Full text met een HU Account Objective: To quantify diversity in components of self-management interventions and explore which components are associated with improvement in health-related quality of life (HRQoL) in patients with chronic heart failure (CHF), chronic obstructive pulmonary disease (COPD), or type 2 diabetes mellitus (T2DM). Methods: Systematic literature search was conducted from January 1985 through June 2013. Included studies were randomised trials in patients with CHF, COPD, or T2DM, comparing self-management interventions with usual care, and reporting data on disease-specific HRQoL. Data were analysed with weighted random effects linear regression models. Results: 47 trials were included, representing 10,596 patients. Self-management interventions showed great diversity in mode, content, intensity, and duration. Although self-management interventions overall improved HRQoL at 6 and 12 months, meta-regression showed counterintuitive negative effects of standardised training of interventionists (SMD = 0.16, 95% CI: 0.31 to 0.01) and peer interaction (SMD = 0.23, 95% CI 0.39 to 0.06) on HRQoL at 6 months. Conclusion: Self-management interventions improve HRQoL at 6 and 12 months, but interventions evaluated are highly heterogeneous. No components were identified that favourably affected HRQoL. Standardised training and peer interaction negatively influenced HRQoL, but the underlying mechanism remains unclear. Practice implications: Future research should address process evaluations and study response to selfmanagement on the level of individual patients
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Music interventions are used for stress reduction in a variety of settings because of the positive effects of music listening on both physiological arousal (e.g., heart rate, blood pressure, and hormonal levels) and psychological stress experiences (e.g., restlessness, anxiety, and nervousness). To summarize the growing body of empirical research, two multilevel meta-analyses of 104 RCTs, containing 327 effect sizes and 9,617 participants, were performed to assess the strength of the effects of music interventions on both physiological and psychological stress-related outcomes, and to test the potential moderators of the intervention effects. Results showed that music interventions had an overall significant effect on stress reduction in both physiological (d = .380) and psychological (d = .545) outcomes. Further, moderator analyses showed that the type of outcome assessment moderated the effects of music interventions on stress-related outcomes. Larger effects were found on heart rate (d = .456), compared to blood pressure (d = .343) and hormone levels (d = .349). Implications for stress-reducing music interventions are discussed.
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Background: Emergency department utilization has increased tremendously over the past years, which is accompanied by an increased necessity for emergency medicine research to support clinical practice. Important sources of evidence are systematic reviews (SRs) and meta-analyses (MAs), but these can only be informative provided their quality is sufficiently high, which can only be assessed if reporting is adequate. The purpose of this study was to assess the quality of reporting of SRs and MAs in emergency medicine using the PRISMA statement. Methods: The top five emergency medicine related journals were selected using the 5-year impact factor of the ISI Web of Knowledge of 2015. All SRs and MAs published in these journals between 2015 and 2016 were extracted and assessed independently by two reviewers on compliance with each item of the PRISMA statement. Results: The included reviews (n = 112) reported a mean of 18 ± 4 items of the PRISMA statement adequately. Reviews mentioning PRISMA adherence did not show better reporting than review without mention of adherence (mean 18.6 (SE 0.4) vs. mean 17.8 (SE 0.5); p = 0.214). Reviews published in journals recommending or requiring adherence to a reporting guideline showed better quality of reporting than journals without such instructions (mean 19.2 (SE 0.4) vs. mean 17.2 (SE 0.5); p = 0.001). Conclusion: There is room for improvement of the quality of reporting of SRs and MAs within the emergency medicine literature. Therefore, authors should use a reporting guideline such as the PRISMA statement. Active journal implementation, by requiring PRISMA endorsement, enhances quality of reporting.
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