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Randomised controlled trials of nursing interventions in spinal cord injury: a scoping review
Louise C Kelly1, Joanne V Glinsky1,2, Lisa A Harvey3
1The John Walsh Centre for Rehabilitation Research, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
Study Design:
Scoping Review OBJECTIVES: Randomised controlled trials (RCTs) are considered the gold standard for evaluating the effectiveness of clinical interventions. In spinal cord injury (SCI) care, nurses deliver many interventions, yet the number, quality, and level of nurse involvement in RCTs remains unclear. Poorly designed RCTs can introduce bias, and limited nurse participation may restrict the development of evidence-based nursing practice. This review aimed to determine: 1. The number and topics of RCTs on nurse-related interventions for people with SCI; 2. The extent of nurse leadership and participation in these RCTs; 3. The methodological quality of the RCTs.
Setting:
Australia METHODS: Three databases were searched over a 20-year period for RCTs involving people with SCI and interventions relevant to nursing practice. Two authors independently screened studies for inclusion. Extracted data included study location, sample size, intervention type, nurse involvement, and authorship by nurses. Methodological quality was assessed using the PEDro scale. The protocol was registered with Open Science Framework ( https://osf.io/k9xde ), and PRISMA-ScR guidelines informed reporting.
Results:
Forty-six RCTs were included from 29,744 retrieved articles. Five main intervention categories were identified, with most studies focusing on bladder and wound management. Studies were primarily conducted in Europe, Asia, and North America. Sample sizes ranged from 9 to 489 participants, with a median (IQR) of 61 (37-91). Nurses were authors on 29 out of the 46 trials, and 26% were nurse led. PEDro scores ranged from 2 to 9, with a median (IQR) of 5 (5-6.8).
Conclusions:
Few RCTs have evaluated nursing interventions for people with SCI. Many studies showed susceptibility to selection bias. Greater nurse leadership and participation in high-quality RCTs are needed to strengthen evidence-based SCI nursing care.
