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Healthcare, Volume 12, Issue 12 (June-2 2024) – 80 articles

Cover Story (view full-size image): This phenomenological study explored families’ experiences of loved ones under physical restraint in ICUs during COVID-19. Interviews with ten family members revealed disrupted sensemaking, communication challenges, emotional turmoil, and ethical dilemmas exacerbated by the pandemic. Findings highlighted the need for enhanced family-centered care, emphasizing clear, compassionate communication and family involvement in decision-making. The study proposed strategies to improve experiences and outcomes through tailored support and education. This research contributes to obtaining a deeper understanding of family experiences with ICU restraints and offers insights for healthcare providers to enhance care delivery during crises. View this paper
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15 pages, 267 KiB  
Article
Investigating Factors Influencing the National Cancer Screening Program among Older Individuals in Republic of Korea—Data from the Korea National Health and Nutrition Examination Survey VIII
by Seok Hwan Kim and Hyo Eun Park
Healthcare 2024, 12(12), 1237; https://doi.org/10.3390/healthcare12121237 - 20 Jun 2024
Viewed by 687
Abstract
This study aims to determine the influencing factors of the participation of older individuals aged 65 years and above in South Korea’s National Cancer Screening Program (NCSP) using data from the eighth wave (2019–2021) of the Korea National Health and Nutrition Examination Survey [...] Read more.
This study aims to determine the influencing factors of the participation of older individuals aged 65 years and above in South Korea’s National Cancer Screening Program (NCSP) using data from the eighth wave (2019–2021) of the Korea National Health and Nutrition Examination Survey (KNHANES VIII), and discuss potential problems and coping strategies. Variables were selected based on Andersen’s healthcare utilization model. “Participation in the NSCP” was considered the dependent variable, with independent variables including sociodemographic characteristics (sex, marital status, residence, education level, income level, economic activity, medical coverage type, and private insurance), health conditions (subjective health status, hypertension, and diabetes), and health behaviors (physical activity, monthly alcohol consumption, and current smoking status). The analysis revealed that higher participation rates correlated with being married, having an education level beyond elementary school, being employed, subscribing to private insurance, perceiving oneself as having average or poor health, engaging in physical activity, and not smoking. Sex, residence, income, medical coverage type, hypertension, diabetes, and monthly alcohol consumption were found to be insignificantly correlated. These findings underscore the importance of tailored promotion and health education for older individuals to boost NCSP participation rates, which could ultimately elevate public health standards. Full article
0 pages, 2674 KiB  
Systematic Review
Exercise Effects on Autonomic Nervous System Activity in Type 2 Diabetes Mellitus Patients over Time: A Meta-Regression Study
by Jui-Kun Chiang, Po-Chen Chiang, Hsueh-Hsin Kao, Weir-Chiang You and Yee-Hsin Kao
Healthcare 2024, 12(12), 1236; https://doi.org/10.3390/healthcare12121236 - 20 Jun 2024
Viewed by 593
Abstract
Background: Diabetic autonomic neuropathy is a common complication of type 2 diabetes mellitus (T2DM), especially in patients with long-term, poorly controlled diabetes. This study investigates the effects of exercise on autonomic nervous system activity in T2DM patients over time. Methods: A literature review [...] Read more.
Background: Diabetic autonomic neuropathy is a common complication of type 2 diabetes mellitus (T2DM), especially in patients with long-term, poorly controlled diabetes. This study investigates the effects of exercise on autonomic nervous system activity in T2DM patients over time. Methods: A literature review using MEDLINE, Embase, Cochrane Library, Scopus, and PubMed identified studies assessed via heart rate variability. Papers were categorized into three groups: immediate effects (within 60 min), short-term effects (2–3 months), and long-term effects (over 4 months). Results: Nine articles with 161 T2DM patients were included in the meta-analysis. RMSSD changes after exercise were −4.3 (p = 0.227), 8.14 (p < 0.001), and 4.17 (p = 0.002) for the immediate, short-term, and long-term groups, respectively. LF/HF ratio changes were 0.21 (p = 0.264), −3.04 (p = 0.102), and −0.05 (p = 0.006) for the respective groups. Meta-regression indicated age, male gender, and exercise duration were associated with increased RMSSD, with coefficients of 2.36 (p = 0.001), 13.76 (p = 0.008), and 1.50 (p = 0.007), respectively. Age positively correlated with the LF/HF ratio, with a coefficient of 0.049 (p = 0.048). Conclusions: Regular exercise (≥3 times per week) for over 2 months increases parasympathetic activity in T2DM patients, while sympathetic activity decreases significantly after 4 months. Further study is needed to validate these findings. Full article
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23 pages, 528 KiB  
Article
Quality of Life of Colorectal Cancer Survivors: Mapping the Key Indicators by Expert Consensus and Measures for Their Assessment
by Urška Smrke, Sara Abalde-Cela, Catherine Loly, Jean-Paul Calbimonte, Liliana R. Pires, Simon Lin, Alberto Sánchez, Sara Tement and Izidor Mlakar
Healthcare 2024, 12(12), 1235; https://doi.org/10.3390/healthcare12121235 - 20 Jun 2024
Viewed by 589
Abstract
Quality of life (QoL) assessments are integral to cancer care, yet their effectiveness in providing essential information for supporting survivors varies. This study aimed to elucidate key indicators of QoL among colorectal cancer survivors from the perspective of healthcare professionals, and to evaluate [...] Read more.
Quality of life (QoL) assessments are integral to cancer care, yet their effectiveness in providing essential information for supporting survivors varies. This study aimed to elucidate key indicators of QoL among colorectal cancer survivors from the perspective of healthcare professionals, and to evaluate existing QoL questionnaires in relation to these indicators. Two studies were conducted: a Delphi study to identify key QoL indicators and a scoping review of questionnaires suitable for colorectal cancer survivors. Fifty-four healthcare professionals participated in the Delphi study’s first round, with 25 in the second. The study identified two primary QoL domains (physical and psychological) and 17 subdomains deemed most critical. Additionally, a review of 12 questionnaires revealed two instruments assessing the most important general domains. The findings underscored a misalignment between existing assessment tools and healthcare professionals’ clinical priorities in working with colorectal cancer survivors. To enhance support for survivors’ QoL, efforts are needed to develop instruments that better align with the demands of routine QoL assessment in clinical practice. Full article
(This article belongs to the Section Health Assessments)
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28 pages, 3611 KiB  
Review
Which Multimodal Physiotherapy Treatment Is the Most Effective in People with Shoulder Pain? A Systematic Review and Meta-Analyses
by Maria Aguilar García, Ana González Muñoz, José Javier Pérez Montilla, Daniel Aguilar Nuñez, Dina Hamed Hamed, Leo Pruimboom and Santiago Navarro Ledesma
Healthcare 2024, 12(12), 1234; https://doi.org/10.3390/healthcare12121234 - 20 Jun 2024
Viewed by 865
Abstract
The study aimed to determine if combined physiotherapy treatments offer additional benefits over exercise-only programs for shoulder pain and to identify the most effective combined treatment. A systematic review, registered in PROSPERO (CRD42023417709), and meta-analyses were conducted. Quality analysis was performed using the [...] Read more.
The study aimed to determine if combined physiotherapy treatments offer additional benefits over exercise-only programs for shoulder pain and to identify the most effective combined treatment. A systematic review, registered in PROSPERO (CRD42023417709), and meta-analyses were conducted. Quality analysis was performed using the PEDro scale on randomized clinical trials published from 2018 to 2023. Twenty articles met the inclusion criteria. The most commonly used combination was exercise plus manual therapy, without being statistically superior to exercise alone. The meta-analysis indicated that combining exercise with low-level laser therapy (mean difference of −1.06, 95% CI: −1.51 to −0.60) and high-intensity laser therapy (mean difference of −0.53, 95% CI: −1.12 to 0.06) resulted in the greatest reduction in SPADI scores. Adding manual therapy provided limited additional benefit (mean difference of −0.24, 95% CI: −0.74 to 0.27). Progressive exercise with advice or telerehabilitation yielded modest improvements. The multimodal meta-analysis for DASH scores showed significant improvement (mean difference of −1.06, 95% CI: −1.51 to −0.60). In conclusion, therapeutic exercise is the cornerstone of shoulder pain treatment, with the addition of laser therapy showing substantial benefits. Manual therapy and educational interventions offer some benefits but are not consistently superior. More rigorous studies are needed. Full article
(This article belongs to the Section Pain Management)
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3 pages, 145 KiB  
Editorial
Advances and Challenges in the Labor Markets for Healthcare Professionals
by Wim Groot and Frits van Merode
Healthcare 2024, 12(12), 1233; https://doi.org/10.3390/healthcare12121233 - 20 Jun 2024
Viewed by 522
Abstract
A lack of nurses is a prevalent and persistent problem in many countries [...] Full article
13 pages, 605 KiB  
Article
Implementation of Nurse Prescriptions throughout the Public Health System in Catalonia (2021–2022)
by Rosa Bayot i Escardívol, Enric Mateo-Viladomat, Paola Galbany-Estragués, Mariona Vilar-Pont, Miquel Angel Calderó i Solé, Gerard Mora-López, Raquel Flores-Montoya, Montse Vicente-Belis, Núria Escoda-Geli, Andrea Molina-Nadal, Olga Canet-Vélez and Glòria Jodar-Solà
Healthcare 2024, 12(12), 1232; https://doi.org/10.3390/healthcare12121232 - 20 Jun 2024
Viewed by 634
Abstract
Background: Nurses in Catalonia have always prescribed health advice, health products, and medication in line with the professional competency of the discipline. Legislation about nurse prescriptions and the implementation of nurse prescribing varies widely among different countries. This article reports data regarding nurse [...] Read more.
Background: Nurses in Catalonia have always prescribed health advice, health products, and medication in line with the professional competency of the discipline. Legislation about nurse prescriptions and the implementation of nurse prescribing varies widely among different countries. This article reports data regarding nurse prescribing in Catalonia in 2021 and 2022. Methods: This retrospective longitudinal study analyzed data from all care-providing units in Catalonia’s integrated public health system. Results: The number of nurse prescriptions increased from 139,435 in 2021 to 573,822 in 2022, and the number of nurses issuing prescriptions increased from 3604 in 2021 to 5563 in 2022. The proportion of prescriptions for different products was similar in the two years analyzed. Prescriptions for medication increased by 7.5% in 2022. Conclusions: Nurse prescribing is a recent advance in Catalonia. Despite some difficulties in rollout, the data indicate that this practice is becoming consolidated, as in other European countries. Full article
(This article belongs to the Section Community Care)
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18 pages, 2164 KiB  
Systematic Review
Effects of Blood Flow Restriction Training in Patients before and after Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-Analysis
by Eduardo Fraca-Fernández, Luis Ceballos-Laita, Héctor Hernández-Lázaro, Sandra Jiménez-del-Barrio, María Teresa Mingo-Gómez, Ricardo Medrano-de-la-Fuente and Ignacio Hernando-Garijo
Healthcare 2024, 12(12), 1231; https://doi.org/10.3390/healthcare12121231 - 20 Jun 2024
Viewed by 699
Abstract
(1) Objective: To examine the effects of blood flow restriction (BFR) training on muscle strength, cross-sectional area and knee-related function in patients selected for anterior cruciate ligament reconstruction (ACLR). (2) Methods: A literature search was conducted in PubMed, PEDro, Cochrane Library, Web of [...] Read more.
(1) Objective: To examine the effects of blood flow restriction (BFR) training on muscle strength, cross-sectional area and knee-related function in patients selected for anterior cruciate ligament reconstruction (ACLR). (2) Methods: A literature search was conducted in PubMed, PEDro, Cochrane Library, Web of Science, SCOPUS, and ProQuest databases until 20 May 2024. Controlled clinical trials comparing the effects of BFR training with unrestricted training in patients before or after ACLR were selected. The GRADE approach was used to assess the degree of certainty for each meta-analysis. (3) Results: Ten studies were included (n = 287 participants). Standardized mean differences in favor of BFR training applied postoperatively were observed in knee extensor (SMD = 0.79; 95% CI = 0.06 to 1.52; I2: 68%) and flexor isokinetic strength (SMD = 0.53; 95% CI = 0.04 to 1.01; I2: 0%), and quadriceps cross-sectional area (SMD = 0.76; 95% CI = 0.27 to 1.26; I2: 0%). No changes were found in knee extensor isometric strength and knee-related function. The degree of certainty according to the GRADE was very low. (4) Conclusions: Very low degree of certainty suggests that BFR training provides additional benefits to unrestricted training on isokinetic strength and quadriceps cross-sectional area in patients undergoing ACLR. Full article
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13 pages, 277 KiB  
Article
Attitudes, Self-Confidence, and Knowledge of Primary Care Professionals towards School Bullying
by María del Carmen Celdrán-Navarro, Ismael Jiménez-Ruiz, César Leal-Costa, James R. Moore and Pedro José López-Barranco
Healthcare 2024, 12(12), 1230; https://doi.org/10.3390/healthcare12121230 - 20 Jun 2024
Viewed by 452
Abstract
Attitudes, practices, and knowledge about bullying were evaluated in a sample of 274 primary care professionals, including general practitioners, pediatricians, community, pediatric and school nurses, and residents of these specialties. This study was based on a mixed method with a parallel convergent design [...] Read more.
Attitudes, practices, and knowledge about bullying were evaluated in a sample of 274 primary care professionals, including general practitioners, pediatricians, community, pediatric and school nurses, and residents of these specialties. This study was based on a mixed method with a parallel convergent design without dominance between phases, data were collected concurrently, and conversion of the results from both phases was carried out during data interpretation. The quantitative phase had a cross-sectional observational design, using The Healthcare Provider’s Practices, Attitudes, Self-confidence, and Knowledge Regarding Bullying Questionnaire as an instrument. Descriptive and bivariate analyses were performed, which showed a positive correlation between higher self-confidence and knowledge scores and a greater predisposition to detect cases. However, although the dimensions of attitudes and knowledge yielded generally high data, low self-confidence was evident in addressing this problem. In addition, a lack of clear guidelines in the workplace was expressed, highlighting the need to create and provide specific resources to intervene in bullying in said context, which could develop an improvement in self-confidence, leading to greater well-being for the educational community regarding bullying. Full article
(This article belongs to the Section School Health)
11 pages, 270 KiB  
Article
The Need to Look at Transgender and Gender Diverse People’s Health: A Preliminary Descriptive Report on Pain, Sexual Distress, and Health Profile of Five Transmasculine People and One Non-Binary Person with Endometriosis
by Sérgio A. Carvalho, Teresa Lapa and Patrícia M. Pascoal
Healthcare 2024, 12(12), 1229; https://doi.org/10.3390/healthcare12121229 - 20 Jun 2024
Viewed by 471
Abstract
The sexual health of transgender and gender diverse (TGD) people with endometriosis has been overlooked, and important emotional experiences, such as sexual distress and its correlates, have been ignored. This has prevented a more comprehensive look at the health experiences of TGD individuals. [...] Read more.
The sexual health of transgender and gender diverse (TGD) people with endometriosis has been overlooked, and important emotional experiences, such as sexual distress and its correlates, have been ignored. This has prevented a more comprehensive look at the health experiences of TGD individuals. This descriptive online survey study preliminarily explored the experiences of pain symptoms, sexual distress, and mental health of N = 6 TGD individuals diagnosed with endometriosis. Descriptive results showed a mean delay of 10 years from the onset of symptoms to the diagnosis. Endometriosis-related pain was a common symptom, although with low to moderate intensity. Results also showed higher mean levels of pain impact, powerlessness and lack of control, somatization, depression, anxiety, and sexual distress, and lower mean levels of emotional well-being, social support, and worse self-image compared to reports on cisgender women with endometriosis in the literature. These results suggested that sexual and mental health in the context of TGD people with endometriosis has specificities and may be associated with factors that need to be accounted for to provide comprehensive and socially just healthcare, such as the recognition of the impact of endometriosis treatment on symptoms of gender dysphoria. To achieve sexual health equity for TGD people, continuous and updated professional training and inclusive research with multiple informants are necessary. Full article
(This article belongs to the Special Issue Psychology in Sex and Gender)
11 pages, 237 KiB  
Article
What Is a Disease for Doctors? A Realist Thematic Qualitative Analysis of the Interpretation of Clinical Vignettes
by Fabrizio Consorti, Rossella Melcarne, Domenico Pisanelli, Chiara Scorziello and Laura Giacomelli
Healthcare 2024, 12(12), 1228; https://doi.org/10.3390/healthcare12121228 - 20 Jun 2024
Viewed by 536
Abstract
Given the long-standing debate about the nature of the concept of disease, the objective of this study was to understand how doctors categorize a condition as a disease or not, and what the kind of information they use is. A survey with a [...] Read more.
Given the long-standing debate about the nature of the concept of disease, the objective of this study was to understand how doctors categorize a condition as a disease or not, and what the kind of information they use is. A survey with a set of eighteen clinical vignettes was designed, and nineteen physicians and senior students purposefully selected were asked to interpret those situations as diseases or not and to produce an anonymous short written piece of text providing the motivation of their choice. Realist thematic analysis was used to analyse the answers, and four themes emerged: the temporal dimension of a disease, reification of disease, disease as an existential condition, and disease as a motivation to action. The respondents’ interpretations were very heterogeneous, supporting the idea that physicians do not share a common prototypical concept of disease. The results suggested that the interpretation of a condition as a disease or not is the final outcome of a process, in which information from objective, subjective, and socially mediated elements is taken into consideration. According to a critical realist and systemic approach, we hypothesize that the context of doctor–patient relationship could influence the interpretation of the same condition as being a disease or not. Full article
13 pages, 1836 KiB  
Article
Toloese Generates Nitric Oxide through Natural Radiation of Far Infrared Rays, Reducing Serum Glucose, Cholesterol, and Triglycerides
by Min-Ho Yeo, Young-Hyeon Lee, Mi-Jin Ryu, Yong-Hak Choi, Hye-Sook Kim and Kyung-Soo Chang
Healthcare 2024, 12(12), 1227; https://doi.org/10.3390/healthcare12121227 - 20 Jun 2024
Viewed by 461
Abstract
Toloese, a bed composition, is formulated with a combination of minerals of various wavelengths by utilizing a specific ratio and particle size. A maturation mixing technique is used without additional compression processes, resulting in the natural formation of numerous fine pores in the [...] Read more.
Toloese, a bed composition, is formulated with a combination of minerals of various wavelengths by utilizing a specific ratio and particle size. A maturation mixing technique is used without additional compression processes, resulting in the natural formation of numerous fine pores in the bed structure. At 40 °C, far infrared radiation in the range of 5–20 μm is emitted with a 0.916 radiant ratio, and the measured emitted radiant energy is 3.69 × 102 W/m2·μm. This study aimed to investigate the influence of far infrared radiation emitted from a Toloese bed on endogenous nitric oxide production. Clinical trials were conducted with 20 healthy adults aged 20 years. Blood samples were collected before and after Toloese bed usage for 1 h daily for 3 weeks. Nitric oxide levels in the saliva and blood of men and women significant increased after they used the Toloese bed for 1 h. Additionally, sweating sharply increased in the upper and lower body regions after Toloese bed usage. No hematological changes or adverse effects were observed, but blood glucose, cholesterol, and triglycerides decreased after Toloese bed usage compared with those before Toloese bed usage. These findings demonstrated that far infrared radiation emitted by the Toloese bed induced endogenous nitric oxide production and contributed to significant reductions in blood glucose, cholesterol, and triglyceride levels. Full article
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9 pages, 721 KiB  
Article
Factors Associated with the Health-Related Self-Care Capacity of Overweight and Obese People
by Liz K. Tenorio-Guerrero, Romara Puente-Alejos, Janett V. Chavez Sosa, Edda E. Newball-Noriega and Salomon Huancahuire-Vega
Healthcare 2024, 12(12), 1226; https://doi.org/10.3390/healthcare12121226 - 20 Jun 2024
Viewed by 489
Abstract
This study aimed to investigate the relationship between beliefs about obese people and health-related self-care among overweight and obese people, considering sociodemographic aspects. This study adopted a cross-sectional design. The sample consisted of 207 participants selected through a simple random sampling method. The [...] Read more.
This study aimed to investigate the relationship between beliefs about obese people and health-related self-care among overweight and obese people, considering sociodemographic aspects. This study adopted a cross-sectional design. The sample consisted of 207 participants selected through a simple random sampling method. The “Beliefs About Obese Persons Scale” (BAOP) and the “Self-Care Agency Rating Scale-Revised” (ASA-R) questionnaires were applied to data collection. The results showed that 82.6% believed that obesity is a condition the individual cannot control, and 74.4% expressed inadequate self-care regarding their health. A multivariate analysis found that belonging to the adult age group increases the probability of presenting adequate health-related self-care by 4.7 times (95% CI = 1.892–11.790) compared to older adults. The belief that obesity is an uncontrollable condition increases the probability of inadequate self-care by 6.3 times (95% CI = 2.360–16.924), in contrast to the perception that it is a controllable condition. Moreover, overweight people are 0.139 times (95% CI = 0.044–0.443) less likely to have adequate self-care compared to people with obesity. In conclusion, being an adult and having the belief that obesity is a condition that can be controlled is associated with adequate health-related self-care, while being overweight is associated with inadequate health care. Full article
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14 pages, 1930 KiB  
Systematic Review
Routine Physical Therapy with and without Neural Mobilization in Chronic Musculoskeletal Neck Disorders with Nerve-Related Symptoms: Systematic Review and Meta-Analysis
by María José López-Pardo, Andrés Calvache-Mateo, Javier Martín-Núñez, Alejandro Heredia-Ciuró, Laura López-López, Marie Carmen Valenza and Irene Cabrera-Martos
Healthcare 2024, 12(12), 1225; https://doi.org/10.3390/healthcare12121225 - 19 Jun 2024
Viewed by 598
Abstract
No previous study has evaluated the effectiveness of routine physical therapy with and without neural mobilization for patients with chronic musculoskeletal neck disorders and cervical radiculopathy. The objective is to evaluate the effectiveness of routine physical therapy with and without neural mobilization on [...] Read more.
No previous study has evaluated the effectiveness of routine physical therapy with and without neural mobilization for patients with chronic musculoskeletal neck disorders and cervical radiculopathy. The objective is to evaluate the effectiveness of routine physical therapy with and without neural mobilization on pain and mobility in patients with chronic musculoskeletal neck disorders and cervical radiculopathy. A systematic review with meta-analysis of randomized clinical trials involving the use of neural mobilization techniques for the treatment of chronic musculoskeletal neck disorders and cervical radiculopathy was conducted. Methodological quality was assessed by the Cochrane Risk of Bias Tool and PEDro scale. Data were pooled and a meta-analysis was performed using a random effects model with Review Manager 5 software. Seven articles were included in our review. Significant differences were found in mobility but not in pain in favor of using routine physical therapy with neural mobilization for the treatment of chronic musculoskeletal neck disorders and cervical radiculopathy. Our results show that routine physical therapy accompanied by neural mobilization is superior for improving mobility in comparison with routine physical therapy alone in patients with musculoskeletal neck disorders and cervical radiculopathy. Full article
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14 pages, 285 KiB  
Article
Evaluation of the Level of Psychological Distress in Construction Workers during the COVID-19 Pandemic in Southern Spain
by Carlos Gómez-Salgado, Juan Carlos Camacho-Vega, Regina Allande-Cussó, Carlos Ruiz-Frutos, Mónica Ortega-Moreno, Jorge Martín-Pereira, Israel Macías-Toronjo, Blanca Prieto-Callejero, Juan Jesús García-Iglesias, Javier Fagundo-Rivera and Juan Gómez-Salgado
Healthcare 2024, 12(12), 1224; https://doi.org/10.3390/healthcare12121224 - 19 Jun 2024
Viewed by 646
Abstract
The COVID-19 pandemic posed a major challenge for construction companies, which were confronted with the need to prevent the enormous negative socio-psychological impact of the pandemic on their employees. The aim of this study was to evaluate the level of psychological distress among [...] Read more.
The COVID-19 pandemic posed a major challenge for construction companies, which were confronted with the need to prevent the enormous negative socio-psychological impact of the pandemic on their employees. The aim of this study was to evaluate the level of psychological distress among construction workers in an advanced phase of the COVID-19 pandemic in Andalusia, southern Spain. For this, a cross-sectional descriptive study was conducted using online questionnaires with data on sociodemographic variables and employment situation, COVID-19 pandemic-related data, and Goldberg’s General Health Questionnaire (GHQ-12). A total of 860 questionnaires from all provinces of Andalusia, Spain, were collected between March and May 2022. Descriptive statistical analyses and non-parametric Mann–Whitney U and Chi-squared tests were performed, followed by logistic regression analysis. The incidence of psychological distress was higher among women, individuals under 43 years of age, those with a family income below EUR 1200, participants whose working conditions had been affected by the pandemic, those who had not received adequate means or specific training to protect themselves from infection, those who had experienced symptoms, those who had suffered side effects after vaccination, and those who had been hospitalised. The logistic regression analysis predicted the occurrence of psychological distress in this study by the effect of the pandemic on mental/emotional well-being, the working conditions affected during the pandemic, health-related variables, and the age of the worker. The correctly classified percentage was 75.1%. Assessing psychological distress in construction sectors may allow for the identification of vulnerable groups or even help to reduce the number of errors in daily practice and potential risks of occupational injury or illness. Full article
(This article belongs to the Special Issue Job Satisfaction and Mental Health of Workers)
15 pages, 2495 KiB  
Article
Comparison of the Short-Term Effect between Iontophoresis and Radial Extracorporeal Shockwave Therapy in the Treatment of Plantar Fasciitis: A Randomized Controlled Trial
by Manuel Pabón-Carrasco, Manuel Coheña-Jiménez, Ana Juana Pérez-Belloso, José Algaba-del-Castillo, Rocío Cáceres-Matos and Aurora Castro-Méndez
Healthcare 2024, 12(12), 1223; https://doi.org/10.3390/healthcare12121223 - 19 Jun 2024
Viewed by 430
Abstract
Conservative treatments for plantar fasciitis have different levels of effectiveness, so it is necessary to personalize the therapeutic modality that improves the patients’ symptoms. Methods: A double-blinded randomized clinical trial was designed to evaluate the short-term efficacy of a physical treatment in chronic [...] Read more.
Conservative treatments for plantar fasciitis have different levels of effectiveness, so it is necessary to personalize the therapeutic modality that improves the patients’ symptoms. Methods: A double-blinded randomized clinical trial was designed to evaluate the short-term efficacy of a physical treatment in chronic plantar fasciitis, namely iontophoresis, compared with radial shockwave therapy. Heel pain, health status using the EuroQol-5D questionnaire, and fascia thickness measured with ultrasound were evaluated. In total, 127 patients were randomly selected for group A and treated with iontophoresis therapy (lidocaine 0.4% and dexamethasone 0.5%), or for group B, in which they were treated with radial shockwave therapy (EWST). Measurements were taken at baseline and at follow-up during the 5 weeks of the study. Results: Statistically significant differences were observed to the shockwave therapy group in respect to the final fascia thickness, and the VAS scale (p = 0.001). The differences between groups A and B showed that the shockwave group follow-up after 3 weeks experienced complete pain remission (1.0 ± 0.9; 95%CI 0.8–1.2) and after the 6-week follow-up, complete pain remission of plantar fasciitis was observed for both therapies. Patients had a better perception of the use of EWST at the end of the treatment, although in both groups it was satisfactory (p = 0.001). Conclusions: The results of this study showed a shorter-term effectiveness of shockwave treatment compared with the use of iontophoresis. However, both techniques were effective in satisfactorily reducing pain in this short period. Full article
(This article belongs to the Special Issue Management and Nursing Strategy for Patients with Pain)
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12 pages, 1265 KiB  
Article
Examining Age-Adjusted Associations between BMI and Comorbidities in Mongolia: Cross-Sectional Prevalence
by Khangai Enkhtugs, Oyuntugs Byambasukh, Damdindorj Boldbaatar, Tumur-Ochir Tsedev-Ochir, Oyunsuren Enebish, Enkhbold Sereejav, Bayarbold Dangaa, Batzorig Bayartsogt, Enkhtur Yadamsuren and Khurelbaatar Nyamdavaa
Healthcare 2024, 12(12), 1222; https://doi.org/10.3390/healthcare12121222 - 19 Jun 2024
Viewed by 484
Abstract
(1) Background: This study investigated the association between body mass index (BMI) categories and comorbidities in the context of a developing country, utilizing data from a nationwide health screening in Mongolia. (2) Methods: The study included 181,080 individuals (mean age 47.0 ± 15.3, [...] Read more.
(1) Background: This study investigated the association between body mass index (BMI) categories and comorbidities in the context of a developing country, utilizing data from a nationwide health screening in Mongolia. (2) Methods: The study included 181,080 individuals (mean age 47.0 ± 15.3, 42.0% male) from the population-based general health screening. We counted the number of diseases from participants’ medical records based on ICD-10 codes, excluding those categorized under Z00-Z99 and codes indicating acute disorders, as well as individuals classified as underweight. (3) Results: Among study participants, the prevalence of two or more comorbidities was 4.2%. The weight distribution comprised 40.4% normal weight; 37.1% overweight; and 16.9%, 4.4%, and 1.2% in the Class I, II, and III obesity categories, respectively. Comorbidities increased with BMI: normal weight (0.222); overweight (0.255); and Class I (0.290), Class II (0.302), and Class III obesity (0.303), suggesting a dose-dependent likelihood of having multiple diseases. Adjusted linear regression (beta coefficients, 95% CIs) showed increased comorbidity risks in overweight (0.017, 0.013–0.021) and obesity (0.034, 0.030–0.039). Interaction analysis with age revealed a significant effect (p < 0.001). While comorbidities tend to increase with higher BMI categories in all age-tertile groups, this association was notably stronger among younger individuals. (4) Conclusions: Obesity is associated with a twofold increase in the prevalence of multiple comorbidities compared to normal weight. Our findings also highlight the critical role of age in the development of multiple diseases, with BMI remaining a significant factor across various age groups, encompassing both younger and older adults. Full article
(This article belongs to the Special Issue Advances and Challenges on Obesity and Its Related Metabolic Disease)
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13 pages, 306 KiB  
Article
Cross-Cultural Adaptation and Validation of an Attitude about Euthanasia Scale in Portuguese Older Adults with Mixed Anxiety–Depressive Disorder
by Luís Fonseca, Luísa Castro, Andreia Gonçalves, Francesco Monteleone, Guilhermina Rêgo and Rui Nunes
Healthcare 2024, 12(12), 1221; https://doi.org/10.3390/healthcare12121221 - 19 Jun 2024
Viewed by 455
Abstract
On 25 May 2023, the Portuguese parliament approved the decriminalisation of euthanasia for incurable illnesses. As the experiences of other countries show us, it will be a matter of time before mental disorders are addressed. Studying the phenomenon, particularly in vulnerable groups, in [...] Read more.
On 25 May 2023, the Portuguese parliament approved the decriminalisation of euthanasia for incurable illnesses. As the experiences of other countries show us, it will be a matter of time before mental disorders are addressed. Studying the phenomenon, particularly in vulnerable groups, in advance is essential for proper law drafting. Therefore, instruments that allow an objective assessment and comparison between groups must be available. This study aims to explore the validation of Faria’s attitude about euthanasia scale in Portuguese older adults with mixed anxiety–depressive disorder. A sample of 114 older adults with mixed anxiety–depressive disorder collected by convenience in the Psychiatry Department of Senhora da Oliveira Hospital in Portugal was included. The pre-final version of the scale was tested in a small group with good results. The validity of the internal structure was analysed using exploratory factorial analysis. The internal consistency study verified reliability. For construct validity, we assessed the correlation with other validated scales measuring attitudes toward euthanasia, cognitive performance, personality and empathy. The attitude about euthanasia scale showed good internal consistency. One factor was retained in the principal component analysis. Significant correlations verified construct validity. The results support the scale’s usefulness and validity. This study makes available a unique instrument to assess the overall tendency of the attitudes towards euthanasia from the European-Portuguese perspective, which can be used, for example, to compare Portuguese with Brazilian older adults suffering from the same disorder. Furthermore, the adapted scale paves the way for other cross-cultural translations, adaptations, validations, and comparative analyses. Full article
16 pages, 2837 KiB  
Article
Comparing Cancer Risks and Mortality between Phytopharmaceuticals and Estrogen-Progestogen Medications for Menopausal Women: A Population-Based Cohort Study
by Tsai-Bei Lin, Chia-Chi Hsieh, Chun-Hsiang Wang, Chiung-Hung Chang, Yu-Ling Hsueh, Yuan-Tsung Tseng and Men-Fong Hsieh
Healthcare 2024, 12(12), 1220; https://doi.org/10.3390/healthcare12121220 - 19 Jun 2024
Viewed by 541
Abstract
We evaluated the long-term risks of overall cancer and all-cause mortality associated with five types of phytopharmaceuticals and the most commonly used estrogen-progestogen medications for the treatment of postmenopausal syndrome in women. Using data from Taiwan’s National Health Insurance Research Database (NHIRD) from [...] Read more.
We evaluated the long-term risks of overall cancer and all-cause mortality associated with five types of phytopharmaceuticals and the most commonly used estrogen-progestogen medications for the treatment of postmenopausal syndrome in women. Using data from Taiwan’s National Health Insurance Research Database (NHIRD) from 1 January 2000 to 31 December 2018, we conducted a 1:2 matched cohort study with 12,087 eligible patients. We compared phytopharmaceuticals -only users (n = 4029, phytopharmaceuticals group) with HRT-only users (n = 8058, HRT group) with a washout period of ≥6 months. The phytopharmaceuticals group had significantly lower risks of overall cancer and all-cause mortality than the HRT group (adjusted hazard ratio [95% confidence interval]: 0.60 [0.40–0.9] and 0.40 [0.16–0.99], respectively) after over 180 days of use. Bupleurum and Peony Formula were associated with lower risks of overall cancer and all-cause mortality (aHR: 0.57 [0.36–0.92] and 0.33 [0.11–1.05], respectively). In conclusion, phytopharmaceuticals may serve as an alternative therapy to HRT for alleviating menopausal symptoms and reducing health risks, leading to more favorable long-term health outcomes. Further randomized control trials are necessary to validate the findings of this study. Full article
(This article belongs to the Special Issue Diagnosis and Treatment for Women's Health: Second Edition)
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9 pages, 747 KiB  
Brief Report
Teaching and Learning Clinical Reasoning in Nursing Education: A Student Training Course
by Paula Leal, Ana Poeira, Diana Arvelos Mendes, Nara Batalha, Hugo Franco, Lucília Nunes, Fernanda Marques, Ljubiša Pađen, Małgorzata Stefaniak, Ana Pérez-Perdomo, Lore Bangels, Kathleen Lemmens and Guida Amaral
Healthcare 2024, 12(12), 1219; https://doi.org/10.3390/healthcare12121219 - 19 Jun 2024
Viewed by 762
Abstract
Clinical reasoning is an essential component of nursing. It has emerged as a concept that integrates the core competencies of quality and safety education for nurses. In cooperation with five European partners, Instituto Politécnico de Setúbal (IPS) realized the “Clinical Reasoning in Nursing [...] Read more.
Clinical reasoning is an essential component of nursing. It has emerged as a concept that integrates the core competencies of quality and safety education for nurses. In cooperation with five European partners, Instituto Politécnico de Setúbal (IPS) realized the “Clinical Reasoning in Nursing and Midwifery Education and Practice” project as part of the Erasmus+ project. As a partner, our team designed a multiplier event—the student training course. The aim of this report is to describe the construction and development of this clinical reasoning training course for nursing students. We outline the pedagogical approach of an undergraduate training course on clinical reasoning in 2023, which we separated into four stages: (i) welcoming, (ii) knowledge exploration, (iii) pedagogical learning, and (iv) sharing experience. This paper presents the learning outcomes of the collaborative reflection on and integration of the clinical reasoning concept among nursing students. This educational experience fostered reflection and discussion within the teaching team of the nursing department regarding the concept, models, and teaching/learning methods for clinical reasoning, with the explicit inclusion of clinical reasoning content in the nursing curriculum. We highlight the importance of implementing long-term pedagogical strategies in nursing education. Full article
(This article belongs to the Section School Health)
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10 pages, 831 KiB  
Article
Influence of Intraoperative Fluid Management on Postoperative Outcome and Mortality of Cytoreductive Surgery for Advanced Ovarian Cancer—A Retrospective Observational Study
by Claudia Neumann, Eva Kranenberg, Alina Schenk, Nicholas Kiefer, Tobias Hilbert, Sven Klaschik, Mignon Denise Keyver-Paik and Martin Soehle
Healthcare 2024, 12(12), 1218; https://doi.org/10.3390/healthcare12121218 - 19 Jun 2024
Viewed by 701
Abstract
Background: The surgical treatment of advanced ovarian cancer is associated with extensive tissue trauma, prolonged operating times and a considerable volume shift. It, therefore, represents a challenge for anaesthesiological management. Aim: The aim of this single-centre, retrospective, observational study was to investigate whether [...] Read more.
Background: The surgical treatment of advanced ovarian cancer is associated with extensive tissue trauma, prolonged operating times and a considerable volume shift. It, therefore, represents a challenge for anaesthesiological management. Aim: The aim of this single-centre, retrospective, observational study was to investigate whether intraoperative extensive volume supply influences postoperative outcomes and long-term survival. Methods: The study included 73 patients with a mean (SD) age of 63 (13) years who underwent extensive tumour-reducing surgery for ovarian cancer between 2012 and 2015. The effect of the intraoperative fluid balance on postoperative complications, such as anastomotic insufficiency or pleural effusions, was investigated using logistic regression. Further, the influence of fluid balance, lactate and creatinine levels on 5-year survival was analysed in a Cox regression model. Associations between anaesthesia time and the intraoperative fluid balance were examined using Spearman’s rank correlation coefficients. Results: The mean (SD) postoperative fluid balance in the considered patient cohort was 9.1 (3.4) litres (l) at a mean (SD) anaesthesia time of 529 (106) minutes. Cox regression did not reveal a statistically significant effect of the fluid balance, but it did reveal a statistically significant association between the lactate level 24 h following surgery and the 5-year survival (HR [95%-CI] fluid balance: 0.97 [0.85, 1.11]; HR [95%-CI] lactate: 1.79 [1.24, 2.58]). According to logistic regression, the intraoperative fluid balance was associated with an increased chance of postoperative complications in the considered patient cohort (OR [95%-CI] 1.28 [1.1, 1.54]). Conclusions: We could not detect a negative impact of an increased fluid balance on 5-year survival, but a negative impact on postoperative complications was found in our patient cohort. Full article
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37 pages, 2843 KiB  
Systematic Review
Delivery of Allied Health Interventions Using Telehealth Modalities: A Rapid Systematic Review of Randomized Controlled Trials
by Melissa J. Raymond, Lauren J. Christie, Sharon Kramer, Carla Malaguti, Zaneta Mok, Betina Gardner, Melita J. Giummarra, Serena Alves-Stein, Claire Hudson, Jill Featherston, Anne E. Holland and Natasha A. Lannin
Healthcare 2024, 12(12), 1217; https://doi.org/10.3390/healthcare12121217 - 18 Jun 2024
Viewed by 827
Abstract
Objectives: To determine whether allied health interventions delivered using telehealth provide similar or better outcomes for patients compared with traditional face-to-face delivery modes. Study design: A rapid systematic review using the Cochrane methodology to extract eligible randomized trials. Eligible trials: Trials were eligible [...] Read more.
Objectives: To determine whether allied health interventions delivered using telehealth provide similar or better outcomes for patients compared with traditional face-to-face delivery modes. Study design: A rapid systematic review using the Cochrane methodology to extract eligible randomized trials. Eligible trials: Trials were eligible for inclusion if they compared a comparable dose of face-to-face to telehealth interventions delivered by a neuropsychologist, occupational therapist, physiotherapist, podiatrist, psychologist, and/or speech pathologist; reported patient-level outcomes; and included adult participants. Data sources: MEDLINE, CENTRAL, CINAHL, and EMBASE databases were first searched from inception for systematic reviews and eligible trials were extracted from these systematic reviews. These databases were then searched for randomized clinical trials published after the date of the most recent systematic review search in each discipline (2017). The reference lists of included trials were also hand-searched to identify potentially missed trials. The risk of bias was assessed using the Cochrane Risk of Bias Tool Version 1. Data Synthesis: Fifty-two trials (62 reports, n = 4470) met the inclusion criteria. Populations included adults with musculoskeletal conditions, stroke, post-traumatic stress disorder, depression, and/or pain. Synchronous and asynchronous telehealth approaches were used with varied modalities that included telephone, videoconferencing, apps, web portals, and remote monitoring, Overall, telehealth delivered similar improvements to face-to-face interventions for knee range, Health-Related Quality of Life, pain, language function, depression, anxiety, and Post-Traumatic Stress Disorder. This meta-analysis was limited for some outcomes and disciplines such as occupational therapy and speech pathology. Telehealth was safe and similar levels of satisfaction and adherence were found across modes of delivery and disciplines compared to face-to-face interventions. Conclusions: Many allied health interventions are equally as effective as face-to-face when delivered via telehealth. Incorporating telehealth into models of care may afford greater access to allied health professionals, however further comparative research is still required. In particular, significant gaps exist in our understanding of the efficacy of telehealth from podiatrists, occupational therapists, speech pathologists, and neuropsychologists. Protocol Registration Number: PROSPERO (CRD42020203128). Full article
(This article belongs to the Special Issue Advances in Telerehabilitation for Optimising Recovery)
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17 pages, 559 KiB  
Systematic Review
Post-Donation Evaluation: Emotional Needs for Social Connection and Social Support among Living Kidney Donors—A Systematic Review
by Valentina Colonnello, Gaetano La Manna, Gabriella Cangini and Paolo Maria Russo
Healthcare 2024, 12(12), 1216; https://doi.org/10.3390/healthcare12121216 - 18 Jun 2024
Viewed by 454
Abstract
Introduction: Evaluation of post-nephrectomy social health in living kidney donors is essential. This systematic review examines their emotional need for social relatedness post-donation. Methods: Following the PRISMA guidelines, we systematically searched Scopus, CINAHL, and PsycINFO. Results: Among the screened records, 32 quantitative and [...] Read more.
Introduction: Evaluation of post-nephrectomy social health in living kidney donors is essential. This systematic review examines their emotional need for social relatedness post-donation. Methods: Following the PRISMA guidelines, we systematically searched Scopus, CINAHL, and PsycINFO. Results: Among the screened records, 32 quantitative and 16 qualitative papers met the inclusion criteria. Quantitative research predominantly utilized questionnaires featuring generic items on social functioning. However, a minority delved into emotional and social dimensions, aligning with qualitative studies emphasizing the importance of social connection and perceived social support post-donation. Specifically, post-donation changes in connecting with others encompass a sense of belongingness, heightened autonomy, shifts in concern for the recipient’s health, and continued care by shielding the recipient from personal health issues. Social acknowledgment and social support from both close and extended networks are reported as relevant for recovery after nephrectomy. Discussion: These findings underscore the necessity for targeted measures of emotional needs and social functioning to effectively assess post-donation adjustment. They also inform the identification of key health themes for kidney donor Patient-Reported Outcome Measures (PROMs) and Patient-Reported Experience Measures (PREMs) questions. Full article
(This article belongs to the Special Issue Emotions in Healthcare: Current and Emerging Directions)
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13 pages, 1333 KiB  
Article
Associated Factors of Dietary Patterns among Adolescents in the Rural Northern Region of Thailand: A Community-Based Cross-Sectional Study
by Penprapa Siviroj, Jukkrit Wungrath and Krongporn Ongprasert
Healthcare 2024, 12(12), 1215; https://doi.org/10.3390/healthcare12121215 - 18 Jun 2024
Viewed by 358
Abstract
This cross-sectional study aims to explore the dietary patterns and associated factors of adolescents, which are often overlooked in nutrition data systems. Face-to-face interviews were conducted with 304 participants aged 10 to 19 in rural northern Thailand, utilizing both open recall and list-based [...] Read more.
This cross-sectional study aims to explore the dietary patterns and associated factors of adolescents, which are often overlooked in nutrition data systems. Face-to-face interviews were conducted with 304 participants aged 10 to 19 in rural northern Thailand, utilizing both open recall and list-based 24 h recall techniques, with the data recorded online. Dietary diversity (DD) was assessed using ten food groups as per the Food and Agricultural Organization guidelines. We employed binary logistic regression and multivariable logistic regression analyses. Most participants consumed items from the grains, white roots, and tubers food group, while the nuts, seeds, and pulses food group was the least consumed. The mean number of food groups consumed was 5.23 ± 0.12, with no significant differences across gender and age groups, and participants reporting no influence of mass media on food choices were more likely to have inadequate DD (AOR = 2.94; 95% CI 1.38–6.28). Conversely, those not influenced by social media when choosing food (AOR = 0.45; 95% CI 0.21–0.96), who felt relaxed during meals (AOR = 0.33; 95% CI 0.19–0.59), and with no role in family meal decisions (AOR = 0.55; 95% CI 0.31–0.95) were less likely to have inadequate dietary diversity. We suggest that assisting adolescents with mealtime management and involving them in selecting healthy menus could improve their dietary variety. Moreover, future research should further investigate these mechanisms to inform strategies for improving DD in this age group. Full article
(This article belongs to the Special Issue Nutrition and Lifestyle Interventions for Improved Child Health)
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9 pages, 562 KiB  
Article
Coding Diagnoses from the Electronic Death Certificate with the 11th Revision of the International Statistical Classification of Diseases and Related Health Problems: An Exploratory Study from Germany
by Jürgen Stausberg and Ulrich Vogel
Healthcare 2024, 12(12), 1214; https://doi.org/10.3390/healthcare12121214 - 18 Jun 2024
Viewed by 343
Abstract
The 11th Revision of the International Statistical Classification of Diseases, Injuries, and Causes of Death (ICD-11) will replace its predecessor as international standard for cause-of death-statistics. The digitization of healthcare is a main motivation for its introduction. In parallel, the replacement of the [...] Read more.
The 11th Revision of the International Statistical Classification of Diseases, Injuries, and Causes of Death (ICD-11) will replace its predecessor as international standard for cause-of death-statistics. The digitization of healthcare is a main motivation for its introduction. In parallel, the replacement of the paper-based death certificate with an electronic format is under evaluation. At the moment, the death certificate is used in paper-based format with ICD-10 for coding in Germany. To be prepared for the switch to ICD-11, the compatibility between ICD-11 and the electronic certificate should be assured. Objectives were to check the appropriateness of diagnosis-related information found on death certificates for an ICD-11 coding and to describe enhancements to the certificate’s structure needed to fully utilize the strengths of ICD-11. As part of an exploratory test of a respective application, information from 453 electronic death certificates were provided by one local health authority. From a sample of 200 certificates, 433 diagnosis texts were coded into the German version of ICD-11. The appropriateness of the results as well as the further requirements of ICD-11, particularly with regard to post-coordination, were checked. For 430 diagnosis texts, 649 ICD-11 codes were used. Three hundred and sixty two diagnosis texts were rated as appropriately represented through the coding result. Almost all certificates contained diagnosis texts that lacked details required by ICD-11 for a precise coding. The distribution of diseases was very similar between ICD-10 and ICD-11 coding. A few gaps in ICD-11 were identified. Information requested by ICD-11 for a mandatory post-coordination were almost entirely absent from the death certificates. The structure and content of the death certificate are currently not well prepared for an ICD-11 coding. Necessary information was frequently missing. The line-oriented structure of death certificates has to be supplemented with a more flexible approach. Then, the semantic knowledge base of ICD-11 should better guide the content related input fields of a future electronic death certificate. Full article
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12 pages, 585 KiB  
Article
Exploring the Influence of Family Attitudes and Individual Psychological Factors on Antibiotic Utilization: A Pilot Study
by Paola Castellano, Paolo Maria Russo and Michela Mazzetti
Healthcare 2024, 12(12), 1213; https://doi.org/10.3390/healthcare12121213 - 18 Jun 2024
Viewed by 556
Abstract
The inappropriate use of antibiotics gives rise to detrimental consequences, both physical and emotional, with a decreased quality of life and higher levels of anxiety and depression. The current observational study aimed to investigate the association between awareness, beliefs, and behaviors toward antibiotics, [...] Read more.
The inappropriate use of antibiotics gives rise to detrimental consequences, both physical and emotional, with a decreased quality of life and higher levels of anxiety and depression. The current observational study aimed to investigate the association between awareness, beliefs, and behaviors toward antibiotics, highlighting the modulating role of individual and psychological factors in response to illness and medication. Through an online questionnaire, several psychological indexes, as well as knowledge of, attitude toward, and experiences with antibiotics, both individual and family-related, were assessed in a sample of 100 responders (74 females, mean age 33.37 ± 11.36). A positive association between intake behavior, awareness, and individual attitude emerged. Familial approach to antibiotics appears as a predictor of individual attitude and behavior toward these drugs, and awareness about antibiotic risks mediate the relationship between the tendency to be more compliant with prescriptions (R2 = 0.300; MSE = 1.541; F(2, 98) = 20.737; p < 0.0001). Moreover, individuals with a personality characterized by higher conscientiousness are more aware of antibiotic risks (p < 0.01), whereas individuals with a lower awareness are those with higher indexes of psychophysical discomfort (i.e., anxiety, perceived stress, somatization) and levels of emotional rebound (p < 0.05). Anxiety (F(3, 96) = 3.874; p = 0.012; R2 = 0.108) and somatization (F(2, 97) = 3.114; p = 0.030; R2 = 0.089) also significatively moderated the intake behavior, despite the family approach. Overall, the current study provides preliminary findings regarding the way in which family experiences and individual psychological aspects may be influencing factors in the behavior and attitude towards antibiotics and can be used to plan patient-centered therapeutic communication and education. Full article
(This article belongs to the Special Issue Emotions in Healthcare: Current and Emerging Directions)
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16 pages, 226 KiB  
Article
Promoting Inclusive Learning Environments: Leveraging University Websites for Digital Empowerment in the Post-COVID-19 Era
by Walaa Sayed Mohammad and Ali Fahad Aldakhil
Healthcare 2024, 12(12), 1212; https://doi.org/10.3390/healthcare12121212 - 18 Jun 2024
Cited by 1 | Viewed by 479
Abstract
In an era of global interdependence, universities play a crucial role in promoting social responsibility and sustainable development. The United Nations Convention on the Rights of Persons with Disabilities emphasizes the empowerment of individuals with disabilities, a key aspect of inclusion. The COVID-19 [...] Read more.
In an era of global interdependence, universities play a crucial role in promoting social responsibility and sustainable development. The United Nations Convention on the Rights of Persons with Disabilities emphasizes the empowerment of individuals with disabilities, a key aspect of inclusion. The COVID-19 pandemic underscored the necessity of digital platforms to ensure equitable opportunities, particularly for those with disabilities. It highlighted challenges in transitioning to remote operations and stressed the importance of accessible digital tools in maintaining inclusivity during disruptions. This study investigates how university websites promote social responsibility and empower individuals with disabilities in Saudi Arabia, the UK, and the US. It also examines how these websites foster inclusivity, advocate for disability rights, and contribute to societal change. Using a qualitative case study design, the study evaluated university websites focusing on accessibility services, inclusive policies, and academic accommodations. Qualitative content and thematic analyses identified recurring themes and variations. The findings reveal diverse strategies in empowerment initiatives, website maintenance practices, community engagement approaches, the accessibility of support services, and the presentation of success stories. Despite differences among websites, this study underscores their significance in empowering individuals with disabilities. Recommendations aim to guide universities worldwide in enhancing their digital platforms, ensuring inclusivity, especially during challenges like the COVID-19 pandemic. Full article
13 pages, 481 KiB  
Review
Motivational Interviewing as a Strategy to Improve Adherence in IBD Treatment: An Integrative Review Amidst COVID-19 Disruptions
by Caterina Mercuri, Maria Catone, Vincenzo Bosco, Assunta Guillari, Teresa Rea, Patrizia Doldo and Silvio Simeone
Healthcare 2024, 12(12), 1210; https://doi.org/10.3390/healthcare12121210 - 18 Jun 2024
Viewed by 715
Abstract
Aims and Objectives: This review aims to analyze the effectiveness of motivational interviewing (MI) in enhancing therapeutic adherence and compliance in adult patients with inflammatory bowel disease (IBD), especially considering the disruptions caused by the COVID-19 pandemic. Background: IBD, which includes conditions such [...] Read more.
Aims and Objectives: This review aims to analyze the effectiveness of motivational interviewing (MI) in enhancing therapeutic adherence and compliance in adult patients with inflammatory bowel disease (IBD), especially considering the disruptions caused by the COVID-19 pandemic. Background: IBD, which includes conditions such as ulcerative colitis and Crohn’s disease, affects over 10 million people globally. It significantly impacts both physical and psychological well-being, leading to challenges in therapeutic adherence. Only 25–47% of patients with IBD adequately follow prescribed treatments. Design and Methods: An integrative methodology that combines qualitative and quantitative research was utilized, following a 7-step framework. This framework encompasses identifying the research question, devising a search strategy, performing a critical appraisal, summarizing findings, extracting data, conducting an analysis, and drawing conclusions. Results: Poor adherence to therapy among patients with IBD can exacerbate disease progression and result in complications. MI has been identified as a promising approach to improving both adherence and treatment outcomes. Studies, including those predating the COVID-19 pandemic, have demonstrated MI’s effectiveness in enhancing adherence among patients with IBD. Conclusions: MI shows promise in enhancing adherence among adult patients with IBD. Although initial results are promising, additional research is needed to thoroughly understand its effectiveness across various clinical contexts. Relevance to Clinical Practice: The findings underscore the potential of MI as an integral component of IBD treatment strategies, suggesting that its implementation could enhance patient–provider interactions and lead to better overall health outcomes. Full article
(This article belongs to the Section Chronic Care)
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14 pages, 888 KiB  
Article
Perinatal Outcomes of Immigrant Mothers and Their Infants Born Very Preterm across Germany
by Britta M. Hüning, Julia Jaekel, Nils Jaekel, Wolfgang Göpel, Egbert Herting, Ursula Felderhoff-Müser, Juliane Spiegler and Christoph Härtel
Healthcare 2024, 12(12), 1211; https://doi.org/10.3390/healthcare12121211 - 17 Jun 2024
Viewed by 481
Abstract
Background: In Germany, more than 40% of infants are born to immigrant parents. Increased survival rates of very preterm (below 32 weeks gestation at birth; VP) infants have not resulted in equally improved life chances and quality of life. More information on perinatal [...] Read more.
Background: In Germany, more than 40% of infants are born to immigrant parents. Increased survival rates of very preterm (below 32 weeks gestation at birth; VP) infants have not resulted in equally improved life chances and quality of life. More information on perinatal variations in outcomes according to social inequalities, migration background, and language barriers is needed. We tested whether mothers’ immigrant status and language barriers are associated with perinatal health and short-term neonatal outcomes. Methods: The data are from the national multi-centre German Neonatal Network (GNN) cohort, including VP births from 2009 onwards. In total, 3606 (n = 1738 female) children were assessed, and 919 (n = 449 female) of these children had immigrant backgrounds. Immigrant status was operationalised as a binary variable based on the children’s mothers’ countries of birth (born in Germany vs. foreign-born). Self-reported home language (L1) was used to calculate the average linguistic distance to German as one continuous variable. Results: Mixed-effects models showed that two out of fourteen effects of interest survived the adjustment for known confounders and accounting for the nestedness of data within birth hospitals. Linguistic distance from mothers’ L1s to German was independently associated with diagnoses of preeclampsia (OR = 1.01, 95% CI = [1.00, 1.01]). Infants of foreign-born mothers had higher odds for amniotic infection syndrome (AIS; OR = 1.45 [1.13, 1.86]) than infants of German mothers. Conclusions: Our findings from this large multi-centre longitudinal cohort of VP-born children indicate that maternal immigrant status and language barriers have limited impact on perinatal health and severe neonatal outcomes. This suggests that, regardless of background or language skills, there may be few inequalities in the perinatal health of pregnant women and their newborn preterm infants. Full article
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10 pages, 658 KiB  
Article
Mindfulness, Gut–Brain Axis, and Health-Related Quality of Life: The Paradigm of IBD Patients
by Efstratios Christodoulou, Tsambika Mpali, Maroula-Eleni Dimitriadou and Antonios E. Koutelidakis
Healthcare 2024, 12(12), 1209; https://doi.org/10.3390/healthcare12121209 - 17 Jun 2024
Viewed by 520
Abstract
Health-related quality of life (HRQoL) is a comprehensive measure that evaluates an individual’s well-being across physical, mental, and social dimensions. Enhancing HRQoL, particularly in individuals with chronic conditions like inflammatory bowel diseases (IBD), necessitates a holistic approach. Mindfulness, a scientifically supported strategy for [...] Read more.
Health-related quality of life (HRQoL) is a comprehensive measure that evaluates an individual’s well-being across physical, mental, and social dimensions. Enhancing HRQoL, particularly in individuals with chronic conditions like inflammatory bowel diseases (IBD), necessitates a holistic approach. Mindfulness, a scientifically supported strategy for managing anxiety, has shown promise in improving both physical and mental health. Its benefits may be partly explained through its effects on the gut–brain axis (GBA), a bidirectional communication link between the gastrointestinal system and the central nervous system. By exploring the interplay between mindfulness and the GBA, this study aims to uncover how these elements collectively influence HRQoL in both healthy individuals and those with IBD, offering insights into potential therapeutic pathways. A cross-sectional investigation involved 338 adults, including 50 IBD patients, utilizing validated Greek scales for Mindfulness (MAAS-15), Mediterranean Diet (14-MEDAS), and HRQoL (EQ-5D-5L). The questionnaire gathered demographic, anthropometric, and lifestyle data. Among healthy participants, EQ-5D-5L showed a moderate correlation with the MAAS-15 scale (r = 0.389, p < 0.05) and a low correlation with 14-MEDAS (r = 0.131, p < 0.05). IBD patients exhibited significantly lower mean EQ-5D-5L scores than healthy individuals (0.75 vs. 0.85, p < 0.05). MAAS-15 demonstrated a robust correlation (r = 0.414, p < 0.001) with EQ-5D-5L in IBD patients. Elevated mindfulness levels emerged as predictive factors for higher HRQoL in IBD patients (OR: 1.101, 95% CI: 1.008, 1.202, p < 0.05, compared to low mindfulness). In summary, factors influencing the GBA, including mindfulness and the Mediterranean diet, exhibit positive associations with HRQoL. Increased mindfulness levels predict better HRQoL in IBD patients, emphasizing the potential for clinical trials to validate these cross-sectional study findings. Full article
(This article belongs to the Special Issue Emerging Risk Factors Associated with Public Health)
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10 pages, 860 KiB  
Article
Depression Accompanied by Hopelessness Is Associated with More Negative Future Thinking
by Hailong Han and Akira Midorikawa
Healthcare 2024, 12(12), 1208; https://doi.org/10.3390/healthcare12121208 - 17 Jun 2024
Viewed by 416
Abstract
Background: This study aimed to delineate the interplay between depression, hopelessness, and episodic future thinking (EFT), focusing on cognitive biases towards negative future thinking that are central to depressive symptomatically. Methods: A Japanese university student was utilized to scrutinize divergences in EFT across [...] Read more.
Background: This study aimed to delineate the interplay between depression, hopelessness, and episodic future thinking (EFT), focusing on cognitive biases towards negative future thinking that are central to depressive symptomatically. Methods: A Japanese university student was utilized to scrutinize divergences in EFT across groups stratified by varying degrees of depression and hopelessness. The research leveraged a modified future thinking task (FTT), the Beck Hopelessness Scale, and the Beck Depression Inventory-II to gauge participants’ levels of hopelessness and depressive symptoms. Results: Consistent with prior research, the non-depressed group showed a reduction in positive EFT, reinforcing the idea that diminished positive future thinking is a hallmark of depressive conditions, even in the absence of a clinical diagnosis. Moreover, individuals with comorbid depression and elevated hopelessness demonstrated a significant decrease in positive EFT and an increase in negative EFT, substantiating a distinctive cognitive profile for this subgroup. This finding suggests that the presence of hopelessness exacerbates the negative cognitive biases associated with depression. Conclusions: The study emphasizes the importance of considering hopelessness as an independent construct when assessing EFT in clinical contexts. The pronounced impact of hopelessness on future thinking in those with depression suggests that targeted interventions, such as future-directed therapy (FDT), may be particularly effective for individuals with hopelessness depression by focusing on modifying negative future thinking patterns and enhancing life quality. Full article
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