Prevalence and factors associated with anemia in women of reproductive age across low- and middle-income countries based on national data.

Anemia is a global threat among women of reproductive age (WRA), or 15-49 years old women, both in developed and developing countries. Prevalence of anemia in WRA is higher by fourfold in developing countries, based on extensive studies and surveys conducted by WHO and UNICEF. However, there is limited studies that conducted pooled analysis of anemia prevalence in low resource countries. This study aimed to assess the prevalence and factors associated with anemia among women of reproductive age in low- and middle-income countries (LMICs). This study used secondary data from the Demographic and Health Survey (DHS) in 46 low- and middle-income countries during 2010-2021. Descriptive statistics of proportions between pregnant and non-pregnant mothers were assessed. Multilevel binary logistic regression was used to test the factors associated with anemia among women of reproductive age. A total of 881,148 women of childbearing age in LMICs were included. This study found a high prevalence of 45.20% (95% CI 41.21, 49.16) of anemia was observed in among pregnant women and 39.52% (95% CI 33.88, 45.15) anemia was observed in non-pregnant women. Educational status, wealth status, family size, media exposure, and residence were common factors significantly associated with anemia in both pregnant and non-pregnant women. The high global burden of anemia in LMICs continues to underline the need for unusual approaches and target interventions on an individual basis. Global commitment and movement to reduce the prevalence of anemia need to be revisited and redesigned for current circumstances.

Effects of Case Management in Trauma Patients in Taiwan: A Randomized, Longitudinal Study.

BACKGROUND: Case management can improve trauma patient outcomes from the acute to rehabilitation phases. However, a lack of evidence on the effects of case management in trauma patients makes it difficult to translate research findings into clinical practice. OBJECTIVE: To examine the effects of case management on illness perception, coping strategies, and quality of life in trauma patients followed up to 9 months post-hospital discharge. METHODS: A four-wave longitudinal experimental design was used. Patients with traumatic injury hospitalized at a regional hospital in southern Taiwan from 2019 to 2020 were randomly assigned to a case management (experimental) or a usual care (control) group. The intervention was implemented during hospitalization with a phone call follow-up about 2 weeks post-discharge. Illness perception, coping strategies, and health-related quality-of-life perceptions were measured at baseline, 3 months, 6 months, and 9 months after discharge. Generalized estimating equations were used for analysis. RESULTS: Findings showed a significant difference in illness perception at 3 and 6 months and coping strategies used at 6 and 9 months after discharge between the two groups. No significant difference in the quality of life over time between the two groups was found. CONCLUSION: Although case management appears to help patients with traumatic injuries decrease illness perception and better cope with their injury, it did not significantly improve their quality of life 9 months after discharge. It is recommended that health care professionals develop long-term case management strategies for high-risk trauma patients.

Early Quality-of-Life Changes in Mild Traumatic Brain Injury: A Prospective Study.

BACKGROUND: Postinjury symptoms and decreased quality of life are common after mild traumatic brain injury. However, few studies have examined how soon, after injury, these changes dissipate. OBJECTIVES: This study aimed to compare changes in postconcussion symptoms, posttraumatic stress, and illness representations and identify predictors of health-related quality of life before and 1 month after hospital discharge for mild traumatic brain injury. METHODS: A prospective, multicenter, correlational design was used to measure postconcussion symptoms, posttraumatic stress, illness representations, and health-related quality of life. The survey was administered to 136 patients with mild traumatic brain injury between June 2020 and July 2021 at three hospitals in Indonesia. Data were collected at discharge and 1 month later. RESULTS: Compared with before hospital discharge, data collected 1 month after discharge showed that patients experienced reduced postconcussion symptoms, posttraumatic stress, better illness perceptions, and quality of life. Those with postconcussion symptoms (ß =-.35, p < .001), more posttraumatic stress symptoms (ß =-.12, p = .044), more identity symptoms (ß = .11, p = .008), worsened personal control (ß =-.18, p = .002), worsened treatment control (ß =-.16, p = .001), and negative emotional representations (ß =-.17, p = .007) were significantly related to worsened health-related quality of life. CONCLUSION: This study shows that within 1 month of hospital discharge, patients with mild traumatic brain injury had decreased postconcussion symptoms, posttraumatic stress, and improved illness perceptions. Efforts to impact mild brain injury quality of life should focus on inhospital care to optimize the transition to discharge.

Effects of chair-based resistance band exercise on physical functioning, sleep quality, and depression of older adults in long-term care facilities: Systematic review and meta-analysis.

Objective: Chair-based resistance band exercise (CRBE) is a simple and safe physical activity for persons with limited mobility. This study aimed to review and analyze CRBE effects on physical functioning, sleep quality, and depression among older adults in long-term care facilities (LTCF). Method: A systematic search guided by the PRISMA 2020 approach was performed on specific databases: AgeLine, CINAHL, PubMed, Embase, Cochrane Library, Scopus, and Web of Science. The randomized controlled trial studies that trialed CRBE for older adults in LTCF, peer-reviewed articles published in the English language from inception to March 2022 were retrieved. Methodological quality was established using the Physiotherapy Evidence Database scale. The random and fixed effects model were used to generate the pooled effect size. Results: Nine studies met the eligibility criteria and were synthesized. The results revealed that CRBE significantly promoted the activity of daily living (six studies; SMD = 0.30, P = 0.001), lung capacity (three studies; MD = 40.35, P < 0.001), handgrip strength (five studies; MD = 2.17, P < 0.001), upper limb muscle endurance (five studies; MD = 2.23, P = 0.012), lower limb muscle endurance (four studies; MD = 1.32, P < 0.001), upper body flexibility (four studies; MD = 3.06, P = 0.022), lower body flexibility (four studies; MD = 5.34, P < 0.001), dynamic balance (three studies; MD = -0.35, P = 0.011), sleep quality (two studies; MD = -1.71, P < 0.001), and reduced depression (two studies; SMD = -0.33, P = 0.035). Conclusion: The evidence suggests that CRBE improved physical functioning parameters, and sleep quality, and lowers depression among older adults in LTCF. This study could be used to persuade long-term care facilities to allow people with limited mobility to engage in physical activity.

Longitudinal Association Among Illness Perceptions, Coping, and Quality of Life After Extremity Injury.

This longitudinal cohort study examined changes in illness perceptions, coping strategies, and quality of life in hospitalized participants who had sustained extremity injuries, and examined the associations among these changes. A sample of 138 patients with extremity injuries was recruited between August 2019 and April 2020 from the trauma units of two similar referral medical centers, each with a capacity of over 200 beds in Surabaya City, Indonesia. Outcome measures were assessed prior to hospital discharge and 3 months post-discharge, including the Brief Illness Perception Questionnaire, the Brief Coping Orientation to Problems Experienced, and the World Health Organization Quality of Life. Hierarchical multiple regression analyses were conducted. We found that lower scores for illness perceptions (i.e., how a participant appraised and understood their medical condition and its possible consequences) and maladaptive coping strategies were significantly associated with lower quality of life scores. In addition, scores for adaptive coping strategies moderated the association between illness perceptions and quality of life. Our findings suggest that clinicians should endeavor to improve patients' illness perceptions and adaptive coping strategies during the first 3 months post-injury to promote improvement in quality of life following extremity injury.

Changes in Self-Regulation and the Predictors of Quality of Life 3 Months After Extremity Injury: A Prospective Study.

This prospective study aimed to examine self-regulation' changes (illness representations and coping strategies) and predictors of quality of life 3 months after hospital discharge. A total of 157 patients with extremity injuries from two hospitals in Indonesia completed the survey 3 months post-discharge. The results showed that patients demonstrated more positive illness representations, better coping strategies, and better quality of life 3 months post-discharge than prior discharge. Hierarchical multiple regression analysis revealed that patients' symptom identity, personal control, and treatment control were significant predictors of quality of life 3 months after extremity injury. Patients with negative perceptions of their injury-related symptoms, personal control, and treatment control at hospital discharge were at higher risk of impaired quality of life 3 months post-discharge than those with positive perceptions. Therefore, clinicians should assess and modify patients' illness representations before discharge from the hospital to achieve a better prognosis for post-injury quality of life.

Effects of telehealth intervention for people with dementia and their carers: A systematic review and meta-analysis of randomized controlled studies.

PURPOSE: Interventions delivered using telehealth modalities are becoming standard practice with patient populations around the world, partly because of innovation necessitated by the COVID-19 pandemic and partly due to improved infrastructure and comfort of providers, patients, and families, through technology. Though increasingly utilized, the effectiveness of telehealth interventions with families with dementia remains unclear. This gives rise to the need for investigation to develop telehealth interventions that are evidence based and not merely convenient tools. This current study is designed to systematically examine the impact and effectiveness of telehealth-delivered psychoeducational and behavioral interventions among persons with dementia and their caregivers. DESIGN: The design combines systematic review and meta-analysis. METHODS: A total of eight databases were electronically accessed and searched as of November 16, 2021. Experimental studies identifying the results of telehealth interventions for persons with dementia and associated caregivers published in English have been reviewed in this study. Standardized mean differences (SMD) offering 95% confidence intervals (CI) were developed to pool the effect size using a random effects model (in this case, Stata 16.0). The Revised Cochrane Risk-of-Bias Tool for Randomized Trials (RoB-2) was used to analyze the study's methodological soundness. FINDINGS: Nineteen cases met the eligibility criteria (including 1379 persons with dementia and 1339 caregivers). Overall, telehealth interventions demonstrated effects in the expected directions on depression (SMD -0.63; 95% degree of confidence intervals (CI) -0.88 to -0.38, p < 0.001); and caregivers' perceived competency (SMD 0.27; 95% CI -0.05 to 0.50, p = 0.02). There were, however, no statistically significant effects observed on cognitive function or multiple aspects of quality of life for subjects. CONCLUSIONS: Telehealth interventions appear to effect a reduction in depression among persons diagnosed with dementia while improving the perceived competency of caregivers. CLINICAL RELEVANCE: The study's results could be used as evidence of the effectiveness of using telehealth for persons with dementia and their caregivers, including contextualizing where they are used (i.e., long-term care facilities, private homes, etc.), understanding the mechanisms in play (including intervention delivery and systems), and isolating and identifying mediating influences.

Effects of reminiscence therapy in people with dementia: A systematic review and meta-analysis.

WHAT IS KNOWN ABOUT ON THE SUBJECT?: Alternative option was developed to improve care due to the increasing costs of care cost and the number of people diagnosed with dementia. Reminiscence therapy is a commonly implemented alternative option used in long-term care facilities. Reminiscence therapy is designed for cognitive decline that is also known as life review. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Reminiscence therapy, known as psychosocial interventions in dementia care, can be used to assist people with dementia recollect prior events, activities, and experiences in order to improve their cognitive, mood, and overall well-being. Reminiscence therapy increased cognitive function and quality of life and reduced depressive and neuropsychiatric symptoms among people with dementia. Reminiscence therapy may be considered a useful non-pharmacological intervention for people with dementia living in nursing homes or other long-term care facilities. The development of a global standard protocol for the application of reminiscence therapy may be necessary for future randomized controlled trials (RCTs). ABSTRACT: Introduction Reminiscence therapy is an alternative to pharmaceutical intervention provided during long-term care, especially for individuals with dementia. However, the effects of reminiscence therapy in dementia care remain inconclusive. Aim The goal of this study is to examine the effects of reminiscence therapy implementation in people with dementia. Design Systematic literature review and meta-analysis were conducted in accordance with the PRISMA guidelines. Methods This study searched systematically using 6 databases. The eligibility criteria included patients with dementia, applied reminiscence therapy, randomized controlled trials or quasi-experimental studies, and published in the English language. The PEDro scale was used to assess the methodological quality of the included studies. The meta-analysis was performed using a random-effects model to calculate the pooled effects of reminiscence therapy. Stata 16.0 was used for statistical analysis. Result A total of 29 studies met the eligibility criteria, including 3102 participants. Overall, reminiscence therapy increased cognitive functions and quality of life and decreased depression and neuropsychiatric symptoms. Implication for Practice Reminiscence therapy may be considered a useful non-pharmacological intervention for people with dementia living in nursing homes or other long-term care facilities. A standard protocol for reminiscence therapy may be necessary for future studies.

Effects of cognitive stimulation therapy for people with dementia: A systematic review and meta-analysis of randomized controlled studies.

BACKGROUND: Cognitive stimulation therapy (CST) has been used to improve cognitive function and reduce negative emotions. However, the efficacy of CST among the dementia population remains inconclusive. AIM: To analyze the efficacy of the CST among people with dementia. DESIGN: Systematic review and meta-analysis. METHODS: A systematic literature search was performed using the Academic Search Complete, CINAHL, EMBASE, MEDLINE, PubMed, OVID (UpToDate), and Web of Science databases from the inception to October 18, 2021. The revised Cochrane risk of bias tool for randomized trials was used to assess the methodological quality of the included studies. A meta-analysis was performed using a random-effects model to calculate the pooled effects of CST. Stata 16.0 was used for statistical analysis. RESULTS: A total of 26 studies were included. Overall, CST increased cognitive function (standardized mean difference [SMD]: 0.97; 95% confidence interval [CI]: 0.66 to 1.28) and decreased depression (SMD: -0.18; 95% CI: -0.33 to -0.04). No significant effects were found for neuropsychiatric symptoms. CONCLUSIONS: Cognitive stimulation therapy effectively improves cognitive function and alleviates depression levels among people with mild-to-moderate dementia. Futures studies can consider a protocol combined with a rigorous study design to address the effects of CST.

Mediating Effects of Coping Strategies on Quality of Life Following Extremity Injury.

BACKGROUND: Few researches have explored the self-regulation process in patients with extremity injuries. Knowledge about the role of coping in the postinjury self-regulation process remains scarce. OBJECTIVES: We examined the relationships between illness representations, coping, and quality of life (QoL) based on the self-regulation framework, assuming adaptive and maladaptive coping strategies play mediating roles between illness representation and QoL in patients with extremity injuries. METHODS: A cross-sectional survey with a correlational model testing design was used. A sample of 192 patients with extremity injury was recruited before hospital discharge at trauma centers in Indonesia. Validated questionnaires were used to assess patients' illness representations, coping, and QoL. Hierarchical regressions were carried out, and multiple mediation analyses were used to identify the mediating role of coping. RESULTS: Patients with extremity injuries who harbored negative illness representations were less focused on using adaptive coping strategies, were more focused on using maladaptive coping strategies, and tended to experience reduced QoL. The mediating effects of coping, which manifested as parallel mediations of adaptive and maladaptive coping strategies, could significantly explain the QoL variance. DISCUSSION: In postinjury self-regulation, coping has a parallel mediating role that can facilitate the effect of illness representations and directly influence postinjury QoL. Enhancing adaptive coping strategies, reducing maladaptive coping techniques, and reframing negative illness representations during the early recovery phase could improve postinjury QoL. Early screening and preventive efforts using psychologically driven interventions may help redirect patients' focus toward adaptive coping strategies and reframe their illness representations before they transition back into the community.

Effects of animal-assisted interventions for people with dementia: A systematic review and meta-analysis.

Animal-assisted interventions (AAIs) are non-pharmacological, cost-effective interventions developed to improve outcomes in patients with dementia; however, the effects remain inconclusive. The purpose of this study was to analyze the efficacy of AAIs for people with dementia. A systematic review and meta-analysis was performed of English-language literature published from January 1, 2001, to July 3,2021, and indexed in the following databases: CINAHL, EMBASE, MEDLINE, PubMed, Web of Science, Cochrane, and PsycINFO. Intervention groups were people with dementia who received AAIs. Study quality was assessed using the Joanna Briggs Institute tool. Among 10 included studies, significant differences in depression levels were identified between the intervention and control groups (p < 0.001). No significant differences in cognitive function, neuropsychiatric syndrome, or independence in activities of daily living were observed between groups. Future research remains necessary to examine the effects of AAIs on depression during different stages of dementia. AAIs therapists may collaborate with healthcare workers to improve AAIs benefits.

Effects of telehealth-assisted interventions among people living with HIV/AIDS: A systematic review and meta-analysis of randomized controlled studies.

INTRODUCTION: Taking antiretroviral therapy (ART) is a daily necessity for people living with HIV but these individuals experience multiple barriers and challenges to medication adherence. Interventions to support medication adherence have yielded effects in the expected direction, but the extent to which telehealth or virtually delivered interventions to promote adherence are effective among people living with HIV/AIDS remains unknown. We aimed to address this knowledge gap and inform future research and practice that promotes the well-being of people living with HIV/AIDs through telehealth interventions addressing medication use. METHODS: A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted using the following databases: Academic Search Complete, Cochrane library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE, MEDLINE, PubMed, OVID (UpToDate), and the Web of Science. Relevant full-text articles published through September 2021 were retrieved. The revised Cochrane risk of bias tool for randomized trials was used to assess the methodological quality of the included studies. A meta-analysis was performed using a random-effects model to calculate the pooled effects of telehealth-assisted interventions for people living with HIV/AIDS. Stata 16.0 was used for statistical analysis. RESULTS: A total of 12 studies (N = 3557 participants) that used telehealth-assisted interventions for people living with HIV/AIDS were included. Telehealth interventions were found to increase the adherence to treatment (standardized mean difference [SMD]: 0.21; 95% confidence interval (CI): 0.03 to 0.40), to reduce depressive symptoms (SMD: -2,74; 95% CI: -3.39 to -2.09), and to improve perceived quality of life (SMD: 0.74; 95% CI: 0.37 to 1.10). DISCUSSION: The meta-effects of telehealth-assisted interventions include significantly enhanced adherence to treatment, improved quality of life, and reduced depressive symptoms among people living with HIV/AIDS. These findings suggesting that delivering health management interventions remotely through telehealth-assisted modalities was both feasible and effective in yielding health benefits for people living with HIV/AIDS. Integrating telehealth-assisted interventions as a modality in HIV/AIDS care might support continuity of care and sustained well-being. Future research should evaluate telehealth intervention outcomes and examine mediating, moderating, or other tailorable variables affecting intervention effectiveness.

Prevalence of mental health problems and sleep disturbances in nursing students during the COVID-19 pandemic: A systematic review and meta-analysis.

AIM: To identify the prevalence of mental health problems and sleep disturbances among nursing students during the COVID-19 pandemic. BACKGROUND: As a future professional workforce, nursing students are expected to play a role in controlling the COVID-19 pandemic; however, physical and mental health problems may hinder their willingness to stay in the nursing profession. Evidence of the prevalence of the health problems among nursing students related to COVID-19 may allow educators to manage their students' health problems and make them feel more positive about their future careers. DESIGN: Systematic review and meta-analysis. This study was prospectively registered with PROSPERO. DATA SOURCES: Databases, including CINAHL, Embase, PubMed and Web of Science, were searched for all related journal articles, from database inception to June 29, 2021, published between 2020 and 2021. METHODS: This review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines using a PICOS search strategy. A DerSimonian-Laird random-effects model was used to estimate the prevalence and potential heterogeneity among the selected studies using the Cochran Q statistic and I-square test. Publication bias was assessed using the Egger intercept test. RESULTS: Seventeen studies were included in the meta-analysis, representing 13,247 nursing students. During the COVID-19 pandemic, the prevalence of four health problems and sleep disturbances were identified. The health problem with the highest prevalence in nursing students was depression (52%). Other COVID-19-related health problems were fear (41%), anxiety (32%) and stress (30%) and sleep disturbances (27%). CONCLUSIONS: The findings from this study showed that strategies are necessary to manage nursing students' teaching and learning during the COVID-19 pandemic or similar future situations. Our results suggest that preparing modified distance learning might reduce the prevalence of health problems related to the educational process. In addition, providing regular mental health assessments or online mental health services to students may improve their mental health and increase their well-being. Nursing education policies regarding clinical practice remain to be formulated to ensure the achievement of competencies to support future careers while considering the mental readiness and safety of students.

Effects of simulation technology-based learning on nursing students' learning outcomes: A systematic review and meta-analysis of experimental studies.

BACKGROUND: Gaps between theory and clinical practice represent challenges for nursing students during their learning processes. Providing simulation technology-based learning for nursing students is essential for modern nurse education, but evidence of efficacy remains scarce. OBJECTIVES: To determine the effects of simulation technology-based learning for nursing students. DESIGN: A systematic review and meta-analysis. METHODS: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Five databases (CINAHL, Embase, MEDLINE, PubMed, and Web of Science) were electronically searched through May 30, 2021. Eligibility criteria included nursing students, simulated technology-based learning as the primary intervention, and randomised controlled trials or quasi-experimental studies published in English. The methodological quality of included studies was evaluated by the Cochrane risk-of-bias tool. Comprehensive Meta-Analysis Version 3.0 was used to conduct a meta-analysis using the random-effects model. Begg's and Egger's tests were performed to assess publication bias, and sensitivity analysis performed using a remove one study method. RESULTS: A total of 17 studies were included in this study. Simulated technology-based learning significantly increased nursing student knowledge acquisition (standard mean difference [SMD]: 0.72, 95% confidence interval [CI]: 0.25-1.18, p < 0.001), enhanced student's confidence (SMD: 0.50, 95% CI: 0.02-0.99, p = 0.043), and increased student's satisfaction in learning (SMD: 0.81, 95% CI: 0.61-1.00, p < 0.001). Subgroup analyses showed that receiving simulation by manikins simulator had a greater effect on knowledge acquisition (SMD: 1.01, 95% CI: 0.27-1.74, p = 0.007). CONCLUSIONS: Simulation technology use may meet the expectations of undergraduate nursing students and prepare them for clinical practice, representing an opportunity to fill gaps between theory and clinical practice while simultaneously developing new teaching scenarios.

Global prevalence of mental health problems among healthcare workers during the Covid-19 pandemic: A systematic review and meta-analysis.

BACKGROUND: Healthcare workers are at high risk of developing mental health issues during the coronavirus disease 2019 (COVID-19) pandemic. However, there is a need for a full picture of mental health problems with comprehensive analysis among healthcare workers during the COVID-19 pandemic. OBJECTIVE: This review aimed to systematically identify the mental health problems among healthcare workers in various countries during the COVID-19 pandemic. DESIGN: Systematic review and meta-analysis. METHODS: A systematic literature search was performed of the following databases: PubMed, Academic Search Complete, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, MEDLINE Complete, and SocINDEX. The last date of our search was November 2, 2020. We included all cohort, case-control and cross-sectional studies and used the Joanna Briggs Institute tool to assess their quality. A meta-analysis was performed to synthesize the pooled prevalence of mental health problems using a random-effects model. Heterogeneity was measured using the I2 statistic and Egger's test was used to assess publication bias. RESULTS: A total of 38 studies were identified that reported the mental health problems of healthcare workers during the COVID-19 pandemic. The distribution of healthcare workers analyzed in this review included 27.9% doctors, 43.7% nurses, and 7.0% allied health workers. The pooled prevalence of mental health problems for post-traumatic stress disorder, anxiety, depression, and distress was 49% (95% confidence interval [CI]: 22-75%), 40% (95% CI: 29-52%), 37% (95% CI: 29-45%), and 37% (95% CI: 25-50%), respectively. CONCLUSION: This review yielded evidence that estimated the global prevalence of mental health problems among healthcare workers during the COVID-19 pandemic. Post-traumatic stress disorder was the most common mental health disorder reported by healthcare workers during the COVID-19 pandemic, followed by anxiety, depression, and distress. Additional studies remain necessary to assess the appropriate management strategies for treating and preventing mental health disorders among healthcare workers during the pandemic.

Effects of case management intervention for people with dementia and their carers: A systematic review and meta-analysis of experimental studies.

BACKGROUND: Case management has been developed and suggested as a method for improving the quality of dementia care by optimising care service and delivery using a feasible and cost-effective approach. However, the effects of case management for improving dementia care remain inconclusive. AIM: To analyse the efficacy of case management interventions for people with dementia and their carers. DESIGN: Systematic review and meta-analysis. METHODS: This study conducted a systematic review of the literature from January 1, 2002, to March 15, 2021, indexed in the following databases: Academic Search Complete, CINAHL, Cochrane Library, EMBASE, MEDLINE, PubMed, OVID, and Web of Science. Intervention studies examining patients with dementia and their carers published in the English language were included. The methodological quality of included studies was evaluated using the PEDro scale. The meta-analysis was performed using a random-effects model to calculate the pooled standardised mean difference (SMD) of case management intervention outcomes for both people with dementia (cognitive function, neuropsychiatric symptoms, and quality of life) and their carers (carer burden). Stata 16.0 was used for statistical analysis. RESULTS: A total of eight studies met the eligibility criteria for this study. The results of the quantitative analysis, ranging from 6 to 18 months, showed no significant effect on cognitive function, quality of life over 12 months and longer, and carer burden over time between groups with and without intervention. However, significant improvements were observed for neuropsychiatric symptoms over 12 months and longer and quality of life at six months in the case management group. CONCLUSION: Case management appears to have the potential to improve the health outcomes among people with dementia. However, these conclusions are limited due to the lack of conducted studies. Future work examining intervention outcomes remains necessary to explore the effects of interventions on the mental and physical wellbeing of carers.

Effects of robotic care interventions for dementia care: A systematic review and meta-analysis randomised controlled trials.

BACKGROUND: The role of robotic care has been studied because it may be a care option applicable to dementia care. However, the effects of robotic care in dementia care are still inconclusive. AIM: To explore the span of the effects of robotic care intervention among patients with dementia. DESIGN: Systematic review and meta-analysis. METHODS: This study searched systematically using the following databases: Academic Search Complete, CINAHL, Cochrane Library, MEDLINE, PubMed, SocINDEX, UpToDate (OVID) and Web of Science. The eligibility criteria were patients with dementia, randomised controlled trials and publications in English. The PEDro scale was used to assess the methodological quality in the included studies. The meta-analysis was performed using a fixed-effects model to calculate the pooled effects of robotic care interventions. STATA 16.0 was used for statistical analysis. The results are reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. RESULTS: A total of 15 studies met the eligibility criteria and included 1684 participants. Overall, the robotic care interventions had positive effects on agitation (SMD = 0.09; 95% CI [-0.22-0.33]), anxiety (SMD = -0.07; 95% CI [-0.42-0.28]), cognitive function (SMD = 0.16; 95% CI [-0.08-0.40]), depression (SMD = -0.35; 95% CI [-0.69-0.02]), neuropsychiatric symptoms (SMD = 0.16; 95% CI [-0.29-0.61]), total hours of sleep during daytime (SMD = -0.31; 95% CI [-0.55 to 0.07]) and quality of life (SMD = 0.24; 95% CI [-0.23-0.70]). CONCLUSION: Robotic care intervention may be an effective and alternative intervention for improving the health outcomes for people with dementia. The robotic care effect on anxiety should be confirmed. Further studies may consider the frequency, duration of intervention and possible negative outcomes after robotic care interventions. RELEVANCE TO CLINICAL PRACTICE: As a non-pharmacological approach, nursing staff may consider the robotic care intervention in providing care for patients with dementia since this intervention has clinical benefits.

Determinants of maternal healthcare service utilisation among Indonesian mothers: A population-based study.

Background: In Indonesia, maternal health care services are widely available, aiming to improve health and survival among mothers. However, these services remain underutilised, and its determining factor was unknown. This study sought to identify determinant factors of maternal healthcare services utilisation among Indonesian mothers. Methods: This population-based cross-sectional study leveraged the 2017 Indonesia Demographic and Health Survey data. A total of 12,033 mothers aged from 15 to 49 years who had a live birth in the five years preceding the survey were included in the analysis. Multivariable logistic regressions were used to identify the determinant factors. Results: Approximately 93.44% of the mothers had adequate antenatal care, 83.73% had a delivery at the healthcare facility, and 71.46% received postnatal care. The mother's age and household wealth index were the typical determinants of all maternal healthcare services. Determinants of antenatal care visits were husband's occupational status, the number of children, and access to the healthcare facility. Next, factors that drive mothers' delivery at the healthcare facility were the mother's education level, husband's educational level, and residential area. The use of postnatal care was determined by the mother's occupational status, husband's educational level, number of children, wealth index, access to the healthcare facility, and residential area. Conclusions: Although there were differences in the determinant factors of three key maternal healthcare services, the mother's age and household wealth index were the typical determinants of all maternal healthcare services utilisation. Providing a tailored programme aligned with these determinant factors may ensure that mothers can access and adequately utilise maternal healthcare services.