Healthcare

14 pages, 558 KiB

Open AccessArticle

The Impact of Relaxation Massage Prior to Bedtime on Sleep Quality and Quantity in People with Symptoms of Chronic Insomnia: A Home-Based Sleep Study

by Ilias Ntoumas, Christina Karatzaferi, Christoforos D. Giannaki, Fotini Papanikolaou, Aggelos Pappas, Efthimios Dardiotis and Giorgos K. Sakkas

Healthcare 2025, 13(2), 180; https://doi.org/10.3390/healthcare13020180 - 17 Jan 2025

Abstract

Background/Objectives: Manual massage is an effective treatment approach for reducing general stress and promoting an overall sense of well-being. Relaxation massage aims to alleviate psychophysiological tension, enhance both blood and lymphatic circulation, and promote mental and physical relaxation. It is particularly beneficial [...] Read more.

Background/Objectives: Manual massage is an effective treatment approach for reducing general stress and promoting an overall sense of well-being. Relaxation massage aims to alleviate psychophysiological tension, enhance both blood and lymphatic circulation, and promote mental and physical relaxation. It is particularly beneficial for those with anxiety-related symptoms (such as generalized anxiety disorder and social anxiety) and sleep disorders, aiming to improve calmness and promote sleepiness. Aims: The purpose of the present study was to assess the effectiveness of a single session of relaxation massage prior to bedtime on sleep quality and quantity indices in individuals with symptoms of chronic insomnia. Methods: In total, 20 (N = 20) healthy individuals (aged 25.5 ± 12.0 years; 6F/14M) with a score on the Athens Insomnia Scale of ≥ 16 participated under three different conditions over one week apart: (1) a 45 min relaxation massage condition (REL), (2) a 45 min sham massage condition (PLA), and (3) a control condition with no massage. Sleep activity was monitored using a portable polysomnographic system. Results: A statistically significant effect was observed between sleep efficiency across the three sessions (p = 0.034), with a notable effect in the relaxation massage (REL) session (p = 0.045). Additionally, sustained sleep efficiency showed a statistically significant difference among the sessions (p = 0.005). Conclusions: Relaxation massage prior to bedtime could be used as an effective and safe non-pharmacological approach for improving sleep efficiency and potentially restoring the fragmented sleep of individuals with symptoms of insomnia. Trial registration number: The trial was registered at clinicaltrials.gov as NCT06781866. Full article

(This article belongs to the Special Issue Psychophysiological Responses to Physical Activity, Exercise and/or Nutrition Interventions in Individuals with Cardiometabolic Health Impairments)

16 pages, 474 KiB

Open AccessReview

Whether Academic Libraries Contribute to Students’ and Communities’ Wellbeing: A Scoping Review

by Shivani Suresh, David Lim, Kanchana Ekanayake and Amit Arora

Healthcare 2025, 13(2), 179; https://doi.org/10.3390/healthcare13020179 - 17 Jan 2025

Abstract

Background/Objectives: Academic libraries offer a range of activities and initiatives for their students and community users. However, wellbeing, as a concept in academic libraries, is not very well defined and is poorly understood. The objective of this scoping review was to examine [...] Read more.

Background/Objectives: Academic libraries offer a range of activities and initiatives for their students and community users. However, wellbeing, as a concept in academic libraries, is not very well defined and is poorly understood. The objective of this scoping review was to examine the role of academic libraries in student and community wellbeing, identify the various kinds of activities and initiatives that they carry out to address their wellbeing, and uncover gaps that might require further research. Methods: An extensive search was conducted in the Library Information Sciences Association (LISA), Education Resources Information Centre (ERIC), Medline (OVID), Scopus, and Web of Science (WOS) databases. Grey literature was searched on a selection of library websites and digital repositories. Data were extracted from studies that met the inclusion criteria for the scoping review. Themes were identified by the authors and reported as a narrative summary. Results: Of the 5437 records identified, a total of 40 documents were included in this scoping review. The authors identified 11 different kinds of activities and initiatives carried out in academic libraries that promote student and community wellbeing, i.e., (1) animal-assisted activities; (2) facilitating dialogues about belonging and identity; (3) fun recreational activities; (4) study support; (5) physical activity promotion; (6) meditation, yoga, and mindfulness; (7) book clubs; (8) art exhibitions; (9) technology and digital support; (10) free food and tea; and (11) health awareness. These activities were found to promote the physical, emotional, and social wellbeing of student and community users. Conclusions: This review highlights the need for further systematic research on the long-term effects of wellbeing initiatives and activities on both student and community users, and how they might impact aspects of wellbeing for specific population groups such as senior citizens and LGBTQIA members. This scoping review demonstrates the potential of academic libraries in promoting health and wellbeing for their users. Full article

(This article belongs to the Special Issue Caring for the Mental Health of Higher Education Students: Coping Strategies and Well-Being Support)

17 pages, 1735 KiB

Open AccessArticle

Trends in Socioeconomic Inequalities in the Prevalence of Chronic Non-Communicable Diseases in China: Evidence from Shaanxi Province During 2003–2013

by Dan Wang, Rashed Nawaz, Xiaojing Fan, Chi Shen, Sha Lai, Zhongliang Zhou and Jianmin Gao

Healthcare 2025, 13(2), 178; https://doi.org/10.3390/healthcare13020178 - 17 Jan 2025

Abstract

Background: The link between chronic non-communicable diseases (NCDs) and poverty in underdeveloped countries is debated. This study aims to examine socioeconomic inequalities related to NCDs and assess the contributing factors to these disparities. Methods: The study utilized data from the National [...] Read more.

Background: The link between chronic non-communicable diseases (NCDs) and poverty in underdeveloped countries is debated. This study aims to examine socioeconomic inequalities related to NCDs and assess the contributing factors to these disparities. Methods: The study utilized data from the National Health Services Survey in Shaanxi Province for 2003, 2008, and 2013, having 71,766 respondents. The concentration index (CI) was employed to rigorously quantify the degree of socioeconomic inequality in the prevalence of non-communicable diseases (NCDs). The CI decomposition identified the contribution of each variable, while the horizontal inequity (HI) index was calculated annually to assess changes in inequality. Additionally, a Probit model was employed to examine the significant determinants contributing to the occurrence of NCDs. Results: The results show a significant increase in NCD prevalence with age, particularly for individuals aged 60 and above, who experienced a 286.55% rise from 2003 to 2013. Higher education levels are associated with decreased NCD prevalence, as evidenced by a 74.13% reduction for those with high school education or above. Additionally, wealthier individuals had a 15.31% lower prevalence of NCDs, indicating that higher socioeconomic status correlates with a reduced likelihood of chronic diseases. Conclusions: The study finds that NCD prevalence significantly increases with age, while higher education levels and greater wealth are associated with reduced prevalence. These findings highlight the need to target older populations and lower socioeconomic groups for effective NCD prevention and management. Policies should focus on improving educational opportunities and socioeconomic conditions to reduce the burden of NCDs, particularly among older and economically disadvantaged groups. Full article

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18 pages, 581 KiB

Open AccessReview

Self-Compassion Intervention Programs for Nurses: A Scoping Review

by Jing Bian, Fazhan Chen, Shihan Fang and Yanbo Wang

Healthcare 2025, 13(2), 177; https://doi.org/10.3390/healthcare13020177 - 17 Jan 2025

Abstract

Background: Nurses frequently face various sources of stress in the workplace, making self-compassion interventions crucial for promoting their mental well-being. This scoping review aims to: (a) identify self-compassion intervention programs implemented within the nursing population; and (b) analyze the content and outcome [...] Read more.

Background: Nurses frequently face various sources of stress in the workplace, making self-compassion interventions crucial for promoting their mental well-being. This scoping review aims to: (a) identify self-compassion intervention programs implemented within the nursing population; and (b) analyze the content and outcome measures of these interventions. Methods: The study follows Arksey and O’Malley’s scoping review framework and adheres to the PRISMA-ScR guidelines. Relevant literature on self-compassion interventions for nurses published between January 2010 and May 2024 was systematically reviewed. Databases searched included PubMed, Web of Science, Scopus, ProQuest, and the Cochrane Library, using MeSH terms and free-text keywords such as “self-compassion”, “self-kindness”, “self-appreciation”, “self-worth”, “self-forgiveness”, “self-awareness”, “nurses”, and “nursing”. Results: Fifteen studies met the inclusion criteria and were included in the review. Self-compassion interventions were categorized into two types: (1) mindfulness-focused programs, such as Mindfulness-Based Stress Reduction (MBSR) and Mindful Self-Care and Resiliency (MSCR), which treat self-compassion as a potential outcome; and (2) self-compassion-focused programs, including Mindful Self-Compassion (MSC), Compassion Focused Therapy (CFT), and Loving-Kindness Meditation (LKM). Conclusions: The mental health challenges faced by nurses have drawn growing attention, underscoring the importance of self-compassion interventions. This review examines empirical studies within the nursing population, contributing to the development of more targeted and effective strategies to enhance the mental health and well-being of nursing professionals. Full article

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15 pages, 952 KiB

Open AccessStudy Protocol

Dealing with Childhood Externalizing Behavior: Protocol for a Feasibility RCT of the Being a Parent Program

by Laura Maciel, Ana Rita Pires, Miguel Basto-Pereira and Crispin Day

Healthcare 2025, 13(2), 176; https://doi.org/10.3390/healthcare13020176 - 17 Jan 2025

Abstract

Concerning numbers of childhood behavior problems have been reported worldwide. Parenting interventions are considered one of the most effective early strategies to intervene with externalizing conduct. This protocol outlines a feasibility RCT that aims to implement a parenting intervention in Portugal and (a) [...] Read more.

Concerning numbers of childhood behavior problems have been reported worldwide. Parenting interventions are considered one of the most effective early strategies to intervene with externalizing conduct. This protocol outlines a feasibility RCT that aims to implement a parenting intervention in Portugal and (a) test key feasibility parameters, (b) assess the fidelity and acceptability of the program, and (c) explore its effectiveness in childhood behavior problems, parenting skills, parental concern, and parental sense of competence. A double-blinded, two-arm feasibility RCT is described. The participants are the primary caregivers of children between the ages of two and eleven years old that identify difficulties in managing their child’s behavior. Families will be randomly assigned to an intervention arm and a waitlist control arm. Parents in the intervention arm will participate in the Being a Parent program (Portuguese version: Ser Pai & Ser Mãe), an eight-week group intervention. Outcomes will be assessed using quantitative and qualitative measures throughout three assessment periods (pre- and post-intervention, and follow-up). This study marks the first feasibility RCT of the Being a Parent program outside the UK. The findings will provide information on the global strength of this program. Challenges and clinical implications are also discussed. Full article

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14 pages, 466 KiB

Open AccessArticle

Effects of Shared Decision-Making, Health Literacy, and Self-Care Knowledge on Self-Care Behavior Among Hemodialysis Patients in Korea: A Cross-Sectional Survey

by Hyohjung Lee and Mi-Kyoung Cho

Healthcare 2025, 13(2), 175; https://doi.org/10.3390/healthcare13020175 - 17 Jan 2025

Abstract

Background: Patients undergoing hemodialysis for chronic kidney failure experience various complications and physical and emotional difficulties, leading to decreased quality of life. Self-care behaviors are essential for preventing complications and reducing mortality rates. Effective self-care behaviors significantly depend on shared decision-making, health literacy, [...] Read more.

Background: Patients undergoing hemodialysis for chronic kidney failure experience various complications and physical and emotional difficulties, leading to decreased quality of life. Self-care behaviors are essential for preventing complications and reducing mortality rates. Effective self-care behaviors significantly depend on shared decision-making, health literacy, and self-care knowledge, each critical in patient self-care performance and disease management. This study aimed to determine the importance and relevance of shared decision-making, health literacy, and self-care knowledge. In particular, it enhances self-care behaviors among hemodialysis patients. Methods: Participants were 108 adult hemodialysis patients from the hemodialysis centers of three medical institutions in Cheongju City, Korea. Moreover, the study utilized a descriptive survey research design. Data were analyzed using descriptive statistics, independent t-tests, one-way ANOVA, Pearson’s correlation coefficients, and multiple linear regression analyses. Results: The average score for self-care behaviors was 125.28 out of 175 points, with high scores for medication and vascular management. Furthermore, there were low scores for social activities and dietary management. Factors influencing self-care behaviors in hemodialysis patients were identified as sex, age, economic status, health literacy, and self-care knowledge. These factors explained 45.2% of the variance in self-care behaviors. Conclusions: To promote self-care behaviors in hemodialysis patients, it is essential to improve health literacy and self-care knowledge, strengthen tailored educational programs, and promote the explanatory role of nurses and shared decision-making. Additionally, comprehensive interventions, including economic support, are necessary. Full article

(This article belongs to the Section Chronic Care)

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15 pages, 259 KiB

Open AccessArticle

Toxoplasmosis Knowledge and Preventive Behaviours Among Pregnant Women in Jeddah, Saudi Arabia: A Cross-Sectional Study

by Wejdan T. Alghafari

Healthcare 2025, 13(2), 174; https://doi.org/10.3390/healthcare13020174 - 16 Jan 2025

Abstract

Background: Toxoplasmosis is an infection caused by the parasite Toxoplasma gondii and is considered asymptomatic in most cases. In pregnant women, however, the disease can be transmitted to the foetus, causing severe congenital consequences. Congenital toxoplasmosis can be avoided by practising simple preventive [...] Read more.

Background: Toxoplasmosis is an infection caused by the parasite Toxoplasma gondii and is considered asymptomatic in most cases. In pregnant women, however, the disease can be transmitted to the foetus, causing severe congenital consequences. Congenital toxoplasmosis can be avoided by practising simple preventive lifestyle measures during pregnancy. Method: This cross-sectional study assessed the toxoplasmosis knowledge and preventive behaviours among 135 pregnant Saudi women in Jeddah, Saudi Arabia. Data were collected by face-to-face interviews using a validated questionnaire covering sociodemographic characteristics, knowledge of toxoplasmosis, and preventive behaviours towards toxoplasmosis between January and April 2023 using convenience snowball sampling. SPSS Statistics was used for data analysis and the qualitative parameters were described as frequencies and percentages. Result: Approximately 45.2% of the participants displayed a poor knowledge of toxoplasmosis. Moreover, participants aged 31–40 years exhibited significantly higher knowledge compared to those aged less than 30 years. Most participants practised effective preventive behaviours, as demonstrated by 90.4% and 86.7% of them reporting that they habitually washed their hands after handling raw meat and did not eat rare meat, respectively. Conclusion: Overall, the poor knowledge of toxoplasmosis among pregnant women in Jeddah highlights the importance of implementing targeted antenatal health education campaigns and interventions to protect pregnant women and minimise the risk of congenital toxoplasmosis. Full article

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

15 pages, 984 KiB

Open AccessArticle

Validation of the Arabic Version of the Maslach Burnout Inventory-HSS Among Tunisian Medical Residents (A-MBI-MR): Factor Structure, Construct Validity, Reliability, and Gender Invariance

by Hamdi Henchiri, Amayra Tannoubi, Chayma Harrathi, Ghada Boussayala, Frank Quansah, John Elvis Hagan, Haifa Mechergui, Amr Chaabeni, Taha Chebbi, Tarek Ben Lakhal, Hatem Belhouchet, Ikram Khatrouch, Abdulhafed Mabrouk Gawar and Fairouz Azaiez

Healthcare 2025, 13(2), 173; https://doi.org/10.3390/healthcare13020173 - 16 Jan 2025

Abstract

Background: Burnout is a major problem for physical and mental health of medical residents. The key for maintaining well-being and quality of care of residents is the assessing tool. The study evaluated the psychometric properties of the Arabic version of the Maslach [...] Read more.

Background: Burnout is a major problem for physical and mental health of medical residents. The key for maintaining well-being and quality of care of residents is the assessing tool. The study evaluated the psychometric properties of the Arabic version of the Maslach Burnout Inventory Human Services Survey (MBI-HSS) among Tunisian medical residents by assessing its factor structure, construct validity, reliability, and gender invariance. Methods: A total of 552 residents, aged 27.01 ± 1.92, 219 males (39.7%) and 333 females (60.3%) completed the Arabic version of the A-MBI-MR. The exploratory (EFA) and confirmatory factor (CFA) analyses were performed to identify the factor structure, with assessments of internal consistency of the model, including gender measurement invariance. Results: The results indicate a high average variance extracted (AVE > 0.50) and factor loading of the scale, signifying robust construct validity and clearly suggesting that the items serve as essential indicators for assessing several dimensions of burnout. The reliability analysis demonstrates excellent and acceptable internal consistency across all areas of emotional exhaustion, personal accomplishment, and depersonalization (Cronbach’s α = 0.95, 0.98, and 0.871) respectively. The CFA confirmed the three-factor structure of the A-MBI-MR, with fit indices indicating an adequate model fit: CFI = 0.945, TLI = 0.938, GFI = 0.951, RMSEA = 0.074, RMSEA CI (0.066, 0.081), RMSEA p-value= 0.000, SRMR = 0.044. Results from the measurement invariance analysis of the MBI scale demonstrated robust invariance between male and female participants. Conclusions: The MBI-MR in Arabic for medical residents is reliable, valid, and effective for measuring burnout levels in Arabic-speaking regions. Full article

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14 pages, 534 KiB

Open AccessArticle

Impact of the COVID-19 Pandemic on Seizure Control in Pediatric Epilepsy: Risk Factors and Clinical Outcomes

by Jihye Lim and Ja Un Moon

Healthcare 2025, 13(2), 172; https://doi.org/10.3390/healthcare13020172 - 16 Jan 2025

Abstract

Background: Epilepsy is a common neurological disorder in children, associated with significant morbidity and socioeconomic burden. The coronavirus disease 2019 (COVID-19) pandemic disrupted healthcare delivery, potentially exacerbating seizure control among pediatric epilepsy patients. This study aimed to evaluate the pandemic’s impact on seizure [...] Read more.

Background: Epilepsy is a common neurological disorder in children, associated with significant morbidity and socioeconomic burden. The coronavirus disease 2019 (COVID-19) pandemic disrupted healthcare delivery, potentially exacerbating seizure control among pediatric epilepsy patients. This study aimed to evaluate the pandemic’s impact on seizure characteristics and identify risk factors contributing to seizure exacerbation in children with epilepsy. Methods: A retrospective cohort study was conducted using medical records of 84 pediatric epilepsy patients at The Catholic University of Korea Yeouido St. Mary’s Hospital from July 2019 to July 2022. Data were collected on demographics, epilepsy characteristics, and healthcare accessibility. Changes in seizure outcomes were analyzed alongside potential risk factors, including infections and socioeconomic variables. Statistical analyses assessed correlations between these factors and seizure exacerbations. Results: Among the 84 pediatric epilepsy patients, 25% experienced significant seizure exacerbations during the COVID-19 pandemic. These included increased seizure frequency (18%), prolonged duration (13%), emergence of new seizure types (4%), and status epilepticus requiring hospitalization (5%). Multivariate analysis identified recent epilepsy diagnosis (<1 year) and low socioeconomic status as independent predictors of seizure worsening (p < 0.05). Infections with non-COVID-19 respiratory viruses, such as RSV and influenza, were strongly associated with exacerbated seizure activity (p < 0.001). Dissatisfaction with access to epilepsy care further increased the risk of poor seizure control, reflecting the challenges posed by disrupted healthcare systems. Notably, no significant relationship was observed between SARS-CoV-2 infection and seizure outcomes, suggesting that indirect factors, rather than direct viral effects, were primary contributors to seizure exacerbation. Conclusions: This study highlights the compounded impact of disrupted healthcare access, socioeconomic challenges, and respiratory viral infections on seizure control during the COVID-19 pandemic. Strategies such as telehealth expansion, regular monitoring, and vaccination against respiratory pathogens are essential to optimize seizure management in future health crises. Full article

(This article belongs to the Collection The Impact of COVID-19 on Healthcare Services)

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12 pages, 201 KiB

Open AccessArticle

Supporting a Family Member with Dementia to Live at Home: The Experiences of Caregivers

by Marcus Redley, Fiona Poland, Linda O’Raw and Martin Orrell

Healthcare 2025, 13(2), 171; https://doi.org/10.3390/healthcare13020171 - 16 Jan 2025

Abstract

Background: In the United Kingdom, specialist teams managing crises in dementia make efforts to reduce inpatient admissions by supporting people to live for longer in their own homes. However, fluctuations in the health and social circumstances of both the person with dementia and/or [...] Read more.

Background: In the United Kingdom, specialist teams managing crises in dementia make efforts to reduce inpatient admissions by supporting people to live for longer in their own homes. However, fluctuations in the health and social circumstances of both the person with dementia and/or their family caregiver can lead to ‘crisis’: a breakdown in home care often leading to inpatient admissions. At this point, a team managing crises in dementia (TMCD) might become involved. These multidisciplinary teams begin with a rapid assessment to establish the needs of the person with dementia and their caregiver(s), followed by intensive but short-term interventions to reduce the risk of inpatient admission. There is little evidence as to how family caregiver experience input from a TMCD. Methods: A thematic analysis of qualitative interviews with caregivers supporting a family member with dementia to live at home and who have received support from a TMCD. Results: The personal troubles of family caregivers are intertwined with their experience of engaging with and trying to gain support from human services, particularly TMCDs. While respondents describe how specific individuals have addressed or added to the troubles they face, the most impactful interventions from their perspectives are medication for managing challenging behaviour and knowing that there is a service they can telephone in a crisis. Conclusions: Efforts to reduce inpatient admissions by supporting people to live in their own homes for as long as is practicable, even when carers may have reached the limits of their caring capacities, can, at best, only delay inpatient to long-stay residential accommodation. This is because when one frail older person has the responsibility of caring for another frail older person, even with support from TMCD and other health and social care services, crises are difficult to manage. Full article

16 pages, 2172 KiB

Open AccessArticle

The Impact of Healthcare Reforms on the Epidemiology Workforce in Kazakhstan: An Interrupted Time Series Analysis with Predictive Modeling of Nationwide Data Sources from 1998 to 2022

by Togzhan Akpanova, Tolebay Rakhypbekov, Yuliya Semenova, Akmaral Mussakhanova, Assiya Turgambayeva, Marina Zhanaliyeva, Ruslan Zharilkassimov, Sergey Kim, Aigerim Alzhanova, Raushan Sekenova and Marzhan Dauletyarova

Healthcare 2025, 13(2), 170; https://doi.org/10.3390/healthcare13020170 - 16 Jan 2025

Abstract

Background: Following its independence, Kazakhstan implemented several reforms, including the adoption of the Entrepreneurial Code in 2008. This study aims to evaluate the impact of these reforms on the number and per capita rates of epidemiologists, nurse epidemiologists, epidemiological surveillance centers, and infectious [...] Read more.

Background: Following its independence, Kazakhstan implemented several reforms, including the adoption of the Entrepreneurial Code in 2008. This study aims to evaluate the impact of these reforms on the number and per capita rates of epidemiologists, nurse epidemiologists, epidemiological surveillance centers, and infectious morbidity from 1998 to 2022. Such an evaluation is critical for informing policy decisions regarding the future of epidemiological services in Kazakhstan. Methods: An interrupted time series analysis using a best-fit epidemiological model was conducted to assess the impact of key interventions—specifically, the adoption of the Entrepreneurial Code of the Republic of Kazakhstan and subsequent legislation—on the number and per capita rates of epidemiologists, nurse epidemiologists, and epidemiological surveillance facilities with infectious morbidity across the country. Results: Infectious morbidity per million individuals ranged from 4698.14 to 2263.79, with a consistent downward trend observed throughout the study period. Over the study period, the per capita rates of urban epidemiologists exhibited a downward trend, whereas the rates of rural epidemiologists showed an upward trajectory. The per capita rate of epidemiological surveillance centers declined from 26.89 to 15.24 over the study period. Substantial disparities were observed between urban and rural areas, with the epidemiology workforce in urban settings being 3–4 times larger than that in rural areas. Conclusions: This evaluation is important for informing policy decisions regarding the future of epidemiological surveillance services in Kazakhstan. Full article

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16 pages, 1055 KiB

Open AccessArticle

The Effects of the Mamanet Cachibol League Intervention Program on Perceived Health Status, Mental Health, and Healthy Lifestyle Among Arab Women

by Karin Eines, Riki Tesler, Ruth Birk, Ariela Giladi, Ayelet Dunsky, Nada Alian, Limor Gonen and Sharon Barak

Healthcare 2025, 13(2), 169; https://doi.org/10.3390/healthcare13020169 - 16 Jan 2025

Abstract

Background: The Israeli Mamanet Cachibol League (MCL) is a community-oriented athletic program serving mothers through non-competitive recreational sports participation. This study aimed to assess the effects of the MCL on perceived health status, mental health (happiness, depression, social capital), and healthy lifestyle behaviors [...] Read more.

Background: The Israeli Mamanet Cachibol League (MCL) is a community-oriented athletic program serving mothers through non-competitive recreational sports participation. This study aimed to assess the effects of the MCL on perceived health status, mental health (happiness, depression, social capital), and healthy lifestyle behaviors (physical activity and nutrition). Methods: This is an experimental study with a sample of 231 women (174 in the experimental group and 57 in the control). Participants completed questionnaires in November 2023 (T1) and then in August 2024 (T2). The questionnaire included questions on sociodemographic characteristics, perceived health status, mental health (happiness, depression, social capital), and healthy lifestyle behaviors (physical activity and nutrition). Results: At T1, the MCL participants reported better mental health (higher subjective happiness and social capital and lower depressive symptoms) than the control group. Over time, participation in the MCL led to significant improvements in mental health (reductions in depression and increases in subjective happiness and social capital). The participants showed substantial improvements in healthy lifestyle behaviors, with moderate effect sizes (effects size > 0.5) observed across these areas. Sociodemographic factors influenced the outcomes, with variations in health perception and physical activity linked to marital status and education level. Conclusions: Participation in the MCL program was associated with better mental health at baseline and significantly improved over time compared to the control group. The MCL participants also showed gains in healthy lifestyle behaviors, highlighting the importance of tailored interventions. Full article

(This article belongs to the Special Issue Women’s Health Care: State of the Art and New Challenges)

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17 pages, 447 KiB

Open AccessArticle

Exploring the Intersection of Mental and Reproductive Health Among Women Living with HIV in Spain: A Qualitative Secondary Data Analysis

by Ariadna Huertas-Zurriaga, David Giménez-Díez and Juan M. Leyva-Moral

Healthcare 2025, 13(2), 168; https://doi.org/10.3390/healthcare13020168 - 16 Jan 2025

Abstract

Background/Objectives: Globally, girls and women make up over half of those living with Human Immunodeficiency Virus (HIV), facing unique reproductive and mental health challenges. An HIV diagnosis impacts motherhood desires and increases trauma, stigma, and depression risks. Addressing these overlapping vulnerabilities with tailored, [...] Read more.

Background/Objectives: Globally, girls and women make up over half of those living with Human Immunodeficiency Virus (HIV), facing unique reproductive and mental health challenges. An HIV diagnosis impacts motherhood desires and increases trauma, stigma, and depression risks. Addressing these overlapping vulnerabilities with tailored, comprehensive healthcare is essential. This study aims to qualitatively explore the complex interplay between mental health and reproductive decision making among women living with HIV (WLWH). Methods: A secondary data analysis approach was employed, utilizing qualitative data from a wider study. Theoretical sampling was used to recruit a sample of WLWH attending the HIV clinic at a public hospital in Badalona (Barcelona, Spain). Interviews took place in a private and quiet space between May 2019 and January 2020. To perform secondary data analysis, Braun and Clarke’s thematic analysis was used. Results: Twenty-six women living with HIV were interviewed, with an average age of 39.3 years. The participants had diverse nationalities and faced economic challenges. Following data analysis, four main themes were identified: Emotional Fragmentation and Reproductive Self-Perception after the HIV Diagnosis; Coping Strategies in Reproductive Decision Making; Impacting Emotional Resilience and Motherhood Decisions; and Emotions, Mental Health, and Desire for Motherhood. The themes revealed the profound emotional impact of HIV on their identity, mental health, and reproductive decision making, affecting motherhood aspirations. Conclusions: Women living with HIV face psychological challenges in reproductive decision making, including anxiety and stigma. The study highlights their resilience and emphasizes incorporating hope-based strategies into HIV care, advocating for integrated and mental health-focused approaches to improve support and outcomes. Full article

(This article belongs to the Special Issue Sexuality, Health, and Gender)

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10 pages, 814 KiB

Open AccessStudy Protocol

Enlightening Nursing Care: A Protocol for a Multicenter Observational Study Measuring Nursing Work in Hospital Settings

by Annamaria Bagnasco, Marco Di Nitto, Ilaria Marcomini, Rosaria Alvaro, Loreto Lancia, Duilio Fiorenzo Manara, Laura Rasero, Gennaro Rocco, Valeria Caponnetto, Manuele Cesare, Yari Longobucco, Francesco Zaghini, Paolo Iovino, Alessandra Burgio, Paolo Landa, Milko Zanini, Maurizio Zega, Giancarlo Cicolini, Walter Sermeus, Jonathan Drennan, John M. Welton, Beatrice Mazzoleni and Loredana Sasso Show full author list Hide full author list

Healthcare 2025, 13(2), 167; https://doi.org/10.3390/healthcare13020167 - 16 Jan 2025

Abstract

Background: Rising costs and demands for improved quality of care present complex challenges for existing healthcare systems. The strain on healthcare resources is exacerbated by the increasing complexity of patient conditions. The Diagnosis-Related Group (DRG) system classifies inpatients according to clinical and [...] Read more.

Background: Rising costs and demands for improved quality of care present complex challenges for existing healthcare systems. The strain on healthcare resources is exacerbated by the increasing complexity of patient conditions. The Diagnosis-Related Group (DRG) system classifies inpatients according to clinical and treatment criteria, controls healthcare expenditures, and ensures the sustainability of procedures. The cost of nursing care is included in the DRG system in the same way as other fixed costs of hospital care, but the amount of nursing care provided for the same DRG can vary widely. This study, which is based on this protocol, will aim to assess the variability of nursing costs within and across DRGs and to measure how much variability in nursing care is explained by DRGs by comparing nursing care delivery in acute care hospitals with the DRG reimbursement system in Italy. It is necessary to develop a specific protocol to ensure systematic and consistent data collection at the national level. Methods: A multicenter retrospective cross-sectional study will be conducted. A random sample of five public Italian hospitals will be enrolled. Patients included in medical or surgical DRGs, hospitalized and discharged in 2022 will be included. Data will be collected retrospectively from two sources: hospital discharge records and nursing records. Inferential statistics will be used to assess the variability of nursing time and costs across hospitals and DRGs. Nursing costs will be determined by several factors, including time spent on nursing activities and the hourly wages of nursing staff. The time needed to complete each activity will be estimated by a convenience sample of nurses from the hospitals included in this study. The annual salary of nurses will be used to calculate the nursing cost per minute, multipled by the amount of time spent per each nursing activity. The cost per patient per day of hospitalization will be calculated. Conclusions: The results of this study will shed light on the variation in nursing care across different DRGs. This understanding will guide recommendations for optimizing healthcare resource allocation and enhancing the efficiency of the DRG system in Italy. Full article

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20 pages, 1017 KiB

Open AccessArticle

Effect of Laser Auriculotherapy on Quality of Life, Fatigue, and Anxiety in Women with Advanced Breast Cancer: Randomized Clinical Trial

by Larissa Marcondes, Poliana Martins Ferreira, Namie Okino Sawada, Tania Couto Machado Chianca, Jorge Vinícius Cestari Felix, Paulo Ricardo Bittencourt Guimarães and Luciana Puchalski Kalinke

Healthcare 2025, 13(2), 166; https://doi.org/10.3390/healthcare13020166 - 16 Jan 2025

Abstract

Objective: To evaluate the effect of laser auriculotherapy on health-related quality of life, cancer-related fatigue, and anxiety in women with advanced breast cancer undergoing palliative chemotherapy. Method: A randomized, parallel, single-blind, single-center clinical trial was conducted in a Brazilian oncology referral [...] Read more.

Objective: To evaluate the effect of laser auriculotherapy on health-related quality of life, cancer-related fatigue, and anxiety in women with advanced breast cancer undergoing palliative chemotherapy. Method: A randomized, parallel, single-blind, single-center clinical trial was conducted in a Brazilian oncology referral hospital. A total of 123 women were randomly divided into groups: 41 in the experimental group (10 weekly laser auriculotherapy sessions), 40 in the sham group (10 weekly sham sessions), and 42 in the control group. Outcomes were assessed at baseline, 5th week, and 11th week, using the Quality of Life Questionnaire Core-30, Functional Assessment of Cancer Therapy: Fatigue and State-Trait Anxiety Inventory. Statistical analyses included Kruskal–Wallis, Mann–Whitney, and Friedman tests. Results: The experimental group exhibited the highest mean overall quality of life, with a significant increase (p < 0.000001) between the second and third evaluations and a significant improvement in fatigue between the second and third evaluations (p = 0.00001). Conversely, women in the sham and control groups experienced a decline and worsening in both their quality of life and fatigue. Women in all three groups showed reduction an anxiety. Changes in anxiety in these women were not statistically significant. Conclusions: reduction improvement in health-related quality of life and a reduction in cancer-related fatigue in the experimental group. These results show a positive effect of auriculotherapy on cancer-related fatigue, demonstrating potential for application in clinical practice in women with advanced breast cancer and in palliative chemotherapy. Brazilian Registry of Clinical Trials: RBR-6hxffx4. Full article

(This article belongs to the Special Issue End-of-Life Care for Cancer Patients)

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9 pages, 215 KiB

Open AccessStudy Protocol

Effects of Resistance Training on Executive Functions of Cognitively Healthy Older Adults: A Systematic Review and Meta-Analysis Protocol

by Felipe Jerez-Salas, Christian Campos-Jara, Sergio Araya Sierralta, Daniel Jerez-Mayorga, Rodrigo Ramirez-Campillo, Guido Contreras-Díaz, Vanessa Carrasco-Alarcón, Hugo Martínez-Cortés, Cristián Arellano-Roco, Victoria Hernández-Cifuentes and Falonn Contreras-Osorio

Healthcare 2025, 13(2), 165; https://doi.org/10.3390/healthcare13020165 - 16 Jan 2025

Abstract

Background/Objectives: Aging involves a series of changes in non-pathological age-related conditions, some of which impact the cognitive functioning of older adults. Executive functions are cognitive skills that are often affected in this process, although they have been shown to improve after physical [...] Read more.

Background/Objectives: Aging involves a series of changes in non-pathological age-related conditions, some of which impact the cognitive functioning of older adults. Executive functions are cognitive skills that are often affected in this process, although they have been shown to improve after physical exercise interventions. This protocol aims to describe the procedures that will be carried out in a systematic literature review, including a meta-analysis of the effects of resistance interventions on the main dimensions of executive function in cognitively healthy older adults compared to active or passive control groups. Methods: The PRISMA-P guidelines will be followed. Eligibility criteria will be organized based on the PICOS strategy (older adults with normal cognition ≥60 years; chronic resistance interventions ≥4 weeks; active or passive control group; direct measures of executive function). The PubMed, EBSCO, Scopus, and Web of Science databases will be used. The risk of bias and quality of evidence will be measured using RoB2 and GRADE, respectively. The DerSimonian–Laird random effects model will be used for the meta-analysis. The effect size will be calculated using Hedges’ g with a 95% confidence interval and p < 0.05 to indicate statistical significance. Discussion: The results of the proposed review may be useful to justify the design and implementation of treatment plans based on resistance training for the prevention and management of cognitive changes typical of aging among older adults. PROSPERO registry: CRD42024571127. Full article

14 pages, 516 KiB

Open AccessOpinion

Framing and Management of Migraines in Women: An Expert Opinion on Challenges, Current Approaches, and Future Multidisciplinary Perspectives

by Piero Barbanti and Rossella E. Nappi

Healthcare 2025, 13(2), 164; https://doi.org/10.3390/healthcare13020164 - 16 Jan 2025

Abstract

Background/Objectives: Migraines are a common neurological disorder that significantly impact women, especially during their reproductive years. Hormonal, neurological, and lifestyle factors shape migraine patterns, with fluctuations during menstruation, pregnancy, perimenopause, and menopause influencing migraine prevalence and severity. This expert opinion explores current challenges, [...] Read more.

Background/Objectives: Migraines are a common neurological disorder that significantly impact women, especially during their reproductive years. Hormonal, neurological, and lifestyle factors shape migraine patterns, with fluctuations during menstruation, pregnancy, perimenopause, and menopause influencing migraine prevalence and severity. This expert opinion explores current challenges, therapeutic strategies, and future directions for personalized care, addressing the limited inclusion of women in clinical research across different life stages. Methods: In order to focus on hormonal influences, pharmacological and non-pharmacological therapies, including CGRP monoclonal antibodies, neuromodulation, and lifestyle interventions, a comprehensive analysis of literature, in particular on clinical trials, real-world studies, and guidelines on migraine management was performed. Emerging digital tools and AI-based approaches were also evaluated to improve personalized care for women with migraine. Results: Hormonal therapies, including contraceptives and HRTs, present both risks and benefits, particularly for women with migraines with aura, highlighting the need for individualized approaches. Advances in CGRP-targeted therapies have shown effectiveness in preventing refractory migraines. Non-pharmacological treatments, such as neuromodulation, acupuncture, and lifestyle adjustments, further expand the treatment landscape. However, research gaps remain, particularly regarding hormonal influences on migraines during pregnancy and menopause. Conclusions: Future research should prioritize female-specific clinical trials to better understand the impact of hormonal changes on migraines. Tailored therapies combining pharmacological, non-pharmacological, and digital solutions are essential for improving care. A multidisciplinary approach integrating personalized medicine, technological advancements, and patient education is crucial to optimizing outcomes and enhancing quality of life for women with migraine. Full article

(This article belongs to the Special Issue Pain Management in Healthcare Practice)

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13 pages, 1372 KiB

Open AccessArticle

The Influence of Prefabricated Foot Orthosis Use on the Modification of Foot Posture in Adults with Pronated Feet: A Randomised Controlled Trial

by María Victoria Cáceres-Madrid, Julián Fernando Calderón-García, Francisco José Rodríguez-Velasco, Belinda Basilio-Fernández, Fidel López-Espuela, Esperanza Santano-Mogena, Marina Fontán-Jiménez and Sergio Rico-Martín

Healthcare 2025, 13(2), 163; https://doi.org/10.3390/healthcare13020163 - 16 Jan 2025

Abstract

Background: The use of foot orthoses to treat different pathologies in pronated feet in adults is widespread among podiatric professionals, although it has not been conclusively demonstrated to modify foot posture in the short or medium term. Objective: The aim of this study [...] Read more.

Background: The use of foot orthoses to treat different pathologies in pronated feet in adults is widespread among podiatric professionals, although it has not been conclusively demonstrated to modify foot posture in the short or medium term. Objective: The aim of this study was to evaluate whether prefabricated foot supports reduce pronated foot posture in adults, as measured by the foot posture index (FPI). Methods: A randomised controlled clinical trial was conducted in 109 subjects with pronated feet. The participants were randomly placed into a control group that did not receive any intervention and an experimental group that used prefabricated orthoses for 6 months. The changes in the FPI were evaluated in both groups at 6 months. Results: Over the six-month follow-up period, the delta FPI variable was changed by −1.1 ± 2.2 points in the experimental group, whereas the same variable was reduced by 1.2 ± 2.1 points in the control group (p = 0.001). The participants in the experimental group neutralised their FPIs significantly more than those in the control group did (39.3% vs. 8.5%; p = 0.041). Moreover, individuals in the experimental group were more likely to migrate from highly pronated feet to pronated feet than those in the control group were (45.8% vs. 20%; p < 0.001). Finally, multivariate analysis indicated that prefabricated foot orthoses were associated with an improved FPI (OR: 6.23, CI%95: 2.72–17.09; p < 0.001). However, the corrective effect provided by the prefabricated foot orthoses, which neutralised the pronated posture, was nullified by the presence of index minus metatarsal formula. Conclusions: The use of prefabricated orthoses resulted in a decreased FPI in adults, especially in those with highly pronated feet. However, the index minus presence nullified the effect of prefabricated orthoses on foot posture neutralisation. Full article

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11 pages, 260 KiB

Open AccessArticle

The Associated Factors of Work Engagement, Work Overload, Work Satisfaction, and Emotional Exhaustion and Their Effect on Healthcare Workers: A Cross-Sectional Study

by Marina Moreno-Martínez and Iván Sánchez-Martínez

Healthcare 2025, 13(2), 162; https://doi.org/10.3390/healthcare13020162 - 16 Jan 2025

Abstract

Background: In today’s fast-paced work environment, work engagement is crucial for both organizational success and individual well-being. Objective: Our aim is this study was to analyze the associated factors of work engagement, work overload, work satisfaction, and emotional exhaustion and describe their effect [...] Read more.

Background: In today’s fast-paced work environment, work engagement is crucial for both organizational success and individual well-being. Objective: Our aim is this study was to analyze the associated factors of work engagement, work overload, work satisfaction, and emotional exhaustion and describe their effect on nurses and physicians in the Central Catalonia Health Region during 2023. Methods: A multicenter cross-sectional study was conducted using an online questionnaire at the Territorial Management of Central Catalonia (Spain). The questionnaire was accessible from 28 November 2022 to 12 March 2023. The analysis was performed using the SPSS software. CHERRIES (Checklist for Reporting Results of Internet E-Surveys) guidelines were followed for communicating research results. Results: A total of 321 professionals answered the questionnaire, 60.7% of whom were nursing professionals and 39.3% of whom were medical professionals. Work overload, work satisfaction, and emotional exhaustion were associated with work engagement. Being a physician, permanent contracts, irregular work shifts, overtime, and salary were related to work overload and emotional exhaustion. Being a woman, salary, academic level, and irregular work shifts were related to work satisfaction. There was a gender inequality in work engagement among nursing professionals to the detriment of men. In terms of class inequality, there was a difference between occupational groups with respect to work overload and emotional exhaustion among women. Conclusions: Organizational practices need to be improved to promote greater engagement and work satisfaction, as well as to reduce emotional overload and exhaustion. This may include regulating unpaid overtime and promoting more stable working hours. Full article

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

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