Objective To formulate an evidence-based nursing strategy of turning over for a patient with the risk of pressure ulcer. Methods The personalized clinical questions were put forward based on the PICO and patient’s condition, and the following databases such as NGC, The Cochrane Library of DARE, CDSR, CCTR, MEDLINE, PubMed and CBM were searched to collect the best clinical evidences of turning over for preventing pressure ulcer. Results One clinical guideline, one systematic review and three randomized controlled trials were included finally. According to the retrieval outcomes, patient’s clinical condition, and patients and their family members’ willingness, a reasonable nursing plan of turning over was formulated: lie on the visco-elastic foam decompression bed, turn over every 4 hours, and combine supine position with alternation of left-oblique 30° position and right-oblique 30° position. During hospitalization, the grade-I pressure ulcer in size of 4×6 cm2 on patient’s sacrococcygeal region was clear, dry and not broken, and the other part of body with pigmentation had no occurrence of pressure ulcer. Conclusion Evidence-based approaches are helpful to provide patient with a nursing plan that meets the needs of both scientificalness and individualization.
Objective To evaluate the effect of mindfulness therapy on sleep problems in adolescents. Methods We searched PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure, Wanfang, Chongqing VIP and SinoMed for relevant randomized controlled trials on mindfulness intervention to improve adolescents’ sleep. The retrieval time was from the establishment of the databases to October 21, 2022. The results were meta-analysed with RevMan 5.4 software. Results A total of 11 randomized controlled trials were included, with a total sample size of 870 cases. The types of mindfulness therapy include mindfulness-based stress reduction, mindfulness-based cognitive therapy, mindfulness meditation, group mindfulness sleep intervention, body scanning and other mindfulness technologies. The duration of single intervention was different. The included studies showed that the mindfulness intervention can effectively improve the sleep problems of adolescents and the accompanying daytime sleepiness, anxiety, depression and other negative emotions compared with the control intervention. Meta-analysis of six studies showed that the sleep quality of adolescents in the mindfulness intervention group was improved [mean difference=−1.21, 95% confidence interval (−1.58, −0.83), P<0.00001]. Conclusion Mindfulness therapy has a good effect on improving adolescents’ sleep problems, but whether it can achieve long-term benefits still needs to be further evaluated by high-quality, multicenter long-term follow-up trials.
ObjectiveTo biliometric analysis of the status quo of tracking rural health service quality, evaluation and supervision mechanism, in order to improve the quality of rural health service, optimize the allocation of resources and increase the quality and level of health service of rural medical staff. MethodsWe searched PubMed, The Cochrane Library (Issue 3, 2016), The Campbell Library, Web of Science, CBM, CNKI, and WanFang Data, as well as relevant websites up to March 2016. EndNote X7 software and Excel 2007 software were used for screening literature and analysis data. ResultsA total of 39 studies were included in the biliometric analysis. Eighteen studies were cross-sectional studies (46.2%), 18 were reviews (46.2%), 2 were cluster randomized trials (5.1%) and 1 was randomized controlled trial (2.6%). Thirteen studies were published in journals indexed by Science Citation Index, 3 were published in journals indexed by Chinese Science Citation Database, 18 were published on other peer-review journals, and 5 were thesis's. The involved theoretical models were as follows: 10 mechanisms (30.8%), 4 frameworks (18%), 11 systems (30.8%) and 12 methods (30.8%). The serviceable range included village clinics (n=3, 7.7%), town-level hospitals (n=3, 7.7%), and community (n=2, 5.1%). The research topics included public health (n=19, 48.7%), clinical care (n=16, 41%), medical insurance (n=4, 10.3%). ConclusionThe studies for rural health service quality tracking, research evaluation and supervision mechanism are still lack of systematic, pertinence and practicability, and the level of evidence is still low. We suggest pay attention and strengthen the rural health service quality tracking, research evaluation and supervision mechanism, and to provide effective evidence for effective evaluation and supervision to promote rural health service quality, and to promote the reasonable optimization the allocation of health resources in rural areas, and to greatly improve the quality and level of rural health service.
High-quality randomized controlled trials are the best source of evidence to explain the relationship between health interventions and outcomes. However, in cases where they are insufficient, indirect, or inappropriate, researchers may need to include non-randomized studies of interventions to strengthen the evidence body and improve the certainty (quality) of evidence. The latest research from the GRADE working group provides a way for researchers to integrate randomized and non-randomized evidence. The present paper introduced the relevant methods to provide guidance for systematic reviewers, health technology assessors, and guideline developers.