Another study reviewed the attitudes, knowledge, and perceptions of CNs regarding EBP, but the study was limited in European community settings. One study concluded the practical contents of EBP in community nursing without analyzing the level of CNs’ EBP. Researchers have reviewed the importance of nursing leadership in EBP, the state of readiness for EBP, barriers and facilitators in guidelines, and strategies of EBP implementation, but all these researches were designed for hospital nurses, but not CNs. Although EBP is equally important to CNs as it is to clinical nurses, EBP in community nursing is still in the initial stage. Systematic implementation of EBP can enhance healthcare safety and improve patient outcomes. EBP refers to using the best available evidence for decision-making and providing efficient and effective care for patients on a scientific basis. WHO has suggested that health improving in communities is dependent upon nursing services underpinned by evidence-based practice (EBP). However, CNs do not always make decisions based on the up-to-date high quality evidence, but on experiences. Therefore, they have to think critically, analyze complex situations, perform health assessment, and make decisions. CNs generally face more independent work in the varied and dynamic community when there is no medical diagnosis or treatment provided by physicians for either patients or family. CNs can provide health care services, contributing to disease and injury prevention, disability alleviation, and health promotion. Community nurses (CNs) combine the skills of nursing, public health, and some phases of social assistance, and they function as a part of the entire public health programs. These roles of nurses have been recognized by the World Health Organization. All rights reserved.Nurses can provide personal care and treatment, work with families and communities, and play a central part in public health and controlling disease and infection. We recommend future investigations oriented toward improving insomnia with other more promising treatments.Ĭopyright 2010 Elsevier B.V. The qualitative dichotomous results suggest that valerian would be effective for a subjective improvement of insomnia, although its effectiveness has not been demonstrated with quantitative or objective measurements. There was heterogeneity in the three meta-analyses, but it diminished in the sub groups analysis. The mean differences in LT between the Valerian and placebo treatment groups was 0.70 min (95% CI, -3.44 to 4.83) the standardized mean differences between the groups measured with SQS was -0.02 (95% CI, -0.35 to 0.31) treatment with Valerian showed a relative risk of SQ of 1.37 (95% CI, 1.05-1.78) compared with the placebo group.
Publication bias was evaluated using the funnel plot.Įighteen RCTs were selected eight had a score of 5 on Jadad's scale.
Heterogeneity was determined with the Q-statistic and was explored through a sub-groups analysis.
Three meta-analyses were carried out using inverse-variance weighted random effects models.
Sleep-quality improvement (SQ, yes/no), sleep-quality improvement quantified through visual analogical scales (SQS) and the latency time (LT) in minutes until getting to sleep. Search for randomized clinical trials (RCTs) of Valerian preparations compared with a placebo on Medline, the Cochrane Library, Embase and Biosis. The aim of this study is to evaluate its effectiveness on insomnia through a meta-analysis of published literature. Valerian might be an alternative treatment with fewer secondary effects. Insomnia is an often seen primary health care problem.
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