Home Medicine Impact of Kolb’s experiential learning theory-based nursing on caregiver burden and psychological state of caregivers of dementia patients
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Impact of Kolb’s experiential learning theory-based nursing on caregiver burden and psychological state of caregivers of dementia patients

  • Yue Xu , Jingzheng Lu , Xinting Yu and Heguo Ding EMAIL logo
Published/Copyright: March 6, 2025
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Open Medicine
From the journal Open Medicine Volume 20 Issue 1

Abstract

Background

Family caregiving for dementia patients is a challenging task, with profound effects on caregivers’ physical and mental well-being. The purpose of this study was to explore the impact of Kolb’s experiential learning theory on the caregiving burden and psychological status of caregivers for dementia patients.

Methods

This study enrolled 110 caregivers of nursing dementia patients. These caregivers were divided into two groups: a control group (n = 55) and an intervention group (n = 55). The control group received routine care, while the intervention group received nursing based on Kolb’s experiential learning theory in addition to routine care. Changes in caregiving burden and psychological status were compared between the two groups before and after the intervention.

Result

The results showed that after the intervention, the intervention group’s caregivers had significantly lower scores on the caregiver burden inventory dimensions and total score compared to the control group (P < 0.05). Additionally, the intervention group’s self-assessment scores on the self-rating anxiety scale and self-rating depression scale were also lower than those of the control group (P < 0.05).

Conclusion

Kolb’s experiential learning theory has a positive impact on alleviating the caregiving burden and reducing anxiety and depression among family caregivers of dementia patients.

Keywords: dementia patients; caregivers; Kolb theory; care burden; anxiety; depression

1 Introduction

“Caregiver burden” refers to the physical, psychological, social, and economic challenges faced by family members while caring for elderly individuals with disabilities [1]. As the health condition of dementia patients gradually deteriorates, their demands and dependence on caregivers increase, resulting in a heavier burden for the caregivers [2]. Over time, caregivers continually confront the worsening condition of their loved ones, which significantly impacts their psychological well-being [3]. In our country, dementia patient care is primarily carried out by family caregivers, but the current state of caregivers’ physical and mental health and caregiving skills is not optimistic [4]. Research indicates that nearly half of caregivers lack essential caregiving knowledge, leading to delays in early diagnosis and intervention for dementia patients [5].

In 1984, the renowned American educator Kolb introduced the Experiential Learning Theory [6], which posits that learning occurs when individuals acquire and transform experiences. According to Kolb, knowledge formation results from “grasping” and “transforming,” enabling better understanding and application of knowledge. While Kolb’s theory has been applied to various patient populations in medical and nursing fields, there is a lack of research on its application to dementia patients’ family caregivers. Therefore, this study aims to explore the impact of a nursing learning plan based on Kolb’s theory on caregiver burden and psychological congruence among family caregivers of dementia patients.

2 Methods

2.1 Study participants

For this research, we enrolled 110 caregivers diagnosed with dementia in the Department of Psychiatry, Huzhou Third Municipal Hospital, the Affiliated Hospital of Huzhou University, from April 2022 to August 2023. The work was carried out in accordance with the Declaration of Helsinki with the research approved by the Ethics Committee of Huzhou Third Municipal Hospital, the Affiliated Hospital of Huzhou University, under approval No. 2022-064. All participants provide a written informed consent in compliance with the ethics regulations. The participants were divided into control and intervention groups using a random number table method (n = 55, respectively). Inclusion criteria for patients were as follows: (1) clinical diagnosis of dementia with some communication ability and (2) age ≥60 years. Exclusion criteria were: (1) patients with critical conditions requiring intensive care unit (ICU) treatment during the intervention period or with fatal outcomes and (2) patients with severe psychiatric symptoms unable to follow instructions.

2.2 Inclusion criteria for caregivers

Caregivers must be 18 years of age or older. Caregivers should be primary caregivers (if the patient has multiple caregivers, the order of preference is spouse, parents or children, and others). The duration of caregiving must be at least 3 months, with an expected continuation of care for at least 6 months. Caregivers should have at least an elementary school education level. Participation in the study is voluntary and requires informed consent.

2.3 Exclusion criteria for caregivers

Caregivers with congenital or acquired hearing impairments or communication difficulties due to accidents or other reasons should be excluded. Caregivers with psychiatric disorders or cognitive impairments and caregivers currently participating in other research projects should be excluded either. In addition, caregivers whose dementia patients are critically ill and require ICU treatment or have a fatal outcome during the intervention period and who are unable to complete intervention activities due to personal reasons should be excluded.

2.4 Intervention study

Both the control group and the intervention group underwent a 4-week intervention.

For the control group, routine nursing care was provided to family caregivers. Disease-related knowledge was imparted primarily through one-on-one education, supplemented by relevant health education manuals. The content covered various aspects of dementia patient care, including basic care, safety measures, medication management, emotional support, and cognitive function care.

For the intervention group, a nursing learning plan based on Kolb’s theory was added to the control group’s routine. Specific measures included:

  1. Preparation: Before the intervention, data on general patient information, caregiver burden, and psychological status were collected to create personalized learning plans.

  2. Personnel training: Standardized training was provided to group members, covering Kolb’s theory, intervention measures, and relevant precautions. Roles within the group were clearly defined.

  3. Implementation of nursing plan based on Kolb’s theory: Kolb’s experiential learning theory is a cyclical process that includes four stages (Figure 1): concrete experience, reflective observation, abstract conceptualization, and active experimentation. Learners first start the learning process through concrete experiences, then reflect and observe these experiences, abstract concepts, and theories from them, and finally, apply these concepts to new contexts through active experimentation, thus starting a new cycle.

    In detail, this method is conducted twice a week for 60 min each time. The nursing researcher played the role of a facilitator in the Kolb theory learning plan, introducing the day’s schedule and important notices to family caregivers. Stage 1 (concrete experience): caregivers were asked to play three roles based on case studies: dementia patient, dementia caregiver, and observer. After role-playing, caregivers interacted freely with simulated dementia patients. The nursing researcher created a friendly atmosphere to facilitate easy conversation. Stage 2 (reflective observation): after the role-playing activity, caregivers gathered in a meeting room to reflect on their performance and discuss challenges encountered in daily patient care. They focused on what dementia patients had said to enhance empathy. The nursing researcher encouraged caregivers to express themselves bravely. Stage 3 (abstract conceptualization): Through discussions with the nursing researcher, caregivers gained a broader and deeper understanding of their experiences. They applied the learned nursing knowledge to daily care activities for dementia patients. For instance, if a caregiver reported that a dementia patient repeatedly shared the same story, the nursing researcher provided positive feedback on how to patiently listen to the patient’s repetitive sharing. Additionally, caregivers were advised to introduce new topics to expand conversations and elicit new stories from dementia patients. The nursing researcher acted as an educational guide, providing guidance and suggestions. Stage 4 (active experimentation): Caregivers applied the knowledge acquired in the first three stages to actual dementia patient care scenarios. The nursing researcher helped caregivers face and cope with new challenges.

  4. Timely summaries and feedback: Research team members actively participated in and documented the implementation according to the intervention plan. After each intervention, summaries and feedback were provided, and problems were promptly analyzed and resolved.

Figure 1 The model graphic of Kolb’s experiential learning.
Figure 1

The model graphic of Kolb’s experiential learning.

2.5 Observation indicators

Caregiver burden: Assessed using the caregiver burden inventory (CBI) [7]. This inventory comprises 24 items, covering multiple dimensions of burden faced by family members during the care of elderly individuals with disabilities. The dimensions include physical burden, emotional burden, social burden, time dependency burden, and developmental restriction burden. Each item is rated on a 5-point scale (0–4), resulting in a total score ranging from 0 to 96. Higher scores indicate a heavier burden borne during the caregiving process.

Psychological state: Evaluated using the self-rating anxiety scale (SAS) and the self-rating depression scale (SDS). These scales were developed by Zung in the 1970s [8,9], consisting of 20 items and a Likert 4-point rating system. Practically, higher scores indicate more severe anxiety and depression symptoms in patients.

2.6 Statistical analysis

We used SPSS 21.0 statistical software for data analysis. Descriptive statistics were employed to present data in the form of mean ± standard deviation, frequencies, and proportions. For the baseline categorical data, we used the chi-square test (χ²). For comparison of caregiver burden and psychological states between the two groups, a paired sample t-test was applied to investigate the different intervention outcomes. A significance level of P < 0.05 was considered statistically significant.

3 Results

3.1 The baseline characteristics of the studied caregivers

To perform an objective judgment on the impact of Kolb’s Experiential Learning Theory, we should first exclude the influence of participants’ baseline characteristics prior to downstream analysis. As shown in Table 1, there was no statistically significant difference in the general characteristics between the two groups (P > 0.05), including factors such as gender, age, disease duration, nursing duration, and education level.

Table 1

The baseline characteristics of the study participants

Item Control group (n = 55) Intervention group (n = 55) χ 2/t Value P-value
Patients
Gender (n) Male 27 28 0.036 0.849
Female 28 27
Average age (years) 70.22 ± 6.37 70.11 ± 6.15 0.092 0.927
Disease duration (years) 4.01 ± 1.23 3.88 ± 0.97 0.615 0.540
Disease severity (n) Mid-stage 40 43 0.442 0.506
Late stage 15 12
Caregivers
Gender (n) Male 22 25 0.334 0.563
Female 33 30
Average age (years) 58.13 ± 7.62 58.21 ± 7.73 0.066 0.948
Education level (n) Junior high school or below 25 28 0.328 0.567
Technical secondary school or above 30 27
Relationship with patient (n) Spouse 24 26 1.171 0.557
Children 21 23
Other 10 6
Caregiving duration (years) 3.42 ± 1.11 3.51 ± 1.05 0.437 0.663

In addition, a comparison of basic burden levels was also made between caregivers and ordinary people (Table 2), which shows that the caregivers were under higher pressure than ordinary people were.

Table 2

The comparison of basic burden levels between caregivers and ordinary people

Groups Cases SAS SDS
Caregivers group n = 110 48.99 ± 5.13* 46.78 ± 5.30*
Ordinary people group n = 110 28.66 ± 5.89* 32.19 ± 4.61*

Note: *P < 0.05.

3.2 The intervention group shows reduced caregiver burden

Before the intervention, there was no statistically significant difference in the CBI scores between the two groups (P > 0.05). After the intervention, the intervention group’s caregivers had lower CBI scores (P < 0.05) across various dimensions, including Physical Burden, Emotional Burden, Social Burden, Time Dependency Burden, and Developmental Restriction Burden. In addition, the total score of the intervention group, compared to the control group displays lower CBI scores with statistically significant differences (P < 0.05) (Table 3).

Table 3

Comparison of caregiver burden between the two groups

Group Time Physical burden Emotional burden Social burden Time dependency burden Developmental restriction burden Total score
Control group (n = 55) Before intervention 6.36 ± 1.12 7.89 ± 1.43 5.46 ± 0.94 12.85 ± 1.57 11.48 ± 1.53 48.77 ± 5.76
After intervention 5.85 ± 0.98* 6.73 ± 1.38* 4.77 ± 0.82* 11.73 ± 1.48* 10.35 ± 1.42* 39.73 ± 5.32*
Intervention group (n = 55) Before intervention 6.41 ± 1.10 7.84 ± 1.47 5.39 ± 0.92 12.83 ± 1.52 11.49 ± 1.57 48.34 ± 5.85
After intervention 5.01 ± 0.86*,# 5.65 ± 1.31*,# 4.01 ± 0.70*,# 10.33 ± 1.36*,# 9.23 ± 1.24*,# 37.81 ± 3.92*,#

Note: In comparison to “Before Intervention Group,” *P < 0.05: In comparison to “Control Group” and # P < 0.05.

3.3 The psychological state of the intervention group is ameliorated

To investigate the psychological state of the participants in a quantitative manner, SAS and SDS scores were recorded for the analysis. As is illustrated in Table 4, before the intervention, there was no statistically significant difference in the SAS and SDS scores between the two groups (P > 0.05). Whereas after the intervention, SAS and SDS scores of the intervention group were significantly reduced than those of the control group (P < 0.05).

Table 4

Comparison of psychological states between the two groups

Group SAS SDS
Before intervention After intervention Before intervention After intervention
Control group 58.81 ± 7.29 48.99 ± 5.13* 56.52 ± 5.89 46.78 ± 5.30a
Intervention group 60.10 ± 7.47 42.76 ± 4.82* 58.03 ± 6.00 40.26 ± 4.81a
t-value 0.897 6.432 1.299 6.498
P-value 0.353 <0.001 0.203 <0.001

Note: * indicates statistical significance (P < 0.05) within the group before and after intervention.

4 Discussion

Alzheimer’s disease, commonly referred to as “senile dementia,” is the most prevalent type of dementia, accounting for approximately two-thirds of all cases. It encompasses various subtypes, including vascular dementia, temporal lobe dementia, and several rare forms of dementia [10]. Globally, around 47 million people suffer from dementia, with age being the primary risk factor for its development. Caring for family members affected by dementia poses a long-term and challenging task [11]. In the middle and later stages of dementia, patients experience cognitive impairments and memory decline, often accompanied by emotional instability, which can lead to conflicts with caregivers. Among this group of family caregivers for dementia patients, a sense of coherence has been shown to predict health-related quality of life, caregiving burden, and caregiving capacity [12].

The nursing learning plan based on Kolb’s theory is an educational approach rooted in experiential learning, which can be traced back to the Experiential Learning Theory proposed by American psychologist David Kolb in the 1970s [13]. According to Kolb, individuals acquire knowledge and skills through a process that involves practical experience, observation, and reflection, which they then apply in real-world contexts [14]. The nursing learning plan, grounded in Kolb’s theory, has been validated in various nursing practice domains and has been shown to positively impact nursing professionals’ competence and care quality [15]. This approach emphasizes active learner participation and experiential engagement [16]. Learners immerse themselves in nursing scenarios through practice and role-playing, leading to a deeper understanding and practical application of nursing knowledge. Additionally, reflection and discussion play a crucial role. By reflecting on observations and abstract concepts, learners enhance their understanding of experiential learning and expand their knowledge through sharing and dialogue. Furthermore, the nursing learning plan based on Kolb’s theory underscores the importance of practice and application. Learners actively apply acquired knowledge to real-world situations, thereby enhancing their nursing skills and confidence [17].

The research results indicate that the intervention group had lower scores in various dimensions of caregiver burden, including physical burden, emotional burden, social burden, time dependency burden, and developmental restriction burden, compared to the control group (P < 0.05). This suggests that the nursing learning plan based on Kolb’s theory can assist caregivers in better coping with the various burdens associated with caregiving, which aligns with the findings of the other study [18]. Additionally, caregivers in the intervention group experienced significant relief from negative emotions. Previous research has also demonstrated that Kolb’s theory can provide effective and systematic learning plans and strategies for patients and their caregivers, leading to professional guidance from healthcare providers [19]. This not only expands social resources for caregivers but also helps alleviate anxiety and negative emotions, consistent with the results of this study. Besides, it was observed in the study that there was no significant difference in nursing skills before intervention, but after applying Kolb’s experiential learning theory, the nursing skills of the intervention group were improved. Therefore, implementing a nursing learning plan based on Kolb’s theory enables caregivers to better understand and adapt to the needs of dementia patients, fostering stronger emotional connections and reducing negative emotions, ultimately alleviating stress and burden during the caregiving process.

The effectiveness of nursing learning plans based on Kolb’s theory primarily might stem from two reasons. Firstly, it enhanced the understanding and application of nursing knowledge. Through role-playing, caregivers gain firsthand experience of dementia patients’ feelings and challenges, thereby enhancing empathy toward dementia patients. The reflection and abstract conceptualization stages help caregivers gain a deeper understanding of their experiences and apply the acquired knowledge to practical nursing care. Second, the application of knowledge in real contexts was improved. The active experimentation stage assists caregivers in applying learned knowledge to actual situations, thereby boosting nursing skills and confidence.

However, implementing nursing learning plans based on Kolb’s theory faces certain challenges. On the one hand, the implementation of the learning plan requires sufficient resources and support, including support for training instructors, educational materials, and scheduling. On the other hand, caregivers’ engagement and motivation are also necessitated. Caregivers may encounter limitations in terms of time, energy, and resistance to new learning methods. Encouragement and appropriate support are crucial to foster active participation and motivation among caregivers. As for the weakness of this study, lacking investigation of the caregivers from different cultural backgrounds may lead to a one-sided conclusion. Also, adopting merely Kolb’s theory may not be the optimal strategy. For future research, we recommend further exploring the applicability and effectiveness of nursing learning plans based on Kolb’s theory across different cultural and social contexts. Additionally, combining Kolb’s theory with other educational methods and strategies could benefit clinical outcomes.

In sum, nursing learning plans based on Kolb’s theory have a positive impact on alleviating caregiver burden and improving the psychological well-being of family caregivers of dementia patients. By reducing the burden of care and enhancing understanding of dementia patients, as well as fostering stronger emotional connections, this plan is worthy of clinical implementation and promotion.

  1. Funding information: This work was supported by the Research Project of Huzhou Third Municipal Hospital under Grant no. 2022SY2022082.

  2. Author contributions: Conceptualization: H. Ding. Methodology: Y. Xu. H. Ding. Investigation: Y. Xu, J. Lu, and X. Yu. Data curation: Y. Xu and X. Yu. Writing: Y. Xu and H. Ding. Supervision: H. Ding.

  3. Conflict of interest: No direct or indirect commercial incentive associated with the publishing of this article.

  4. Data availability statement: All data included in this study are available upon request.

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Received: 2024-04-18
Revised: 2025-01-12
Accepted: 2025-01-22
Published Online: 2025-03-06

© 2025 the author(s), published by De Gruyter

This work is licensed under the Creative Commons Attribution 4.0 International License.

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  83. Comparison and correlations between findings of hysteroscopy and vaginal color Doppler ultrasonography for detection of uterine abnormalities in patients with recurrent implantation failure
  84. The effects of different types of RAGT on balance function in stroke patients with low levels of independent walking in a convalescent rehabilitation hospital
  85. Causal relationship between asthma and ankylosing spondylitis: A bidirectional two-sample univariable and multivariable Mendelian randomization study
  86. Correlations of health literacy with individuals’ understanding and use of medications in Southern Taiwan
  87. Correlation of serum calprotectin with outcome of acute cerebral infarction
  88. Comparison of computed tomography and guided bronchoscopy in the diagnosis of pulmonary nodules: A systematic review and meta-analysis
  89. Curdione protects vascular endothelial cells and atherosclerosis via the regulation of DNMT1-mediated ERBB4 promoter methylation
  90. The identification of novel missense variant in ChAT gene in a patient with gestational diabetes denotes plausible genetic association
  91. Molecular genotyping of multi-system rare blood types in foreign blood donors based on DNA sequencing and its clinical significance
  92. Exploring the role of succinyl carnitine in the association between CD39⁺ CD4⁺ T cell and ulcerative colitis: A Mendelian randomization study
  93. Dexmedetomidine suppresses microglial activation in postoperative cognitive dysfunction via the mmu-miRNA-125/TRAF6 signaling axis
  94. Analysis of serum metabolomics in patients with different types of chronic heart failure
  95. Diagnostic value of hematological parameters in the early diagnosis of acute cholecystitis
  96. Pachymaran alleviates fat accumulation, hepatocyte degeneration, and injury in mice with nonalcoholic fatty liver disease
  97. Decrease in CD4 and CD8 lymphocytes are predictors of severe clinical picture and unfavorable outcome of the disease in patients with COVID-19
  98. METTL3 blocked the progression of diabetic retinopathy through m6A-modified SOX2
  99. The predictive significance of anti-RO-52 antibody in patients with interstitial pneumonia after treatment of malignant tumors
  100. Exploring cerebrospinal fluid metabolites, cognitive function, and brain atrophy: Insights from Mendelian randomization
  101. Development and validation of potential molecular subtypes and signatures of ocular sarcoidosis based on autophagy-related gene analysis
  102. Widespread venous thrombosis: Unveiling a complex case of Behçet’s disease with a literature perspective
  103. Uterine fibroid embolization: An analysis of clinical outcomes and impact on patients’ quality of life
  104. Discovery of lipid metabolism-related diagnostic biomarkers and construction of diagnostic model in steroid-induced osteonecrosis of femoral head
  105. Serum-derived exomiR-188-3p is a promising novel biomarker for early-stage ovarian cancer
  106. Enhancing chronic back pain management: A comparative study of ultrasound–MRI fusion guidance for paravertebral nerve block
  107. Peptide CCAT1-70aa promotes hepatocellular carcinoma proliferation and invasion via the MAPK/ERK pathway
  108. Electroacupuncture-induced reduction of myocardial ischemia–reperfusion injury via FTO-dependent m6A methylation modulation
  109. Hemorrhoids and cardiovascular disease: A bidirectional Mendelian randomization study
  110. Cell-free adipose extract inhibits hypertrophic scar formation through collagen remodeling and antiangiogenesis
  111. HALP score in Demodex blepharitis: A case–control study
  112. Assessment of SOX2 performance as a marker for circulating cancer stem-like cells (CCSCs) identification in advanced breast cancer patients using CytoTrack system
  113. Risk and prognosis for brain metastasis in primary metastatic cervical cancer patients: A population-based study
  114. Comparison of the two intestinal anastomosis methods in pediatric patients
  115. Factors influencing hematological toxicity and adverse effects of perioperative hyperthermic intraperitoneal vs intraperitoneal chemotherapy in gastrointestinal cancer
  116. Endotoxin tolerance inhibits NLRP3 inflammasome activation in macrophages of septic mice by restoring autophagic flux through TRIM26
  117. Lateral transperitoneal laparoscopic adrenalectomy: A single-centre experience of 21 procedures
  118. Petunidin attenuates lipopolysaccharide-induced retinal microglia inflammatory response in diabetic retinopathy by targeting OGT/NF-κB/LCN2 axis
  119. Procalcitonin and C-reactive protein as biomarkers for diagnosing and assessing the severity of acute cholecystitis
  120. Factors determining the number of sessions in successful extracorporeal shock wave lithotripsy patients
  121. Development of a nomogram for predicting cancer-specific survival in patients with renal pelvic cancer following surgery
  122. Inhibition of ATG7 promotes orthodontic tooth movement by regulating the RANKL/OPG ratio under compression force
  123. A machine learning-based prognostic model integrating mRNA stemness index, hypoxia, and glycolysis‑related biomarkers for colorectal cancer
  124. Glutathione attenuates sepsis-associated encephalopathy via dual modulation of NF-κB and PKA/CREB pathways
  125. FAHD1 prevents neuronal ferroptosis by modulating R-loop and the cGAS–STING pathway
  126. Association of placenta weight and morphology with term low birth weight: A case–control study
  127. Investigation of the pathogenic variants induced Sjogren’s syndrome in Turkish population
  128. Nucleotide metabolic abnormalities in post-COVID-19 condition and type 2 diabetes mellitus patients and their association with endocrine dysfunction
  129. TGF-β–Smad2/3 signaling in high-altitude pulmonary hypertension in rats: Role and mechanisms via macrophage M2 polarization
  130. Ultrasound-guided unilateral versus bilateral erector spinae plane block for postoperative analgesia of patients undergoing laparoscopic cholecystectomy
  131. Profiling gut microbiome dynamics in subacute thyroiditis: Implications for pathogenesis, diagnosis, and treatment
  132. Delta neutrophil index, CRP/albumin ratio, procalcitonin, immature granulocytes, and HALP score in acute appendicitis: Best performing biomarker?
  133. Anticancer activity mechanism of novelly synthesized and characterized benzofuran ring-linked 3-nitrophenyl chalcone derivative on colon cancer cells
  134. H2valdien3 arrests the cell cycle and induces apoptosis of gastric cancer
  135. Prognostic relevance of PRSS2 and its immune correlates in papillary thyroid carcinoma
  136. Association of SGLT2 inhibition with psychiatric disorders: A Mendelian randomization study
  137. Motivational interviewing for alcohol use reduction in Thai patients
  138. Luteolin alleviates oxygen-glucose deprivation/reoxygenation-induced neuron injury by regulating NLRP3/IL-1β signaling
  139. Polyphyllin II inhibits thyroid cancer cell growth by simultaneously inhibiting glycolysis and oxidative phosphorylation
  140. Relationship between the expression of copper death promoting factor SLC31A1 in papillary thyroid carcinoma and clinicopathological indicators and prognosis
  141. CSF2 polarized neutrophils and invaded renal cancer cells in vitro influence
  142. Proton pump inhibitors-induced thrombocytopenia: A systematic literature analysis of case reports
  143. The current status and influence factors of research ability among community nurses: A sequential qualitative–quantitative study
  144. OKAIN: A comprehensive oncology knowledge base for the interpretation of clinically actionable alterations
  145. The relationship between serum CA50, CA242, and SAA levels and clinical pathological characteristics and prognosis in patients with pancreatic cancer
  146. Identification and external validation of a prognostic signature based on hypoxia–glycolysis-related genes for kidney renal clear cell carcinoma
  147. Engineered RBC-derived nanovesicles functionalized with tumor-targeting ligands: A comparative study on breast cancer targeting efficiency and biocompatibility
  148. Relationship of resting echocardiography combined with serum micronutrients to the severity of low-gradient severe aortic stenosis
  149. Effect of vibration on pain during subcutaneous heparin injection: A randomized, single-blind, placebo-controlled trial
  150. The diagnostic performance of machine learning-based FFRCT for coronary artery disease: A meta-analysis
  151. Comparing biofeedback device vs diaphragmatic breathing for bloating relief: A randomized controlled trial
  152. Serum uric acid to albumin ratio and C-reactive protein as predictive biomarkers for chronic total occlusion and coronary collateral circulation quality
  153. Multiple organ scoring systems for predicting in-hospital mortality of sepsis patients in the intensive care unit
  154. Single-cell RNA sequencing data analysis of the inner ear in gentamicin-treated mice via intraperitoneal injection
  155. Suppression of cathepsin B attenuates myocardial injury via limiting cardiomyocyte apoptosis
  156. Influence of sevoflurane combined with propofol anesthesia on the anesthesia effect and adverse reactions in children with acute appendicitis
  157. Review Articles
  158. The effects of enhanced external counter-pulsation on post-acute sequelae of COVID-19: A narrative review
  159. Diabetes-related cognitive impairment: Mechanisms, symptoms, and treatments
  160. Microscopic changes and gross morphology of placenta in women affected by gestational diabetes mellitus in dietary treatment: A systematic review
  161. Review of mechanisms and frontier applications in IL-17A-induced hypertension
  162. Research progress on the correlation between islet amyloid peptides and type 2 diabetes mellitus
  163. The safety and efficacy of BCG combined with mitomycin C compared with BCG monotherapy in patients with non-muscle-invasive bladder cancer: A systematic review and meta-analysis
  164. The application of augmented reality in robotic general surgery: A mini-review
  165. The effect of Greek mountain tea extract and wheat germ extract on peripheral blood flow and eicosanoid metabolism in mammals
  166. Neurogasobiology of migraine: Carbon monoxide, hydrogen sulfide, and nitric oxide as emerging pathophysiological trinacrium relevant to nociception regulation
  167. Plant polyphenols, terpenes, and terpenoids in oral health
  168. Laboratory medicine between technological innovation, rights safeguarding, and patient safety: A bioethical perspective
  169. End-of-life in cancer patients: Medicolegal implications and ethical challenges in Europe
  170. The maternal factors during pregnancy for intrauterine growth retardation: An umbrella review
  171. Intra-abdominal hypertension/abdominal compartment syndrome of pediatric patients in critical care settings
  172. PI3K/Akt pathway and neuroinflammation in sepsis-associated encephalopathy
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  174. Giant borderline ovarian tumours – review of the literature
  175. Leveraging artificial intelligence for collaborative care planning: Innovations and impacts in shared decision-making – A systematic review
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  177. Risk factors of frailty/sarcopenia in community older adults: Meta-analysis
  178. Supplement strategies for infertility in overweight women: Evidence and legal insights
  179. Scurvy, a not obsolete disorder: Clinical report in eight young children and literature review
  180. A meta-analysis of the effects of DBS on cognitive function in patients with advanced PD
  181. Protective role of selenium in sepsis: Mechanisms and potential therapeutic strategies
  182. Strategies for hyperkalemia management in dialysis patients: A systematic review
  183. C-reactive protein-to-albumin ratio in peripheral artery disease
  184. Case Reports
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  186. Semaglutide treatment for type 2 diabetes in a patient with chronic myeloid leukemia: A case report and review of the literature
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  191. Molecular hydrogen-rhodiola as an adjuvant therapy for ischemic stroke in internal carotid artery occlusion: A case report
  192. Coronary artery anomalies: A case of the “malignant” left coronary artery and its surgical management
  193. Rapid Communication
  194. Biological properties of valve materials using RGD and EC
  195. A single oral administration of flavanols enhances short-term memory in mice along with increased brain-derived neurotrophic factor
  196. Letter to the Editor
  197. Role of enhanced external counterpulsation in long COVID
  198. Expression of Concern
  199. Expression of concern “A ceRNA network mediated by LINC00475 in papillary thyroid carcinoma”
  200. Expression of concern “Notoginsenoside R1 alleviates spinal cord injury through the miR-301a/KLF7 axis to activate Wnt/β-catenin pathway”
  201. Expression of concern “circ_0020123 promotes cell proliferation and migration in lung adenocarcinoma via PDZD8”
  202. Corrigendum
  203. Corrigendum to “Empagliflozin improves aortic injury in obese mice by regulating fatty acid metabolism”
  204. Corrigendum to “Comparing the therapeutic efficacy of endoscopic minimally invasive surgery and traditional surgery for early-stage breast cancer: A meta-analysis”
  205. Corrigendum to “The progress of autoimmune hepatitis research and future challenges”
  206. Retraction
  207. Retraction of “miR-654-5p promotes gastric cancer progression via the GPRIN1/NF-κB pathway”
  208. Retraction of: “LncRNA CASC15 inhibition relieves renal fibrosis in diabetic nephropathy through downregulating SP-A by sponging to miR-424”
  209. Retraction of: “SCARA5 inhibits oral squamous cell carcinoma via inactivating the STAT3 and PI3K/AKT signaling pathways”
  210. Special Issue Advancements in oncology: bridging clinical and experimental research - Part II
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  212. Lathyrol affects the expression of AR and PSA and inhibits the malignant behavior of RCC cells
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  215. Meta-analysis of clinical efficacy and safety of immunotherapy combined with chemotherapy in non-small cell lung cancer
  216. Special Issue Computational Intelligence Methodologies Meets Recurrent Cancers - Part IV
  217. Exploration of mRNA-modifying METTL3 oncogene as momentous prognostic biomarker responsible for colorectal cancer development
  218. Special Issue The evolving saga of RNAs from bench to bedside - Part III
  219. Interaction and verification of ferroptosis-related RNAs Rela and Stat3 in promoting sepsis-associated acute kidney injury
  220. The mRNA MOXD1: Link to oxidative stress and prognostic significance in gastric cancer
  221. Special Issue Exploring the biological mechanism of human diseases based on MultiOmics Technology - Part II
  222. Dynamic changes in lactate-related genes in microglia and their role in immune cell interactions after ischemic stroke
  223. A prognostic model correlated with fatty acid metabolism in Ewing’s sarcoma based on bioinformatics analysis
  224. Red cell distribution width predicts early kidney injury: A NHANES cross-sectional study
  225. Special Issue Diabetes mellitus: pathophysiology, complications & treatment
  226. Nutritional risk assessment and nutritional support in children with congenital diabetes during surgery
  227. Correlation of the differential expressions of RANK, RANKL, and OPG with obesity in the elderly population in Xinjiang
  228. A discussion on the application of fluorescence micro-optical sectioning tomography in the research of cognitive dysfunction in diabetes
  229. A review of brain research on T2DM-related cognitive dysfunction
  230. Metformin and estrogen modulation in LABC with T2DM: A 36-month randomized trial
  231. Special Issue Innovative Biomarker Discovery and Precision Medicine in Cancer Diagnostics
  232. CircASH1L-mediated tumor progression in triple-negative breast cancer: PI3K/AKT pathway mechanisms
https://doi.org/10.1515/med-2025-1157
Keywords for this article
dementia patients; caregivers; Kolb theory; care burden; anxiety; depression
Creative Commons
BY 4.0

Articles in the same Issue

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  4. Knockdown of CCNB1 alleviates high glucose-triggered trophoblast dysfunction during gestational diabetes via Wnt/β-catenin signaling pathway
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  25. Mechanism research on inhibition of gastric cancer in vitro by the extract of Pinellia ternata based on network pharmacology and cellular metabolomics
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  84. The effects of different types of RAGT on balance function in stroke patients with low levels of independent walking in a convalescent rehabilitation hospital
  85. Causal relationship between asthma and ankylosing spondylitis: A bidirectional two-sample univariable and multivariable Mendelian randomization study
  86. Correlations of health literacy with individuals’ understanding and use of medications in Southern Taiwan
  87. Correlation of serum calprotectin with outcome of acute cerebral infarction
  88. Comparison of computed tomography and guided bronchoscopy in the diagnosis of pulmonary nodules: A systematic review and meta-analysis
  89. Curdione protects vascular endothelial cells and atherosclerosis via the regulation of DNMT1-mediated ERBB4 promoter methylation
  90. The identification of novel missense variant in ChAT gene in a patient with gestational diabetes denotes plausible genetic association
  91. Molecular genotyping of multi-system rare blood types in foreign blood donors based on DNA sequencing and its clinical significance
  92. Exploring the role of succinyl carnitine in the association between CD39⁺ CD4⁺ T cell and ulcerative colitis: A Mendelian randomization study
  93. Dexmedetomidine suppresses microglial activation in postoperative cognitive dysfunction via the mmu-miRNA-125/TRAF6 signaling axis
  94. Analysis of serum metabolomics in patients with different types of chronic heart failure
  95. Diagnostic value of hematological parameters in the early diagnosis of acute cholecystitis
  96. Pachymaran alleviates fat accumulation, hepatocyte degeneration, and injury in mice with nonalcoholic fatty liver disease
  97. Decrease in CD4 and CD8 lymphocytes are predictors of severe clinical picture and unfavorable outcome of the disease in patients with COVID-19
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  99. The predictive significance of anti-RO-52 antibody in patients with interstitial pneumonia after treatment of malignant tumors
  100. Exploring cerebrospinal fluid metabolites, cognitive function, and brain atrophy: Insights from Mendelian randomization
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  103. Uterine fibroid embolization: An analysis of clinical outcomes and impact on patients’ quality of life
  104. Discovery of lipid metabolism-related diagnostic biomarkers and construction of diagnostic model in steroid-induced osteonecrosis of femoral head
  105. Serum-derived exomiR-188-3p is a promising novel biomarker for early-stage ovarian cancer
  106. Enhancing chronic back pain management: A comparative study of ultrasound–MRI fusion guidance for paravertebral nerve block
  107. Peptide CCAT1-70aa promotes hepatocellular carcinoma proliferation and invasion via the MAPK/ERK pathway
  108. Electroacupuncture-induced reduction of myocardial ischemia–reperfusion injury via FTO-dependent m6A methylation modulation
  109. Hemorrhoids and cardiovascular disease: A bidirectional Mendelian randomization study
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  111. HALP score in Demodex blepharitis: A case–control study
  112. Assessment of SOX2 performance as a marker for circulating cancer stem-like cells (CCSCs) identification in advanced breast cancer patients using CytoTrack system
  113. Risk and prognosis for brain metastasis in primary metastatic cervical cancer patients: A population-based study
  114. Comparison of the two intestinal anastomosis methods in pediatric patients
  115. Factors influencing hematological toxicity and adverse effects of perioperative hyperthermic intraperitoneal vs intraperitoneal chemotherapy in gastrointestinal cancer
  116. Endotoxin tolerance inhibits NLRP3 inflammasome activation in macrophages of septic mice by restoring autophagic flux through TRIM26
  117. Lateral transperitoneal laparoscopic adrenalectomy: A single-centre experience of 21 procedures
  118. Petunidin attenuates lipopolysaccharide-induced retinal microglia inflammatory response in diabetic retinopathy by targeting OGT/NF-κB/LCN2 axis
  119. Procalcitonin and C-reactive protein as biomarkers for diagnosing and assessing the severity of acute cholecystitis
  120. Factors determining the number of sessions in successful extracorporeal shock wave lithotripsy patients
  121. Development of a nomogram for predicting cancer-specific survival in patients with renal pelvic cancer following surgery
  122. Inhibition of ATG7 promotes orthodontic tooth movement by regulating the RANKL/OPG ratio under compression force
  123. A machine learning-based prognostic model integrating mRNA stemness index, hypoxia, and glycolysis‑related biomarkers for colorectal cancer
  124. Glutathione attenuates sepsis-associated encephalopathy via dual modulation of NF-κB and PKA/CREB pathways
  125. FAHD1 prevents neuronal ferroptosis by modulating R-loop and the cGAS–STING pathway
  126. Association of placenta weight and morphology with term low birth weight: A case–control study
  127. Investigation of the pathogenic variants induced Sjogren’s syndrome in Turkish population
  128. Nucleotide metabolic abnormalities in post-COVID-19 condition and type 2 diabetes mellitus patients and their association with endocrine dysfunction
  129. TGF-β–Smad2/3 signaling in high-altitude pulmonary hypertension in rats: Role and mechanisms via macrophage M2 polarization
  130. Ultrasound-guided unilateral versus bilateral erector spinae plane block for postoperative analgesia of patients undergoing laparoscopic cholecystectomy
  131. Profiling gut microbiome dynamics in subacute thyroiditis: Implications for pathogenesis, diagnosis, and treatment
  132. Delta neutrophil index, CRP/albumin ratio, procalcitonin, immature granulocytes, and HALP score in acute appendicitis: Best performing biomarker?
  133. Anticancer activity mechanism of novelly synthesized and characterized benzofuran ring-linked 3-nitrophenyl chalcone derivative on colon cancer cells
  134. H2valdien3 arrests the cell cycle and induces apoptosis of gastric cancer
  135. Prognostic relevance of PRSS2 and its immune correlates in papillary thyroid carcinoma
  136. Association of SGLT2 inhibition with psychiatric disorders: A Mendelian randomization study
  137. Motivational interviewing for alcohol use reduction in Thai patients
  138. Luteolin alleviates oxygen-glucose deprivation/reoxygenation-induced neuron injury by regulating NLRP3/IL-1β signaling
  139. Polyphyllin II inhibits thyroid cancer cell growth by simultaneously inhibiting glycolysis and oxidative phosphorylation
  140. Relationship between the expression of copper death promoting factor SLC31A1 in papillary thyroid carcinoma and clinicopathological indicators and prognosis
  141. CSF2 polarized neutrophils and invaded renal cancer cells in vitro influence
  142. Proton pump inhibitors-induced thrombocytopenia: A systematic literature analysis of case reports
  143. The current status and influence factors of research ability among community nurses: A sequential qualitative–quantitative study
  144. OKAIN: A comprehensive oncology knowledge base for the interpretation of clinically actionable alterations
  145. The relationship between serum CA50, CA242, and SAA levels and clinical pathological characteristics and prognosis in patients with pancreatic cancer
  146. Identification and external validation of a prognostic signature based on hypoxia–glycolysis-related genes for kidney renal clear cell carcinoma
  147. Engineered RBC-derived nanovesicles functionalized with tumor-targeting ligands: A comparative study on breast cancer targeting efficiency and biocompatibility
  148. Relationship of resting echocardiography combined with serum micronutrients to the severity of low-gradient severe aortic stenosis
  149. Effect of vibration on pain during subcutaneous heparin injection: A randomized, single-blind, placebo-controlled trial
  150. The diagnostic performance of machine learning-based FFRCT for coronary artery disease: A meta-analysis
  151. Comparing biofeedback device vs diaphragmatic breathing for bloating relief: A randomized controlled trial
  152. Serum uric acid to albumin ratio and C-reactive protein as predictive biomarkers for chronic total occlusion and coronary collateral circulation quality
  153. Multiple organ scoring systems for predicting in-hospital mortality of sepsis patients in the intensive care unit
  154. Single-cell RNA sequencing data analysis of the inner ear in gentamicin-treated mice via intraperitoneal injection
  155. Suppression of cathepsin B attenuates myocardial injury via limiting cardiomyocyte apoptosis
  156. Influence of sevoflurane combined with propofol anesthesia on the anesthesia effect and adverse reactions in children with acute appendicitis
  157. Review Articles
  158. The effects of enhanced external counter-pulsation on post-acute sequelae of COVID-19: A narrative review
  159. Diabetes-related cognitive impairment: Mechanisms, symptoms, and treatments
  160. Microscopic changes and gross morphology of placenta in women affected by gestational diabetes mellitus in dietary treatment: A systematic review
  161. Review of mechanisms and frontier applications in IL-17A-induced hypertension
  162. Research progress on the correlation between islet amyloid peptides and type 2 diabetes mellitus
  163. The safety and efficacy of BCG combined with mitomycin C compared with BCG monotherapy in patients with non-muscle-invasive bladder cancer: A systematic review and meta-analysis
  164. The application of augmented reality in robotic general surgery: A mini-review
  165. The effect of Greek mountain tea extract and wheat germ extract on peripheral blood flow and eicosanoid metabolism in mammals
  166. Neurogasobiology of migraine: Carbon monoxide, hydrogen sulfide, and nitric oxide as emerging pathophysiological trinacrium relevant to nociception regulation
  167. Plant polyphenols, terpenes, and terpenoids in oral health
  168. Laboratory medicine between technological innovation, rights safeguarding, and patient safety: A bioethical perspective
  169. End-of-life in cancer patients: Medicolegal implications and ethical challenges in Europe
  170. The maternal factors during pregnancy for intrauterine growth retardation: An umbrella review
  171. Intra-abdominal hypertension/abdominal compartment syndrome of pediatric patients in critical care settings
  172. PI3K/Akt pathway and neuroinflammation in sepsis-associated encephalopathy
  173. Screening of Group B Streptococcus in pregnancy: A systematic review for the laboratory detection
  174. Giant borderline ovarian tumours – review of the literature
  175. Leveraging artificial intelligence for collaborative care planning: Innovations and impacts in shared decision-making – A systematic review
  176. Cholera epidemiology analysis through the experience of the 1973 Naples epidemic
  177. Risk factors of frailty/sarcopenia in community older adults: Meta-analysis
  178. Supplement strategies for infertility in overweight women: Evidence and legal insights
  179. Scurvy, a not obsolete disorder: Clinical report in eight young children and literature review
  180. A meta-analysis of the effects of DBS on cognitive function in patients with advanced PD
  181. Protective role of selenium in sepsis: Mechanisms and potential therapeutic strategies
  182. Strategies for hyperkalemia management in dialysis patients: A systematic review
  183. C-reactive protein-to-albumin ratio in peripheral artery disease
  184. Case Reports
  185. Delayed graft function after renal transplantation
  186. Semaglutide treatment for type 2 diabetes in a patient with chronic myeloid leukemia: A case report and review of the literature
  187. Diverse electrophysiological demyelinating features in a late-onset glycogen storage disease type IIIa case
  188. Giant right atrial hemangioma presenting with ascites: A case report
  189. Laser excision of a large granular cell tumor of the vocal cord with subglottic extension: A case report
  190. EsoFLIP-assisted dilation for dysphagia in systemic sclerosis: Highlighting the role of multimodal esophageal evaluation
  191. Molecular hydrogen-rhodiola as an adjuvant therapy for ischemic stroke in internal carotid artery occlusion: A case report
  192. Coronary artery anomalies: A case of the “malignant” left coronary artery and its surgical management
  193. Rapid Communication
  194. Biological properties of valve materials using RGD and EC
  195. A single oral administration of flavanols enhances short-term memory in mice along with increased brain-derived neurotrophic factor
  196. Letter to the Editor
  197. Role of enhanced external counterpulsation in long COVID
  198. Expression of Concern
  199. Expression of concern “A ceRNA network mediated by LINC00475 in papillary thyroid carcinoma”
  200. Expression of concern “Notoginsenoside R1 alleviates spinal cord injury through the miR-301a/KLF7 axis to activate Wnt/β-catenin pathway”
  201. Expression of concern “circ_0020123 promotes cell proliferation and migration in lung adenocarcinoma via PDZD8”
  202. Corrigendum
  203. Corrigendum to “Empagliflozin improves aortic injury in obese mice by regulating fatty acid metabolism”
  204. Corrigendum to “Comparing the therapeutic efficacy of endoscopic minimally invasive surgery and traditional surgery for early-stage breast cancer: A meta-analysis”
  205. Corrigendum to “The progress of autoimmune hepatitis research and future challenges”
  206. Retraction
  207. Retraction of “miR-654-5p promotes gastric cancer progression via the GPRIN1/NF-κB pathway”
  208. Retraction of: “LncRNA CASC15 inhibition relieves renal fibrosis in diabetic nephropathy through downregulating SP-A by sponging to miR-424”
  209. Retraction of: “SCARA5 inhibits oral squamous cell carcinoma via inactivating the STAT3 and PI3K/AKT signaling pathways”
  210. Special Issue Advancements in oncology: bridging clinical and experimental research - Part II
  211. Unveiling novel biomarkers for platinum chemoresistance in ovarian cancer
  212. Lathyrol affects the expression of AR and PSA and inhibits the malignant behavior of RCC cells
  213. The era of increasing cancer survivorship: Trends in fertility preservation, medico-legal implications, and ethical challenges
  214. Bone scintigraphy and positron emission tomography in the early diagnosis of MRONJ
  215. Meta-analysis of clinical efficacy and safety of immunotherapy combined with chemotherapy in non-small cell lung cancer
  216. Special Issue Computational Intelligence Methodologies Meets Recurrent Cancers - Part IV
  217. Exploration of mRNA-modifying METTL3 oncogene as momentous prognostic biomarker responsible for colorectal cancer development
  218. Special Issue The evolving saga of RNAs from bench to bedside - Part III
  219. Interaction and verification of ferroptosis-related RNAs Rela and Stat3 in promoting sepsis-associated acute kidney injury
  220. The mRNA MOXD1: Link to oxidative stress and prognostic significance in gastric cancer
  221. Special Issue Exploring the biological mechanism of human diseases based on MultiOmics Technology - Part II
  222. Dynamic changes in lactate-related genes in microglia and their role in immune cell interactions after ischemic stroke
  223. A prognostic model correlated with fatty acid metabolism in Ewing’s sarcoma based on bioinformatics analysis
  224. Red cell distribution width predicts early kidney injury: A NHANES cross-sectional study
  225. Special Issue Diabetes mellitus: pathophysiology, complications & treatment
  226. Nutritional risk assessment and nutritional support in children with congenital diabetes during surgery
  227. Correlation of the differential expressions of RANK, RANKL, and OPG with obesity in the elderly population in Xinjiang
  228. A discussion on the application of fluorescence micro-optical sectioning tomography in the research of cognitive dysfunction in diabetes
  229. A review of brain research on T2DM-related cognitive dysfunction
  230. Metformin and estrogen modulation in LABC with T2DM: A 36-month randomized trial
  231. Special Issue Innovative Biomarker Discovery and Precision Medicine in Cancer Diagnostics
  232. CircASH1L-mediated tumor progression in triple-negative breast cancer: PI3K/AKT pathway mechanisms
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