The effectiveness of tele-transitions of care interventions in high-risk older adults: A systematic review and meta-analysis

Effects of telehealth interventions on the caregiver burden and mental health for caregivers of people with dementia: a systematic review and meta-analysis

OBJECTIVES

To systematically evaluate the effects of telehealth interventions on the caregiver burden and mental health of caregivers for people with dementia (PWD).

METHOD

Relevant randomized controlled trials (RCTs) of telehealth interventions on caregivers were extracted from nine electronic databases (PubMed, The Cochrane Library, Web of Science, Embase, CINAHL, SinoMed, CNKI, WanFang, and VIP). The retrieval time was from inception to 26 July 2023.

RESULTS

Twenty-two articles with 2132 subjects were included in the final analysis. The meta-analysis demonstrated that telehealth interventions exerted a significant effect in reducing caregiver burden (SMD: -0.14, 95 % CI: -0.25, -0.02, p = 0.02), depression (SMD = -0.17; 95%CI: -0.27, -0.07, p < 0.001) and stress (SMD = -0.20, 95%CI: -0.37, -0.04, p = 0.01). However, no statistically significant effect was observed on anxiety (SMD = -0.12, 95%CI: -0.27, 0.03, p = 0.12). Moreover, subgroup analysis showed that tailored interventions were associated with more evident reductions in depression (SMD = -0.26; 95%CI: -0.40, -0.13, p < 0.001) than standardized interventions (SMD = -0.08; 95%CI: -0.22, 0.06, p = 0.25). In addition, telehealth was effective in relieving depression in Internet-based (SMD = -0.17, 95%CI: -0.30, -0.03, p = 0.01) and Telephone-based group (SMD = -0.18, 95%CI: -0.34, -0.02, p = 0.03), while there was no significant difference in the Internet and Telephone-based group (SMD = -0.18, 95%CI: -0.54, 0.18, p = 0.32).

CONCLUSION

Telehealth could effectively reduce the burden and relieve the depression and stress of caregivers of PWD, while its effect on anxiety requires further research. Overall, telehealth has potential benefits in dementia care.

Effect of Tele-exercise Interventions on Quality of Life in Cancer Patients: A Meta-analysis

PURPOSE

To evaluate the impacts of tele-exercise intervention with cancer patients' quality of life, taking into account the influence of the duration of tele-exercise intervention, type of intervention, and gender of cancer patients on quality of life.

METHODS

The PubMed (MEDLINE), Embase, CINAHL, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, and PsycINFO databases were searched from inception to August 21, 2023. The Cochrane Collaboration's risk of bias tool 2 was utilized to estimate the risk of bias, and the Grading of Recommendations, Assessment. For statistical analyses, R Studio was employed.

RESULTS

This meta-analysis contained eight trials. When compared to controls, tele-exercise interventions (SMD = 0.41, 95% CI: 0.12 to 0.70, p < .010; I2 = 54%, p = .030) have a positive influence on boosting the quality of life within cancer patients. Subgroup analyses demonstrated the greater effectiveness of tele-exercise in enhancing the quality of life of cancer patients when the duration was greater than or equal to 10 weeks. Furthermore, tele-exercise was found to have a stronger advantageous effect on quality of life among female cancer. In addition, among the types of interventions for tele-exercise, neither web-based nor telephone-based formats significantly enhanced quality of life among cancer patients.

CONCLUSION

Tele-exercise interventions are a cost-effective and feasible non-pharmacologic complementary way to promote cancer patients' quality of life. Additional large-sample, carefully designed randomized controlled trials are warranted to further validate the impact of tele-exercise concerning cancer patients' quality of life.

REGISTRATION NUMBER

CRD42023477147.

The Effect of Education and Monitoring via Tele-Nursing to Elderly Cancer Patients Using Oral Anticancer Agents on Self-efficacy and Medication Adherence: A Randomized Controlled Trial

OBJECTIVES

This study was conducted as a randomized controlled trial to determine the effect of the education and monitoring provided via tele-nursing to elderly cancer patients using oral anticancer agents on their medication treatment adherence self-efficacy and medication adherence.

METHODS

The sample of the study consisted of 60 elderly cancer patients who presented to the oncology outpatient clinics of a medical faculty hospital in Turkey. An Elderly Information Form, the Oral Chemotherapy Adherence Scale, the Medication Adherence Self-Efficacy Scale, a Tele-nursing Evaluation Form, and a Telephone Monitoring Form were used to collect data. Patients in the intervention group were sent text messages and educational videos via WhatsApp® for the first four weeks, and after the fifth week, they were monitored by phone for eight weeks. Data collection tools were applied to the control and intervention groups at weeks 1, 8, and 12. Independent samples t-test, Repeated measurements analysis of variance chi-square test, and Pearson correlation test were used to analyze the data.

RESULTS

In the study, while there was no significant difference between the mean scores of the intervention and control groups on the pretest application of the Oral Chemotherapy Adherence Scale and the Medication Adherence Self-Efficacy Scale (p > .05), a significant difference was found between the mean posttest scores of the groups (p < .05).

CONCLUSIONS

In this study, it was determined that the education and monitoring provided to elderly cancer patients via tele-nursing positively affected their self-efficacy and medication adherence.

IMPLICATIONS FOR NURSING PRACTICE

In line with the research results, it is recommended that nurses use tele-nursing applications in the care of elderly cancer patients using oral anticancer agents.

[Frailty: Prevention]

The Frailty syndrome is usually related to the aging process and chronological age, but it is not an inevitable consequence of it - at least until the final phase of life. Primary care interventions that promote physical activity and nutrition can prevent the progression from pre-frailty to frailty. This article presents the current state of knowledge on primary and secondary prevention of frailty.

Effectiveness of Digital Health Literacy Interventions in Older Adults: Single-Arm Meta-Analysis

BACKGROUND

In a world of rapid digital technology development, the lack of digital health literacy (DHL) among older people cannot be ignored. DHL is becoming an essential competency that can facilitate the health status and health management of older adults. DHL interventions that are feasible and appropriate can be implemented on a large scale through the health care system for older people.

OBJECTIVE

The purpose of this meta-analysis was to assess the effectiveness of DHL interventions for older adults.

METHODS

English publications in PubMed, Web of Science, Embase, and the Cochrane Library were searched from inception to November 20, 2022. Two reviewers independently completed the data extraction and quality assessment. Review Manager (version 5.4; Cochrane Informatics & Technology Services) software was used for all meta-analyses.

RESULTS

A total of 7 studies, including 2 randomized controlled trials and 5 quasi-experimental studies, involving 710 older adults were considered eligible. The main outcome was scores on the eHealth Literacy Scale, and secondary outcomes were knowledge, self-efficacy, and skills. Quasi-experimental studies compared baseline and postintervention outcomes, while randomized controlled trials compared pre- and postintervention outcomes in the intervention group. Of the 7 studies, 3 used face-to-face instruction, while 4 adopted web-based interventions. Among them, 4 of the interventions were conducted using theoretical guidance, while 3 were not. Intervention duration varied from 2 to 8 weeks. In addition, the studies included were all conducted in developed countries, mainly in the United States. Pooled analysis presented that DHL interventions had positive effects on eHealth literacy efficacy (standardized mean difference 1.15, 95% CI 0.46 to 1.84; P=.001). Subgroup analysis revealed that DHL interventions that chose face-to-face teaching (standardized mean difference 1.15, 95% CI 0.46 to 1.84; P=.001), were guided by a conceptual framework (standardized mean difference 1.15, 95% CI 0.46 to 1.84; P=.001), and were sustained over 4 weeks (standardized mean difference 1.1, 95% CI 0.46 to 1.84; P=.001) had a more significant effect. Moreover, the outcomes showed considerable gains in knowledge (standardized mean difference 0.93, 95% CI 0.54 to 1.31; P<.001) and self-efficacy (standardized mean difference 0.96, 95% CI 0.16 to 1.77; P=.02). No statistically significant effect was found for skills (standardized mean difference 0.77, 95% CI -0.30 to 1.85; P=.16). The small number of studies, variable study quality, and heterogeneity are some limitations of this review.

CONCLUSIONS

DHL interventions have positive effects on the health status and health management of older adults. Practical and effective DHL interventions are crucial for the use of modern digital information technology in managing the health of older people.

TRIAL REGISTRATION

PROSPERO International Prospective Register of Systematic Reviews CRD42023410204; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=410204.