Healthcare

10 pages, 425 KiB

Open AccessArticle

Evaluating Adverse Drug Reactions, Their Reporting Rates and Their Impact on Attitudes Toward Pharmacotherapy Among Female Patients with Schizophrenia: Insights and Implications from a Cross-Sectional Study

by Josipa Bukić, Dora Herceg, Darko Modun, Ivana Krce, Dario Leskur, Toni Durdov, Miroslav Herceg, Ana Šešelja Perišin and Doris Rušić

Healthcare 2024, 12(24), 2595; https://doi.org/10.3390/healthcare12242595 - 23 Dec 2024

Viewed by 507

Abstract

Background/Objectives: Schizophrenia is a chronic psychiatric disorder usually managed with antipsychotics, which can cause adverse drug reactions (ADRs) that may impact patients’ attitudes toward their treatment, as well as treatment adherence. This study aimed to assess the influence of ADRs and other factors [...] Read more.

Background/Objectives: Schizophrenia is a chronic psychiatric disorder usually managed with antipsychotics, which can cause adverse drug reactions (ADRs) that may impact patients’ attitudes toward their treatment, as well as treatment adherence. This study aimed to assess the influence of ADRs and other factors on treatment attitudes among female patients with schizophrenia. Methods: A cross-sectional study was conducted at the Vrapče Psychiatry Clinic with 109 female schizophrenia patients. The DAI-10 (Drug Attitude Inventory) questionnaire was used to assess attitudes toward treatment. Data on their demographic details, pharmacotherapy, ADR occurrence and ADR reporting rates were collected. Multiple regression analyses were used to identify predictors of DAI-10 scores. Results: Patients using more medications and those experiencing ADRs had lower DAI-10 scores, indicating less favorable attitudes (F (2, 106) = 7.364, p = 0.001, R² = 0.105). ADRs, primarily extrapyramidal symptoms and weight gain, were reported by 43.1% of patients; however, only one patient formally reported them. First-generation antipsychotics were associated with a higher prevalence of ADRs (χ² = 4.969, df = 1, p = 0.022). Conclusion: Negative experiences with ADRs significantly impact patients’ attitudes and adherence. Low ADR reporting rates highlight the need for better pharmacovigilance education. Enhancing patient awareness may foster more positive attitudes and adherence, potentially improving patient outcomes. Full article

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19 pages, 568 KiB

Open AccessSystematic Review

Cognitive Functioning in Children and Young People with Congenital Heart Disease: A Systematic Review of Meta-Analyses

by Maria Koushiou, Sauleha Manzoor, Antonis Jossif and Nuno Ferreira

Healthcare 2024, 12(24), 2594; https://doi.org/10.3390/healthcare12242594 - 23 Dec 2024

Viewed by 482

Abstract

Objectives: Congenital heart disease (CHD) is a prevalent condition affecting young people that often necessitates complex medical interventions. This study aims to provide a synthesis of existing meta-analyses examining the impact of CHD on the cognitive functioning in children and young people; [...] Read more.

Objectives: Congenital heart disease (CHD) is a prevalent condition affecting young people that often necessitates complex medical interventions. This study aims to provide a synthesis of existing meta-analyses examining the impact of CHD on the cognitive functioning in children and young people; Methods: A comprehensive literature review was conducted, identifying peer-reviewed meta-analyses from 1 January 1976 to 17 December 2024, focusing on the cognitive outcomes of CHD patients aged 0–24 years. Data extraction covered study details, participant demographics, outcomes, and quality assessments. Quality assessment followed the Scottish Intercollegiate Guidelines Network (SIGN) checklist, and a narrative synthesis was conducted; Results: The narrative synthesis highlighted significant cognitive impairments in children with CHD across domains such as Intelligence Quotient (IQ), executive functions (EF), memory, and alertness. Cognitive impairments were also observed to become worse with increasing age. Furthermore, surgical interventions were found to impact cognitive outcomes, with surgeries at an early age improving survival rates but not entirely mitigating cognitive deficits. Cognitive impairments were more marked in young people assessed at an older age and with a more complex CHD presentation. Conclusions: Children with CHD face persistent cognitive challenges, underscoring the need for early identification and tailored interventions. Routine cognitive assessments and comprehensive care, including educational and psychological support, are crucial for improving neurodevelopmental outcomes. Future research should focus on longitudinal studies to track cognitive development and explore effective rehabilitation programs. Full article

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17 pages, 578 KiB

Open AccessArticle

How Does Digital Integration Influence the Mental Health of Low-Income Populations?

by Xiaoli Wen and Beihai Tian

Healthcare 2024, 12(24), 2593; https://doi.org/10.3390/healthcare12242593 - 23 Dec 2024

Viewed by 523

Abstract

Background: In recent years, the growing prevalence of digital technology has transformed every aspect of life, including mental health care and support. Digital integration—referring to both access to digital technology and the utilization of digital tools in daily life—has the potential to alleviate [...] Read more.

Background: In recent years, the growing prevalence of digital technology has transformed every aspect of life, including mental health care and support. Digital integration—referring to both access to digital technology and the utilization of digital tools in daily life—has the potential to alleviate existing health inequalities, a phenomenon that has been labeled the ‘digital divide’. It is, therefore, imperative to gain an understanding of the mental health dynamics of vulnerable groups in the context of the digital age if we are to develop effective policies and interventions. Objectives: The present study aimed to expand the existing knowledge base on the impact of digital integration on the mental health of low-income populations, with a specific focus on its association with social participation and the contextual variations observed between urban and rural settings. Methods: A total of 930 Chinese urban and rural low-income residents (≥18 years old) were included in the study using data from the Comprehensive Social Survey of Urban and Rural Low-Income Populations in Hubei Province, China, 2022. Multiple linear regression, generalized propensity score matching, causal step regression, and bootstrap methods were adopted to assess the direct impact of digital integration on the mental health of low-income populations, as well as to test the mediating role of social participation. Results: Digital integration was positively associated with the mental health of low-income populations, particularly reducing symptoms of anxiety and depression among low-income individuals, which remains robust even after accounting for potential selective bias. Social participation played a significant mediating role in the relationship between digital integration and the mental health of low-income populations. Heterogeneity analyses indicated that while digital integration has been demonstrated to markedly enhance mental health outcomes among urban low-income groups, this effect has not been observed in rural low-income populations. Conclusions: The present study contributes to the growing understanding of digital integration as a pathway to reducing mental health inequalities. It is imperative that targeted interventions be implemented to enhance digital integration and, in turn, improve mental health outcomes in low-income communities, particularly in rural areas, where the impact is less discernible. Full article

(This article belongs to the Special Issue The Impact of Digital Technology Use on the Mental and Physical Health)

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12 pages, 203 KiB

Open AccessArticle

Improving Data-Informed Care in New Brunswick Long-Term Care Homes: A Qualitative Study on an Educational Intervention for interRAI Coordinators

by Rachel MacLean, Pamela Durepos, Lisa Keeping-Burke and Rose McCloskey

Healthcare 2024, 12(24), 2592; https://doi.org/10.3390/healthcare12242592 - 23 Dec 2024

Viewed by 652

Abstract

Background/Objectives: InterRAI is a globally validated platform aimed at improving care for individuals with disabilities and complex medical needs, particularly in long-term care settings. This study explores the experiences of interRAI coordinators in New Brunswick, Canada, and their perceptions of an educational [...] Read more.

Background/Objectives: InterRAI is a globally validated platform aimed at improving care for individuals with disabilities and complex medical needs, particularly in long-term care settings. This study explores the experiences of interRAI coordinators in New Brunswick, Canada, and their perceptions of an educational intervention designed to enhance their ability to effectively use interRAI data for quality care. Methods: The study recruited interRAI coordinators from 73 New Brunswick long-term care homes for an educational intervention. Nine coordinators participated in interviews about their experiences. A qualitative descriptive approach was used to analyze field notes and interview transcripts with thematic analysis. Results: Nine interviews and six sets of field notes were collected over one year, focusing on the roles of interRAI coordinators. Participants (all female, averaging 54 years old) expressed positive perceptions of the intervention, noting increased knowledge and collaboration. Key themes included the context of the interRAI coordinator role, the use of interRAI data for quality indicators, and recommendations for future educational initiatives. Conclusions: The findings emphasize the critical role of interRAI coordinators in improving quality care in long-term care settings through effective data use and collaboration. Participants reported that the educational intervention significantly improved their understanding and application of interRAI data. Recommendations for ongoing training and broader engagement stress the importance of continuous support to advance care quality in long-term care homes. Full article

(This article belongs to the Section Chronic Care)

11 pages, 238 KiB

Open AccessArticle

Volunteer Services in Palliative Care by Third Age University Students

by Gönül Düzgün, Yasemin Kılıç Öztürk, Gökşen Polat and Sevnaz Şahin

Healthcare 2024, 12(24), 2591; https://doi.org/10.3390/healthcare12242591 - 23 Dec 2024

Viewed by 382

Abstract

Background: Volunteering is a type of support that provides high motivation and supports social participation during the active aging process without any financial reward. Volunteering services provided by an active older person not only provide free services to the community where needed but [...] Read more.

Background: Volunteering is a type of support that provides high motivation and supports social participation during the active aging process without any financial reward. Volunteering services provided by an active older person not only provide free services to the community where needed but also help individuals feel valued by creating a social environment, thereby increasing their resilience. The aim of this study was to determine the views on volunteering in palliative care services among older individuals over the age of sixty who attend the Ege University of the Third Age [U3A] and outline the volunteer profile of older students after receiving palliative care training. Methods: This study was conducted using a qualitative research method. The study population consisted of seventy students from the Ege U3A in İzmir who met the inclusion criteria. Before the training, the U3A students were given a brief pre-test about palliative care and volunteering, followed by 2-day, 16 h basic palliative care training. After the training, the students were asked to respond to written questions about volunteering in palliative care, and their responses were collected in their own handwriting. For the data analysis, a thematic content analysis was conducted using MAXQDA 20, a qualitative data analysis program. Results: In this study, the average age of the 70 University of the Third Age students were 67.47 (60–89) years. The participants were 75% women; 85% were married, 40% lived with their spouse, and 37.14% had been students at the University of the Third Age for 3 years. After the thematic analysis, six main themes emerged: physical and social support, educational support, medical/clinical support, financial support, spiritual support, and caregiving for pediatric patients. Conclusions: In our study, it was clearly observed that older students enrolled in the Ege U3A, who had a high potential for volunteering, were willing to work voluntarily in palliative care within the limits of their physical abilities and resources. This research, which aimed to create a volunteer profile in palliative care, allowed older students to find suitable roles for themselves and increased their motivation to provide this unpaid service. Based on this, it aimed to establish an effective start and an encouraging practice for the development of a pilot study, which is needed for Türkiye. Full article

(This article belongs to the Special Issue New Advances in Palliative Care)

13 pages, 858 KiB

Open AccessArticle

Factors Affecting Handgrip Strength in Menopausal Women at High Risk of Sarcopenia: A National Population-Based Study

by Anna Lee and Sooyeon Park

Healthcare 2024, 12(24), 2590; https://doi.org/10.3390/healthcare12242590 - 23 Dec 2024

Viewed by 381

Abstract

Background/Objectives: Hand grip strength (HGS) reflects muscle strength and is an important indicator of sarcopenia. There is a gap in the research regarding the determinants of relative HGS that take sex differences into account. Therefore, this study aimed to evaluate the association [...] Read more.

Background/Objectives: Hand grip strength (HGS) reflects muscle strength and is an important indicator of sarcopenia. There is a gap in the research regarding the determinants of relative HGS that take sex differences into account. Therefore, this study aimed to evaluate the association between relative HGS and physical, behavioral, and psychological factors in menopausal women from South Korea. Methods: This study used data obtained from the 7th National Health and Nutrition Examination Survey (2016–2018), which had a complex, stratified, and multistage sample design. A total of 2129 menopausal women aged between 40 and 64 were included in this cross-sectional study. To evaluate physical, behavioral, and psychological factors associated with relative HGS, a multiple regression analysis was used. Results: In this study, the sociodemographic factors that influenced relative HGS were education (high school: B = 0.03, p = 0.001; college: B = 0.04, p = 0.003) and marital status (live with: B = 0.04, p = 0.004). Among the physical factors, abdominal obesity (B = −0.16, p < 0.001) and comorbidities (B = −0.03, p = 0.026) were associated with a significantly lower relative HGS. Regarding behavioral factors, relative HGS was significantly lower for those who slept more than 8 h (B = −0.03, p = 0.041) than for those who slept 6–8 h. Regarding psychological factors, relative HGS was significantly higher for those with fair (B = 0.04, p = 0.001) and good (B = 0.06, p < 0.001) self-rated health. Conclusions: Relative HGS is associated with physical, behavioral, and psychological factors in menopausal women. These findings can inform research and guidelines for sarcopenia prevention using relative HGS as an indicator of health status. Full article

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15 pages, 895 KiB

Open AccessArticle

Attributes Desired in a General Practitioner by Adults: Implications for Humanization in Medicine and Enhancement of the Patient Experience

by Agnieszka J. Szczepek, Malgorzata Wrzosek and Marta Makowska

Healthcare 2024, 12(24), 2589; https://doi.org/10.3390/healthcare12242589 - 23 Dec 2024

Viewed by 432

Abstract

Background: Progress in medical education is reflected in healthcare quality and patient satisfaction. However, there are still gaps in knowledge regarding the patients’ expectations of general practitioners (GPs), even though patients’ interactions with GPs are among the most frequent in healthcare. Accordingly, this [...] Read more.

Background: Progress in medical education is reflected in healthcare quality and patient satisfaction. However, there are still gaps in knowledge regarding the patients’ expectations of general practitioners (GPs), even though patients’ interactions with GPs are among the most frequent in healthcare. Accordingly, this study investigated the qualities desired by adults in GPs, intending to include them in future medical humanization education to enhance the patients’ experience. Methods: Using an online survey, 1057 respondents (52.8% female; mean age, 46.55 years old, SD 16.03) were asked to rate 15 statements on a scale of 1 to 10 regarding desirable characteristics of general practitioners. In addition to the respondents’ high regard for their GP’s ongoing education and sincerity in conveying both positive and negative information, the findings suggest that the socio-demographic attributes of the respondents influence their expectations of GPs. Results: Women had higher overall expectations than men. In addition, those who reported higher satisfaction with their lives and recent healthcare users had higher expectations of GPs than those who were dissatisfied. The youngest group of respondents exhibited the lowest expectations of the GPs’ attributes, except for their greater willingness to engage in discussions with GPs regarding personal or professional issues, compared with the older groups. Conclusions: The information presented in this work can be utilized during medical students’ humanization training and physicians’ continuing education. The knowledge gained should enhance GPs’ awareness of the distinctions in patients’ expectations, enabling them to adapt their approach and services to align with their patients’ unique needs, expectations, and experiences. Full article

(This article belongs to the Section Healthcare Quality and Patient Safety)

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12 pages, 270 KiB

Open AccessArticle

Impact of a Community-Based Health Intervention on Health Knowledge, Lifestyle Goals, Dietary Practices, and Physical Activity in Older Adults: A Multisite Cohort Study

by Shanice Wei En Lim, Jesslyn Hwei Sing Chong, Jia Yi Chee, Charles Chin Han Lew, Hee Hoon Lee, Lancelot Kher Wi Chua, Kian Chong Lim, Hui An Koh, Bao Yin Sow, Janelle Wood, Dorcas Gui and Adrian Ujin Yap

Healthcare 2024, 12(24), 2588; https://doi.org/10.3390/healthcare12242588 - 23 Dec 2024

Viewed by 657

Abstract

Background: Studies on the effectiveness of community-based health interventions (CBHIs) in improving lifestyle practices among older adults are limited. Objectives: This study evaluated the impact of a CBHI on health knowledge, lifestyle goal attainment, and practices among older adults in Singapore. Methods: Older [...] Read more.

Background: Studies on the effectiveness of community-based health interventions (CBHIs) in improving lifestyle practices among older adults are limited. Objectives: This study evaluated the impact of a CBHI on health knowledge, lifestyle goal attainment, and practices among older adults in Singapore. Methods: Older adults (aged ≥60 years) were recruited from 29 senior recreation centres to participate in the “Wise and Well” programme, a 3-month CBHI designed to empower individuals to make healthier lifestyle choices. Pre- and post-programme assessments of health knowledge, goal attainment, and lifestyle behaviours (dietary practices and physical activity levels) were conducted using a health knowledge questionnaire, Goal Attainment Scaling (GAS), the Modified Dietary Practice Questionnaire (DPQ), and the Global Physical Activity Questionnaire (GPAQ), respectively. Statistical analysis was performed using the Wilcoxon signed-rank and McNemar’s tests (α = 0.05). Results: The study comprised 464 participants (mean age 73.1 years [SD 7.6]; 75.9% women). Three months post-program, participants showed significantly increased health knowledge (p < 0.001) and improved lifestyle goal attainment (p < 0.001). Additionally, there was a significant increase in the proportion of participants meeting or exceeding fruit (p < 0.001) and vegetable (p = 0.002) intake recommendations and reductions in sugar-sweetened beverage consumption (p = 0.002). However, no significant changes were observed in fried food consumption or physical activity levels. High health knowledge scores were associated with 2.17 (95% confidence interval 1.02,4.64) times greater odds of increased vegetable intake. Conclusions: The CBHI shows potential as an effective approach to improving health knowledge and enhancing lifestyle goals and practices among older adults Full article

(This article belongs to the Special Issue Nutrition and Exercise Health Services for Older Adults: A Focus on Frailty)

35 pages, 1620 KiB

Open AccessReview

Federated Learning in Smart Healthcare: A Comprehensive Review on Privacy, Security, and Predictive Analytics with IoT Integration

by Syed Raza Abbas, Zeeshan Abbas, Arifa Zahir and Seung Won Lee

Healthcare 2024, 12(24), 2587; https://doi.org/10.3390/healthcare12242587 - 22 Dec 2024

Viewed by 798

Abstract

Federated learning (FL) is revolutionizing healthcare by enabling collaborative machine learning across institutions while preserving patient privacy and meeting regulatory standards. This review delves into FL’s applications within smart health systems, particularly its integration with IoT devices, wearables, and remote monitoring, which empower [...] Read more.

Federated learning (FL) is revolutionizing healthcare by enabling collaborative machine learning across institutions while preserving patient privacy and meeting regulatory standards. This review delves into FL’s applications within smart health systems, particularly its integration with IoT devices, wearables, and remote monitoring, which empower real-time, decentralized data processing for predictive analytics and personalized care. It addresses key challenges, including security risks like adversarial attacks, data poisoning, and model inversion. Additionally, it covers issues related to data heterogeneity, scalability, and system interoperability. Alongside these, the review highlights emerging privacy-preserving solutions, such as differential privacy and secure multiparty computation, as critical to overcoming FL’s limitations. Successfully addressing these hurdles is essential for enhancing FL’s efficiency, accuracy, and broader adoption in healthcare. Ultimately, FL offers transformative potential for secure, data-driven healthcare systems, promising improved patient outcomes, operational efficiency, and data sovereignty across the healthcare ecosystem. Full article

(This article belongs to the Special Issue Artificial Intelligence in Healthcare: Opportunities and Challenges)

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14 pages, 1190 KiB

Open AccessSystematic Review

The Efficacy of Transversus Abdominis Plane (TAP) Blocks When Completed by Anesthesiologists Versus by Surgeons: A Systematic Review and Meta-Analysis

by Dylan Irvine, Christopher Rennie, Emily Coughlin, Imani Thornton, Rahul Mhaskar and Jeffrey Huang

Healthcare 2024, 12(24), 2586; https://doi.org/10.3390/healthcare12242586 - 22 Dec 2024

Viewed by 677

Abstract

Background/Objectives: Current literature has demonstrated the benefits of transversus abdominis plane (TAP) blocks for reducing postoperative pain and opioid consumption for an array of surgical procedures. Some randomized controlled trials and retrospective studies have compared ultrasound guidance TAP blocks completed by anesthesiologists [...] Read more.

Background/Objectives: Current literature has demonstrated the benefits of transversus abdominis plane (TAP) blocks for reducing postoperative pain and opioid consumption for an array of surgical procedures. Some randomized controlled trials and retrospective studies have compared ultrasound guidance TAP blocks completed by anesthesiologists (US-TAP) to laparoscopic guidance TAP blocks completed by surgeons (LAP-TAP). However, the findings of these studies have not been consolidated to improve recommendations and patient outcomes. Our objective is to consolidate and summarize current literature regarding the efficacy of TAP blocks for postoperative pain control and opioid consumption when performed with ultrasound guidance (US-TAP, compared to laparoscopic guidance (LAP-TAP). Methods: We performed a systematic review and meta-analysis of RCTs and retrospective studies to evaluate US-TAP versus LAP-TAP blocks for postoperative pain control and opioid consumption. We searched PubMed/MEDLINE, CINAHL, Cochrane, and Web of Science databases for all articles meeting the search criteria until the time of article extraction in February 2024. The primary outcome variables were postoperative pain scores and opioid consumption. The secondary outcome variables were complications, time taken to perform the block, length of stay (LOS) in the hospital, and cost of performing the block. Results: Of the 1673 articles initially identified, 18 studies met the inclusion criteria for evaluation. Of the included studies, 88.9% and 77.8% found no significant difference in postoperative pain scores or opioid consumption, respectively, between US-TAP and LAP-TAP groups. Six studies (33.3%) found that LAP-TAP was faster to perform than US-TAP. Meta-analysis demonstrated no statistically significant differences in postoperative pain scores or opioid consumption between groups but showed that block times were significantly longer in the US-TAP group. Conclusions: US-TAP and LAP-TAP blocks may be equivocal in terms of reducing postoperative pain and opioid consumption. LAP-TAPs may be less time-consuming and more cost-effective and viable alternatives to US-TAP blocks in the perioperative setting. Full article

(This article belongs to the Section Pain Management)

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16 pages, 642 KiB

Open AccessArticle

Exploring the Association Between Adolescents’ Health Literacy and Health Behavior by Using the Short Health Literacy (HLS₁₉-Q12) Questionnaire

by Saulius Sukys, Gerda Kuzmarskiene and Kristina Motiejunaite

Healthcare 2024, 12(24), 2585; https://doi.org/10.3390/healthcare12242585 - 22 Dec 2024

Viewed by 546

Abstract

Background: Health literacy (HL) is an important element of public health that is linked to health behavior in children and adolescents. This study aimed to investigate the structural validity and reliability of the HLS₁₉-Q12 in the adolescent population, to measure the [...] Read more.

Background: Health literacy (HL) is an important element of public health that is linked to health behavior in children and adolescents. This study aimed to investigate the structural validity and reliability of the HLS₁₉-Q12 in the adolescent population, to measure the general HL of adolescents, and to assess the relationship between adolescents’ HL and health behavior. Methods: This cross-sectional study involved 825 students aged 15–19 years attending Lithuanian gymnasiums. The participants completed an online survey that collected information on key sociodemographic, HL, and health behavior indicators. Factor analysis, Cronbach’s alpha, and McDonald’s omega were used to validate the Lithuanian version of the HLS₁₉-Q12. Health behavior indicators, including physical activity, smoking, alcohol consumption, self-rated health, and body mass index (BMI), were measured. We used regression analyses to assess the associations. Results: The HLS₁₉-Q12 showed an acceptable reliability index (Cronbach’s α = 0.885, McDonald’s omega ω = 0.877) and adequate structural validity (comparative fit index = 0.89, Tucker and Lewis’s index of fit = 0.88, root mean square error of approximation = 0.06). We found that 67.1% of the adolescents had excellent or sufficient HL, 27.7% had problematic HL, and 5.2% had inadequate HL. Compared with girls, boys had greater HL. HL was positively related to physical activity and self-rated health and negatively related to alcohol use and smoking. Conclusions: HLS₁₉-Q12 is a reliable and valid measure of HL among adolescents in upper grades; higher levels of HL have been found to result in better health behaviors. Full article

(This article belongs to the Special Issue Health, Sport, Physical Activity and Education: Innovations in Improving the Quality of Life of Children and Adolescents)

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9 pages, 215 KiB

Open AccessArticle

The “Ideal Birth”: The Occurrence of Severe Perineal Lacerations, Related Factors and the Possibility of Identifying Patients at Higher Risk

by Carmen Imma Aquino, Alessia Tivano, Francesca Della Sala, Sofia Colagiorgio, Lucia Scalisi, Tewobista Ewnetu Alemu, Lorenza Scotti, Elisabetta Tarrano, Valentino Remorgida and Daniela Surico

Healthcare 2024, 12(24), 2584; https://doi.org/10.3390/healthcare12242584 - 22 Dec 2024

Viewed by 575

Abstract

Background: Obstetric lesions of the anal sphincter (OASIS) are tears intersecting the structure of the anus after vaginal delivery. Our aim is to provide data on the incidence of OASIS and investigate potentially connected risk factors. Methods: This is a retrospective analysis of [...] Read more.

Background: Obstetric lesions of the anal sphincter (OASIS) are tears intersecting the structure of the anus after vaginal delivery. Our aim is to provide data on the incidence of OASIS and investigate potentially connected risk factors. Methods: This is a retrospective analysis of 464 parturient patients admitted to the AOU Maggiore della Carità, Novara (Italy), in the last ten years (2013–2023), comparing 116 cases (with OASIS) versus 348 controls (with no OASIS). Results: The incidence of OASIS was 1.1%. Among the significant risk factors associated with the risk of severe perineal laceration in our sample, we observed nulliparity, previous caesarean sections, assisted reproduction technology, kilos gained during pregnancy, induced delivery, the use of oxytocin for augmentation, epidural analgesia, delivery after 40 weeks of gestation, position at delivery, the duration of labor, the application of a vacuum cup, newborn weight and head circumference. Conclusions: It was a challenge to find data on OASIS and on more preventable and modifiable risk factors. Beyond the improvement of the corresponding diagnostic and therapeutic tools, a new aim could be to stratify women giving birth based on possible risk factors. Full article

(This article belongs to the Section Women's Health Care)

23 pages, 6225 KiB

Open AccessArticle

Clinical Presentation and Integrated Management of Pressure Injuries in the Emergency Hospital Setting: A Plastic Surgeon’s Perspective

by Stefan Cacior, Eliza-Maria Bordeanu-Diaconescu, Vladut-Alin Ratoiu, Andreea Grosu-Bularda, Florin-Vlad Hodea, Khalid Al-Falah, Razvan-Nicolae Teodoreanu, Serban-Arghir Popescu, Ioan Lascar and Cristian-Sorin Hariga

Healthcare 2024, 12(24), 2583; https://doi.org/10.3390/healthcare12242583 - 22 Dec 2024

Viewed by 457

Abstract

Background: Pressure injuries are localized areas of tissue damage or necrosis that occur when pressure is applied to the skin for prolonged periods, often over bony prominences, often the sacrum, heels, ischial tuberosities, and greater trochanters. The pathophysiology is complex, involving a [...] Read more.

Background: Pressure injuries are localized areas of tissue damage or necrosis that occur when pressure is applied to the skin for prolonged periods, often over bony prominences, often the sacrum, heels, ischial tuberosities, and greater trochanters. The pathophysiology is complex, involving a combination of mechanical forces, ischemia, and tissue hypoxia. Methods: We conducted a 2-year retrospective study aiming to assess the clinical characteristics, risk factors, and management of pressure injuries in patients admitted to an emergency hospital who underwent a plastic surgery examination. Results: This study included 176 patients with clinically diagnosed pressure ulcers, with findings showing 28.52% of cases as stage III and 35.57% as stage IV. Common sites included the sacrum (40.94%), ischium (15.1%), and heel (14.43%). The median patient age was 76 years, with 47.15% between 60 and 80 years and 36.93% ≥ 80 years, often presenting with comorbidities increasing the risk of pressure injuries, such as cardiovascular disease (71.59%), diabetes (18.18%) and obesity (9.66%). Important risk factors included neurological diseases (46.02%), spinal cord injuries (14.7%), and nutritional deficiencies, as indicated by anemia (10.43g/dL; 95% CI [10.04; 10.82]), low serum albumin (2.56 g/dL; 95% CI [2.43; 2.69]) and proteins (5.54 g/dL; 95% CI [5.34; 5.73]). Mortality was significant, at 36.93%, with 23.3% occurring within the first 7 days of hospitalization due to the patients’ critical condition. Decision-making for surgical intervention considered the patient’s general status, comorbidities, and ulcer severity. Surgical treatment consisted of seriate debridement, negative pressure vacuum therapy, and/or coverage using skin grafting, local advancement, or rotation flaps. Conclusions: The key question for a plastic surgeon to consider is how pressure ulcers should be managed. Various debridement and covering techniques should be tailored to the wound’s characteristics, considering patient comorbidities and general health condition. Full article

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14 pages, 696 KiB

Open AccessArticle

Psychometric Assessment of the Communication Skills Scale Among Peruvian Nurses and Factors Associated with Job Insecurity

by Gabriela Samillán-Yncio, Jhon Alex Zeladita-Huaman, Eduardo Franco-Chalco, Roberto Zegarra-Chapoñan, Iván Montes-Iturrizaga and Zulma Jeanette Rivera-Medrano

Healthcare 2024, 12(24), 2582; https://doi.org/10.3390/healthcare12242582 - 22 Dec 2024

Viewed by 421

Abstract

Background/Objectives: The aim of this study was to evaluate the psychometric properties of the Communication Skills Scale (CSS) among Peruvian nurses, as well as the factors associated with job insecurity during the COVID-19 pandemic. Methods: We explored five models of confirmatory factor analysis [...] Read more.

Background/Objectives: The aim of this study was to evaluate the psychometric properties of the Communication Skills Scale (CSS) among Peruvian nurses, as well as the factors associated with job insecurity during the COVID-19 pandemic. Methods: We explored five models of confirmatory factor analysis for the CSS and its four subscales and assessed the convergent validity and criterion validity of the scale by analyzing its connection with job insecurity through stepwise multiple regression. We used insights from a focus group for the cultural adaptation of the scale. In the psychometric phase, 225 nurses participated through a virtual survey. Results: The psychometric analysis revealed that the CSS and its subscales have a robust internal structure—similar to the original questionnaire—and are optimally reliable in the Peruvian population. Furthermore, the results show that job insecurity was associated with contract type, communication skills, empathy, and job satisfaction. Conclusions: The CSS and its subscales are valid and reliable to be applied to Peruvian nurses. Initiatives should be undertaken to strengthen communication skills and increase job satisfaction among nursing professionals by improving their working conditions, especially in times of crisis, to reduce job insecurity and promote well-being. Full article

(This article belongs to the Special Issue Job Satisfaction and Mental Health of Workers)

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14 pages, 663 KiB

Open AccessArticle

Threats to the Dignity of People with Advanced Illness Who Are Treated in Emergency Departments: A Qualitative Study

by Alba Fernández-Férez, Ousmane Berthe-Kone, Gonzalo Granero-Heredia, Matías Correa-Casado, María del Mar Jiménez-Lasserrotte, Álvaro Martínez-Bordajandi and José Granero-Molina

Healthcare 2024, 12(24), 2581; https://doi.org/10.3390/healthcare12242581 - 22 Dec 2024

Viewed by 427

Abstract

Background: Dignity is a key element in end-of-life care. Patients with advanced illness attend the emergency department to seek symptom relief but may find their dignity under threat in these services. Objective: The purpose of the study was to explore the threats to [...] Read more.

Background: Dignity is a key element in end-of-life care. Patients with advanced illness attend the emergency department to seek symptom relief but may find their dignity under threat in these services. Objective: The purpose of the study was to explore the threats to dignity perceived by people with advanced illnesses who are treated in emergency departments. Methods: A descriptive qualitative study was designed for which 18 patients with advanced illnesses were interviewed after being seen in an emergency department. The study complied with the principles of the Declaration of Helsinki for medical research involving human subjects. Results: Two themes were developed from the data analysis that shed light on how patients with advanced illnesses perceive threats to their dignity when seen in emergency departments: (1) “when care focused on diagnosis and treatment limits the dignity of the patient with advanced illness” and (2) “the social dimension of dignity in people with advanced illness in emergency departments”. Conclusions: We conclude that the structural, organizational, and care characteristics of emergency departments may pose a threat to the dignity of people with advanced illnesses who attend the emergency department. Family members, professionals, and other patients can both guarantee and threaten the dignity of people with advanced illnesses when they are treated in emergency departments. Full article

(This article belongs to the Special Issue New Insights into Understudied Phenomena in Healthcare)

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16 pages, 432 KiB

Open AccessArticle

Predicting Clinical Dishonesty Among Nursing Students: The Impact of Personal and Contextual Factors

by Renata Apatić, Boštjan Žvanut, Nina Brkić-Jovanović, Marija Kadović, Vedran Đido and Robert Lovrić

Healthcare 2024, 12(24), 2580; https://doi.org/10.3390/healthcare12242580 - 22 Dec 2024

Viewed by 413

Abstract

Background/Objectives: Numerous studies have examined nursing students’ academic dishonesty; however, there is still a gap in understanding the predictors of such behavior. This study aimed to identify personal (intrapersonal and interpersonal) and contextual factors predicting nursing students’ dishonesty during clinical training. Methods: A [...] Read more.

Background/Objectives: Numerous studies have examined nursing students’ academic dishonesty; however, there is still a gap in understanding the predictors of such behavior. This study aimed to identify personal (intrapersonal and interpersonal) and contextual factors predicting nursing students’ dishonesty during clinical training. Methods: A two-phase, prospective, predictive study was conducted at a nursing faculty in Croatia. The validated “Mentor Support Evaluation Questionnaire” was used in the first phase to assess students’ evaluations of the quality of mentor support during clinical training. The validated instruments “Optimism/Pessimism Scale” and “Nursing Student Perceptions of Dishonesty Scale” were used in the second phase to examine self-reported dishonesty and its contributing factors. The second phase also investigated the students’ knowledge of the university’s ethical and disciplinary regulations. Results: Of 398 participants, 195 (48.9%) reported engaging in clinical dishonesty. Hierarchical regression analysis identified critical predictors of frequent clinical dishonesty: lack of fear of consequences (β = −0.072), positive attitudes toward dishonesty (β= −0.081), higher incidence of academic dishonesty in the classroom (β = 0.221), lack of knowledge of the university’s regulations (β = −0.349), and low quality of mentor support (β = −0.430). The final model explained 60.7% of the variance in participants’ clinical dishonesty (p < 0.001). Conclusions: The identified predictors indicate that interpersonal factors, i.e., the quality of mentor support, influence students’ clinical dishonesty more than intrapersonal factors (e.g., attitudes or knowledge). Contextual factors (healthcare employment and study overload) were unrelated to clinical dishonesty. This finding can help develop strategies to reduce nursing students’ dishonesty and improve patient safety. Full article

(This article belongs to the Collection Current Nursing Practice and Education)

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12 pages, 847 KiB

Open AccessArticle

Evaluation of Dynamic Respiratory Muscle Strength, Physical Fitness, and Physical Activity in Children with Asthma and Healthy Peers

by Seyma Nur Onal, Gulnar Aliyeva, Ebru Calik Kutukcu, Naciye Vardar Yagli, Bulent Enis Sekerel, Ozge Uysal Soyer and Umit Murat Sahiner

Healthcare 2024, 12(24), 2579; https://doi.org/10.3390/healthcare12242579 - 21 Dec 2024

Viewed by 580

Abstract

Background: Systemic inflammation, attacks, deterioration of thoracic region mechanics, medications used, and decreased physical activity level (PAL) and fitness negatively may affect respiratory muscle strength. The primary aim of this study was to evaluate dynamic inspiratory muscle strength (S-index), PAL, and physical [...] Read more.

Background: Systemic inflammation, attacks, deterioration of thoracic region mechanics, medications used, and decreased physical activity level (PAL) and fitness negatively may affect respiratory muscle strength. The primary aim of this study was to evaluate dynamic inspiratory muscle strength (S-index), PAL, and physical fitness in children with asthma compared to healthy peers. The secondary aim of this study was to investigate the relationships between S-index and peak inspiratory flow (PIF) values and functional parameters in childhood asthma. Methods: This cross-sectional prospective study consisted of participants of 6–11 years of age, specifically, 20 children with asthma and 20 healthy peers. The device (POWERbreathe K5) evaluated PIF and S-index variables. PAL was determined with the Physical Activity Questionnaire-Child (PAQ-C) and fitness was evaluated with the FITNESSGRAM test battery. Results: The PIF Average (Avg): 1.8 ± 0.6, Best: 2.6 ± 0.6 (asthmatic children) vs. Avg: 2.4 ± 0.7, Best: 3.1 ± 0.9 (healthy children); p = 0.017, p = 0.027, respectively) and S-index (Avg: 34.1 ± 10.3, Best: 45.6 ± 9.9 (asthmatic children) vs. Avg: 43.2 ± 12.1, Best: 56.6 ± 14.7 (healthy children); p = 0.015, p = 0.008 respectively) values of children with asthma were significantly lower compared to healthy peers. The PAL and physical fitness of asthmatic and healthy peers were similar (p > 0.05). There were significant relationships between S-indexavg and S-indexbest with the PAQ-C score (r = 0.498, p < 0.025 r = 0.547, p < 0.013, respectively) and PIFavg and PIFbest with the PAQ-C score (r = 0.490, p < 0.028 r = 0.602, p < 0.005) in children with asthma. Conclusions: Dynamic respiratory muscle strength is negatively affected in children with asthma whereas their physical activity and fitness levels are comparable to their peers. However, it was found that children with a higher S-index and PIF rate had higher PALs. These findings suggest that pulmonary rehabilitation interventions to improve respiratory muscle function should be considered an important strategy to maintain and increase physical activity levels in children with asthma. Full article

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23 pages, 1275 KiB

Open AccessReview

Caregiver-Reported Economic Impacts of Pediatric Rare Diseases—A Scoping Review

by Niamh Buckle, Orla Doyle, Naonori Kodate, Melissa Kinch and Suja Somanadhan

Healthcare 2024, 12(24), 2578; https://doi.org/10.3390/healthcare12242578 - 21 Dec 2024

Viewed by 656

Abstract

Background/Objectives: Rare diseases are conditions that are individually rare but collectively common. These diseases can incur significant direct and indirect costs with a combination of high medical expenses, loss of income, and additional non-medical costs. Despite this, research into the economic cost [...] Read more.

Background/Objectives: Rare diseases are conditions that are individually rare but collectively common. These diseases can incur significant direct and indirect costs with a combination of high medical expenses, loss of income, and additional non-medical costs. Despite this, research into the economic cost for families of children with a rare disease is lacking. This scoping review aimed to document the evidence on the economic impacts of living with a rare disease for children and their families. Methods: Six electronic databases were searched to identify relevant peer-reviewed literature that discussed the family costs (direct medical, direct non-medical, and indirect) of having a child with a rare disease, published between January 1983 and April 2023. The geographical location, type of rare disease, and language were not limited. Data were extracted from the included studies following the screening process and are reported following the PAGER framework for reporting scoping review results. Results: The final analysis included 28 studies. The studies highlighted areas of high costs, including visits to healthcare professionals (n = 36), medication costs (n = 11), presenteeism (n = 17), and informal care (n = 11). However, gaps in the existing research, such as the focus on metabolic or musculoskeletal rare diseases and the lack of a distinction between rare and ultra-rare diseases, were apparent. Conclusions: Having a child with a rare disease can significantly impact a family’s financial health, and these costs extend beyond healthcare costs. Understanding the costs experienced by the rare disease population is important to better define and comprehend the economic impact of rare diseases. Full article

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21 pages, 5045 KiB

Open AccessArticle

Tackling Cardiovascular Care Deserts in Romania: Expanding Population Access in Underserved Areas

by Alexandra Cioclu, Liliana Dumitrache, Alina Mareci and Mariana Nae

Healthcare 2024, 12(24), 2577; https://doi.org/10.3390/healthcare12242577 - 21 Dec 2024

Viewed by 460

Abstract

Background: Cardiovascular deserts are areas that lack medical facilities, specialists and equipment to effectively diagnose, treat and manage cardiovascular diseases (CVDs). Romania registers the highest incidence and the highest mortality due to CVDs in Europe. Population ageing is a significant concern, as it [...] Read more.

Background: Cardiovascular deserts are areas that lack medical facilities, specialists and equipment to effectively diagnose, treat and manage cardiovascular diseases (CVDs). Romania registers the highest incidence and the highest mortality due to CVDs in Europe. Population ageing is a significant concern, as it increases the risk of CVDs and the demand for specialised care. Although almost 50% of Romanians still live in rural areas, most medical resources are concentrated in a few large cities, leaving large parts of the country underserved. Methods: This study used the Application Programming Interface (API) Matrix service from Google Maps and open data sources to identify cardiovascular (CV) deserts. Results: This research indicates that over 64% of the Romanian population resides in areas lacking CV care, having to travel more than 60 km and over 30 min to reach the nearest facility that offers specialised treatment. Moreover, 14% live in areas affected by a high degree of cardiovascular desertification. These areas are primarily located in northeastern, southern and western Romania. They experience higher mortality rates from CVDs and an ageing population, along with a shortage of general physicians and a scarcity of cardiologists. Conclusions: The identified cardiovascular deserts in this study overlap mountainous regions, the Danube Delta and remote rural areas with poor transportation infrastructure. Implementing telemedicine or mobile healthcare services, involving community healthcare workers and policy support could be solutions to expand access to specialised care in cardiovascular deserts. Full article

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14 pages, 277 KiB

Open AccessViewpoint

Advancing District Nursing Care Through a Learning Healthcare System: A Viewpoint on Key Requirements

by Jessica Veldhuizen, Marieke Schuurmans, Misja Mikkers and Nienke Bleijenberg

Healthcare 2024, 12(24), 2576; https://doi.org/10.3390/healthcare12242576 - 21 Dec 2024

Viewed by 499

Abstract

The increasing complexity of healthcare needs driven by an ageing population places pressure on district nursing care. Many vulnerable older adults prefer to remain at home, requiring care coordinated with general practitioners and other professionals. This demand for integrated care is further challenged [...] Read more.

The increasing complexity of healthcare needs driven by an ageing population places pressure on district nursing care. Many vulnerable older adults prefer to remain at home, requiring care coordinated with general practitioners and other professionals. This demand for integrated care is further challenged by a shortage of nursing professionals and the lack of standardised approaches to measure care quality. This article identifies the key requirements for implementing a learning healthcare system in district nursing care, using patient outcome data to foster continuous improvement and create a more adaptive, evidence-based, and patient-centred approach. This paper synthesises findings from multiple studies conducted as part of a PhD thesis, utilising a multi-method approach. These methods include examining patient outcomes in district nursing care and evaluating necessary cultural, organisational, and financial changes. Four key requirements were identified: (1) standardising patient outcome measures; (2) fostering a data-driven culture and strengthening professional autonomy; (3) enhancing organisational support and integrated care; and (4) adopting financing models that incentivise continuous learning and quality improvement. Implementing a learning healthcare system with patient outcome data in district nursing care requires a transformative shift. Standardising outcome measures, investing in information systems, and promoting continuous learning are crucial. Aligning financial incentives with patient outcomes, strengthening professional autonomy, and enhancing organisational support can make district nursing more responsive and capable of meeting complex needs. The described requirements are essential for advancing district nursing care through a more adaptive, evidence-based, and patient-centred approach. Full article

(This article belongs to the Special Issue Primary and Community Care: Opportunities and Challenges)

17 pages, 2767 KiB

Open AccessArticle

Physical Activity Levels of Community-Dwelling Older Adults During Daily Life Activities: A Descriptive Study

by Dieuwke van Dartel, Ying Wang, Johannes H. Hegeman and Miriam M. R. Vollenbroek-Hutten

Healthcare 2024, 12(24), 2575; https://doi.org/10.3390/healthcare12242575 - 21 Dec 2024

Viewed by 413

Abstract

Background/Objectives: Measuring the physical functioning of older hip fracture patients using wearables is desirable, with physical activity monitoring offering a promising approach. However, it is first important to assess physical activity in healthy older adults. This study quantifies physical functioning with physical activity [...] Read more.

Background/Objectives: Measuring the physical functioning of older hip fracture patients using wearables is desirable, with physical activity monitoring offering a promising approach. However, it is first important to assess physical activity in healthy older adults. This study quantifies physical functioning with physical activity parameters and assesses those parameters in community-dwelling older adults. The results are compared with the results from one case participant 2 months post-hip fracture surgery. Methods: Twenty-four community-dwelling older adults (aged ≥ 80) participated. The acts of moving around the house, toileting, getting in/out of bed, and preparing meals was quantified by total time, time spent sitting, standing, and walking, number of transfers, and intensity of physical activity. MOX and APDM sensors measured the intensity of physical activity, with the tasks performed in a living lab while video-recorded. The case participant’s total time and intensity of physical activity were measured for walking to a door and getting in/out of bed. Results: Preparing meals showed the longest total time and time spent standing/walking, while moving around the house and getting in/out of bed had the highest intensity of physical activity. Only getting in/out of bed required sitting. The physical activity parameters varied among participants, with very active participants completing tasks faster. The case participant had longer total times and lower intensities of physical activity two months post-surgery compared to before the fracture. Conclusions: This study provides initial insights into the physical activity levels of community-dwelling older adults. It represents the beginning of more efficient and continuous monitoring of physical functioning. Full article

(This article belongs to the Section Community Care)

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13 pages, 317 KiB

Open AccessArticle

The Relationship Between Nursing Work Environment and Breastfeeding Prevalence During Child Hospitalization: A Multicenter Study

by Martina Batino, Jacopo Fiorini, Francesco Zaghini, Valentina Biagioli, Simona Frigerio and Alessandro Sili

Healthcare 2024, 12(24), 2574; https://doi.org/10.3390/healthcare12242574 - 21 Dec 2024

Viewed by 673

Abstract

Background/Objectives: Breastfeeding during pediatric hospitalization is often challenging, especially in a setting where nursing work environments can affect breastfeeding support. This study examines the relationship between nursing work environments and the prevalence of breastfeeding during child hospitalization, focusing on aspects such as [...] Read more.

Background/Objectives: Breastfeeding during pediatric hospitalization is often challenging, especially in a setting where nursing work environments can affect breastfeeding support. This study examines the relationship between nursing work environments and the prevalence of breastfeeding during child hospitalization, focusing on aspects such as nursing workload, stress levels, and quality of work life (QoWL). Methods: A cross-sectional multicenter study was conducted in Italian pediatric hospitals from October 2023 to January 2024. Each ward head nurse completed a form daily for 30 consecutive days to record the number of children breastfed. Nurses’ workload, stress, and QoWL were measured using validated self-report questionnaires. Multivariate regression was employed to examine the associations between organizational variables and breastfeeding prevalence. Results: A total of 256 nurses from low- and medium-intensity pediatric wards completed the survey (86.7% female, mean age = 39.2, SD = 9.96). Nurses reported low stress levels (M = 2.74; SD = 0.54) and a good QoWL (M = 3.03; SD = 0.50) despite high workloads (M = 3.34; SD = 0.95). The breastfeeding prevalence mean was 1.12 (SD = 1.38), which was highest in surgical units. Regression analysis revealed that higher breastfeeding prevalence was associated with nurses’ female gender (β = 0.17), clinical setting, and higher levels of nurses’ QoWL (β = 0.14) (R² = 0.23; p < 0.001). Conclusions: To enhance breastfeeding support during child hospitalizations, healthcare policies should address workload management, stress reduction, and work–life balance. Future longitudinal research should expand to other clinical settings and include detailed patient data to understand these relationships. Full article

(This article belongs to the Special Issue Innovations in Precision Nursing: Patient-Centric Care and Technological Advancements)

21 pages, 6232 KiB

Open AccessArticle

User Experience Study of the Patient Monitoring Systems Based on Usability Testing and Eye Tracking

by Hyeonkyeong Choi and Wonseuk Jang

Healthcare 2024, 12(24), 2573; https://doi.org/10.3390/healthcare12242573 - 20 Dec 2024

Viewed by 491

Abstract

Background/Objectives: The patient monitoring system is a critical tool commonly used in hospitals, making it essential to assess caregivers’ user requirements and satisfaction with its usability. In intensive care units (ICUs), the usability of these systems is closely linked to the work efficiency [...] Read more.

Background/Objectives: The patient monitoring system is a critical tool commonly used in hospitals, making it essential to assess caregivers’ user requirements and satisfaction with its usability. In intensive care units (ICUs), the usability of these systems is closely linked to the work efficiency of key users, such as nurses, and directly impacts patient safety and treatment outcomes. This study evaluates the usability of patient monitoring systems in intensive care units (ICUs), focusing on user requirements and satisfaction among nurses, the primary users. Usability is directly linked to work efficiency and patient safety, with post-marketing surveillance (PMS) data from overseas, highlighting issues such as unrecognized alarms, leading to worsened patient conditions. Methods: This study involved 22 ICU nurses who had used the system for over a year, assessing usability through testing, satisfaction surveys, the Health-ITUES, and eye-tracking analysis. Results: The results showed a high success rate (94%) and positive satisfaction scores (4.15, SD = 0.88), with a Health-ITUES score of 4.13 (SD = 0.78). Eye tracking revealed that some functions, including alarms, were overlooked or not recognized. Conclusions: Recommendations include improving the interface for alarm messages and recording deletion functions to enhance user satisfaction and patient safety. Full article

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17 pages, 977 KiB

Open AccessReview

From Wristbands to Implants: The Transformative Role of Wearables in Heart Failure Care

by Catarina Gregório, João R. Agostinho, Joana Rigueira, Rafael Santos, Fausto J. Pinto and Dulce Brito

Healthcare 2024, 12(24), 2572; https://doi.org/10.3390/healthcare12242572 - 20 Dec 2024

Viewed by 562

Abstract

Background: Heart failure (HF) management increasingly relies on innovative solutions to enhance monitoring and care. Wearable devices, originally popularized for fitness tracking, show promise in clinical decision-making for HF. This study explores the application and potential for the broader integration of wearable technology [...] Read more.

Background: Heart failure (HF) management increasingly relies on innovative solutions to enhance monitoring and care. Wearable devices, originally popularized for fitness tracking, show promise in clinical decision-making for HF. This study explores the application and potential for the broader integration of wearable technology in HF management, emphasizing remote monitoring and personalized care. Methods: A comprehensive literature review was performed to assess the role of wearables in HF management, focusing on functionalities like vital sign tracking, patient engagement, and clinical decision support. Clinical outcomes and barriers to adopting wearable technology in HF care were critically analyzed. Results: Wearable devices increasingly track physiological parameters relevant to HF, such as heart rate, physical activity, and sleep. They can identify at-risk patients, promote lifestyle changes, facilitate early diagnosis, and accurately detect arrhythmias that lead to decompensation. Additionally, wearables may assess fluid status, identifying early signs of decompensation to prevent hospitalization and supporting therapeutic adjustments. They also enhance physical activity and optimize cardiac rehabilitation programs, improving patient outcomes. Both wearable and implanted cardiac devices enable continuous, non-invasive monitoring through small devices. However, challenges like data integration, regulatory approval, and reimbursement impede their widespread adoption. Conclusions: Wearable technology can transform HF management through continuous monitoring and early interventions. Collaboration among involved parties is essential to overcome integration challenges and validate most of these devices in clinical practice. Full article

(This article belongs to the Special Issue Telehealth and Remote Patient Monitoring)

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14 pages, 1086 KiB

Open AccessArticle

Approaching Suffering in Young University Students, New Challenge for a Compassionate University: A Qualitative Study of Undergraduate Nursing Students

by Sonia García-Navarro, E. Begoña García-Navarro, Miriam Araujo-Hernández, Ángela Ortega-Galán and María José Cáceres-Titos

Healthcare 2024, 12(24), 2571; https://doi.org/10.3390/healthcare12242571 - 20 Dec 2024

Viewed by 528

Abstract

Background/Objectives: Student distress is diverse and manifests itself in a variety of ways. Driven by the constant pressure to meet academic and personal expectations, many students experience a deep sense of insufficiency and hopelessness. Anxiety and depression are widespread and are often accompanied [...] Read more.

Background/Objectives: Student distress is diverse and manifests itself in a variety of ways. Driven by the constant pressure to meet academic and personal expectations, many students experience a deep sense of insufficiency and hopelessness. Anxiety and depression are widespread and are often accompanied by self-critical thoughts and feelings of worthlessness. Seeking temporary relief that often exacerbates their long-term struggles, some students resort to self-harm as a way to manage their emotional pain. Methods: This study employs an exploratory qualitative design with a phenomenological approach to deeply examine students’ experiences of suffering. Using semi-structured interviews, the study captures detailed narratives from 17 purposely selected students, providing a rich understanding of their lived experiences. Adhering to COREQ guidelines (Consolidated Criteria for Reporting Qualitative Studies). Results: The analysis identified four main themes: the concept of suffering, its causes, students’ responses, and coping strategies. Eleven sub-themes were identified, highlighting the significant challenges students face, including low self-esteem, anxiety, depression, and self-harm. These problems are increased by academic stress and social pressure derived from the intensive use of social networks. The constant social comparison and the search for external validation on social networks generate feelings of inadequacy and emotional exhaustion. Students often lack effective strategies to manage these pressures. In addition, bullying and the absence of meaningful relationships in the academic environment increase their suffering. Conclusions: This study provides a novel contribution by focusing on the lived experiences of nursing students and emphasizing the importance of the compassionate university model as a framework for addressing student suffering. It highlights the urgent need to implement strategies for support and compassion in educational institutions centred on emotional management, presence, listening, and specific mindfulness and stress management programmes. Additionally, fostering healthier and more mindful use of social media is crucial to help students manage their expectations, reduce their suffering, and cultivate self-compassion. Full article

(This article belongs to the Special Issue Compassionate Person-Centered and Interprofessional Palliative Care: Challenges and Opportunities)

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15 pages, 950 KiB

Open AccessArticle

Perceived Health Needs, Social Support, and Depression Among Patients with Myocardial Infarction: A Cross-Sectional Study

by Bushra Alshammari, Fatmah Awad Alrshedy, Awatif M. Alrasheeday, Sameer Alkubati, Mohamed Ayoub Tlili, Wiem Aouicha, Maha Dardouri, Sarah Basheer Alshammari, Hanan Qayyadh Alanazi, Teflah Saud Alshammari, Abdullah Ayad Alharbi, Nashi Masnad Alreshidi, Hind Abdullah Alrashedi, Nouf Shannan Alshammari, Farhan Alshammari, Afrah Madyan Alshammari, Abeer Nuwayfi Alruwaili and Sahar Maziad Alshammari

Healthcare 2024, 12(24), 2570; https://doi.org/10.3390/healthcare12242570 - 20 Dec 2024

Viewed by 861

Abstract

Background: Cardiovascular diseases are the leading cause of mortality globally. Myocardial infarction (MI), a major type of cardiovascular disease, presents long-term challenges for patients. Recognizing patients’ perceived health needs and the factors that influence them is crucial for providing comprehensive care and improving [...] Read more.

Background: Cardiovascular diseases are the leading cause of mortality globally. Myocardial infarction (MI), a major type of cardiovascular disease, presents long-term challenges for patients. Recognizing patients’ perceived health needs and the factors that influence them is crucial for providing comprehensive care and improving outcomes. Aim: This paper explores the perceived health needs, levels of depression, and social support among MI patients, as well as investigates the correlations between these factors. Methods: A cross-sectional study was conducted at King Salman Specialist Hospital from March to June 2024, enrolling 244 MI patients through convenience sampling. Data collection was performed using the following three validated questionnaires: the Cardiac Patient Learning Needs Inventory (CPLNI) to assess the learning needs of MI patients, the Patient Health Questionnaire-9 (PHQ-9) to evaluate depression levels, and the Oslo Social Support Scale (OSSS-3) to measure social support. Statistical analysis was carried out using IBM SPSS Statistics, Version 27. Results: Patients aged 40 years or older and those who were employed exhibited greater learning needs (p < 0.001). Female patients were more depressed than males (p = 0.008). Higher social support was reported by the female patients, those with a family history of MI, and those who were employed (p = 0.002, 0.002, and 0.003, respectively). The total mean score for perceived learning needs was 3.72, with the highest needs in “other pertinent information”, “medication information”, and “anatomy and physiology”. Depression was indicated in 45.1% of MI patients, with significantly higher depression levels in female than in male patients. Additionally, a significant positive correlation was found between social support and perceived learning needs (r = 0.205, p = 0.001), as well as a negative correlation between social support and depression (r = −0.441, p < 0.001). Conclusions: Addressing both the physical and psychological needs is essential for MI patients. Comprehensive educational programs and mental health support services are necessary for improving outcomes. Personalized patient education and routine depression screenings should be integrated into post-MI care. Future research should examine longitudinal changes in learning needs and mental health status. Full article

(This article belongs to the Section Chronic Care)

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14 pages, 1209 KiB

Open AccessArticle

Exploring Beekeepers’ Experiences and Perceptions of Anaphylaxis Risks: A Qualitative Study to Inform Targeted Health Education Programs

by Tea Močnik, Sabina Ličen, Mihaela Zidarn and Mirko Prosen

Healthcare 2024, 12(24), 2569; https://doi.org/10.3390/healthcare12242569 - 20 Dec 2024

Viewed by 662

Abstract

Background: Beekeeping plays crucial natural and economic roles but also poses health risks, as bee stings can cause severe allergic reactions like anaphylaxis, a potentially life-threatening condition that requires timely intervention. Understanding symptoms and the proper use of adrenaline autoinjectors is essential to [...] Read more.

Background: Beekeeping plays crucial natural and economic roles but also poses health risks, as bee stings can cause severe allergic reactions like anaphylaxis, a potentially life-threatening condition that requires timely intervention. Understanding symptoms and the proper use of adrenaline autoinjectors is essential to minimize risks. This study aimed to assess the need for education on anaphylaxis and to develop a health education program to enhance beekeepers’ preparedness and safety. Methods: A qualitative descriptive interpretative method was employed. Two focus groups were conducted, one with eight health care professionals specializing in allergy and clinical immunology and the other with six active beekeepers. The data were analyzed via content analysis using QDA Miner^® Lite v3.0.5 software. Results: The analysis structure comprises five thematic areas: (1) the management of anaphylaxis; (2) the prevention of anaphylaxis; (3) health education approaches; (4) systemic approaches in prevention; and (5) adrenaline autoinjectors. The results highlight key challenges, including the need for better strategies to manage anaphylaxis, improve prevention, and provide practical educational programs for beekeepers. There is also a need for better collaboration between health care professionals and beekeepers, as well as improved access to and knowledge of adrenaline autoinjectors. Conclusions: Targeted education for beekeepers on recognizing anaphylaxis symptoms and using adrenaline autoinjectors is essential for timely intervention and preventing severe outcomes. Given their exposure to bee stings, beekeepers require proper training and regular practice to improve preparedness and safety. This research underscores the need for a comprehensive educational program to reduce anaphylaxis risk and enhance safety in beekeeping. Full article

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12 pages, 545 KiB

Open AccessArticle

Long-Term Determinants of Depression Mood: A 19-Year Follow Up of 2344 Middle-Aged and Older Adults

by Nae-Fang Miao, Chia-Jung Hsieh and Pei-Shan Li

Healthcare 2024, 12(24), 2568; https://doi.org/10.3390/healthcare12242568 - 20 Dec 2024

Viewed by 415

Abstract

Objectives: This study explores depression changes and influencing factors in middle-aged and older individuals, focusing on different cognitive function states. Methods: This cohort study uses panel data from seven waves of the nationally representative Taiwan Longitudinal Study on Aging (1996–2015) with 2344 participants [...] Read more.

Objectives: This study explores depression changes and influencing factors in middle-aged and older individuals, focusing on different cognitive function states. Methods: This cohort study uses panel data from seven waves of the nationally representative Taiwan Longitudinal Study on Aging (1996–2015) with 2344 participants aged 50 or above. Data analysis was conducted from 25 January 2023 to 4 May 2023. Results: Multivariate logistic regression analyzed three trajectories: maintained mood, progressive depression, and consistent depression. Protective factors for progressive depression included self-health perception, exercise, family satisfaction, and financial well being, while risk factors were chronic diseases, pain, substance use, and daily activity limitations. Cognitive function emerged as a significant protective factor, while pain exhibited the highest risk. In the cognitive dysfunction group, only social participation showed notable differences. Conclusion: Progressive and consistent depression in middle-aged and older people have aroused concern. In addition to necessary protection and risk factors, special attention should be paid to the risks posed by the level of pain. Addressing pain as a crucial risk factor is essential, particularly for middle-aged and older people with cognitive impairment and depression, necessitating targeted support. Full article

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14 pages, 776 KiB

Open AccessArticle

Evaluation of the Epidemiological Disease Burden and Nationwide Cost of Endometriosis in Hungary

by Dalma Pónusz-Kovács, Róbert Pónusz, Luca Fanni Sántics-Kajos, Tímea Csákvári, Bettina Kovács, Ákos Várnagy, Kálmán András Kovács, József Bódis and Imre Boncz

Healthcare 2024, 12(24), 2567; https://doi.org/10.3390/healthcare12242567 - 20 Dec 2024

Viewed by 453

Abstract

Background: Endometriosis is one of the most common gynecological diseases that can lead to infertility. The aim of this quantitative, descriptive, and cross-sectional study was to analyze the prevalence and the annual nationwide health insurance treatment cost of endometriosis in Hungary in 2010 [...] Read more.

Background: Endometriosis is one of the most common gynecological diseases that can lead to infertility. The aim of this quantitative, descriptive, and cross-sectional study was to analyze the prevalence and the annual nationwide health insurance treatment cost of endometriosis in Hungary in 2010 and 2019. Methods: The data used in this study were sourced from publicly funded, national, real-world datasets administered by the National Health Insurance Administration (NHIFA). The total number of cases of endometriosis in the Hungarian population was determined by ICD codes and all types of care. The total prevalence, age-specific prevalence, and annual health insurance expenditure by age group were evaluated. Results: The highest numbers of patients and prevalence (2010: 101.9/100,000 women; 2019: 197.3/100,000 women) were found in outpatient care. Endometriosis, regardless of its type, mainly affects patients in the 30–39-year age group (number of patients—2010: 6852; 2019: 11,821). The NHIFA spent a total of EUR 1,639,612 on endometriosis treatment in 2010 and EUR 1,905,476 in 2019. The average annual health insurance expenditure per capita was EUR 574 in 2010 and EUR 426 in 2019. There was a significant correlation between length of stay and mean age of patients in both years (2010 r = 0.856, p < 0.001; 2019 r = 0.877, p < 0.001). Conclusions: The number endometriosis cases is increasing. Early diagnosis and targeted treatment would reduce endometriosis symptoms and therefore improve patients’ quality of life and reduce health insurance costs. This would be helped by the establishment of endometriosis centers. Full article

(This article belongs to the Section Women's Health Care)

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14 pages, 338 KiB

Open AccessArticle

The Cardiac Output–Cerebral Blood Flow Relationship Is Abnormal in Most Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Patients with a Normal Heart Rate and Blood Pressure Response During a Tilt Test

by C (Linda) M. C. van Campen, Freek W. A. Verheugt, Peter C. Rowe and Frans C. Visser

Healthcare 2024, 12(24), 2566; https://doi.org/10.3390/healthcare12242566 - 20 Dec 2024

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Abstract

Introduction: Orthostatic intolerance is highly prevalent in patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and is caused by an abnormal reduction in cerebral blood flow (CBF). In healthy controls (HCs), the regulation of CBF is complex and cardiac output (CO) is an important [...] Read more.

Introduction: Orthostatic intolerance is highly prevalent in patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and is caused by an abnormal reduction in cerebral blood flow (CBF). In healthy controls (HCs), the regulation of CBF is complex and cardiac output (CO) is an important determinant of CBF: a review showed that a 30% reduction in CO results in a 10% reduction in CBF. In previous and separate ME/CFS studies, we showed that CO and CBF decreased to a similar extent during tilt testing. The aim of the study: to test the relationship between CBF and CO, which seems to be abnormal in ME/CFS patients and is different from that in HCs. Methods: In this retrospective study we analyzed this relationship in a large group of patients. To compare the patient data with those of HCs, we focused on patients with a normal heart rate (HR) and blood pressure (BP) response to upright tilt. Also, the influence of clinical data was analyzed. A total of 534 ME/CFS patients and 49 HCs underwent tilt testing with measurements of HR, BP, CBF, CO, and end-tidal PCO₂. To measure CBF, extracranial Doppler flow velocity and vessel diameters were obtained using a GE echo system. The same device was used to measure suprasternal aortic flow velocities. End-tidal PCO₂ was recorded using a Nonin Lifesense device. Results: In 46 (9%) patients, CO and CBF changes were in the normal range for HCs, and in 488 (91%) an abnormal CO and CBF reduction was found. In patients with abnormal CO and CBF reductions, the slope of the regression line of CO versus CBF reduction was almost 1. The multiple regression analysis of the latter group showed that the CO reduction for the most part predicted the CBF reduction, with a limited role for the P_ETCO₂ reduction. Conclusions: Two different patient groups with a normal HR and BP response during the tilt were identified: those with a CO and CBF in the normal range for HCs and those with an abnormal CO and CBF reduction during the tilt (91% of patients). In the latter group of patients, an almost 1:1 relationship between the CO and CBF reduction suggests the absence of compensatory vasodilation in the cerebral vasculature. This might indicate endothelial dysfunction in most ME/CFS patients and may have clinical and therapeutic implications. Full article

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Healthcare, Volume 12, Issue 24 (December-2 2024) – 104 articles

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