ABSTRACT
BACKGROUND: Mild cognitive impairment (MCI) in the elderly is a health problem worldwide. Several clinical trials indicated that traditional Chinese medicine (TCM) exercise therapies can effectively improve MCI, such as Tai Ji, Baduan jin exercise, Liuzi jue, and finger exercise. However, there is still controversy over which therapy is the best for elderly MCI patients. In this study, we aimed to systematically evaluate and compare the effectiveness and safety of these 4 TCM exercise therapies in elderly patients with MCI. METHODS: The Web of Science, PubMed, EMBASE, Cochrane Central Register of Controlled Trials, Clinical Trials, China National Knowledge Infrastructure, Wangfang database, and Chinese Biomedical Medicine will be comprehensively searched to collect all randomized controlled trials which included elderly participants with MCI receiving TCM exercise therapies through July 2020. Two reviewers will independently screen and evaluate each included study and extract the outcome indexes. ADDIS 1.16.8 software will be used for the network meta-analysis and STATA 14 software will be used for drawing network evidence plots and funnel plots. RESULTS: We will use the Bayesian statistical model to conduct a network meta-analysis to rank the effectiveness and safety of these 4 interventions, and use the GRADE approach to interpret the results. CONCLUSION: This network meta-analysis will find out the optimal treatment plan for MCI and provide evidence-based bias for clinical treatments decision-making. PROTOCOL REGISTRATION NUMBER: INPLASY202070006.
Subject(s)
Cognitive Dysfunction , Exercise Therapy , Medicine, Chinese Traditional , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Clinical Decision-Making , Cognitive Dysfunction/therapy , Combined Modality Therapy , Exercise Therapy/methods , Medicine, Chinese Traditional/methods , Mental Status and Dementia Tests/standards , Network Meta-Analysis , Randomized Controlled Trials as Topic , Safety , Tai Ji/methods , Treatment Outcome , Meta-Analysis as Topic , Systematic Reviews as TopicABSTRACT
Research has consistently demonstrated that viewing one's body in a mirror after an amputation or other perceived or visible body disfigurements can be a traumatic experience. Mirror viewing or mirroring is a taboo subject, which may be the reason this trauma has not been previously detected or acknowledged. Traumatic mirror viewing may lead to mirror discomfort, mirror avoidance, and a host of psychosocial concerns, including post-traumatic stress. As mirroring is complex, four qualitative mirror viewing studies, embodiment concepts, polyvagal theory, and memory theories were used to develop a model. In this article, foundational knowledge that led to the development of the model is shared. A neurocognitive model of mirror viewing is offered together with implications for nursing research, practice, and education.
Subject(s)
Body Image/psychology , Mental Status and Dementia Tests/standards , Humans , Self ConceptABSTRACT
Objective: To investigate the prevalence of family surrogates' do-not-resuscitate (DNR) intention for patients with dementia (PwD), and factors influencing family surrogates' decisions. Methods: This is a descriptive and cross-sectional study. Patients with dementia and their family surrogates from Dementia Outpatient Clinic of a teaching hospital in southern Taiwan were included. Data were collected using chart review and questionnaire survey. Influential factors were analyzed using multiple logistic regression. Results: One hundred and forty of the 223 participants (62.8%) have intention to sign DNR consents for their dementia relatives. Factors influencing the intention were: (1) Comorbid with musculoskeletal diseases or diabetes (p < .05); (2) psychological symptoms of repetitive wording and behavior (p < .05); (3) spouse (p < .05) and lineal relatives (p < .01); (4) previous discussion between families and patient about DNR directive (p = .001); (5) believers of Taiwan folk belief (Buddhism or Taoism) (p < .05). Conclusions: Advanced dementia patients cannot express intention about their end-of-life care and depend on family surrogates to decide for them. Our study showed that spouse and direct relatives, comorbidities of musculoskeletal disease or diabetes, psychological symptoms of repetitive wording and behavior, previous discussion about patients' intention, and believers of Taiwan folk belief are all positive influencing factors for surrogates to consent DNR directive for patients. Our findings are important in promoting DNR directive for PwD. Clinical implications: Our results may help to promote DNR decisions for dementia patients, especially in Chinese populations.