{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T16:41:27Z","timestamp":1790095287144,"version":"4.0.1"},"reference-count":52,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T00:00:00Z","timestamp":1758240000000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007225","name":"Ministry of Science and Technology","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007225","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Scandinavian Caring Sciences"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims and Objectives<\/jats:title>\n                    <jats:p>Sleep disturbances are prevalent among older adults and are linked to adverse health outcomes. While warm footbaths are widely practised as a non\u2010pharmacological intervention, their effectiveness and optimal parameters remain uncertain. This systematic review and meta\u2010analysis aimed to evaluate the effects of footbaths on sleep quality and determine evidence\u2010based procedural recommendations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methodological Design and Justification<\/jats:title>\n                    <jats:p>Nine databases were systematically searched up to November 2023. Study quality was assessed using the Joanna Briggs Institute tools, and certainty of evidence was graded via the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Meta\u2010analyses were conducted using random\u2010effects models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 18 studies involving 950 older adults (aged \u2265\u200960\u2009years; 52.3% female) were included. Warm footbaths significantly improved subjective sleep quality compared with non\u2010footbath controls (SMD\u2009=\u2009\u22120.76; 95% CI: [\u22121.22, \u22120.29];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001). Optimal effects were observed with water temperatures \u2264\u200940\u00b0C (SMD\u2009=\u2009\u22121.31; 95% CI: [\u22121.63, \u22120.99];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), immersion times \u2265\u200910\u2009min (SMD\u2009=\u2009\u22120.96; 95% CI: [\u22121.36, \u22120.57];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and intervention periods of at least one week (SMD\u2009=\u2009\u22121.06; 95% CI: [\u22121.64, \u22120.48];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0003), which showed significant sleep quality improvements.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Warm footbaths before bedtime may enhance perceived sleep quality in older adults, offering a simple, culturally adaptable intervention. Standardised protocols could strengthen their role in sleep hygiene practices. Future large\u2010scale, multicentre trials integrating subjective and objective assessments are warranted to confirm efficacy and explore cross\u2010cultural applicability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>International Platform of Registered Systematic Review and Meta\u2010analysis Protocols (INPLASY): INPLASY202290025<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/scs.70118","type":"journal-article","created":{"date-parts":[[2025,9,20]],"date-time":"2025-09-20T04:19:49Z","timestamp":1758341989000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["A Systematic Review and Meta\u2010Analysis of Footbath Effects and Optimal Procedures to Improve Sleep in Older Adults"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4127-381X","authenticated-orcid":false,"given":"Shih\u2010Yu","family":"Chang","sequence":"first","affiliation":[{"name":"Department of Nursing College of Medicine, National Cheng Kung University  Tainan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3982-4691","authenticated-orcid":false,"given":"Yi\u2010Chih","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Nursing, National Cheng Kung University, Hospital, College of Medicine National Cheng Kung University  Tainan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5270-5059","authenticated-orcid":false,"given":"Hsiao\u2010Ying","family":"Hung","sequence":"additional","affiliation":[{"name":"Department of Nursing College of Medicine, National Cheng Kung University  Tainan Taiwan"},{"name":"Department of Nursing, National Cheng Kung University, Hospital, College of Medicine National Cheng Kung University  Tainan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5684-7911","authenticated-orcid":false,"given":"Chia\u2010Te","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Nursing College of Medicine, National Cheng Kung University  Tainan Taiwan"},{"name":"Graduate Institute of Clinical Nursing, College of Medicine National Chung Hsing University  Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7892-8840","authenticated-orcid":false,"given":"Ching\u2010Ju","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Secretariat, National Cheng Kung University, Hospital, College of Medicine National Cheng Kung University  Tainan Taiwan"},{"name":"Medical Library National Cheng Kung University  Tainan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7353-3383","authenticated-orcid":false,"given":"Yen\u2010Chin","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Nursing College of Medicine, National Cheng Kung University  Tainan Taiwan"},{"name":"School of Medicine, College of Medicine National Sun Yat\u2010Sen University  Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,19]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"R.NewsomandJ.DeBantos \u201cAging and Sleep \u201d (2023) https:\/\/www.Sleepfoundation.Org\/Aging\u2010And\u2010Sleep."},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.7172"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2016.05.005"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI90328"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1004109"},{"issue":"1","key":"e_1_2_11_7_1","first-page":"31","article-title":"Comparisons of Sleep Quality and Predictors Between Nursing Home Residents and Community Dwelling Elderly","volume":"21","author":"Yang C. 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