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Healthcare

Healthcare is an international, scientific, peer-reviewed, open access journal on health care systems, industry, technology, policy, and regulation, and is published semimonthly online by MDPI.
The European Medical Association (EMA), Ocular Wellness & Nutrition Society (OWNS) and Italian Society of Nephrology Nurses (SIAN) are affiliated with Healthcare and their members receive discounts on the article processing charges.
Indexed in PubMed | Quartile Ranking JCR - Q2 (Health Policy and Services | Health Care Sciences and Services)

All Articles (14,955)

Mirror Neurons and Pain: A Scoping Review of Experimental, Social, and Clinical Evidence

  • Marco Cascella,
  • Pierluigi Manchiaro and
  • Valentina Cerrone
  • + 4 authors

Background: The mirror neuron system (MNS) has been proposed as a key neural mechanism linking action perception, motor representation, and social cognition. This framework has increasingly been applied to pain research, encompassing pain empathy, observational learning of pain, and rehabilitative interventions such as mirror therapy. However, the literature is conceptually heterogeneous, methodologically diverse, and spans experimental, social, and clinical domains. Objective: This scoping review aims to map the extent, nature, and characteristics of the available evidence on the relationship between the MNS and pain, clarifying how MNS-related mechanisms are defined, investigated, and applied across different contexts. Methods: A scoping review was conducted using the methodological framework proposed by the Joanna Briggs Institute and reported in accordance with PRISMA-ScR guidelines. We searched PubMed/MEDLINE, Scopus, Web of Science, and PsycINFO. Studies were included if they addressed MNS-related mechanisms in pain processing, pain empathy, pain modulation, or pain rehabilitation. Eligible studies were charted and synthesized descriptively and thematically. Results: Twenty-one studies met the inclusion criteria. The evidence was predominantly derived from clinical and rehabilitative settings, with most studies focusing on mirror therapy or mirror visual feedback interventions. The majority of included populations consisting of adults with chronic pain conditions, particularly phantom limb pain and complex regional pain syndrome. Pain intensity, assessed mainly through self-reported clinical scales, was the most frequently reported outcome. A smaller number of studies investigated action observation or motor imagery paradigms, primarily in chronic musculoskeletal pain, showing short-term hypoalgesic effects. Across studies, substantial heterogeneity was observed in the conceptualization of MNS-related constructs, intervention protocols, outcome measures, and follow-up duration. Conclusions: Despite extensive theoretical discussion of the MNS, empirical applications are largely confined to clinical mirror-based interventions, with limited use of direct neurophysiological or neuroimaging markers. Since crucial conceptual and methodological gaps constrain comparability and translation into clinical practice, there is a need for clearer operational definitions and more integrated experimental and clinical research approaches.

22 January 2026

Schematic representation of the mirror neuron system (MNS). Mirror neurons are classically described within a predominantly contralateral fronto-parietal network, including the premotor cortex and inferior parietal lobule. These neurons are activated both during the execution of a goal-directed action and during the observation of the same action performed by others. Visual input related to action observation is integrated with motor representations, giving rise to sensorimotor resonance and action–perception coupling mechanisms that are thought to support action understanding, imitation, and embodied simulation.

Background/Objectives: Professional quality of life influences patient care, staff well-being, and organizational efficacy. The COVID-19 pandemic placed pressure on healthcare professionals, disrupting their professional quality of life and imposing a psychological burden. In Greece, these issues were intensified by a decade of economic crisis, marked by constrained healthcare budget, personnel shortages, and insufficient resources. This study investigates the pandemic’s impact on the professional quality of life of Greek healthcare professionals to support targeted interventions. Methods: A cross-sectional study was conducted using descriptive statistics. The participants were a convenience sample of 246 healthcare professionals from a Greek regional university hospital with at least one year of experience and who had worked with COVID-19-positive or potentially exposed but asymptomatic patients. Data were collected between March and June 2021 using the Professional Quality of Life Scale (version 5). Results: Of the 246 participants, 81.3% were women and 33.8% were aged 50 or older. Moderate concern and fear regarding COVID-19 were reported, with 34.6% extremely afraid of transmitting the virus to family or friends and 22.8% to patients or their families. Overall professional quality of life was moderate: compassion satisfaction was moderate to high, while burnout and secondary traumatic stress were moderate to low. Higher compassion satisfaction was linked to holding a position of responsibility. Burnout was associated with having children, permanent employment, years of experience, and increased pandemic-related fear. Higher secondary traumatic stress was associated with older age, more years of experience, and greater pandemic-related fear. Conclusions: These findings support international research and highlight that the moderate levels observed indicate intrinsic motivation based on professionalism in patient care, providing evidence of resilience and coping mechanisms that reduce psychological consequences on well-being due to the pandemic.

22 January 2026

Distribution % of responses to questions related to the COVID-19 pandemic regarding contact with patients among the 246 healthcare professionals in the study.

Background: In recent years, the sociopolitical landscape in the United States has shifted due to an increase in state-level legislation regarding LGBTQ+ rights, a trend that has been particularly pronounced in the Commonwealth of Kentucky. While the mental health impacts of enacted laws are increasingly documented, a critical gap remains in understanding the psychological toll of the legislative debates themselves—the prolonged periods of public discourse surrounding the restriction of rights. Methods: Utilizing data from the 2025 Queer Kentucky Survey (N = 817), this exploratory study examined the association between LGBTQ+ community belongingness and acute suicidality attributed specifically to anti-LGBTQ+ legislative debates. Data were derived from a non-probability snowball sample. Binary logistic regression models that adjusted for age, race, gender identity, education, and income were utilized. Results: Prevalence of debate-attributed suicidality was alarmingly high: 59.7% of the sample attributed increased suicidal thoughts, and 44.1% attributed a suicide attempt, specifically to the legislative debates. LGBTQ+ belongingness was a robust protective correlate, associated with significantly lower odds of both suicidal thoughts (OR = 0.61, p < 0.001) and attempts (OR = 0.41, p < 0.001). Analyses further revealed divergent risk for suicidality across demographic characteristics. Conclusions: Findings are consistent with the interpretation that legislative debates may function as distinct structural stressors associated with suicidal thoughts and suicide attempts. While community belongingness may offer a critical buffer, the elevated risks among Transgender and Black, Indigenous, and People of Color (BIPOC) populations highlight the need for intersectional, structural interventions beyond individual resilience.

22 January 2026

Theoretical Model of LGBTQ+ Belongingness and Suicidality Attributed to Anti-LGBTQ+ Legislative Debates.

Background: Prior research confirms that social support promotes resilience among medical patients with chronic illness. Beyond emotional benefits, research has increasingly shown the importance of social support on physical health outcomes. Therefore, identifying and evaluating interventions that increase social support among medical patients with chronic conditions is a priority for healthcare. Methods: This meta-analysis summarized data from 39,493 medical patients across 14 non-randomized trials that had been identified by a prior review of the survival benefits of social support interventions. Results: Across four studies reporting hazard ratio data, the results failed to reach statistical significance (HR = 2.10, 95% CI = 0.99 to 4.48, p = 0.0546), and the results of ten studies reporting odds ratio data were of smaller magnitude (OR = 1.27, 95% CI [0.72, 2.23], p > 0.05). Heterogeneity characterized both the odds ratio data (I2 = 53%; Q = 18.1, p = 0.03) and hazard ratio data (I2 = 89%, Q = 23, p < 0.001). A notable finding was that studies with longer periods of data collection showed longer survival among medical patients receiving social support. Conclusions: Long-term observations may be necessary for the survival benefits of social support interventions to become apparent. Further research with a larger pool of data from long-term follow-up studies will be needed to establish firm conclusions.

21 January 2026

Forest Plot of Natural Log Odds Ratios for Medical Patient Survival Outcomes Across 10 NRCT Studies. Note: The vertical black line indicates “no effect” and the red vertical line indicates the observed weighted average effect [89,90,91,93,94,96,97,98,100,101].

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Healthcare - ISSN 2227-9032