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Healthcare, Volume 11, Issue 11 (June-1 2023) – 141 articles

Cover Story (view full-size image): High-risk health behaviors, which are associated with chronic diseases, are increasing in schoolchildren and in adolescents. Since schools offer the opportunity to encourage positive habits, the World Health Organization recommends that schools adopt a whole-school strategy for healthy behaviors, involving different health professionals that promote healthy decisions.
The aim of the present systematic review was to evaluate the efficacy of nurse-led interventions in collaboration with kinesiologists on physical activity and lifestyle behaviors’ outcomes in school settings. This work highlights the effectiveness of this type of intervention, synthesizes the available evidence on health promotion in schools and shows that nurses, in association with other professionals such as kinesiologists, are important ambassadors in school health promotion. View this paper
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24 pages, 1114 KiB  
Review
What Is Hidden behind Amputation? Quanti-Qualitative Systematic Review on Psychological Adjustment and Quality of Life in Lower Limb Amputees for Non-Traumatic Reasons
by Laura Calabrese, Marina Maffoni, Valeria Torlaschi and Antonia Pierobon
Healthcare 2023, 11(11), 1661; https://doi.org/10.3390/healthcare11111661 - 5 Jun 2023
Cited by 4 | Viewed by 3012
Abstract
Objective: This systematic review aims to investigate Quality of Life (QoL)/Health Related Quality of Life (HRQoL) and psychological adjustment in non-traumatic lower limb amputees (LLA). Methods: PubMed, Scopus, and Web of Science databases were used for the literature search. Studies were read and [...] Read more.
Objective: This systematic review aims to investigate Quality of Life (QoL)/Health Related Quality of Life (HRQoL) and psychological adjustment in non-traumatic lower limb amputees (LLA). Methods: PubMed, Scopus, and Web of Science databases were used for the literature search. Studies were read and analysed using the (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) PRISMA statement procedure. Results: The literature search retrieved 1268 studies, of which 52 were included in the systematic review. Overall, psychological adjustment, especially depression with or without anxiety symptoms, influences the QoL/HRQoL in this clinical population. Other factors influencing QoL/HRQoL include subjective characteristics, physical aspects, the cause and level of the amputation, relational aspects, social support, and the doctor-patient relationship. In addition, the patient’s emotional-motivational status, depression and/or anxiety symptoms, and acceptance play a key role in the subsequent rehabilitation process. Conclusions: In LLA patients, psychological adjustment is a complex and multifaceted process, and QoL/HRQoL may be influenced by various factors. Shedding light on these issues may provide useful suggestions for promoting clinical and rehabilitative interventions that may be tailored and effective in this clinical population. Full article
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14 pages, 641 KiB  
Article
Quality of Life, Fatigue, and Physical Symptoms Post-COVID-19 Condition: A Cross-Sectional Comparative Study
by Maha M. AlRasheed, Sinaa Al-Aqeel, Ghada I. Aboheimed, Noura M. AlRasheed, Norah Othman Abanmy, Ghadeer Abdulaziz Alhamid, Hadeel Mohammed Alnemari, Saad Alkhowaiter, Abdullah Rashed Alharbi, Fowad Khurshid, Khaled Trabelsi, Haitham A. Jahrami and Ahmed S. BaHammam
Healthcare 2023, 11(11), 1660; https://doi.org/10.3390/healthcare11111660 - 5 Jun 2023
Cited by 7 | Viewed by 2425
Abstract
The magnitude of post-COVID-19 syndrome was not thoroughly investigated. This study evaluated the quality of life and persistence of fatigue and physical symptoms of individuals post-COVID-19 compared with noninfected controls. The study included 965 participants; 400 had previous COVID-19 disease and 565 controls [...] Read more.
The magnitude of post-COVID-19 syndrome was not thoroughly investigated. This study evaluated the quality of life and persistence of fatigue and physical symptoms of individuals post-COVID-19 compared with noninfected controls. The study included 965 participants; 400 had previous COVID-19 disease and 565 controls without COVID-19. The questionnaire collected data on comorbidities, COVID-19 vaccination, general health questions, and physical symptoms, in addition to validated measures of quality of life (SF-36 scale), fatigue (fatigue severity scale, FSS), and dyspnea grade. COVID-19 participants complained more frequently of weakness, muscle pain, respiratory symptoms, voice disorders, imbalance, taste and smell loss, and menstrual problems compared to the controls. Joint symptoms, tingling, numbness, hypo/hypertension, sexual dysfunction, headache, bowel, urinary, cardiac, and visual symptoms did not differ between groups. Dyspnea grade II–IV did not differ significantly between groups (p = 0.116). COVID-19 patients scored lower on the SF-36 domains of role physical (p = 0.045), vitality (p < 0.001), reported health changes (p < 0.001), and mental-components summary (p = 0.014). FSS scores were significantly higher in COVID-19 participants (3 (1.8–4.3) vs. 2.6 (1.4–4); p < 0.001). COVID-19 effects could persist beyond the acute infection phase. These effects include changes in quality of life, fatigue, and persistence of physical symptoms. Full article
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13 pages, 509 KiB  
Review
Sexual and Reproductive Health Care for Irregular Migrant Women: A Meta-Synthesis of Qualitative Data
by José Granero-Molina, Ariadna Sara Gómez-Vinuesa, Gonzalo Granero-Heredia, Alba Fernández-Férez, María Dolores Ruiz-Fernández, Isabel María Fernández-Medina and María del Mar Jiménez-Lasserrotte
Healthcare 2023, 11(11), 1659; https://doi.org/10.3390/healthcare11111659 - 5 Jun 2023
Viewed by 1395
Abstract
Migratory movements are a political, social, and public health issue on a global scale. Access to sexual and reproductive health services for irregular migrant women (IMW) is a public health issue. The aim of this study is to identify qualitative evidence of IMW’s [...] Read more.
Migratory movements are a political, social, and public health issue on a global scale. Access to sexual and reproductive health services for irregular migrant women (IMW) is a public health issue. The aim of this study is to identify qualitative evidence of IMW’s experiences of sexual and reproductive health care in emergency and primary care settings. The methods employed involve conducting a meta-synthesis of qualitative studies. Synthesis includes assembling and categorising findings based on similarity in meaning. The search was conducted between January 2010 and June 2022 using PubMed, WOS, CINAHL, SCOPUS, and SCIELO databases. Out of the initial pool of 142 articles identified, only 9 fulfilled the predetermined criteria and were subsequently included in the review. Four main themes were established: (1) the need to focus emergency care on sexual and reproductive health; (2) unsatisfactory clinical experiences; (3) forced reproduction; and (4) alternating between formal and informal healthcare services. The attitudes of IMW towards sexual and reproductive health are influenced by culture, educational level, fear, barriers, and the attitude of healthcare providers. Healthcare institutions need to be aware of the IMW’s experiences to understand the specific difficulties they face. IMW calls for socially and culturally sensitive health care, cultural mediators, improved communication, and safe environments that ensure confidentiality. Full article
(This article belongs to the Section Women's Health Care)
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13 pages, 763 KiB  
Article
Helicobacter pylori Infection and Peptic Ulcer Disease in Symptomatic Children in Southern Vietnam: A Prospective Multicenter Study
by Tu Cam Nguyen, Ngoc Le Chau Tang, Giao Kim Ngoc Le, Vy Thuy Nguyen, Khuong Hoang Gia Nguyen, Thai Hoang Che, Van Thi Tuong Phan, Ngoc Minh Nguyen, Dinh Quang Truong, Xuan Minh Ngo, Hiep Thanh Nguyen, Annie Robert, Patrick Bontems and Phuong Ngoc Van Nguyen
Healthcare 2023, 11(11), 1658; https://doi.org/10.3390/healthcare11111658 - 5 Jun 2023
Cited by 3 | Viewed by 2289
Abstract
Background: Helicobacter pylori (H. pylori) remains a major cause of gastroduodenal diseases. We aimed to evaluate the burden of this infection, particularly peptic ulcer disease in Vietnamese children. Methods: We enrolled consecutive children referred for esophagogastroduodenoscopy at two tertiary children’s hospitals [...] Read more.
Background: Helicobacter pylori (H. pylori) remains a major cause of gastroduodenal diseases. We aimed to evaluate the burden of this infection, particularly peptic ulcer disease in Vietnamese children. Methods: We enrolled consecutive children referred for esophagogastroduodenoscopy at two tertiary children’s hospitals in Ho Chi Minh City, from October 2019 to May 2021. Children treated with proton pump inhibitors during the last two weeks or antibiotics for four weeks, and those having a previous or interventional endoscopy were excluded. H. pylori infection was diagnosed with either a positive culture or positive histopathology combined with a rapid urease test, or with a polymerase chain reaction of the urease gene. The study was approved by the Ethics Committee and written informed consent/assent was obtained. Results: Among 336 enrolled children aged 4–16 (mean: 9.1 ± 2.4 years; 55.4% girls), H. pylori infection was positive in 80%. Peptic ulcers were detected in 65 (19%), increasing with age, and 25% with anemia. cagA+ strains were detected at a higher rate in children with ulcers. Conclusions: Prevalence of H. pylori and peptic ulcers is high among symptomatic Vietnamese children. It is crucial to have a program for early detection of H. pylori to reduce ulcer risk and gastric cancer later. Full article
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10 pages, 1623 KiB  
Article
The Effect of Sexual Intercourse during Pregnancy on Preterm Birth: Prospective Single-Center Cohort Study in Japan
by Yoshie Yo, Kaoru Kawasaki, Kaori Moriuchi, Reona Shiro, Masao Shimaoka and Noriomi Matsumura
Healthcare 2023, 11(11), 1657; https://doi.org/10.3390/healthcare11111657 - 5 Jun 2023
Viewed by 1856
Abstract
Several studies in Europe and the United States have shown that sexual intercourse (SI) during pregnancy is not associated with preterm birth. However, it is unclear whether these findings apply to pregnant Japanese women. The aim of this prospective cohort study was to [...] Read more.
Several studies in Europe and the United States have shown that sexual intercourse (SI) during pregnancy is not associated with preterm birth. However, it is unclear whether these findings apply to pregnant Japanese women. The aim of this prospective cohort study was to elucidate the influence of SI during pregnancy on preterm birth in Japan. A total of 182 women who underwent antenatal care and delivery were included in this study. The frequency of SI was assessed using a questionnaire, and its association with preterm birth was analyzed. The results showed that SI during pregnancy was associated with a significantly higher cumulative preterm birth rate (p = 0.018), which was more pronounced for SI more than once a week (p < 0.0001). Multivariate analysis showed that SI, bacterial vaginosis in the second trimester, previous preterm birth, and smoking during pregnancy were independent risk factors for preterm birth. The combination of SI and second trimester bacterial vaginosis was associated with a 60% preterm birth rate, whereas either factor alone was associated with a lower rate, suggesting a synergistic effect (p < 0.0001). Future studies are needed to investigate the effect of prohibiting SI in pregnant women with bacterial vaginosis on preterm birth. Full article
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13 pages, 1349 KiB  
Article
Healthcare Service Efficiency: An Empirical Study on Healthcare Capacity in Various Counties and Cities in Taiwan
by Jih-Shong Wu
Healthcare 2023, 11(11), 1656; https://doi.org/10.3390/healthcare11111656 - 5 Jun 2023
Cited by 2 | Viewed by 1393
Abstract
As human lifespan increases and the need for elderly care grows, the demand for healthcare services and its associated costs have surged, causing a decline in the operational efficiency of universal healthcare. This has created an imbalance in medical services across different regions, [...] Read more.
As human lifespan increases and the need for elderly care grows, the demand for healthcare services and its associated costs have surged, causing a decline in the operational efficiency of universal healthcare. This has created an imbalance in medical services across different regions, posing a long-standing challenge for the public. To address this issue, strategies to enhance the capacity, efficiency, and quality of healthcare services in various regions must be developed. The appropriate allocation of medical resources is a fundamental requirement for countries to establish a robust healthcare system. This empirical study utilized data envelopment analysis (DEA) to evaluate the efficiency of medical service capacity and identify potential improvement strategies for counties and cities in Taiwan during the period from 2015 to 2020. The results of this study show that (1) the annual average efficiency of medical service capacity in Taiwan is approximately 90%, indicating that there is still room for a 10% improvement; (2) among the six municipalities, only Taipei City has sufficient healthcare capacity, whereas the efficiency of the remaining municipalities needs improvement; and (3) most counties and cities demonstrated increasing returns to scale, indicating a need to scale up the capacity of medical services as appropriate. Based on the findings of this study, it is recommended that medical personnel be increased accordingly to balance the workload, a favorable working environment be provided to stabilize the medical workforce, and urban–rural medical disparities be balanced to improve service quality and reduce cross-regional health services. These recommendations are expected to provide a reference for society as a whole to promote and enhance public health policies, leading to a continual improvement of the quality of medical services. Full article
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13 pages, 1776 KiB  
Article
Assessing Therapeutic Choices and Adherence to Antidiabetic Therapy in Naïve Patients: A Retrospective Observational Study in a Local Health Authority of the Piedmont Region (Italy)
by Lucrezia Greta Armando, Gianluca Miglio, Raffaella Baroetto Parisi, Mariangela Esiliato, Cristina Rolando, Valeria Vinciguerra, Abdoulaye Diarassouba and Clara Cena
Healthcare 2023, 11(11), 1655; https://doi.org/10.3390/healthcare11111655 - 5 Jun 2023
Cited by 1 | Viewed by 1074
Abstract
Due to its prevalence and socio-economic burden on health systems, diabetes mellitus (DM) is considered a major health emergency. This retrospective, observational study aimed to describe a population of DM-naïve patients of the Local Health Authority (LHA) ASL TO4 Regione Piemonte and the [...] Read more.
Due to its prevalence and socio-economic burden on health systems, diabetes mellitus (DM) is considered a major health emergency. This retrospective, observational study aimed to describe a population of DM-naïve patients of the Local Health Authority (LHA) ASL TO4 Regione Piemonte and the prescriptive behavior of LHA general practitioners. Drug dispensing data collected between January 2018 and December 2021 was analyzed. Adult patients were included if they received their first prescription for an antidiabetic drug (AD) in 2019 and had ≥2 prescriptions/year of ADs during the follow-up. Patients who started antidiabetic therapy with metformin were selected to investigate comorbidities, medication adherence, and first treatment intensification. Comorbidities were identified through a modified version of the Rx-Risk Index; adherence was measured as the continuous measure of medication availability (CMA). Among 1927 DM-naïve patients, 1361 started therapy with metformin. Most of them received drugs related to cardiovascular diseases, hypertension, and infectious diseases during the study period. Median CMA was 58.8%, with the majority of patients being partially adherent to ADs (40 ≤ CMA < 80). Initial antidiabetic therapy was mostly modified (switch, add-on) with SGLT-2 inhibitors and sulfonylureas. These findings help to identify areas of intervention to improve the use of ADs in the LHA. Full article
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10 pages, 829 KiB  
Article
A Service Reconfiguration Bundle for Expanding Access to Peritoneal Dialysis Including for Older Frailer Patients
by Michael Corr, Carolyn Hunter, Daniel Conroy, Damian McGrogan, Damian Fogarty and Stephen O’Neill
Healthcare 2023, 11(11), 1654; https://doi.org/10.3390/healthcare11111654 - 5 Jun 2023
Viewed by 1412
Abstract
Introduction: Rates of peritoneal dialysis (PD) have been traditionally low in Northern Ireland. With rising numbers of patients reaching end-stage kidney disease, PD is a more cost-effective treatment than haemodialysis and aligns with international goals to increase home-based dialysis options. The aim of [...] Read more.
Introduction: Rates of peritoneal dialysis (PD) have been traditionally low in Northern Ireland. With rising numbers of patients reaching end-stage kidney disease, PD is a more cost-effective treatment than haemodialysis and aligns with international goals to increase home-based dialysis options. The aim of our study was to highlight how a service reconfiguration bundle expanded access to PD in Northern Ireland. Methods: The service reconfiguration bundle consisted of the appointment of a surgical lead, a dedicated interventional radiologist for fluoroscopically guided PD catheter insertion, and a nephrology-led ultrasound-guided PD catheter insertion service in an area of particular need. All patients in Northern Ireland who had a PD catheter inserted in the year following service reconfigurations were included and prospectively followed up for one-year. Patient demographics, PD catheter insertion technique, setting of procedure, and outcome data were summarised. Results: The number of patients receiving PD catheter insertion doubled to 66 in the year following service reconfigurations. The range of approaches to PD catheter insertion (laparoscopic n = 41, percutaneous n = 24 and open n = 1) allowed a wide range of patients to benefit from PD. Six patients had emergency PD catheter insertion, with four receiving urgent or early start PD. Nearly half (48%, 29/60) of the PD catheters inserted electively were in smaller elective hubs rather than the regional unit. A total of 97% of patients successfully started PD. Patients who experienced percutaneous PD catheter insertion were older [median age 76 (range 37–88) vs. 56 (range 18–84), p < 0.0001] and had less previous abdominal surgery than patients who experienced laparoscopic PD catheter insertion (25%, 6/24 vs. 54%, 22/41, p = 0.05). Discussion: Through a service reconfiguration bundle, we were able to double our annual incident PD population. This study highlights how flexible models of service delivery introduced as a bundle can quickly deliver expanded access to PD and home therapy. Full article
(This article belongs to the Special Issue Management of the Patient with Kidney Disease)
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11 pages, 616 KiB  
Article
The Nursing Work Environment, Supervisory Support, Nurse Characteristics, and Burnout as Predictors of Intent to Stay among Hospital Nurses in the Republic of Korea: A Path Analysis
by Young-Bum Kim and Seung-Hee Lee
Healthcare 2023, 11(11), 1653; https://doi.org/10.3390/healthcare11111653 - 5 Jun 2023
Cited by 1 | Viewed by 1584
Abstract
This study aimed to examine the comprehensive impact of five aspects of the nursing work environment as well as supervisory support, nurse characteristics, and burnout on intent to stay (ITS) among Korean hospital nurses. A cross-sectional questionnaire was distributed in seven general hospitals [...] Read more.
This study aimed to examine the comprehensive impact of five aspects of the nursing work environment as well as supervisory support, nurse characteristics, and burnout on intent to stay (ITS) among Korean hospital nurses. A cross-sectional questionnaire was distributed in seven general hospitals from May to July of 2019. Data were collected from a sample of 631 Korean nurses. The hypothesized model was evaluated using the STATA program for path models. Findings demonstrated that burnout played a mediating role on the relationships between the nursing work environment, supervisory support, nurse characteristics, and ITS. Burnout was the most influential predictor of ITS (β = −0.36, p < 0.001). Nurse participation in hospital affairs (β = 0.10, p = 0.044) and collegial nurse–physician relationships (β = 0.08, p = 0.038) had a direct effect on ITS. Supervisory support had a significant direct effect on ITS (β = 0.19, p < 0.001). Therefore, to increase nurses’ ITS, it is necessary to improve their participation in hospital affairs and collegial relationships, as well as strengthen support from supervisors and reduce burnout. Full article
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16 pages, 693 KiB  
Review
The Role of Micronutrients in Human Papillomavirus Infection, Cervical Dysplasia, and Neoplasm
by Filippo Alberto Ferrari, Francesca Magni, Mariachiara Bosco, Giulia Biancotto, Pier Carlo Zorzato, Antonio Simone Laganà, Vito Chiantera, Ricciarda Raffaelli, Massimo Franchi, Stefano Uccella and Simone Garzon
Healthcare 2023, 11(11), 1652; https://doi.org/10.3390/healthcare11111652 - 5 Jun 2023
Cited by 2 | Viewed by 2571
Abstract
There is evidence that diet and nutrition are modifiable risk factors for several cancers. In recent years, attention paid to micronutrients in gynecology has increased, especially regarding Human papillomavirus (HPV) infection. We performed a review of the literature up until December 2022, aiming [...] Read more.
There is evidence that diet and nutrition are modifiable risk factors for several cancers. In recent years, attention paid to micronutrients in gynecology has increased, especially regarding Human papillomavirus (HPV) infection. We performed a review of the literature up until December 2022, aiming to clarify the effects of micronutrients, minerals, and vitamins on the history of HPV infection and the development of cervical cancer. We included studies having as their primary objective the evaluation of dietary supplements, in particular calcium; zinc; iron; selenium; carotenoids; and vitamins A, B12, C, D, E, and K. Different oligo-elements and micronutrients demonstrated a potential protective role against cervical cancer by intervening in different stages of the natural history of HPV infection, development of cervical dysplasia, and invasive disease. Healthcare providers should be aware of and incorporate the literature evidence in counseling, although the low quality of evidence provided by available studies recommends further well-designed investigations to give clear indications for clinical practice. Full article
(This article belongs to the Special Issue Gynecological Cancer Diagnosis and Prevention)
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15 pages, 1804 KiB  
Article
EASY-NET Program: Methods and Preliminary Results of an Audit and Feedback Intervention in the Emergency Care for Acute Myocardial Infarction in the Lazio Region, Italy
by Laura Angelici, Carmen Angioletti, Luigi Pinnarelli, Paola Colais, Egidio de Mattia, Nera Agabiti, Marina Davoli and Anna Acampora
Healthcare 2023, 11(11), 1651; https://doi.org/10.3390/healthcare11111651 - 5 Jun 2023
Cited by 2 | Viewed by 976
Abstract
Within the EASY-NET network program (NET-2016-02364191), Work Package 1 Lazio evaluates the effectiveness of a structured audit and feedback (A&F) intervention compared with the web-based regional periodic publication of indicators in improving the appropriateness and timeliness of emergency healthcare for acute myocardial infarction [...] Read more.
Within the EASY-NET network program (NET-2016-02364191), Work Package 1 Lazio evaluates the effectiveness of a structured audit and feedback (A&F) intervention compared with the web-based regional periodic publication of indicators in improving the appropriateness and timeliness of emergency healthcare for acute myocardial infarction (AMI). This work describes the A&F methodology and presents the results of the first feedback delivered. The intervention involves sending periodic reports via e-mail to participating hospitals. The feedback reports include a set of volume and quality (process and outcome) indicators, calculated by facility through the health information system of the Lazio Region and compared with regional mean, target values and values calculated for hospitals with similar volumes of activity. Health managers and clinicians of each participating hospital represent the “feedback recipients”. They are invited to organize clinical and organizational audit meetings to identify possible critical issues in the care pathway and define, where necessary, improvement actions. A total of 16 facilities are involved. Twelve facilities present high volumes in all volume indicators, while three facilities present low volumes for each indicator. Concerning the quality indicators, four facilities do not present critical indicators or had average results, three facilities do not present critical indicators but show average results in at least one of the indicators and six facilities present a critical value for at least one of the indicators. The first report highlighted some critical issues in some facilities on several indicators. During the audit meetings, each facility analyzes these issues, defining appropriate improvement actions. The outcome of these actions will be monitored through subsequent reporting to support the continuous care quality improvement process. Full article
(This article belongs to the Special Issue Patient Care Assessment)
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11 pages, 290 KiB  
Article
The Consequences of Child Abuse
by Ami Rokach and Shauna Clayton
Healthcare 2023, 11(11), 1650; https://doi.org/10.3390/healthcare11111650 - 5 Jun 2023
Cited by 2 | Viewed by 3194
Abstract
This review provides an overview of the consequences of early adverse experiences across various domains of life. Drawing on the Adverse Childhood Experiences (ACEs) conceptual framework, we discuss the ACE pyramid and the varying degrees of consequences that ACE exposure may elicit. Using [...] Read more.
This review provides an overview of the consequences of early adverse experiences across various domains of life. Drawing on the Adverse Childhood Experiences (ACEs) conceptual framework, we discuss the ACE pyramid and the varying degrees of consequences that ACE exposure may elicit. Using online search engines such as Google Scholar, the authors sifted through empirical research to locate relevant articles and research to help prepare this review. This article sheds light on the implications of ACEs for health, socio-emotional and psychosocial well-being, relationships, personality, and cognitive functioning. Full article
(This article belongs to the Special Issue Mental Health at a Personal, Communal, and Social Level)
9 pages, 453 KiB  
Article
Health Utilities of Bilateral Severe-to-Profound Hearing Loss with Assistive Devices
by Yi-Wen Chen, Pei-Hsuan Lin, Te-Yung Fang, Chen-Chi Wu, Pa-Chun Wang, Han Wang and Yu Ko
Healthcare 2023, 11(11), 1649; https://doi.org/10.3390/healthcare11111649 - 5 Jun 2023
Viewed by 1006
Abstract
Hearing loss is a common sensory disorder in newborns. Early intervention with assistive devices benefits children’s auditory and speech performance. This study aimed to measure the health utilities of children with bilateral severe-to-profound hearing impairment with different assistive devices. The descriptions of four [...] Read more.
Hearing loss is a common sensory disorder in newborns. Early intervention with assistive devices benefits children’s auditory and speech performance. This study aimed to measure the health utilities of children with bilateral severe-to-profound hearing impairment with different assistive devices. The descriptions of four hypothetical health states were developed, and their utility values were obtained from healthcare professionals via the visual analogue scale (VAS) and time trade-off (TTO) methods. Thirty-seven healthcare professionals completed the TTO interview and were included in the analysis. The mean utility scores obtained via VAS were 0.31 for no assistive devices, 0.41 for bilateral hearing aids, 0.63 for bimodal hearing, and 0.82 for bilateral cochlear implants. As for the utility scores obtained via TTO, mean values were 0.60, 0.69, 0.81, and 0.90, respectively. None of the four groups had the same VAS- or TTO-elicited utility (p < 0.001). The post hoc test results showed that the difference was significant between any two groups (all p < 0.05). In conclusion, this study elicited health utility of bilateral hearing impairment with different assistive devices using the VAS and TTO methods. The utility values obtained provide critical data for future cost–utility analysis and health technology assessment. Full article
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11 pages, 246 KiB  
Article
Addictive Behaviors, Depression, and Quality of Life among Korean Fishermen
by Mi Yeul Hyun and Suyoung Choi
Healthcare 2023, 11(11), 1648; https://doi.org/10.3390/healthcare11111648 - 5 Jun 2023
Viewed by 1557
Abstract
This study investigated addictive behaviors (alcohol dependence and gambling tendencies), depression, and quality of life (QoL) among Korean fishermen in the Jeju Island region, Korea. The study utilized the Alcohol Use Disorder Identification Test—Korean version, the Korean version of the Canadian Problem Gambling [...] Read more.
This study investigated addictive behaviors (alcohol dependence and gambling tendencies), depression, and quality of life (QoL) among Korean fishermen in the Jeju Island region, Korea. The study utilized the Alcohol Use Disorder Identification Test—Korean version, the Korean version of the Canadian Problem Gambling Index, the Center for Epidemiological Studies Depression Scale, and the Korean version of the World Health Organization QOL-BREF to measure the study variables. The results showed that 18.1% of the fishermen had alcohol dependence and 9.9% abused alcohol, 13.6% were categorized as problem gamblers, 15.2% were moderate risk gamblers, and 14.4% were low-risk gamblers; 25.1% and 20.8% suffered from severe and mild depression, respectively. The mean QoL score was 3.13 ± 0.56, and the psychological health section scored the highest. The degree of alcohol dependence varied by age, education level, and job satisfaction; gambling tendency varied by age, job position, and job satisfaction; depression varied by religion and job satisfaction; QoL varied by religion and job satisfaction. Alcohol dependence, gambling tendency, and depression were significantly negatively correlated with QoL. Specifically, higher levels of alcohol dependence were associated with lower QoL scores in the subcategories of physical health and psychological health, while higher levels of gambling tendencies were associated with lower QoL scores in the subcategories of physical health, psychological health, social relationships, and general subcategories. Finally, higher levels of depression were associated with lower QoL scores across all five subcategories. Overall, participants exhibited remarkably elevated levels of alcohol dependence, gambling tendencies, and depression, and lower QoL compared with the general population. Further efforts are required to increase Korean fishermen’s job satisfaction to improve these problems. In addition, public health policies must address and promote fishermen’s QoL. Full article
13 pages, 300 KiB  
Article
Differences in Loneliness and Social Isolation among Community-Dwelling Older Adults by Household Type: A Nationwide Survey in Japan
by Nanami Oe and Etsuko Tadaka
Healthcare 2023, 11(11), 1647; https://doi.org/10.3390/healthcare11111647 - 4 Jun 2023
Cited by 3 | Viewed by 1713
Abstract
(1) Background: Social isolation and loneliness are determinants of healthy longevity. However, previous research has focused on either social isolation or loneliness and has not considered household types. This study sought to clarify loneliness and social isolation among older adults using single-person (ST) [...] Read more.
(1) Background: Social isolation and loneliness are determinants of healthy longevity. However, previous research has focused on either social isolation or loneliness and has not considered household types. This study sought to clarify loneliness and social isolation among older adults using single-person (ST) or multi-person (MT) household types. (2) Methods: We administered a national, anonymous, self-administered survey to 5351 Japanese older adults aged 65 years or older. The survey included subjects’ demographic characteristics and scores for loneliness (University of California Los Angeles (UCLA) Loneliness Scale version 3 (Cronbach’s α = 0.790)), social isolation (Lubben Social Network Scale (LSNS-6) (Cronbach’s α = 0.82)), and self-efficacy (GSES). (3) Results: After adjusting for age and gender, ST individuals had significantly lower LSNS-6 and significantly higher UCLA scores than MT individuals (p < 0.001). Lower LSNS-6 and higher UCLA scores were significantly associated with lower GSES scores, and the effect of GSES was greater for ST than for MT (LSNS-6, ST (β = 0.358, p < 0.001); MT (β = 0.295, p < 0.001)) (UCLA, ST (β = −0.476, p < 0.001); MT (β = −0.381, p < 0.001)). (4) Conclusions: Specific healthcare systems and programs based on self-efficacy should be developed by household type to reduce both social isolation and loneliness. Full article
(This article belongs to the Topic Public Health and Healthcare in the Context of Big Data)
15 pages, 315 KiB  
Review
Development and Use of Assistive Technologies in Spinal Cord Injury: A Narrative Review of Reviews on the Evolution, Opportunities, and Bottlenecks of Their Integration in the Health Domain
by Giovanni Morone, Antonia Pirrera, Antonio Iannone and Daniele Giansanti
Healthcare 2023, 11(11), 1646; https://doi.org/10.3390/healthcare11111646 - 4 Jun 2023
Cited by 3 | Viewed by 1634
Abstract
Assistive technologies are increasingly taking a leading role in supporting people with spinal cord injury (SCI). This narrative review of reviews intends to contribute by making a map point investigating the integration of ATs in SCI. The methodology of the review was based [...] Read more.
Assistive technologies are increasingly taking a leading role in supporting people with spinal cord injury (SCI). This narrative review of reviews intends to contribute by making a map point investigating the integration of ATs in SCI. The methodology of the review was based on: (I) a search of PubMed and Scopus and (II) an eligibility assessment using specific parameters. The outcome highlighted the following: -The evolution of ATs considered in the context of SCI, considering ATs as both products and/or services in standalone and/or networked devices, and as processes of delivery. -Innovative technologies could play an important role in improving the quality of life and in minimizing costs in healthcare. -The international scientific community has identified ATs as one of the six strategic development areas in SCI. The overview also allowed the detection of some problems: (I) The ethical and regulatory aspects have been addressed in a weak way and only in specific and limited cases. (II) There is a lack of studies on the use and applications of ATs in SCI with a focus in multiple domains (e.g., costs, acceptance, dissemination, problems, regulatory aspects, ethical aspects, and other issues important for integration into the health domain). This review highlights the need for further studies and activities focused on integrating consensus in multiple domains, including ethics and regulations, to aid researchers and decision-makers in the field. Full article
10 pages, 993 KiB  
Brief Report
Personality Traits Predict Self-Rated Health (SRH) in Coronary Heart Disease (CHD) Patients and Healthy Controls
by Weixi Kang and Antonio Malvaso
Healthcare 2023, 11(11), 1645; https://doi.org/10.3390/healthcare11111645 - 4 Jun 2023
Cited by 2 | Viewed by 1176
Abstract
Objective: The objective of the present study is to examine the association between Big Five personality traits and self-rated health (SRH) among individuals with coronary heart disease (CHD), and to compare this relationship with that of healthy control participants, which is of importance [...] Read more.
Objective: The objective of the present study is to examine the association between Big Five personality traits and self-rated health (SRH) among individuals with coronary heart disease (CHD), and to compare this relationship with that of healthy control participants, which is of importance as SRH can be a determinant of outcomes. Methods: The current study used data from 566 participants with CHD with a mean age of 63.00 (S.D. = 15.23) years old (61.13% males) and 8608 age- and sex-matched healthy controls with a mean age of 63.87 (S.D.= 9.60) years old (61.93% males) from the UKHLS. The current study used predictive normative modelling approaches, one-sample t tests, a hierarchical regression, and two multiple regressions. Results: The current study found that CHD patients have significantly lower Conscientiousness (t(565) = −3.84, p < 0.001, 95% C.I. [−0.28, −0.09], Cohen’s d = −0.16) and SRH (t(565) = −13.83, p < 0.001, 95% C.I. [−0.68, −0.51], and Cohen’s d = −0.58) scores compared to age and sex-matched healthy controls. Moreover, health status (controls vs. CHD patients) moderated the links between Neuroticism, Extraversion and SRH. Specifically, Neuroticism (b = −0.03, p < 0.01, 95% C.I. [−0.04, −0.01]), Openness (b = 0.04, p < 0.001, 95% C.I. [0.02, 0.06]), and Conscientiousness (b = 0.08, p < 0.001, 95% C.I. [0.06, 0.10]) were significant predictors of SRH in healthy controls, whereas Conscientiousness (b = 0.08, p < 0.05, 95% C.I. [0.01, 0.16]) and Extraversion (b = −0.09, p < 0.01, 95% C.I. [−0.15, −0.02]) were significant predictors of SRH in CHD patients. Conclusion: Based on the close associations between personality traits and SRH, and the subsequent impact on patient outcomes, the results of this study should be taken into consideration by clinicians and health professionals when developing tailored treatment and intervention programs for their patients. Full article
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10 pages, 242 KiB  
Article
Translation and Psychometric Properties of the Strategies Used by People to Promote a Health Instrument for the Assessment of Self-Care Self-Efficacy among Patients Undergoing Hemodialysis in Vietnam
by Thi Thuy Nga Nguyen, Shu-Yuan Liang, Chieh-Yu Liu and Huu Dung Nguyen
Healthcare 2023, 11(11), 1644; https://doi.org/10.3390/healthcare11111644 - 4 Jun 2023
Viewed by 1534
Abstract
Self-care and self-efficacy play an important role in predicting quality of life among patients undergoing hemodialysis, but there currently is a lack of an instrument in the Vietnamese language for assessing self-care and self-efficacy. This limits the ability of researchers to explore and [...] Read more.
Self-care and self-efficacy play an important role in predicting quality of life among patients undergoing hemodialysis, but there currently is a lack of an instrument in the Vietnamese language for assessing self-care and self-efficacy. This limits the ability of researchers to explore and determine the confidence patients have in their ability to perform relevant self-care activities. The purpose of this investigation was to assess the validity and reliability of the Strategies Used by People to Promote Health questionnaire-Vietnamese version. This cross-sectional study involved translation, validation, and cultural adaptation of the questionnaire into Vietnamese and a trial with 127 patients undergoing hemodialysis in Bach Mai Hospital (Hanoi, Vietnam). The questionnaire was translated by bilingual translators and validated by three experts. Internal consistency and confirmatory factor analysis were applied. This questionnaire demonstrated good content validity and a Cronbach’s alpha of 0.95 for the total scale. Confirmatory factor analysis of the three-factor model showed moderate model fit (comparative fit index = 0.84, Tucker–Lewis coefficient = 0.82, root mean square error of approximation = 0.09). Overall, this questionnaire exhibited acceptable validity and reliability for measuring self-care and self-efficacy among patients undergoing hemodialysis. Full article
(This article belongs to the Special Issue Clinical Nursing in Healthcare)
12 pages, 491 KiB  
Article
The Effect of a Modified Mindfulness-Based Stress Reduction (MBSR) Program on Symptoms of Stress and Depression and on Saliva Cortisol and Serum Creatine Kinase among Male Wrestlers
by Elham Mousavi, Dena Sadeghi-Bahmani, Habibolah Khazaie, Annette Beatrix Brühl, Zeno Stanga and Serge Brand
Healthcare 2023, 11(11), 1643; https://doi.org/10.3390/healthcare11111643 - 3 Jun 2023
Cited by 1 | Viewed by 1703
Abstract
Objectives: The aims of the present study were two-fold: to investigate whether, compared to an active control condition, a modified mindfulness-based stress reduction (MBSR) program could (1) reduce symptoms of stress and depression, and (2) regulate salivary cortisol and serum creatine kinase (CK) [...] Read more.
Objectives: The aims of the present study were two-fold: to investigate whether, compared to an active control condition, a modified mindfulness-based stress reduction (MBSR) program could (1) reduce symptoms of stress and depression, and (2) regulate salivary cortisol and serum creatine kinase (CK) concentrations, two physiological stress markers. Methods: Thirty male wrestlers (Mage = 26.73 years) were randomly assigned either to the MBSR intervention or the active control condition. Both at the beginning and at the end of the intervention, the participants completed questionnaires on perceived stress and depression; in parallel, salivary samples were collected to measure cortisol in saliva, while blood samples were collected to assess serum CK. The study lasted for eight consecutive weeks. The intervention consisted of 16 group sessions (90 min each); the active control condition had an identical schedule, though without bona fide interventions. During the study period, the participants kept their sleeping, nutritional and exercising schedules unaltered. Results: Over time, symptoms of stress and depression decreased; the level of decrease was more prominent in the MBSR condition than the active control condition (significant p values and large effect sizes of interaction). Further, cortisol and creatine kinase concentrations also decreased more in the MBSR condition compared to the active control condition (large effect sizes of interaction). Conclusions: The present study’s findings suggest that among male wrestlers, a modified MBSR intervention have the potential to reduce both psychological (stress and depression) and physiological (cortisol and creatine kinase) indices as compared to an active control condition. Full article
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14 pages, 1082 KiB  
Article
Measurement Property Evaluation of the Arabic Version of the Patient-Specific Functional Scale for Patients with Stroke
by Mohammad A. ALMohiza, Mohammed A. Khafaji, Faisal Asiri, Muhammad O. Al-Heizan, Ali H. Alnahdi and Ravi Shankar Reddy
Healthcare 2023, 11(11), 1642; https://doi.org/10.3390/healthcare11111642 - 3 Jun 2023
Viewed by 1282
Abstract
Neurological disorders refer to disorders that occur due to disease or damage to the nervous system. Stroke is one of the most common neurological disorders in which individuals commonly present with motor and sensory deficits, leading to the limitations on the activities of [...] Read more.
Neurological disorders refer to disorders that occur due to disease or damage to the nervous system. Stroke is one of the most common neurological disorders in which individuals commonly present with motor and sensory deficits, leading to the limitations on the activities of daily life. Outcome measures are used to assess and monitor patients’ condition change. The patient-specific functional scale (PSFS) is an outcome measure used to assess changes in performance levels in participants with a functional disability during daily activities. This study aimed to assess the reliability and validity of the Arabic version of the patient-specific functional scale (PSFS-Ar) in individuals with stroke. A longitudinal cohort study was used to examine the reliability and validity of the PSFS-Ar in patients with stroke. All participants completed the PSFS-Ar in addition to other outcome measures. Fifty-five individuals participated (fifty male, five female). The PSFS-Ar showed excellent test–retest reliability, with ICC2,1 = 0.96, p < 0.001. The SEM and MDC95 of the PSFS-Ar were 0.37 and 1.03, respectively. No floor and ceiling effect was observed in this study. Additionally, the construct validity of the PSFS-Ar showed 100% satisfaction with the pre-defined hypotheses. Since the number of female participants was very small in this study, the findings were established for male individuals with stroke. This study showed that the PSFS-Ar is a reliable and valid outcome measure for male individuals with stroke. Full article
(This article belongs to the Special Issue Outcome Measures and Assessment Tools in Rehabilitation)
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22 pages, 6001 KiB  
Article
Quality of Life in Amyotrophic Lateral Sclerosis Patients and Care Burden of Caregivers in Sardinia during COVID-19 Pandemic
by Davide Gentili, Giovanna Deiana, Vanna Chessa, Annalisa Calabretta, Elisabetta Marras, Costanzo Solinas, Carmelo Gugliotta and Antonio Azara
Healthcare 2023, 11(11), 1641; https://doi.org/10.3390/healthcare11111641 - 3 Jun 2023
Cited by 2 | Viewed by 1513
Abstract
Amyotrophic Lateral Sclerosis (ALS) is a rare neurogenerative disorder whose median survival ranges from 2 to 4 years after symptomatic onset. Therefore, the global Quality of Life (QoL) assessment in these patients should be carefully evaluated to guarantee an adequate care level, particularly [...] Read more.
Amyotrophic Lateral Sclerosis (ALS) is a rare neurogenerative disorder whose median survival ranges from 2 to 4 years after symptomatic onset. Therefore, the global Quality of Life (QoL) assessment in these patients should be carefully evaluated to guarantee an adequate care level, particularly during the COVID-19 pandemic period, given the increased social isolation and the pressure on healthcare services. Caregiving has been recognized as an important source of physical and psychological burden, with a possible QoL impairment. The purpose of this study was to evaluate the QoL of ALS patients and the burden of their caregivers across Sardinia, Italy. The ALS Specific QoL Instrument-Short Form (ALSSQOL-SF) and the Zarit Burden Inventory (ZBI) tools were used to assess patient’s QoL and the burden on their caregivers, respectively. The questionnaires were supplemented with items specific for the COVID-19 period. Sixty-six family units of patients with advanced ALS were interviewed between June and August 2021 across Sardinia. Patients’ psychological and social well-being were found to significantly affect the patients’ QoL, regardless of their physical condition. In addition, the caregiver burden resulted as being inversely proportional to the patient’s perceived QoL. Lack of adequate psychological support was reported among the caregivers during the emergency period. Providing adequate psychological and social support might be useful to improve QoL in middle and late stages of ALS patients and to decrease caregivers’ perceived home care burden. Full article
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14 pages, 1669 KiB  
Article
Optimizing Medication Safety with Oral Antitumor Therapy: A Methodological Approach for the Real-World Implementation of the AMBORA Competence and Consultation Center
by Lisa Cuba, Katja Schlichtig, Pauline Dürr, Elisabeth C. Inwald, Martin F. Fromm and Frank Dörje
Healthcare 2023, 11(11), 1640; https://doi.org/10.3390/healthcare11111640 - 3 Jun 2023
Cited by 1 | Viewed by 1468
Abstract
Generating evidence for the efficacy of an intervention is not sufficient to guarantee its implementation in real-world settings. The randomized AMBORA trial (Medication Safety with Oral Antitumor Therapy) demonstrated that an intensified clinical pharmacological/pharmaceutical care program has substantial benefits for patients, treatment teams, [...] Read more.
Generating evidence for the efficacy of an intervention is not sufficient to guarantee its implementation in real-world settings. The randomized AMBORA trial (Medication Safety with Oral Antitumor Therapy) demonstrated that an intensified clinical pharmacological/pharmaceutical care program has substantial benefits for patients, treatment teams, and the healthcare system. Thus, we are now investigating its implementation into routine care within the AMBORA Competence and Consultation Center (AMBORA Center). We perform a multicenter type III hybrid trial following the RE-AIM framework to assess the clinical effectiveness of this care program under real-world conditions, while evaluating the implementation outcomes. Semi-structured stakeholder interviews based on the Consolidated Framework for Implementation Research (CFIR) have been conducted to identify barriers and facilitators. So far, 332 patients treated with oral antitumor drugs have been referred to the AMBORA Center by 66 physicians from 13 independent clinical units. In 20 stakeholder interviews (e.g., with clinic directors), 30% (6/20) of the interviewees anticipated possible barriers which may partly hinder sustainable implementation (e.g., unavailable consultation rooms). Furthermore, important facilitators (e.g., operational processes) were identified. This methodological description adds knowledge on how to structure a hybrid effectiveness–implementation trial and proposes multilevel implementation strategies to improve the medication safety of oral antitumor therapy. Full article
(This article belongs to the Section Healthcare Quality and Patient Safety)
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14 pages, 331 KiB  
Article
Victimization Perceived and Experienced by Teens in an Abusive Dating Relationship: The Need to Tear down Social Myths
by Isabel Cuadrado-Gordillo, Guadalupe Martín-Mora-Parra and Ismael Puig-Amores
Healthcare 2023, 11(11), 1639; https://doi.org/10.3390/healthcare11111639 - 3 Jun 2023
Cited by 2 | Viewed by 1135
Abstract
The phenomenon of adolescent dating violence is a social health problem that affects thousands of people in different contexts and parts of the world. To date, much of the work that has focused on analysing this phenomenon has tended to study it from [...] Read more.
The phenomenon of adolescent dating violence is a social health problem that affects thousands of people in different contexts and parts of the world. To date, much of the work that has focused on analysing this phenomenon has tended to study it from the perspective of victimized adolescent girls, considering that gender violence predominates in violent pair relationships. Nonetheless, there is a growing body of evidence that the victimization of adolescent boys is a reality. Thus, mutual violence between boys and girls is increasingly prevalent. Given this context, the present study’s objective was to analyse and compare the victimization profile of a sample of female and male adolescents, taking into account the variables most commonly associated with victimization in these abusive relationships (perceived violence suffered, perceived severity, sexism, and moral disengagement). With this objective, different instruments were administered (CUVINO, Scale of Detection of Sexism Adolescents (DSA), and Mechanism of Moral Disengagement Scale (MMDS)). Data analysis based on the construction of a multiple linear regression model confirmed that the boys and girls in the sample revealed having suffered violence from their partners to a different degree. It is evident that the victimization profile of the two sexes is different. Thus, boys show less perception of severity, more sexism, and greater use of certain moral disengagement mechanisms than girls. These results reveal the need to tear down social myths and construct prevention programs that take into account different victimization profiles. Full article
22 pages, 2332 KiB  
Article
Impact of the First Year of the COVID-19 Pandemic on Pediatric Emergency Department Attendance in a Tertiary Center in South Italy: An Interrupted Time-Series Analysis
by Alessandra Alongi, Francesca D’Aiuto, Cristina Montomoli and Paola Borrelli
Healthcare 2023, 11(11), 1638; https://doi.org/10.3390/healthcare11111638 - 2 Jun 2023
Cited by 2 | Viewed by 1040
Abstract
Background: The evidence shows a reduction in pediatric emergency department (PED) flows during the early stages of the COVID-19 pandemic. Using interrupted time-series analysis, we evaluated the impact of different stages of the pandemic response on overall and cause-specific PED attendance at a [...] Read more.
Background: The evidence shows a reduction in pediatric emergency department (PED) flows during the early stages of the COVID-19 pandemic. Using interrupted time-series analysis, we evaluated the impact of different stages of the pandemic response on overall and cause-specific PED attendance at a tertiary hospital in south Italy. Our methods included evaluations of total visits, hospitalizations, accesses for critical illnesses and four etiological categories (transmissible and non-transmissible infectious diseases, trauma and mental-health) during March–December 2020, which were compared with analogous intervals from 2016 to 2019; the pandemic period was divided into three segments: the “first lockdown” (FL, 9 March–3 May), the “post-lockdown” (PL, 4 May–6 November) and the “second lockdown” (SL, 7 November–31 December). Our results showed that attendance dropped by a mean of 50.09% during the pandemic stages, while hospitalizations increased. Critical illnesses decreased during FL (incidence rate ratio -IRR- 0.37, 95% CI 0.13, 0.88) e SL (IRR 0.09, 95% CI 0.01, 0.74) and transmissible disease related visits reduced more markedly and persistently (FL: IRR 0.18, 95% CI 0.14, 0.24; PL: IRR 0.20, 95% CI 0.13, 0.31, SL: IRR 0.17, 95% CI 0.10, 0.29). Non-infectious diseases returned to pre-COVID-19 pandemic levels by PL. We concluded that that the results highlight the specific effect of the late 2020 containment measures on transmissible infectious diseases and their burden on pediatric emergency resources. This evidence can inform resource allocation and interventions to mitigate the impact of infectious diseases on pediatric populations and the health-care system. Full article
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19 pages, 1212 KiB  
Systematic Review
Driving Rehabilitation for Stroke Patients: A Systematic Review with Meta-Analysis
by Sujin Hwang and Chiang-Soon Song
Healthcare 2023, 11(11), 1637; https://doi.org/10.3390/healthcare11111637 - 2 Jun 2023
Cited by 2 | Viewed by 1924
Abstract
Driving enables stroke survivors to freely participate in social integration. The purpose of this review was to summarize the evidence for the therapeutic effects of driving rehabilitation for patients when they return to driving after stroke and evaluate the predictors of returning to [...] Read more.
Driving enables stroke survivors to freely participate in social integration. The purpose of this review was to summarize the evidence for the therapeutic effects of driving rehabilitation for patients when they return to driving after stroke and evaluate the predictors of returning to driving to identify the factors impacting their driving rehabilitation. This study employed a systematic review and meta-analysis. PubMed and four other databases were searched until 31 December 2022. Our review included randomized controlled trials (RCT) and non-RCTs that investigated driving rehabilitation for stroke and observational studies. A total of 16 studies (two non-RCT and 14 non-RCT) were reviewed; two RCTs investigated the effect of driving rehabilitation with a simulator system, and eight and six non-RCTS evaluated the predictive factors of driving return post-stroke and compared the effects of driving rehabilitation for stroke, respectively. The National Institute of Health Stroke Scale (NIHSS) and Mini Mental State Examination (MMSE) scores and having paid employment were significant predictors of resuming driving after stroke. The results suggest that NIHSS, MMSE, and paid employment are predictors of returning to driving post-stroke. Future research should investigate the effect of driving rehabilitation on the resumption of driving in patients with stroke. Full article
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14 pages, 485 KiB  
Systematic Review
Causes for Medical Errors in Obstetrics and Gynaecology
by Désirée Klemann, Maud Rijkx, Helen Mertens, Frits van Merode and Dorthe Klein
Healthcare 2023, 11(11), 1636; https://doi.org/10.3390/healthcare11111636 - 2 Jun 2023
Cited by 2 | Viewed by 1925
Abstract
Background: Quality strategies, interventions, and frameworks have been developed to facilitate a better understanding of healthcare systems. Reporting adverse events is one of these strategies. Gynaecology and obstetrics are one of the specialties with many adverse events. To understand the main causes of [...] Read more.
Background: Quality strategies, interventions, and frameworks have been developed to facilitate a better understanding of healthcare systems. Reporting adverse events is one of these strategies. Gynaecology and obstetrics are one of the specialties with many adverse events. To understand the main causes of medical errors in gynaecology and obstetrics and how they could be prevented, we conducted this systematic review. Methods: This systematic review was performed in compliance with the Prisma 2020 guidelines. We searched several databases for relevant studies (Jan 2010–May 2023). Studies were included if they indicated the presence of any potential risk factor at the hospital level for medical errors or adverse events in gynaecology or obstetrics. Results: We included 26 articles in the quantitative analysis of this review. Most of these (n = 12) are cross-sectional studies; eight are case–control studies, and six are cohort studies. One of the most frequently reported contributing factors is delay in healthcare. In addition, the availability of products and trained staff, team training, and communication are often reported to contribute to near-misses/maternal deaths. Conclusions: All risk factors that were found in our review imply several categories of contributing factors regarding: (1) delay of care, (2) coordination and management of care, and (3) scarcity of supply, personnel, and knowledge. Full article
(This article belongs to the Special Issue Safety and Quality in Maternal and Neonatal Care)
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17 pages, 563 KiB  
Review
Methods of Primary Clinical Prevention of Dental Caries in the Adult Patient: An Integrative Review
by Nélio Veiga, Ricardo Figueiredo, Patrícia Correia, Pedro Lopes, Patrícia Couto and Gustavo Vicentis Oliveira Fernandes
Healthcare 2023, 11(11), 1635; https://doi.org/10.3390/healthcare11111635 - 2 Jun 2023
Cited by 7 | Viewed by 2757
Abstract
Aim: Preventive approaches to oral health diseases, mainly dental caries, require individual and collective policies. Thus, this review was conducted to identify the primary prevention methods of dental caries in adults to improve oral health at the clinical and community levels. Methods: This [...] Read more.
Aim: Preventive approaches to oral health diseases, mainly dental caries, require individual and collective policies. Thus, this review was conducted to identify the primary prevention methods of dental caries in adults to improve oral health at the clinical and community levels. Methods: This review followed the PICO strategy with the research question: “What are the methods of primary prevention of dental caries, in adults, for improving and maintaining oral health integrating clinical and community-based strategies?” Electronic screening was carried out by two independent reviewers in five databases (MedLine/PubMed, SciELO, Web of Science, Cochrane Library, and LILACS) to find relevant publications between 2015–2022. We applied eligibility criteria for selection of the articles. The following MeSH terms were used: “Primary Prevention”; “Adult”; “Oral Health”; “Dental Caries”; “Fluorides, Topical”; “Fluoride Varnishes”; “Pit and Fissure Sealants”; “Preventive Dentistry”. Although the term “Prevention strategy” is not a MeSH descriptor, several correlated terms appeared and were used in the search engines: “Preventative Care”, “Disease Prevention, Primary”, and “Prevention, Primary”. The tool provided by the JBI organization (Joanna Briggs Institute) was used to assess the quality of the included studies. Results: Nine studies were included. Overall, it was found that the main primary prevention methods applied in dentistry in adults are the application of pit and fissure sealants, topical application of fluoride performed in the dental clinic, use of fluoridated toothpaste, mouthwash with chlorhexidine at home, use of xylitol, the recommendation for regular appointments with the dentist, and the need to inform patients about the saliva buffer capacity and adoption of a non-cariogenic diet. For that purpose, preventive policies should be taken to prevent dental caries. These include three major challenges: providing the adult population with more knowledge regarding their oral health, empowering patients through adopting healthy lifestyles, and developing new preventive strategies and awareness campaigns aimed at the adult population to promote proper oral health habits. Conclusions: A small number of studies were found whose participants were adult patients. There was some consistency regarding primary prevention methods in our studies. However, good quality randomized control studies are still required to define the best intervention strategies for adult caries prevention. Full article
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13 pages, 667 KiB  
Article
Sex-Based Differences in Clinical Profile and Complications among Individuals with Type 2 Diabetes Seen at a Private Tertiary Diabetes Care Centre in India
by Rajendra Pradeepa, Lal Shreya, Ranjit Mohan Anjana, Saravanan Jebarani, Ulagamathesan Venkatesan, Nithyanantham Kamal Raj, Onkar C. Swami and Viswanathan Mohan
Healthcare 2023, 11(11), 1634; https://doi.org/10.3390/healthcare11111634 - 2 Jun 2023
Cited by 2 | Viewed by 1753
Abstract
This study aimed to compare the clinical and biochemical profiles as well as the complications in males and females with type 2 diabetes (T2DM) presenting to a private tertiary diabetes care centre in India. This is a retrospective study, conducted between 1 January [...] Read more.
This study aimed to compare the clinical and biochemical profiles as well as the complications in males and females with type 2 diabetes (T2DM) presenting to a private tertiary diabetes care centre in India. This is a retrospective study, conducted between 1 January 2017 and 31 December 2019, and included 72,980 individuals with T2DM, aged ≥ 18 years (age and sex-matched—males—36,490; females—36,490). Anthropometric measurements, blood pressure, fasting plasma glucose (FPG), post-prandial plasma glucose (PPPG), glycated haemoglobin (HbA1c), lipids, urea, and creatinine were measured. Retinopathy was screened using retinal photography, neuropathy using biothesiometry, nephropathy measuring urinary albumin excretion, peripheral vascular disease (PVD) using Doppler, and coronary artery disease (CAD) based on the history of myocardial infarction and/or drug treatment for CAD and/or electrocardiographic changes. Obesity (73.6% vs. 59.0%) rates were significantly higher in females compared to males. FPG, PPPG, and HbA1c were higher among younger age groups among both sexes, with males having higher values compared to females. However, after the age of 44 years, control of diabetes was worse among females. In addition, only 18.8% of the females achieved glycemic control (HbA1c < 7%) compared to 19.9% in males (p < 0.001). Males had higher prevalence of neuropathy (42.9% vs. 36.9%), retinopathy (36.0% vs. 26.3%), and nephropathy (25.0% vs. 23.3%) compared to females. Males had 1.8- and 1.6-times higher risk of developing CAD and retinopathy compared to females. Hypothyroidism (12.5% vs. 3.5%) and cancers (1.3% vs. 0.6%) were significantly higher in females compared to males. In this large sample of T2DM seen at a chain of private tertiary diabetes centres, females had higher prevalence of metabolic risk factors and poorer diabetes control compared to males, emphasizing the need for better control of diabetes in females. However, males had higher prevalence of neuropathy, retinopathy, nephropathy, and CAD compared to females. Full article
(This article belongs to the Section Health Informatics and Big Data)
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10 pages, 526 KiB  
Protocol
Transcutaneous Tibial Nerve Stimulation for Primary Dysmenorrhea: A Protocol for a Randomized Controlled Trial
by Marta Correyero-León, Rocío Llamas-Ramos, Javier Calvo-Rodrigo, Jorge Juan Alvarado-Omenat and Inés Llamas-Ramos
Healthcare 2023, 11(11), 1633; https://doi.org/10.3390/healthcare11111633 - 2 Jun 2023
Cited by 1 | Viewed by 1368
Abstract
Primary dysmenorrhea (PD) is a painful menstruation that can persist for the duration of a woman’s fertile life. Non-steroidal anti-inflammatory drugs, hormonal therapy, physiotherapy techniques, etc., are the main treatments. The main objective of this study is to evaluate the effectiveness of transcutaneous [...] Read more.
Primary dysmenorrhea (PD) is a painful menstruation that can persist for the duration of a woman’s fertile life. Non-steroidal anti-inflammatory drugs, hormonal therapy, physiotherapy techniques, etc., are the main treatments. The main objective of this study is to evaluate the effectiveness of transcutaneous posterior tibial nerve stimulation (TTNS) in PD patients. The study will consist of a single-blind randomized clinical trial, parallel-assigned with two arms. Women with PD (18–43 years) with regular menstrual cycles and at least 4 points in VAS will be randomly divided into experimental (TTNS) and placebo (simulated stimulation) groups during 12 treatment sessions (1 session/week) and several follow-ups: monthly during treatment and 1, 3 and 6 months after. Maximum and mean pain intensity, pain duration, pain severity, number of anti-inflammatory drugs, quality of life, sleep quality, overall improvement, treatment satisfaction and secondary effects will be measured once a month every 6 months and at 3 and 6 months. The Student’s t-test for independent samples or the Mann–Whitney U test will be used. The literature shows effective physiotherapeutic techniques for PD in the short term, which do not act on causes and have limitations. The TTNS technique can be used in transcutaneous and percutaneous modalities, with similar effectiveness, but the transcutaneous causes less discomfort. TTNS modulates pain, and long-term benefits could be achieved at low cost and without patient discomfort. Full article
(This article belongs to the Special Issue Diagnosis and Treatment for Women's Health: Second Edition)
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16 pages, 857 KiB  
Article
Clinical Features and Treatment Outcomes of COVID-19 Admissions in the Can Tho City Hospital of Tuberculosis and Respiratory Diseases, Vietnam: A Hospital-Based Observational Study
by Hung Do Tran, Tran Thanh Hung, Tran Hoang Thuy Phuong, Le Thanh Tam, Hung Gia Tran and Phuoc Huu Le
Healthcare 2023, 11(11), 1632; https://doi.org/10.3390/healthcare11111632 - 2 Jun 2023
Viewed by 1417
Abstract
Background: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, is among the top global health crises. As confirmed by the Vietnam Ministry of Health on 25th January 2023, Vietnam had a cumulative total of more than 11.52 [...] Read more.
Background: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, is among the top global health crises. As confirmed by the Vietnam Ministry of Health on 25th January 2023, Vietnam had a cumulative total of more than 11.52 million COVID-19 patients, including 10.61 million recoveries and 43,186 deaths. Objectives: This study aimed to describe the clinical and subclinical characteristics, treatment progress, and outcomes of 310 cases of SARS-CoV-2 infection. Methods: A total of 310 patients with medical records of SARS-CoV-2 were admitted to Can Tho City Hospital of Tuberculosis and Lung Diseases, Can Tho city, Vietnam, between July 2021 and December 2021. Demographic and clinical data, including laboratory examinations, of all the patients were collected and analyzed. Results: The median duration of hospital stay was 16.4 ± 5.3 days. There were 243 (78.4%) patients with clinical symptoms of COVID-19 and 67 (21.6%) patients without clinical symptoms. The common symptoms included cough (71.6% of 310 patients), fever (35.4%), shortness of breath (22.6%), sore throat (21.4%), loss of smell/taste (15.6%), and diarrhea (14.4%). Regarding treatment outcomes, 92.3% of the patients were discharged from the hospital, 1.9% of the patients suffered a more severe illness and were transferred to a higher-level hospital, and 5.8% of the patients died. The RT-PCR results were negative in 55.2% of the patients, and 37.1% of the patients had positive RT-PCR results with Ct values of >30 on the discharge/transfer day. Multivariate logistic regression analyses showed that comorbidity and decreased blood pH were statistically significantly related to the treatment outcomes of the patients with COVID-19 (p < 0.05). Conclusions: This study provides useful information (i.e., the clinical characteristics and treatment outcomes) on the COVID-19 pandemic in Vietnam during its biggest outbreak; the information may be used for reference and for making improvements in the handling of future health crises. Full article
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