000 or more fatalities and the most overall fatalities have occurred in China. Physical therapists must develop a better understanding of the patient and injury types that they are likely to treat post‐earthquake disasters. This systematic review of Chinese and Western literature identified the primary patients treated by physical therapists post‐earthquake disasters for injuries that negatively impacted physical function, activity, and participation. Methods: Comparisons were made between reports of earthquakes in China and reports from the rest of the world combined. Results: Sixty‐seven studies of 71,986 patients (51.8% male) at 40.6 ± 15 years of age were included. Studies were mostly prospective (n = 48, 71.6%). Reports of earthquakes in China represented more recently occurring disasters (p = .003) and more prospective research designs (p = .003). Reports from China also had a higher median fracture number (p = .004). Studies from China used manual muscle testing (p = .02), visual analogue pain scales (p = .008), Barthel index or modified Barthel index (p < .0001), and joint motion assessment (p = .007) with greater frequencies. Discussion: Physical therapists from China are more likely to treat patients with a fracture; however, physical therapists from both regions are likely to treat patients with general injuries representing poly‐trauma to multiple body regions, traumatic brain‐closed head injuries, spinal cord injuries, peripheral nerve injuries, and soft tissue injuries. Implications on physiotherapy practice: These data can help improve earthquake disaster planning, infrastructure development, and resource needs assessment effectiveness. More prospective research study designs and more recent earthquake disasters in China are likely associated with greater explicit use of valid and reliable outcome measurements such as joint motion assessment, manual muscle testing, visual analogue pain scale, and the Barthel index or modified Barthel index. [ABSTRACT FROM AUTHOR]

Background Health-care professionals worldwide have started to appreciate patients' perspectives on the use of complementary and alternative medicine ( CAM) particularly given its popularity. However, cultural perspectives may vary and it may not be possible to apply research findings on the use of CAM from the west to the east. Objective This systematic review aims to synthesize usage patterns of traditional Chinese medicine ( TCM) amongst Chinese populations in different parts of the world and explore potential geographical variations. Search strategy Six international and four Chinese databases were searched, and manual searches of relevant monographs and government publications were carried out. Inclusion criteria Quantitative, qualitative or mixed-method research that aimed to investigate Chinese patients' perception of, and perspectives on, TCM was included. Data extraction and synthesis For each study included, texts under the headings of 'results' or 'findings' were extracted and subjected to analysis. A thematic synthesis approach was adopted for synthesizing qualitative and quantitative studies. Main results Amongst the 28 studies included, twenty were quantitative surveys, six were qualitative studies and two were mixed-method studies. The overall methodological quality was mediocre. Data synthesis suggested that patients from all regions share a common cultural affinity to TCM and consider it to be an effective complement to western medicine (WM) for treating chronic or serious diseases. However, heterogeneous views on (i) disclosing TCM use to WM doctors and (ii) the potential harm of herbs emerged across different study locations. Discussion and conclusions Future research should explore how variation in health systems may influence patients' perception of CAM in different countries. [ABSTRACT FROM AUTHOR]