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Introduction: Gastrointestinal immobility is experienced by many patients who undergo gastric surgery. This complication delays enteral nutrition, prolongs hospitalization, and causes discomfort. Acupoint stimulation is a popular alternative nonpharmacological treatment for gastrointestinal immobility. This study aimed to explore the effects of acupoint stimulation on gastrointestinal immobility after gastrectomy. Design: Systematic review and meta-analysis. Methods: Databases (PubMed, Cochrane, Joanna Briggs Institute EBP Database, Medline, CINAHL Complete, and Airiti library) were searched from their inception to April 2022 for relevant articles. Articles in Chinese and English were included, without limitations on year, region, or country. The inclusion criteria were studies with participants >18 years of age, postgastric surgery, and hospitalization. In addition, randomized controlled trials (RCTs) were included. Data were analyzed using random effects models, and data heterogeneity was investigated using subgroup analysis. Meta-analysis was performed using Review Manager 5.4 software. Results: We included 785 participants from six studies. Invasive and noninvasive acupoint stimulation reduced the time of gastrointestinal mobility better than usual care. In the control group, the time of first flatus was 43.56 ± 9.57 h to 108 ± 19.2 h, and the time of first defecation was 77.27 ± 22.67 h to 139.2 ± 24 h. In the experimental group, the time of first flatus and defecation was 36.58 ± 10.75 h to 79.97 ± 37.31 h and 70.56 ± 15.36 h to 108.55 ± 10.75 h, respectively. Subgroup analysis showed that invasive acupoint stimulation with acupuncture reduced the time of first flatus and defecation to 15.03 h (95% confidence interval [CI] = −31.06 to 1.01) and 14.12 h (95% CI = −32.78 to 4.54), respectively. Noninvasive acupoint stimulation, including acupressure and transcutaneous electrical acupoint stimulation (TEAS), reduced the time of first flatus and defecation to 12.33 h and (95% CI = −20.59 to −4.06) and 12.20 h (95% CI = −24.92 to 0.52), respectively. Conclusions: Acupoint stimulation improved the gastrointestinal immobility of postgastrectomy. In the included RCT articles, invasive and noninvasive stimulations were effective. However, noninvasive acupoint stimulation, such as with TEAS and acupressure, was more efficient and convenient than invasive stimulation. Overall, health care professionals with adequate training or under the supervision of an acupuncturist can effectively perform acupoint stimulation to improve the quality of postgastrectomy care. They can select commonly used and effective acupoints to enhance gastrointestinal motility. Clinical relevance: Acupoint stimulation, such as acupressure, electrical acupoint stimulation, or acupuncture, can be included in postgastrectomy routine care to improve gastrointestinal motility and reduce abdominal discomfort. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to explore the subgroups of symptom severity and impact of their trajectories on quality of life in lymphoma survivors. Methods: Secondary data were analysed from a prospective study with four‐time measures: before treatment (T1), during treatment (T2), treatment completion (T3) and 10 weeks after treatment (T4). Data were analysed using descriptive statistics, group‐based trajectory model and generalised estimation equation. Results: Fifty nine of 61 participants completed three‐time measure (mean age = 60.43 years, male‐predominant). The changes in symptom severity over time were divided into two subgroups: slight‐stable group (n = 54, 89%) and mild‐fickle group (n = 7, 11%). Pain, tiredness and sleeping trouble were the predominant symptoms. The quality of life change in the slight‐stable group was significantly better than that of the mild‐fickle group (B = 13.35, SE = 3.53, p < 0.001). The overall quality of life at T2, T3 and T4 was better than it was at T1. Conclusion: The different trajectories of symptom severity significantly influenced quality of life changes in lymphoma survivors. Healthcare providers must be aware that there is a group of lymphoma survivors with relatively severe symptoms when newly diagnosed, compared to the opposite. More attention must be paid to this group, in addition to providing in‐time symptom management. [ABSTRACT FROM AUTHOR]

Abstract: Aims: To investigate the relationships among social support, health literacy, and self‐management, and the factors influencing self‐management of chronic kidney disease (CKD). Design: Cross‐sectional study. Methods: A random sample of 410 patients was recruited from nephrology clinics. Data were collected using structured questionnaires and chart reviews from January 2013 to February 2014. Hierarchical regression analysis was used to determine the predictive factors of self‐management behaviors and ∆R2 to determine each variable's explanatory power. Findings: Health literacy and social support were positively correlated with self‐management behaviors. Furthermore, social support, health literacy, and marital status were significant predictors of self‐management behaviors. Social support had a relatively greater explanatory power for self‐management behaviors than did health literacy. Particularly, healthcare provider support had the greatest influence on patients’ self‐management behaviors. Conclusions: Health literacy and social support play independent positive roles in self‐management behaviors of patients with CKD, with social support having a particularly dominant role. Further research using a systems approach to improving self‐management behaviors is necessary to clarify the role of social support. Clinical Relevance: Health literacy and social support are independently and positively related to self‐management. Social support, which is a system‐level factor, is a relatively stronger and crucial predictor than is health literacy. Nurses have to refine self‐management programs to focus on families and adopt a systems approach to help CKD patients improve their self‐management behaviors. [ABSTRACT FROM AUTHOR]

Background: Exercise interventions apparently reduce the risks of and prevent coronary artery disease (CAD). Developing an exercise intervention for patients with CAD is a rapidly expanding focus worldwide. The results of previous studies are inconsistent and difficult to interpret across various types of exercise programme. Aim: This study aimed to update prior systemic reviews and meta-analyses in order to determine the overall effects of endurance exercise training on patients with CAD. Methods: The databases (PubMed, Medline, CINAHL, EMBASE and Cochrane Library) were searched for the interventions published between January 1, 2000, and May 31, 2015. Comprehensive meta-analysis software was used to evaluate the heterogeneity of the selected studies and to calculate mean differences (MDs) while considering effect size. Results: A total of 18 studies with 1286 participants were included. Endurance exercise interventions at a moderate to high training intensity significantly reduced resting systolic blood pressure (MD: −3.8 mmHg, p = 0.01) and low-density lipoprotein cholesterol (MD: −5.5 mg/dL, p = 0.02), and increased high-density lipoprotein cholesterol (MD: 3.8 mg/dL, p < 0.001). There were also significant positive changes in peak oxygen consumption (MD: 3.47 mL/kg/min, p < 0.001) and left ventricular ejection fraction (MD: 2.6%, p = 0.03) after the interventions. Subgroup analysis results revealed that exercise interventions of 60–90 minutes per week with a programme duration of >12 weeks had beneficial effects on functional capacity, cardiac function and a number of cardiovascular risk factors. Conclusions: Endurance exercise training has a positive effect on major modifiable cardiovascular risk factors and functional capacity. Nurses can develop endurance exercise recommendations for incorporation into care plans of clinically stable CAD patients following an acute cardiac event or revascularisation procedure. [ABSTRACT FROM AUTHOR]

li i-c., chen y-c., hsu l-l., lin c-h. & chrisman n.j. (2012) The effects of an educational training workshop for community leaders on self-efficacy of program planning skills and partnerships. Journal of Advanced Nursing 68(3), 600-613. Abstract Aim. This aim of this study was to evaluate the effects of a 6-month educational workshop for community leaders designed to improve their confidence in health promotion programmes and to develop partnerships among the participants. Background. It is important for public health nurses to work with community leaders to provide community-orientated services. However, only a few existing studies have reported the content and effects of training programmes aimed at enhancing the capabilities of community leaders. Methods. A participatory action research design with pre- and post-test methods was applied in this study. Fifteen community leaders completed a 6-month educational workshop that was held in Tamsui, Taipei and Taiwan. It was designed to enable community leaders to improve their confidence in planning health programmes and developing group partnerships. Data were collected from April 2009 to October 2009, and descriptive statistics and Wilcoxon signed-rank test analyses were carried out. Results. Participants demonstrated improvements in their self-efficacies of planning health programmes by completing a structured questionnaire after attending a 6-month educational workshop ( Z = −2·90, P = 0·004). Their confidence in data collection, needs assessment and diagnosis, programme planning, and programme evaluation were significantly improved ( Z = −3·1, P = 0·002; Z = −2·42, P = 0·016, Z = −2·84, P = 0·004, and Z = −2·68, P = 0·007, respectively). Conclusions. Providing training workshops for community leaders is a useful strategy for increasing their capabilities and confidence in planning health programmes. Nurses have a responsibility to advocate and provide training programmes for community leaders. [ABSTRACT FROM AUTHOR]

Background: The prevalence and incidence of end-stage renal disease (ESRD) in Taiwan are the highest of any country in the world. The different renal replacement therapies that are adopted by patients with ESRD significantly affect their social roles and daily life. However, because of the complexities of different renal replacement therapies, patients may be unsure of which to choose. Purpose: The aim of this study was to explore the effectiveness of a shared decision-making (SDM) program regarding different renal replacement therapies for patients with chronic kidney disease. Methods: A quasi-experimental design was conducted at two similar regional hospitals in Miaoli County, Taiwan. One hospital hosted the intervention group, and the other hospital hosted the control group. The 31 participants in the intervention group took part in a SDM program. The 36 control group participants took part in the pre-ESRD care program. Data collection included demographic and disease characteristics, decisional conflict scale, and decision self-efficacy scale. Results were analyzed using independent t test, Fisher's exact test, generalized estimating equation, and paired t tests. Results: The study results revealed that the intervention group experienced a significant increase in decision self-efficacy and a significant decrease in decisional conflict at 1 month after receiving the SDM intervention in comparison to before and immediately after receiving the intervention. Moreover, the intervention group had higher decision self-efficacy and lower decisional conflict than the control group. Conclusions/Implications for Practice: The SDM program may be an effective intervention for complex decision-making processes, such as the process involved in making renal replacement treatment decisions. The SDM program group intervention improved decisional conflict and decision self-efficacy. Thus, to improve patients' decision-making processes, the application of an SDM program focused on the personal values and opinions of patients with ESRD will be necessary. Physicians and case managers of patients with ESRD should act in complementary and cooperative roles in SDM programs. [ABSTRACT FROM AUTHOR]

• This is first systematic review on exercise program's efficacy for muscle wasting. • Overall benefits of exercise for muscle wasting were determined. • Body composition, muscle strength, and physical performance were examined. • The results can help to provide exercise recommendations for muscle atrophy. • Exercise programs may support muscle function in older people with muscle wasting. : To conduct a comprehensive evidence synthesis to verify the available literature on the effects of exercise intervention on muscle mass, muscle strength, and physical function in older adults with muscle wasting. Systematic literature searches of the PubMed/Medline, CINAHL, EMBASE, Cochrane Library, and Airiti Library databases were performed for exercise-related randomized controlled trials among adults aged 60 years and above with muscle wasting disease, published from 2010 to April 30, 2021. The search included the keywords and synonyms: "older," "sarcopenia," "cachexia," "muscle wasting," "exercise'. The systematic review included 34 studies: 25 on patients with sarcopenia and 9 on patients with cachexia. Sarcopenia and cachexia were analyzed as separate subgroups. The effects of exercise in the sarcopenia group showed significant improvement in the following parameters: body composition (appendicular skeletal muscle [ASM] [standardized mean difference, SMD 0.38, P = 0.05] and ASM/height2 [SMD 0.14, P = 0.02]), muscle strength (grip strength [SMD 1.73, P < 0.0001]), and physical performance (gait speed [SMD 0.14, P < 0.00001] and the timed up and go test [SMD -1.20, P < 0.00001]). Similarly, in the cachexia group, exercise intervention showed improvement in the body composition (ASM [SMD 3.38, P = 0.001]) and physical performance (400 m walk [SMD -36.00, P = 0.02]). Exercise intervention has significant benefits in older adults with muscle wasting diseases. More well-designed large-sample-sized studies with long-term follow-ups are warranted to verify the benefits of exercise intervention in this population. [ABSTRACT FROM AUTHOR]