We aimed to evaluate the effectiveness of CBT-i in patients with fibromyalgia in comparison with other non-pharmacological treatments.Randomized controlled trials assessing the effects of CBT-i in ...

Background: Parkinson disease (PD) is a rapidly growing neurological condition worldwide. While physiotherapy and exercise are effective interventions, the addition of motivational aspects that improve adherence could be beneficial for people with PD. Incorporating technological devices into motor rehabilitation, coupled with gamification elements, could enhance the relevance of rehabilitation and alleviate motor symptoms. Objective: The aim of this scoping review was to identify and classify the technological devices that integrate gamification elements used in motor rehabilitation in PD, and to describe the justification behind the use of these devices and elements in this context. Methods: We conducted a scoping review following the framework proposed by Joanna Briggs Institute, along with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. Major health science databases (MEDLINE, EMBASE, Scopus, Cochrane, Web of Science, PsycINFO, and Epistemonikos) were systematically searched. Relevant studies were included if they used technological interventions with gamification elements for motor symptom rehabilitation in PD. Gamification elements were extracted and categorized based on established frameworks, and content analysis was used to review the justifications for the use of technologies integrating gamification. Results: A total of 4451 studies were retrieved from the search. After the abstract and full-text screening, 81 studies were eligible for data extraction. The analysis identified 453 gamification elements across studies, with development and accomplishment being the most prominent core drive. Progress/feedback was the most frequently used element (79/81, 98% of studies), followed by points (70/81, 86%) and levels/progression (66/81, 81%). Other notable elements included badges, leaderboards, and customization, while several core drives, like ownership and possession, lacked reported elements. Most interventions were delivered through commercial video game consoles (33/81, 41%), followed by computer-based systems (32/81, 40%). Tablet-based applications and integrated rehabilitation platforms were used in 11% (9/81) and 10% (8/81) of the studies, respectively. The expected roles of technology were clear, but intentional use of gamification was scarce. Conclusions: This scoping review highlights the widespread adoption of technologies integrating gamification elements for motor symptom rehabilitation in individuals with PD. However, it also underscores a critical gap in understanding and justifying gamification mechanics. The current landscape relies heavily on commercial video games and emphasizes performance-based experiences, lacking theoretical grounding.

Introduction: Non-pharmacological approaches have shown promising results in improving symptoms and quality of life of patients with fibromyalgia. However, these approaches may not be easily accessible or feasible for everyone. eHealth interventions may offer a more convenient and cost-effective approach to reach a wider range of patients with fibromyalgia and improve their outcomes. As eHealth tools become more prevalent in clinical practice, it is crucial to understand their effectiveness, limitations and how they can be integrated into standard care to optimise clinical outcomes. This systematic review aims to evaluate the effectiveness of eHealth therapeutic education interventions in managing fibromyalgia. Methods and analysis: Randomised controlled trials including eHealth therapeutic education interventions for individuals ≥18 years old with fibromyalgia, published in English or Spanish, will be retrieved by searching the databases PubMed, CINAHL Plus, EMBASE, Scopus, ISI Web of Science, PsycINFO and the Cochrane Central Register of Controlled Trials. Covidence software will be used for the selection of studies and data extraction. The risk of bias and the certainty of evidence will be assessed using the Cochrane Risk of Bias Assessment tool. We plan to perform a meta-analysis contingent on the number of studies retrieved and the interstudy heterogeneity, which will be explored with I ² statistics. Ethics and dissemination: This protocol and the subsequent systematic review will not collect individual-level data and do not require approval by an ethical committee. We intend to disseminate the study results via peer-reviewed scientific journals and relevant (inter)national conferences. PROSPERO registration number: CRD42022343373.

Background: obstructive sleep apnoea is a common and burdensome condition, characterised by obstruction of the airway during sleep at the level of the pharynx, which may occur with symptoms or without any symptoms. The most common place for obstructive sleep apnoea management is in specialised sleep units. Aim: to identify what is known about nurses’ role in comprehensive management of obstructive sleep apnoea, and to determine the effectiveness of nurse-led interventions as well as the cost effectiveness of management of obstructive sleep apnoea in primary care settings. Methods: a scoping review was carried out by searching PubMed/Medline, CINAHL, Scopus, Cochrane Database of Systematic Reviews and ScienceDirect. The study findings were synthesised using a thematic analysis approach. Results: In this review, 12 articles were included, and three key themes emerged, namely the role of nurses in the diagnosis of obstructive sleep apnoea, role of nurses in the follow up and support of obstructive sleep apnoea patients, and role of nurses in the management of obstructive sleep apnoea in primary care and the cost-effectiveness. Conclusion: Nurses can play a critical role in obstructive sleep apnoea. There are many ways in which nurses can contribute, including screening, assessment, diagnosis, promotion of therapy adherence, and following up with patients, including monitoring for any side effects associated with the CPAP machine, such as irritation of the face. Additionally, nurses can provide patient education and coordinate with other health care providers. Nursing interventions such as patient education have been demonstrated to be highly effective in promoting adherence to PAP therapy in both sleep units and primary care settings. Based on the findings of this review, the primary care model is more cost-effective than the sleep unit model in the management of obstructive sleep apnoea patients. The role of nurses in managing Obstructive Sleep Apnoea in both paediatric and adult populations shares similarities, but also includes differences that should be carefully considered and explored. In this review, one article only explored the role of nurses in paediatric OSA care. Thus, there is a need to identify the potential role of nursing in the comprehensive management of paediatric obstructive sleep apnoea, as well as to explore alternative cost-effective approaches that include primary care settings.

Introduction: The management of a chronic and frequent pathology, such as obstructive sleep apnoea (OSA), requires personalised programmes that implement new technology-based tools to improve the comprehensive treatment of the patient to reduce the morbidity associated with this disease. This study will evaluate the effectiveness of an eHealth tool in managing the pathophysiological consequences of OSA and how they impact the quality of life after 3 months of intervention among adults. Methods and analysis: This is a mixed-method sequential exploratory study protocol. Participants will be≥18 years with a new diagnosis of moderate OSA and diagnosed with hypertension. The qualitative phase will consist of personal semistructured interviews. The quantitative phase will be a triple-blind randomised controlled trial. The experimental group (n=135) will receive an eHealth intervention using an electronic wrist device and a mobile application that will offer specific healthcare recommendations, physical activity indications and hygienic and dietary advice. These recommendations will be based on the information obtained in the qualitative phase. Those in the control group (n=135) will receive the usual educational materials from the sleep unit. The primary outcome will be blood pressure changes at 3 months. Secondary outcomes are subjective sleep quality, sleep apnoea-related parameters, daytime sleepiness, physical activity, empowerment and motivation for change, quality of life, anthropometry, cost–benefit and adherence. Ethics and dissemination: Ethical approval for the study has been obtained from the Hospital Universitari Arnau de Vilanova (CEIC-2511). Results will be published in a peer-reviewed journal. Trial registration number: ClinicalTrials.gov Identifier: NCT05380726.