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There is increasing evidence that non\u2010pharmacological interventions are safe and effective for alleviating depression. However, the efficacy and comparative effectiveness of various non\u2010pharmacological interventions for community\u2010dwelling individuals with SCI remain unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Systematic review and network meta\u2010analysis (NMA) according to PRISMA\u2010NMA guidance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We included randomized controlled trials (RCTs) of community\u2010dwelling individuals with SCI comparing non\u2010pharmacological interventions versus usual care\/waiting list and reporting depressive symptoms using validated scales. China National Knowledge Infrastructure, Wanfang Data, Chinese Biomedical Literature Database, China Science and Technology Journal Database, the Cochrane Library, PubMed, Web of Science, Embase, ProQuest and Scopus were systematically retrieved. Pairwise meta\u2010analyses were performed using Review Manager 5.4.1, and the network meta\u2010analysis was conducted using Stata 15.1.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirty\u2010two RCTs involving 2200 participants were identified from database inception to May 2026. Compared with the control group, combination therapy (SMD\u2009=\u2009\u22120.86, 95% CI: \u22121.46 to \u22120.27), exercise therapy (SMD\u2009=\u2009\u22120.66, 95% CI: \u22121.16 to \u22120.15), psychological interventions (SMD\u2009=\u2009\u22120.41, 95% CI: \u22120.70 to \u22120.13) and self\u2010management education (SMD\u2009=\u2009\u22120.33, 95% CI: \u22120.61 to \u22120.05) showed statistically significant effects, whereas vocational rehabilitation was not (SMD\u2009=\u2009\u22120.03, 95% CI: \u22121.00 to 0.95). Combination therapy had the highest SUCRA (89.1%, mean rank\u2009=\u20091.5), followed by exercise therapy (76.9%, mean rank\u2009=\u20092.2), psychological interventions (55.5%, mean rank\u2009=\u20093.2), self\u2010management education (44.0%, mean rank\u2009=\u20093.8) and vocational rehabilitation (24.7%, mean rank\u2009=\u20094.8).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Combination therapy had the highest ranking probability. However, all comparisons were rated as very low certainty according to CINeMA. The findings should be interpreted with caution.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Relevance to Clinical Practice<\/jats:title>\n                    <jats:p>Community nurses may consider integrating exercise, self\u2010management education and brief psychological support into individualized depression management for individuals with SCI. Support should be tailored according to depressive symptom severity, functional status, secondary complications, patient preferences, safety considerations and available community resources. Nurse\u2010led or nurse\u2010coordinated care may include depressive symptom screening, exercise planning, self\u2010management coaching, motivational interviewing, scheduled follow\u2010up and referral to mental health professionals when indicated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>PROSPERO: CRD42022342155<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jocn.70523","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T06:08:46Z","timestamp":1787638126000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Effects of Non\u2010Pharmacological Interventions on Depression Among Community\u2010Dwelling Individuals With Spinal Cord Injury: A Systematic Review and Network 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