Experiences of patients with metachromatic leukodystrophy, adrenoleukodystrophy, or Krabbe disease and their family members: a qualitative systematic review.

OBJECTIVE: This review aimed to synthesize the experiences of patients with metachromatic leukodystrophy, adrenoleukodystrophy, or Krabbe disease and those of their families. INTRODUCTION: Leukodystrophies are metabolic diseases caused by genetic mutations. There are multiple forms of the disease, varying in age of onset and symptoms. The progression of leukodystrophies worsens central nervous system symptoms and significantly affects the lives of patients and their families. INCLUSION CRITERIA: Qualitative studies on the experiences of patients with leukodystrophies and their family members were included. These experiences included treatments such as enzyme replacement therapy and hematopoietic stem cell transplantation; effects of tracheostomy and gastrostomy; burdens on the family, coordinating care within the health care system, and family planning due to genetic disorders. This review considered studies in any setting. METHODS: MEDLINE (Ovid), CINAHL Plus (EBSCOhost), APA PsycINFO (EBSCOhost), Scopus, and MedNar databases were searched on November 18, 2022. Study selection, critical appraisal, data extraction, and data synthesis were conducted in accordance with the JBI methodology for systematic reviews of qualitative evidence, and synthesized findings were evaluated according to the ConQual approach. RESULTS: Eleven studies were eligible for synthesis, and 45 findings were extracted corresponding with participants' voices. Of these findings, 40 were unequivocal and 5 were credible. The diseases in the included studies were metachromatic leukodystrophy and adrenoleukodystrophy; no studies were identified for patients with Krabbe disease and their families. These findings were grouped into 11 categories and integrated into 3 synthesized findings, including i) providing care by family members and health care providers as physical symptoms progress, which relates to effects of the characteristics of progressive leukodystrophies; ii) building medical teamwork to provide appropriate support services, comprising categories related to the challenges experienced with the health care system for patients with leukodystrophy and their families; and iii) coordinating family functions to accept and cope with the disease, which included categories related to family psychological difficulties and role divisions within the family. According to the ConQual criteria, the second synthesized finding had a low confidence level, and the first and third synthesized findings had a very low confidence level. CONCLUSIONS: The synthesized findings of this review provide evidence on the experiences of patients with metachromatic leukodystrophy or adrenoleukodystrophy and their families. These findings indicate that there are challenges in managing a patient's physical condition and coordinating the health care system and family functions. REVIEW REGISTRATION: PROSPERO CRD42022318805.

Impact of nurse-led interprofessional work in older patients with heart failure and multimorbidity: A retrospective cohort study.

Background: The number of patients with multimorbidity has increased due to the aging of the global population. Although the World Health Organization has indicated that multimorbidity will be a major medical problem in the future, the appropriate interventions for patients with multimorbidity are currently unknown. This study aimed to investigate whether nurse-led interprofessional work is associated with improved prognosis in heart failure patients with multimorbidity aged ≥65 years who were admitted in an acute care hospital. Methods: Patients who were admitted to the cardiovascular medicine ward of an acute care hospital in Osaka, Japan, and underwent nurse-led interprofessional work from April 1, 2017 to March 31, 2020, and from April 1, 2014 to March 31, 2016, were included in this retrospective cohort study. The patients were matched by age, sex, and New York Heart Association classification. The nurse-led interprofessional work was based on a three-step model that incorporates recommendations from international guidelines for multimorbidity. The primary outcome was all-cause mortality. Results: The mean age of the participants was 80 years, and 62 % were men. The nurse-led interprofessional work group showed a significant difference in all-cause mortality compared with the usual care group (hazard ratio, 0.45; 95 % confidence interval [CI], 0.29-0.69; P < 0.001). Compared with the usual care group, the nurse-led interprofessional work group exhibited a 7 % difference in mortality rate at 1-year post-discharge (P < 0.001). Conclusions: Nurse-led interprofessional work may reduce the all-cause mortality in older patients with heart failure and multimorbidity.

Exploring the impact of socially assistive robots on health and wellbeing across the lifespan: An umbrella review and meta-analysis.

BACKGROUND: Socially assistive robots offer an alternate source of connection for interventions within health and social care amidst a landscape of technological advancement and reduced staff capacity. There is a need to summarise the available systematic reviews on the health and wellbeing impacts to evaluate effectiveness, explore potential moderators and mediators, and identify recommendations for future research and practice. OBJECTIVE: To explore the effect of socially assistive robots within health and social care on psychosocial, behavioural, and physiological health and wellbeing outcomes across the lifespan (PROSPERO registration number: CRD42023423862). DESIGN: An umbrella review utilising meta-analysis, narrative synthesis, and vote counting by direction of effect. METHODS: 14 databases were searched (ProQuest Health Research Premium collection, Scopus, PubMed, Web of Science, ASM Digital Library, IEEE Xplore, Cochrane Reviews, and EPISTEMONIKOS) from 2005 to May 4, 2023. Systematic reviews including the effects of socially assistive robots on health outcomes were included and a pooled meta-analysis, vote counting by direction of effect, and narrative synthesis were applied. The second version of A MeaSurement Tool to Assess systematic Reviews (AMSTAR-2) was applied to assess quality of included reviews. RESULTS: 35 reviews were identified, most focusing on older adults with or without dementia (n = 24). Pooled meta-analysis indicated no effect of socially assistive robots on quality of life (standard mean difference (SMD) = 0.43), anxiety (SMD = -0.02), or depression (SMD = 0.21), although vote counting identified significant improvements in social interaction, mood, positive affect, loneliness, stress, and pain across the lifespan, and narrative synthesis identified an improvement in anxiety in children. However, some reviews reported no significant difference between the effects of socially assistive robots and a plush toy, and there was no effect of socially assistive robots on psychiatric outcomes including agitation, neuropsychiatric symptoms, and medication use. DISCUSSION: Socially assistive robots show promise for improving non-psychiatric outcomes such as loneliness, positive affect, stress, and pain, but exert no effect on psychiatric outcomes such as depression and agitation. The main mechanism of effect within group settings appeared to be the stimulation of social interaction with other humans. Limitations include the low quality and high amount of overlap between included reviews. CONCLUSION: Socially assistive robots may help to improve loneliness, social interaction, and positive affect in older adults, decrease anxiety and distress in children, and improve mood, stress, and reduce pain across the lifespan. However, before recommendations for socially assistive robots can be made, a cost-effectiveness analysis of socially assistive robots to improve mood across the lifespan, and a quantitative analysis of the effects on pain, anxiety, and distress in children are required.

Sleep quality assessment of adults in care settings using non-wearable sleep trackers: Scoping review.

AIMS: This review aimed to explore and map the literature on sleep quality assessments of adults in care settings using non-wearable sleep trackers. BACKGROUND: Sleep-monitoring technology is advancing, and sleep quality assessments using non-wearable sleep trackers can provide objective evidence for quality care. DESIGN: This was a scoping review. DATA SOURCES: Four electronic databases (PubMed, CINAHL, PsycInfo and Embase) were searched on 23 September 2022. REVIEW METHODS: This review followed the Joanna Briggs Institute's methodology and used the PRISMA-ScR checklist. RESULTS: Thirty studies met our inclusion criteria. Sleep quality was assessed at home and in acute, non-acute and long-term care facilities. Physiological (heart rate and respiratory rate) and sleep parameters were assessed alone or in combination during patient care using non-wearable sleep trackers. Sleep parameters representing sleep quality varied across studies. Real-time monitoring with non-wearable sleep-tracking devices effectively shortened the length of hospital stay. However, studies investigating caregivers and nursing outcomes are lacking in the literature. CONCLUSION: Sleep quality assessments using non-wearable sleep trackers may facilitate the provision of quality care in home-based and clinical care settings. Future studies should focus on caregivers and care outcomes that could contribute to evidence-based nursing practice for sleep care in adults.

Expressed Emotion in Families of People With Dementia: A Review of Scale-Based Measures.

PURPOSE: Research on the concept of expressed emotion (EE) has expanded in recent years but its role in dementia still requires elucidation. Understanding the role of EE in the dementia context could help in the development of appropriate interventions. METHOD: The current review synthesized relevant literature to investigate the prevalence and correlates of EE status in families of people with dementia. A comprehensive search of four databases from inception to 2022 produced 2,683 papers; 18 studies met inclusion criteria. RESULTS: The use of EE criteria differed not only across cultural contexts, but even within the same cultural context. Overall, the prevalence of EE in families with dementia compared with other psychiatric conditions was not high. CONCLUSION: Specific changes in EE over time remain to be explored, and findings emphasize the need to carefully discriminate High EE status based on the cultural background of family members with dementia. [Journal of Gerontological Nursing, 50(2), 17-25.].

Social robot for older adults with cognitive decline: a preliminary trial.

The number of older adults living alone is rapidly increasing. Loneliness in older adults not only degrade their quality of life but also causes troubles such as heavy burden on the medical staff, especially when cognitive decline is present. Social robots could be used in several ways to reduce such problems. As a first step towards this goal, we introduced conversation robots into the homes of older adults with cognitive decline to evaluate the robot's availability and acceptance during several months. The study involved two steps, one for evaluating the robustness of the proposed robotic system, and the second one to examine the long-term acceptance of social robots by older adults with cognitive decline living alone. Our data shows that after several weeks of human-robot interaction, the participants continued to use the robot and successfully integrated them into their lives. These results open the possibility of further research involving how sustained interaction can be achieved, as well as which factors contributed to the acceptance of the robot.

Effectiveness of non-pharmacological interventions to prevent anemia in pregnant women: a quantitative systematic review protocol.

OBJECTIVE: This review aims to identify the effectiveness of non-pharmacological interventions in preventing iron deficiency anemia in pregnant women with a normal course of pregnancy. INTRODUCTION: The global prevalence of anemia among pregnant women is 36.5%, posing risks to women and fetuses. This underscores the need for effective prevention; however, the effectiveness of non-pharmacological approaches in preventing pregnancy anemia remains unclear. INCLUSION CRITERIA: This review will encompass experimental and quasi-experimental studies on the following approaches to prevent anemia during pregnancy: recommendations for dietary supplements, oral iron supplements (over the counter), provision of supplements to promote iron absorption, participation in anemia prevention education, and provision of information. There will be no restrictions on the duration or frequency of intervention, and longitudinal intervention studies will be included. In studies with a control group, the comparator may be usual care or pharmacological interventions; in studies without, it may involve no intervention, temporal comparisons, or baseline periods without non-pharmacological interventions. Evaluation of hemoglobin, hematocrit, and ferritin will be included as primary outcomes. Low birth weight, preterm birth, amount of blood loss at delivery, small for gestational age, and Apgar scores will be included as secondary outcomes. METHODS: A search will be conducted of MEDLINE (Ovid), Embase, CINAHL (EBSCOhost), Scopus, Australian New Zealand Clinical Trials Registry, Cochrane Central Register of Controlled Trials, and ICHUSHI-Web. Researchers will screen studies, extract data, assess the quality of studies, and analyze the data in accordance with the JBI guidance for systematic reviews of effectiveness. GRADE will be used to assess the certainty of the findings. REVIEW REGISTRATION NUMBER: PROSPERO CRD42022344155.

Prevalence of sleep disturbances in people with mild cognitive impairment: a systematic review protocol.

OBJECTIVE: This review will determine the prevalence of sleep disturbances in individuals with mild cognitive impairment. INTRODUCTION: Mild cognitive impairment is regarded as a transitional state between normal functioning and dementia, and has a high likelihood of conversion to dementia. Individuals with mild cognitive impairment may suffer more severe sleep disturbances compared with normal older people. In some studies, sleep disturbances were associated with significantly higher odds of mild cognitive impairment. There is a need for prevalence estimates of sleep disturbances in people with mild cognitive impairment based on the currently available literature to guide clinical health care professionals and public health policies. INCLUSION CRITERIA: The review will consider studies reporting on the prevalence of sleep disturbances in individuals with mild cognitive impairment, using validated instruments, including subjective and/or objective measures. Studies will be excluded if the participants report sleep-related breathing or movement disorders. Studies using only the Mini-Mental State Examination to diagnose mild cognitive impairment will also be excluded. METHODS: The review will follow the JBI methodology for systematic reviews of prevalence and incidence. The MEDLINE (Ovid), Embase, Cochrane Library (CDSR and CENTRAL), CINAHL (EBSCOhost), PsycINFO (EBSCOhost), Scopus, and Web of Science Core Collection databases will be systematically searched from inception to the present with no language limitations. Analytical observational studies, including prospective and retrospective cohort, case-control, and cross-sectional studies, will be considered. Two reviewers will independently conduct the study selection, critical appraisal, and data extraction. Methodological quality will be evaluated using the JBI critical appraisal checklist for studies reporting prevalence data. A meta-analysis will be conducted to synthesize the prevalence data, where possible. REVIEW REGISTRATION: PROSPERO CRD42022366108.

Effect of sleep report feedback using information and communication technology combined with health guidance on improving sleep indicators in community-dwelling older people: a pilot trial.

BACKGROUND: This study evaluated the preliminary effect of an integrated novel intervention comprising visualised sleep report feedback using information and communication technology and periodic health guidance on improving sleep indicators among community-dwelling older people. METHODS: The intervention was implemented among 29 older people in Sakai City, Japan, in a 3 months pilot trial. Non-worn actigraph devices were placed under participants' bedding to continuously measure their sleep state, and they received monthly sleep reports in writing. Sleep efficiency, total sleep time, sleep latency, and the number of times away from bed were recorded. A trained nurse expertly interpreted participants' sleep data and provided telephone health guidance. The first month's data were used as the baseline (T1), the second month provided data for the first intervention (T2), and the third month provided data for the second intervention (T3). Friedman tests and Wilcoxon signed-rank tests were used to examine differences in sleep outcomes between different time points. RESULTS: Participants' mean age was 78.97 ± 5.15 years, and 51.72% (15/29) were female. Comparison of T2 and T1 showed the intervention decreased participants' sleep latency at T2 (P = 0.038). Compared with T1, the intervention significantly decreased sleep latency (P = 0.004), increased total sleep time (P < 0.001), and improved sleep efficiency (P < 0.001) at T3. When T3 was compared with T2, only total sleep time was significantly increased (P < 0.001). There were no significant differences in the number of times away from bed across the three time points (P > 0.05). CONCLUSIONS: This visualised sleep report feedback and periodic health guidance intervention for community-dwelling older people showed promising, albeit small preliminary effects on sleep. A fully powered randomised controlled trial is required to verify the significance of this effect.

Communication-related experiences of individuals in the early phase of semantic dementia and their families: an interview study.

BACKGROUND: Semantic dementia (SD), a subtype of frontotemporal dementia, manifests as verbal symptoms, including social and behavioural deficits, associated with focal atrophy of the frontotemporal lobes. This study aimed to clarify the experiences of individuals with early-onset SD receiving speech and language rehabilitation (hereafter referred to as 'rehabilitation'), with the intent of making it routine, as well as the experiences of their families. METHODS: Individual interviews were conducted with nine families with members who had adopted rehabilitation. Verbatim transcripts were used as data, and analyzed inductively according to the content analysis process. RESULTS: The family members realised the changes in the personality and behaviour of the individual with SD early, to the extent that they thought the individual with SD was different from before and were distressed by the loss of verbal communication. Nevertheless, the family members found a way to communicate by maintaining residual functions through rehabilitation and utilising their unique relationship with the individual with SD. CONCLUSIONS: It is important to carefully explain the characteristics of the disease and the long-term significance of rehabilitation to individuals with SD and their families in the early stages of the disease.

Nurses' perception towards care robots and their work experience with socially assistive technology during COVID-19: A qualitative study.

This study aimed to explore nurses' perceptions towards care robots and their work experiences in caring for older adults who use socially assistive technology. This qualitative descriptive study included 18 nurses who cared for older adults with dementia or living alone at home. Interviews via Zoom were conducted, and the collected data were analyzed using inductive content analysis. The three themes were identified: (1) perceived benefits, (2) perceived challenges, and (3) improvements needed to enhance the quality of care. The participants perceived that the care robot and socially assistive technology were useful in caring for older adults during COVID-19. However, they noted that the limited capabilities of the technology and an increased workload negatively impacted the quality of care for older adults. The findings of this study indicated that socially assistive technology and care robots have potential benefits in assisting older adults with dementia or living alone.

Experiences of patients and their family members with metachromatic leukodystrophy, adrenoleukodystrophy, and Krabbe disease: a qualitative systematic review protocol.

OBJECTIVE: The objective of this review is to synthesize the experiences of patients with metachromatic leukodystrophy (MLD), adrenoleukodystrophy (ALD), and Krabbe disease and the experiences of their family members. INTRODUCTION: MLD, ALD, and Krabbe disease are rare disorders that are classified as lysosomal storage or peroxisomal disorders, with similar presentations as leukodystrophy. As these diseases cause cognitive and neurological decline due to the progression of leukodystrophy associated with demyelination, they have significant impact on the lives of patients and their families. It is important to identify the impact and challenges of these diseases on patients' lives and on their families, as well as to synthesize qualitative studies regarding their experiences. INCLUSION CRITERIA: We will consider studies including patients with MLD, ALD, or Krabbe disease and their family members. These experiences will include the challenges, dissatisfactions, and frustrations with symptoms and treatments; complications of hematopoietic stem cell transplantation; and the increased caregiver burden with disease progression. This is important since the impacts of disease progression are experienced in a variety of settings beyond the hospital, such as in the community and at home. METHODS: The search strategy will follow JBI methodology and be conducted in 3 steps: an initial limited search, a comprehensive database search, and a reference search of the included articles. MEDLINE, CINAHL Plus, PsycINFO, and Scopus will be searched with no restriction on language or publication dates. The study selection, critical appraisal, data extraction, and data synthesis will be performed according to JBI guidelines for systematic reviews of qualitative research. Final syntheses will be assessed using the ConQual approach. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42022318805.

Randomised controlled trials addressing how the clinical application of information and communication technology impacts the quality of patient care-A systematic review and meta-analysis.

BACKGROUND: The number of people with chronic and long-term conditions has increased during recent decades; this has been addressed by leveraging information and communication technology (ICT) to develop new self-care solutions. However, many of the developed technological solutions have not been tested in terms of impact(s) on patients' quality of care. OBJECTIVES: This systematic review aimed to identify the current best evidence on the types of interventions that have been developed to improve the quality of patient care through the clinical application of ICT in primary, tertiary or home care. DESIGN: A systematic review, including a meta-analysis, was conducted according to the JBI Manual for Evidence Synthesis guidelines. DATA SOURCES: Relevant data were identified from four electronic databases: CINAHL, PUBMED, SCOPUS and MEDIC. REVIEW METHODS: The eligibility criteria were formatted according to PICOS inclusion and exclusion criteria. At least two researchers performed the screening process separately, after which they agreed upon the results. The Cochrane Risk of Bias Assessment and JBI Critical Appraisal tool for randomised controlled studies (RCTs) were used to assess research quality. Data were extracted, and a meta-analysis was performed if the research met quantitative requirements. RESULTS: Of the 528 initially identified studies, 11 studies were chosen for final data synthesis. All of the interventions integrated ICT solutions into patient care to improve the quality of care. Patients across all of the RCTs were educated through direct training, the provision of information relevant to their disease or one-to-one educational coaching. The interventions included various interactions, e.g. nurse expert visits and support, and support provided by peers, groups or family members. These interactions occurred through face-to-face coaching, virtual human coaching or virtual coaching that relied on an algorithm. The performed meta-analysis included 6 of the 11 identified studies. The overall effect was nonsignificant, with three studies demonstrating a significant postintervention effect on patients' quality of care and quality of life and three studies a nonsignificant effect. CONCLUSIONS: The presented results suggest that ICT-based care should be developed in collaboration with nurses and other health care professionals, involve patients in decision-making and combine ICT solutions with human interaction and coaching. ICT education was found to be essential to the success of an intervention.

Non-pharmacological interventions for cancer-related fatigue in terminal cancer patients: a systematic review and meta-analysis.

BACKGROUND: Cancer-related fatigue (CRF) is a highly distressing symptom in patients with cancer. Although various interventions have been reported to reduce fatigue, few are available for use in terminally ill cancer patients, and it is unknown which interventions are effective. They are also often difficult to implement in terminally ill patients with cancer. We, therefore, assessed the recommended interventions to reduce CRF in terminally ill cancer patients. METHODS: Four electronic databases were searched to identify studies published between January 2015 and March 2021. The inclusion criteria were terminally ill cancer patients; non-pharmacological interventions; studies in which usual care or control groups were compared, or comparisons were made prior to the post-intervention period; studies in which the primary outcome was fatigue scale or symptom scale (including those measuring fatigue on a subscale); and experimental study designs including randomised controlled trials (RCTs) and quasi-experimental studies. A summary of the data extracted from each study was created. We also conducted a meta-analysis of the RCTs. RESULTS: A total of 1,954 publications were identified from the initial database, eight of which were included in this study. Three RCTs and five non-RCTs were included in the final evaluation. Most of the studies had a small number of participants. We conducted a meta-analysis of two of the three RCTs included in this study. There was insufficient evidence to determine the effects of the interventions compared to the controls [standard mean difference, -0.05; 95% confidence interval (CI): -0.48 to 0.37; two studies; 290 participants; I2=65%]. CONCLUSIONS: Few reports exist on non-pharmacological interventions for patients with terminal cancer and there was insufficient evidence to determine the effect of the interventions on fatigue. This highlights the lack of RCTs on non-pharmacological procedures and therapies for reducing fatigue.

Gradient boosting decision tree becomes more reliable than logistic regression in predicting probability for diabetes with big data.

We sought to verify the reliability of machine learning (ML) in developing diabetes prediction models by utilizing big data. To this end, we compared the reliability of gradient boosting decision tree (GBDT) and logistic regression (LR) models using data obtained from the Kokuho-database of the Osaka prefecture, Japan. To develop the models, we focused on 16 predictors from health checkup data from April 2013 to December 2014. A total of 277,651 eligible participants were studied. The prediction models were developed using a light gradient boosting machine (LightGBM), which is an effective GBDT implementation algorithm, and LR. Their reliabilities were measured based on expected calibration error (ECE), negative log-likelihood (Logloss), and reliability diagrams. Similarly, their classification accuracies were measured in the area under the curve (AUC). We further analyzed their reliabilities while changing the sample size for training. Among the 277,651 participants, 15,900 (7978 males and 7922 females) were newly diagnosed with diabetes within 3 years. LightGBM (LR) achieved an ECE of 0.0018 ± 0.00033 (0.0048 ± 0.00058), a Logloss of 0.167 ± 0.00062 (0.172 ± 0.00090), and an AUC of 0.844 ± 0.0025 (0.826 ± 0.0035). From sample size analysis, the reliability of LightGBM became higher than LR when the sample size increased more than [Formula: see text]. Thus, we confirmed that GBDT provides a more reliable model than that of LR in the development of diabetes prediction models using big data. ML could potentially produce a highly reliable diabetes prediction model, a helpful tool for improving lifestyle and preventing diabetes.

Effects of a dementia virtual reality-based training with peer support for home care workers: A cluster randomized controlled trial.

OBJECTIVES: Home care workers who are the first-line care workers for community-dwelling dementia patients often have limited dementia knowledge, skills, and empathy towards those with dementia. Research is sparse on dementia care training using virtual reality (VR) technology and support network for home care workers. METHODS: This cluster randomized controlled trial evaluated the effects of a dementia VR-based training with peer support on dementia knowledge, attitude, competence, and empathy of home care workers. Each home care worker team was used as the unit for randomization. Sixteen teams were randomly assigned to either VR group or non-VR control group There was a total of 124 participants completed the study, the VR group (n = 61) received a dementia VR-based training consisted of 3-month dementia care e-book modules, dementia VR-based activity and 1-h monthly face-to-face peer support group meetings. The non-VR control group (n = 63) only receive the 3-month dementia care e-book modules and 1-h monthly regular staff meetings with no VR activity. Outcome measures were assessed at three time points: baseline, the end of the 3-month intervention, and 1-month post intervention. RESULTS: Generalized estimating equations results indicate that the improvement in dementia knowledge, attitudes, competence, and empathy over time is significant in the VR group compared to the non-VR control group. The effects remained significant 1 month after the end of the 3-month intervention. CONCLUSIONS: Innovative and accessible dementia training using VR technology with peer support is a promising training approach to improve dementia knowledge, attitudes, competence, and empathy of home care workers.

Relationship between Health Counselor Characteristics and Counseling Impact on Individuals at High-Risk for Lifestyle-Related Disease: Sub-Analysis of the J-HARP Cluster-Randomized Controlled Trial.

Early diagnosis and treatment are necessary to prevent lifestyle-related diseases among high-risk individuals. This study aimed to examine the impact of counselor characteristics on clinic visits among individuals at high risk for lifestyle-related diseases. A total of 8975 patients aged 40 to 74 years with lifestyle-related comorbidities, who underwent an annual health checkup and received health counseling, were included in this study. Data intervention timing, mode of counseling, number of counseling sessions, and explanation methods were collected. We assessed the impact of counselor characteristics, including profession (public health nurse, clinical nurse, and nutritionist), age, and years of counseling experience, on counseling outcomes. The probability ratios (95% confidence intervals) of clinic visits were 1.22 (1.11-1.35) for public health nurses and 1.04 (0.90-1.20) for nurses compared with nutritionists. After adjustment for participant and counselor characteristics and initial timing, mode, and number of counseling sessions, the corresponding probability ratios (95% confidence intervals) were 1.16 (1.05-1.29) and 1.12 (0.95-1.31), respectively. Counselor age and years of experience did not influence clinic visits of the target population. Public health nurses were more effective in increasing clinic visits among the target population owing to their profession-specific knowledge, skills, and experience.

Experiences of families of people living with frontotemporal dementia: a qualitative systematic review.

Frontotemporal dementia (FTD) is characterised by atrophy of the frontal and/or temporal lobes. People with FTD show language and emotional disturbances from onset, and communication problems usually affect people with FTD and their families even before diagnosis. These unique characteristics of FTD are not well understood and create substantial problems for people living with FTD and their families. This review explores the experiences of families of people living with FTD. Studies were selected and screened according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched four bibliographic databases for articles up to February 2021 to identify qualitative data on the experiences of families. The Critical Appraisal Skills Programme checklist for qualitative studies was used to assess all included studies. Of 235 identified articles, we included six studies in the qualitative synthesis. Meta-ethnography was conducted to interpret families' experiences of people living with FTD. The emergent concepts were synthesised into five themes: Something is wrong with my loved one; No one fully understands; Existential pain of caring for a loved one with FTD; Increased burden owing to specific FTD symptoms; and Forced to adapt to new and unique ways of living with a loved one with FTD. This review highlighted families' confusion and suffering (which began in the early stages of the disease, and sometimes before diagnosis) and the difficulty of communicating with people with FTD. These findings have implications for future practice, as they demonstrate the positive effect on family life of appropriate support that is provided early, rather than after the disease has progressed.