Objective This meta-analysis aims to systematically evaluate the effects of massage on infants with jaundice. Methods Multiple electronic databases, including Cochrane Library, PubMed, EMBASE, Web of Science, China Biology Medicine (CBM), Wan Fang Data, VIP Database for Chinese Technical Periodicals and China National Knowledge Infrastructure (CNKI), were used to search for studies on the effects of massage on infants with jaundice. Data were analysed by Rev Man 5.3. Results A total of 14 randomised controlled trials with 1889 patients were included. Statistically significant difference in percutaneous bilirubin [ MD = −1.21, 95% CI (−1.90, −0.52), P < 0.05; MD = −2.00, 95% CI (−2.68, −1.32), P < 0.05; MD = −2.00, 95% CI (2.56, −1.44), P < 0.05; MD = −1.93, 95% CI (−2.44, −1.43), P < 0.05] was found between two groups at 48, 72, 96 and 168 h. Studies on the serum total bilirubin level were divided into two subgroups according to sample size, and the results of subgroup analysis showed that the serum total bilirubin level in the intervention group was significantly lower than that in the control group [ MD = −52.06, 95% CI (−57.76, −46.36), P < 0.05 and MD = −10.65, 95% CI (−14.66, −6.63), P < 0.05]. Statistically significant difference in defecation frequency was observed between the two groups at 48 h after birth[ SMD = 0.44, 95%CI (0.02, 0.87), P < 0.05]. Conclusion Massage can decrease serum total bilirubin and percutaneous bilirubin levels and increasing defecation frequency. However, due to heterogeneity among studies, numerous multi-centre, large-sample and high-quality randomised controlled trials are needed to verify the effects of massage.
Objectives: To examine the best practice evidence of the effectiveness of the flipped classroom (FC) as a burgeoning teaching model on the development of self-directed learning in nursing education. Data sources: The relevant randomized controlled trial (RCT) and non-RCT comparative studies were searched from multiple electronic databases including PubMed, Embase, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Central Register of Controlled Trials (CENTRAL), Wanfang Data, China National Knowledge Infrastructure (CNKI), and Chinese Science and Technology Periodical Database (VIP) from inception to June 2017.Review methods: The data were independently assessed and extracted for eligibility by two reviewers. The quality of included studies was assessed by another two reviewers using a standardized form and evaluated by using the Cochrane Collaboration's risk of bias tool. The self-directed learning scores (continuous outcomes) were analyzed by using the 95% confidence intervals (CIs) with the standard deviation average (SMD) or weighted mean difference (WMD). The heterogeneity was assessed using Cochran's I 2 statistic. Results: A total of 12 studies, which encompassed 1440 nursing students (intervention group = 685, control group = 755), were eligible for inclusion in this review. Of 12 included studies, the quality level of one included study was A and of the others was B. The pooled effect size showed that compared with traditional teaching models, the FC could improve nursing students' selfdirected learning skill, as measured by the Self-Directed Learning Readiness Scale (SDLRS), Self-Directed Learning Readiness Scale for Nursing Education (SDLRSNE), Self-Regulated Learning Scale (SRL), Autonomous Learning Competencies scale (ALC), and Competencies of Autonomous Learning of Nursing Students (CALNS). Overall scores and subgroup analyses with the SRL were all in favor of the FC. Conclusions: The result of this meta-analysis indicated that FCs could improve the effect of self-directed learning in nursing education. Future studies with more RCTs using the same measurement tools are needed to draw more authoritative conclusions.
Objective To study the post-traumatic growth level and influencing factors in patients with maintenance hemodialysis. Methods A total of 179 patients receiving maintenance hemodialysis from a third-level grade A hospital in Tianjin, China were investigated using Post-traumatic Growth Inventory (PTGI), Perceived Social Support Scale, and Medical Coping Modes Questionnaire. Results The total score for the PTGI was 53.73 ± 16.45. Multiple linear regression analysis showed that social support, coping style, marital status, and family income significantly influenced the post-traumatic growth level in patients undergoing maintenance hemodialysis. These factors explained 41.4% of the variance. Conclusion Medical staff should help patients under maintenance hemodialysis to fulfill their potentials by boosting the level of social support and to effectively cope with internal conflicts. In addition, nursing staff should provide relevant psychological health education to patients to improve their post-traumatic growth.
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