Aims and Objectives: Evidence suggests that preparing patients for surgery using nonpharmacological strategies reduces their anxiety. However, there is no consensus on what the best practices are. This study aims to answer the question: Are interventions using nonpharmacological therapies effective in reducing preoperative anxiety?Background: Preoperative anxiety causes physiological and psychological adverse effects, with a negative effect on postoperative recovery.Introduction: According to the World Health Organization, between 266 and 360 million surgical procedures are performed annually worldwide, and it is estimated that more than 50% of patients will experience some degree of preoperative anxiety.Design: Systematic review of systematic reviews with results of interventions aimed at mitigating preoperative anxiety.Methods: A search was conducted for systematic reviews with meta‐analyses published between 2012 and 2021 in Medline, Scopus, Web of Science and Cochrane Library. Quality was assessed using the AMSTAR‐2 scale. The protocol was registered in PROSPERO.Results: A total of 1016 studies were examined, of which 17 systematic reviews were selected, yielding 188 controlled trials with 16,884 participants. In adults, the most common intervention included music, followed by massage, in children virtual reality and clowns. Almost all controlled trials reported a reduction in preoperative anxiety after the intervention, of which almost half had statistically significant results.Conclusion: Interventions that include music, massage and virtual reality reduce preoperative anxiety and have shown that they are cost‐effective, minimally invasive and with a low risk of adverse effects. Preoperative anxiety can be reduced through a short‐term intervention involving nursing professionals as an alternative or complement to drugs.Relevance to clinical practice: This review suggests that nursing professionals, in collaboration with other health professionals, should continue to conduct research on the reduction in preoperative anxiety. Further research in this area is needed, to reduce heterogeneity and consolidate the results.No Patient or Public Contribution: Not applied to our study, as it is a systematic review of systematic reviews.

Observational studies have found that women tend to have lower adherence to highly active antiretroviral therapy (HAART) than men do, though no meta-analysis has yet investigated this trend. The aims of the current meta-analysis are to determine if and to what degree the percentage of men versus women maintaining ≥90% adherence to prescribed HAART differs, and if the external variables moderating adherence differs by gender. Eight electronic databases were searched to locate all relevant studies available by May 2011. Fifty-six observational studies were eligible for inclusion in the meta-analysis. A random effect model was assumed for the global percentage estimation and to explain the heterogeneity. Across these studies, the difference between men and women in the proportion of individuals with ≥90% adherence to HAART was marginally significant (p<0.1; 67% and 62%, respectively). A greater proportion of men maintaining ≥90% adherence to HAART was more likely in studies with higher proportions of men who have sex with men (MSM), lower proportions of male alcohol users or lower proportions of men in a methadone program. In women, higher rates of adherence were found in studies conducted in Africa, Asia, and South America, when the sample included more widows or when the sample had a lower basal CD4 count. That both the percentage of adherent individuals and the variables associated with such adherence differ between men and women are suggestive of the need for improving gender-tailored interventions for adherence to HAART.

Background: The nursing work environment can be compromised due to workload, stress and many other issues. A good nursing work environment is needed to for the health and wellbeing of nurses and therefore measures are developed to improve nursing work environment.Aim: To determine whether measures designed to improve the work environment for nursing professionals are effective.Methodology: Online research in the Medline, Scopus, Web of Science, ERIC, CINHAL, PsycINFO, and American Doctoral Dissertations databases, along with manual search, was carried out. Primary experimental studies made up of intervention and control groups were included, with pre‐/post‐measure evaluation in the nursing team, based on the effects of the interventions. Risk of bias was calculated using the Cochrane tool.Results: A total of 1997 studies were examined; 19 clinical trials met the inclusion criteria. A total of 1427 nurses participated in the selected studies. The fields of application of the interventions were personal and environmental. Out of the fields targeting individuals, three methodologies were identified: cognitive‐behavioral techniques, stress management, channeling anxiety and physical well‐being; and those aimed at environmental fields: aromatization and organization. The most evaluated characteristic was teamwork, and the most analyzed symptom was stress. Most of the interventions concluded with at least one significant improvement.Conclusions: Interventions aimed at enhancing the work environment are effective ways of increasing job satisfaction. The heterogeneity of the data did not allow us to determine which intervention is the most effective. The combination, type, and duration are variables that affect efficacy.Implication for nursing and nursing policy: This systematic review provides resources for improving the work environment that affects nursing staff, other professionals, and patients. Encouraging a healthy atmosphere leads to excellence in care and improved safety.