Healthcare

33 pages, 826 KiB

Open AccessArticle

Effects of Short Video App Guided Mindfulness Meditation on Policemen’s Communication Anxiety, PTSD, Anger Management, and Mood Disorders

by Chao Liu, Li-Jen Lin, Kang-Jie Zhang, Thu-Hua Liu and Wen-Ko Chiou

Healthcare 2025, 13(10), 1213; https://doi.org/10.3390/healthcare13101213 - 21 May 2025

Abstract

Background: Law enforcement is a high-stress profession, with officers frequently exposed to traumatic events, leading to mental health challenges such as communication anxiety, post-traumatic stress disorder (PTSD), anger management difficulties, and mood disorders. Mindfulness meditation (MM), particularly when guided through short video applications, [...] Read more.

Background: Law enforcement is a high-stress profession, with officers frequently exposed to traumatic events, leading to mental health challenges such as communication anxiety, post-traumatic stress disorder (PTSD), anger management difficulties, and mood disorders. Mindfulness meditation (MM), particularly when guided through short video applications, has shown promise in addressing these issues by enhancing emotional regulation and resilience. Objective: This study explores the effects of an 8-week MM intervention, delivered via short video apps, on communication anxiety, PTSD, anger management, and mood disorders in police officers. Methods: A randomized controlled trial (RCT) was conducted with 110 full-time police officers aged 25–55 in China. The final 92 eligible participants were divided into two groups: the MM group (n = 46) and the control group (n = 46). The intervention consisted of daily 10–15 min video-guided MM sessions. Pre- and post-intervention measures included validated questionnaires assessing communication anxiety (PRCA-24), PTSD (PCL-5), anger management (STAXI-2), and mood disorders (DASS-21). Data analysis was performed using MANOVA. Results: The intervention group showed significant improvements in communication anxiety (F = 8.505, p = 0.004), PTSD (F = 25.831, p < 0.001), anger management (F = 4.968, p = 0.027), and mood disorders (F = 13.058, p < 0.001) compared to the control group. These improvements were supported by significant interaction effects between group and time, indicating that the MM intervention had a positive impact on these mental health variables. Conclusions: Video-guided MM delivered via short video apps significantly reduced communication anxiety, PTSD symptoms, and mood disorders, and improved anger management among police officers. These findings highlight the potential of digital MM interventions as a scalable and accessible tool for enhancing mental well-being and resilience in law enforcement personnel. Full article

19 pages, 805 KiB

Open AccessArticle

Metabolic, Hematological, and Functional Health in Adults with Down Syndrome and Significance of Parental Health Literacy: A Cross-Sectional Study

by Petra Rajkovic Vuletic, Marijana Geets-Kesic, Anamarija Jurcev-Savicevic, Nurjanah Nurjanah and Barbara Gilic

Healthcare 2025, 13(10), 1212; https://doi.org/10.3390/healthcare13101212 - 21 May 2025

Abstract

Background/Objectives: The evaluation of metabolic and physiological health indicators in people with Down syndrome (DS) is crucial, since these people are more prone to metabolic problems. However, there is limited scientific evidence regarding the health status and health literacy (HL) of adults [...] Read more.

Background/Objectives: The evaluation of metabolic and physiological health indicators in people with Down syndrome (DS) is crucial, since these people are more prone to metabolic problems. However, there is limited scientific evidence regarding the health status and health literacy (HL) of adults with DS and their legal guardians. This study aimed to assess the health status of adults with DS and determine the HL levels of their legal guardians. Methods: Eighteen adults (11 females, 7 males) with DS aged 28.64 ± 9.01 years were tested for health status, and their legal guardians completed the HL survey. Gender differences in all study variables were checked by t-tests for independent samples and Cohen’s D effect sizes (ESs). Differences in all study variables between parents with low and adequate HL were calculated via receiver operating characteristic curves. Results: Males were overweight, whereas females were obese (mean BMI = 26.51 and 30.10 for males and females, respectively). Females had higher high-density lipoprotein concentrations (large ES), whereas males had higher hematocrit and hemoglobin concentrations (large ES). Hematological parameters were the most significant variables that differed between parents with limited and adequate HL status (AUC = 0.79–0.87). Conclusions: These findings suggest that in the absence of severe comorbidities, adults with DS may achieve stable health profiles, particularly when supported by structured physical activity and informed caregiving. The influence of parental HL on health parameters points to the potential for parent-targeted health education to improve health outcomes and promote autonomy in individuals with DS through supported decision-making. Thus, our findings highlight the need for greater investment in caregiver and parental health education and systemic support to optimize health outcomes in adults with DS. Future research should explore interventions aimed at improving parental HL and examine the extent to which these efforts translate into improved health outcomes for people with DS. Full article

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15 pages, 490 KiB

Open AccessArticle

The Mediation Role of Emotion Regulation in the Relationship Between Anxiety and Depression in University Students with Specific Learning Disorder

by Michela Camia, Angela Ciaramidaro, Erika Benassi, Sara Giovagnoli, Damiano Angelini, Sandro Rubichi and Maristella Scorza

Healthcare 2025, 13(10), 1211; https://doi.org/10.3390/healthcare13101211 - 21 May 2025

Abstract

Background: Difficulties in emotion regulation are associated with a range of emotional disorders, such as anxiety disorders and depression. However, the mechanisms that underpin this relationship are still unclear. Moreover, little is known about emotion regulation in university students with specific learning disorder [...] Read more.

Background: Difficulties in emotion regulation are associated with a range of emotional disorders, such as anxiety disorders and depression. However, the mechanisms that underpin this relationship are still unclear. Moreover, little is known about emotion regulation in university students with specific learning disorder (SLD). This study examined emotion regulation and its role as mediator in the relationship between anxiety and depressive symptoms in a group of university students with and without SLD. Methods: One hundred and twenty-nine Italian university students between 18 and 31 years of age were enrolled. Fifty students had a diagnosis of SLD and seventy-nine were typically developing students (TD). The data were obtained from a cross-sectional study conducted as part of a broader research project investigating the well-being of university students. Participants completed questionnaires for emotion regulation (DERS), anxiety (BAI), and depression (BDI). Results: In comparison to the group without SLD, the participants with SLD self-reported more frequent emotional regulation problems and more symptoms of anxiety and depression. SLD students also reported more difficulties in three domains of emotion regulation (nonacceptance, strategies, and clarity). Moreover, in both SLD and TD students, emotion regulation was found to mediate the association between anxiety and depression. Conclusions: The study suggests the importance of promoting adaptive emotion regulation strategies in university students with SLD and incorporating emotion regulation as a clinical target into existing interventions. Full article

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20 pages, 260 KiB

Open AccessArticle

The Cross-Cultural Competencies and Attitudes Toward Ultraorthodox Clients Among Secular Therapists in Israel: An Explanatory Study

by Einat Doron, Dariusz Walkowiak, Rivka Tuval-Mashiach, Sławomir Tobis and Jan Domaradzki

Healthcare 2025, 13(10), 1210; https://doi.org/10.3390/healthcare13101210 - 21 May 2025

Abstract

Background: To provide effective mental health care across cultural differences, therapists must develop cultural competencies, including an awareness of and sensitivity to diverse backgrounds. In Israel, secular therapists (STs) working with ultra-orthodox (UO), also referred to as Haredi, clients face challenges due to [...] Read more.

Background: To provide effective mental health care across cultural differences, therapists must develop cultural competencies, including an awareness of and sensitivity to diverse backgrounds. In Israel, secular therapists (STs) working with ultra-orthodox (UO), also referred to as Haredi, clients face challenges due to mutual distrust and sociopolitical tensions between the communities. This study aims to assess Israeli STs’ cross-cultural competencies and attitudes toward Haredi clients, examining the association between perceptions and competencies. Methods: The data were collected from an anonymous, self-administered online survey conducted between April and November 2024 among 70 STs in Israel. The study utilized the Cross-Cultural Competence of Healthcare Professionals (CCCHP-27) scale and a self-developed questionnaire assessing STs’ attitudes toward UO clients. The statistical analysis was performed using JASP 0.18.3. Results: While STs exhibited high general cross-cultural competence, their competence in working with Haredi clients was lower and more complex. Therapists with more experience treating UO clients had more positive attitudes toward them, whereas those working in public settings demonstrated lower cultural awareness. Although STs faced cultural and ideological challenges, many expressed openness and professional growth. Notably, while 57.2% felt that working with UO clients improved their skills, only 37.2% recommended it to others. Similarly, while 52.8% enjoyed working with diverse clients, only 27.2% reported enjoying working with UO clients. A negative correlation was found between the emotions about minorities scale and two UO-related subscales, views (ρ = −0.307, p = 0.01) and awareness (ρ = −0.534, p < 0.001), suggesting that local sociopolitical factors influence attitudes toward the Haredi community. Conclusions: This study highlights a gap between STs’ general cross-cultural competencies and their attitudes toward the Haredi population. The findings underscore the need for continued professional training in culturally competent therapy, as personal interactions play a crucial role in bridging societal divides and improving therapeutic relationships. Full article

14 pages, 1115 KiB

Open AccessArticle

Regional Alliance for Cervical Cancer Prevention in Eastern Europe and Central Asia: Progressing Towards the Target 1 of the Global Strategy for Cervical Cancer Elimination

by Silvia Ussai, Teymur Seyidov, Tamar Khomasuridze and on behalf of the Regional Alliance Group of Experts on HPV Vaccination

Healthcare 2025, 13(10), 1209; https://doi.org/10.3390/healthcare13101209 - 21 May 2025

Abstract

Background and Objectives: Cervical cancer remains a critical public health challenge in Eastern Europe and Central Asia (EECA), where systemic barriers have hindered prevention efforts. This descriptive regional study evaluates progress toward achieving Target 1 of the WHO Global Strategy for Cervical Cancer [...] Read more.

Background and Objectives: Cervical cancer remains a critical public health challenge in Eastern Europe and Central Asia (EECA), where systemic barriers have hindered prevention efforts. This descriptive regional study evaluates progress toward achieving Target 1 of the WHO Global Strategy for Cervical Cancer Elimination—vaccinating 90% of girls by age 15—in 17 countries and territories. The research is situated within the context of the Regional Alliance for Cervical Cancer Prevention in EECA, a multi-stakeholder platform launched by UNFPA in 2021 to accelerate regional progress toward WHO targets. The Alliance supports countries through technical collaboration, shared learning, and political engagement. Therefore, as a secondary endpoint, the study explores possible correlations between national achievements and the post-2021 scale-up efforts supported by the Alliance. Methods: A standardized questionnaire, consolidated by United Nation Population Fund (UNFPA) technical experts, was disseminated in November 2024 to 17 national focal points, yielding 19 responses due to disaggregated submissions from Bosnia and Herzegovina. The survey collected data on HPV vaccination policies, delivery models, vaccine type, target populations, and coverage. Results: By late 2024, six countries had implemented HPV vaccination before 2021, while six more launched programs after the Regional Alliance’s formation in 2021. Coverage varied widely, from 0.2% in Brčko District to 99.3% in Uzbekistan. Most countries targeted girls aged 9–14, with increasing male inclusion and catch-up cohorts. Gardasil 4 was the most used vaccine, though Gardasil 9 is gaining ground. School-based and hybrid delivery strategies were associated with significantly higher coverage (p = 0.0121). Inferential analysis also showed significant variation by vaccine type (p = 0.0067) and a positive correlation with program maturity (ρ = 0.52, p = 0.067). However, findings should be interpreted considering limitations including reliance on self-reported country data and absence of independent validation. Conclusions: The results offer actionable insights into delivery models, gender inclusion, and regional disparities—supporting efforts to close the gap toward 2030 elimination targets in EECA Countries. Full article

(This article belongs to the Special Issue UN Sustainable Development Goals (SDGs) Beyond 2023 Agenda: The Role of International Partnerships and Alliances Towards Equitable Access to Care)

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12 pages, 794 KiB

Open AccessArticle

Knowledge, Adherence, and Barriers to Gluten-Free Diet Among Adults with Celiac Disease in Saudi Arabia: A Pilot Study at a Tertiary Hospital in Madinah, Saudi Arabia

by May A. Alsayb, Suliman A. Alharbi, Renad H. Alloqmani, Ghaida A. Madkli, Rahaf A. Basharahil, Marah I. Alhejaili and Walaa A. Mumena

Healthcare 2025, 13(10), 1208; https://doi.org/10.3390/healthcare13101208 - 21 May 2025

Abstract

Background: Celiac disease (CD) is an autoimmune condition triggered by gluten ingestion in genetically predisposed individuals. Management typically involves a strict gluten-free diet (GFD). However, there are limited data concerning adherence to GFD among adult CD patients in Saudi Arabia. Therefore, this [...] Read more.

Background: Celiac disease (CD) is an autoimmune condition triggered by gluten ingestion in genetically predisposed individuals. Management typically involves a strict gluten-free diet (GFD). However, there are limited data concerning adherence to GFD among adult CD patients in Saudi Arabia. Therefore, this study aimed to pilot test the assessment of knowledge, adherence to GFD, and barriers to adherence to GFD among adult celiac patients in Madinah, Saudi Arabia. Methods: Cross-sectional data were collected from 36 adults with celiac disease at King Fahad Hospital, Madinah (2021–2022). After obtaining consent, participants completed an online questionnaire covering sociodemographic data, GFD knowledge, adherence, and related barriers. Results: Only 33% of participants were aware of the Ministry of Health’s GFD support program, with 30.6% utilizing gluten-free products and 27.8% receiving financial assistance. Higher adherence scores were significantly associated with awareness of the program, reading nutrition labels, understanding GFD requirements, receiving financial support, and using separate utensils for gluten-free food preparation. The majority (58.3%) had not consulted a dietitian, and no significant association was found between dietitian consultation and GFD adherence. Poor knowledge and difficulty interpreting nutrition labels were reported as primary barriers. Conclusions: Improving public and patient awareness of the GFD and available support programs is essential in enhancing adherence among CD patients in Saudi Arabia. Healthcare providers should play a more active role in patient education and ongoing support. Full article

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18 pages, 892 KiB

Open AccessArticle

Trends of Korean Medicine Treatment for Parkinson’s Disease in South Korea: A Cross-Sectional Analysis Using the Health Insurance Review and Assessment Service–National Patient Sample Database

by BackJun Kim, Huijun Kim, Ye-Seul Lee, Yoon Jae Lee, In Chul Jung, Ju Yeon Kim and In-Hyuk Ha

Healthcare 2025, 13(10), 1207; https://doi.org/10.3390/healthcare13101207 - 21 May 2025

Abstract

Background/Objectives: Parkinson’s disease (PD) is a major neurodegenerative condition, mainly treated using dopamine-based therapies. However, the side effects and limitations of these therapies hinder their use. This study aimed to analyze the utilization of Korean medicine (KM) by patients with PD in Korea. [...] Read more.

Background/Objectives: Parkinson’s disease (PD) is a major neurodegenerative condition, mainly treated using dopamine-based therapies. However, the side effects and limitations of these therapies hinder their use. This study aimed to analyze the utilization of Korean medicine (KM) by patients with PD in Korea. Methods: Data of the Health Insurance Review and Assessment Service–National Patient Sample were used to investigate the status and trend of KM utilization by patients with PD in Korea from January 2010 to December 2019. Data of 18,562 patients were included, and analyses were performed on the status of KM and Western medicine (WM) utilization, cost of care, prescribed medications, comorbidities, and characteristics of patients with PD. Results: The number of patients who utilized KM services for PD gradually increased over the 10-year period, with 10.6% of all patients with PD using KM services in 2019. In addition, the number of KM users with PD, number of claims, and expenses all showed an increase. The rate of increase in KM service utilization was greater than that of WM. Among KM services, acupuncture had the highest expense (50.6%). Regarding comorbidities in patients with PD, musculoskeletal diseases were the most common (58.6%). Among WM medications prescribed for the KM users, dopa and dopa derivatives (15.5%) and anti-dementia drugs (11.7%) were the most common. Conclusions: This study provides useful information on KM utilization status and trends among patients with PD and the characteristics of these patients. Follow-up research is warranted on the utilization status of more diverse KM services. Full article

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18 pages, 1347 KiB

Open AccessArticle

Reconciliation of Work and Personal Roles Among Critical Care Nurses: Constructivist Grounded Theory Research

by Miguel Valencia-Contrera, Lissette Avilés and Naldy Febré

Healthcare 2025, 13(10), 1206; https://doi.org/10.3390/healthcare13101206 (registering DOI) - 21 May 2025

Abstract

Objectives: There are numerous and varied theoretical gaps in the study of work–family interaction, which limits the understanding and approach to this phenomenon, especially among vulnerable groups such as critical care nursing professionals. In this regard, the objective of this study was to [...] Read more.

Objectives: There are numerous and varied theoretical gaps in the study of work–family interaction, which limits the understanding and approach to this phenomenon, especially among vulnerable groups such as critical care nursing professionals. In this regard, the objective of this study was to theorize the work–family interaction process among nurses working in Critical Care Units in Chile. Methods: Constructivist grounded theory was employed to conceptualize the phenomenon of interest from the perspectives of nurses, their families, and administrative staff. Data were collected through observations in two high-complexity hospitals in Chile, one public and one private; document analysis; and 51 in-depth interviews. Data analysis was conducted using constant comparisons and multi-level coding. To ensure rigor, the study followed the 13 criteria proposed by Charmaz and Thornberg for constructivist grounded theory studies and was approved by a Scientific Ethics Committee. Results: The reconciliation of work and personal roles emerged as the core process explaining the interaction between work and personal life among nurses in Critical Care Units. This complex and multidimensional process comprised three stages: resisting the war of roles, hitting rock bottom, and reconciling, through which nurses attempt to achieve balance between work and personal roles. Conclusions: We developed a theory that explains the work–family interaction process. The theory developed highlights the importance of an integrated approach that considers both sources of conflict and reconciliation strategies. Addressing this phenomenon effectively requires interventions at the individual, organizational, and public policy levels. Full article

(This article belongs to the Section Nursing)

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23 pages, 1106 KiB

Open AccessReview

A Scoping Review of AI-Driven Digital Interventions in Mental Health Care: Mapping Applications Across Screening, Support, Monitoring, Prevention, and Clinical Education

by Yang Ni and Fanli Jia

Healthcare 2025, 13(10), 1205; https://doi.org/10.3390/healthcare13101205 - 21 May 2025

Abstract

Background/Objectives: Artificial intelligence (AI)-enabled digital interventions are increasingly used to expand access to mental health care. This PRISMA-ScR scoping review maps how AI technologies support mental health care across five phases: pre-treatment (screening), treatment (therapeutic support), post-treatment (monitoring), clinical education, and population-level prevention. [...] Read more.

Background/Objectives: Artificial intelligence (AI)-enabled digital interventions are increasingly used to expand access to mental health care. This PRISMA-ScR scoping review maps how AI technologies support mental health care across five phases: pre-treatment (screening), treatment (therapeutic support), post-treatment (monitoring), clinical education, and population-level prevention. Methods: We synthesized findings from 36 empirical studies published through January 2024 that implemented AI-driven digital tools, including large language models (LLMs), machine learning (ML) models, and conversational agents. Use cases include referral triage, remote patient monitoring, empathic communication enhancement, and AI-assisted psychotherapy delivered via chatbots and voice agents. Results: Across the 36 included studies, the most common AI modalities included chatbots, natural language processing tools, machine learning and deep learning models, and large language model-based agents. These technologies were predominantly used for support, monitoring, and self-management purposes rather than as standalone treatments. Reported benefits included reduced wait times, increased engagement, and improved symptom tracking. However, recurring challenges such as algorithmic bias, data privacy risks, and workflow integration barriers highlight the need for ethical design and human oversight. Conclusion: By introducing a four-pillar framework, this review offers a comprehensive overview of current applications and future directions in AI-augmented mental health care. It aims to guide researchers, clinicians, and policymakers in developing safe, effective, and equitable digital mental health interventions. Full article

(This article belongs to the Special Issue Adversarial Learning and Its Applications in Healthcare)

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17 pages, 620 KiB

Open AccessReview

Surface Electromyography Combined with Artificial Intelligence in Predicting Neuromuscular Falls in the Elderly: A Narrative Review of Present Applications and Future Perspectives

by Yuandan Liao, Gang Tan and Hui Zhang

Healthcare 2025, 13(10), 1204; https://doi.org/10.3390/healthcare13101204 - 21 May 2025

Abstract

Background: Falls among the elderly are a major public health concern, leading to increased disability and mortality. Traditional protective measures are important, but early detection and prevention are equally critical. Surface electromyography (sEMG) signals, which assess muscle electrical activity, can indicate a [...] Read more.

Background: Falls among the elderly are a major public health concern, leading to increased disability and mortality. Traditional protective measures are important, but early detection and prevention are equally critical. Surface electromyography (sEMG) signals, which assess muscle electrical activity, can indicate a fall risk by detecting muscle weakness or instability. Objective: This narrative review synthesizes the research progress of sEMG in predicting neuromuscular falls among the elderly. Our goal is to explore the innovative application and development potential of the integration of sEMG and artificial intelligence (AI) in fall prevention among the elderly. Methods: A systematic search of PubMed, IEEE Xplore, and Web of Science (2013–2023) was conducted using the following keywords: artificial intelligence, wearable, sEMG, neuromuscular, and fall prediction. The inclusion criteria prioritized studies integrating sEMG with AI for elderly fall risk assessments, while non-empirical or non-English studies were excluded. Results: AI algorithms hold significant potential in medical applications, and studies on predicting neuromuscular falls in the elderly using sEMG signals have made notable progress. However, limitations include a reliance on simulated data, a lack of standardized models, sensor inaccuracies, and a focus on prediction rather than prevention. To address these challenges, this study proposes collecting authentic sEMG signals from elderly individuals with fall histories and healthy controls. By leveraging AI to develop predictive models and designing a portable sEMG acquisition and analysis system tailored for elderly communities, real-time fall risk predictions and early warnings can be achieved, thereby reducing fall incidences among the elderly. Conclusions: The combination of sEMG and AI presents a substantial promise for predicting neuromuscular falls in the elderly. Future research should prioritize validating models in real-world settings, refining sensor technology and signal processing techniques, and shifting focus toward comprehensive preventive strategies rather than mere prediction. These advancements could significantly enhance the quality of life and health outcomes of the elderly, while alleviating burdens on families and healthcare systems. Full article

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14 pages, 2068 KiB

Open AccessProject Report

How to Promote the Idea of Transplantation—Second Life Social Campaign as an Example of Successful Action in Poland—What Youth Is Used to, Adults Remember

by Jacek Zawierucha, Julia Piasecka, Agnieszka Patelka, Sławomir Jerzy Małyszko, Jacek Stanisław Małyszko and Jolanta Małyszko

Healthcare 2025, 13(10), 1203; https://doi.org/10.3390/healthcare13101203 - 21 May 2025

Abstract

Background: Solid organ transplantation, which began as an experimental procedure over 100 years ago, has now become a viable therapeutic option for the vast majority of patients with end-stage organ failure. However, a major limiting factor remains the shortage of organs available [...] Read more.

Background: Solid organ transplantation, which began as an experimental procedure over 100 years ago, has now become a viable therapeutic option for the vast majority of patients with end-stage organ failure. However, a major limiting factor remains the shortage of organs available for transplantation. To expand the donor pool, it is essential to increase awareness of transplantation, including its legal, cultural, and ethical aspects. Every year, numerous organizations, primarily non-governmental, organize hundreds of campaigns promoting transplantation worldwide. The majority of these initiatives are one-time events tied to observances such as World Transplant Day, World Kidney Day, and others. The growing role of social media in spreading information is also becoming a key factor in promoting organ donation and transplantation, as social factors play an important role in expanding the donor pool. Many organizations that support transplantation, along with healthcare providers, widely use platforms like Facebook and other social media to promote and increase organ donation. Objectives: The “Second Life” is a social campaign presentation to raise awarenes about transplantation. Project Description: The campaign has been running continuously for 17 years in Poland, promoting the concepts of organ donation and transplantation in collaboration with high school students. During this time, 950 high schools across the country participated in the project, with approximately 450,000 high school students actively engaging in the campaign. Outcomes: They organized a series of activities to promote organ donation and transplantation within their social circles, distributing nearly 1.5 million declarations of will. Additionally, they helped raise awareness about presumed consent and educated others on the concepts of organ donation and transplantation. Conclusions/Implications: This long-term initiative is crucial for raising awareness, educating the public, and promoting the idea of organ donation. It fosters a more positive attitude toward organ donation and transplantation, ultimately contributing to the expansion of the donor pool and an increase in transplantations in the near future. Full article

(This article belongs to the Special Issue Health Promotion, Disease Prevention, and Chronic Illness Experience: A Health Psychology Perspective)

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11 pages, 1014 KiB

Open AccessViewpoint

Multimorbidity: Addressing the Elephant in the Clinic Room

by David Cosio

Healthcare 2025, 13(10), 1202; https://doi.org/10.3390/healthcare13101202 - 21 May 2025

Abstract

Multimorbidity is the conjoint presence of multiple conditions in patients, which is a public health problem. Multimorbidity is like the elephant in the clinic room because it remains the unaddressed challenge we face in healthcare. Clinical health psychology has a role to play [...] Read more.

Multimorbidity is the conjoint presence of multiple conditions in patients, which is a public health problem. Multimorbidity is like the elephant in the clinic room because it remains the unaddressed challenge we face in healthcare. Clinical health psychology has a role to play in this undertaking because it recognizes the intersection and interface of concurrent mental and/or behavioral problems and physical diseases. The current article will define multimorbidity, describe current statistics, how it differs from comorbidity, how to use the biopsychosocial model, and ways in which clinical health psychologists can manage and prevent it in their clinics. A model of how to address multimorbidity will be shared using the role of a clinical health psychologist working in a multidisciplinary pain clinic in a hospital setting serving patients who are socioeconomically disadvantaged. Full article

(This article belongs to the Special Issue Innovations in Interprofessional Care and Training)

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25 pages, 592 KiB

Open AccessArticle

Beyond the Unitary: Direct, Moderated, and Mediated Associations of Mindfulness Facets with Mental Health Literacy and Treatment-Seeking Attitudes

by Matea Gerbeza, Kelsy Dąbek, Katelyn Lockinger, Isabelle M. Wilkens, Mia Loarca-Rodriguez, Katimah Grogan and Shadi Beshai

Healthcare 2025, 13(10), 1201; https://doi.org/10.3390/healthcare13101201 - 20 May 2025

Abstract

Background and Objectives: Psychological disorders are prevalent and distressing. Early treatment initiation can prevent adverse outcomes and reduce healthcare system impacts. Improving mental health literacy (MHL)—one’s knowledge regarding psychological disorders—and treatment-seeking attitudes (TSAs) is key in early treatment initiation. Examining the facets of [...] Read more.

Background and Objectives: Psychological disorders are prevalent and distressing. Early treatment initiation can prevent adverse outcomes and reduce healthcare system impacts. Improving mental health literacy (MHL)—one’s knowledge regarding psychological disorders—and treatment-seeking attitudes (TSAs) is key in early treatment initiation. Examining the facets of dispositional mindfulness—the capacity to pay attention to present-moment experiences with acceptance—may offer more granular insights into understanding MHL and TSAs. This study examined (a) associations between mindfulness facets and MHL and TSAs, (b) facets’ prediction of MHL and TSAs beyond demographics, (c) moderation of the MHL–TSA relationship by mindfulness facets, and (d) mediation of mindfulness–TSA relationships via general self-efficacy (GSE). Methods: A community sample of 299 adults was recruited online (TurkPrime) and completed demographic questions and self-report measures: Five-Facet Mindfulness Questionnaire-15, Mental Health Literacy Scale, Mental Help-Seeking Attitudes Scale, and General Self-Efficacy Scale. Results: Describe, Non-Judgment, and Act with Awareness were modestly associated with MHL; all five facets correlated with TSAs. Hierarchical regressions controlling for demographics showed that Describe and Non-Reactivity predicted MHL, while Act with Awareness uniquely predicted TSAs. Non-Reactivity moderated the MHL–TSA relationship, with higher Non-Reactivity amplifying the relationship. GSE fully mediated relationships between Observe and Non-Judgment with TSAs, suggesting self-efficacy is a key mechanism of these facets. Conclusions: Interventions cultivating Non-Reactivity, Describe, and Act with Awareness may improve the translation of mental health knowledge into treatment-seeking behaviors. Future research should explore how mindfulness facets independently and interactively foster early intervention and treatment engagement. Full article

(This article belongs to the Special Issue Health Promotion, Disease Prevention, and Chronic Illness Experience: A Health Psychology Perspective)

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15 pages, 435 KiB

Open AccessArticle

Pretransplant Physical Activity and Cardiovascular Risk Factors in Kidney Transplant Candidates: A Cross-Sectional Study

by Emilia Ferrer-López, Víctor Cantín-Lahoz, Francisco Javier Rubio-Castañeda, Juan José Aguilón-Leiva, María García-Magán, Carlos Navas-Ferrer, Eva Benito-Ruiz, María Isabel Serrano-Vicente, Isabel Blázquez-Ornat, Isabel Antón-Solanas and Fernando Urcola-Pardo

Healthcare 2025, 13(10), 1200; https://doi.org/10.3390/healthcare13101200 - 20 May 2025

Abstract

Background/Objectives: Individuals with chronic kidney disease often face significant physical and clinical challenges, such as muscle weakness, fatigue, and reduced cardiorespiratory capacity, that impact their quality of life. Physical activity has emerged as an effective intervention to counteract these effects, with clinical guidelines [...] Read more.

Background/Objectives: Individuals with chronic kidney disease often face significant physical and clinical challenges, such as muscle weakness, fatigue, and reduced cardiorespiratory capacity, that impact their quality of life. Physical activity has emerged as an effective intervention to counteract these effects, with clinical guidelines recommending exercise as a standard treatment for kidney transplant recipients. The aim of this study was to assess pretransplant physical activity levels in a cohort of transplant patients and analyze their relationships with cardiovascular risk factors. Methods: A cross-sectional, analytical, and correlational study was conducted from September 2020 to June 2022 with a sample of 122 kidney transplant recipients assessed before kidney transplantation. Sociodemographic data, anthropometric data, comorbidities, renal replacement therapy types, and clinical and analytical data were collected from the patients’ clinical records. Physical activity was assessed via the International Physical Activity Questionnaire. Results: The average time spent waiting for transplantation was 423 ± 405 days, which was longer (387 ± 524) in the group of those under 65 years than in those over 65 years (194 ± 256) (p = 0.010). The median energy expenditure was 1742 (IQR = 1719) METs. In addition, 15.6% of the participants reported inactivity. Men reported higher physical activity levels (median: 2076 METs/week; IQR: 2037) than women did (median: 1386 METs/week; IQR: 1238). A higher level of physical activity was found in non-dialysis patients, overweight patients, and those with a history of stroke. A significant positive correlation was found between physical activity levels and serum urea. Conclusions: Increased physical activity levels were observed in men and in participants under 65 years of age. Patients with cardiovascular risk factors, such as hypertension, diabetes mellitus, dyslipidemia, overweight and obesity, reported lower activity levels, whereas those with a prior history of cerebrovascular accidents engaged in more physical activity. This study highlights the importance of assessing physical activity and promoting exercise for chronic kidney disease patients awaiting kidney transplantation. Further research is needed to explore the evolution of physical activity in this population and its impact post-transplantation. Full article

(This article belongs to the Special Issue Nursing Competencies: New Advances in Nursing Care)

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18 pages, 467 KiB

Open AccessArticle

Beliefs and Attitudes of Hesitant Spaniards Towards COVID-19 Vaccines: “A Personal Decision”

by Andrea Langbecker and Daniel Catalan-Matamoros

Healthcare 2025, 13(10), 1199; https://doi.org/10.3390/healthcare13101199 - 20 May 2025

Abstract

Background/Objectives: Vaccine hesitancy has increased during the coronavirus pandemic, a period marked by the spread of disinformation and conspiracy theories about COVID-19 vaccines. This qualitative study aimed to explore the beliefs and attitudes of Spaniards towards COVID-19 vaccines and analyze the role of [...] Read more.

Background/Objectives: Vaccine hesitancy has increased during the coronavirus pandemic, a period marked by the spread of disinformation and conspiracy theories about COVID-19 vaccines. This qualitative study aimed to explore the beliefs and attitudes of Spaniards towards COVID-19 vaccines and analyze the role of information sources in this process. Methods: Semi-structured interviews were conducted with 35 residents of Spain who exhibited varying levels of vaccine hesitancy. Through thematic content analysis, the narratives supporting vaccination-related decisions, as well as the influence and trust in information sources, were examined. Results: Reasons for getting vaccinated included perceptions of it being “almost an obligation” and “fear of illness and death”. Conversely, reasons for not getting vaccinated included “uncertainty about vaccines”, the belief that “the risk is not real”, and the perception that “vaccination is a personal decision”. Regarding vaccine-related information sources, interviewees expressed distrust of the media, particularly television, as they considered news about vaccine effectiveness and characteristics to be contradictory and constantly changing, which created uncertainty about its reliability. Most interviewees were unsure if social media influenced their decision not to get vaccinated. However, those who acknowledged its impact mentioned trusting sources such as people with a university education. Additionally, close contacts—particularly healthcare professionals—had a significant influence on the decision not to get vaccinated. Conclusions: This study shows that the decision not to vaccinate is shaped by personal beliefs and sources of information—particularly social media and close acquaintances, including healthcare professionals. Full article

(This article belongs to the Section Coronaviruses (CoV) and COVID-19 Pandemic)

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18 pages, 226 KiB

Open AccessArticle

Knowledge, Attitude, and Practice Regarding Antibiotic Prescription Among Dentists in Saudi Arabia—A Cross-Sectional Survey

by Kiran Iyer, Jawaher Alhababi, Alanoud Aldhafayan, Amal Albarrak, Faey Alburidy, Fatimah Alanazi, Fatimah Albawardi and Abdulmohsen Alfadley

Healthcare 2025, 13(10), 1198; https://doi.org/10.3390/healthcare13101198 - 20 May 2025

Abstract

Background/Objectives: Prescription challenges in antibiotics contribute to the global prevalence of antimicrobial resistance (AMR). We are rapidly moving into an age of ‘resistome’, which has grave consequences. Dentists frequently prescribe antibiotics for intraoral infections and as prophylaxis, particularly for immunocompromised patients, although the [...] Read more.

Background/Objectives: Prescription challenges in antibiotics contribute to the global prevalence of antimicrobial resistance (AMR). We are rapidly moving into an age of ‘resistome’, which has grave consequences. Dentists frequently prescribe antibiotics for intraoral infections and as prophylaxis, particularly for immunocompromised patients, although the clinical justification for these prescriptions remains a point of concern. This study aimed to evaluate the knowledge, attitudes, and practices of dental practitioners in Saudi Arabia regarding antibiotic prescription. Methods: A cross-sectional survey was conducted from October to November 2024, involving 252 dentists from various regions of Saudi Arabia. Data were gathered through social media. Results: The dentists were likely to agree to prescribe antibiotics post-procedurally to be safe [OR 0.18, p = 0.42, CI −0.94]. Contrastingly, the knowledge of less experienced dentists [OR 9.60, p = 0.03, CI 1.21–76.15] was updated regarding prescribing penicillin for women in the third trimester of pregnancy than that of experienced dentists (>10 years). Conclusions: Although the knowledge level of practitioners in the public sector is reasonably good, there are concerns about antibiotic prescription practice among private dental practitioners. Full article

(This article belongs to the Special Issue Implications for Healthcare Policy and Management)

20 pages, 666 KiB

Open AccessArticle

Influence of Lifestyle Habits on Psychological Well-Being of University Students: A Quantitative Cross-Sectional Study

by Laura García-Pérez, Rosario Padial-Ruz, Mar Cepero-González and José Luis Ubago-Jiménez

Healthcare 2025, 13(10), 1197; https://doi.org/10.3390/healthcare13101197 - 20 May 2025

Abstract

Background: This study explored the influence of three key lifestyle habits—physical activity (PA), adherence to the Mediterranean diet (MD), and sleep duration—on psychological well-being indicators (resilience, psychological distress, and self-esteem) in university students. Methods: A total of 928 students (67.3% females; [...] Read more.

Background: This study explored the influence of three key lifestyle habits—physical activity (PA), adherence to the Mediterranean diet (MD), and sleep duration—on psychological well-being indicators (resilience, psychological distress, and self-esteem) in university students. Methods: A total of 928 students (67.3% females; total sample mean age = 21.01 ± 1.95) from the Faculty of Education at the University of Granada participated. Validated self-report instruments were used to assess all variables: the International Physical Activity Questionnaire (IPAQ-SF), the KIDMED index, the Connor–Davidson Resilience Scale (CD-RISC), the Depression Anxiety Stress Scales (DASS-21), and the Rosenberg Self-Esteem Scale. Results: Results showed that male students reported higher levels of PA, better MD adherence, longer sleep duration, and more favorable psychological outcomes. Stepwise regression analyses indicated that MD adherence was the strongest and most consistent predictor of resilience, self-esteem, and psychological distress. Sleep duration emerged as a key factor, particularly in predicting resilience among men. Although no direct association was found between PA and psychological distress, mediation analysis revealed a significant indirect effect through sleep duration. Conclusions: These findings underscore the relevance of promoting healthy lifestyle habits in an integrated and sex-sensitive manner to enhance mental health (MH) in university students. In particular, targeting future teachers may be essential, given their potential role as promoters of well-being in school settings. Full article

(This article belongs to the Special Issue Future Trends of Physical Activity in Health Promotion)

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13 pages, 624 KiB

Open AccessSystematic Review

Effects of Physical Exercise on the Physical and Mental Health of Family Caregivers: A Systematic Review

by Ana Bravo-Vazquez, Ernesto Anarte-Lazo, Juan Jose Gonzalez-Gerez, Cleofas Rodriguez-Blanco and Carlos Bernal-Utrera

Healthcare 2025, 13(10), 1196; https://doi.org/10.3390/healthcare13101196 - 20 May 2025

Abstract

The number of family caregivers of dependent older adults is increasing. The adverse effects of the work provided by these caregivers can have a negative impact on their own physical and mental health, so it is necessary to develop strategies that support and [...] Read more.

The number of family caregivers of dependent older adults is increasing. The adverse effects of the work provided by these caregivers can have a negative impact on their own physical and mental health, so it is necessary to develop strategies that support and improve the quality of life and functional capacity of this group. Background/Objectives: The aim of this systematic review is to analyze physical exercise interventions for family caregivers and the effects on their physical and mental health, quality of life and functioning. Methods: A comprehensive search was conducted in the scientific databases PubMed, Embase, Scopus and CINAHL. Data extraction was carried out from the selected articles, obtaining information about the characteristics of the study subjects, type and characteristics of the intervention and results. Results: A total of 17 studies were selected for the review. All studies were based on physical exercise interventions and reported significant improvements in caregivers’ physical and mental health, as well as an increase in their quality of life and functioning. Most of the study subjects were older adult women relatives. No adverse effects were found to the interventions. Conclusions: Physical exercise seems to be effective in improving the physical and mental health of family caregivers, increasing their quality of life and functional capacity. More future research is needed to make interventions more accessible to family caregivers. Full article

(This article belongs to the Topic New Trends in Physiotherapy Care: Improvements in Functionality, Pain Management, and Quality of Life)

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15 pages, 649 KiB

Open AccessArticle

Smoking Knowledge and Behaviors in a Population of Italian Students in Dental Hygiene or Other Health Disciplines

by Fabrizio Guerra, Alessia Pardo, Vanessa Di Nasta, Roberta Grassi and Gianna Maria Nardi

Healthcare 2025, 13(10), 1195; https://doi.org/10.3390/healthcare13101195 - 20 May 2025

Abstract

Background/Objectives: Smoking remains a major public health concern, and healthcare professionals (HCPs) play a crucial role in smoking cessation efforts. This study aimed to assess the awareness, knowledge, and smoking behaviors of Italian students and graduates in dental hygiene from different regional [...] Read more.

Background/Objectives: Smoking remains a major public health concern, and healthcare professionals (HCPs) play a crucial role in smoking cessation efforts. This study aimed to assess the awareness, knowledge, and smoking behaviors of Italian students and graduates in dental hygiene from different regional areas (Group A) and students in health disciplines at a single university (Group B). Methods: Two separate surveys were conducted using a specifically designed online questionnaire administered to voluntary participants between February and April 2024. The questionnaire collected data on smoking habits, awareness of smoke-free products, sources of information, and perceptions of health effects. Results: A total of 878 questionnaires were completed. While 49.8% of participants had never smoked, 16.3% were regular smokers and 14% were occasional users of either traditional cigarettes or alternative smoke-free products. Awareness of non-combustion products was high, with social circles (74%) and social media (47.9%) being primary sources of information. Users of smoke-free products reported subjective improvements in halitosis, dental discoloration, cough, exercise capacity, and sense of taste. Despite 78% of participants receiving specific training on smoking-related diseases, gaps in knowledge persisted, particularly regarding the toxicological nature of smoking and the role of nicotine in smoking-related diseases. Conclusions: These findings highlight the need for continued education and training on smoking cessation and tobacco harm reduction among future HCPs. Strengthening evidence-based knowledge could enhance their ability to manage smoking-related diseases and promote effective cessation strategies. Full article

(This article belongs to the Special Issue Oral Health Care and Services for Patients)

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