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Meta-analysis

Meta-analysis is the collection, arrangement and analysis of numerous empirical studies on a certain topic by scholars and experts in the hope of finding a clear relationship model between the problem or the variables concerned, which can make up for the deficiency of traditional review articles.
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The effect of traditional Chinese medicine washing combined with massage for neonatal jaundice: a meta-analysis
Li Wang, Ting Shuai, Yun-Yun Wang, Hong Cao
3TMR Integrative Nursing    2017, 1 (2): 36-44.   https://doi.org/10.12032/TMRIN20171203
Abstract HTML PDF (1398KB)  

Highlights

This meta-analysis systematically evaluated the efficacy of TCM washing combined with massage for neonatal jaundice, and showed TCM washing combined with massage can accelerate the excretion of meconium, shorten the time for transformation of meconium, and decrease transcutaneous bilirubin index and the level of serum bilirubin.

Editor’s Summary

TCM washing combined with massage is one of the common therapies avoiding the side effects of common treatments. However, the potential of TCM washing combined with massage remains debate. This article found that TCM washing combined with massage may be an effective therapy for the treatment of neonatal jaundice.

ABSTRACT

Objective: To systematically assess the effect of traditional Chinese medicine washing (TCM washing) combined with massage for the treatment of neonatal jaundice. Methods and analysis: Databases, including PubMed, the Cochrane Library, Embase, Web of Science, the Chinese Biomedical Literature Database (CBM), CNKI, and Wanfang Data were electronically searched for randomized controlled trials (from inception to July 2017). The methodological qualities of included trials were evaluated by the Cochrane risk of bias assessment tool. The meta-analysis was performed by using RevMan 5.3 software.Results: Overall, thirteen trials with a total of 1998 participants were included. The results of meta-analysis indicated that TCM washing combined with massage group was significantly superior to the control group in the first meconium time (MD, -16.67; 95% CI, -24.59 to -8.74; P<0.001), time for transformation of meconium (MD, -15.44; 95% CI, -23.59 to -7.28; P<0.001), transcutaneous bilirubin index changes [after treating three days (MD, -1.99; 95% CI, -2.57 to -1.40; P<0.001), after treating four days (MD, -1.86; 95% CI, -2.77 to -0.95; P<0.001), after treating five days (MD, -2.44; 95% CI, -3.47 to -1.42; P<0.001), after treating six days (MD, -2.23; 95% CI, -3.30 to -1.16; P<0.001), and the changes of serum bilirubin levels [after treating five days (MD, -3.17; 95% CI, -5.83 to -0.50; P=0.02), after treating six days (MD, -1.63; 95% CI, -3.10 to -0.16; P=0.03), after treating fifteen days (MD,-1.20; 95% CI, -1.99 to -0.41; P=0.003).Conclusions: TCM washing combined with massage may be an effective therapy for the treatment of neonatal jaundice. It can accelerate the excretion of meconium, shorten the time for transformation of meconium, and decrease transcutaneous bilirubin index and the level of serum bilirubin. But it should be careful to interpreting these findings. Well-designed RCTs are needed to further clarify the conclusion.

The prevalence of health literacy of Chinese residents for infectious disease between 2011 and 2015: findings from a meta-analysis
Chun-Mei Gao, Xing-Yue Qiao, Ge Li, Jing-Bo Zhai, Jin-Hua Si, Chen Zhao, Sheng-Nan Huang
3TMR Integrative Nursing    2018, 2 (2): 76-86.   https://doi.org/10.12032/TMRIN20180302
Abstract HTML PDF (1113KB)  

Highlights

The prevalence of health literacy of Chinese residents for infectious diseases is generally low. It is noted that, this given prevalence is still different between urban and rural areas, with distinction among different regions. Of these all factors, educational level may be an essential one.

Editor’s Summary

Health literacy is the key contributor to maintain and promote the quality of their own health. It is essential to know the overall prevalence of Chinese residents for infectious diseases under the situation of facing the double challenges resulted from new cases and recurrence.

ABSTRACT

Objective: To systematically investigate the prevalence of health literacy of Chinese residents for infectious disease between 2011 and 2015. Methods: The eligible studies were identified by searching China National Knowledge Infrastructure (CNKI), Wanfang database and Chinese Scientific and Technical Periodicals Database. After abstracted information and appraised the risk of bias of all eligible studies, Stata software version12.0 was used to perform statistical analysis. Results: A total of 35 cross-sectional studies, including 94631 residents, were finally included in the present study. All eligible studies were appraised as to have the quality of more than 14 grades. Meta-analysis revealed that the prevalence of health literacy of Chinese residents for infectious disease between 2011 and 2015 was 20.00% (95% CI, 18% to 23%). Conclusion: The prevalence of health literacy of Chinese resident for infectious disease between 2011 and 2015 are extremely low. And thus, it is essential to take targeted health education program depending on the characteristics of diverse group of people in order to improve the overall health of Chinese resident.

Effects of mechanical tongue cleaning on halitosis: A meta-analysis
Chen Chen, Ying-Shu Jin
3TMR Integrative Nursing    2018, 2 (2): 68-75.   https://doi.org/10.12032/TMRIN20180303
Abstract HTML PDF (714KB)  

Highlights

This meta-analysis systematically evaluatd the efficacy of mechanical tongue cleaning on halitosis, and showed that treatment combined with mechanical tongue cleaning could reduce risks of halitosis and Winkel Tongue Coating Index.

Editor’s Summary

Mechanical tongue cleaning is effective in reducing volatile sulphur compounds. However, there is insufficient evidence indicate the effective of mechanical tongue cleaning on preventing halitosis. This article found that mechanical tongue cleaning could reduce Winkel Tongue Coating Index and improve improve overall oral health condition.

ABSTRACT

Objective: To systematically review the effects of mechanical tongue cleaning on halitosis. Methods: Searching and collecting the RCTs about treatment combine with mechanical tongue cleaning from inception to May 2017 in the databases, like CNKI, VIP, WanFang Data, PubMed, the Cumulative Index to Nursing and Allied Health Literature, The Cochrane Library, Web of Science. Two reviewers screened the literatures according to inclusion and excluding criteria, extracted the data independenly, assessed bias risks. In case of disagreement, the discussion shall be settled by the third reviewer. Meta-analysis was conducted by RevMan 5.3. Results: A total of 4 RCTs with 185 volunteers were included. The results of Meta-analysis showed that treatment combine with mechanical tongue cleaning has an advantage over the control group in the levels of Winkel Tongue Coating Index [MD = 2.15, 95%CI(0.93,3.36), = 0.0006], Organoleptic Assessment [MD = -0.71, 95%CI(-0.95,-0.48), <0.00001], but no significant differences between two groups in Volatile Sulphur Compounds [SMD = -1.13, 95%CI(-2.91,0.65), = 0.21], Bleeding On Probing [MD = -1.01, 95%CI(-7.05,5.03), = 0.74]. Conclusion: Treatment combined with mechanical tongue cleaning could reduce risks of halitosis and Winkel Tongue Coating Index.

Correlation between time management disposition and ability confidence of chinese nursing students: a meta-analysis
Meng-Jie Lei, Ya-Qian Liu, Ting-Ting Liu, Ming Sang, Si-Qi Xiong, Chang-De Ji
TMR Integrative Nursing    2018, 2 (3): 123-131.   https://doi.org/10.12032/TMRIN20180721
Abstract HTML PDF (880KB)  

Highlights:

This study integrated the correlation between time management and behavioral self-confidence in nursing student. The correlation varies with the nursing student's area, nursing student's diploma, measurement tools and sample size. These results provided a basis for the improvement of nursing students’ education and clinical capabilities.

Editor’s Summary

To date, there is a lack of studies with large-scale and high quality on the correlation between nurses’ time management and ability self-confidence. This meta-analysis found that time management disposition of nursing students is moderately related to ability confidence, and the association respond to changes in some variables such as area.

Abstract

Objective: To evaluate the correlation between time management disposition and ability confidence of Nursing Students in China through the Pearson correlation coefficient. Methods: Electronic databases including the Cochrane library, PubMed, EMBASE, the Web of Science, CBM, Wanfang, VIP and CNKI were searched from inception to October 2017 to collect literature on the correlation between time manage-ment disposition and ability confidence of Chinese nursing students. The studies were examined according to the inclusion and exclusion criteria. After extracting data and evaluating the quality of the included studies. Meta-analysis was carried out using Stata 12.0 software. Results: A total of 7 articles with 1632 nursing students were included, and the quality of the literature was at medium level. Meta-analysis shown the total score of time management disposition of Chinese nursing students and its three dimensions were related to ability confidence. The summary correlation coefficient between time management disposition and ability confidence was 0.52 (0.43 to 0.59) ; There is a weak correlation between time value and ability confidence (r, 0.33; 95% CI, 0.25 to 0.39); There was a moderate level of correlation between time control and ability confidence (r, 0.49; 95% CI, 0.43 to 0.54); There was a moderate level of correlation between time efficacy and ability confidence (0.47, 0.41, 0.53).And the relevance of nursing time management disposition and behavioral confidence varies with the nursing student's area, nursing student's diploma, measurement tools and sample size. Conclusion: The time management disposition of Chinese nursing students is moderately related to ability confidence. When there are different in nursing students in the area, nursing diploma, measurement tools and sample size, the relevance is very different. The time management disposition of Chinese nursing students and their ability confidence are mutually reinforcing, and the time management disposition and their ability confidence should be further strengthened in the future.

Moxibustion treatment for knee osteoarthritis: cumulative meta-analysis and trial sequential analysis
Jun-Chen Fan, Hui-Min Zhang, Miao Zhang, Fan-Mei Kong, Wen-Rui Wang, Yu-Ling Wang
TMR Integrative Nursing    2018, 2 (3): 115-122.   https://doi.org/10.12032/TMRIN20180720
Abstract HTML PDF (1103KB)  

Highlights:

This article evaluated the effect of moxibustion on knee osteoarthritis patients with cumulative meta-analysis, and trial sequential analysis was applied to test the authenticity of results.

Editor’s summary:

Pain is a major problem in patients with knee Osteoarthritis. Moxibustion, a traditional non-invasive treatment in China, stimulates specific acupuncture points by the heat from the burning strips to alleviate symptoms, such as muscle strain, osteoarthritis, shoulder pain, neck and back pain.

Abstract

Objective: To evaluate the effect of moxibustion on knee osteoarthritis patients with cumulative meta-analysis, and trial sequential analysis was applied to test the authenticity of results. Methods: We searched PubMed, EMbase, The Cochrane Library, CNKI and CBM to collect RCTs about moxibustion on knee osteoarthritis patients. The selection of literature, data extraction and evaluation of eligible literature were carried out independently by two reviewers. Then Stata11.0 software was used for data analysis. Result: Totally 11 RCTs involved 1005 patients were recruited. The results of meta-analysis showed that no significant differences were found between the two groups in VAS, moxibustion is better than drug therapy in effective rate [OR = 0.40, 95%CI (0.27, 0.60)] and knee score [SMD = -0.70, 95%CI (-1.22, -0.19)]. The result of trial sequential analysis indicated that the sample size didn’t reach the TSA Boundary on VAS, the sample size of effectiveness achieved Require Information Size. In the indicator of knee score has obtained certain result before reaching the Require Information Size. Conclusion: moxibustion is superior to drug therapy on treatment knee osteoarthritis. However, large sample size and high-quality studies are still needed.

Efficacy and safety of the heated gel mattress for prevention of hypothermia in preterm infants during intra-hospital transport: a meta-analysis
Ya-Qian Liu, Meng-Jie Lei, Ting-Ting Liu, Yu-Feng Li, Chu-Yun Cui, Li-Jia Ni, Chang-De Jin
TMR Integrative Nursing    2018, 2 (3): 132-140.   https://doi.org/10.12032/TMRIN20180717
Abstract HTML PDF (658KB)  

Highlights:

This study evaluated the efficacy and safety of the heated gel mattress for prevention of heat loss on preterm infants with hypothermia during the transport systematically and objectively.

Editor’s Summary

Premature baby's hypothermia will cause short-term as well as long-term morbidities, including oxygen consumption, sepsis, early retinopathy and intraventricular hemorrhage. Therefore, implementation of early intervention strategies is vitally essential to prevent premature hypothermia.

Abstract

Objective: To evaluate the efficacy and safety of the heated gel mattress for prevention of heat loss on preterm infants with hypothermia during the transport systematically and objectively. Methods: Systematic searches on PubMed, EMBASE, Cochrane Library, Web of Science, CBM, CNKI, Wanfang and VIP were performed for randomized controlled trials (RCTs) or quasi-RCTs which explored the effects of heated gel mattress on prevention of hypothermia in premature infants relative to conventional alternatives. Studies were screened according to inclusion and exclusion criteria, extracted data and assessed quality. Then, meta-analysis and trial sequential analysis were performed by RevMan 5.3 and TSA v0.9 software developed at the Copenhagen Clinical Trials Center in Denmark, independently. Results: This systematic review included 10 studies which comprised 7 RCTs and 3 quasi-RCTs, encompassing 773 patients. The results of meta-analysis showed that in heated gel mattress group admission temperature on neonatal intensive care unit (SMD, 0.63; 95% CI, 0.40 to 0.87; P = 0.00), incidence of hypothermia (RR, 0.73; 95% CI, 0.57 to 0.93; P = 0.01) and hyperthermia (RR, 1.82; 95% CI, 1.31 to 2.54l P = 0.00) compared with the control group had significantly statistical difference; however, there was no significant difference in admission temperature on exothermic mattresses or TransWarmer mattress group, mortality, sepsis, retinopathy of prematurity, intraventricular hemorrhage III/IV between two groups. trial sequential analysis confirmed that the pooled results of admission temperature on neonatal intensive care unit and hyperthermia were stable and reliable; but the combination of low-temperature incidence and mortality indicators suggested that the sample size was insufficient. Conclusion: Heated gel mattress is a safe and effective rewarming intervention that can improve body temperature of hypothermic preterm infants during transport, reduce the incidence of hypothermia and does not increase the incidence of morbidity and complications. However, it is recommended that clinical monitoring of body temperature should be performed dynamically to decrease the potential risk of high fever. In addition, due to the limitation of quantity and quality of included studies, its cost-effectiveness and far-reaching influence on long-term follow-up outcomes need further evaluation through clinical multicenter, large sample, and high-quality research.

Effect of continuing nursing on self-care ability of diabetic patients: A meta-analysis
Bo Zhang, Xiang-Shu Cui
3TMR Integrative Nursing    2019, 3 (2): 49-55.   https://doi.org/10.12032/TMRIN20190216
Abstract HTML PDF (423KB)  

Highlights:

This study evaluated the effect of continued-nursing on self-care ability of diabetic patients by using meta-analysis, in order to provide evidence-based basis for health education and improve the effect of health education for nurses.

Editor’s summary:

Continuing nursing is an open and extended mode of health education and nursing. Continuing nursing can increase the self-care ability of patients with diabetes discharge and improve their health behaviors. However, there are certain deficiencies. This article evaluated the effect of continuing nursing on self-care ability of diabetic patients.

Abstract

Objective: To evaluate the effect of continuing nursing on self-care ability of diabetic patients. Methods: Meta-analysis was used to search multiple Chinese and English databases, and relevant randomized controlled trials were collected. After reviewing the literature quality, RevMan 5.2 software was used for data analysis. Results: A total of 8 randomized controlled trials (RCTs) were included. The results showed that the self-care ability of the continuing care observation group was significantly higher than that of the control group [WMD = 17.88, 95%CI (17.30, 18.47), P < 0.001]. Conclusion: Continuing nursing shows superiority in improving self-care ability of diabetic patients.

Effect of Baduanjin on rehabilitation of patients with coronary heart disease: A meta-analysis of 8 randomized controlled trials
Tian-Tian Gai, Wei Fan, Meng-Xi Gao, Yu Cui, Yan Wang
3TMR Integrative Nursing    2019, 3 (4): 133-139.   https://doi.org/10.12032/TMRIN20190810
Abstract HTML PDF (570KB)  

Highlights

This study evaluated the impact of Baduanjin exercise on rehabilitation of patients with coronary heart disease. The current research results showed that Baduanjin improved cardiopulmonary function and exercise tolerance and alleviated patients' bad mood.

Editor’s summary

Baduanjin has the benefits of strengthening the muscles and the bones, nourishing the vital energy, speeding up blood circulation, coordinating the internal organs. Studies have shown that, insisting on regular exercise of Baduanjin reduced the blood pressure, blood lipids and blood sugar in exercisers and promoted the physical and mental health of the elderly.

ABSTRACT

Backgroud: As one of the traditional rehabilitation exercises recommended by the State Sports General Administration, Baduanjin is widely used in the prevention and treatment of coronary heart disease. To systematically evaluate the impact of Baduanjin exercise on rehabilitation of patients with coronary heart disease. A search in Cochrane Library, PubMed, EMbase, Web of science, China Biology Medicine disc (CBM), CNKI, Wan Fang Date and VIP database was performed in order to collect randomized controlled trials (RCTs) of Baduanjin in patients with coronary heart disease from inception to November 2018. Two reviewers independently screened literatures, extracted data and assessed risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3. Results: A total of 8 RCTs including 615 patients were considered. Compared with the control regime, Baduanjin improved the ejection fraction of patients [MD = 2.99, 95% CI (1.54, 4.45), P < 0.001], increased the walking distance of six minutes [SMD = 2.29, 95% CI (0.44, 4.13), P = 0.02], decreased the score of self-rating anxiety scale and self-rating depression scale [MD = -5.06, 95% CI (-6.63, -3.49), P < 0.001], [MD = -5.12, 95% CI (-8.73, -1.50), P = 0.006]. Conclusion: The current research results showed that Baduanjin improved cardiopulmonary function and exercise tolerance and alleviated patients’ bad mood.

Application of FICare mode in premature infants of NICU: A meta-analysis
Min Zhang, Ya-Nan Leng, Zhi Guan, Ying Wang
3TMR Integrative Nursing    2019, 3 (4): 125-132.   https://doi.org/10.12032/TMRIN20190328
Abstract HTML PDF (1157KB)  

Highlights

This article systematically evaluated the effect of FICare mode on the growth and development of premature infants in NICU. Meta-analysis showed that FICare mode can effectively promote the growth and development of premature infants and alleviate the harm caused by the separation of mother and infants.

Editor’s summary

FICare is the philosophy that guides how we provide care for infants in the NICU, which effectively integrates the parents of premature infants to care for the newborn with the medical staff, and shifts the focus from focusing on the treatment of premature infants to establishing effective kinship with the family.

ABSTRACT

Objective: To systematically review the effect of Family Integrated Care (FICare) mode on the growth and development of premature infants. Methods: Systematic searches in PubMed, EMBASE, The Cochrane Library, Web of Science, Chinese biomedical literature database, China National Knowledge Infrastructure, Wanfang medical and VIP database were performed for randomized controlled trials (RCTs) or quasi-RCTs which explored the effects of FICare mode on growth and development of premature infants in neonatal intensive care unit. Then, meta-analysis was performed by RevMan 5.3 after two independent investigators screened the literature, extracted the data and evaluated the risk of bias of all included studies. Results: A total of 14 articles were included, including 3120 preterm infants and their families. Meta-analysis showed that compared with the traditional management mode, FICare mode can effectively improve the growth rate of premature infants' weight [Weight mean difference (WMD) = 4.02, 95%CI (2.47, 5.56), P < 0.001], increase sleep time [WMD = 3.25, 95%CI (2.05, 4.44), P < 0.001], improve breastfeeding rate [RR = 1.38, 95%CI (1.15, 1.64), P < 0.001], reduce readmission rate [Relative risk (RR) = 0.49, 95%CI (0.33, 0.71), P < 0.001], promote the development of the nervous system [WMD = 3.96, 95%CI (3.18, 4.74), P < 0.001], improve nursing skills of Premature infants' parents [WMD = 17.40, 95%CI (13.64, 21.1), P < 0.001], reduce the influence of maternal and infant separation on parents' emotions. Conclusion: FICare mode can effectively promote the growth and development of premature infants and alleviate the harm caused by the separation of mother and infants. Limited by the quality and region of the included studies, the appeal conclusion still needs to be tested by more high-quality studies.

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