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Aim: To determine the effectiveness of brief reminiscence‐based psychosocial interventions in alleviating psychological distress in cancer patients. Background: Cancer patients suffer tremendous psycho‐spiritual pain, which affects their quality of life. Brief reminiscence‐based psychosocial interventions have demonstrated positive effects on the mental health of cancer patients; however, the efficacy of these interventions has been inconsistent. Design: A systematic review and meta‐analysis. Methods: This review was conducted and reported in accordance with the PRISMA 2020 checklist provided by the EQUATOR network. The Cochrane Library, Web of Science, PsycINFO, PubMed, Embase, CINAHL and Scopus databases were systematically searched from inception to 27 November 2022 to identify randomised controlled trials (RCTs) published in English. Results: Twenty studies involving 1744 cancer participants were included. The meta‐analysis showed statistically significant effects of brief reminiscence‐based psychosocial interventions on hope, anxiety and depression at post‐intervention. A separate analysis revealed that brief reminiscence‐based psychosocial interventions had a sustainable effect on hope, spiritual well‐being, anxiety and depression at 1 month after the intervention. However, no statistically significant effect on quality of life was found in our study either immediately after the intervention or at 1 month. Conclusions: Brief reminiscence‐based psychosocial interventions can significantly reduce anxiety and depressive symptoms and improve hope and spiritual well‐being in cancer patients. Relevance to Clinical Practice: This study further supports that brief reminiscence‐based psychosocial interventions should be incorporated into the routine care of cancer patients to address their psychosocial distress. Patient or Public Contribution: All authors of this article contributed to the study conception and design. All authors of the included studies provided original data for this paper. [ABSTRACT FROM AUTHOR]

Introduction: Art therapy (AT) has been widely utilized as a therapeutic approach for clinical nurses. In recent years, more and more researchers have applied art therapy to enhance clinical nurses' mental well‐being. However, many studies conducted in this area have suffered from limited sample sizes and insufficient research evidence. Aim: This study aims to conduct a systematic evaluation of the efficacy of art therapy on the mental health of clinical nurses. Methods: RCTs on art therapy for clinical nurses were searched across databases such as PubMed, Embase, etc., the results were analysed using RevMan 5.3. Results: There were 19 RCTs encompassing 1338 clinical nurses involved in this analysis. The Meta‐analysis revealed that art therapy exhibited a significant reduction in anxiety levels (measured by the SAS) among clinical nurses, as well as depression levels and perceived stress levels (measured by the CPSS). Furthermore, art therapy demonstrated a reduction in negative coping style and an improvement in positive coping style. Discussion: Findings indicate that art therapy can reduce anxiety, depression and stress levels in clinical nurses, while also enhance positive coping styles and promote mental well‐being. Therefore, the widespread implementation of art therapy in this context is highly recommended. Declaration: I hereby declare that my article is directly relevant to the field of mental health nursing. It highlights the critical importance of psychological well‐being and supplements the evidence on The effects of art therapy on the occupational mental health of clinical nurses. [ABSTRACT FROM AUTHOR]

Background: Sleep disturbance is highly prevalent among post‐operative cardiac patients, with negative impacts on surgical recovery and rehabilitation. Post‐operative pain and anxiety commonly seen in cardiac surgery patients are associated with poor sleep. Sleep medications commonly used are not ideal with prolonged usage, and non‐pharmacological interventions can be good alternatives or complements. Aim: To examine effectiveness of non‐pharmacological interventions in post‐operative cardiac settings on sleep quality, pain intensity and anxiety. Design: Systematic review and meta‐analysis. Methods: PubMed, CENTRAL, Embase, CINAHL, Scopus, CNKI and ProQuest Dissertations and Theses were searched on 12 October 2022. Randomised controlled trials of non‐pharmacological interventions examining sleep quality for adult post‐operative cardiac patients were included. Included studies were appraised using Cochrane Risk of Bias tool version 1. Meta‐analysis was conducted using RevMan version 5.4.1, and heterogeneity was assessed using I2 statistics and Cochran Q's test. Results: Eighteen studies involving 1701 participants were identified. Coronary artery bypass graft was most common. Non‐pharmacological interventions varied in types and duration. All intervention groups were compared to usual care, placebo, no interventions or active comparators. Statistically significant improvement in sleep quality (SMD = −.91, 95% CI = −1.17 to −.65) was found among intervention groups that explored cognitive behavioural therapy, relaxation techniques, exercise, massage, acupressure, aromatherapy, music, eye mask and earplugs. Pain intensity was reduced (SMD = −.63, 95% CI = −1.05 to −.20) with cognitive behavioural therapy, relaxation techniques, massage, music and eye mask. Anxiety was improved (SMD = −.21, 95% CI = −.38 to −.04) with exercise and music. Conclusion: The overall use of non‐pharmacological interventions can optimise sleep after cardiac surgery. Further research with greater methodological rigour is needed to investigate different intervention‐related characteristics while considering potential confounders. Relevance to Clinical Practice: Post‐operative cardiac settings can consider incorporating non‐pharmacological interventions. Patients and healthcare providers can be better informed about the use of such interventions to improve sleep. Registration: PROSPERO CRD42022384991. [ABSTRACT FROM AUTHOR]

Aims and objectives: To examine the effectiveness of family‐centred interventions among family caregivers. Background: Family‐centred interventions are an emerging form of intervention that can be effective at improving physical and mental health outcomes for patients and family caregivers. To date, no reviews have examined the effectiveness of family‐centred interventions for family caregivers. Design: A systematic review, including a meta‐analysis, was conducted according to the Preferred Reporting Items for Systematic reviews and Meta‐Analyses (PRISMA 2020) checklist. Methods: Seven English and two Chinese electronic databases were compressively searched from the outset to March 2023. Two researchers independently reviewed the abstracts and full texts, extracted the data and assessed the risk of bias independently by using the Cochrane 'Risk of bias assessment tool'. Results: This systematic review and meta‐analysis included 20 articles. The results of the meta‐analysis showed that family‐centred interventions could significantly improve caregiver burden (p=0.003), quality of life (p = 0.007), depression (p = 0.0002), and stress (p < 0.0001) but not anxiety or family functioning. According to our subgroup analysis, the family‐centred empowerment model (p = 0.009) was superior to the other family intervention (p=0.004) in reducing caregiver burden. Family‐centred interventions are more effective at reducing the burden of caregiving on family caregivers of adolescent patients (SMD=−0.79, 95% CI[−1.22,−0.36], p = 0.0003) than on adult patients (SMD=−0.37, 95% CI [−0.61,−0.12], p = 0.004). Conclusions: Family‐centred interventions could enhance family caregivers' burden, quality of life, stress and depression but had no significant impact on anxiety or family functioning. Relevance to Clinical Practice: Family‐centred interventions have the potential to improve the health status and caregiving burden of family caregivers. Rigorous and high‐quality evidence is needed to confirm the long‐term effects of these interventions on family caregivers. Trial Registration Details: The protocol has been registered in the PROSPERO international prospective register of systematic reviews (Protocol registration ID: CRD42023453607). [ABSTRACT FROM AUTHOR]

Aims: This study aimed to (i) evaluate the effectiveness of mindfulness‐based interventions in improving self‐efficacy, reducing stress and anxiety among peritoneal dialysis patients, and (ii) compare the most effective method of mindfulness based interventions. Methods: This randomized three‐arm controlled trial recruited first‐time peritoneal dialysis patients from the peritoneal dialysis outpatient clinic in Singapore. Patients were randomly allocated to either video‐assisted mindfulness training, therapist‐assisted mindfulness training or treatment‐as‐usual. All groups received 4.5 days of structured peritoneal dialysis training at the peritoneal dialysis centre, while video‐assisted mindfulness training and therapist‐assisted mindfulness training groups were taught additional mindfulness‐based techniques. The perceived stress scale, self‐efficacy, and anxiety (State and Trait Anxiety Inventory) were measured at baseline, 4‐ and 12 weeks post‐randomization, using reliable and valid instruments. Results: Thirty‐nine patients were recruited (13 in each group). All the therapies showed a significant time trend in anxiety. Only therapist‐ and video‐assisted mindfulness training showed a significant trend in perceived stress scale scores but not treatment‐as‐usual. All Intervention X Time interactions were not significant. Patients in therapist‐ and video‐assisted mindfulness training groups had reduced perceived stress scale scores compared to treatment‐as‐usual at week 12. Conclusion: This study demonstrated the potential of mindfulness‐based interventions in reducing stress among first‐time PD patients. Summary Statement: What is already known about this topic? Mindfulness‐based interventions have been recommended to mediate stressful events.Mindfulness‐based interventions as complementary therapy can be taught to patients who are starting peritoneal dialysis for the first time; however, the best method to guide mindfulness‐based interventions is unknown. What this paper adds? The findings showed that mindfulness‐based interventions can potentially reduce stress and anxiety but have no statistically significant effect on self‐efficacy for patients undergoing peritoneal dialysis for the first time.Video‐ or therapist‐guided mindfulness training is just as effective in teaching mindfulness‐based interventions. The implications of this paper: Nurses hold an essential role in improving the experience of patients undergoing peritoneal dialysis by advocating and facilitating the use of MBI during dialysis, especially those who display high levels of stress and anxiety, as well as signs of coping issues. [ABSTRACT FROM AUTHOR]

Aim: To understand the content and context of a realized peer mentor intervention, and to explore how mentors and mentees experienced the intervention. Design: The study was designed as a qualitative process evaluation of a 24-week peer mentor intervention. Methods: Semi-structured individual interviews were conducted from November 2021 to May 2022 in a purposeful sample of older vulnerable people with ischemic heart disease, referred to as mentees (n = 13), and their peer mentors (n = 12). Thematic analysis was used to analyse, categorize and interpret interview data. Results: Five themes captured the content and context of the peer mentor intervention as experienced by mentors and mentees. 'Takes one to know one', stressing the importance of the mentor--mentee matching process; 'Varying demand for mentors', illustrating the difficulties in predicting who has the greatest need for mentoring; 'Varying degree of familiarity', describing the mentor--mentee relationship as a continuum from formal mentor to informal friend; 'Putting the patient first', illustrating how mentors support mentees based on their personal experiences of successful recovery while letting the mentee set the pace and goals; and 'Varying view of success', showing how intervention success is perceived differently by mentors and mentees. Conclusions: The study provides new knowledge on how and under what contextual circumstances a mentor intervention works. These findings are important for the implementation of future peer mentor interventions to achieve successful peer mentor support. Implications and Impact: Non-attendance and drop-out from the cardiac rehabilitation program are prevalent problems among older vulnerable people with cardiovascular disease. This study describes a low-cost peer mentor intervention that can support this group of patients. Reporting Method: Standards for reporting qualitative research (SRQR) guided our study. Patient or Public Contribution: A board of cardiovascular patients have contributed to the development and implementation of the intervention being evaluated. [ABSTRACT FROM AUTHOR]

Background: Pain and anxiety management in patients undergoing medical and surgical procedures is an important competence area for nurses. Aim: This study aimed to determine and compare the effects of virtual reality and acupressure interventions on pain, anxiety, vital signs and comfort levels in the process of femoral catheter extraction for patients undergoing coronary angiography. Methods: The study was a single‐blind, three‐group, randomized controlled trial conducted in the cardiology clinics of a university hospital in 2021. A total of 153 patients (51 virtual reality, 51 acupressure, 51 control) participated in the study. Data were collected using a Visual Analogue Scale, the State–Trait Anxiety Inventory, a vital signs follow‐up form and the Perianesthesia Comfort Scale. Results: Both intervention groups had significantly lower pain and anxiety scores, as well as higher comfort scores, compared to the control group (p < 0.001). The virtual reality group had lower systolic blood pressure, respiratory rate and pulse rate than the control group (p < 0.05). The acupressure group had lower systolic and diastolic blood pressure and respiratory rate than the control group (p < 0.05). Conclusions: While neither intervention group was found to be superior to the other, both interventions improved vital signs and comfort levels by reducing pain and anxiety. Summary statement: What is already known about this topic? Uncontrolled pain and anxiety during medical and surgical procedures may increase the risk of complications and have negative effects on the pulmonary and cardiovascular systems, leading to changes in vital signs and compromising patients' hemodynamics.Virtual reality has demonstrated its potential to restore cognitive attention capacities, enabling patients to remain engaged and mentally focused during procedures, and thus reducing pain and anxiety.Acupressure, as a non‐pharmacological intervention, involves applying pressure to specific points on the body to alleviate pain and anxiety. It constitutes a safe, side‐effect‐free and cost‐effective option for improving patient outcomes.What this paper adds? This paper contributes to the knowledge of virtual reality and acupressure interventions as non‐pharmacological approaches that nurses can safely incorporate within their independent professional roles.The study evaluates the effects of traditional acupressure and technological virtual reality interventions on patients, comparing the two interventions for the first time to the best of our knowledge. Furthermore, to the best of our knowledge, these procedures were applied for the first time in femoral catheter extraction after coronary angiography.The implications of this paper: This study emphasizes the positive impacts of virtual reality and acupressure interventions administered by nurses for patients undergoing medical procedures.Overall, the findings suggest that non‐pharmacological techniques such as virtual reality and acupressure can contribute to a similar degree in improving patient outcomes during medical procedures. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the impact of a virtual reality (VR) intervention on adult patients' preoperative anxiety, heart rate, respiration rate and blood pressure. Design: A systematic review and meta‐analysis of randomized controlled trials (RCTs). Data Sources: A librarian‐designed search of the Cochrane Library, PubMed, Web of Science, EMBASE, CINAHL, CBM, CNKI and Wanfang databases was conducted to identify research studies in English or Chinese on RCTs from their inception to 31 May 2022. Detailed search strategies and the checklist are provieded in Supplementary files S1 and S2. Review Methods: Two researchers independently screened eligible studies. The Cochrane Handbook for Systematic Reviews of Interventions was used to assess the risk of bias in the included studies. A fixed‐ or random‐effects meta‐analysis model was used to determine the pooled mean difference based on the results of the heterogeneity test. Results: This study included 11 articles with a total of 892 participants. VR distraction comprised five studies, and VR exposure consisted of six studies. The results indicated that VR could reduce preoperative anxiety in adult patients and VR exposure seems to be more effective. The results also indicated that VR intervention can effectively reduce patients' heart rate and blood pressure compared to traditional intervention methods, but had no significant effect on respiration rate. Conclusion: VR technology could relieve preoperative anxiety in adult patients through distraction or exposure. More well‐designed RCTs containing a wider range of surgical types are needed to verify our findings before we can make strong recommendations. Impact: Our systematic review and meta‐analysis show a positive effect of VR distraction and exposure interventions in reducing preoperative anxiety in adult patients. We suggest incorporating VR into preoperative procedures as an auxiliary way to reduce negative emotions in eligible patients. No Patient or Public Contribution: Our paper is a systematic review and meta‐analysis and such details do not apply to our work. [ABSTRACT FROM AUTHOR]

Aims: To evaluate the effects of couple‐based dyadic interventions on breast cancer patients and their intimate partners and compare the effects between interventions with different durations (<3 months; =3 months; >3 months). Design: A systematic review and meta‐analysis. Data sources: Six English databases, PubMed, Embase, Web of Science Core Collection, the Cochrane Library, Medline, PsycINFO, and three Chinese databases, China National Knowledge Infrastructure (CNKI), WanFang, and Weipu (VIP), from database inception to 19 February 2022. Review Methods: The quality of the included RCTs was evaluated using the Cochrane risk‐of‐bias tool and the data analysis was performed by using RevMan 5.4 and Stata 15. The outcomes were categorized into five aspects: dyadic relationship, overall quality of life (QOL), physical health, psychological health and social adjustment. Results: Nineteen RCTs were included. For patients' overall effects, couple‐based dyadic interventions can improve sexual frequency, psychological health (anxiety; depression; well‐being; body image) and social adjustment (family function‐cohesion; social function‐total). In the subgroup analysis, it can adjust patients' relationship satisfaction (>3 months), sexual frequency (>3 months), depression (<3 months and >3 months), well‐being (>3 months), and body image (3 months). For intimate partners, no statistically significant overall effects were found, and all results in the subgroup analyses showed no statistical significance. Conclusions: The results revealed the different effects of couple‐based dyadic interventions on dyads. It also suggested that tailored intervention duration should be a focus in future studies to obtain the potential actor‐partner benefits. Impact: This study revealed that the overall effects of the couple‐based dyadic interventions include enhancing patients' sexual frequency, psychological health and social adjustment. Clinical practitioners should consider the intimate partners' outcomes and conduct couple‐based dyadic interventions that contain more tailored elements to achieve better effects. No Patient or Public Contribution: Registration: The systematic review and meta‐analysis of RCTs has been registered in PROSPERO (Number: CRD 42021286679). [ABSTRACT FROM AUTHOR]

Aims and Objectives: Evidence suggests that preparing patients for surgery using nonpharmacological strategies reduces their anxiety. However, there is no consensus on what the best practices are. This study aims to answer the question: Are interventions using nonpharmacological therapies effective in reducing preoperative anxiety? Background: Preoperative anxiety causes physiological and psychological adverse effects, with a negative effect on postoperative recovery. Introduction: According to the World Health Organization, between 266 and 360 million surgical procedures are performed annually worldwide, and it is estimated that more than 50% of patients will experience some degree of preoperative anxiety. Design: Systematic review of systematic reviews with results of interventions aimed at mitigating preoperative anxiety. Methods: A search was conducted for systematic reviews with meta‐analyses published between 2012 and 2021 in Medline, Scopus, Web of Science and Cochrane Library. Quality was assessed using the AMSTAR‐2 scale. The protocol was registered in PROSPERO. Results: A total of 1016 studies were examined, of which 17 systematic reviews were selected, yielding 188 controlled trials with 16,884 participants. In adults, the most common intervention included music, followed by massage, in children virtual reality and clowns. Almost all controlled trials reported a reduction in preoperative anxiety after the intervention, of which almost half had statistically significant results. Conclusion: Interventions that include music, massage and virtual reality reduce preoperative anxiety and have shown that they are cost‐effective, minimally invasive and with a low risk of adverse effects. Preoperative anxiety can be reduced through a short‐term intervention involving nursing professionals as an alternative or complement to drugs. Relevance to clinical practice: This review suggests that nursing professionals, in collaboration with other health professionals, should continue to conduct research on the reduction in preoperative anxiety. Further research in this area is needed, to reduce heterogeneity and consolidate the results. No Patient or Public Contribution: Not applied to our study, as it is a systematic review of systematic reviews. [ABSTRACT FROM AUTHOR]

Background: A range of psychological issues often accompany breast cancer chemotherapy. Due to their ubiquity, mobile phones have been used to deliver supportive interventions addressing these issues. However, we currently lack sufficient evidence to guide the design of such interventions. Aim: To analyse and synthesise available evidence on the effectiveness of mobile‐phone‐based (mHealth) interventions in alleviating the psychological issues experienced by women receiving chemotherapy for breast cancer. Methods: A systematic literature search was conducted from 14 relevant databases. Revman 5.4 was used to pool the quantitative results from comparable studies for statistical meta‐analysis. For clinically heterogeneous studies where statistical pooling of results was not possible, a narrative summary was used to present the findings. Results: The review included nine RCTs which covered 1457 patients. The meta‐analysis results indicated a significant improvement in the quality of life (standardised mean difference [SMD] = 0.32, 95% confidence interval [CI] [0.07, 0.58], p =.01, I2 = 17%). No significant effects were found for anxiety (SMD = −0.01, 95% CI [−0.26, 0.25], p =.96, I2 = 53%) and depression (SMD = 0.02, 95% CI [−0.17, 0.20], p =.87, I2 = 0%). Individual studies suggest reduced symptom prevalence (p =.033, d = 0.27), symptom distress (p =.004, d = 0.34), symptom interference (p =.02, d = 0.51), supportive care needs (p <.05, d = 2.43); improved self‐efficacy (p =.03, d = 0.53), self‐esteem (p <.001, d = 0.87) and emotional functioning (p =.008, d = 0.30). The methodological quality ranged from low to moderate. Conclusion: mHealth interventions might help address certain psychological issues experienced by this population, although the evidence is still being gathered and not yet conclusive. More rigorous trials are warranted to confirm the suitable duration while addressing the methodological flaws found in previous studies. PROSPERO registration number: CRD42021224307. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to determine the effect of web‐based patient education on anxiety in patients scheduled for thyroid surgery. A secondary aim was to evaluate the patients' postoperative recovery outcomes. Design: This study is a randomized controlled trial. Method: The study was conducted at a university hospital in Turkey between September 2018 and May 2019 with 76 patients scheduled for thyroidectomy surgery and randomly assigned into two groups. Patients in the intervention group received web‐based education, while those in the control group were given only routine care. Measurements were performed before surgery, on the day of surgery, and 1 week after discharge. Results: On the day of surgery, intervention group anxiety levels were lower than those of the control group, and the majority of early recovery parameters were significantly better in the intervention group than in the control group. One week after discharge, the intervention group patients' anxiety levels were significantly lower. Web‐based education had no impact on pain, time in the operating room, readmission to the hospital after discharge, or length of hospitalization. Conclusions: Nurse‐led web‐based education reduced patients' anxiety regarding surgery. The results also show that it may improve postoperative early recovery. Summary statement: What is already known about this topic? Preoperative anxiety can be associated with numerous symptoms, and recovery time may be prolonged but preoperative information is effective in reducing patient anxiety and hastening early recovery.Nurses have active roles in patient education and the information given by the nurse during preparation for surgery process can positively impact patient health outcomes.As technology has advanced, methods used by patients for acquiring information have changed, and written materials have been replaced by online platforms. What this paper adds? Nurse‐led patient education can exert positive effects on surgical patients.Web‐based education reduces patients' anxiety about surgery compared with the traditional approach. The implications of this paper: Nurse‐led web‐based patient education can be a useful method for reducing patients' anxiety and improving early recovery.Nurses can use this research to develop innovative approaches to the education of perioperative patients. [ABSTRACT FROM AUTHOR]

Introduction: Patients under spinal anaesthesia experience high levels of anxiety during surgery. Clinical nurses tried to manage patient's anxiety under spinal anaesthesia using non‐pharmacological interventions for its benefit. Thus, it is required to identify comprehensive evidences of various non‐pharmacological interventions and of how to measure anxiety under spinal anaesthesia. Aims: This study aims to review current research on the non‐pharmacological interventions to relieve intraoperative anxiety under spinal anaesthesia and to identify subjective and objective measures of intraoperative anxiety under spinal anaesthesia. Methods: Wittemore and Knafl's integrative review methodology was used. Researchers conducted five scientific rigor steps; problem identification, searching literature, evaluation of literature, analysis of literature and presentation of results. The PRISMA checklist was used. To evaluate the level of evidence, critical appraisal tools of Joanna Briggs Institute were used. Results: Eleven studies were included in this integrative review. Delivering music is the most frequently used as non‐pharmacological intervention by researchers. They tried to manage intraoperative anxiety under spinal anaesthesia with using diverse genre and application of music. In addition, dry cupping method, progressive muscle relaxation (PMR) exercise and virtual reality (VR) goggles were used in included studies. Researchers measured intraoperative anxiety under spinal anaesthesia with objective or subjective way. The State‐Trait Anxiety Inventory and visual analogue scale were used as subjective method to approach intraoperative anxiety. In contrary, researchers tried to obtain objective evidence of intraoperative anxiety with vital signs, cortisol, blood glucose, alpha‐amylase and adrenocorticotropic hormone. Conclusion: Various types of non‐pharmacological interventions are effective to manage patient's intraoperative anxiety under spinal anaesthesia. It is recommended to measure intraoperative anxiety under spinal anaesthesia with using both objective and subjective methods. Relevance to Clinical Practice: Clinical nurses can use non‐pharmacological interventions to manage intraoperative anxiety under spinal anaesthesia by comprehensive monitoring with diverse measures. [ABSTRACT FROM AUTHOR]

Background: To evaluate how effective preparatory interventions for paediatric day surgery are at reducing parents' anxiety and stress and children's pain and fear. Methods: A systematic review was conducted according to Joanna Briggs Institute (JBI) guidelines and reported using the PRISMA 2020 checklist. PubMed, CINAHL (EBSCO), Scopus, Medic and Web of Science were screened for original research published up until December 2020, while Mednar and EBSCO Open Dissertations were used to identify any relevant grey literature. The methodological quality and risks of bias were evaluated according to JBI guidelines by two authors. The eligibility criteria were parents of a preschool (2‐ to 6‐year‐old) child going through day surgery with preparatory interventions, outcomes measured anxiety, stress (parent), fear and pain (child), and randomised controlled trial (RCT). Results: Two thousand and three hundred and fourteen RCTs were screened. Fifteen studies (including 1514 participants) were chosen for narrative synthesis of parental anxiety and stress and children's fear and pain. Nine studies underwent a meta‐analysis of parental anxiety (n = 970). The interventions were categorised as functional, informative or a combination of both. Four interventions reduced parents' anxiety while two significantly alleviated children's postoperative pain. The interventions found to be effective combined various ways of providing information. The meta‐analysis did reveal a statistically significant impact on parents' anxiety (SMD =0.22, 95% Cl [0.03, 0.41], z = 2.28, p =.023). None of the studies dealt with parental stress or fear in children. Conclusions: The studied interventions used various preparatory approaches, some of which were effective at reducing parental anxiety. More RCT studies are needed to find the most effective methods for preparing parents and their children for day surgery. Relevance to Clinical Practice: Preparation for day surgery through appropriate interventions can reduce anxiety among parents and postoperative pain in children. [ABSTRACT FROM AUTHOR]

Aims: To systematically review existing evidence and assess the effectiveness of Acceptance and Commitment Therapy for people with advanced cancer. Design: Systematic review and meta‐analysis of randomized controlled trials. Data Sources: Nine databases, including PubMed, Web of Science, Cochrane Library, Embase, CINAHL, PsycINFO, Chinese National Knowledge Infrastructure, VIP Database and Wanfang, were searched. The search covered the period between the inception of the selected databases and August 2022. Review Methods: Two authors independently examined eligible studies and appraised the methodological quality of the included studies by applying the criteria suggested by the Cochrane Effective Practice and Organization of Care followed by data abstraction. The Template for Intervention Description and Replication (TIDieR) checklist was used to identify intervention characteristics. Meta‐analysis was performed using RevMan 5.4 software, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to evaluate the certainty of evidence. Results: Eight studies, involving 488 people with advanced cancer, were included. The results showed significant effects of Acceptance and Commitment Therapy on the improvement of quality of life and the alleviation of anxiety, depression, psychological distress and fatigue in people with advanced cancer. However, its effects in relieving psychological flexibility and pain were not statistically significant. The certainty of the evidence was low to moderate. Conclusion: People with advanced cancer can benefit from Acceptance and Commitment Therapy, which is conducive to improving their health outcomes. Impact This review provides evidence about the effectiveness of Acceptance and Commitment Therapy in people with advanced cancer. Further well‐designed studies with larger sample sizes are required. This review may help nurses and researchers to design and implement Acceptance and Commitment Therapy in clinical practice, thereby improving health outcomes in this population. PROSPERO Registration Number: CRD42021244568. [ABSTRACT FROM AUTHOR]

Aim and Objectives: To conduct a systematic review and meta‐analysis to evaluate the effects of cold application on pain and anxiety reduction after chest tube removal (CTR). Background: The act of removing the chest tube often causes pain among cardiothoracic surgery patients. Most guidelines regarding CTR do not mention pain management. The effects of cold application on reducing pain and anxiety after CTR are inconsistent. Design: Systematic review and meta‐analysis. Methods: We searched six databases, including Embase, Ovid Medline, Cochrane Library, Scopus, the Index to Taiwan Periodical Literature System and Airiti Library, to identify relevant articles up to the end of February 2021. We limited the language to English and Chinese and the design to randomised controlled trials (RCTs). All studies were reviewed by two independent investigators. The Cochrane Collaboration's tool was used to assess the risk of bias, Review Manager 5.4 was used to conduct the meta‐analysis. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology was used for assessing certainty of evidence (CoE). Results: Ten RCTs with 683 participants were included in the meta‐analysis. The use of cold application could effectively reduce pain and anxiety after CTR. The subgroup showed that a skin temperature drops to 13°C of cold application was significantly more effective for the immediate reduction in pain intensity after CTR compared with control group. The GRADE methodology demonstrated that CoE was very low level. Conclusion: Cold application is a safe and easy‐to‐administer nonpharmacological method with immediate and persistent effects on pain and anxiety relief after CTR. Skin temperature drops to 13°C or lasts 20 min of cold application were more effective for immediate reduction of pain intensity following CTR. Relevance to clinical practice: In addition to pharmacological strategy, cold application could be used as evidence for reducing pain intensity and anxiety level after CTR. [ABSTRACT FROM AUTHOR]

Aims: To evaluate the effectiveness of virtual reality (VR) intervention in the management of pain, anxiety and fear in paediatric patients undergoing needle‐related procedures. Design: A systematic review and meta‐analysis of randomized controlled trials (RCTs). Data sources A librarian‐designed search of the Cochrane Library, PubMed, Web of Science, EMBASE, CINAHL, CBM, CNKI, and Wanfang databases was conducted to identify research articles in English or Chinese on RCTs up to February 28, 2022. Review methods: Two researchers independently screened eligible articles. The Cochrane Handbook for Systematic Reviews was used to assess the risk of bias in the included studies. A fixed‐ or random‐effects meta‐analysis model was used to determine the pooled mean difference based on the results of the heterogeneity test. Results: A total of 2269 articles were initially screened. The meta‐analysis included data from 27 studies representing 2224 participants. Compared with the non‐VR group, the VR intervention group significantly reduced pain, anxiety, and fear in paediatric patients who underwent puncture‐related procedures. Subgroup analysis showed that VR has advantages over conventional and other distraction methods. Conclusion: Paediatric patients undergoing needle‐related procedures would benefit from VR interventions for pain, anxiety and fear management. Impact VR intervention has the potential to reduce pain, anxiety and fear in paediatric patients undergoing puncture‐related procedures. Future clinical interventions could incorporate VR into puncture procedures as an effective method to reduce negative emotions in children eligible for VR distractions. Patient or Public Contribution: Our paper is a systematic review and meta‐analysis and such details don't apply to our work. [ABSTRACT FROM AUTHOR]

Background: Games are increasingly being used as a means of alleviating pain and anxiety in paediatric patients, in the view that this form of distraction is effective, non‐invasive and non‐pharmacological. Aims: To determine whether a game‐based intervention (via gamification or virtual reality) during the induction of anaesthesia reduces preoperative pain and anxiety in paediatric patients. Methods: A systematic review with meta‐analysis of randomised controlled trials was performed in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta‐Analyses) guidelines and using RevMan software. The review was based on a search of the EMBASE, CINAHL, Medline, SciELO and Scopus databases, conducted in July 2021. No restriction was placed on the year of publication. Results: 26 studies were found, with a total study population of 2525 children. Regarding pain reduction, no significant differences were reported. For anxiety during anaesthesia induction, however, a mean difference of −10.62 (95% CI −13.85, −7.39) on the Modified Yale Preoperative Anxiety Scale, in favour of game‐based intervention, was recorded. Conclusions: Game‐based interventions alleviate preoperative anxiety during the induction of anaesthesia in children. This innovative and pleasurable approach can be helpful in the care of paediatric surgical patients. Relevance to clinical practice: In children, preoperative management is a challenging task for healthcare professionals, and game‐based strategies could enhance results, improving patients' emotional health and boosting post‐surgery recovery. Distractive games‐based procedures should be considered for incorporation in the pre‐surgery clinical workflow in order to optimise healthcare. [ABSTRACT FROM AUTHOR]

Aims: This integrative review aimed to identify, analyse and synthesise studies investigating the clinical efficacy of virtual reality (VR) distraction for children undergoing varying painful and anxiety‐inducing medical procedures across different hospital settings and to identify implications for research and clinical practice. Background: Virtual reality has been leveraged as a distraction tool in the healthcare setting to help patients manage procedural pain and anxiety. Initial studies in the burn wound care setting using VR as a non‐pharmacological analgesia led to the use of VR during other medical procedures. Design: An integrative review of the literature was conducted following the PRISMA guidelines across four electronic databases. Published studies between 2000 and 2020 investigating the clinical efficacy of VR in managing paediatric procedural pain or anxiety were included for review. Results: Reviewed studies collectively included 2,174 patients aged 6 months‐18 years used VR during burn wound care, post‐burn physiotherapy, dental, needle‐related and other procedures. Additionally, ten studies included samples with adults, for which paediatric data could not be isolated (n = 507). Overall, studies supported the efficacy of VR in managing procedural pain and anxiety in the paediatric setting. Conclusion: Virtual reality is redefining pain management by immersing children in a virtual world, reducing pain and anxiety at the hospital. A notable gap was the neglected use of VR in children with chronic conditions receiving orthopaedic procedures as part of their standard care. Relevance to Clinical Practice: Ultimately, VR distraction will reduce the fear associated with medical interventions, preventing increased pain sensitivity, exacerbated anxiety and healthcare avoidance in adulthood. Nurses will play an important role in ensuring the smooth integration of VR in clinical practice by championing the technology and transferring evidence‐based methods for VR use. [ABSTRACT FROM AUTHOR]

Aims and objectives: To review the literature regarding the effects of mirror exposure on behaviour and obese patients. The review explored how mirror exposure influences behaviour in obese patients in terms of activity level, psychology and eating habits. Background: Obesity is a major epidemic that affects people worldwide but is more predominant in the Western world. Many health issues are directly linked to obesity, and current therapies have failed to provide a sustainable resolution to this problem. Mirror exposure has been used in eating disorders such as anorexia nervosa, bulimia and binge eating; however, there exists a gap in the use of mirrors in obese patients. The literature review focuses on the effects of mirror exposure on behaviour and obese patients. Method: A literature review of articles published between 2006 and 2020 related to mirror exposure in obese patients and the related effects. Results: Literature that explicitly discussed mirror exposure in obese patients was included; five research articles were reviewed. Conclusions: Mirror exposure can influence behaviour modification in obese patients. Therefore, the use of mirrors should be considered as an adjunct therapy in this group of patients. Relevance to clinical practice: Mirror exposure can positively alter behaviour in obese patients and can be used as an intervention in clinical practice to assist in weight loss and improve health outcomes. [ABSTRACT FROM AUTHOR]

Aims: This review aims to examine updated evidence to evaluate the effectiveness of caregiver‐mediated exercise interventions on basic and extended activities of daily living (ADL), anxiety and depression of post‐stroke rehabilitation individuals. Design: A systematic review and meta‐analysis. Data sources Six electronic databases, including CINAHL, CENTRAL, Embase, PubMed, PsycINFO and Scopus, grey literature and trial registry were searched from inception until February 2021. Methods: Only randomized controlled trials written in English were included. Meta‐analyses were conducted for basic and extended ADL, anxiety and depression outcomes using RevMan software. Overall quality of evidence was assessed using Grading of Recommendations, Assessment, Development and Evaluation framework. Results: A total of 11 randomized controlled trials comprising 2120 participants were identified, with 10 trials meta‐analysed. Meta‐analyses indicated statistically significant effects favouring caregiver‐mediated exercise interventions for basic ADL. Subgroup analyses revealed significant effects for exercise‐only interventions mediated by caregivers for basic ADL. No significant effects were found for extended ADL, anxiety and depression for stroke survivors. Conclusion: Caregiver‐mediated exercise interventions appear to have beneficial impacts on basic ADL for stroke survivors, suggesting caregiver‐mediated exercise interventions as a potentially feasible way to improve functional independence. Impact Caregiver‐mediated intervention with exercises as a major component could be a promising approach to augment stroke rehabilitation. Future research should include high‐quality studies with focus on specific intervention components or to explore caregiver outcomes. [ABSTRACT FROM AUTHOR]

Aims: To find out which variables may be associated with comfort of patients in an epilepsy monitoring unit. Design: Exploratory, quantitative study design. Methods: Data were collected from October 2018 to November 2019 in Austria and Southern Germany. A total of 267 patients of 10 epilepsy centres completed the Epilepsy Monitoring Unit Comfort Questionnaire which is based on Kolcaba's General Comfort Questionnaire. Secondary data analysis were conducted by using descriptive statistics and an exploratory model building approach, including different linear regression models and several sensitivity analyses. Results: Total comfort scores ranged from 83 to 235 points. Gender, occupation and centre turned out to be possible influential variables. On average, women had a total comfort score 4.69 points higher than men, and retired persons 28.2 points higher than high school students ≥18 years. Comfort scores of younger patients were lower than those of older patients. However, age did not show a statistically significant effect. The same could be observed in marital status and educational levels. Conclusion: When implementing comfort measures, nurses must be aware of variables which could influence the intervention negatively. Especially, high school students ≥18 years should be supported by epilepsy specialist nurses, in order to reduce uncertainty, anxiety and discomfort. But, since the identified variables account only for a small proportion of the inter‐individual variability in comfort scores, further studies are needed to find out additional relevant aspects and to examine centre‐specific effects more closely. Impact: Nurses ensure patient comfort during a hospital stay. However, there are variables that may impair the effectiveness of the nursing measures. Our study showed that the experience of comfort was highly individual and could be explained by sociodemographic variables only to a limited extent. Nurses must be aware that additional factors, such as the situation in the individual setting, may be relevant. [ABSTRACT FROM AUTHOR]

Aims and Objectives: The aim of the study was to determine the effect of a care programme based on the Comfort Theory on reducing parental anxiety forming during the perioperative process of paediatric day surgery. Background: According to the Comfort Theory, nurses provide comfort and take precautions related to comfort, and they provide care and assistance by encouraging individuals/families/society and supporting coping methods. This study is the first randomised controlled study to test the effect of a nursing care programme based on the Comfort Theory for paediatric day surgery. Design: Randomised controlled trial. Methods: The research was completed from June–September 2019 with participation of parents whose children were undergoing paediatric day surgery at a hospital in the Mediterranean region of Turkey. A total of 120 participants were randomly assigned to two equal groups. The intervention group received care programme based on Comfort Theory. The control group received nursing care routinely provided in the clinic. Data were collected using the State‐Trait Anxiety Inventory. Measures were obtained at six points, at baseline, at four interval observations after the initial point and during follow‐up on the 10th postoperative day. The repeated measures ANOVA test and t‐test for independent samples were used to compare the anxiety levels between the intervention and control groups. Results: There was a statistically significant difference in favour of the group receiving the care programme based on the Comfort Theory when the anxiety levels between the intervention and control groups were compared. Conclusions: The care programme based on the Comfort Theory was effective in reducing parental anxiety forming in the perioperative process of paediatric day surgery. Relevance to clinical practice: The results of this study show the applicability of the care programme for paediatric day surgery. It is recommended that this programme be introduced to nurses in paediatric day surgery. [ABSTRACT FROM AUTHOR]

Aims: Secondary prevention of coronary heart disease is of utmost importance to facilitate people to achieve health outcomes and behaviours. This study was to investigate the effect of a nursing intervention based on Cox's interaction model of client health behaviour to improve health outcomes and behaviours of secondary prevention of coronary heart disease. Design: This study is a cluster randomised controlled trial. Methods: Participants were recruited between August and November 2019 in two community settings in Hengyang city, Hunan province, China. Participants in the intervention group received a nursing intervention based on Cox's interaction model of client health behaviour and routine health education, while those in the control group received routine health education only. The outcome variables included self‐management, physical activity, medication compliance, anxiety, sexual knowledge, the ability to identify sexual health education needs, blood pressure, body mass index (BMI), and low‐density lipoprotein cholesterol (LDL‐C). The influential statistical tests applied to analyse the data included χ2 tests and t tests. Results: Seventy‐seven participants completed this study. Compared with the control group (n = 40), the intervention group (n = 37) showed statistically significant better health outcomes and behaviours regarding self‐management, physical activity (except for high energy consumption), medication compliance, anxiety, sexual knowledge, the ability to identify sexual health education needs, systolic blood pressure, BMI, and LDL‐C. However, there was no statistically significant difference in diastolic blood pressure and high energy consumption for physical activity. Conclusion: A well‐developed nursing intervention based on Cox's interaction model of client health behaviour could successfully improve health outcomes and behaviours of secondary prevention of coronary heart disease. Such an intervention may be incorporated into community healthcare practice by nurses to improve patient care. Impact: This study provides a valuable insight to facilitate further development of effective nursing interventions to improve secondary prevention of coronary heart disease in community settings. [ABSTRACT FROM AUTHOR]

Aims: The aim of this review and meta-analysis is to analyse the effectiveness of nursing interventions for the management of preoperative anxiety in adults. Background: The perioperative process is a stressful situation for many people who are going to be operated and it can generate feelings of anxiety. Also, preoperative anxiety can appear in the perioperative period. Nursing management of preoperative anxiety through individualized interventions can be effective for reducing anxiety. Design: A systematic review with meta-analysis was performed. Data sources: CINAHL, CUIDEN, Pubmed, ProQuest and Scopus databases were consulted without restriction per year of publication. The search was conducted in February 2020. Review methods: Experimental studies on nursing management in preoperative anxiety with adults sample (>18 years) published in English and/or Spanish were included. All types of surgery were included in the review. A random effects meta-analysis was performed to estimate the effect size for preoperative anxiety measured with STAI. Results: After the selection process n = 9 quantitative studies with nursing interventions for preoperative anxiety were included. A preoperative educational and informative interview was used in six studies, one study used empathic interview, one used motivational interview and one used hand massage. The meta-analysis, including four studies using nursing interviews, had a sample of n = 419 in the intervention group and n = 445 in the control group. The mean difference in preoperative state anxiety measured with the STAI was in favour of the nursing intervention. Conclusion: Nursing interventions for patients who are going to be operated seems to have a positive impact in their preoperative anxiety. However, due to the low number of studies and the heterogeneity of the sample, more research is needed about the topic. [ABSTRACT FROM AUTHOR]

Aim and objectives: This study was conducted to determine the effect of showing images of the foetus to the pregnant women with the virtual reality glass during labour process on labour pain, childbirth perception and anxiety level. Background: Virtual reality is an effective and inexpensive method that allows the creation of simulated scenarios in which it interacts with the virtual environment with multisensory stimuli. Design: This is a randomised controlled experimental study. This study was conducted with the guidelines of Consolidated Standards of Reporting Trials (CONSORT). The study was enrolled in the Clinical Trials database (NCT04664114). Methods: The study included 100 pregnant women (50 intervention group and 50 control group). Ultrasound images of the foetus were recorded on the 28th week of pregnancy of the women in the intervention group. These images were shown to the women with the virtual reality glass during labour process. Routine procedures were carried out for the women in the control group. The Visual Analog Scale (VAS) was applied to both groups when cervical dilatation was 4 cm and 9 cm. The Women's Perception for the Scale of Supportive Care Given During Labor (POBS) and the Perinatal Anxiety Screening Scale (PASS) were applied almost two hours after labour. Results: The VAS scores of the women in the intervention group with 9 cm dilatation and their PASS mean scores were significantly lower than women in the control group while their POBS score were significantly higher (p < 0.01). Conclusion: The results of this study show that showing images of the foetus to women with virtual reality decreased labour pain and anxiety level. Relevance to clinical practice: It is known that supportive care given during labour is important both for the mother's and baby's health. Therefore, it is important that nurses and midwives, who spend the most time with women and provide the most support, reduce the pain and anxiety of the woman with nonpharmacological practices and make them feel positive feelings about delivery. [ABSTRACT FROM AUTHOR]

Aims: To examine the efficacy of an immersive virtual reality distraction compared with an active non‐immersive distraction, such as video games on a tablet, for pain and anxiety management and memory of pain and anxiety in children requiring percutaneous bone pins and/or suture removal procedures. Design: Three‐centre randomized clinical trial using a parallel design with two groups: experimental and control. Methods: Study to take place in the orthopaedic department of three children hospital of the Montreal region starting in 2019. Children, from 7–17 years old, requiring bone pins and/or suture removal procedures will be recruited. The intervention group (N = 94) will receive a virtual reality game (Dreamland), whereas the control group (N = 94) will receive a tablet with video games. The primary outcomes will be both the mean self‐reported pain score measured by the Numerical Rating Scale and mean anxiety score, measured by the Child Fear Scale. Recalls of pain and anxiety will be measured 1 week after the procedure using the same scales. We aim to recruit 188 children to achieve a power of 80% with a significance level (alpha) of 5%. Discussion: While multiple pharmacological methods have previously been tested for children, no studies have evaluated the impact of immersive virtual reality distraction for pain and anxiety management in the orthopaedic setting. Impact: Improved pain management can be achieved using virtual reality during medical procedures for children. This method is innovative, non‐pharmacological, adapted to the hospital setting, and user‐friendly. Trial Registration: NCT03680625, registered on clinicaltrials.gov. [ABSTRACT FROM AUTHOR]

Aim: To quantify the effect of mind–body interventions on stress in pregnant women. Design: A systematic review and meta‐analysis of randomized controlled trials was performed. Data Sources: PubMed, Embase, CENTRAL, Web of Science and PsycINFO were searched from each database inception to January 2020. Review methods: Randomized controlled trials regarding mind–body interventions for stress in pregnant women were included. Methodological quality was evaluated using the Cochrane Collaboration 'Risk of Bias' tool and meta‐analysis was performed via RevMan 5.3. Subgroup analysis and publication bias assessment were conducted. Post hoc sensitivity analysis was performed to investigate the source of heterogeneity. Results: In total, 28 studies comprising 1944 participants were included. The overall meta‐analysis showed that antenatal stress of pregnant women in the mind–body interventions groups showed significant high improvements (SMD=−0.94; 95% CI [−1.25, −0.63]; p <.00001) compared with the control groups. Results of subgroup analyses indicated that all types of mind–body interventions including mindfulness intervention, cognitive behavioural therapy, relaxation techniques and yoga were beneficial to antenatal stress. Both groups and individual formats mind–body interventions were effective. 4–8 weeks mind–body interventions were seemed as the optimal choice. Moreover, mind–body interventions were concomitant with reducing antenatal anxiety and depression. Conclusion: Mind–body interventions are promising approaches for stress reduction in pregnant women. Nevertheless, the results should be interpreted with caution because of high heterogeneity and publication bias. Further high‐quality studies are needed to verify the findings. Impact: Mind–body interventions have been widely implemented to ameliorate antenatal stress, but conflicting results were found across studies. This systematic review and meta‐analysis suggested that mind–body interventions are relatively safe and convenient and can successfully promote antenatal stress. The suggestions proposed in this review may be useful for developing a scientific mind–body interventions regimen and encouraging the application of mind–body interventions in pregnant women, thereby managing antenatal stress effectively. [ABSTRACT FROM AUTHOR]

The article explores the difficulties and possible remedies of employing distraction methods while conducting venepuncture on children in hospital emergency departments. It calls for further research into innovative approaches like artificial intelligence and stresses the importance of child-centered, evidence-based, and culturally sensitive care to minimize cognitive distress during needle-related procedures.

Aims: To explore whether music can reduce anxiety and pain in patients who underwent diagnostic endoscopic examinations in conscious and deep sedation and to assess degree of satisfaction and willingness to repeat the procedure. Design: Prospective study led by nursing. Methods: Between March 2019–June 2019, consecutive outpatients undergoing endoscopic examinations were simple matched into four groups: Group 1: conscious sedation with music; Group 2: conscious sedation without music; Group 3: deep sedation with music and Group 4: deep sedation without music. Ten minutes before the procedure, two trainee nurses applied music. State‐Trait Anxiety Inventory was used to evaluate anxiety. Results: Before and at the end of the procedure, patients who listened to music had a lower level anxiety than those who did not listen and, also, reported lower pain intensity during procedure. Only within Group 1 median anxiety, measured after the procedure, is lower than that measured before. In the bivariate logistic regression model, pain and listening to music were independent factors for satisfaction and willingness to repeat procedure. Conclusion: music in digestive endoscopy reduce pain and anxiety in conscious sedation, thus could be used to reduce anxiety in support to conscious sedation leading to lower usage of deep sedation and consequently reduction of costs and adverse events. Impact: Anxiety in digestive endoscopy limits patients' satisfaction.Music in digestive endoscopy as a specific nursing intervention could reduce anxiety of patients.This nursing intervention study confirms positive effect of music in digestive endoscopy.As part of nursing management, the addition of music to daily care practice in digestive endoscopy may reduce anxiety and increase the patient's degree of satisfaction.Use of music could limit deep sedation use in digestive endoscopy with consequent reduction of risks for patients, execution times, and costs of procedures. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the effect of an 8‐week humour intervention programme on reducing depression and anxiety and improving subjective well‐being, cognitive function and sleep quality in nursing home residents. Design: A single‐blinded and quasi‐experimental design with repeated measures. Methods: Seventy‐four older adults were recruited from May 2018–September 2018, with 37 older adults in the humour group received humour intervention and 37 in the control group received no intervention. The intervention was an 8‐week humour intervention programme for older adults to learn to use humour and release their emotions. Primary outcomes include depression, anxiety and subjective well‐being and secondary outcomes were cognitive function and sleep quality. Two‐way repeated measures ANOVA was used to compare the differences of outcome measures between the two groups. Outcomes were measured at baseline, 8 and 16 weeks. Results: There was no significant difference between the two groups at baseline. The adherence to the sessions of humour intervention over the 8‐weeks was 97.6%. Two‐way repeated measures ANOVA revealed significant improvement in depression, anxiety, subjective well‐being and sleep quality during the postintervention (8 weeks) and follow‐up (16 weeks) periods in the humour group versus the control group. However, a significant time × group interaction for cognitive function was only found during postintervention. Conclusion: The humour intervention programme was effective in reducing depression and anxiety symptoms and increasing subjective well‐being, cognitive function and sleep quality in older adults. Impact: Physical and mental health problems are common among older adults in nursing homes. The study demonstrated that humour intervention has feasibility and potential to be used as an effective non‐pharmacological intervention in improving well‐beings of Chinese nursing home residents. Trial Registration: ChiCTR1800016148. [ABSTRACT FROM AUTHOR]

Aims: To evaluate the effectiveness of web-based mobile health interventions on paediatric patients and their parents in the day surgery context, where the primary outcome was children's pre-operative anxiety and secondary outcomes were postoperative pain and parents' anxiety and satisfaction with entire course of the day surgery. Design: A systematic review and meta-analysis of randomized controlled trials. Data sources: CENTRAL, CINAHL, Scopus, Ovid MEDLINE, and Web of Science were systematically searched without time limits (up to December 2018). Review methods: Studies were appraised using the Cochrane risk of bias tool. A random effect meta-analysis of children's pre-operative anxiety was performed. Results: Eight studies with a total of 722 patients were included in the analysis. The effectiveness of web-based mobile health interventions, including age-appropriate videos, web-based game apps, and educational preparation games made for the hospital environment, was examined in pre-operative settings. A meta-analysis (N = 560 children) based on six studies found a statistically significant reduction in pre-operative anxiety measured by the Modified Yale Pre-operative Anxiety Scale with a moderate effect size. Three studies reported parental satisfaction. Conclusion: Web-based mobile health interventions can reduce children's pre-operative anxiety and increase parental satisfaction. Web-based mobile health interventions could be considered as non-pharmacological distraction tools for children in nursing. There is not enough evidence regarding the effectiveness of reducing children's postoperative pain and parental anxiety using similar interventions. Impact: Web-based mobile health interventions reduce children's pre-operative anxiety and could therefore be considered as non-pharmacological distraction tools for children in nursing. [ABSTRACT FROM AUTHOR]

Aims and objectives: To investigate the effects of education and counselling on anxiety and pain in women undergoing hysterosalpingography (HSG) as part of infertility treatment. Background: The hysterosalpingography has an important diagnostic role in finding the cause of infertility and making a decision on management of treatment. In addition, it is considered a feared procedure in the infertility process and the one about which very little is known. Women often experience anxiety and pain during the HSG procedure. Design: A randomised controlled trial. Methods: The CONSORT guidelines have been used to describe the methods. Women who were diagnosed with infertility between February–October 2016 were included in the study. The participants were randomised and divided into intervention (52) and control (53) groups. The sociodemographic and obstetric data collection form, the State‐Trait Anxiety Inventory and a visual analogue scale were used before the procedure. After the questionnaires were applied to the intervention group, individual learning and counselling sessions were given about the hysterosalpingography process. Brochures were also distributed to the patients for their reference after the learning session. The control group received standard care. Results: When the intervention and control groups were compared, it was found that the education and counselling given before the HSG procedure significantly decreased the level of pain and anxiety felt by women. In addition, a significant positive correlation was found between pain and anxiety after the training in the intervention group. Conclusions: This study indicates that the education and counselling given to women before the HSG procedure are effective interventions for reducing pain and anxiety in women undergoing HSG. Relevance to clinical practice: With the application of HSG education and counselling, and the distribution of brochures to each patient, pain and anxiety can be reduced during the HSG procedure. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To establish the predictive utility of specific social support domains for emotional well‐being in cancer caregivers, six months after their partner's cancer diagnosis. Background: In cancer caregivers, social support has been consistently related to anxiety and depression. There is little information, however, about the predictive utility of specific social support domains for psychological well‐being in the first six months after a partner's cancer diagnosis. Design: Longitudinal research study. Methods: Sixty‐seven caregivers of recently diagnosed cancer patients were recruited from the Reina Sofia University Hospital in Cordoba (Spain). Participants completed a set of questionnaires including the Berlin Social Support Scale (BSSS), the Hospital Anxiety and Depression Scale (HADS) and a socio‐demographic questionnaire. Data were collected at two time points: T1 (30–45 days after diagnosis) and T2 (180–200 days after). TRIPOD checklist was used. Results: Most of the caregivers were female (65%) and the partner of the patient (58%), with an average age of 51.63 years (SD = 13.25). Statistical differences were observed between the two assessment points for the social support domains of perceived emotional support, satisfaction with support and protective buffering. Logistic regression analysis showed that less physical and sports activity, more support seeking and less informational support received at T1 predicted anxiety at T2, while less perceived available support predicted depression. Conclusions: Accurate information and support from other members of the community and the promotion of physical and sports routines for cancer caregivers may help to alleviate symptoms of anxiety and depression in the first months after a partner's cancer diagnosis. Relevance to clinical practice: Clinicians must pay attention to the social support needs and physical activity of caregivers in the first days after diagnosis, in order to prevent anxiety and depression. [ABSTRACT FROM AUTHOR]

Aim: To quantify the effect of laughter and humour interventions on depression, anxiety, and sleep quality in adults. Design: A meta‐analysis of randomized controlled trials. Data Sources: PubMed, Embase, PsycINFO, Web of Science, Cochrane Central Register of Controlled Trials, Chinese National Knowledge Infrastructure, Weipu, and Wanfang Data were searched from their inception up to December 2018. Review methods: The reporting of this meta‐analytical review was conducted according to the guidelines of the Cochrane Collaboration. Two reviewers selected the studies, extracted the data, and evaluated the risk of bias (Cochrane Collaboration bias assessment tool) of the included papers independently. Results: Ten studies comprising 814 participants were included. Meta‐analysis showed that these interventions significantly decreased adults' depression, anxiety, and improved their sleep quality. The results of subgroup analysis showed that depression benefits more from long‐term laughter intervention. Conclusions: This meta‐analysis revealed that laughter and humour interventions are effective in relieving depression, anxiety, and improve sleep quality in adults. More studies with high quality and follow‐up assessment should be conducted for future research. Impact: This review synthesized current evidence using laughter and humour interventions to reduce negative emotion and promote better results in adults, especially with respect to target the applicability between different populations or intervention methods. In addition, humour and laughter interventions are safe, convenient, interesting and can promote interpersonal relationship in both patients and medical workers, which have great feasibility and potential to be used as an aspect of psychotherapy for clinical and nursing to improve well‐beings in adults. [ABSTRACT FROM AUTHOR]

Aims and objectives: To develop a grounded theory to explain mental health nurses' responses to clients with suicidal behaviour. Background: Mental health nurses are an integral part of the multi‐disciplinary teams supporting people who experience suicidal behaviour, yet limited research is available that explores how nurses respond to the needs of people at risk of suicide and what factors influence their responses and actions. Methods: Grounded theory was the methodology for this study. Interviews were conducted with 33 mental health nurses working in an urban area in the Republic of Ireland. Data were analysed using the concurrent processes of comparative analysis, theoretical sampling, theoretical sensitivity and memo writing. COREQ 32‐item checklist was used. Results: The core category from the data was "Attenuating Anxieties." Participants' main concerns about caring for suicidal clients were related to their feelings of professional and personal vulnerability and the need to protect clients and themselves. This theory "Attenuating Anxieties" highlights the way in which nurses allay their anxieties by utilising historically known risk adverse strategies to care for the suicidal person. Acquisition of further psychotherapeutic training, clinical supervision as well as increased reflexivity protected some participants and enabled them to work creatively and collaboratively while supporting and facilitating therapeutic risk‐taking. Conclusions: The theory of "Attenuating Anxieties" identifies how participants worked within the context of mental health as members of the "risk society," wherein they worried about the possibility and probability of a negative or adverse effect for both the client and self, leaving them to feel constantly vulnerable and unsafe. Relevance to clinical practice: This theory highlights the need for a culture of openness that acknowledges nurses' and organisations' anxieties surrounding suicide and promotes a discourse among nurses that moves from a position of risk aversion to a relational and recovery‐orientated approach. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study was to systematically examine the efficacy of interventions aimed at improving nursing students' mental health and to identify which form of interventions was effective. Background: Recent research has demonstrated mental disorders in common among nursing students and may lead to adverse consequences like low self‐efficacy and poor academic performance. Design: According to the recommendations of the Cochrane Collaboration, a systematic review and meta‐analysis was conducted. Data sources: PubMed, EMBase, the Cochrane central register of randomized controlled trials, PsycINFO and Web of Science were used to identify potential studies (January 1990–April 2017). Review methods: A systematic review of the literature and meta‐analysis of randomized controlled trials on the efficacy of interventions on reducing mental disorders in nursing students. Review Manager version 5.3 was used to obtain pooled results. Results: Twelve studies with a total sample size of 651 participants met the inclusion criteria. Interventions included psychotherapy, exercise, training programme and other forms of intervention. The results of subgroup analysis showed that depression benefit more from psychotherapy, anxiety benefit from psychotherapy and non‐psychotherapy. Interventions were effective in managing stress and systolic blood pressure. Improvements on self‐efficacy and diastolic blood pressure was not observed. Conclusion: Psychotherapy should be chosen to reduce depression and anxiety of nursing students. There is a need for further studies should explore more potential value of psychotherapy on stress and biological change. [ABSTRACT FROM AUTHOR]

Abstract: Aim: To explore the effectiveness of preoperative psychological preparation programmes aimed to reduce paediatric preoperative anxiety and the potential factors that could have an impact on parent and children's acceptance of such interventions. Background: Various preoperative psychological preparation programmes are available to address paediatric preoperative anxiety. No mixed‐method review has been conducted to explore the effectiveness and acceptability of these programmes. Design: A mixed‐method systematic review. Data sources: Seven bibliographic databases were searched from inception to September 2016, complemented by hand searching of key journals, the reference lists of relevant reviews, search for grey literature and the contacting of associated experts. Review methods: The review process was conducted based on the framework developed by the Evidence for Policy and Practice Information and Co‐ordinating Centre. A narrative summary and a thematic synthesis were developed to synthesize the quantitative and qualitative data respectively, followed by a third synthesis to combine the previous syntheses. Results: Nineteen controlled trials and eleven qualitative studies were included for data synthesis. The controlled trials reveal that educational multimedia applications and web‐based programmes may reduce paediatric preoperative anxiety, while the effectiveness of therapeutic play and books remains uncertain. Qualitative studies showed parent–child dyads seek different levels of information. Conclusions: Providing matched information provision to each parent and child, actively involving children and their parents and teaching them coping skills, may be the essential hallmarks of a successful preoperative psychological preparation. Further research is necessary to confirm the effectiveness of therapeutic play and books. [ABSTRACT FROM AUTHOR]

Abstract: Background: Undergoing surgery is an anxious experience for children. Applying anxiety reduction age‐appropriate programs by nurses would be beneficial in reducing anxiety to children. Aim: To test the effectiveness of age‐appropriate preoperative information session in reducing anxiety levels of school‐age children undergoing elective surgery in Jordan. Design: The study used a quasi‐experimental design. Methods: One hundred and twenty‐six children were recruited from an educational hospital in Amman from January to June 2012 and were randomly assigned to intervention and control groups. The anxiety levels of children were assessed using the State Anxiety Scale for children, and children's levels of cooperation after surgery were assessed using Children Emotional Manifestation Scale. The heart rate and blood pressure of children were also measured 1 hour before going to operation room. Results: The study results revealed that children in the intervention group reported lower anxiety levels and more cooperation than children in the control group. Also, they displayed lower heart rate and blood pressure than children in the control group. Conclusion: The application of age‐appropriate preoperative intervention for children could be beneficial in decreasing anxiety levels and increasing their cooperation post surgery. [ABSTRACT FROM AUTHOR]

Abstract: Aim: This study aimed to evaluate the efficacy of music therapy for reducing the anxiety and pain of patients who underwent a biopsy. Background: Music can affect human anxiety and pain by triggering a neuroendocrine effect. Clinical study results indicated that music can influence the anxiety and pain caused by invasive procedures. There is no effective solution for anxiety and pain arising from a biopsy. Although researchers in this field have different views, music still holds promise in reducing the anxiety and pain in patients undergoing the biopsy. Design: Systematic review and meta‐analysis of randomized controlled trials. Data Sources: Systematic searches were conducted in PubMed, Embase, Medline and Cochrane databases for studies reported in the English language. The review period covered 2000 ‐ December 2016. The outcome measure of interest was anxiety and pain. Methods: This review followed Cochrane methods. Studies were selected according to the PICOS framework. The methodological quality of studies was assessed with the Cochrane risk of bias tool. A systematic review of effectiveness was conducted by using GRADE approach. Results: Nine randomized controlled trials with a total of 326 participants in the music intervention group and 323 controls met the inclusion criteria. Music had a tendency towards decreasing systolic blood pressure before the biopsy, State‐Trait Anxiety Inventory scores after the biopsy, diastolic blood pressure after the biopsy and heart rate after the biopsy. Similarly, music also tended to be more effective for controlling pain after the biopsy. There was moderate quality evidence for the outcome: State‐Trait Anxiety Inventory scores after the biopsy; and low‐ or very low‐quality evidence for other outcomes. Conclusion: Music can be used for patients before and during the biopsy procedure. This approach may be performed by nurses to promote the recovery of patients after the biopsy. [ABSTRACT FROM AUTHOR]

Aims and objectives: To evaluate the effect of video information given before cardiovascular magnetic resonance imaging on patient anxiety and to compare patient experiences of cardiovascular magnetic resonance imaging versus myocardial perfusion scintigraphy. To evaluate whether additional information has an impact on motion artefacts. Background: Cardiovascular magnetic resonance imaging and myocardial perfusion scintigraphy are technically advanced methods for the evaluation of heart diseases. Although cardiovascular magnetic resonance imaging is considered to be painless, patients may experience anxiety due to the closed environment. Design: A prospective randomised intervention study, not registered. Methods: The sample (n = 148) consisted of 97 patients referred for cardiovascular magnetic resonance imaging, randomised to receive either video information in addition to standard text‐information (CMR‐video/n = 49) or standard text‐information alone (CMR‐standard/n = 48). A third group undergoing myocardial perfusion scintigraphy (n = 51) was compared with the cardiovascular magnetic resonance imaging‐standard group. Anxiety was evaluated before, immediately after the procedure and 1 week later. Five questionnaires were used: Cardiac Anxiety Questionnaire, State‐Trait Anxiety Inventory, Hospital Anxiety and Depression scale, MRI Fear Survey Schedule and the MRI‐Anxiety Questionnaire. Motion artefacts were evaluated by three observers, blinded to the information given. Data were collected between April 2015–April 2016. The study followed the CONSORT guidelines. Result: The CMR‐video group scored lower (better) than the cardiovascular magnetic resonance imaging‐standard group in the factor Relaxation (p = .039) but not in the factor Anxiety. Anxiety levels were lower during scintigraphic examinations compared to the CMR‐standard group (p < .001). No difference was found regarding motion artefacts between CMR‐video and CMR‐standard. Conclusion: Patient ability to relax during cardiovascular magnetic resonance imaging increased by adding video information prior the exam, which is important in relation to perceived quality in nursing. No effect was seen on motion artefacts. Relevance to clinical practice: Video information prior to examinations can be an easy and time effective method to help patients cooperate in imaging procedures. [ABSTRACT FROM AUTHOR]

Aims and objectives To examine factors which contribute to the individual's experience of pain in relation to intrauterine contraception insertion and determine evidence-based nursing strategies to best assess and manage this pain. Background Nurses are increasingly involved in consultations regarding intrauterine contraception. However, concerns regarding painful or difficult insertion may inhibit uptake and discourage nurses from promoting or inserting intrauterine contraception. Design Integrative review. Methods Database searches of CINAHL, PubMed, Wiley Online Library and the Cochrane Collaboration for relevant literature. Eight papers met the inclusion criteria and were analysed using an integrative review process. Results Physical causes and pharmacological interventions for insertion pain have been thoroughly investigated. Absence of previous vaginal delivery and anxiety may increase the likelihood of procedural pain. The literature fails to conclusively determine any universally effective prophylactic analgesia. Cervical anaesthesia may be beneficial in some cases and oral analgesia may relieve postprocedural pain. Distraction in the form of conversation, music or television can be effective in reducing anxiety. Conclusions A combination of physical, psychological and environmental factors contribute to the individual's pain experience. Nurses have the potential to make a significant impact on pain outcomes by demonstrating clinical expertise and creating a trustful environment. Giving reliable information, acknowledging the significance of anxiety and providing reassurance and distraction are effective pain reducing strategies. Research into nonpharmacological approaches is warranted, especially those which reduce anxiety. Relevance to clinical practice Increasing uptake of long-acting reversible contraception is a public health goal. Providing effective pain management strategies to improve patient experience may encourage more nurses to recommend, or enhance their scope of practice to include, intrauterine contraception insertion. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: This study aimed to investigate the effect of aromatherapy massage on anxiety, depression, and physiologic parameters in older patients with acute coronary syndrome. Methods: This randomized controlled trial was conducted on 90 older women with acute coronary syndrome. The participants were randomly assigned into the intervention and control groups (n = 45). The intervention group received reflexology with lavender essential oil, but the control group only received routine care. Physiologic parameters, the levels of anxiety and depression in the hospital were evaluated using a checklist and the Hospital's Anxiety and Depression Scale, respectively, before and immediately after the intervention. Results: Significant differences in the levels of anxiety and depression were reported between the groups after the intervention. The analysis of physiological parameters revealed a statistically significant reduction (P < .05) in systolic blood pressure, diastolic blood pressure, mean arterial pressure, and heart rate. However, no significant difference was observed in the respiratory rate. Conclusions: Aromatherapy massage can be considered by clinical nurses an efficient therapy for alleviating psychological and physiological responses among older women suffering from acute coronary syndrome. [ABSTRACT FROM AUTHOR]

Aims and objectives To examine the extent that individualised education helps reduce depression and anxiety and improves self-care for people who have undergone coronary artery bypass graft surgery. Background Individualised discharge planning is increasingly important following cardiac surgery due to recurrent admissions as well as the issue of anxiety and depression, often due to lack of preparation. The hospital to home transition is fundamental in the recovery process. Individualised education and person-centred care ensure that patients' educational needs are met. This empowers patients, increasing self-efficacy or confidence, resulting in autonomy, a smoother discharge process and avoiding postdischarge problems and rehospitalisation. Design A critical review of published peer-reviewed literature was conducted. Methods Electronic databases searched included MEDLINE, CINAHL, the Cochrane Library and PsychInfo 2009-2015. Results Eight articles were identified for review, and a Critical Appraisal Skills Programme framework was used to determine the quality of the papers, all of the papers focussed on coronary artery bypass graft. The designs were typically experimental or quasi-experimental with two reviews. Conclusion A greater understanding of the patients' needs allows tailored education to be provided, which promotes self-care management. This level of patient empowerment increases confidence and ultimately minimise anxiety and depression. Despite the varying teaching and learning methods associated with individualised education, patient-centred education has the potential to assist cardiac nurses in adequately preparing patients for discharge following their coronary artery bypass graft. Relevance to clinical practice Development of individualised education programmes is crucial in preparing patients for discharge. The reduction in readmission to hospital has a significant effect on already stretched resources, and the reduction in postoperative complications during the recovery period linked with depression and anxiety will have a positive effect on the individuals' ability to self-care, health and well-being. [ABSTRACT FROM AUTHOR]

Aims and objectives This study evaluated the effect of infant massage on anxiety in mothers of preterm infants who discharged from the neonatal intensive care unit. Background Birth of preterm infants commonly leads to great levels of distress and anxiety in mothers. Although various methods have been suggested to help mothers cope with such stressful conditions, the effects of infant massage have not been adequately studied in mothers. Design This was a quasi-experimental clinical trial. Methods Overall, in 70 mothers and their preterm infants who scheduled to be discharged within 24 hours, State-Trait Anxiety Inventory scale (Spielberger) was completed for mothers in both groups in the morning of the day before discharge. The experimental group received eight minutes of massage including two standard similar parts (each part four minutes). The massage was repeated in two parts on the day of discharge, and then, state anxiety was re-measured using Spielberg's scale for all mothers. The control group received no intervention. Results The results showed that on the day of discharge, there was a significant difference in the overall mean score of maternal state anxiety between the two groups ( p < 0·002), although not in the severity of maternal state anxiety. In both groups, the mean score of maternal state anxiety was significantly decreased on the day of discharge ( p < 0·001). Conclusions The findings provide evidence that infant massage by mother has an effect on the state anxiety of mothers of preterm infants, so it is recommended that mothers apply massage for preterm infants to improve their mental health. Relevance to clinical practice Mothers of preterm infants can promote mental health by continuing massage of their infants at home. [ABSTRACT FROM AUTHOR]

Aim To review the effects of mindfulness-based interventions on Registered Nurses and nursing students. Background Work-related stress among nurses is estimated to be the biggest occupational health problem after musculoskeletal disorders. Design A mixed-method systematic review incorporating quantitative and qualitative data was conducted. Data sources Studies on the effects of mindfulness-based interventions for nurses and nursing students published between 1980 and 2014 were identified through a systematic search in electronic databases: Medline, Embase, Psyc INFO, Cochrane Library and Cinahl. Review methods Data analysis was conducted based on the framework of Thomas and Harden (2004). Results A total of 32 studies, including 17 controlled designs, 11 pre-post designs and four qualitative designs were reviewed. Meta-analysis suggests that mindfulness-based interventions may be effective in significantly reducing state anxiety and depression at posttreatment and state anxiety and trait anxiety at follow-up. Qualitative studies and uncontrolled studies shed light on benefits overlooked in RCTs, including improvements in the well-being of individuals (e.g. inner state of calmness, awareness and enthusiasm) and improved performance at work (better communication with colleagues and patients, higher sensitivity to patients' experiences, clearer analysis of complex situations and emotional regulation in stressful contexts). Conclusions Mindfulness appeared to improve nurses' mental health significantly. It could be used in worksite health promotion programmes. Only a few studies have explored the impact of mindfulness on nurses' professional behaviours and their relationships with patients and colleagues. Future research should further explore the long-term impacts of mindfulness on performance and well-being at work using sound methodological designs. [ABSTRACT FROM AUTHOR]