Virtual reality-based dementia educational programmes for formal and informal caregivers of people with dementia: A scoping review.

AIM: To map evidence of the existing virtual reality-based dementia educational programmes and the effects of these educational programmes on dementia formal and informal caregivers. DESIGN: A scoping review. METHODS: A comprehensive search of nine databases was conducted to find studies from the inception of the databases to October 2023. Two authors independently screened the titles and abstracts related to the eligibility criteria. Full texts of potentially relevant studies were read by one author and checked by a second. Data extraction and synthesis using NVivo 12 were undertaken by one author and checked by two other authors. RESULTS: Nineteen studies published between 2002 and 2022. The four randomised controlled studies and five qualitative studies were of moderate to good methodological quality. The 10 quasi-experimental studies were of weak to moderate quality. Fifteen virtual reality-based educational programmes had a positive influence on formal and informal caregivers, including improving caregivers' perceptions changing attitudes towards people with dementia, while the nursing competence of formal caregivers did not improve in short term. Educational programmes that covered dementia-related information and care strategies better improved the knowledge level of dementia formal and informal caregivers. CONCLUSIONS: The qualitative and quantitative studies of moderate to good quality included in this study support the idea that virtual reality-based dementia educational programmes may be a safe and effective way and have potential benefits for improving knowledge, perceptions, attitudes and nursing competence. IMPACT: This scoping review will provide an emerging teaching model for formal and informal caregivers of people with dementia and help them better understand the types and the influence of virtual reality-based dementia educational programmes. REPORTING METHOD: PRISMA-ScR. NO PATIENT OR PUBLIC CONTRIBUTION: Not required as this review in accordance with the aim to map existing literature from the dementia formal and informal caregivers' perspective.

Life experience and identity of spousal caregivers of people with dementia: A qualitative systematic review.

BACKGROUND: The number of people with dementia is on the rise worldwide, and dementia care has become the focus of global health services. People with dementia are primarily cared for by informal caregivers, with spouses seen as a particularly vulnerable group. Focusing on the spousal caregiving experience and having a good caregiver identity contributes to group bonding and enhanced social support. OBJECTIVE: To explore the dynamic changes that occur in the caregiving experience of spouse caregivers and explicate the identity of spouses during this process alongside its causes. DESIGN: A qualitative systematic review. DATA SOURCE: The following eight electronic databases were searched: PubMed, Web of Science (Core Collection), The Cochrane Library, Embase, CINAHL and CNKI, WanFang and Vip. REVIEW METHODS: The Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) and Joanna Briggs Institute Reviewer's Manual criteria were used to report the results. Study screening and data extraction were conducted independently by two reviewers, and quality was assessed using the Joanna Briggs Institute's Qualitative Research Standard Assessment tool. Data synthesis was performed using thematic analysis. RESULTS: A total of 15 studies were included and synthesized into three analytical themes: (1) attitudes and emotions toward dementia, (2) emotional ups and downs in dementia care, and (3) who am "I". In binary care, patience and marital responsibilities are identified as facilitators, while care burden and social isolation are identified as hindrances. In addition, gender differences were identified as influencers of identity. CONCLUSIONS: In this review, spouse identity of people with dementia is complex and affects caregiving experience together with dementia cognition. Disease cognition, caregiving burden and social isolation are identified. Interventions for barriers are suggested to enhance social support.

The impact of education/training on nurses caring for patients with stroke: a scoping review.

BACKGROUND: Stroke survivors have complex needs that necessitate the expertise and skill of well-trained healthcare professionals to provide effective rehabilitation and long-term support. Limited knowledge exists regarding the availability of specialized education and training programs specifically designed for nurses caring for stroke patients. AIM: This review aims to assess the content and methods of training for nurses caring for stroke patients, examine its impact on both nurses and patients, and identify key facilitators and barriers to its implementation. METHODS: We conducted a comprehensive scoping review by reviewing multiple databases, including PubMed, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, Embase, Web of Science, Scopus, ProQuest Dissertations and Theses, Google Scholar, and Cochrane databases. Data extraction and narrative synthesis were performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. RESULTS: Seventeen articles were included in this review. We found that education/training not only enhanced patients' self-care abilities, nursing outcomes, and satisfaction, but also had a positive impact on the knowledge, skills, and practices of nurses. The obstacles to education/training included feasibility and cost-effectiveness, while the driving factors were management support and participation, professional education/training, and controlled environment creation. CONCLUSIONS: This review highlights the crucial role of education/training in enhancing stroke care provided by nurses. Effective education/training integrates various educational methods and management support to overcome implementation barriers and optimize clinical practice benefits. These findings indicate the necessity of universal and consistent stroke education/training for nurses to further improve patient outcomes in stroke care.

Effect of thickened water swallow training in tube-feeding and dysphagia patients in the acute and early subacute phases of stroke: A quasi-experimental study.

BACKGROUND: Thickened water has been widely used in patients with dysphagia who receive oral feeding, but there is little evidence for tube-feeding patients. OBJECTIVE: To explore the effects of thickened water swallow training in tube-feeding and dysphagia patients in the acute and early subacute phases of stroke. METHODS: A quasi-experimental study. Hospitalised patients with acute and early subacute stroke who received tube feeding due to dysphagia were recruited from March to December 2021. Patients assigned to the intervention group (n = 23) received thickened water swallow training three times daily until the feeding tube was removed or they were discharged, and patients in the control group (n = 23) received usual care. The main outcomes were duration of tube feeding and rates of weaning at discharge. RESULTS: Patients in the intervention group had a shorter tube-feeding duration (p = .046) and a higher rate of weaning at discharge (p = .017) than those in the control group. Significant interaction effects between time and group were detected regarding quality of life except for the swallowing burden dimension. CONCLUSIONS: Thickened water swallow training is feasible and effective for stroke patients with tube feeding and can shorten the duration of tube feeding and improve the rates of weaning and quality of life. Healthcare providers in nonrehabilitation units should actively conduct swallowing function intervention training to maximise the potential for acute and early subacute phase rehabilitation.

Genetic testing decision-making experiences within families of colorectal cancer patients: A qualitative study.

PURPOSE: Genetic testing is the gold standard for the diagnosis of hereditary colorectal cancer syndromes but is currently inadequate and nonideal. The decision-making processes regarding genetic testing are even less well known. The present study aims to explore the decision-making experience of genetic testing for colorectal cancer patients and their family members. METHOD: A descriptive qualitative study was employed. Data were collected using individual semi-structured interviews with 5 colorectal cancer patients and 20 family members from November 2020 to April 2021. Interviews were transcribed and analysed using inductive content analysis. RESULTS: Four categories were identified: 1) the source of information for genetic testing, 2) the differentiated attitudes towards genetic testing, 3) genetic testing decisional needs, and 4) the factors influencing genetic testing decision-making. Colorectal cancer patients and their families engaged in two distinct pathways to genetic testing decisions: direct decision-making and indirect decision-making. Throughout these processes, due to the limited source of information, they had information needs that were met and facilitated genetic testing decision-making. CONCLUSIONS: Colorectal cancer patients and family members need knowledge related to genetic testing, but they have limited access to information, which prevents them from making informed decisions. Providing decision aid interventions and informational support are significant steps towards addressing the support needs of this population.

The influence of web-based decision aids on informal caregivers of people with dementia: A systematic mixed-methods review.

Caring for people with dementia is considered one of the most stressful and difficult forms of care. Informal caregivers constantly face high physical and emotional burdens. Therefore, it is essential to provide them with effective and practical support. Web-based decision aids can provide convenient and effective decision support for informal caregivers. The aim of this study was to assess and synthesize the influence of web-based decision aids on informal caregivers of people with dementia. Searches of electronic databases (CINAHL, MEDLINE, Web of Science Core Collection, Embase, PsycINFO, CNKI, Open Grey and Baidu Wenku) and reference lists of relevant studies were conducted in July 2022. Qualitative, quantitative and mixed-methods studies published in Chinese and English on the use of web-based decision aids by informal caregivers of people with dementia were included. The studies were selected by screening titles, abstracts and full texts, and the quality of each study was assessed by two researchers independently. Fourteen studies were published between 2010 and 2022, including five qualitative studies, four quantitative studies and five mixed-methods studies. Web-based decision aids have a positive influence on informal caregivers of people with dementia by providing decision support, satisfying needs, promoting psychological health, improving communication ability and reducing caregiver burden. Informal caregivers of people with dementia are receptive to web-based decision aids and expect their functionality to be optimized further. Web-based decision aids offer potential benefits to informal caregivers by providing effective decision-making support and improving their psychological health and ability to communicate.

Gaps in awareness and practice of healthy lifestyles among individuals at high risk of colorectal cancer: A qualitative evidence synthesis.

AIMS: To systematically examine and review relevant qualitative studies exploring the current lifestyle among individuals at high risk of colorectal cancer (CRC), and their awareness of the role of a healthy lifestyle in CRC prevention. BACKGROUND: The increasing incidence and mortality of CRC have presented a serious threat against the health and life of people. As the major population affected by CRC, the lifestyle of individuals at a high risk of CRC is attracting increasing attention. DESIGN: A qualitative evidence synthesis using the Thomas and Harden method and the PRISMA 2020 checklist provided by the EQUATOR network were used. DATA SOURCES: Literature was retrieved from PubMed, Web of Science, the Cochrane Library, Embase, CINAHL and PsycINFO from the inception to December 2021. REVIEW METHODS: Two reviewers independently screened the titles and abstracts and identified the eligible studies. Critical appraisals of each included study were performed. Thematic analysis was used to guide the data synthesis. RESULTS: The data from nine articles were analysed. Three interpretive themes were extracted that formed an overarching synthesis of the experience with healthy lifestyles among high-risk individuals of CRC. The findings suggested that these individuals with limited awareness of CRC and personal risks lacked sufficient knowledge about the relationship between lifestyle and CRC, and their attitudes and practices towards the role of a healthy lifestyle in CRC prevention were also diversified. CONCLUSION: Professionals can potentially provide personalised guidance for healthy lifestyles based on knowledge of prevention, the actual background and social support of individuals at high risk of CRC. IMPACT: Considering that knowledge gaps and health beliefs among these individuals are the premise blocking their adoption of a healthy lifestyle, the findings of this review may make contributions to the design and content of public health policy and prevention programs. No patient or public contribution.

How tablets/applications enhance social connections and social support in people with dementia: A qualitative systematic review.

The 2020 Lancet issue identified social isolation as one of 12 modifiable risk factors for dementia and revealed that enhanced social connections and social support can effectively reduce the incidence of social isolation. During the COVID-19 pandemic, technology attracted an increasing amount of attention, and it is necessary to synthesize ideas from existing evidence. First, we explored how people with dementia experienced changes in social connection and social support due to tablet/app use. Second, we explored the attitudes of people with dementia towards tablets and mobile applications. Third, we explored the feasibility of using tablets and mobile applications to enhance social connection and social support among people with dementia. We systematically searched the PubMed, Web of Science, Cochrane Library, Embase, CINAHL, CNKI, WanFang, and VIP databases. Two reviewers independently screened the titles and abstracts of studies, extracted the data and performed critical appraisals of each included study. The data synthesis was conducted using thematic analysis. A total of nine studies were included. Eight studies used mobile applications via tablets, and one study collected textual data from Twitter for analysis. Four themes were synthesized: (1) change from the perspective of caregivers; (2) growth of nonsingle aspects; (3) emotional feeling of belonging; and (4) feasibility of using digital technology. Tablet- and mobile application-based interventions can enhance both online and offline social connections and provide multiple types of social support among people with dementia. People with dementia have positive attitudes towards tablets and mobile applications. Overall, it is feasible for people with dementia to use technology.

Exploring the role of communication in missed nursing care: A systematic review.

AIMS: To systematically review the literature on relationships between communication issues and missed nursing care. DESIGN: Systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 Statement. DATA SOURCES: EMBASE, Web of Science, CINAHL, PubMed and Cochrane databases were comprehensively searched from inception to December 2021. REVIEW METHODS: Screening, data extraction and initial quality assessment were conducted independently by two reviewers. The JBI quality assessment tool was used for study appraisal and the certainty of evidence was assessed using the five Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria. Discrepancies were settled by consulting a third researcher. RESULTS: A total of 18 articles were included. Missed nursing care was common and the status of communication was not optimistic in clinical. Nurses' sociodemographic characteristics and work environment both influenced missed nursing care and communication. Intrateam communication included three parts: doctors-nurses communication, nurses-nurses communication and nurses-patients communication, poor intrateam communication could contribute to missed nursing care. There was an interaction between missed nursing care and communication. CONCLUSION: Promoting efficient intrateam communication, to acknowledge the importance of communication factors in reducing the incidence of missed nursing care in clinics is required. Future research can explore the impact of the internal dimension of communication on missed nursing care and consider interventions aimed at nurses' effective communication. IMPACT: What problem did the study address? This study offers new evidence that the impact of intrateam communication on missed nursing care. What were the main findings? Effective intrateam communication can reduce the incidence of missed nursing care, there is mutual influence between communication and missed nursing care. Where and on whom will the research have an impact? Policymakers can provide positive interventions on communication problems in different populations (e.g. nurses-patients, nurses-nurses and doctors-nurses) to provide high-quality patient care.

'It is my turn to raise her' - Decision-making regarding physical restraint in home care in China: A descriptive qualitative study.

BACKGROUND: The phenomenon of physical restraint applied to people with dementia in home care is receiving increasing interest from nursing scholars. Although family caregivers play key roles in caring for people with dementia, little is known regarding the ways in which family caregivers make decisions with respect to physical restraint. OBJECTIVES: The aim of this study was to explore Chinese family caregivers' decision-making regarding physical restraint in home care for persons living with dementia. DESIGN: A descriptive qualitative study was employed. METHODS: Using maximum variation sampling and purposive sampling, 18 family caregivers were recruited. Semistructured interviews were conducted in a memory clinic in northeast China between July 2020 and September 2020; the interviews were transcribed verbatim and analysed via thematic analysis. RESULTS: 'It is my turn to raise her' is a strong thread, which links three themes: (a) identifying culture-based family and filial ties; (b) maintaining culture-based family and filial ties; and (c) decision-making between belief and reality. The quote reflects the context of a Confucian and filial piety culture, which children care for their parents to repay the kindness of being provided an upbringing. Decisions based on this point are aimed at providing good personal care for people with dementia. Evaluating whether physical restraint is beneficial to people with dementia in general is an important factor in decisions regarding physical restraint. To repay the kindness of being provided an upbringing, children in the context of a Confucian culture cannot bear imposing physical restraint on their parents. CONCLUSIONS: This qualitative study provides new insight into the substantial influence of culture on family caregivers' decision-making. Perpetuating Confucian culture and improving the home care system can help reduce the use of physical restraint for people with dementia at home.

The influence path of caregivers' positive aspects, expressed emotion and coping style on behavioral and psychological symptoms of dementia.

OBJECTIVES: To analyze the correlation and mechanism of action among caregivers' expressed emotion, positive aspects, coping style and the behavioral and psychological symptoms of people with dementia by using the theory of planned behavior as a framework. METHODS: We investigated 193 pairs of people with dementia and caregivers to assess patients' behavioral and psychological symptoms, as well as caregivers' expressed emotion, positive aspects and coping style. Regression analysis and structural equation modeling were used. RESULTS: Dementia severity and psychotropic drug use were influencing factors of behavioral and psychological symptoms. Caregivers' positive aspects predicted expressed emotion and coping style, while expressed emotion predicted behavioral and psychological symptoms. Expressed emotion played a completely mediating role between caregivers' positive aspects and dementia patients' behavioral and psychological symptoms. CONCLUSION: Health care professionals should follow strict guidelines on medication, and focus on the caregiver's emotional state to reduce adverse effects on the person with dementia.