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Given the aging population and increasing incidence of severe intestinal diseases, elderly ostomy patients face home self-management challenges with insufficient care capacity, and the lack of systematically integrated evidence for their specific needs necessitates summarizing the best evidence to support clinical care and improve their quality of life. A computerized literature search was systematically performed to identify studies focusing on home stoma self-management among elderly ostomy patients. The search was conducted across multiple sources, including domestic and international guideline platforms, official websites of relevant institutions, and major academic databases. Eligible literature included clinical practice guidelines, clinical decision-making tools, expert consensus statements, systematic reviews, and evidence summaries. Literature was searched from January 2015 to October 2025 in the following resources. A total of 15 high-quality studies were included, encompassing six core domains: self-management goals, stoma assessment, psychological adjustment, dietary management, behavioral management and medication management. A total of 36 pieces of evidence were summarized in this study, which fills the gap of systematically integrated evidence for home stoma self-management in elderly ostomy patients. However, given that this evidence was derived from diverse countries with diverse healthcare systems and contexts, its clinical application should be tailored to the specific clinical conditions and individual needs of this population. Future research should focus on developing more targeted, evidence-based interventions to optimize home stoma self-management for elderly ostomy patients. This evidence summary followed the reporting specifications for evidence summaries developed by the Fudan University Center for Evidence-based Nursing, which were based on the methodological framework for evidence summaries produced by the Joanna Briggs Institute (JBI). The reporting process included establishing the evidence-based question, literature retrieval, literature screening, quality appraisal, evidence synthesis and grading, and development of practice recommendations. This study was registered in the evidence summary registration system of Fudan University Center for Evidence-based nursing under the title "Evidence-based summary of optimal home self-management for elderly ostomy patients" with the registration number ES20246036. No direct on-site patient or public participants were recruited for this literature-based evidence summary. All patient-related experiences and practical perspectives were extracted and integrated from the included published studies to ensure the applicability of the optimal home self-management evidence for elderly ostomy patients. Identifier ES20246036.

Acute pancreatitis has complex causes, and traditional Chinese medicine plays a significant role in its treatment. However, there is a lack of standardized protocols and a comprehensive best evidence summary for rhubarb administration in acute pancreatitis, leading to inconsistent clinical practice. This study aimed to retrieve and summarize the best evidence on the administration of rhubarb in the treatment of acute pancreatitis and to provide a theoretical reference for the development of clinical practice. A systematic search was performed from database inception to 31 October, 2025 across multiple electronic databases and guideline repositories, including the UK National Institute for Health and Care Excellence, the US Agency for Healthcare Research and Quality, Cochrane Library, PubMed, EMbase, China biomedical, CNKI, Wanfang, and VIP. Eligible evidence comprised clinical practice guidelines, expert consensus statements, and systematic reviews focusing on rhubarb administration in adult patients with acute pancreatitis. The methodological quality of included studies was independently evaluated using the AGREE II, JBI, and AMSTAR 2.0 tools. A total of 15 documents were included, including 3 clinical guidelines, 3 expert consensus, and 9 systematic evaluations. Twenty-seven pieces of evidence related to rhubarb administration in patients with acute pancreatitis were extracted and summarized into four themes: mechanism of action, feasibility, evaluation, and clinical implementation. Healthcare providers may apply the best evidence for rhubarb administration in acute pancreatitis to improve intestinal function recovery. However, recommendations should be interpreted cautiously, as all evidence comes from Chinese studies with limited generalizability and some low-level findings. This study is in accordance with the evidence summary reporting specifications of the Fudan University Center for the Evidence-based Nursing, and the registration number is "ES20246947".

To systematically review and analyze the literature on intrahospital neonatal transport and synthesize the available evidence to inform the development of standardized transport procedures. Following the "6S" evidence model, a systematic search was conducted across multiple databases from inception to August 31, 2025. Eligible documents were appraised for methodological quality, and relevant recommendations and evidence statements were extracted and synthesized narratively. The level of evidence and strength of recommendations were graded according to the 2014 JBI evidence pre-grading system. A total of 10 documents were included, comprising 7 guidelines, 2 evidence summaries, and 1 systematic review. A total of 35 evidence statements were synthesized and grouped into 7 themes: transport team; pre-transport assessment and decision-making; preparation of healthcare providers and neonates; preparation of supplies and medications; transport equipment; monitoring and care during transport; and handover and quality management. The evidence base was primarily derived from guideline recommendations, evidence summaries, and expert consensus. This review provides a structured synthesis and critical appraisal of the available evidence and recommendations for intrahospital neonatal transport. The synthesized recommendations may help inform standardized transport procedures; however, they should be interpreted with caution because a substantial proportion of the evidence base is derived from guidelines or expert consensus. Further high-quality prospective, multicenter studies are warranted to evaluate the effectiveness, feasibility, and generalizability of these recommendations across diverse clinical settings.

To systematically search, assess, and compile the best evidence on the management of nebulization in adult patients on nasal high-flow oxygen therapy, thereby providing a reference for evidence-based nursing practice. This evidence summary was conducted following the Joanna Briggs Institute (JBI) methodology for evidence synthesis and was guided by the '6S' evidence resource model. A systematic search was performed in multiple databases, including PubMed, Embase, the Cochrane Library, Web of Science, CINAHL, China National Knowledge Infrastructure (CNKI), Wanfang Data, VIP Database, and the China Biomedical Literature Database, for publications up to September 2024. The study selection process was reported in accordance with the PRISMA-ScR guidelines. Three researchers independently performed the literature appraisal, evidence extraction, and grading of recommendations. In total, 839 records were retrieved, and 13 articles were finally included, comprising 1 clinical decision, 2 guidelines, 1 team standard, 7 expert consensuses, and 2 evidence summaries. Quality appraisal using AGREE II showed all three guidelines/standards scored above 60% across all domains. Among the seven expert consensuses, most items were rated positively. From the included literature, 26 best evidence statements were extracted and summarized across seven key areas: preparation for nebulization, medication management, selection and setup of nebulization devices, proper usage, monitoring and nursing, management of nebulization in respiratory infectious diseases, and patient education. The evidence levels ranged from Level 1 to Level 5, and the grades of recommendation included both A (strong) and B (weak). The research has compiled and consolidated the optimal evidence for managing nebulization in adult patients receiving nasal high-flow oxygen therapy. This summary provides a structured compilation of current best practices, primarily derived from guidelines and expert consensus, which can serve as a practical reference to guide the nebulization process for these patients.

Pediatric urinary tract infections (UTIs) significantly affect children's health and quality of life. Health education plays a key role in improving parental health literacy, treatment adherence, and recurrence prevention. This study aimed to systematically synthesize the best available evidence on health education for the prevention and management of pediatric UTIs to serve as a reference for clinical practice. Following the "6S" evidence resource model, an evidence search was conducted in a top-down manner across the following sources: BMJ Best Practice, UpToDate, National Institute for Health and Care Excellence (NICE), Guidelines International Network (GIN), National Guideline Clearinghouse (NGC), Registered Nurses' Association of Ontario (RNAO), Canadian Medical Association (CMA), New Zealand Ministry of Health Guidance Library, MedLive, American Academy of Pediatrics (AAP), European Association of Urology (EAU), Cochrane Library, EMbase, Ovid MEDLINE, PubMed, Web of Science, CINAHL, China National Knowledge Infrastructure (CNKI), Wanfang Data, VIP, and SinoMed. The search period covered from database inception to October 31, 2025. Two reviewers independently screened and evaluated the retrieved literature. Evidence was extracted and summarized according to the JBI evidence grading and recommendation system. A total of 14 publications were finally included: 4 clinical decisions, 5 guidelines, 1 evidence summary, 3 expert consensuses, and 1 systematic review. Through evidence synthesis and integration, 42 best-evidence statements were developed across eight domains: disease awareness, symptom recognition, diagnosis and evaluation, urine specimen collection, imaging examinations, treatment and medication, recurrence prevention, and follow-up instructions. This best-evidence summary comprehensively synthesizes evidence-based health education for pediatric urinary tract infections. The rigorous methodology and broad content coverage provide valuable scientific guidance for healthcare professionals involved in UTI health education.

Perioperative nutritional management is crucial for patients undergoing prostate cancer (PCa) surgery, as malnutrition is prevalent and strongly associated with increased complications and impaired recovery. Despite numerous guidelines for cancer or surgical patients, evidence specific to the perioperative care of prostatectomy patients remains fragmented, inconsistent, and lacks a unified, up-to-date synthesis, creating a barrier to consistent clinical application. This review aimed to systematically search, appraise, and synthesize the best available evidence on perioperative nutritional support for patients undergoing PCa surgery, addressing the current fragmentation in existing guidelines and recommendations. The PICOS framework defined the scope: Patients undergoing PCa surgery; Interventions of perioperative nutritional management; Compared to standard care or alternative strategies; Outcomes including nutritional indicators, complications, and quality of life; Study types including guidelines, expert consensus, systematic reviews, evidence summaries, and randomized controlled trials (RCTs). A comprehensive search of PubMed, Embase, CINAHL, Cochrane Library, and CNKI was conducted up to March 2026. Two reviewers (T.C., M.L.) independently screened studies, assessed quality [using Appraisal of Guidelines for Research & Evaluation II (AGREE II) for guidelines and JBI tools for other study types], and extracted data. Evidence was synthesized and graded (JBI system, Level 1-5). Fourteen studies were included: 4 guidelines, 5 expert consensus documents, 3 systematic reviews, 1 evidence summary, and 1 RCT. The guidelines demonstrated high methodological quality. All other study types were rated as "yes" across all evaluated items, indicating acceptable to high quality. From these, 30 best-evidence recommendations were synthesized, covering six domains: preoperative nutritional assessment, optimal timing of supplementation, personalized formulation, enteral nutrition selection, management strategies, and health education. This review consolidates evidence-based recommendations to guide perioperative nutritional care for prostatectomy patients, supporting early screening, personalized oral nutritional supplements (ONS), and sustained health education. However, evidence regarding stage-specific needs, particularly for patients receiving androgen deprivation therapy (ADT), remains limited and represents a key priority for future high-quality research.

Sleep disturbances affect 10%-30% of adults worldwide. Non-invasive electrical stimulation (e.g., transcranial electrical stimulation) has emerged as a promising non-pharmacological intervention. Although numerous systematic reviews and meta-analyses have been published, they vary considerably in methodological quality, populations, intervention types, and conclusions. No umbrella review has yet synthesised the evidence across different modalities and populations. This evidence mapping umbrella review aims to systematically chart the existing systematic reviews, assess methodological quality, quantify overlap, and describe evidence patterns across diverse modalities and populations. Following JBI guidelines, we will search PubMed, Embase, Cochrane Database of Systematic Reviews, Web of Science, PsycINFO, and Scopus (inception to April 2026), restricted to English. Grey literature will be searched via PROSPERO, ClinicalTrials.gov, Google Scholar (first 200 records), and reference list screening (snowballing). We will include systematic reviews and meta-analyses of randomised controlled trials evaluating any non-invasive electrical stimulation for sleep outcomes. Two reviewers will independently screen, extract data, and assess methodological quality using AMSTAR 2. Primary study overlap will be quantified by the Corrected Covered Area. Where feasible, we will calculate 95% prediction intervals, perform Egger's regression tests, and conduct excess significance tests using review-level summary estimates. Subgroup analyses will be stratified by intervention and population type. Sensitivity analyses will exclude: (1) reviews with critically low AMSTAR 2 ratings, (2) preprints, (3) reviews at high risk of reporting bias, and (4) studies where sleep is not the primary outcome. The primary outcome is subjective sleep quality; total sleep time is a key secondary outcome. Evidence will be graded using the Fusar-Poli classification, with GRADE for key outcomes. This umbrella review will provide the highest level of evidence synthesis, identifying modalities with more consistent or higher certainty evidence and highlighting areas where evidence remains uncertain. Limitations include restriction to English (which may disproportionately impact modalities such as TEAS), expected heterogeneity, and possible insufficient data for some subgroup analyses. All amendments have been documented in PROSPERO (CRD420261357590). https://www.crd.york.ac.uk/prospero/, identifier CRD420261357590.

Ostomy care primarily relies on professional nursing and guidance, including basic stoma care skills, prevention and management of peristomal complications, and care of stenting tubes. The specialized skills and expertise of healthcare professionals play a crucial role in enhancing patients' self-care ability, reducing the incidence of peristomal complications and urinary tract infections, and improving patients' quality of life. This study aims to develop a set of clinical guidelines applicable to healthcare providers for nursing adult patients with urostomy. This study was conducted in two phases. In the first phase, key issues in the nursing care of adult patients with urostomy were identified, and evidence-based questions were formulated. A systematic search, quality appraisal, and evidence synthesis were performed to develop a draft guideline. In the second phase, a Delphi survey among experts was conducted to finalize the strength of recommendations and revise the consensus statements. The expert consensus on Nursing Care of Adult Patients with Urostomy comprises a total of 57 recommendations across four domains: basic requirements, psychological support, preoperative care, and postoperative care. All recommendations achieved strong consensus, with over 50% of experts endorsing a strong recommendation (indicating that benefits clearly outweigh risks). This study developed an expert consensus applicable to healthcare providers in various medical institutions for the care of adult patients with urostomy, with the goal of improving the quality of specialized stoma care, reducing the occurrence of stoma-related and peristomal skin complications, and enhancing patients' quality of life.

Community optometrists are primary eye care professionals who are well positioned to provide assessment and treatment for vision-related falls prevention. The aim of this mixed methods review was to synthesise the best available evidence for community optometrists' practice of falls prevention assessment and treatment for community dwelling older adults. A mixed methods systematic review utilised the convergent integrated approach in accordance with the Joanna Briggs Institute (JBI) guidelines and was conducted following a published protocol. Four databases, Ovid MEDLINE, Embase, Scopus and CINAHL Complete, and grey literature were searched from January 1980 to November 2025. Quantitative, qualitative and mixed methods studies that investigated community optometrists' practice of falls prevention screening, assessments, treatment or providing falls prevention advice to community dwelling older adults were eligible for inclusion. Two independent reviewers utilised standardised methods to search, screen, and code the studies included. Methodological quality of studies was assessed by two independent reviewers using JBI critical appraisal tools. Data synthesis followed the JBI convergent integrated approach. From 3853 articles screened, 11 articles (seven quantitative, one qualitative and three mixed methods studies) and four reports met the inclusion criteria. Two analytical themes were identified: (i) there was limited evidence that optometrists practiced falls risk screening and assessment, although they were aware and knowledgeable about the association between vision impairments and falls; (ii) there was sparse evidence for optometrists providing falls prevention treatment. There was limited evidence that optometrists were conducting key ocular assessments relevant for identifying falls risk such as depth perception or contrast sensitivity, and scant evidence of falls screening. There was some evidence for the practice of tailored spectacle prescription, but scant evidence for providing falls prevention advice. There was evidence for optometrists providing effective falls prevention treatment within a multidisciplinary team, but no evidence that identified if optometrists referred patients to other health professionals for falls prevention care. Further research that investigates how community optometrists as primary care health professionals can systematically practice falls prevention care is urgently required. CRD 42024539668.

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are among the most rapidly growing drug classes in contemporary medicine, approved for type 2 diabetes mellitus (T2DM) and obesity management. Although gastrointestinal adverse effects are well characterised, the pulmonary safety profile of GLP-1 RAs remains incompletely defined, representing an important evidence gap given the scale of global prescribing. This systematic review aims to synthesise published evidence on respiratory adverse events temporally associated with GLP-1 RA therapy in adults, characterise their patterns and severity, appraise the risk of bias using validated design-appropriate tools, describe proposed pathophysiological mechanisms, and grade the certainty of evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework. Given the heterogeneity of the included evidence-spanning case reports, pharmacovigilance analyses, and observational cohorts-this review is framed primarily as a signal-detection and evidence-mapping exercise rather than a causal-inference analysis. Adults (≥ 18 years) receiving any approved GLP-1 RA for any indication. Eligible study designs included randomised controlled trials (RCTs), retrospective and prospective observational cohorts, pharmacovigilance disproportionality analyses, and case reports or series. Studies were excluded if they enrolled paediatric populations, involved animal or in vitro experiments, reported only metabolic or cardiovascular outcomes without respiratory adverse-event data, or were narrative reviews, editorials, or commentaries without primary data. A systematic review was conducted following PRISMA 2020 guidelines (PROSPERO: CRD420261305875). PubMed, Embase, and Scopus were searched from inception to January 2026. Risk of bias was assessed using the Cochrane Risk of Bias 2 (RoB2) tool for RCTs, the Newcastle-Ottawa Scale (NOS) for cohort studies, and Joanna Briggs Institute (JBI) checklists for case reports, case series, and pharmacovigilance studies. GRADE was applied at the outcome-domain level; evidence from uncontrolled designs (case reports, case series, pharmacovigilance analyses) was initially rated very low certainty, as these designs are inherently uncontrolled and start below the lowest GRADE tier. Given substantial heterogeneity, meta-analytic pooling was not performed; a pre-specified narrative synthesis following the Synthesis Without Meta-Analysis (SWiM) reporting guideline was conducted. Nineteen studies met inclusion criteria: four RCTs (n = 1,884 participants), five retrospective cohort studies (n = 1,122,653 participants), three pharmacovigilance analyses (n = 498,892 spontaneous adverse-event reports), and seven case reports or case series (n = 13 patients). Spontaneous reports do not represent unique exposed individuals and were not pooled with participant counts. Risk of bias: all four RCTs were rated low risk by RoB2 (with some concerns for open-label outcome ascertainment in three trials, a domain-specific issue that does not alter the overall RoB2 category from low); three of five cohort studies were rated moderate and one high risk by NOS (one cohort study rating not reported, classified as not reported/unable to rate); all three pharmacovigilance studies were rated high risk by JBI; and case reports were rated as methodologically adequate by JBI, though these instruments cannot overcome the inherent anecdotal nature and very limited generalisability of single-case designs. Upper respiratory tract infections (URTIs) were the most frequently reported adverse event (8 of 12 reporting studies, 66.7%), occurring at rates comparable to controls across RCTs (GRADE: MODERATE certainty). Pharmacovigilance analyses identified disproportionate reporting signals for dyspnoea and asthma-like events, particularly with exenatide, using the reporting odds ratio (ROR 2.14, 95% CI 1.88-2.43; Cazzola 2024); these signals are hypothesis-generating only and do not establish causality or incidence. Serious adverse events reported in temporal association with GLP-1 RA exposure included anaphylaxis with bronchospasm (n = 4 cases), acute eosinophilic pneumonia (n = 1), perioperative aspiration pneumonitis or pneumonia (multiple perioperative cases across two cohort studies and one case series), acute respiratory distress syndrome (ARDS; n = 2, one fatal requiring extracorporeal membrane oxygenation [ECMO]), and spontaneous pneumomediastinum (n = 1). A large global retrospective cohort study (n = 331,863 matched patients; Henney 2024) demonstrated a potentially meaningful reduction in incident pneumonia with GLP-1 RAs compared with dipeptidyl peptidase-4 (DPP-4) inhibitors (hazard ratio [HR] 0.60, 95% confidence interval [CI] 0.58-0.62; GRADE: LOW certainty); this finding should be interpreted cautiously given the retrospective design, active and non-inert comparator, and likelihood of residual confounding. Evidence certainty for serious respiratory events was very low, driven by sparse case reports and high-risk pharmacovigilance data. GLP-1 RA therapy has a respiratory safety profile that is neither uniformly benign nor hazardous, stratified by mechanism, agent subclass, and clinical context. Common upper airway symptoms are mild and comparable to controls. Rare but clinically consequential events-including anaphylaxis, eosinophilic pneumonia, perioperative aspiration, and ARDS-have been reported in temporal association with GLP-1 RA exposure, predominantly in case reports and pharmacovigilance data of very low certainty; these signals are hypothesis-generating and should not be interpreted as confirmed causal risks. Exendin-4-based agents (exenatide and lixisenatide) appear to carry the highest reported risk of hypersensitivity reactions, attributable to their non-human structural origin. Clinicians should maintain heightened awareness for aspiration risk in perioperative settings; individualised, extended pre-procedural fasting intervals calibrated to the specific agent's pharmacokinetic profile should be considered. Prospective, standardised, and adequately powered studies with pre-specified respiratory endpoints are required to move from signal detection to causal inference.

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Breast milk is recognized as the ideal source of nutrition for infants; however, the widespread early interruption of exclusive breastfeeding within the first six months postpartum constitutes a major public health challenge. Despite clear recommendations from the World Health Organization and strong maternal intentions to exclusively breastfeed, complex factors continue to lead to involuntary interruption, and it is estimated that only 44% of infants worldwide are exclusively breastfed. This unplanned cessation not only deprives infants of irreplaceable nutritional and immunological benefits and increases the risk of morbidity, but also negatively affects maternal psychological well-being and results in substantial economic losses. Current evidence on the determinants of this interruption remains scattered across single-region studies, with a lack of cross-cultural and systematic synthesis of qualitative findings. Therefore, this study aimed to systematically review and meta-synthesize global qualitative evidence to identify the multidimensional determinants of early interruption of exclusive breastfeeding, thereby providing an evidence base for developing multilevel and effective intervention strategies. We systematically searched PubMed, CINAHL, the Cochrane Library, Web of Science, and Embase for publications from March 6, 2021 to March 6, 2026. The methodological quality of the included studies was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Qualitative Research, and the JBI meta-aggregation approach was used to summarize and synthesize the findings. A total of 33 studies were included, from which 252 findings were extracted. These findings were grouped into 10 categories and further synthesized into three integrated findings: mothers turning to supplementary feeding amid feeding uncertainty and physical and psychological burden; insufficient social support systems weakening the continuation of exclusive breastfeeding; and sociocultural factors, infrastructure gaps, and the commercial power of formula milk jointly normalizing supplementary feeding. Early interruption of exclusive breastfeeding is influenced by multilevel factors involving mothers, families and communities, healthcare services, work systems, sociocultural contexts, and commercial marketing. Future efforts should move beyond mother-focused health education and establish comprehensive support strategies covering families, communities, healthcare institutions, workplaces, and policy settings to reduce avoidable interruption of exclusive breastfeeding. PROSPERO Number CRD420251179108.

This mixed-methods systematic review synthesizes evidence on how cultural determinants influence acceptance of assistive health technologies (AHTs) among older adults aged 60 years and over in Asian low- and middle-income countries (LMICs). Despite increasing availability of digital health technologies, adoption rates among elderly populations in these settings remain critically low, and the dominant technology acceptance frameworks, developed in Western contexts, may inadequately account for cultural dimensions prevalent in Asian societies. Following a protocol pre-registered on the Open Science Framework (DOI: 10.17605/OSF.IO/8E9CD), systematic searches were conducted across PubMed, Scopus, IEEE Xplore, and Web of Science. From 488 records identified, 20 underwent full-text screening against five eligibility criteria. The most critical criterion required that cultural factors be explicitly investigated as a variable or theme. Six studies met all criteria. Quality assessment used design-matched tools: the JBI Critical Appraisal Checklist for Qualitative Research (10 items), the JBI Checklist for Analytical Cross-Sectional Studies (8 items), and the Mixed Methods Appraisal Tool (MMAT, 5 items). Synthesis followed a convergent integrated approach per JBI methodology. Six studies (3 qualitative, 2 quantitative, 1 mixed-methods) from China (n=4), India (n=1), and Thailand (n=1) were included. Five overarching cultural themes emerged: (1) family and filial piety as a double-edged enabler; (2) stigma and face culture (mianzi); (3) collectivist social norms; (4) trust and traditional health beliefs; and (5) digital literacy as a culturally mediated gap. Methodological quality was good: qualitative studies scored 8/10 to 10/10, the cross-sectional studies scored 6/8 and 8/8, and the mixed-methods study scored 5/5. Cultural determinants exert pervasive influence on AHT acceptance. Current acceptance frameworks require cultural adaptation. The evidence is geographically concentrated in East Asia, predominantly China, indicating an urgent need for studies from Southeast and South Asian LMICs.

Cardiovascular disease (CVD) is a leading cause of disability and mortality worldwide, with a rising prevalence among young adults. Digital health technologies (DHTs) offer potential support for disease management, yet their integration into the daily lives of young adults with CVD remains poorly understood. This study aims to systematically review and synthesize qualitative evidence on how young adults with CVD experience and engage with DHTs, from the perspective of media affordances. This review will employ a qualitative systematic review and meta-synthesis. We will search seven databases (Cochrane Library, PubMed, Web of Science, Scopus, Embase, CINAHL, PsycINFO) for qualitative and mixed-methods studies published from January 2013 to August 2025. Studies involving young adults (aged 18-49) with CVD who have used DHTs for disease management will be included. Two independent reviewers will screen studies, assess methodological quality, extract data, and synthesize findings, using the JBI Critical Appraisal Checklist for Qualitative Research for quality assessment and thematic synthesis guided by the Theory of Media Affordances for data synthesis. Confidence in the synthesized findings will be assessed using the GRADE-CERQual approach.Clinical Trial Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251138307, PROSPERO registration number CRD420251138307.

Due to the gap in the existing literature regarding the absence of meta-synthesis of qualitative studies in the field of gynecological cancer-related lymphedema, and the limited attention to patient's experiences, the purpose of this study is to synthesize the qualitative experiences of the subjective real experience of gynecological cancer-related lymphedema patients to provide a reference to formulate clinically targeted strategies for management. Journal articles were identified by conducting electronic searches in PubMed, CINAHL, PsycINFO, Web of Science, Cochrane Library, Embase, Chinese National Knowledge Infrastructure, Sino Med, Wanfang, VIP databases were searched to identify qualitative studies on real patient experiences of gynecological cancer-related lymphedema from inception to February 2026. The Integrating Methods were applied to synthesize and integrate the results. The methodological quality of included studies was assessed using the JBI Critical Appraisal Checklist for Qualitative Research tool. The quality of the synthesis results was assessed using Con Qual. A total of 12 studies involving 141 patients were included. Three themes and 10 subthemes were synthesized: Three synthesized findings were 1) Impacts of gynecological cancer-related lymphedema on patients, 2) Cognition and adaptation of patients with gynecological cancer-related lymphedema, and 3) Multifaceted support needs of patients with gynecological cancer-related lymphedema. The Con Qual rating of the synthesis results is moderate. Patients with gynecological cancer-related lymphedema bear dual physical and psychological burdens. Disease cognition and coping strategies exhibit significant heterogeneity across different patients. It is imperative to provide patients with comprehensive support. Future research should broaden geographical coverage and enhance the evidence system to improve the quality of life for patients with gynecological cancer-related lymphedema and to formulate more targeted clinical management strategies.

Falls are one of the most common adverse events among inpatients. Patients' awareness of fall risk can influence patient' behaviors and potentially reduce fall incidence. Although the importance of risk awareness in falls prevention has been increasingly recognized, how to effectively enhance awareness among high fall-risk inpatients and its consequent impact on fall rates remains to be further validated. To develop and implement an evidence-based practice protocol to enhance fall risk awareness among high fall-risk inpatients and evaluate its effectiveness, and to clarify its unique value compared with existing fall prevention approaches. This study constituted a nonrandomized, pre-post quasi-experimental evidence implementation project following the JBI PACES (Practical Application to Clinical Evidence System). The project was conducted in seven inpatient wards with the highest fall incidence rates over the preceding three years at a tertiary hospital in Changsha, China. A total of 420 high- risk inpatients (210 at baseline, 210 post-implementation) and 70 nurses from these wards were enrolled. Through evidence synthesis, 22 best practice recommendations were initially identified. Following FAME (feasibility, appropriateness, meaningfulness, and effectiveness) evaluation, 18 recommendations were retained, from which 20 audit criteria were developed. A baseline audit was conducted among 210 inpatients (June-July 2024) and the 70 nurses to evaluate compliance with these criteria. Barriers to best practice implementation were systematically identified through baseline audit findings using the JBI Getting Research into Practice (GRiP) framework, and a concise targeted implementation strategy was developed and applied for three months. This program employed multifaceted strategies across five dimensions: organizational support, system optimization, staff training, patient education, and electronic medical record (EMR)-integrated warning systems. A follow-up audit was then conducted (October-December 2024). Outcome measures, including audit criteria compliance rates, fall and injury incidence, patients' fall risk perception scores, patients' knowledge, attitude, and behavior regarding fall prevention and nursing staff's knowledge and attitudes, were compared pre- and post-implementation. Following EBP implementation, 16 of the 20 audit criteria demonstrated significant improvement (p&#x2009;<&#x2009;0.01). Notably, nine criteria achieved 100% compliance, and seven criteria increased from 0% to 100%. The incidence of falls decreased from 0.48% (1/210) to 0% (0/210), and the injury rate decreased correspondingly from 0.48% to 0%. Patients' Fall Risk Perception Scores increased significantly post-EBP: at admission, the mean score increased from 15.5 (SD 12.93) to 20.21 (SD 13.52); at discharge, from Mean score 16.8 (SD 12.69) to Mean score 28.15 (SD 19.76). Patients' scores across the three dimensions of fall prevention knowledge, attitudes, and behaviors were significantly higher post-EBP (p&#x2009;<&#x2009;0.01). Nursing staff demonstrated significantly improved knowledge on five fall risk awareness-related items (p&#x2009;<&#x2009;0.01), and their attitude scores were significantly higher post-intervention (P&#x2009;<&#x2009;0.01). This evidence-based practice protocol effectively enhanced fall risk awareness among high fall-risk inpatients, improved their knowledge, attitudes, and behaviors regarding fall prevention, enhanced nursing staff's knowledge and attitudes, and improved compliance with audit criteria. These findings provide a scientific basis for integrating patient-centered risk communication into routine fall prevention programs for fall high-risk inpatient populations. This evidence implementation project was retrospectively registered with the Fudan University Centre for Evidence-based Nursing-a JBI Centre of Excellence. This was not a randomized controlled trial. ER20251072. 9 January 2025.

To synthesize international qualitative evidence on nurses' experiences of returning to work after maternity leave and to develop an integrated understanding of the challenges, supports, and transition processes involved. Returning to work after childbirth represents a major professional and personal transition for nurses, with implications for well-being, workforce retention, and quality of care. Although qualitative research in this area has grown, the existing evidence remains fragmented and lacks an integrated conceptual understanding. A qualitative systematic review and meta-synthesis were conducted. Multiple electronic databases were searched for qualitative studies published in English or Chinese that explored nurses' experiences of returning to work after maternity leave. Methodological quality was critically appraised using the JBI critical appraisal tool, and findings were synthesized using a meta-aggregative approach. Confidence in the synthesized findings was assessed using the ConQual approach. Four interconnected domains characterized nurses' return-to-work experiences: conflict, including emotional distress, physical recovery challenges, work-family strain, and organizational barriers; support, encompassing family involvement, peer relationships, and workplace resources; coping, referring to strategies used to manage competing demands; and growth, involving career reflection and identity reconstruction. Confidence in the synthesized findings ranged from moderate to high. Return-to-work experiences are shaped by the dynamic interaction of personal recovery, family responsibilities, and organizational conditions. Supportive environments-including flexible work arrangements, breastfeeding accommodations, and empathetic leadership-facilitate healthier transitions and help mitigate early reintegration difficulties. Returning to work after maternity leave is a multidimensional transition influenced by individual, interpersonal, and organizational factors. Healthcare organizations and policy-makers should implement family-friendly and gender-responsive measures, including structured reintegration pathways, flexible scheduling, breastfeeding-friendly environments, and psychosocial support, to promote postpartum nurses' well-being, retention, and sustainable workforce development.

This meta-synthesis integrates qualitative evidence on how brain tumor patients' experiences of treatment decision-making consultations in order to identify the essential elements of a patient-centered consultation framework tailored to their needs. We used a Thomas and Harden's approach. Systematic search was conducted in Web of Science, PubMed, Embase, and Scopus for studies until June 15th, 2025. All included studies were critically appraised using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Qualitative Research. The study was registered on PROSPERO with registration number CRD42023457607. This synthesis identified four analytical themes that should guide healthcare providers: (1) consultations must address emotional and existential concerns; (2) communication should be personalized; (3) decision-making must remain flexible, allowing patients to delegate control to trusted others when desired; and (4) the irreplaceable and multifaceted roles of family and social support. Our findings reveal a persistent gap in shared decision-making among brain tumor patients, many of whom defer decisions to physicians due to emotional distress, cognitive limitations, and informational barriers. Enhancing patient-centered care therefore requires strategies that strengthen trust, support patient engagement, and address these structural and emotional challenges. Clinical consultation should consider about patients' emotional and existential concerns, incorporate personalized communication, adopt a flexible approach to decision-making, and appropriately involve family and social support.

The current health education for stroke patients and their families often fails to take into account the systematic differences in their needs, and most of the approaches are based on the single perspective of either the patients or the caregivers, lacking a systematic integration from a dual perspective. This study integrates the health education needs of stroke patients and caregivers, to inform the development of tailored health education programs for both stroke patients and their caregivers. A systematic search was conducted across Chinese and English databases including CNKI, Wanfang Database, VIP Chinese Science and Technology Journal Database, PubMed, Web of Science, Embase, Cochrane Library, and CINAHL for qualitative research papers addressing health education needs among stroke patients or caregivers. The search period spanned from the inception of each database to September 2025. The quality of included studies was assessed using the qualitative research tool developed by the JBI Centre for Evidence-Based Healthcare. Meta-synthesis was performed using the meta-synthesis approach. A total of 11 studies were included, yielding 38 findings that were ultimately synthesized into 11 new categories. These were consolidated into three outcomes: disease knowledge needs, psychosocial support needs, and resource support needs. The analysis further revealed systematic differences in health education needs between patients and caregivers. Healthcare providers should prioritize the needs of patients and their caregivers, developing health education plans based on a segmented, phased, and collaborative approach. This involves delivering targeted health education content to meet their specific educational requirements.