Displaying publications 1 - 20 of 48 in total

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  1. Chong MC
    PMID: 25030469 DOI: 10.1016/S1976-1317(09)60022-0
    Reflective practices have been advocated as a method to bridge the gap between nursing theory and practice, and as a tool to develop knowledge embedded in practice.
  2. Nelwati, Abdullah KL, Chong MC
    Nurse Educ Pract, 2019 Nov;41:102648.
    PMID: 31707147 DOI: 10.1016/j.nepr.2019.102648
    BACKGROUND: Undergraduate nursing students are required to acquire professional values during professional nurse education to provide safe and high quality patient care. However, there was no documentation in professional values among Indonesian undergraduate nursing students and the factors influencing its development.

    PURPOSE: The purpose of this study was to determine professional values among Indonesian undergraduate nursing students and examine the relationship between students' demographic factors and professional values.

    DESIGN: A cross-sectional study using convenience sampling was applied to recruit 391 Indonesian undergraduate nursing students. The 26 items of Nurses Professional Values Scale Revision (NPVS-R) with five dimensions was employed to collect data. Descriptive and inferential statistics, independent samples t-test were applied to analyse and interpret data.

    RESULTS: The result showed that the total score of nurse professional values was high (95.80 ± 12.93). The most important professional value dimension was caring, while activism was the least important values. The NPVS-R total score had a significant association with length of professional clinical practice of the students (p 

  3. Nelwati, Abdullah KL, Chong MC, McKenna L
    J Prof Nurs, 2020 03 19;36(6):477-483.
    PMID: 33308543 DOI: 10.1016/j.profnurs.2020.03.008
    BACKGROUND: Peer learning has enabled undergraduate nursing students to develop competence and clinical skills. It is rare to find quantitative studies examining the effect of peer learning on professional competence development among undergraduate nursing students comprehensively.

    OBJECTIVE: To examine the effect of peer learning on professional competence development among Indonesian undergraduate nursing students.

    DESIGN: A quasi-experimental study with non-equivalent control group pre-test post-test design.

    PARTICIPANTS: Convenience sampling was used to recruit participants. Seventy-five students completed the study (37 in the intervention group and 38 in the control group).

    METHODS: The intervention group received the peer learning program, while the control group received conventional learning during clinical practice. The Nurse Professional Competence (NPC) was used to collect data at pre-test and post-test measurement. Data were analysed using descriptive and inferential statistics.

    RESULTS: Professional competence had significantly increased in the intervention group. A significant interaction effect of time (pre-test and post-test) and group on professional competence development was also found. The effect of peer learning on professional competence development was significantly greater than the conventional method.

    CONCLUSION: Peer learning was demonstrated as an innovative learning method to develop professional competence during clinical practice among Indonesian undergraduate nursing students. It is recommended for nurse educators to consider implementing peer learning during clinical education.

  4. Che CC, Hairi NN, Chong MC
    J Adv Nurs, 2017 Sep;73(9):2049-2064.
    PMID: 28122163 DOI: 10.1111/jan.13265
    AIMS: To review systematically the psychometric properties of instruments used to measure intention to work with older people.

    BACKGROUND: Nursing students are part of the future healthcare workforce; thus, being aware of their intention to work with older people would give valuable insights to nursing education and practice. Despite a plethora of research on measuring intention to work with older people, a valid and reliable instrument has not been identified.

    DESIGN: A systematic literature review of evidence and psychometric properties.

    DATA SOURCES: Eight database searches were conducted between 2006 - 2016.

    REVIEW METHODS: English articles were selected based on inclusion and exclusion criteria. The COSMIN checklist was used to assess instruments reporting a psychometric evaluation of validity and reliability.

    RESULTS: Of 41 studies identified for full text review, 36 met the inclusion criteria. Seven different types of instruments were identified for psychometric evaluation. Measures of reliability were reported in eight papers and validity in five papers. Evidence for each measurement property was limited, with each instrument demonstrating a lack of information on measurement properties. Based on the COSMIN checklist, the overall quality of the psychometric properties was rated as poor to good.

    CONCLUSION: No single instrument was found to be optimal for use. Studies of high methodological quality are needed to properly assess the measurement properties of the instruments that are currently available. Until such studies are available, we recommend using existing instruments with caution.

  5. Maniam R, Tan MP, Chong MC
    Patient Educ Couns, 2021 Sep 29.
    PMID: 34625322 DOI: 10.1016/j.pec.2021.09.026
    OBJECTIVE: End-of-life care is often overlooked in the dialysis unit despite high mortality rates. This study aimed to understand the diverse subjectivity of opinions on end-of-life care preferences, feelings, needs, value and goals in life among a haemodialysis population.

    METHODS: The Q methodology was used where 37 opinion statements were ranked in order of importance in a unimodal shaped grid. Results were explored using the Centroids factor extraction and Varimax rotation.

    RESULTS: Four-three persons living with haemodialysis, mean age± SD= 56.58 ± 10.22 years, participated in the study. Five-factors were identified: living in the present, family preference, self preservation, power vs. control and autonomy in decision making, loaded by eleven, four, four, three and three participants with 16 individuals not loading significantly and two were confounded. Preferences for remaining positive in the face of illness through a healthy lifestyle and preserving relationships and autonomy were demonstrated.

    CONCLUSIONS: End-of-life discussions are potentially inhibited by preferences to live for the present which should be explored in future studies.

    PRACTICE IMPLICATION: Statement sets may be used to help facilitate end-of-life discussions through identification of opinion groups. Establishing preferences may guide identification of those willing to initiate discussions.

  6. Noviani W, Chong MC, Tang LY
    Heliyon, 2023 Mar;9(3):e13433.
    PMID: 36895334 DOI: 10.1016/j.heliyon.2023.e13433
    BACKGROUND: Professional socialization could support competency achievement and assist the transition phase. It is rare to find quantitative studies examining the effects of professional socialization for nursing students (NS).

    OBJECTIVES: To investigate the effects of a socialization in professional reality integration for nursing student transition (SPRINT) to improve the professional competence of undergraduate NS in Indonesia.

    DESIGN: A quasi-experimental study non-equivalent control group pre-test post-test design was conducted using convenience sampling.

    PARTICIPANTS: One hundred twenty NS (60 participants in the experimental group and 60 participants in the control group) from two nursing departments in private universities in Indonesia.

    METHODS: The SPRINT educational intervention consisted of professional socialization training using several learning methods and activities. Meanwhile, the control group received conventional socialization. The Nurse Professional Competence short-form (NPC-SF) scale was evaluated prior to the participants' internship program, lasting from 6 to 12 weeks after clinical education in both groups.

    RESULTS: SPRINT intervention significantly increased overall professional competence scores of the experimental groups higher than the control group. By comparing the mean scores in three times measurement, the six competency areas mean score increased significantly for the experimental group while, for the control only three areas of competence increased in twelve week post-test.

    CONCLUSION: A "SPRINT" as an innovative educational program developed in collaboration with academia, clinical preceptors, could improve professional competence. It is recommended to implement SPRINT program to assist the smooth transition from academic into clinical education.

  7. Che CC, Chong MC, Hairi NN
    Int J Nurs Stud, 2018 Sep;85:61-67.
    PMID: 29852374 DOI: 10.1016/j.ijnurstu.2018.05.007
    BACKGROUND: Studies have reported that student nurses hold positive attitudes towards older people; nevertheless, working with older people has consistently remained one of the least desired career choices among student nurses in most countries.

    OBJECTIVES: The current study aimed to assess student nurses' intentions to work with older people and to determine the predictors of working intentions among nursing students.

    DESIGN: The study adopted a cross-sectional design.

    SETTINGS: Multistage sampling was used to recruit nursing students from five states in Malaysia.

    PARTICIPANTS: A total of 1462 nursing students from eleven nursing education institutions participated in this study.

    METHODS: A self-administered questionnaire was used to collect data. This study is underpinned by the Theory of Planned Behaviour. The Intent to Work with Older People Scale and Kogan Attitudes Toward Old People Scale were used to assess nursing students' intentions and attitudes towards care of older people respectively. Researcher-developed instruments were used to assess subjective norms and perceived behavioural control among nursing students.

    RESULTS: The present study found that nursing students in Malaysia demonstrated a moderate level of intention to work with older people, with a mean of 39.72 (±4.38). There were significant differences in effects of gender, ethnic group, academic level, type of nursing institution and setting of older person care clinical experience on intentions to work with older people. There was a moderate and positive relationship between attitudes towards older people and intentions to work with older people, as well as between perceived behavioural control and intentions to work with older people; it was found that r = 0.36 for both relationships. Attitudes, subjective norms and perceived behavioural control accounted for 19.7% of the variance in intentions to work with older people.

    CONCLUSION: The primary findings of this national study revealed that Malaysian nursing students have a moderate level of intention to work with older people. It is imperative to develop educational interventions to nurture attitudes for caring and promote stronger intentions to work with older people.

  8. Chong MC, Francis K, Cooper S, Abdullah KL
    Nurs Res Pract, 2014;2014:126748.
    PMID: 24523961 DOI: 10.1155/2014/126748
    Nurses need to participate in CPE to update their knowledge and increase their competencies. This research was carried out to explore their current practice and the future general needs for CPE. This cross-sectional descriptive study involved registered nurses from government hospitals and health clinics from Peninsular Malaysia. Multistage cluster sampling was used to recruit 1000 nurses from four states of Malaysia. Self-explanatory questionnaires were used to collect the data, which were analyzed using SPSS version 16. Seven hundred and ninety-two nurses participated in this survey. Only 80% (562) of the nurses had engaged in CPE activities during the past 12 months. All attendance for the various activities was below 50%. Workshops were the most popular CPE activity (345, 43.6%) and tertiary education was the most unpopular activity (10, 1.3%). The respondents did perceive the importance of future CPE activities for career development. Mandatory continuing professional education (MCPE) is a key measure to ensure that nurses upgrade their knowledge and skills; however, it is recommended that policy makers and nurse leaders in the continuing professional development unit of health service facilities plan CPE activities to meet registered nurses' (RNs) needs and not simply organizational requirements.
  9. Chong MC, Sellick K, Francis K, Abdullah KL
    PMID: 25029948 DOI: 10.1016/S1976-1317(11)60012-1
    PURPOSE: A cross sectional descriptive study, which involved government hospitals and health clinics from Peninsular Malaysia sought to identify the continuing professional education (CPE) needs and their readiness for E-learning. This paper focuses on the first phase of that study that aimed to determine the factors that influence nurses' participation in CPE.
    METHODS: Multistage cluster sampling was used to recruit 1,000 nurses randomly from 12 hospitals and 24 health clinics from four states in Peninsular Malaysia who agreed to be involved. The respondent rate was 792 (79.2%), of which 562 (80%) had participated in CPE in the last 12 months.
    RESULTS: Findings suggested that updating knowledge and providing quality care are the most important factors that motivate participation in CPE, with respective means of 4.34 and 4.39. All the mean scores for educational opportunity were less than 3.0. Chi-square tests were used to test the association of demographic data and CPE participation. All demographical data were significantly associated with CPE participation, except marital status.
    CONCLUSIONS: Implementation of mandatory CPE is considered an important measure to increase nurse's participation in CPE. However, effective planning that takes into consideration the learning needs of nurses is recommended.
  10. Ibrahim Alzamel LG, Abdullah KL, Chong MC, Chua YP
    J Egypt Public Health Assoc, 2020 Aug 14;95(1):20.
    PMID: 32813099 DOI: 10.1186/s42506-020-00048-9
    BACKGROUND: Understanding the factors influencing nurses' turnover intention, particularly the work life quality and commitment to organization, is important to all countries suffering from nursing shortage. The study aims to determine the mediating role of commitment to organization on work life quality and its relationship with turnover intention among Malaysian nurses.

    METHODS: A descriptive cross-sectional design, using a self-report survey was conducted on 430 nurses from a teaching hospital from February to April 2019. A structural equation model version 3 was used for testing study hypotheses.

    RESULTS: The mediating effect (indirect effect) of organizational commitment on the relationship between work life quality and turnover intention (QWL→OC→IT) was negative with path coefficient - 0.234, whereas the direct effect of work life quality on turnover intention (QWL→IT) was negative with smaller path coefficient - 0.228. This means that the relationship between work life quality and turnover intention was partially mediated by the organizational commitment (P < 0.001).

    CONCLUSION: Organizational commitment has a negative partial mediating effect between work life quality of nurses and intention of turnover in teaching hospitals where the organizational commitment significantly reduced the nurses' intention to leave. The study findings can guide nursing managers to be carefully attended to the levels of nurses' commitment to their organization.

  11. Jamaludin TSS, Zakaria MA, Saidi S, Chong MC
    MyJurnal
    Objective: As the incidence of emergencies has steadily increased in recent years, it is important to en-sure that individuals, including university students, are adequately trained to deal with such events. This study aimed to assess the level of knowledge and awareness of, and attitudes towards, first aid among IIUM Kuantan campus students.

    Method: A quantitative cross-sectional survey with stratified random sam-pling study was conducted among 348 students at the International Islamic University Malaysia (IIUM) Kuantan. Data were collected using a self-administered questionnaire which was adapted from Hong Kong Red Cross. The questionnaire was available in both English and the Malay language.

    Results: A total of 42.8% participants had a moderate level of first aid knowledge. However, 90.8% participants had aware-ness of and a positive attitude towards first aid knowledge. On the other hand, 55.4% of study participants had not experienced taking first aid courses and they had little knowledge of this. There were significant associations between gender, Kulliyyah or faculty, year of study, and first aid training experience, and the level of first aid knowledge based on a one-way ANOVA test with p-values of < 0.05 representing statistical significance.

    Conclusion: The findings indicate that most health sciences university students have good awareness and attitudes towards first aid. Nevertheless, implementation of regular educational programs with structured modules may be able to improve their knowledge of first aid practices and skills.
  12. Krishnasamy K, Tang LY, Chong MC, Lau PC, Chinna K
    Clin J Oncol Nurs, 2017 02 01;21(1):E23-E29.
    PMID: 28107326 DOI: 10.1188/17.CJON.E23-E29
    BACKGROUND: Malnutrition is common among patients with cancer, but little attention is given to its risks and consequences.
    OBJECTIVES: The aim of this study is to assess the nutritional status and identify the factors associated with malnutrition among newly diagnosed patients with cancer.
    METHODS: Patients admitted with newly diagnosed cancer at a teaching hospital in Malaysia were recruited from January to April 2015. Nutritional status was assessed before treatment initiation, and patients were classified into three categories.
    FINDINGS: A total of 132 pretreatment patients were recruited into the study. About half were severely malnourished. Patients with stage III cancer had the highest prevalence of severe malnourishment. Clinical parameters and disease characteristics were significantly associated with nutritional status. Demographic variables were also statistically significantly associated with severe nutritional status.
    KEYWORDS: malnutrition; nutrition status; nutritional assessment; risk factor
  13. Liao SJ, Chong MC, Tan MP, Chua YP
    Geriatr Nurs, 2018 08 31;40(2):154-159.
    PMID: 30173939 DOI: 10.1016/j.gerinurse.2018.08.001
    Depression leads to a poorer quality of life (QOL) which is a determinant of healthy ageing. Cost-effective solutions for enhancing QOL in the older population are much needed in China, with its rapidly ageing population. We conducted a randomized controlled trial involving 112 community-dwelling older participants with mild to moderate depression, to evaluate the effect of Tai Chi with music on QOL (57 in intervention group, 55 in control group). WHO Quality of Life-BREF was used to measure QOL at baseline and at every month for three months. Following the adjustments for sociodemographic data, the effect of intervention on QOL was assured (F = 25.145, P 
  14. Omar Daw Hussin E, Wong LP, Chong MC, Subramanian P
    J Clin Nurs, 2018 Feb;27(3-4):e688-e702.
    PMID: 29076190 DOI: 10.1111/jocn.14130
    AIMS AND OBJECTIVES: To examine nurses' perceptions of barriers to and facilitators of end-of-life care, as well as their association with the quality of end-of-life care.

    BACKGROUND: Often, dying patients and their families receive their care from general nurses. The quality of end-of-life care in hospital wards is inadequate.

    METHOD: A self-administered questionnaire was completed by 553 nurses working in a tertiary teaching hospital in Malaysia.

    RESULTS: The barrier with the highest mean score was "dealing with distressed family members." The facilitator with the highest mean score was "providing a peaceful and dignified bedside scene for the family once the patient has died." With regard to barrier and facilitator categories, the barrier category with the highest total mean score was patient-related barriers and the facilitator category with the highest total mean score concerned facilitators related to healthcare professionals. In the multivariate analysis, age, patient family-related barriers and healthcare professional-related facilitators significantly predict the quality of end-of-life care.

    CONCLUSION: The results of this study suggest that there is an urgent need to overcome barriers related to the patient and family members that hinder the quality of care provided for dying patients, as well as to enhance and implement the facilitators related to healthcare providers. In addition, there is also a need to enhance the quality of end-of-life care provided by younger nurses through end-of-life care courses and training.

    RELEVANCE TO CLINICAL PRACTICE: Helping nurses overcome barriers and implement facilitators may lead to enhanced quality of care provided for dying patients.

  15. Tan K, Chong MC, Subramaniam P, Wong LP
    Nurse Educ Today, 2018 May;64:180-189.
    PMID: 29500999 DOI: 10.1016/j.nedt.2017.12.030
    BACKGROUND: Outcome Based Education (OBE) is a student-centered approach of curriculum design and teaching that emphasize on what learners should know, understand, demonstrate and how to adapt to life beyond formal education. However, no systematic review has been seen to explore the effectiveness of OBE in improving the competencies of nursing students.

    OBJECTIVE: To appraise and synthesize the best available evidence that examines the effectiveness of OBE approaches towards the competencies of nursing students.

    DESIGN: A systematic review of interventional experimental studies.

    DATA SOURCES: Eight online databases namely CINAHL, EBSCO, Science Direct, ProQuest, Web of Science, PubMed, EMBASE and SCOPUS were searched.

    REVIEW METHODS: Relevant studies were identified using combined approaches of electronic database search without geographical or language filters but were limited to articles published from 2006 to 2016, handsearching journals and visually scanning references from retrieved studies. Two reviewers independently conducted the quality appraisal of selected studies and data were extracted.

    RESULTS: Six interventional studies met the inclusion criteria. Two of the studies were rated as high methodological quality and four were rated as moderate. Studies were published between 2009 and 2016 and were mostly from Asian and Middle Eastern countries. Results showed that OBE approaches improves competency in knowledge acquisition in terms of higher final course grades and cognitive skills, improve clinical skills and nursing core competencies and higher behavioural skills score while performing clinical skills. Learners' satisfaction was also encouraging as reported in one of the studies. Only one study reported on the negative effect.

    CONCLUSIONS: Although OBE approaches does show encouraging effects towards improving competencies of nursing students, more robust experimental study design with larger sample sizes, evaluating other outcome measures such as other areas of competencies, students' satisfaction, and patient outcomes are needed.

  16. Liao SJ, Tan MP, Chong MC, Chua YP
    Issues Ment Health Nurs, 2018 May;39(5):398-402.
    PMID: 29436896 DOI: 10.1080/01612840.2017.1417519
    BACKGROUND: The effectiveness of pharmacological treatment may be limited in older persons. Several studies using Tai Chi or music therapy separately confirmed positive effects in the reduction of depressive symptoms. We conducted a cluster randomized controlled trial to evaluate the possible synergistic effect of combined music and Tai Chi on depressive symptoms.

    METHODS: One hundred and seven older adults with mild to moderate depressive symptoms were recruited from Ya'an city. Fifty-five participants were cluster randomized to combined music and Tai Chi group for three months, while the other fifty-two individuals were randomized to the control group that entailed routine health education delivered monthly by community nurses. The primary outcome of depressive symptoms was measured with the Geriatric Depression Scale (GDS) at baseline and monthly for three months.

    RESULTS: At three-month follow-up, a statistically significant improvement in depressive symptoms was found in the intervention group compared with control group (F(3,315) = 69.661, P < 0.001). Following adjustments for socio-demographic data, the true effect of intervention on depressive symptoms was significant (F = 41.725, P < 0.01, ηp2 = 0.574).

    CONCLUSIONS: Combined music and Tai Chi reduced depressive symptoms among community-dwelling older persons. This represents an economically viable solution to the management of depression in highly populous developing nations.

  17. Hussin EOD, Wong LP, Chong MC, Subramanian P
    Int Nurs Rev, 2018 Jun;65(2):200-208.
    PMID: 29430644 DOI: 10.1111/inr.12428
    AIM: To examine the factors associated with nurses' perceptions of the quality of end-of-life care.

    BACKGROUND: With increasing demand for hospitals to provide end-of-life care, the low quality of palliative care provided in hospital settings is an issue of growing concern in developing countries. Most dying patients receive their care from general nurses, irrespective of the nurses' specialty or level of training.

    METHOD: A structured cross-sectional questionnaire survey was conducted of 553 nurses working at a teaching hospital in Malaysia.

    RESULTS: The mean scores for nurses' knowledge about end-of-life care, their attitudes towards end-of-life care and the perceived quality of end-of-life care were low. The factors identified as significantly associated with the quality of end-of-life care were nurses' levels of knowledge and their attitudes towards end-of-life care.

    DISCUSSION: Factors that contributed to the low quality of end-of-life care were inadequate knowledge and negative attitudes. These findings may reflect that end-of-life care education is not well integrated into nursing education.

    CONCLUSION: The findings of this study suggest that there is a need to increase the nurses' level of knowledge and improve their attitude towards end-of-life care in order to enhance the quality of care provided to dying patients.

    IMPLICATIONS FOR NURSING AND HEALTH POLICY: Nurse managers and hospital policymakers should develop strategies to enhance nurses' level of knowledge, as well as providing adequate emotional support for nurses who care for dying patients and their families. Nurses should be proactive in increasing their knowledge and adopting more positive attitudes towards end-of-life care.

  18. Fauziningtyas R, Chong MC, Setiawan HW, Tan MP
    J Multidiscip Healthc, 2023;16:3379-3392.
    PMID: 37964796 DOI: 10.2147/JMDH.S436766
    INTRODUCTION: Adverse incidents in nursing home (NH) may occur as the result of inadequate monitoring for signs of unobservable initial complications, medical errors, improper nursing interventions, lack of communication, and inadequate reporting.

    PURPOSE: This study explores incident types, causes, handling, and documentation in Indonesian NHs through a qualitative approach.

    PATIENTS AND METHODS: In-depth interviews were conducted with 23 NH staff members, including managers, nurses, and support staff.

    RESULTS: Five themes and 17 sub-themes emerged, with falls and resident-to-resident abuse as common adverse incidents. Causes included older adults' conditions, environment, and misunderstanding. Follow-up action included first aid, hospital referrals, and assertive communication. Adverse incidents were actively reported through verbal and written reports or WhatsApp groups. Reports and documentation remain unstructured, however, as there were no standard operating procedures regarding incident reporting, documentation, and the types of adverse incidents that staff should report.

    CONCLUSION: Improvements in management, documentation, and reporting adverse incidents are highlighted in this research. Practitioners, nurses, and social workers should develop guidelines for handling, reporting, and documenting adverse incidents in NHs.

  19. Zhou Y, Che CC, Chong MC, Zhao H, Lu Y
    Support Care Cancer, 2023 May 30;31(6):361.
    PMID: 37249639 DOI: 10.1007/s00520-023-07826-z
    PURPOSE: Literature on marital self-disclosure interventions for cancer patients lacks consistency in methodology and content. Moreover, the impact of such interventions on physical and psychological health, marital relationships, and self-disclosure ability is controversial. This review aims to systematically analyze the studies of marital self-disclosure intervention, synthesize the structure and topics of marital self-disclosure, and summarize and evaluate its effects on improving physical and psychological outcomes and marital relationships in cancer patients and their spouses.

    METHOD: This systematic review used the preferred reporting items of Systematic Reviews and Meta-Analyses (PRISMA). We conducted a systematic review of randomized controlled and quasi-experimental studies published from the establishment of the database to October 2022. Marital self-disclosure interventions were conducted with both cancer patients and their spouses. Studies published in a language other than English or Chinese, and studies below a quality grade of C were excluded. Data were extracted through a standardized data collection form, and two reviewers independently extracted and evaluated the data. The quality of the included studies was assessed using the Cochrane Handbook of Systematic Reviews of Interventions, and a third reviewer adjudicated in case of disagreement. The data were synthesized by vote counting based on direction of effect according to the Synthesis Without Meta-analysis (SWiM) reporting guideline.

    RESULTS: Thirteen studies were included in the review. Based on quality evaluation, three studies were categorized as grade A (good), and ten studies were grade B (moderate). Seven studies reported moderate rates of participant refusal and attrition. The structure and topics of marital self-disclosure varied across different studies. The five studies had various prespecified disclosure topics, such as fear of cancer recurrence, benefit finding, and emotional distress. The overall results suggest that marital self-disclosure interventions can improve physical and psychological health, enhance marital relationships, and increase self-disclosure ability.

    CONCLUSION: The limited number of studies, small sample sizes, diverse intervention strategies, and methodological heterogeneity weakened the evidence base for the effectiveness of marital self-disclosure interventions. Therefore, further high-quality randomized controlled trials (RCTs) are recommended to confirm the effectiveness of such interventions. These studies should also evaluate the interventions' long-term impact, analyze optional topics and methods, identify key features, and explore the development of the best intervention program.

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