Introduction Self-care is central to long-term heart failure (HF) management, yet patients encounter multiple barriers to sustaining recommended behaviors. Existing evidence remains fragmented across individual, social, and healthcare contexts. This scoping review aimed to synthesize barriers to HF self-care and interpret them using the Capability–Opportunity–Motivation–Behavior (COM-B) model. Methods This scoping review followed the Population–Concept–Context framework and PRISMA Extension for Scoping Reviews (PRISMA-ScR) guidelines. Five electronic databases (PubMed, Scopus, ScienceDirect, CINAHL, and ProQuest) were searched for studies published from 2016 to 2026. Eligible primary qualitative, quantitative, and mixed-methods studies were screened against predefined criteria, and identified barriers were synthesized thematically and mapped onto the COM-B model. Results Nineteen studies were included. Barriers were synthesized into individual, sociocultural, and healthcare system domains. Knowledge- and information-related barriers were reported in 13 studies, healthcare access, continuity, and system-related barriers in 12, and practical adherence or lifestyle difficulties in nine. Emotional and physical or symptom-related barriers were each identified in eight studies, while barriers related to family and social support were identified in nine studies. Communication, cultural, motivational, and financial barriers were also identified across the evidence. The expression of barriers varied across country income contexts. COM-B mapping demonstrated limitations across capability, opportunity, and motivation. Conclusion HF self-care barriers are multidimensional and extend beyond knowledge deficits. Understanding how behavioral and contextual barriers interact may help identify relevant targets for context-sensitive self-care support.
Meta-analysis is a systematic statistical method that combines the findings of other studies in a single field. In other words, meta-analysis analyzes the findings of various studies with the help of statistical methods. In these studies, it is very acceptable that the initial studies included in the study are homogeneous. Any lack of uniformity in the studies included in the meta-analysis is called heterogeneity. Our goal in this study is to state that heterogeneity in meta-analysis studies can be a result of the methodology of the primary studies, and that this heterogeneity in cross-sectional studies that report prevalence can be natural due to the study being conducted in the same population and at different time periods, because the studies were conducted in different samples, times, ages, genders, and races, and all of these can be the reason for heterogeneity. Therefore, this study only describes how to deal with heterogeneity in prevalence studies compared to observational or interventional studies and notes that this heterogeneity in prevalence studies can be more natural and that researchers can conduct subgroup analyses and meta-regressions in their meta-analyses to examine it, but with a more positive and robust view of the methodology of prevalence studies.
Neurofibromatosis type 1 (NF1) is a multisystem tumor predisposition syndrome in which peripheral nerve sheath tumors (PNTs) represent a key clinical hallmark. Magnetic resonance imaging (MRI) is the reference standard for imaging during follow-up consultations, but in children, it is limited by the need for sedation, high costs, and risk of incidental findings. This scoping review evaluates the feasibility and clinical value of nerve ultrasound (US) in children with NF1. A systematic literature search identified 11 relevant publications, most of which provided low-level evidence. Ultrasound is mainly applied as a first-line, child-friendly modality for assessing superficial lesions and peripheral nerves. Its main advantages over MRI are accessibility, real-time dynamic imaging, and the avoidance of anesthesia, while its limitations include poor visualization of deep structures and a limited ability to distinguish benign from malignant lesions. Nerve ultrasound appears promising as a complementary screening tool alongside MRI, but high-quality studies are required to define its role in pediatric NF1 care.
Cancer caregivers often experience significant physical and emotional strain. Wearable technology enables real-time tracking of caregiver stress, physical activity, and sleep. This review examined how wearable technology has been used to monitor cancer caregivers' health and well-being, including the outcomes measured and tools used. Following PRISMA (PROSPERO CRD420251030428), we searched PubMed, CINAHL, PsycINFO, and Scopus through June 8, 2026. Peer-reviewed qualitative and quantitative studies of wearable use in cancer caregivers were eligible; records were screened in duplicate and data extracted on design, devices, outcomes, and findings. From 1,596 records, 28 studies met inclusion criteria, mostly from the United States and also Taiwan, Spain, Norway, and Australia. Studies used research-grade actigraphs, accelerometers, and consumer wrist-worn trackers (e.g., Fitbit, Garmin); one used an ambulatory blood pressure monitor. Samples ranged from about 10 to 430; monitoring lasted 24 hours to one year. Sleep was the most measured outcome, followed by physical activity and quality of life; studies also assessed heart rate, depression, anxiety, and stress at individual and dyadic levels. Adherence was generally high, though devices and measures varied widely. The review found that wearable technology is a feasible, acceptable way to monitor cancer caregivers' sleep, activity, and stress in everyday settings. Because the evidence is small and dominated by feasibility, pilot, and observational studies, it supports the promise of wearable monitoring rather than its effectiveness. Several studies captured patient–caregiver interdependence. Future research should test wearable-enabled interventions in larger, more diverse samples, with attention to long-term outcomes and equitable access.
Australian Military Veterans face significant physical and mental health challenges, and structural barriers in accessing healthcare. Limited healthcare access, identity loss, and employment difficulties impact reintegration, as structural barriers, loss of military role and purpose, and service-related injuries collectively undermine veterans’ ability to secure timely care, stable identity, and meaningful work. Veterans experience higher rates of comorbid disease with some mental health conditions occurring at twice the national average. More specifically, military veterans frequently suffer from chronic pain and musculoskeletal disorders, notably arthritis and back pain, especially among those who were deployed to combat duties in Afghanistan and Iraq. Post-traumatic stress disorder (PTSD), panic disorder, anxiety, depression, insomnia, and bipolar disorder are highly prevalent among Australian military personnel and significantly higher than civilians (6.4% vs 3.1%). Veterans with PTSD face twice the dementia risk and higher rates of insomnia, sleep apnoea, cardiovascular, autoimmune, musculoskeletal, and gastrointestinal disease compared to those without PTSD. Likewise, the suicide risk is 107% higher than the general population. Families and children of deployed military personnel are also impacted by their service and are at increased risk for anxiety, depression, CVD, diabetes, and stroke. Veterans and their families require coordinated care that must be led by the family doctor in close association with social services and allied care. Veteran-specific training should be embedded in Australia’s continuing medical curriculum. Veteran mental health remains a key government policy focus, driving ongoing professional development within the mental health workforce in Australia, particularly in rural settings where access barriers are most pronounced. Family-based interventions, partnerships with veteran organizations, and lessons from international models, including those implemented in the United States can further align programs with lived experience, enhancing relevance, effectiveness, and trust.
