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  1. Thomas DC, Chui PL, Yahya A, Yap JW
    Worldviews Evid Based Nurs, 2022 Aug;19(4):267-274.
    PMID: 35635245 DOI: 10.1111/wvn.12582
    BACKGROUND: Pressure injuries (PIs) are generally regarded as predictable and preventable. Therefore, providing appropriate care for PI prevention and its management is vital. Patient education is a significant component of the PI international guideline-recommended strategy in preventing PIs. Despite the availability of evidence supporting patient education, consensus regarding the effect of patient education on knowledge, patient participation, wound healing progress, and quality of life is still lacking.

    AIMS: The main aim was to systematically evaluate the available evidence regarding the effectiveness of structured patient education on their knowledge, participation, wound healing, and quality of life.

    METHODS: The search strategy retrieved studies published between 2009 and 2021 in English across PubMed, MEDLINE, CINAHL, ProQuest, and Cochrane Library. Adult participants aged 18 years and above were included. Randomized controlled trials, quasi-experimental, and interventional studies were all included in this review. Three independent reviewers assessed the methodological quality of the studies, prior to critical appraisal, using standardized tools, that is, the Joanna Briggs Institute checklist for randomized and non-randomized studies. A narrative synthesis was conducted.

    RESULTS: A total of eight studies (466 participants) were included in this review. Available evidence indicated improved patient knowledge, participation, and quality of life with structured patient education. However, there was insufficient high-quality evidence to conclude the effect on wound healing.

    LINKING EVIDENCE TO ACTION: Structured patient education for PI was deemed to help improve patients' knowledge, participation, and quality of life. More rigorous trials are needed for the effect on wound healing progress. Thus, future educational interventions should include wound care components that describe the patient's role in promoting wound healing. A well-structured patient education program protocol is crucial to ensure the educational intervention was measurable in its effectiveness and reproducibility.

  2. Tan TW, Tan HL, Chung YC
    Worldviews Evid Based Nurs, 2024 Dec;21(6):687-694.
    PMID: 39572015 DOI: 10.1111/wvn.12756
    BACKGROUND: Breast cancer patients undergoing chemotherapy experience body composition changes impacting treatment outcomes. The role of resistance training in mitigating chemotherapy-induced sarcopenia in breast cancer patients is not well defined.

    AIMS: This study aims to assess the efficacy of resistance training in preventing sarcopenia among breast cancer patients undergoing chemotherapy.

    METHODS: A systematic search was conducted across PubMed, EMBASE, Medline, the Cochrane Library, and CINAHL until May 5, 2023. Selected literature focused on the effects of resistance training on body fat, muscle mass, muscle strength, and physical performance in breast cancer patients undergoing chemotherapy. Cochrane Risk of Bias tool version 2.0 was employed for quality assessment, and data were analyzed using Comprehensive Meta-Analysis version 2.0.

    RESULTS: Eleven randomized controlled trials (RCTs) showed that resistance training had a significant positive impact on reducing body fat (SMD = -0.250, 95% CI [-0.450, -0.050]), increasing lean body mass (SMD = 0.374, 95% CI [0.178, 0.571]), and enhancing handgrip strength at both the affected site (SMD = 0.326, 95% CI [0.108, 0.543]) and the nonaffected site (SMD = 0.276, 95% CI [0.059, 0.492]). Additionally, significant improvements were observed in leg press strength (SMD = 0.598, 95% CI [0.401, 0.796]) and overall physical performance (SMD = 0.671, 95% CI [0.419, 0.923]).

    LINKING EVIDENCE TO ACTION: Resistance training is a recommended intervention for reducing body fat, increasing muscle mass, muscle strength, and enhancing physical performance in breast cancer patients undergoing chemotherapy. Ideal low-intensity resistance training programs span 8-24 weeks, with 20-to-90-min sessions 2-4 times weekly. Regimens generally entail 8-12 repetitions at 40%-90% of one-repetition maximum test, with free-weight resistance training targeting major muscle groups yielding substantial benefits. Further research should explore outcomes across different chemotherapy phases and investigate long-term resistance training effects for a comprehensive view.

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