搜索结果：nursing

Accurate dosage calculation is vital for patient safety, making effective instructional methods a priority in nursing education. This study investigated whether embedding images of medications or syringes in medication calculation exams affects students' performance and metacognitive judgments. In a randomized controlled trial, 120 students took a calculation exam either with images (n = 63) or without (n = 57). Performance and ease of learning judgments were analyzed using t-tests, analyses of covariance, and logistic regression. The image group achieved significantly higher scores (M = 7.22 vs. 6.04/8, P <.001) and reported greater perceived ease of learning P <.001). The benefit was pronounced for early-semester students. The effect of the image remained significant after controlling for native language. Calibration accuracy showed no significant difference. Images in medication dosage calculation exams were associated with improved performance and higher perceived ease of learning among nursing students. Incorporating images may better support the mastery of medication calculation.

The rapid advancement of digital technologies, combined with the evolving complexity of health care environments, has introduced a new paradigm in nursing practice. Clinical nurses are now required not only to deliver safe and effective patient care but also to demonstrate competencies in digital literacy and innovation. Among these emerging competencies, digital leadership has become a critical attribute-enabling nurses to lead digital transformation, ensure patient safety, enhance care quality, and support system-level change within health care organizations. Despite its increasing relevance, there is a notable absence of validated measurement tools tailored to assess digital leadership in clinical practice. This study aimed to develop and psychometrically validate a Digital Leadership Scale for Clinical Nurses (DLS-CN) to systematically evaluate the digital leadership capabilities of nurses working in clinical settings. The scale development process followed a rigorous multistep procedure. Initial items were derived from previous qualitative research involving a literature review and in-depth interviews, complemented by an additional literature review conducted in this study. The content validity of 38 preliminary items was evaluated by 9 experts over 2 rounds. A pilot test was conducted with 30 nurses, followed by cognitive interviews with 5 nurses to refine item clarity and relevance. The final set of items was administered to 446 clinical nurses across various health care institutions. Data were randomly split for exploratory factor analysis and confirmatory factor analysis. Additional analyses were conducted to evaluate item discrimination, convergent validity, and internal consistency using IBM SPSS 25.0 and AMOS 23.0. The finalized DLS-CN consists of 29 items grouped under four domains: (1) ability to use digital technology, (2) digital safety management, (3) digital collaboration mindset, and (4) organizational influence. These 4 factors explained 56.9% of the total variance. The scale showed strong internal consistency (Cronbach &#x3b1;=0.95). Convergent validity was demonstrated through strong positive correlations with the Nursing Informatics Competency Scale (Pearson correlation coefficient r=0.82; P<.001) and the Self-Leadership Scale (Pearson correlation coefficient r=0.83; P<.001). The DLS-CN is a valid and reliable instrument for measuring digital leadership among clinical nurses. It offers a practical tool for educators, administrators, and researchers to assess and enhance digital leadership capabilities-ultimately supporting the digital transformation of health care systems.

Septic arthritis (SA) is a medical emergency associated with substantial morbidity and mortality. Although the knee is the most commonly affected joint in adults, contemporary national data describing characteristics, mortality, and healthcare utilization in knee-specific native SA are limited. We conducted a retrospective study of adult hospitalizations for nongonococcal native knee SA in the United States using the National Inpatient Sample database from 2016 to 2022. Hospitalizations were identified using ICD-10 diagnostic codes, excluding gonococcal and prosthetic joint infections. Thus, the analytic cohort was restricted to native joint disease and did not include prosthetic joint infection. Weighted analyses were performed to generate national estimates. Multivariable logistic regression was used to identify factors independently associated with in-hospital mortality. Among approximately 205 million adult hospitalizations, 92,290 (0.045%) had native SA of the knee. In-hospital mortality was 2.5%. Patients who died were older, had longer lengths of stay, and incurred more than double the median hospital charges compared with survivors. In multivariable analysis, factors independently associated with higher odds of in-hospital death included respiratory failure (odds ratio [OR] 8.54), sepsis (OR 3.57), liver disease (OR 3.45), cerebrovascular disease (OR 2.27), acute kidney injury (OR 2.05), chronic kidney disease (OR 1.66), myocardial infarction (OR 1.60), heart failure (OR 1.55), and increasing age. Survivors demonstrated substantial postacute care needs, with 36% discharged to skilled nursing or intermediate care facilities. In this nationally representative cohort, nongonococcal native septic knee arthritis showed substantial in-hospital mortality, morbidity, and healthcare utilization. Mortality was driven primarily by multiorgan dysfunction rather than demographic or socioeconomic factors. Early identification and aggressive management of high-risk patients may improve outcomes.

Parkinsonian syndromes are increasingly recognized in aging populations, but data from the Caribbean remain limited. In the French West Indies, atypical forms may be particularly prevalent, potentially linked to environmental exposures. This study assessed the prevalence, clinical features, and one-year mortality of parkinsonian syndromes in institutionalized older adults. We analyzed two observational cohorts: KASEHPAD (n&#x202f;=&#x202f;332 nursing home residents) and KASAF (n&#x202f;=&#x202f;107 professional foster family residents). Parkinsonian syndromes were defined by clinical diagnosis and/or antiparkinsonian medication use. Data collected included demographics, comorbidities, cognitive function (MMSE), functional dependence (ADL), physical performance (SPPB), quality of life (EQ-5D-3L), and neuropsychiatric symptoms (NPI-Q). Cox model identified predictors of one-year mortality. Among 439 residents, 51 (11.7%; 95% CI: 8.7-14.7) presented with a parkinsonian syndrome. Compared with non-parkinsonian residents, they had greater functional dependence (ADL score: 1.6&#x202f;&#xb1;&#x202f;1.9 vs. 2.2&#x202f;&#xb1;&#x202f;2.1), more depressive symptoms, lower quality of life (EQ-5D score: 0.11&#x202f;&#xb1;&#x202f;0.36 vs. 0.24&#x202f;&#xb1;&#x202f;0.42; p&#x202f;=&#x202f;0.035), and higher anxiety prevalence (66.7% vs. 43.3%; p&#x202f;=&#x202f;0.002). One-year mortality did not differ (22.5% vs. 22.2%; p&#x202f;=&#x202f;0.975), and parkinsonian status was not independently associated with mortality. Parkinsonian syndromes are common and clinically severe in French Caribbean long-term care facilities, with substantial functional and neuropsychiatric burden, but without increased short-term mortality. Mortality may be mainly influenced by frailty, comorbidities, and functional impairment, underscoring the need for tailored care strategies. NCT04545775 and NCT04587466.

To explore what works for whom, how and why when implementing women's sexual and reproductive health interventions in prisons to understand the barriers and facilitators to implementation and to generate recommendations for policymakers. Realist review using the Realist And Meta-narrative Evidence Synthesis: Evolving Standards guidelines. We systematically searched Ovid MEDLINE, Global Health, Embase, the Cumulative Index to Nursing and Allied Health Literature (CINAHL) and the American Psychological Association (APA) PsycINFO databases and hand-searched unpublished literature and reference lists, January-June 2025. Primary studies of implementing women's sexual and/or reproductive health interventions, including those addressing sexually transmitted infections, cervical health, breast screening, contraception and women's health holistically. Study populations included people in prisons that detain women in high-income countries. We extracted and analysed data relating to implementation processes using a grounded theory approach and retroductive inference to articulate cross-case Intervention-Context-Actor-Mechanism-Outcome configurations (ICAMOCs) and refine programme theory. We discussed findings in relation to existing theories from the literature to elicit recommendations for policymakers. Of 4617 deduplicated records, 26 met the inclusion criteria. Ten ICAMOCs were constructed from cross-case analyses, grouped into three themes: (1) planning (teaming, team leadership, assessing needs and capacity, tailoring and planning), (2) doing (piloting, standardisation and support, trauma-informed engagement and peer advocacy) and (3) sustaining (evaluation-adaptation cycles). The ICAMOCs indicated three overarching mechanisms as being key to effective implementation, namely, perceived utility of the intervention, motivation and empowerment. For women's sexual and reproductive health interventions to be effective in prisons, everyone involved in implementation needs to perceive the intervention's benefit and be both motivated and empowered to take action. We recommend policymakers build a resilient and empowered delivery workforce, invest in research partnerships to increase awareness and understanding and promote trauma-informed approaches to women's healthcare in prisons.

To compare the effects of high-immersion versus low-immersion virtual reality (VR) on pain, anxiety, and sense of presence during burn dressing changes in adult patients. A quasi-experimental, non-randomized crossover study. The study was conducted in an inpatient burn center between September 2021 and August 2023. Adult patients undergoing routine nurse-led burn dressing changes experienced both high-immersion and low-immersion VR during two consecutive sessions, alongside standard care without VR. Pain intensity, anxiety, and sense of presence were assessed using validated self-report measures. Linear mixed-effects models were applied to analyze differences across conditions while accounting for repeated measurements and session-related factors. Sixty-seven patients completed both VR conditions. Use of VR during dressing changes was associated with significantly lower pain and anxiety compared with standard care. No statistically significant differences were found between high- and low-immersion VR for pain or anxiety outcomes. High-immersion VR, however, resulted in significantly higher levels of perceived presence. Virtual reality is an effective nonpharmacological adjunct for reducing pain and anxiety during burn dressing changes. In this clinical context, increased immersion enhanced subjective presence but did not produce additional analgesic or anxiolytic benefits. Burn dressing changes are predominantly nurse-led procedures, placing nurses in a central role in procedural pain and anxiety management. These findings suggest that VR interventions, including low-immersion systems, can be feasibly implemented by nursing staff as part of routine care, indicating clinically relevant reductions in pain and anxiety without substantially increasing technical or workflow demands.

ObjectiveTo map rehabilitation interventions and rehabilitation-relevant management reported for lateral medullary stroke (Wallenberg syndrome) and distinguish direct intervention evidence from management and assessment reports.Data sourcesPubMed/MEDLINE, Ichushi-Web, and Web of Science Core Collection were searched from inception to 12 March 2026. Cumulative Index to Nursing and Allied Health Literature was searched on 24 April 2026. Citation tracking was performed.Review methodsReports were eligible if they described rehabilitation, rehabilitation-relevant management, assessment, prognosis, or monitoring relevant to recovery or safety. Two reviewers screened records; charting and classification were verified by a second reviewer using operational definitions. Reports were grouped by clinical phase, target domain, safety management, outcome measures, and primary reporting function.ResultsThe searches identified 741 records; 486 unique records were screened and 78 reports were included. Publication years ranged from 1997 to 2026; 60 reports were case reports or case series. Primary reporting functions were categorized as explicit intervention/program (n&#x2009;=&#x2009;29), management/procedural pathway (n&#x2009;=&#x2009;21), assessment/prognostic/monitoring (n&#x2009;=&#x2009;18), and minimal-detail supportive/diagnostic (n&#x2009;=&#x2009;10). Dysphagia was addressed in 63 reports, but only 22 were explicit intervention/program reports. No included report explicitly described sensory safety education.ConclusionThe accessible literature is useful but mixed. Interpretation is limited by unretrieved full-text candidates, omitted databases/grey literature, no critical appraisal, and no independent agreement statistic for post hoc reporting-function classification. Future reports should separate therapeutic training from management pathways and describe dosage, safety management, reassessment timing, discharge function, sensory safety education, and daily-life precautions.

Stroke is a disease with one of the highest disability rates, frequently associated with multiple functional impairments. Among these, dysphagia is a relatively common complication, with an incidence rate exceeding 30%. PSD not only causes malnutrition, dehydration, and aspiration pneumonia but also prolongs hospital stays and severely compromises patients' quality of life. Both the "Opening the Orifices and Alleviating Throat Obstruction" four-step acupuncture technique (a TCM therapy) and motor imagery (MI) therapy are effective for PSD. However, the efficacy of combining this specific acupuncture technique with MI remains unclear. This study aims to investigate the safety and effectiveness of integrating the "Opening the Orifices and Alleviating Throat Obstruction" four-step acupuncture technique with MI therapy for PSD rehabilitation. Patients were randomized into two groups: the control group received standard rehabilitation, while the treatment group received the combined acupuncture and MI therapy in addition to standard care. Outcomes were assessed using the Water Swallowing Test (WST), Functional Oral Intake Scale (FOIS), and Penetration-Aspiration Scale (PAS). The results demonstrated that after 28 days of treatment, the WST and PAS scores decreased in both groups relative to pre-treatment levels, while the FOIS scores increased. Furthermore, the WST and PAS scores in the treatment group were lower than those in the control group, and the FOIS score was higher, with statistically significant differences (P < 0.05). The treatment group scored higher than the control group in three dimensions of the Nurse-Patient Satisfaction Nursing Scale (NPSNS): medical professional level, clinical treatment effect, and overall satisfaction. These differences were statistically significant (P < 0.05). However, no statistically significant differences were observed in the scores for the two dimensions of hardware environment configuration and medical service experience between the two groups (P > 0.05). These results highlight the efficacy of the combined treatment approach in enhancing swallowing function and minimizing leakage and aspiration.

Comprehensive telehealth is used effectively for treatment-resistant chronic diseases in certain integrated health systems but has seldom been implemented in systems that provide mainly fee-for-service (FFS) care. To examine the effectiveness and implementation of comprehensive telehealth delivered in an FFS environment for patients with uncontrolled type 2 diabetes (T2D) and comorbid hypertension. Pragmatic, randomized, effectiveness-implementation trial. (ClinicalTrials.gov: NCT05120544). 6 academic primary care or endocrinology clinics. Participants had both T2D with hemoglobin A1c (HbA1c) persistently at 8.0% or higher for at least 6 months and hypertension with at least 1 systolic blood pressure (BP) above 140 mm Hg or diastolic BP above 90 mm Hg in the past year. Two 12-month, mobile monitoring-enabled interventions: a self-monitoring control program and a nurse-delivered, comprehensive telehealth program incorporating self-management support and medication management. Primary (HbA1c) and secondary outcomes were evaluated at 12 months. Implementation analyses evaluated fidelity and barriers to intervention delivery. Participants were 64% female and 68% Black. The mean age was 54.5 years, mean HbA1c 9.8%, and mean BP 135/81 mm Hg. The estimated mean change in HbA1c from 0 to 12 months was -0.7 percentage points with self-monitoring and -1.1 percentage points with comprehensive telehealth; the estimated mean between-group difference in HbA1c change at 12 months was -0.4 percentage points (95% CI, -1.0 to 0.3 percentage points). Between-group differences in change in secondary outcomes did not reach statistical significance, except for diabetes self-care (0.4 [CI, 0.0 to 0.9], favoring comprehensive telehealth). The comprehensive program was delivered with suboptimal fidelity (median encounters per participant, 9; fidelity threshold, &#x2265;12); analyses identified barriers to program delivery. Generalizability to dissimilar populations and systems lacking telehealth infrastructure may be limited. Comprehensive telehealth did not substantially lower HbA1c relative to control in this study. Population factors, intervention and control program design, and barriers to FFS implementation of comprehensive telehealth may have contributed to these findings. National Institute of Nursing Research and Duke Clinical & Translational Science Institute.

This paper aims to promote international collaboration among air medical organizations and provide an overview of the Japanese Society for Aeromedical Services (JSAS) Annual Congress. In 2025, the 32nd Annual Congress of the JSAS was held in Numazu City from November 13 to 15 under the theme "Toward a Shared Vision: A New Era in Aeromedical Care." The congress included 220 presentations and was attended by 980 participants. It remains the only national conference in Japan dedicated exclusively to air medical care. The meeting provided a comprehensive overview of current air medical services and future directions. Key topics included the status of helicopter emergency medical services in Europe, lifesaving cases involving Japan's doctor-helicopter (DH) system, helicopter underwater escape training, international air medical evacuation, and operations of the US Air Force Critical Care Air Transport Team. Sessions also addressed challenges related to prehospital blood product administration, ventilator requirements, safety management, and aircraft maintenance systems. Additional discussions focused on the standardization of clinical protocols, dispatch criteria, and flight physician education, as well as the development of quality indicators through multidisciplinary collaboration. The program further highlighted nationwide public awareness initiatives, nursing practices in air medical settings, responses to large-scale disasters, activities of related organizations, and international air medical evacuation. We believe that the face-to-face relationships fostered through the JSAS Annual Congress play a vital role in strengthening collaboration among DH teams and other aerospace-related organizations.

Urinary tract infections (UTIs) in men, though less frequent than in women, represent a significant clinical challenge due to their increasing incidence with age and distinct microbiological profiles. This expert review analyzed data of urine cultures in men with community-acquired UTIs, collected from emergency departments of 15 french hospitals, from the private laboratory group Atoutbio (21 sites in Meurthe-et-Moselle and the Vosges French departments, alongside primary care records from the AntibioClic tool and the PRIMO database, to characterize the bacterial epidemiology of community-acquired male UTIs in France. Escherichia coli (39-40%) dominated, followed by Enterococcus faecalis (13-15%), Klebsiella pneumoniae (6-8%), and Proteus mirabilis (5-6%). Resistance rates were as follows amoxicillin (47-53.5%), amoxicillin-clavulanate (24-35.7%), trimethoprim-sulfamethoxazole (25.4-31.5%), and fluoroquinolones (16.3-20.2%). Resistance to third-generation cephalosporins (6.6-9.3%) and mecillinam (6.8-8.9%) was lower, while fosfomycin (1.4-1.5%) and nitrofurantoin (0.4-0.7%) retained high susceptibility. Extended-spectrum &#x3b2;-lactamase (ESBL)-producing E. coli ranged from 2 to 8.4%, with carbapenemase producers remaining rare (0.1%). Resistance was higher in men >65&#x202f;years, particularly in nursing homes, where 3GC resistance reached 15-18%. &#xab; Emerging uropathogens &#xbb; (Aerococcus urinae 1-1.1%, Actinotignum schaalii 0.1-0.4%) were rare. This study highlights the greater microbial diversity in male UTIs compared to women and underscores the need for systematic urine culture, susceptibility testing, and empirical therapy tailored to resistance patterns, age, and risk factors.

Sandtray therapy is a non-pharmacological expressive intervention that enables individuals to communicate inner experiences through symbolic and metaphorical representation. Unlike traditional non-directive sandplay therapy, sandtray therapy is more structured and may include facilitator prompts. It has been associated with psychosocial benefits across diverse age groups experiencing psychological or behavioral challenges. This study examined the effects of sandtray therapy on cognition, mood, self-efficacy, life satisfaction, and gerotranscendence among community-dwelling older adults in Taiwan, and further explored participants' lived experiences. A mixed-methods design was employed. A total of 140 participants were randomly assigned to an intervention or control group. The intervention group attended weekly 30-40-minute sandtray sessions for four weeks, while the control group received no intervention. Outcomes were assessed pre- and post-intervention using the Mini-Mental State Examination (MMSE), Geriatric Depression Scale-Short Form (GDS-SF), General Self-Efficacy Scale (GSES), Satisfaction with Life Scale (SWLS), and Gerotranscendence Scale (GS). Semi-structured interviews were conducted following the intervention. A one-way analysis of covariance analyses revealed significant between-group differences in self-efficacy (p&#x202f;<&#x202f;.001), life satisfaction (p&#x202f;<&#x202f;.001), and gerotranscendence (p&#x202f;<&#x202f;.001). No significant effects were observed for cognitive function or depressive symptoms. Qualitative analysis identified three overarching themes: building social connectedness, the essential role of play in later life, and engagement in cognitively demanding processes. Sandtray therapy appeared feasible and well-tolerated within this study sample. The findings suggest that sandtray therapy may serve as a beneficial non-pharmacological intervention for promoting positive aging, particularly through improvements in self-efficacy, life satisfaction, and psychosocial growth among older adults.

Although technology has been widely implemented in Parkinson's disease (PD) research, little is known about its efficacy on participants' psychosocial domains. This study assessed the potential effect and usability of the Voice-Activated Intelligent Personal Assistant (VIPA) on participants' sense of coherence and psychosocial well-being. This single-blinded, 2-arm pilot randomised controlled trial, with 7 post-intervention interviews, recruited 48 participants. Intervention group participants received a user protocol for their 8-week VIPA usage, while the control group received usual care. Primary outcome was the Sense of Coherence 13-item scale (SOC-13). Other outcomes were Mental Health Continuum-Short Form (MHC-SF), UCLA Three-Item Loneliness Scale, Parkinson's Disease Questionnaire-8, Brief Resilient Coping Scale, and System Usability Scale. Generalized Estimating Equation (GEE) was selected as the primary analysis, with multiple imputation performed as sensitivity analysis. A significant reduction of positive emotion in IG was identified for the MHC-SF emotional well-being at post-intervention (&#x3b2;&#x202f;=&#x202f;-1.69, p&#x202f;=&#x202f;0.028) but not at week 12 follow-up (&#x3b2;&#x202f;=&#x202f;-0.96, p&#x202f;=&#x202f;0.31). Exploratory effect sizes were identified for SOC-13 meaningfulness (d&#x202f;=&#x202f;0.27), manageability (d&#x202f;=&#x202f;0.19), and MHC-SF psychological well-being (d&#x202f;=&#x202f;0.27). Interviewee reportedly internalised their failed interaction attempts into speech characteristics, and it resembled being ignored by a real person. The study identified preliminary trends of improvements in participants' meaningfulness domain and psychological well-being. The decrease in emotional well-being could be attributed to the reported technical difficulties and VIPA's fair usability. A future VIPA redesign is required to avoid similar adverse effects.

Maternal suicide is a leading cause of postpartum death. Suicidal ideation in perinatal depression is associated with significant risks to maternal, infant, and family well-being. While previous studies have explored trajectories of perinatal suicidal ideation, the dynamic relationships between symptoms remain unclear. To examine the predictive role of suicidal ideation within the perinatal depression symptom network across different stages of the perinatal period, using cross-lagged network analysis. Data were obtained from a population-based perinatal depression screening program in Shenzhen, China (June 2020-May 2022). Among 144,887 women with at least one EPDS screening record, 91,123 contributed data from at least two survey time points; after excluding 694 women who delivered before 32 gestational weeks, 90,429 were included in the final analysis. Depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS). Cross-lagged networks were estimated using the 'glmnet' and 'qgraph' packages in R, with missing data imputed via the mice package. Suicidal ideation (EPDS Item 10) demonstrated the strongest predictive influence (out-expected influence) across all three cross-lagged networks. In the T3&#x202f;&#x2192;&#x202f;T4 network (late pregnancy to postpartum), suicidal ideation showed the highest out-expected influence (0.193), predicting symptoms including sadness (E8), tearfulness (E9), guilt (E3), and sleep disturbance (E7). The strongest edge across all networks was between suicidal ideation and sadness, with edge weights ranging from 0.1164 to 0.1820. Stability analyses indicated high robustness (CS-coefficients >0.75). Suicidal ideation plays a central and sustained predictive role in the evolution of perinatal depressive symptoms, particularly from late pregnancy to postpartum. Systematic monitoring of suicidal ideation and targeted interventions across perinatal stages are essential to mitigate the progression of depressive symptoms. Not registered.

Coronary obstruction is a critical risk in valve-in-valve transcatheter aortic valve replacement (TAVR). The UNICORN (undermining iatrogenic coronary obstruction with radiofrequency needle) technique mitigates this risk via intraleaflet valve deployment. However, comprehensive bench testing data regarding this technique is lacking in the literature. The aims of this study were to evaluate leaflet behavior after intraleaflet balloon dilatation across different transcatheter heart valve (THV) platforms, simulate the crossing of a second THV across de novo fenestrations, and understand leaflet behavior during and after deployment. In vitro bench testing used 4 index THV platforms: SAPIEN 3, Evolut, Navitor, and ACURATE neo2. Following leaflet traversal, target leaflets underwent sequential balloon dilatation (8-14 mm). We assessed the maximum balloon size tolerated without laceration, the minimum size required for a second balloon-expandable THV (SAPIEN 3 Ultra RESILIA) to cross the fenestration, deployment feasibility, and postdeployment valve geometry. Most index THV leaflets tolerated balloon dilatation up to 12 to 14 mm without laceration. A minimum fenestration size of 12 to 14 mm facilitated most of the second THV crossing. Postdeployment models confirmed coronary clearance on the treated side. Successful intraleaflet THV deployment was achieved with the SAPIEN 3, Evolut, and ACURATE neo2. Conversely, intraleaflet deployment in the Navitor (and Portico) platform was unsuccessful; the leaflet remained intact following expansion, resulting in frame distortion and inner-valve tilting possibly due to stiff leaflet and compliant frame. This bench study defines optimal balloon sizing for UNICORN across common THV platforms and confirms coronary clearance. It was determined that one index valve resisted intraleaflet deployment. Further clinical validation is required before widespread adoption.

By 2050, two-thirds of people with dementia will live in low-and-middle-income countries (LMICs). However, multimodal prevention lifestyle interventions for people at risk are being developed predominantly in higher-income countries. We systematically reviewed randomised controlled trials (RCTs) evaluating non-pharmacological interventions in individuals with mild cognitive impairment and subjective cognitive decline in LMICs. We assessed quality using the Mixed Methods Assessment Tool, meta-analysed and synthesised evidence. We included 25 RCTs from six countries (most in China, n=17), involving 1304 participants. In the 15 studies with sufficient data to meta-analyse, we found significant positive effects on cognition favouring interventions (1.49 (standardised mean difference, 95% CI 1.06 to 1.93)). There was significant publication bias. We classified interventions into exercise, multidomain and arts/creative expression. Exercise (1.67, 95% CI 1.24 to 2.11, n=8) and multidomain (1.22, 95% CI 0.22 to 2.21, n=5) had replicated evidence of effectiveness. There was insufficient data to meta-analyse the arts/creative category. We propose greater consideration and investment in the development of interventions accounting for specific LMIC contexts from the outset, so they are acceptable and used by local services. CRD42023403908.

暂无摘要（点击查看详情）