Effects of mechanical tongue cleaning on halitosis: A meta-analysis
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 (CINAHL), 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 (WTCI) [MD = 2.15, 95%CI(0.93,3.36), = 0.0006], Organoleptic Assessment (ORG) [MD = -0.71, 95%CI(-0.95,-0.48), ＜0.00001], but no significant differences between two groups in Volatile Sulphur Compounds (VSCs) [SMD = -1.13, 95%CI(-2.91,0.65), = 0.21], Bleeding On Probing (BOP) [MD = -1.01, 95%CI(-7.05,5.03), = 0.74]. Conclusion: Treatment combined with mechanical tongue cleaning could reduce risks of halitosis and WTCI.
Objective: To explore and clarify the concept of self-management in the context of cancer patients’ home-based rehabilitation. This concept analysis will provide a theoretical lens for nurses to help cancer patients to develop self-management strategies and enables them to improve their ability in symptom self-management of home-based rehabilitation. Method: Walker and Avant’s framework (2011) was used to analyse the concept of self-management. Results: Self-management is defined as a dynamic process that involves perception of one’s needs, resource utilisation, problem solving and active participation. Antecedents of self-management include self-efficacy, disease knowledge and social support. Improving cancer patients’ ability in symptom self-management can improve their health outcomes and quality of life and reduce healthcare expenditures. Although Strategy and Effectiveness of Symptom Self-Management scale is perceived as an ideal instrument to measure self-management and thus it is used worldwide, whether this instrument fits to measure this concept for cancer patients in Chinese context has still not yet been verified and thus further research is needed. Conclusion: According to the concept analysis, nurses should encourage cancer patients to involve actively in making a home-based rehabilitation plan and promote their ability in symptom self-management of home-based rehabilitation so as to improve their health outcomes and reduce healthcare expenditures.
Objective: To explore and identify the concept of adherence in the context of cardiac rehabilitation. This concept analysis will provide a framework for clinical decision-making and intervention to improve patients’ adherence to cardiac rehabilitation programme. Method: Walker and Avant’s framework was used to analysis the concept of adherence. Results: Adherence is defined as patients collaboration with health care provider, active involvement in the treatment regimen, and persistence in practice characterized by self-efficacy and relapse-prevention. Defining Attributes of adherence include collaboration relationship; self-efficacy promotion and relapse-prevention. Antecedents of adherence include health care provider’s prescription, illness perceptions, social-economic and environmental factors. Patients adherence to cardiac rehabilitation programme can improve clinical outcomes. However, there is no standard instrument to measure adherence. Conclusion:Based on the concept analysis, in order to improve patients’ adherence to cardiac rehabilitation, health care provider should invite patients active involvement in making rehabilitation plan and promote patients’ self-efficacy and prevention relapse.