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Aims: This review aims to assess the effect of comprehensive nursing care on liver cancer patients undergoing interventional therapy in China. Methods: In accordance with PRISMA guidelines, we reviewed randomized controlled trials and observational studies assessing the effect of comprehensive nursing care against standard care on liver cancer patients undergoing specific interventional therapies in China, including PubMed, Embase, CENTRAL and CINAHL till June 2023. Data synthesis was conducted using a random‐effects model and reported as pooled odds ratio (OR) or mean difference (MD) or standardized mean differences (SMD). Results: Ten Chinese studies with 1682 participants were evaluated. Comprehensive nursing care significantly enhanced patient outcomes in liver cancer treatment. Quality of life improved markedly (OR: 0.16, 95% CI: 0.06–0.41). Notable reductions were observed in anxiety (MD: −8.96, 95% CI: −11.52 to −6.40) and depression (MD: −9.47, 95% CI: −11.79 to −7.14). Patients also experienced increased physical (SMD: 1.70, 95% CI: 1.15–2.25), social (SMD: 1.65, 95% CI: 1.14–2.16) and activity scores (SMD: 1.94, 95% CI: 1.49–2.39), alongside a decrease in post‐treatment complications (OR: 0.28, 95% CI: 0.21–0.37), demonstrating the multifaceted benefits of comprehensive care. Conclusion: Comprehensive nursing care may improve patient outcomes in liver cancer treatment, offering potential benefits in reducing the side effects of interventional therapy. Summary statement: What is already known about this topic? Liver cancer patients undergoing interventional therapy often experience significant physical and psychological challenges.Comprehensive nursing care has been hypothesized to offer potential benefits in addressing these challenges.There is limited evidence on the exact impacts of comprehensive nursing care on these patients, leading to knowledge gaps in its applicability and efficacy. What this paper adds? This review demonstrates that comprehensive nursing care can lead to significant improvements in the quality of life for liver cancer patients in China.This review provides evidence that comprehensive care reduces levels of anxiety and depression in these patients.This review shows that this approach boosts physical, social function and activity scores while also reducing post‐treatment complications. The implications of this paper: This paper suggests integrating comprehensive nursing care as a standard practice, given its potential to significantly improve patient outcomes and quality of life.This research emphasizes the importance of equipping oncology nurses with comprehensive care skills and expanding their roles to ensure optimal patient outcomes.Despite promising results, there is a need for further high‐quality, randomized controlled trials to confirm these findings and delve deeper into other potential benefits and best practices of comprehensive nursing care for liver cancer patients. [ABSTRACT FROM AUTHOR]

As the ageing population in China continues to grow, more people will be living with long-term health conditions and require support from family care-givers. This scoping review therefore aims to explore sources of stress and coping mechanisms adopted by care-givers of older relatives living with long-term conditions in mainland China. Literature searches were conducted in English (CINAHL, EMBASE, MEDLINE, PsycINFO and SCOPUS) and Chinese (CNKI, WANFANG DATA, CQVIP and CBM) databases between October and November 2019. The searches focused on the stressors and coping mechanisms utilised by family care-givers residing in the community. Narrative synthesis was used to identify themes within the data. Forty-six papers were included: 20 papers from English and 26 from Chinese databases. Six themes captured stressors: care-giving time (N = 22), financial resources (N = 17), role and personal strains (N = 42), preparedness (N = 4), social roles (N = 10) and lack of adequate formal support (N = 22); and one theme captured coping (N = 14). Unmet needs of care-givers of older relatives in mainland China were found to be extensive. Only a few studies had attempted to explore the causal link between stressors, coping and the influence of culture. Findings underscore the significance of adequately capturing intricacies around care-givers' unmet needs, rather than generalising on the basis of culture. Qualitative studies are critical to providing a better understanding of the relationship between stressors, coping and resources afforded to care-givers by their cultural environment. Having such understanding is crucial to inform the development of competent care, which promotes self-efficacy and self-actualisation in care-givers in mainland China. [ABSTRACT FROM AUTHOR]

Aims: This meta‐analysis aimed to synthesize the available evidence on the effectiveness of psychoeducational interventions on family function among families after stroke. Background: Family function may be improved by psychoeducational intervention, but findings about the effect of psychoeducation on family function among families after stroke have been mixed. Methods: This was a meta‐analysis carried out by searching five international electronic databases, including Cochrane Library, PubMed, EMBASE, Web of Science and CINAHL, as well as four national electronic databases, including Chinese Biological Medicine (CBM), China National Knowledge Infrastructure (CNKI), VIP and Wanfang. Two groups of researchers screened the studies independently, assessed the quality of the studies and extracted data. Meta‐analysis was performed by using the RevMan 5.3 software. Results: Five studies on psychoeducational interventions were included. Pooled analysis of these studies showed a small effect of the interventions on improving family function (WMD: −0.13, 95% CI: −0.24 to −0.01, P < 0.05). Subgroup analysis showed significant differences between the psychoeducation and control groups at 1 month postintervention (WMD: −0.12, 95% CI: −0.18 to −0.05, P < 0.05) and more than 6 months postintervention (WMD: −0.14, 95% CI: −0.24 to −0.04, P < 0.05). The psychoeducational interventions also had positive effect on improving the problem solving (WMD: −0.22, 95% CI: −0.14 to −0.03, P < 0.05) and communication (WMD: −0.23, 95% CI: −0.41 to −0.05, P < 0.05) functions of the family. There were significant differences in the group of dyad intervention (WMD: −0.14, 95% CI: −0.25 to −0.02, P < 0.05) and the group using face to face method (WMD: −0.58, 95% CI: −0.84 to −0.32, P < 0.05). Conclusions: Synthesized results demonstrated the favourable effect of psychoeducational interventions on the improvement of the family function among families after stroke, especially in terms of family problem solving and family communication. Future psychoeducational intervention research design should consider the combination of multiple intervention methods and the applicable population of intervention. Summary statement: What is already known about this topic? Good family function can promote the physical and mental health of family caregivers, improve the life quality of stroke survivors and lighten a heavy burden on the whole family.Family function may be improved by psychoeducational intervention, but findings about the effect of psychoeducation on family function among families after stroke have been mixed.What this paper adds? The psychoeducational intervention has a positive effect on family function among families after stroke, especially in terms of family problem solving and family communication.The implications of this paper: The psychoeducational intervention can be an acceptable method to improve family function among families after stroke. [ABSTRACT FROM AUTHOR]

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]

Background: Obstetric critical illness is an important factor that leads to an increase in maternal mortality. Early warning assessment can effectively reduce maternal and neonatal mortality and morbidity. However, there are multiple early warning systems, and the effect and applicability of each system in China still need to be explored. Objectives: To elaborate on the application, effectiveness and challenges of the existing early warning systems for high‐risk obstetric women in China and to provide a reference for clinical practice. Design: A scoping review guided by the Arksey and O'Malley framework and reported using the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis for scoping review (PRISMA‐ScR) guidelines. Eligibility criteria: We included original studies related to early warning and excluded those that were guidelines, consensus and reviews. The included studies were published in Chinese or English by Chinese scholars as of June 2021. Data sources: CNKI, Wanfang, VIP, Cochrane, CINAHL, Embase, PubMed and Web of Science databases were searched systematically, and the reference sections of the included papers were snowballed. Results: In total, 598 articles were identified. These articles were further refined using keyword searches and exclusion criteria, and 17 articles met the inclusion criteria. We extracted data related to each study's population, methods and results. Early warning tools, outcome indices, effects and challenges are discussed. Conclusions: Although all studies have shown that early warning systems have good application effects, the use of early warning systems in China is still limited, with poor regional management and poor sensitivity for specific obstetric women. Future research needs to develop more targeted early warning tools for high‐risk obstetric women and address the current challenges in clinical applications. [ABSTRACT FROM AUTHOR]

Introduction: Cancer patients and caregivers have myriad unmet needs which can have detrimental consequences on their psychosocial wellbeing. This systematic review aims to identify the unmet supportive care needs of immigrant and native Chinese cancer patients and caregivers. Methods: We systematically searched various electronic databases (e.g. Scopus, CINAHL, PsycInfo, etc.) from the earliest date available until January 2018. Additional studies were identified through reference lists and citation tracking. Eligibility criteria included: (a) qualitative, quantitative and/or mixed methods studies published in English; (b) immigrant and native Chinese cancer patients and/or caregivers (age ≥18 years); (c) unmet needs and/or their correlates. Studies were assessed for their risk of bias, and a narrative synthesis of findings was performed. Results: Forty‐seven papers from 45 studies met eligibility criteria. The most prevalent area of unmet needs was health system and information. Patients most commonly desired one member of the hospital to talk to about all aspects of their care. Caregivers preferred information about the patient's prognosis and likely outcome. Anxiety was most commonly associated with higher levels of health system and information needs. Conclusion: Chinese patients and caregivers experience a range of unmet health system and information needs, which differ depending on their stage along the cancer trajectory. [ABSTRACT FROM AUTHOR]

Aims and objectives: To establish an understanding of healthcare professionals' dementia knowledge and attitudes towards dementia care, and family carers' perceptions of dementia care in China. Background: Healthcare professionals and family carers of people with dementia deliver most of the dementia care in China. However, little research on healthcare professionals' dementia knowledge and attitudes towards dementia care, and family carers' dementia care perceptions has been conducted in China. Methods: An integrative review was conducted and reported based on the PRISMA guidelines and Whittemore and Knafl's framework. Eight English databases were searched without date restriction: CINAHL Plus with Full Text, MEDLINE, PubMed, Web of Science, Cochrane Library, Embase, PsycINFO and Scopus; and three Chinese databases: China National Knowledge Infrastructure, Chongqing Weipu and Wanfang, plus a manual search of reference lists. Results: Thirty‐eight primary research papers were included in the review. Three themes were identified from the synthesis: (a) knowledge and competency; (b) attitudes towards dementia care; and (c) carers' burden and unmet needs. Healthcare professionals' dementia knowledge ranged from low to moderate levels and attitudes towards dementia care were generally negative. With low levels of knowledge of dementia and negative attitudes including stigma, family carers were under stress with insufficient support, and they expected more support from community nurses. Conclusions: There is an apparent need for a national policy on healthcare professional education and training to improve dementia care practice in China. Such a policy may improve support services for family carers. Relevance to clinical practice: Nurses, and particularly community nurses, are well‐positioned to support family carers in China. However, healthcare professionals in China are not prepared for this. Therefore, education and training on dementia care should be integrated into medical and nursing undergraduate programmes and provided for healthcare professionals after commencing employment, and strategies to reduce stigma are needed. [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]

Why you should read this article?: • To familiarise yourself with the healthcare needs of overseas Chinese students • To understand the barriers experienced by overseas Chinese students when accessing UK student primary healthcare • To enhance your knowledge of strategies to increase access to healthcare services for this population Individuals from China comprise the largest cohort of international students in the UK, making up almost one quarter of those coming to the country to study. The large Chinese student population at UK universities means there are considerable numbers each year who require access to student primary healthcare. This article describes a literature and narrative review that aimed to critically review the evidence concerning whether the primary healthcare needs of overseas Chinese students studying at UK universities are being met. Three themes were identified: primary healthcare accessibility and potential barriers for overseas Chinese students; health-seeking behaviour and health needs; and cultural and spiritual foundations of health needs and trusted health-seeking frameworks. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To assess the effectiveness of different nonpharmacological treatments for severe radiation‐induced oral mucositis in patients with head and neck cancer. Background: Radiation‐induced oral mucositis is highly prevalent in patients with head and neck cancer. Current medications for radiation‐induced oral mucositis are limited in effectiveness and susceptible to side effects, and while there is an increasing adoption of nonpharmacological interventions, the optimal one remains unclear. Design: Systematic review and network meta‐analysis based on the PRISMA‐NMA guidelines. Methods: Six databases were searched. Two authors independently performed the literature screening, data extraction and methodological quality assessment of the included studies. Traditional pairwise meta‐analysis was performed by R Studio. A network meta‐analysis was then conducted to assess the effects of nonpharmacological interventions for severe radiation‐induced oral mucositis in patients with head and neck cancer. Results: Fifty‐two studies involving seven types of nonpharmacological interventions were enrolled. The network meta‐analysis indicated that natural plant‐based therapies might be the most effective, health education interventions might be the second most effective, and honey might be the third most effective interventions for reducing the incidence of severe radiation‐induced oral mucositis. For reducing the incidence of severe oral mucositis‐related pain, the pairwise meta‐analysis showed that only natural plant‐based therapies and health education interventions were effective. Conclusions: Nonpharmacological interventions are effective in the management of severe radiation‐induced oral mucositis among patients with head and neck cancer. Relevance to clinical practice: Nonpharmacological interventions are a category of safe and effective adjunctive therapies that should be encouraged in clinical practice. Trial registration details: CRD42023400745. [ABSTRACT FROM AUTHOR]

Aim: To summarize existing studies that focused on improving hospitalized patient safety through patient and family engagement interventions to identify priorities and gaps. Design: A scoping review. Methods: Eight databases and citations of important reviews were searched on 30 September 2022. Two researchers independently screened the records. Then, two researchers extracted the data and cross‐checked. The results were synthesized narratively, and a comparison was performed for studies from China and those from other countries. Results: Ninety‐eight studies were included. The results indicated that patient and family engagement interventions were applied to decrease the incidence of patient safety incidents, and to improve the healthcare providers' and patients' knowledge, attitude or practice of patient safety. Most studies only engaged patients and families at the direct care level, and the engagement strategies at the organization and health system levels were insufficient. For stakeholders, many studies failed to consider patients' perspectives in intervention design and report taking staff training as a supportive strategy. Healthcare providers, especially nurses, were the main implementers of current interventions. Certain differences were observed between studies from China and those from other countries in the above aspects. Conclusions: International interest in engaging patient and family for patient safety is growing. Future studies should enhance the patient and family engagement as a partner in various patient safety at the direct care level, and further explore the engagement at the organization and health system levels. Relevance to Clinical Practice: Nurses, as the main formal caregivers for patients, should promote patient and family engagement in patient safety, especially at direct care level. Nurse should also incorporate the perspectives of patients in the design and implementation of interventions. Reporting Method: PRISMA‐ScR Checklist. [ABSTRACT FROM AUTHOR]

Background: Education has been recognised as necessary in forming and internalising professional values. The system and instructors' content in existing educational institutions focus on developing students' knowledge, skills and practices. Still, the development of values has yet to achieve significant effects, leading to a crisis in students' professional identity. Aims: To construct a professional values growth theory for undergraduate nursing students and develop a corresponding education framework. Methods: Through the review, some databases(PubMed、CINAHL、Web of Science、Wiley and Google Scholars)were searched using a systematic search strategy to collect relevant literature on professional values education. Based on the nursing professional values growth theory (Li and Li, Nursing Ethics In press, 2022), a theory of professional values growth of nursing undergraduates was developed using the method of theory derivation. Two rounds of expert meetings were conducted to review and revise an education framework of professional values of nursing undergraduates derived from that theory. Findings: A total of 10 studies were included. The contents of two themes were analysed: theories and models and the current status of the professional values development of nursing students. The resulting professional values growth theory for undergraduate nursing students consists of five parts: key aspects, decisive opportunities, drivers, embodiment (humanistic sentiments, moral emotions), and outcomes. A total of five experts in the relevant fields were invited to this study. After two rounds of expert meetings, an education framework for undergraduate nursing students was finally developed, which consists of four parts: education objectives, education process and content, environment and conditions, and evaluation. Conclusion: The education framework developed in this study has practical implications for the development of professional values of undergraduate nursing students, providing educational strategies and methods for the growth and internalisation of professional values of undergraduate nursing students. [ABSTRACT FROM AUTHOR]

Objective: Clarifying the distinctions between art-based creative activities in the domains of occupational therapy and art therapy in the context of stroke rehabilitation, while also describing the effects of art-based creative activities on stroke rehabilitation. Design: Scoping review. Data source: A systematic search was performed in nine databases (Web of Science, PubMed, EMBASE, Cochrane Library, CINAHL and four Chinese database) from their inception to December 2023. Review methods: The study included randomized and non-randomized controlled trials involving art-based creative activities, as well as qualitative research providing detailed intervention measures. The study focused on stroke patients, with primary outcomes related to patients' physiological recovery, psychological well-being, ADL, etc. Data extraction included information on intervention strategies and study results. Results: Seventeen studies were included, extracting six similarities and differences in creative activity between two domains. Creative activities were observed to have positive impacts on daily living activities, limb motor function, fine motor ability, and emotional well-being in stroke patients. Conclusion: Creative activities, whether in occupational therapy or art therapy, involve providing participants with tangible crafting materials for the creation of artistic works. Future stroke rehabilitation practices should tailor activities and intervention focus based on patients' rehabilitation needs, preferences, and cultural background. The current comprehensive analysis provides initial support for the potential positive role of creative activities in stroke rehabilitation, but further in-depth research is needed to confirm their effectiveness. [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]

The aim of this qualitative systematic review is to analyze the barriers and facilitators to the uptake of antihypertensive medication in hypertensive patients. The databases of PubMed, Embase, Web of Science, CINAHL, Cochrane Library, MEDLINE, China National Knowledge Infrastructure, Wanfang, VIP, and Chinese Biomedical were searched from inception to June 2023. The studies were screened, extracted, and assessed independently by two researchers. Previously, the researchers used the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research to assess the quality of the included studies. A total of 27 studies were considered, resulting in two combined findings: a good level of knowledge, belief, and behavior and adequate social support were facilitators of medication adherence in hypertensive patients. In contrast, lack of medication literacy, difficulty adapting to roles, reduced sense of benefit from treatment, limited access to healthcare resources, and unintentional nonadherence were barriers. Medication adherence in hypertensive patients remains a challenge to be addressed. Future research should explore how complex interventions using a combination of evidence-based strategies and targeting multiple adherence behaviors (eg, long-term adherence to medication) are effective in improving medication adherence. [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]

Aims and Objective: To systematically review and synthesise existing qualitative research evidence describing the survival experience of patients undergoing oesophagectomy during recovery. Background: Patients with oesophageal cancer undergoing surgical treatment have severe physical and psychological burdens during the recovery period. Qualitative studies on the survival experience of patients undergoing oesophagectomy are increasing annually, but there is no integration of qualitative evidence. Design: A systematic review and synthesis of qualitative studies were conducted following the ENTREQ. Methods: Five English (CINAHL, Embase, PubMed, Web of Science and Cochrane Library) and three Chinese (Wanfang, CNKI and VIP) databases were searched for literature on the survival of patients undergoing oesophagectomy during the recovery period from its establishment in April 2022. The quality of the literature was evaluated by the 'Qualitative Research Quality Evaluation Criteria for the JBI Evidence‐Based Health Care Centre in Australia', and the data were synthesised by the thematic synthesis method of Thomas and Harden. Results: A total of 18 studies were included, and four themes were identified: physical and mental dual challenges, impaired social functioning, efforts to return to normal life, lack of knowledge and skills in post‐discharge care, and thirst for external support. Conclusions: Future research should focus on the problem of reduced social interaction during the recovery of patients with oesophageal cancer, formulating individualised exercise intervention programs and establishing a sound social support system. Relevance to Clinical Practice: The results of this study provide evidence‐based support for nurses to carry out targeted interventions and reference methods for patients with oesophageal cancer to rebuild their lives. No Patient or Public Contribution: The report was a systematic review and did not involve a population study. [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]

Objective: The objective of the study was to evaluate the effectiveness of telehealth‐based exercise intervention on pain, physical function and quality of life in patients with knee osteoarthritis. Design: A systematic review and meta‐analysis of randomised controlled trials (RCTs). Methods: Six databases (PubMed, Embase, Cochrane Library, CINAHL, PEDro and Web of Science Core Collection) were searched for relevant randomised controlled trials published from database inception to 3 June 2021. Reviewers independently screened the literature, extracted data and used the Cochrane Collaboration Risk of Bias Tool for quality assessment. A meta‐analysis and subgroup analyses, stratified by control condition, intervention duration and delivery type, were conducted by Revman 5.4. The study was reported in compliance with PRISMA statement. Results: A total of 9 independent RCTs with 861 participants were included. The meta‐analysis showed that the telehealth‐based exercise interventions significantly reduced pain in KOA patients (SMD = −0.28, 95% CI [−0.49, −0.08], p <.01) and produced similar effects to controls in terms of physical function and quality of life. Subgroup analysis revealed that telehealth‐based exercise interventions were superior to the use of exercise booklet and usual care in terms of pain and physical function and were similar to face‐to‐face exercise treatment; a long‐term (>3 months) intervention and the use of web and smartphone APPs to deliver exercise interventions were associated with better pain relief and physical function. Conclusions: Telehealth‐based exercise intervention is an effective strategy for KOA management during the COVID‐19 epidemic, and it is significantly better than usual care in reducing knee pain and improving physical function and was able to achieve the effects of traditional face‐to‐face exercise treatment. Although the duration and type of delivery associated with the effect of the intervention have been identified, patient preference and acceptability need to be considered in practice. [ABSTRACT FROM AUTHOR]

Aims: A meta‐analysis was carried out to review and identify correlates of stigma in poststroke patients. Background: Patients suffer from impaired physical functions and sequelae of stroke. Stroke‐related stigma hinders the recovery process and produces poorer clinical outcomes of stroke, leading to compromised quality of life. Design: A systematic review and meta‐analysis was reported by following PRISMA 2020 guidelines. Review Methods: Nine databases were searched from their inception to May 2021 to identify studies focused on the relationships among demographics, disease‐related factors, psychosocial factors and poststroke stigma. Included studies were assessed by using the Agency for Healthcare Research and Quality (AHRQ) scale. The statistical software R studios were used to perform statistical analysis. Results: Nineteen studies were included in the meta‐analysis. Four demographic factors (age, caregiver, residence, monthly income), seven stroke‐related characteristics (type of stroke, mRS, ADLs, stroke duration, recurrence, sequelae, chronic disease comorbidity) and three psychosocial factors (depression, social support, quality of life) showed significant associations with stroke‐related stigma. Conclusions: The results of our study can serve as a foundation for designing interventions to reduce stigma and improve the overall quality of life of poststroke patients and may produce positive clinical outcomes. Healthcare professionals should be aware of stroke patients who are characterised by correlates of stigma. Relevance to clinical practice Poststroke patients showed a moderate‐to‐high level of stigma, and this issue warrants more attention. This review provides a preliminary foundation for healthcare professionals to develop interventions to address stroke‐related stigma by focusing on demographic, disease‐related and psychosocial factors. Additionally, stigma identification should be a part of clinical nursing evaluation. The involvement of clinical and community nursing is very important to screen stroke‐related stigma and pay attention to this population. [ABSTRACT FROM AUTHOR]

Aims and objective: To synthesise current international empirical evidence on loneliness and social isolation in Chinese late‐life immigrants. Background: Loneliness causes adverse health consequences in Chinese late‐life immigrants leading to increased utilisation of often increasingly limited healthcare resources. However, little is known about how Chinese late‐life immigrants perceive and experience loneliness and social isolation in their host countries. Design: An integrative review methodology. Methods: Using a systematic search strategy, Google scholar and databases, such as Scopus, Web of Science, PubMed, CHNAHL, Medline and open access Theses were searched. No limitation was placed on publication date. Peer‐reviewed studies published from the database inception to May 6, 2021 in the English language were included. The review process is reported according to PRISMA. Results: Eight articles met the criteria and were included in this review. Two themes resulting from the data synthesis process were identified. Firstly, 'disrupted social relations after late‐life immigration' and secondly 'moving away from filial expectations'. Conclusion: Loneliness and social isolation are commonly experienced by Chinese late‐life immigrants when residing in host countries. Understanding and identification of the sources of loneliness and social isolation among late‐life immigrants are essential prompts for healthcare professionals, particularly nurses, to engage sensitively with Chinese late‐life immigrants. Nurses culturally relevant care delivery in a variety of settings may best serve recipients' social and health related needs. Relevance to clinical practice: This integrated review informs the planning of health and social services for addressing Chinese late‐life immigrants' experiences of loneliness and social isolation. Focused attention on cultural responsiveness is an important component of providing quality and safe nursing care. This review of the recent evidence on socially‐rooted health concerns affected by both immigration and ageing will help advance nursing practice in providing culturally responsive care interventions. [ABSTRACT FROM AUTHOR]

Aims and objectives: This systematic review and meta‐analysis aimed to compare the incidence of PVC‐related complications between catheterisation in the forearm and back of the hand in adult patients. Background: A peripheral intravenous catheter (PVC) is often inserted as part of care during patients' hospitalisation. The catheter is typically inserted in the forearm or at the back of the hand in usual practice. Studies have not yet reached a consensus on the optimal insertion site in any clinical setting. Design: We performed a systematic review and meta‐analysis based on PRISMA guidelines. Methods: We searched the following electronic databases: PubMed, Cochrane Library, Embase, and CINAHL. Randomised controlled trials, cohort studies, case–control studies and cross‐sectional studies from inception to July 2021 reporting the incidence of PVC‐related complications at the forearm and back of the hand were included. Fixed‐effects models and random‐effects models were used to derive the pooled risk ratios. Results: Twenty‐four studies involving 16562 PVCs met our inclusion criteria. The meta‐analysis showed that compared with PVC placement in the back of the hand, placement in the forearm was associated with a higher incidence of total complications and infiltration/extravasation. However, the differences between the PVC indwelling sites were not significant (total complications: P = 0.43; phlebitis: P = 0.35; infiltration/extravasation: P = 0.51). Both incidence of total complications and infiltration/extravasation analyses showed high heterogeneity (total complications: I2 = 60%; infiltration/extravasation: I2 = 58%). Conclusion: Available evidence suggests that there is no significant difference between PVC placement in the forearm and at the back of the hand in terms of the incidence of complications, thus making both approaches suitable. Relevance to clinical practice: For patients who need indwelling PVC, medical staff can choose the best indwelling site, and both forearm and back of the hand are suitable. [ABSTRACT FROM AUTHOR]

The objective of this scoping review was to synthesize the available evidence and evaluate the effectiveness of chronoradiotherapy interventions in cervical cancer patients. This scoping review was performed by searching in the PubMed, Cochrane Library, Embase, Web of Science, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL), China National Knowledge Infrastructure (CNKI), Wanfang, Wenpu, and Chinese Biomedical Literature (CBM) databases. Databases were searched for studies published in English or Chinese from inception to 21 May 2021, and reference lists of relevant reports were scanned. Two investigators independently screened eligible studies in accordance with predetermined eligibility criteria and extracted data. The included studies were summarized and analyzed. Five studies including a total of 422 patients with cervical cancer were included in the scoping review; four studies were Chinese, and one was Indian. Main themes identified included the efficiency of chronoradiotherapy and relevant toxic and side effects, including diarrhea toxicity, hematologic toxicity, myelosuppression, gastrointestinal mucositis, and skin reactions. Administration of radiotherapy at different times of the day resulted in similar efficacy. However, the toxic side effects of morning radiotherapy (MR) and evening radiotherapy (ER) differed, with radiotherapy in the evening leading to more severe hematologic toxicity and myelosuppression. There were conflicting conclusions about gastrointestinal reactions with chronoradiotherapy, and further studies are needed. Radiation responses may be associated with circadian genes, through the influence of cell cycles and apoptosis. [ABSTRACT FROM AUTHOR]

This scoping review explored the occupations of terminally ill Chinese adults and their caregivers. Seven databases were searched for peer-reviewed journal articles published in English or Chinese before June 2020. Of the 16 studies that met the selection criteria, only one directly used the term "occupations" while the other 15 studies contained descriptions of occupations. Eight themes were extracted and compared with existing literature. The top two reported themes were occupations surrounding life roles and tasks and those surrounding food and eating. More study is required about the occupational engagement of this client group. [ABSTRACT FROM AUTHOR]

Background: Patients with inflammatory bowel disease (IBD) are often accompanied by a more significant burden of depression or anxiety, and approximately one-third are prescribed antidepressants. However, previous studies on the efficacy of antidepressants in IBD have shown inconsistent results. Objectives: To evaluate the effect of antidepressants on depression, anxiety, disease activity, and quality of life (QoL) in IBD patients. Design: A systematic review and meta-analysis. Methods: We searched MEDLINE via Ovid, EMBASE via Ovid, the Cochrane Library, CINAHL, PsycINFO, Chinese CBM Database, China National Knowledge Infrastructure, VIP, and Wanfang Database from inception to 13th July 2022 without language restrictions. Results: In all, 13 studies containing 884 individuals were included. Compared with the control group, antidepressants were superior in reducing depression scores [standardized mean difference (SMD) = -0.791; 95% confidence interval (CI): -1.009 to -0.572; 푝 < 0.001], anxiety scores (SMD = -0.877; 95% CI: -1.203 to -0.552; 푝 < 0.001), and disease activity scores (SMD = -0.323; 95% CI: -0.500 to -0.145; 푝 < 0.001). Antidepressants had a positive effect in reaching clinical remission [risk ratio (RR) = 1.383; 95% CI: 1.176-1.626; 푝 < 0.001]. Higher physical QoL (SMD = 0.578; 95% CI: 0.025-1.130; 푝 = 0.040), social QoL (SMD = 0.626; 95% CI: 0.073-1.180; 푝 = 0.027), and Inflammatory Bowel Disease Questionnaire (SMD = 1.111; 95% CI: 0.710-1.512; 푝 < 0.001) were found in the experimental group. No significant differences were observed in clinical response (RR = 1.014; 95% CI: 0.847-1.214; 푝 = 0.881), psychological QoL (SMD = 0.399; 95% CI: -0.147 to 0.944; 푝 = 0.152), and environmental QoL (SMD = 0.211; 95% CI: -0.331 to 0.753; 푝 = 0.446). Conclusion: Antidepressants are effective for ameliorating depression, anxiety, disease activity, and QoL in IBD patients. Due to most studies having a small sample size, further well-designed studies are required. [ABSTRACT FROM AUTHOR]

Introduction: The relation between body mass index (BMI) categories and the occurrence of primary dysmenorrhea has been investigated, but the results of these studies are inconsistent and controversial. The aim of our study was to systematically review the literature and investigate the association between each category of BMI and the occurrence of primary dysmenorrhea. Material and methods: We conducted a systematic review and meta‐analysis of observational studies related to BMI and primary dysmenorrhea. Eleven databases—PubMed, Medline, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), Chinese Science and Technology Periodical Database (VIP), Chinese Biomedical Literature Database (CBM), and Wanfang database—were systematically searched from inception to March 2022. We used the 11 items recommended by the Agency for Healthcare Research and Quality to assess the quality of included studies. The Q test and the I2 test were used to evaluate the heterogeneity among studies. Odds ratios (OR) and their 95% confidence intervals (CI) were pooled by fixed‐effects models or random‐effects models. Stata software version 16.0 was used to complete the statistical analyses. Results: A total of 4181 articles were collected from the database, and 12 studies were included based on inclusion and exclusion criteria. A total of 29 647 participants were included in the study, with a mean baseline age of 17–45 years. All included literature was published between 2017 and 2021 and was conducted in six countries. Eleven included studies were of medium quality and one included study was of high quality. Being underweight may be related to the occurrence of primary dysmenorrhea (12 studies, n = 6545, OR 1.43, 95% CI 1.18–1.73). Being overweight (12 studies, n = 3098) and obesity (four studies, n = 94) may not be associated with the development of primary dysmenorrhea. Conclusions: Being underweight may increase the risk of the occurrence of primary dysmenorrhea, whereas overweight and obesity might not be associated with primary dysmenorrhea. Due to the limitations of the meta‐analysis, more studies are needed to investigate the relation between each category of BMI and the occurrence of primary dysmenorrhea. To maintain a balanced diet and an appropriate lifestyle is beneficial for people to have the normal category of BMI and live a healthy life, which may play a role in preventing the occurrence of primary dysmenorrhea. [ABSTRACT FROM AUTHOR]

Background: Knee patient-reported outcome measures (PROMs) are widely used in research in China, but there is limited evidence on the quality of cross-culturally adapted and original Chinese PROMs. We investigated Chinese language knee PROMs to provide evidence for clinicians on their quality and to guide PROM choices. Method: A systematic literature search of databases: PUBMED, CINAHL, EMBASE, and CNKI, using adequate search strings and a three-step screen process identified relevant studies. An independent standardized assessment of the selected studies based on the Evaluating the Measurement of Patient-Reported Outcomes (EMPRO) tool was performed. Inter-rater reliability was assessed using intraclass coefficients (ICC). Results: Thirty-three articles corresponding to 23 knee PROMs were evaluated with EMPRO global scores (100) ranging from 11.11 to 55.42. The attributes 'reliability,' 'validity,' and 'cultural and language adaptation' were significantly better evaluated compared to the attributes 'responsiveness,' 'interpretability,' and 'burden' (for all comparisons p < 0.0001). Moderate-to-excellent inter-rater agreement was observed with ICC values ranging from 0.538 to 0.934. Conclusion: We identified six PROMs with a minimum acceptable threshold (> 50/100). The osteoarthritis of knee and hip quality of life, the lower extremity function scale, and the Western Ontario Meniscal Evaluation tool ranked highest. Nevertheless, no single PROM had evidence encompassing all EMPRO attributes, necessitating further studies, especially on responsiveness, interpretability, and burden. We identified duplication of effort as shown by repeated translations of the same PROM; this inefficiency could be ameliorated by rapid approval of Chinese language PROMs documented on original PROM developers' platforms. [ABSTRACT FROM AUTHOR]

Falls among community-dwelling older people is a serious concern globally since they are recognized as a major cause of mortality and an increasing illness burden. This integrative review aimed to gain insight to the characteristics and effectiveness of fall prevention interventions among Asian community-dwelling older people. MEDLINE, CINAHL, Web of Sciences, and Embase databases were used to search for articles published between 2006 and 2020. The research was carried out in English or Vietnamese and combined the following inclusion criteria: fall prevention intervention, community-dwelling elderly, and results concerning fall-related outcomes. Thirteen studies from China, Thailand, Japan, and Iran met the inclusion criteria and were included in the study. The characteristics of fall prevention interventions were categorized into five main components: fall risk assessment, medication management, physical exercise, environmental modification, and health education. Overall, the effectiveness of fall prevention intervention significantly reduced fall rates and fall-related outcomes for community-dwelling older people in Asian countries. However, there were differences in intervention types, outcome measures, and time frames. This review emphasizes the importance of combined exercise intervention as an essential component in strengthening motor skills, balancing ability, and increasing physical condition. Future study should be conducted in big databases to avoid missing important studies, and additional research from Asia is essential to prepare for future challenges of reducing falls among the elderly in this area. [ABSTRACT FROM AUTHOR]

Effects of religion, spirituality and supernatural beliefs (RSS) upon health in mainland China remain poorly understood, despite strong RSS beliefs influencing Chinese society. We conducted a Chinese–English bilingual systematic review to summarize the state of RSS-health research in mainland China. Study quality was assessed using the Critical Appraisal Skills Program tool. We screened 1858 studies, 162 of which were included in the review. From 2000–2004 to 2015–2019, the number of RSS-health studies in China increased from five to 73. However, only 7% of studies were rated as higher quality. Cross-sectional and case–control studies represented the vast majority of study designs (94%) and religious affiliation was the only RSS measure for 58% of studies. Higher, moderate, and lower quality studies indicated that RSS has both beneficial and adverse health implications. RSS-health research in China has accelerated rapidly in the last 20 years, but fundamental gaps in knowledge remain. Longitudinal study designs and nuanced RSS measures are needed to advance understanding of RSS health effects in China. [ABSTRACT FROM AUTHOR]

Spirituality is recognised as a fundamental aspect of health and nursing care. Yet, there are few studies exploring how this concept may be understood outside of Western culture. This scoping review seeks to address this omission by focusing specifically on research conducted with Chinese populations. This is important because people from Chinese backgrounds (PBC) are now residing all over the world, and their spirituality and spiritual needs should be considered when providing healthcare. Adopting a purely generalist understanding and application of spirituality may not capture the cultural difference that exists between the East and West. This scoping review adopted Arksey and O'Malley's method to focus on spirituality and spiritual care among PBC in health and nursing. The systematic strategy was adopted and used to search the main databases in health and nursing. Eighteen (n = 18) empirical studies were included in the review: 11 qualitative studies and seven quantitative involving 1870 participants. The scoping review revealed that in the Chinese understanding of spirituality is an abstract and personal concept which can refer to an internal vital force, experiences of suffering, and traditional Chinese cultural and religious values. As the multidimensional understanding of spirituality and spiritual care may cause confusion, these findings may provide a direction for the researchers emphasising the need for cultural and religious sensitivity when understanding of spirituality. [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]

Aim: This review aims to demonstrate the current core competencies of the Chinese midwifery workforce and to summarize the influencing factors of core competencies. Background: Midwifery core competencies are crucial to providing high‐quality maternal and newborn health care, but little is known about the overall status of the core competencies of the Chinese midwifery workforce. Evaluation: A scoping review was conducted following the latest Joanna Briggs Institute (JBI) scoping review methodology and Preferred Reporting Items for Systematic reviews and Meta‐Analyses extension for Scoping Reviews (PRISMA‐ScR) checklist. Key issues: Forty‐one studies were included in this review. Regarding core competency assessment tools, the Midwife Core Competency Scale was used most frequently among 16 identified tools. Generally, the core competencies of the Chinese midwifery workforce were at a moderate or high level, but the competencies in pre‐pregnancy, public health care and integrative competence were relatively inadequate. The main factors influencing the core competencies of the midwifery workforce were their working years, educational level and training experience. Conclusion: This review provides a comprehensive overview of the core competencies of the Chinese midwifery workforce at the national level. Future studies are encouraged to use objective instruments to reflect core competencies and explore the intervenable influencing factors of core competencies. Implications for Nursing Management: Core competency assessment tools can be used to select the qualified midwifery workforce. Targeted core competency enhancement programmes should be formulated based on the current core competencies level and the factors influencing core competencies. [ABSTRACT FROM AUTHOR]

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Objective Sex and intimacy are basic needs and important aspects of quality of life among humans. This focus of this review was to synthesise and present the best available qualitative evidence on the sexual life experiences and needs of Chinese adults living with cancer. Moreover, the first‐hand experience, meaning and perspective about the sexual life changes and support needs during the survival and extended treatment period were synthesised in this study. Methods: A systematic review of qualitative studies was undertaken using the Joanna Briggs Institute System for the Unified Management, Assessment and Review of Information (JBI‐SUMARI). A comprehensive search of five databases: CINAHL, MEDLINE, PubMed, Scopus and Google Scholar were undertaken from 2010 until February 2020 using defined criteria. Methodological quality and data extraction were undertaken using JBI‐SUMARI. Results: Eight studies were included in the review. A total of 39 findings were extracted and aggregated into eight categories based on similarity of meaning. Three synthesised themes were generated: (i) misconceptions and lack of education or information regarding sexual activity exists for patients with cancer, (ii) concerns for overall health and well‐being as well as physical and psychological changes can alter sexual desire and behaviours in patients with cancer and (iii) lack of sexual activity and intimacy can create relationship problems. Conclusions: Sexual relationships are intimate, personal and private in Chinese culture and beliefs. Chinese adults living with cancer report many neglected issues on sexual well‐being in various domains. Adequate and consistent education about sexual intimacy issues from health care providers was identified as an important need. Unaddressed needs might affect adults' coping strategies in managing their sexual relations during various stages of cancer treatment and beyond. It must be noted that there are many Chinese ethnic minorities living with cancer outside the Greater China region. The evidence provides valuable recommendations to health care providers globally to consider the specific sexual needs and initiate culturally sensitive sexuality education and care support for Chinese adults living with cancer. [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]