Healthcare

13 pages, 1000 KiB

Open AccessEditor’s ChoiceArticle

Enhanced Recovery after Surgery (ERAS) Implementation and Barriers among Healthcare Providers in France: A Cross-Sectional Study

by Augustin Clet, Marin Guy, Jean-François Muir, Antoine Cuvelier, Francis-Edouard Gravier and Tristan Bonnevie

Healthcare 2024, 12(4), 436; https://doi.org/10.3390/healthcare12040436 - 8 Feb 2024

Cited by 7 | Viewed by 4031

Abstract

The implementation of Enhanced Recovery After Surgery (ERAS) is a challenge for healthcare systems, especially in case of patients undergoing major surgery. Despite a proven significant reduction in postoperative complications and hospital lengths of stay, ERAS protocols are inconsistently used in real-world practice, [...] Read more.

The implementation of Enhanced Recovery After Surgery (ERAS) is a challenge for healthcare systems, especially in case of patients undergoing major surgery. Despite a proven significant reduction in postoperative complications and hospital lengths of stay, ERAS protocols are inconsistently used in real-world practice, and barriers have been poorly described in a cohort comprising medical and paramedical professionals. This study aims to assess the proportion of French healthcare providers who practiced ERAS and to identify barriers to its implementation amongst those surveyed. We conducted a prospective cross-sectional study to survey healthcare providers about their practice of ERAS using an online questionnaire. Healthcare providers were contacted through hospital requests, private hospital group requests, professional corporation requests, social networks, and personal contacts. The questionnaire was also designed to explore barriers to ERAS implementation. Identified barriers were allocated by two independent assessors to one of the fourteen domains of the Theoretical Domains Framework (TDF), which is an integrative framework based on behavior change theories that can be used to identify issues relating to evidence on the implementation of best practice in healthcare settings. One hundred and fifty-three French healthcare providers answered the online questionnaire (76% female, median age 35 years (IQR: 29 to 48)). Physiotherapists, nurses, and dieticians were the most represented professions (31.4%, 24.2%, and, 14.4%, respectively). Amongst those surveyed, thirty-one practiced ERAS (20.3%, 95%CI: 13.9 to 26.63). Major barriers to ERAS practice were related to the “Environmental context and resources” domain (57.6%, 95%CI: 49.5–65.4), e.g., lack of professionals, funding, and coordination, and the “Knowledge” domain (52.8%, 95%CI: 44.7–60.8), e.g., ERAS unawareness. ERAS in major surgery is seldom practiced in France due to the unfavorable environment (i.e., logistics issues, and lack of professionals and funding) and a low rate of procedure awareness. Future studies should focus on devising and assessing strategies (e.g., education and training, collaboration, institutional support, the development of healthcare networks, and leveraging telehealth and technology) to overcome these barriers, thereby promoting the wider implementation of ERAS. Full article

(This article belongs to the Special Issue Physiotherapy and Cardiothoracic Care in Acute and Chronic Care)

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14 pages, 244 KiB

Open AccessEditor’s ChoiceArticle

Experiences of Frontline Managers during the COVID-19 Pandemic: Recommendations for Organizational Resilience

by Sonia Udod, Pamela Baxter, Suzanne Gagnon, Gayle Halas and Saba Raja

Healthcare 2024, 12(3), 407; https://doi.org/10.3390/healthcare12030407 - 4 Feb 2024

Cited by 6 | Viewed by 2870

Abstract

The COVID-19 pandemic caused a global health crisis directly impacting the healthcare system. Healthcare leaders influence and shape the ability of an organization to cope with and recover from a crisis such as the COVID-19 pandemic. Their actions serve to guide and support [...] Read more.

The COVID-19 pandemic caused a global health crisis directly impacting the healthcare system. Healthcare leaders influence and shape the ability of an organization to cope with and recover from a crisis such as the COVID-19 pandemic. Their actions serve to guide and support nurses’ actions through unpredictable health service demands. The purpose of this paper was to examine frontline managers’ experiences and organizational leadership responses that activated organizational resilience during the COVID-19 pandemic, and to learn for ongoing and future responses to healthcare crises. Fourteen managers participated in semi-structured interviews. We found that: (1) leadership challenges (physical resources and emotional burden), (2) the influence of senior leader decision-making on managers (constant change, shortage of human resources, adapting care delivery, and cooperation and collaboration), and (3) lessons learned (managerial caring behaviours and role modelling, adaptive leadership, education and training, culture of care for self, and others) were evidence of managers’ responses to the crisis. Overall, the study provides evidence of managers experiences during the early waves of the pandemic in supporting nurses and fostering organizational resilience. Knowing manager’s experiences can facilitate planning, preparing, and strengthening their leadership strategies to improve work conditions is a high priority to manage and sustain nurses’ mental health and wellbeing. Full article

(This article belongs to the Section Nursing)

10 pages, 226 KiB

Open AccessEditor’s ChoiceArticle

The Commitment to Excellence: Understanding Nurses’ Perspectives on Continuous Professional Development

by Biljana Kurtović, Petra Gulić, Snježana Čukljek, Biserka Sedić, Martina Smrekar and Sanja Ledinski Fičko

Healthcare 2024, 12(3), 379; https://doi.org/10.3390/healthcare12030379 - 1 Feb 2024

Cited by 7 | Viewed by 6793

Abstract

Continuous Professional Development (CPD) is essential for nurses to maintain up-to-date knowledge and skills in the evolving healthcare sector. This study explores nurses’ attitudes toward CPD, its necessity, and the challenges encountered. The aim is to examine nurses’ perspectives on CPD, focusing on [...] Read more.

Continuous Professional Development (CPD) is essential for nurses to maintain up-to-date knowledge and skills in the evolving healthcare sector. This study explores nurses’ attitudes toward CPD, its necessity, and the challenges encountered. The aim is to examine nurses’ perspectives on CPD, focusing on their participation and motivation, in relation to their workplace, workplace function, and form of work. A cross-sectional study design was employed with 151 nurses from University Hospital Centre Split, Croatia. Data were collected using the “Professional Development of Nurses questionnaire (Q-PDN)” and analyzed using descriptive statistical methods, the Kolmogorov–Smirnov test, Pearson’s correlation, ANOVA test, and t-test. The average level of participation in CPD activities was 4.27 (±0.63), indicating a positive inclination towards CPD. The study identified a statistically significant difference in activities related to CPD (t = 2.12; p = 0.036) among employees of surgical and intensive care units compared to other departments, where a higher level of engagement was present among employees of other departments. Notably, nurses without managerial roles showed 0.16 points higher participation in CPD activities compared to their managerial counterparts, though this was not statistically significant (t = 0.92; p = 0.357). Nurses in managerial roles valued CPD for professional development more highly, with a significant difference (t = 2.77; p = 0.006). Full-time nurses demonstrated a higher perception of the importance of personal professional development compared to part-time nurses, with a significant difference (F = 2.88; p = 0.038). The study reveals a strong commitment to CPD among nurses, with variations based on workplace roles and schedules. It underscores the need for role-specific and adaptable CPD programs to meet diverse needs and enhance professional competence in the nursing workforce. Full article

(This article belongs to the Special Issue Research, Education, Workforce, and Regulation to Transforming Nursing Practice and Leadership: The Future of Nursing)

13 pages, 549 KiB

Open AccessEditor’s ChoiceArticle

Empowering Community Health Workers in Japan: Determinants of Non-Communicable Disease Prevention Competency

by Yuki Imamatsu, Yuka Iwata, Ayuka Yokoyama, Yuko Tanaka and Etsuko Tadaka

Healthcare 2024, 12(3), 297; https://doi.org/10.3390/healthcare12030297 - 24 Jan 2024

Cited by 2 | Viewed by 2243

Abstract

Background: Community health workers (CHWs), hailing from the general populace, play a pivotal role in fortifying healthcare systems, with a primary focus on mitigating non-communicable diseases (NCDs) and elevating overall life expectancy. To assess the aptitude of CHWs in NCD prevention, we introduced [...] Read more.

Background: Community health workers (CHWs), hailing from the general populace, play a pivotal role in fortifying healthcare systems, with a primary focus on mitigating non-communicable diseases (NCDs) and elevating overall life expectancy. To assess the aptitude of CHWs in NCD prevention, we introduced the Community Health Workers Perceptual and Behavioral Competency Scale for preventing non-communicable diseases (COCS-N). This study examines the multifaceted interplay of individual and community factors that influence CHWs’ COCS-N scores. Methods: The research design is a secondary analysis using data from a self-administered questionnaire survey of 6480 CHWs residing in municipalities across Japan, which obtained 3120 valid responses, between September to November 2020. The COCS-N was employed as the dependent variable, while the independent variables were individual-related factors, including years of community health work, health literacy, and community-related factors, such as CHWs’ sense of community. To ascertain the significance of associations between individual and community factors and CHWs’ competency, an analysis of covariance (ANCOVA) was utilized to compare the three groups Q1/Q2/Q3 by low, medium, and high scores on the COCS-N scale. Statistical significance was considered to be indicated by a p-value of less than 0.05. Results: The ANCOVA analysis revealed that three factors were significantly linked to CHWs’ competence. These comprised individual factors: “years of CHWs” (mean ± SD Q1: 6.0 ± 6.0, Q2: 7.8 ± 7.0, Q3: 8.2 ± 7.7, p < 0.001) and “health literacy” (Q1: 27.7 ± 6.6, Q2: 30.4 ± 6.9, Q3: 33.8 ± 7.8, p < 0.001), as well as a community factor: “Sense of community” (Q1: 14.8 ± 3.7, Q2: 16.5 ± 3.5, Q3: 18.2 ± 3.6, p < 0.001). Conclusions: Our finding is that a positive association was derived between COCS-N scores and certain determinants. Notably, “years of CHWs” and “health literacy” in the individual domain, along with the “Sense of community” in the communal context, were firmly established as being significantly associated with CHWs’ competency. Consequently, CHWs need training to increase their “health literacy” and “sense of community”, to acquire high competency in NCD prevention, which will lead to the empowerment of CHWs and maintain their motivation to continue. Full article

(This article belongs to the Section Community Care)

14 pages, 1346 KiB

Open AccessEditor’s ChoiceArticle

Trajectories of Competitive Employment of Autistic Adults through Late Midlife

by Emily J. Hickey, Leann Smith DaWalt, Jinkuk Hong, Julie Lounds Taylor and Marsha R. Mailick

Healthcare 2024, 12(2), 265; https://doi.org/10.3390/healthcare12020265 - 20 Jan 2024

Cited by 2 | Viewed by 1616

Abstract

Autistic adults experience challenges in maintaining employment; however, little is known about patterns of competitive employment through late midlife. This longitudinal study examined the change in hours of competitive employment for a cohort of autistic adults over a 22-year period. The study’s aims [...] Read more.

Autistic adults experience challenges in maintaining employment; however, little is known about patterns of competitive employment through late midlife. This longitudinal study examined the change in hours of competitive employment for a cohort of autistic adults over a 22-year period. The study’s aims were to provide a fine-grained analysis of competitive employment patterns, to determine whether there was age-related change, and to test whether trajectories differed between those with and without intellectual disability (ID). Using an accelerated longitudinal design, trajectories of hours of competitive employment were estimated from young adulthood through late midlife in a community-based cohort (n = 341; 1327 observations). Results indicated a significant curvilinear trajectory of age-related change in hours of competitive employment, with differences between those with and without ID. For those without ID, the number of competitive employment hours increased from young adulthood until early midlife, then leveled off and decreased into late midlife. For those with ID, engagement in competitive employment was low throughout. Although competitive employment is just one option for vocational engagement, it is a goal often articulated by autistic adults who seek entry into the general workforce. The present research reveals their degree of engagement in the competitive workforce across the decades of adulthood. Full article

(This article belongs to the Special Issue Autism beyond School-Age: Characterization, Intervention, and Community Support)

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15 pages, 554 KiB

Open AccessEditor’s ChoiceReview

Nurses’ Well-Being at Work in a Hospital Setting: A Scoping Review

by Débora Almeida, Ana Rita Figueiredo and Pedro Lucas

Healthcare 2024, 12(2), 173; https://doi.org/10.3390/healthcare12020173 - 11 Jan 2024

Cited by 10 | Viewed by 6520

Abstract

The aim of this review was to analyze the scientific evidence about nurses’ well-being at work in the hospital context. Well-being is present in our daily experiences, whether in a personal or professional context. Nurses are frequently put under pressure and stressed at [...] Read more.

The aim of this review was to analyze the scientific evidence about nurses’ well-being at work in the hospital context. Well-being is present in our daily experiences, whether in a personal or professional context. Nurses are frequently put under pressure and stressed at work, which can influence their well-being. Nurses’ well-being at work in a hospital setting is crucial due to its relevance to occupational health, the quality of patient care, and the identification of stress and satisfaction factors. Methods: This systematic review followed the methodological guidelines of the Joanna Briggs Institute (JBI). The databases searched included CINAHL, MEDLINE, Scopus, Cochrane Database of Systematic Reviews, LILACS, Scientific Electronic Library Online (SciELO), and the Open Access Scientific Repositories of Portugal (RCAAP). The following inclusion criteria were defined: studies in Portuguese or English; with abstracts or full texts available; with a publication date from 2018 to 2022; and research containing the identified keywords in the title (TI) or abstract (AB). To organize and synthesize the data, we used a table to extract the significant information from each included study. Results: Eight studies were included, all of them emphasizing the assessment of well-being at work and the manager’s intervention to promote this well-being. We found that most studies indicate that nurses are satisfied with their work. There are several factors that can influence this positive level of well-being at work, such as interaction with management, culture, and organizational commitment. It can be concluded that nurse managers have a decisive role in promoting well-being at work. Full article

(This article belongs to the Section Nursing)

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17 pages, 4131 KiB

Open AccessEditor’s ChoiceReview

Mobile Apps for COVID-19: A Systematic Review of Reviews

by Felix Holl, Johannes Schobel and Walter J. Swoboda

Healthcare 2024, 12(2), 139; https://doi.org/10.3390/healthcare12020139 - 8 Jan 2024

Cited by 1 | Viewed by 2079

Abstract

Background: One measure national governments took to react to the acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) pandemic was mobile applications (apps). This study aims to provide a high-level overview of published reviews of mobile apps used in association with coronavirus disease 19 [...] Read more.

Background: One measure national governments took to react to the acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) pandemic was mobile applications (apps). This study aims to provide a high-level overview of published reviews of mobile apps used in association with coronavirus disease 19 (COVID-19), examine factors that contributed to the success of these apps, and provide data for further research into this topic. Methods: We conducted a systematic review of reviews (also referred to as an umbrella review) and searched two databases, Medline and Embase, for peer-reviewed reviews of COVID-19 mobile apps that were written in English and published between January 1st 2020 and April 25th 2022. Results: Out of the initial 17,611 studies, 24 studies were eligible for the analysis. Publication dates ranged from May 2020 to January 2022. In total, 54% (n = 13) of the studies were published in 2021, and 33% (n = 8) were published in 2020. Most reviews included in our review of reviews analyzed apps from the USA, the UK, and India. Apps from most of the African and Middle and South American countries were not analyzed in the reviews included in our study. Categorization resulted in four clusters (app overview, privacy and security, MARS rating, and miscellaneous). Conclusions: Our study provides a high-level overview of 24 reviews of apps for COVID-19, identifies factors that contributed to the success of these apps, and identifies a gap in the current literature. The study provides data for further analyses and further research. Full article

(This article belongs to the Special Issue The 10th Anniversary of Healthcare—TeleHealth and Digital Healthcare)

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14 pages, 275 KiB

Open AccessEditor’s ChoiceArticle

Adoption Processes of Innovations in Health Systems: The Example of Telemedicine in Germany

by Yvonne Rauner and Harald Stummer

Healthcare 2024, 12(2), 129; https://doi.org/10.3390/healthcare12020129 - 6 Jan 2024

Cited by 1 | Viewed by 2668

Abstract

(1) Background: Individual adoption experiences represent important factors in implementing innovations. In the context of health systems, where the implementation of innovations aims to improve the quality of care, they provide an important basis for developing and adapting implementation strategies. (2) Methods: This [...] Read more.

(1) Background: Individual adoption experiences represent important factors in implementing innovations. In the context of health systems, where the implementation of innovations aims to improve the quality of care, they provide an important basis for developing and adapting implementation strategies. (2) Methods: This study examines the adoption experiences of (tele-)medical experts (n = 13) using the example of telemedicine in the German healthcare system by means of a qualitative, guideline-based interview study. The interview guide, as well as the deductive–inductive analysis, is based on Rogers’ adoption theory. The transcription and analysis process was carried out according to Kuckartz. (3) Results: A total of 304 interview statements could be coded and assigned to the five main categories of persuasion, knowledge, implementation, decision and confirmation. More than half of all statements were coded under the main category persuasion, with its subcategories of convictions regarding the implementation of telemedicine (n = 89), international comparison of Germany’s development (n = 50), telemedicine as a way of optimizing resources (n = 22) and conviction to understand telemedicine as an overall system (n = 10). (4) Conclusions: This study provides insight into how the implementation of telemedicine in the German healthcare system is perceived by experts and allows for adjustments to the ongoing implementation strategy. Full article

(This article belongs to the Section TeleHealth and Digital Healthcare)

15 pages, 270 KiB

Open AccessEditor’s ChoicePerspective

Telehealth Competencies: Training Physicians for a New Reality?

by Ilian Cruz-Panesso, Issam Tanoubi and Pierre Drolet

Healthcare 2024, 12(1), 93; https://doi.org/10.3390/healthcare12010093 - 31 Dec 2023

Cited by 6 | Viewed by 3572

Abstract

In North America, telehealth increased by 40% between 2019 and 2020 and stabilized at 40% in 2021. As telehealth becomes more common, it is essential to ensure that healthcare providers have the required skills to overcome the challenges and barriers of this new [...] Read more.

In North America, telehealth increased by 40% between 2019 and 2020 and stabilized at 40% in 2021. As telehealth becomes more common, it is essential to ensure that healthcare providers have the required skills to overcome the challenges and barriers of this new modality of care. While the COVID-19 pandemic has accelerated the design and implementation of telehealth curricula in healthcare education programs, its general adoption is still a major gap and an important barrier to ensuring scaling up and sustainability of the telesshealth practice. Lack of experienced faculty and limited curricular time are two of the most common barriers to expanding telehealth education. Overcoming the barriers of telehealth curricula implementation may require moving away from the classic expert model of learning in which novices learn from experts. As the adoption of telehealth curricula is still in its early stages, institutions may need to plan for faculty development and trainee education at the same time. Questions regarding the timing and content of telehealth education, the interprofessional development of curricula, and the identification of optimal pedagogical methods remain open and crucial. This article reflects on these questions and presents telesimulation as an ideal instructional method for the training of telehealth competencies. Telesimulation can provide opportunities for practical training across a range of telehealth competencies, fostering not only technical proficiency but also communication skills and interprofessional collaboration. Full article

(This article belongs to the Special Issue The 10th Anniversary of Healthcare—TeleHealth and Digital Healthcare)

12 pages, 289 KiB

Open AccessEditor’s ChoiceArticle

Medical Gaslighting and Lyme Disease: The Patient Experience

by Jennifer L. Fagen, Jeremy A. Shelton and Jenna Luché-Thayer

Healthcare 2024, 12(1), 78; https://doi.org/10.3390/healthcare12010078 - 29 Dec 2023

Cited by 10 | Viewed by 14331

Abstract

Even though there are approximately half a million new cases of Lyme disease in the US annually, according to the CDC, it is often undiagnosed or misdiagnosed, which can result in a chronic, multisystemic condition. Lyme disease is a recognized public health threat [...] Read more.

Even though there are approximately half a million new cases of Lyme disease in the US annually, according to the CDC, it is often undiagnosed or misdiagnosed, which can result in a chronic, multisystemic condition. Lyme disease is a recognized public health threat and is a designated “notifiable disease”. As such, Lyme disease is mandated to be reported by the CDC. Despite this, both acute and chronic Lyme disease (CLD) have been relegated to the category of “contested illnesses”, which can lead to medical gaslighting. By analyzing results from an online survey of respondents with Lyme disease (n = 986), we elucidate the lived experiences of people who have been pushed to the margins of the medical system by having their symptoms attributed to mental illness, anxiety, stress, and aging. Further, respondents have had their blood tests and erythema migrans (EM) rashes discounted and were told that CLD simply does not exist. As a result, a series of fruitless consultations often result in the delay of a correct diagnosis, which has deleterious consequences. This is the first study that addresses an extensive range of gaslighting techniques experienced by this patient population. Full article

(This article belongs to the Section Chronic Care)

10 pages, 241 KiB

Open AccessEditor’s ChoiceArticle

Perception of Paternal Postpartum Depression among Healthcare Professionals: A Qualitative Study

by Aziz Essadek, Alix Marie, Michel-Alexandre Rioux, Emmanuelle Corruble and Florence Gressier

Healthcare 2024, 12(1), 68; https://doi.org/10.3390/healthcare12010068 - 28 Dec 2023

Cited by 2 | Viewed by 2923

Abstract

The pathway to parenthood constitutes a fundamental and transformative stage in every individual’s life. While postpartum depression in mothers has been increasingly studied and acknowledged, paternal postpartum depression (PPD) has garnered only moderate research attention. This study aims to delve into the comprehension [...] Read more.

The pathway to parenthood constitutes a fundamental and transformative stage in every individual’s life. While postpartum depression in mothers has been increasingly studied and acknowledged, paternal postpartum depression (PPD) has garnered only moderate research attention. This study aims to delve into the comprehension and knowledge of healthcare professionals who may encounter men suffering from postpartum depression. Within the framework of this qualitative research, we conducted six semi-structured interviews with various healthcare professionals. The data were subjected to interpretative phenomenological analysis, revealing the following themes: (1) the professionals’ uncertainty in the face of paternal PPD; (2) the context and timing of healthcare professionals’ involvement appeared unsuited for detecting paternal PPD; (3) the experiences of fathers were found not to be shared with healthcare professionals due to their inhibitions and avoidance reactions; (4) the social representation of the role of fathers influenced professionals in their considerations of this aspect. Strengthening the training and confidence of healthcare professionals in France would lead to an enhancement in the screening and management of paternal PPD. Additionally, the healthcare system should better organize postnatal support to enable caregivers to be more available during the peak of depression occurrence. Full article

(This article belongs to the Special Issue Perinatal Mental Health and Care)

12 pages, 401 KiB

Open AccessEditor’s ChoiceArticle

The Relationship between Self-Rated Health and Physical Fitness in Polish Youth

by Maciej Kochman, Aleksandra Kielar, Marta Kasprzak, Krystian Maruszczak and Wojciech Kasperek

Healthcare 2024, 12(1), 24; https://doi.org/10.3390/healthcare12010024 - 21 Dec 2023

Cited by 2 | Viewed by 1762

Abstract

Self-rated health (SRH) is a tool for assessing a population’s health across the lifetime, and seems to be a dynamic assessment of current health status and a strong predictor of cardiovascular disease and mortality, whereas insufficient levels of physical fitness in adolescence are [...] Read more.

Self-rated health (SRH) is a tool for assessing a population’s health across the lifetime, and seems to be a dynamic assessment of current health status and a strong predictor of cardiovascular disease and mortality, whereas insufficient levels of physical fitness in adolescence are a significant health problem and may contribute to the development of many disorders in adulthood. In this cross-sectional study, we attempted to assess the relationship between SRH and the physical fitness of adolescents. Two hundred and thirty-five adolescents (eighty-five boys and one hundred and fifty girls) aged 16–17 were recruited for this study. The study procedures included a short author questionnaire and physical fitness assessment (Zuchora’s Physical Fitness Index). Boys declared better health states and reported less frequent morbidity of seasonal diseases (p < 0.05). No differences were found in physical fitness, the incidence of postural disorders, lower limb malalignments, foot deformities, sleep duration, and perception of physical activity on physical condition and well-being in boys and girls (p > 0.05). The comparison of physical fitness levels in adolescents with different SRH, sleep duration, perceptions of physical activity on physical condition and well-being also showed significant differences (p < 0.05). Positive SRH and perception of physical activity on physical condition and well-being, proper sleep duration (7–8 h/night), and a lack of foot deformities are associated with a better physical fitness in adolescents. Physical fitness seems to be a good predictor of SRH only in Polish boys, but not girls and the entire population. The lack of significance in the entire population could be attributed to the substantial number of girls in the study group. Despite that, it is recommended to encourage adolescents to engage in regular exercises, sleep routines and healthy lifestyles. Further research should be based on a more representative group, with a comparable number of girls and boys in the study group and potential confounders, but also they should be focused on SRH predictors to improve SRH in Polish girls. Full article

(This article belongs to the Special Issue Review of Research on School Health)

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37 pages, 1047 KiB

Open AccessEditor’s ChoiceReview

The Effects of Digital Addiction on Brain Function and Structure of Children and Adolescents: A Scoping Review

by Keya Ding, Yining Shen, Qianming Liu and Hui Li

Healthcare 2024, 12(1), 15; https://doi.org/10.3390/healthcare12010015 - 20 Dec 2023

Cited by 10 | Viewed by 11531

Abstract

The escalating prevalence of studies investigating digital addiction (DA) and its detrimental impact on the human brain’s structure and functionality has been noticeable in recent years. Yet, an overwhelming majority of these reviews have been predominantly geared towards samples comprising college students or [...] Read more.

The escalating prevalence of studies investigating digital addiction (DA) and its detrimental impact on the human brain’s structure and functionality has been noticeable in recent years. Yet, an overwhelming majority of these reviews have been predominantly geared towards samples comprising college students or adults and have only inspected a single variant of DA, such as internet gaming disorder, internet addiction disorder, problematic smartphone use, tablet overuse, and so forth. Reviews focusing on young children and adolescents (ages 0–18), or those which amalgamate various types of DA, are decidedly scarce. Given this context, summarizing the effects of DA on brain structure and functionality during the vital developmental stage (0–18 years) is of immense significance. A scoping review, complying with the PRISMA extension for such reviews, was conducted to amalgamate findings from 28 studies spanning a decade (2013–2023) and to examine the influence of assorted forms of DA on the brains of children and adolescents (0–18 years). The synthesized evidence indicated two primary results: (1) DA exerts harmful effects on the structure and functionality of the brains of children and adolescents, and (2) the prefrontal lobe is the region most consistently reported as impacted across all research. Furthermore, this review discerned a notable void of studies investigating the neural indices of digital addiction, along with a shortage of studies focusing on young children (0–6 years old) and longitudinal evidence. This research could provide the necessary theoretical basis for the thwarting and intervention of digital addiction, a measure indispensable for ensuring healthy brain development in children and adolescents. Full article

(This article belongs to the Section TeleHealth and Digital Healthcare)

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15 pages, 937 KiB

Open AccessEditor’s ChoiceReview

Clinical Applications of Virtual Reality in Musculoskeletal Rehabilitation: A Scoping Review

by Elizabeth Chaplin, Christos Karatzios and Charles Benaim

Healthcare 2023, 11(24), 3178; https://doi.org/10.3390/healthcare11243178 - 15 Dec 2023

Cited by 10 | Viewed by 5255

Abstract

(1) Background: VR is based on a virtual world that creates sounds effects and videos that replace the real environment. Arising literature shows VR efficacy in the field of neurological rehabilitation (NR) and that its use is also taking a place in musculoskeletal [...] Read more.

(1) Background: VR is based on a virtual world that creates sounds effects and videos that replace the real environment. Arising literature shows VR efficacy in the field of neurological rehabilitation (NR) and that its use is also taking a place in musculoskeletal rehabilitation (MSR), as a treatment of various disorders that cause disability and chronic pain. (2) Aim: We discuss the role of VR in MSR, presenting its use and development on acute and chronic musculoskeletal disorders, based on the most recent literature. (3) Design and Methods: Literature searches were conducted in the databases Pubmed and Medline up to 30 September 2023. The PRISMA-Scr Checklist was followed. (4) Results: A total of 51 records were included. The analysed studies were conducted within a variety of populations, musculoskeletal disorders, settings, and VR technologies. Only a few studies could statistically affirm the efficacy of VR in MSR, as mentioned for the rehabilitation of the upper limb. Nevertheless, the observed trend is an improvement of the global perceived effect compared to traditional rehabilitation. (5) Conclusion: VR allows for the personalisation of treatment with an adaptable treatment platform, which may improve the participation of the patient and increase acceptability and adherence to long-term rehabilitation programs. We provide recommendations and suggestions for future research and use of VR in musculoskeletal rehabilitation. Full article

(This article belongs to the Special Issue Advances in Physical Therapy: Rehabilitation, Therapeutic Exercise and Promotion of Quality of Life)

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14 pages, 511 KiB

Open AccessEditor’s ChoiceReview

The Influence of Social Support in PROMs of Patients with COPD in Primary Care: A Scoping Review

by Antonia Aravantinou-Karlatou, Izolde Bouloukaki, Antonios Christodoulakis and Ioanna Tsiligianni

Healthcare 2023, 11(24), 3141; https://doi.org/10.3390/healthcare11243141 - 11 Dec 2023

Cited by 5 | Viewed by 2195

Abstract

Chronic obstructive pulmonary disease (COPD) is a prevalent and multidimensional disease with symptoms that greatly influence patients’ health. Healthcare professionals utilize patient-reported outcome measures (PROMs) to classify and better manage the disease. Despite the value of PROMs, they inadequately represent some important dimensions [...] Read more.

Chronic obstructive pulmonary disease (COPD) is a prevalent and multidimensional disease with symptoms that greatly influence patients’ health. Healthcare professionals utilize patient-reported outcome measures (PROMs) to classify and better manage the disease. Despite the value of PROMs, they inadequately represent some important dimensions of COPD, like social support and healthcare access/utilization. This is important, especially for social support, since it can positively influence PROMs results and the overall health of patients with COPD. Therefore, a scoping review was conducted to determine how social support affects PROMs of patients with COPD in primary care. The PRISMA–Scoping approach was adopted, and we sought articles published in MEDLINE and COHRANE. We screened 2038 articles for inclusion and finally included a total of 10 articles. Most of the articles were conducted in the U.S. and Norway. Social support had a strong positive impact on PROMs. Additionally, different types of social support were observed. Moreover, higher levels of social support were linked to better quality of life, mental health, self-care behaviors, self-management, functionality, and less severe COPD. Consequently, this scoping review highlights the value of social support in patients with COPD and its underrepresentation and misrepresentation in PROMs literature. Full article

(This article belongs to the Special Issue The 10th Anniversary of Healthcare—Quality of Life of Older People with Disability in the Community)

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21 pages, 6354 KiB

Open AccessEditor’s ChoiceArticle

Assessment of the Prescribing Pharmacist’s Role in Supporting Access to Prescription-Only Medicines—Metadata Analysis in Poland

by Artur Owczarek, Dominik M. Marciniak, Rafał Jezior and Bożena Karolewicz

Healthcare 2023, 11(24), 3106; https://doi.org/10.3390/healthcare11243106 - 5 Dec 2023

Cited by 3 | Viewed by 2910

Abstract

In 2020, pharmacists in Poland received additional authority to prescribe drugs. In this study, we analyzed prescribing after the implementation of this new responsibility. We assessed how the new regulation works in practice and what it means for the healthcare system in the [...] Read more.

In 2020, pharmacists in Poland received additional authority to prescribe drugs. In this study, we analyzed prescribing after the implementation of this new responsibility. We assessed how the new regulation works in practice and what it means for the healthcare system in the area of access to prescription-only medicines. Data analysis included information on the prescriptions written, the type of substance according to the ATC classification, and data on the prescribing pharmacists. The study used over 2.994 million e-prescriptions written by pharmacists in Poland, which were made available by the e-Health Center. The largest group of drugs prescribed were drugs used in the treatment of cardiovascular diseases, accounting for 25% of all prescribed medications during the time of the analysis. The next prescription groups were for drugs used in gastrointestinal diseases and metabolic disorders, and those acting on the central nervous system, the respiratory system, and the musculoskeletal system. Among pharmaceutical prescriptions, 73% were pharmaceutical prescriptions issued in pharmacies at full price to the patient. The results indicate that pharmacists are eager to use their permission to prescribe drugs in authority situations. Almost three million records showed improved patient access to medicines in the healthcare system (approximately 5% of repeat prescriptions for all patients during the study period). These data confirm the possibility of cooperation between physicians and pharmacists in strengthening the efficiency of the patient healthcare system. An important conclusion from this work is the need to create the possibility for the pharmacist to access the information resources of the implemented Internet Patient Account system, including therapeutic indications for the drugs used. Full article

(This article belongs to the Special Issue Pharmacist-Led Intervention)

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19 pages, 351 KiB

Open AccessEditor’s ChoiceReview

Recent Advances in the Management of Anal Cancer

by Laxmi Upadhyay, Michelle Hartzell, Aparna R. Parikh, Matthew R. Strickland, Samuel Klempner and Midhun Malla

Healthcare 2023, 11(23), 3010; https://doi.org/10.3390/healthcare11233010 - 21 Nov 2023

Cited by 6 | Viewed by 3763

Abstract

The incidence and mortality of squamous cell carcinoma of the anus (SCCA) is on the rise, which highlights the unmet need for advances in treatment options. The landscape of treatment for this cancer is rapidly evolving with novel combination strategies including immunotherapy, radiation [...] Read more.

The incidence and mortality of squamous cell carcinoma of the anus (SCCA) is on the rise, which highlights the unmet need for advances in treatment options. The landscape of treatment for this cancer is rapidly evolving with novel combination strategies including immunotherapy, radiation therapy and biomarker-guided therapy. This review article features an overview of recent advancements in both locoregional and metastatic SCCA. The recent focus on locoregional SCCA management is to tailor treatment according to tumor burden and minimize treatment-related toxicities. Mitomycin plus either infusional 5-fluorouracil (5-FU) or capecitabine is used for first-line chemoradiotherapy (CRT), and intensity-modulated radiotherapy (IMRT) is the preferred modality for radiation for locoregional anal cancer. Locally recurrent disease is managed with surgical resection. Systemic treatment is first-line for metastatic SCCA and immunotherapy with nivolumab and pembrolizumab being included as second-line agents. Current and future clinical trials are evaluating treatments for SCCA including immunotherapy alone or in combination regimens, radiotherapies, targeted treatments and novel agents. Another critical aspect of current research in SCCA is the personalization of CRT and immunotherapies based on molecular characterization and biomarkers such as the programmed death-ligand 1 (PD-L1), epidermal growth factor receptor (EGFR) and circulating tumor DNA. Full article

(This article belongs to the Special Issue Advances in Treatment of Gastrointestinal Cancer)

16 pages, 1323 KiB

Open AccessEditor’s ChoiceReview

The Internet, Apps, and the Anesthesiologist

by Samuel Smith, Andrew Houghton, Brydie Mockeridge and André van Zundert

Healthcare 2023, 11(22), 3000; https://doi.org/10.3390/healthcare11223000 - 20 Nov 2023

Cited by 3 | Viewed by 1926

Abstract

Modern anesthesia continues to be impacted in new and unforeseen ways by digital technology. Combining portability and versatility, mobile applications or “apps” provide a multitude of ways to enhance anesthetic and peri-operative care. Research suggests that the uptake of apps into anesthetic practice [...] Read more.

Modern anesthesia continues to be impacted in new and unforeseen ways by digital technology. Combining portability and versatility, mobile applications or “apps” provide a multitude of ways to enhance anesthetic and peri-operative care. Research suggests that the uptake of apps into anesthetic practice is becoming increasingly routine, especially amongst younger anesthetists brought up in the digital age. Despite this enthusiasm, there remains no consensus on how apps are safely and efficiently integrated into anesthetic practice. This review summarizes the most popular forms of app usage in anesthesia currently and explores the challenges and opportunities inherent in implementing app use in anesthesia, with an emphasis on a practical approach for the modern anesthetist. Full article

(This article belongs to the Special Issue Reviews on Critical Care)

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15 pages, 319 KiB

Open AccessEditor’s ChoiceArticle

by Loredana Benedetto, Ilenia Sabato, Carola Costanza, Antonella Gagliano, Eva Germanò, Luigi Vetri, Michele Roccella, Lucia Parisi, Costanza Scaffidi Abbate and Massimo Ingrassia

Healthcare 2023, 11(21), 2885; https://doi.org/10.3390/healthcare11212885 - 2 Nov 2023

Cited by 3 | Viewed by 2877

Abstract

Vegetarianism can meet healthy, ethical, or ecological values (such as equality and protection of animals or the environment). At the same time, it can represent a response to the need for self-determination in adolescence. Furthermore, some studies show vegetarians have greater depressive risk [...] Read more.

Vegetarianism can meet healthy, ethical, or ecological values (such as equality and protection of animals or the environment). At the same time, it can represent a response to the need for self-determination in adolescence. Furthermore, some studies show vegetarians have greater depressive risk and a lower sense of body satisfaction. Considering the spread of non-meat diets in the Western world, researchers have investigated the benefits and risks to physical and psychological health. Despite this, few studies have been conducted on factors influencing adolescent’s vegetarian diet-related attitudes. Through self-administered loosely structured interviews, this research investigated factors potentially associated with vegetarian choices in adolescence. It checked (a) gender differences in vegetarian choices; (b) religious, familial, ethical, or health factors implied in vegetarian choices; and (c) indicators of well-being among young vegetarians. The findings suggest that for our sample, non-vegetarians have lower scores on health-related questions than others, while for vegetarian adolescents, the benefits of vegetarianism mainly depend on their ethical stances, beliefs, and values. Conversely, it is unrelated to factors such as the desire to lose weight, dissatisfaction about one’s body shape, or depressive feelings. Full article

(This article belongs to the Special Issue Psychological Well-Being, Decision-Making Style, and Individual Differences)

22 pages, 25952 KiB

Open AccessEditor’s ChoicePerspective

Functional Neuromyofascial Activity: Interprofessional Assessment to Inform Person-Centered Participative Care—An Osteopathic Perspective

by Francesca Baroni, Robert Schleip, Lorenzo Arcuri, Giacomo Consorti, Giandomenico D’Alessandro, Rafael Zegarra-Parodi, Anna Maria Vitali, Marco Tramontano and Christian Lunghi

Healthcare 2023, 11(21), 2886; https://doi.org/10.3390/healthcare11212886 - 2 Nov 2023

Cited by 6 | Viewed by 4911

Abstract

Introduction: Health professionals and bodyworkers may be pivotal in promoting prevention programs, providing tailored advice and guidance to patients’ adherence to self-care strategies, such as physical activity. Contemporary evidence encourages manual therapists to involve patients in decision-making and treatment procedures integrating passive [...] Read more.

Introduction: Health professionals and bodyworkers may be pivotal in promoting prevention programs, providing tailored advice and guidance to patients’ adherence to self-care strategies, such as physical activity. Contemporary evidence encourages manual therapists to involve patients in decision-making and treatment procedures integrating passive and active approaches in treatment planning. This manuscript provides a definition and applications of neuromyofascial movement patterns, discusses the significance of functional assessment, and gives an example of clinical applications in the osteopathic field to highlight how this assessment can promote interdisciplinarity. Methods: The reporting framework used in the current manuscript followed guidelines for writing a commentary. Results: The manuscript highlights the crucial role that the neuromyofascial system plays in human movement and overall well-being and the importance of a functional neuromyofascial activity assessment in the context of person-centered participative care. Conclusions: Understanding individual neuromyofascial patterns could help healthcare practitioners, movement specialists, and bodyworkers in tailoring treatment plans, meeting patients’ unique needs, and promoting a more effective personalized approach to care. The current perspective could spark debates within the professional community and provide a research roadmap for developing an evidence-informed interprofessional framework. Full article

(This article belongs to the Section Chronic Care)

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11 pages, 657 KiB

Open AccessEditor’s ChoiceArticle

Understanding the Contribution of Community Organisations to Healthy Ageing and Integrated Place-Based Care: Evidence from Integrated Care Data

by Chris Dayson, Chris Damm, Jan Gilbertson, David Leather and Will Ridge

Healthcare 2023, 11(21), 2827; https://doi.org/10.3390/healthcare11212827 - 26 Oct 2023

Viewed by 1706

Abstract

(1) Background. There is interest in the role community organisations can play to support healthy ageing and the integration of health and social care. This study explored the contribution community organisations can make to this goal through the Leeds (UK) Neighbourhood Networks [...] Read more.

(1) Background. There is interest in the role community organisations can play to support healthy ageing and the integration of health and social care. This study explored the contribution community organisations can make to this goal through the Leeds (UK) Neighbourhood Networks (LNNs), a novel example of community-based support. (2) Methods. An observational study of 148 LNN beneficiaries compared to the Leeds population aged 64 and over (n = 143,418) using the Leeds Data Model, and an analytical resource developed to support care planning. Measures included demographic characteristics, Electronic Frailty Index (EFI), the number of long-term health conditions (LTCs), and public health management cohort categorisation. (3) Results. LNN’s are primarily focussed on older people who are fit (44 percent) or experiencing the onset of LTCs (27 percent) and/or mild frailty (41 percent). However, they also support smaller numbers of people with moderate/severe frailty (15 percent) and five or more long-term conditions (19 percent). (4) Conclusions. Community organisations are well placed to support the ambitions of integrated care by providing support for older people with mild to moderate health and care needs. They also have the capacity to support older people with more severe needs if resourced to do so. Full article

(This article belongs to the Special Issue Ageing and Healthcare Utilisation)

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8 pages, 864 KiB

Open AccessEditor’s ChoiceBrief Report

Improving the Therapeutic Relationship When Prescribing Antidepressants: A Pilot Study

by Konrad Michel, Daniela Lutz-Beck and Sylva Engeroff

Healthcare 2023, 11(21), 2825; https://doi.org/10.3390/healthcare11212825 - 25 Oct 2023

Viewed by 1472

Abstract

Studies indicate that the quality of the doctor–patient relationship moderates the effect of pharmacotherapy. To enhance the quality of the therapeutic relationship in the pharmacotherapy of depression, we developed a brief manual with interactive materials for residents in psychiatry and their patients. In [...] Read more.

Studies indicate that the quality of the doctor–patient relationship moderates the effect of pharmacotherapy. To enhance the quality of the therapeutic relationship in the pharmacotherapy of depression, we developed a brief manual with interactive materials for residents in psychiatry and their patients. In a pilot study at a psychiatric university hospital’s outpatient department, we compared patient-centered treatment parameters of a first patient group treated as usual and a second patient group treated using the manual. The study had no influence on the choice of medication. In the manual group, patient satisfaction with the doctor–patient relationship increased significantly at the three-month follow-up. Depression parameters declined in both groups, without group differences. Continuation of antidepressant medication at six months was higher in the manual group. In conclusion, a simple intervention using written materials for doctors prescribing antidepressants improved doctors’ and patients’ satisfaction with treatment. Full article

(This article belongs to the Section Medication Management)

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15 pages, 647 KiB

Open AccessFeature PaperEditor’s ChoiceReview

The Risk Factors and Screening Uptake for Prostate Cancer: A Scoping Review

by Seidu Mumuni, Claire O’Donnell and Owen Doody

Healthcare 2023, 11(20), 2780; https://doi.org/10.3390/healthcare11202780 - 20 Oct 2023

Cited by 8 | Viewed by 5164

Abstract

Objectives: The purpose of this scoping review was to identify the risk factors and screening uptake for prostate cancer. Design: Scoping review. Methods: Arksey and O’Malley’s framework guided this review; five databases (Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, PsycINFO, [...] Read more.

Objectives: The purpose of this scoping review was to identify the risk factors and screening uptake for prostate cancer. Design: Scoping review. Methods: Arksey and O’Malley’s framework guided this review; five databases (Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, PsycINFO, Academic Search Complete and Cochrane Library) and grey literature were searched. Screening was undertaken against predetermined inclusion criteria for articles published before July 2023 and written in English. This review is reported in line with PRISMA-Sc. Results: 10,899 database results were identified; 3676 papers were removed as duplicates and 7115 papers were excluded at title and abstract review. A total of 108 papers were full-text reviewed and 67 were included in the review. Grey literature searching yielded no results. Age, family history/genetics, hormones, race/ethnicity, exposure to hazards, geographical location and diet were identified as risk factors. Prostatic antigen test (PSA), digital rectal examination (DRE), transrectal ultrasound (TRUS), magnetic resonance imaging (MRI), magnetic resonance spectroscopic imaging (MRSI) and prostate biopsy were identified as screening/diagnostic methods. The evidence reviewed highlights moderate knowledge and screening uptake of prostate cancer with less than half of men reporting for PSA screening. On the other hand, there is a year-to-year increase in PSA and DRE screening, but factors such as poverty, religion, culture, communication barriers, language and costs affect men’s uptake of prostate cancer screening. Conclusion: As prostate cancer rates increase globally, there is a need for greater uptake of prostate cancer screening and improved health literacy among men and health workers. There is a need to develop a comprehensive prostate cancer awareness and screening programme that targets men and addresses uptake issues so as to provide safe, quality care. Strengths and limitations of this study: (1) A broad search strategy was utilised incorporating both databases and grey literature. (2) The PRISMA reporting guidelines were utilised. (3) Only English language papers were included, and this may have resulted in relevant articles being omitted. Full article

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19 pages, 1162 KiB

Open AccessEditor’s ChoiceReview

Leveraging Generative AI and Large Language Models: A Comprehensive Roadmap for Healthcare Integration

by Ping Yu, Hua Xu, Xia Hu and Chao Deng

Healthcare 2023, 11(20), 2776; https://doi.org/10.3390/healthcare11202776 - 20 Oct 2023

Cited by 111 | Viewed by 20958

Abstract

Generative artificial intelligence (AI) and large language models (LLMs), exemplified by ChatGPT, are promising for revolutionizing data and information management in healthcare and medicine. However, there is scant literature guiding their integration for non-AI professionals. This study conducts a scoping literature review to [...] Read more.

Generative artificial intelligence (AI) and large language models (LLMs), exemplified by ChatGPT, are promising for revolutionizing data and information management in healthcare and medicine. However, there is scant literature guiding their integration for non-AI professionals. This study conducts a scoping literature review to address the critical need for guidance on integrating generative AI and LLMs into healthcare and medical practices. It elucidates the distinct mechanisms underpinning these technologies, such as Reinforcement Learning from Human Feedback (RLFH), including few-shot learning and chain-of-thought reasoning, which differentiates them from traditional, rule-based AI systems. It requires an inclusive, collaborative co-design process that engages all pertinent stakeholders, including clinicians and consumers, to achieve these benefits. Although global research is examining both opportunities and challenges, including ethical and legal dimensions, LLMs offer promising advancements in healthcare by enhancing data management, information retrieval, and decision-making processes. Continued innovation in data acquisition, model fine-tuning, prompt strategy development, evaluation, and system implementation is imperative for realizing the full potential of these technologies. Organizations should proactively engage with these technologies to improve healthcare quality, safety, and efficiency, adhering to ethical and legal guidelines for responsible application. Full article

(This article belongs to the Section Health Informatics and Big Data)

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11 pages, 558 KiB

Open AccessEditor’s ChoiceArticle

Timing of Early Cholecystectomy for Acute Calculous Cholecystitis: A Multicentric Prospective Observational Study

by Paola Fugazzola, Fikri M. Abu-Zidan, Lorenzo Cobianchi, Francesca Dal Mas, Marco Ceresoli, Federico Coccolini, Simone Frassini, Matteo Tomasoni, Fausto Catena, Luca Ansaloni and on behalf of the S.P.Ri.M.A.C.C. Collaborative Group

Healthcare 2023, 11(20), 2752; https://doi.org/10.3390/healthcare11202752 - 17 Oct 2023

Cited by 4 | Viewed by 3420

Abstract

The definition of Early Cholecystectomy (EC) is still debatable. This paper aims to find whether the timing of EC affects outcomes. The article reports a multicentric prospective observational study including patients with acute calculous cholecystitis (ACC) who had cholecystectomy within ten days from [...] Read more.

The definition of Early Cholecystectomy (EC) is still debatable. This paper aims to find whether the timing of EC affects outcomes. The article reports a multicentric prospective observational study including patients with acute calculous cholecystitis (ACC) who had cholecystectomy within ten days from the onset of symptoms. Kruskall-Wallis test, Fisher’s Exact test, and Spearman rank correlation were used for statistical analysis. The patients were divided into three groups depending on the timing of the operation: 0–3 days, 4–7 days, or 8–10 days from the onset of symptoms. 1117 patients were studied over a year. The time from the onset of symptoms to EC did not affect the post-operative complications and mortality, the conversion, and the reintervention rate. The time represented a significant risk factor for intraoperative complications (0–3 days, 2.8%; 4–7 days, 5.6%; 8–10 days, 7.9%; p = 0.01) and subtotal cholecystectomies (0–3 days, 2.7%; 4–7 days, 5.6%; 8–10 days, 10.9%; p < 0.001). ACC is an evolutive inflammatory process and, as the days go by, the local and systemic inflammation increases, making surgery more complex and difficult with a higher risk of intraoperative complications. We recommend performing EC for ACC as soon as possible, within the first ten days of the onset of symptoms. Full article

(This article belongs to the Section Critical Care)

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12 pages, 1110 KiB

Open AccessEditor’s ChoiceArticle

Polish Adaptation and Psychometric Validation of the PREM-C9 Questionnaire for Patients with Chronic Obstructive Pulmonary Disease

by Iwona Damps-Konstańska, Weronika Ciećko, Ewa Jassem, Tomasz Bandurski, Dominika Bosek, Marzena Olszewska-Karaban and Ewa Bandurska

Healthcare 2023, 11(20), 2746; https://doi.org/10.3390/healthcare11202746 - 16 Oct 2023

Cited by 1 | Viewed by 1507

Abstract

Introduction: Chronic obstructive pulmonary disease (COPD) is a common, preventable, and treatable disease. The first PREM (patient-reported outcome measure)-type questionnaire that has been dedicated to assess the experience of care in COPD is the PREM-C9. Aim: The aim of this study [...] Read more.

Introduction: Chronic obstructive pulmonary disease (COPD) is a common, preventable, and treatable disease. The first PREM (patient-reported outcome measure)-type questionnaire that has been dedicated to assess the experience of care in COPD is the PREM-C9. Aim: The aim of this study was to create a Polish version of the PREM-C9 and determine its psychometric characteristics. Methods: The validation procedure involved forward and back translation. We included 42 patients with COPD. The psychometric properties were assessed using Cronbach’s alpha, Bartlett’s test, the Kaiser–Meyer–Olkin test, and Spearman’s correlation coefficient. The validity of the questionnaire was assessed using a principal component analysis for the extracted principal components. The validity of the factor analysis was demonstrated using Bartlett’s sphericity test and the Kaiser–Meyer–Olkin (KMO) test. A factor analysis was performed using the Oblimin and Varimax rotation. The reliability of the questionnaire was assessed using Cronbach’s alpha. Results: The Polish version of the analyzed questionnaire met all the validation criteria: face, translation, psychometric, functional, and reconstruction equivalence. Spearman’s correlation results between the Polish PREM-C9 and CAT were as follows: rho = 0.44, p = 0.003539; HADS-Anxiety: rho = 0.370864, p = 0.015612; and HADS-Depression: rho = 0.387405, p = 0.011253. Conclusions: The developed Polish PREM-C9 questionnaire is a reliable and valid tool that assesses Polish COPD patients’ experiences of their disease and the care they receive. Full article

(This article belongs to the Special Issue Cost, Economics and Databases of Pharmaceutical Drugs in Public Health)

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14 pages, 276 KiB

Open AccessEditor’s ChoiceArticle

Opinion of Polish Patients with Epilepsy on Generic Medications

by Katarzyna Swakowska, Urszula Religioni and Anna Staniszewska

Healthcare 2023, 11(20), 2717; https://doi.org/10.3390/healthcare11202717 - 12 Oct 2023

Cited by 1 | Viewed by 1251

Abstract

Aim: The majority of medicines used in Poland are generic drugs and substitutions of the originals. The objective of this study was to obtain information on the current knowledge about generic medicines among Polish patients with epilepsy. Material and Methods: The conducted study [...] Read more.

Aim: The majority of medicines used in Poland are generic drugs and substitutions of the originals. The objective of this study was to obtain information on the current knowledge about generic medicines among Polish patients with epilepsy. Material and Methods: The conducted study was based on a self-developed questionnaire. The questionnaire consisted of 26 questions, including the questions regarding the respondents’ knowledge about generics, their previous experience, and the factors behind these choices. Results: Overall, 1220 questionnaires were analyzed. Among all patients, 66.4% reportedly had heard about generics. Of these, 61.5% of patients had used generic drugs in the past. A significant proportion of participants had never been recommended to switch to a generic medicine by their healthcare professional (23% physicians and 13.9% pharmacists). Statistically, relevant differences were observed regarding the respondents’ kind and level of education, place of residence, and net income per household. Conclusions: Significant gaps were identified in the knowledge and perceptions among patients regarding generic medicines, especially in relation to their efficacy and safety. Efforts must be directed towards increasing public awareness of generic medicines and there should also be a focus on educating patients about generic medicines. Full article

(This article belongs to the Special Issue Cost, Economics and Databases of Pharmaceutical Drugs in Public Health)

20 pages, 1867 KiB

Open AccessEditor’s ChoiceArticle

Awareness, Attitudes and Willingness to Donate Biological Samples to a Biobank: A Survey of a Representative Sample of Polish Citizens

by Łukasz Pronicki, Marcin Czech, Mariusz Gujski and Natalia D. Boguszewska

Healthcare 2023, 11(20), 2714; https://doi.org/10.3390/healthcare11202714 - 11 Oct 2023

Cited by 5 | Viewed by 1897

Abstract

Biotechnology is developing at an ever-increasing pace, and the progressive computerization of health care and research is making it increasingly easy to share data. One of the fastest growing areas is biobanking. However, even with the best equipment and the best trained staff, [...] Read more.

Biotechnology is developing at an ever-increasing pace, and the progressive computerization of health care and research is making it increasingly easy to share data. One of the fastest growing areas is biobanking. However, even with the best equipment and the best trained staff, a biobank will be useless without donors. For this reason, we have decided to gauge Polish citizens’ awareness and attitudes towards biobanking and their willingness to donate biological samples. For this purpose the survey was conducted among a nationwide group of 1052 Poles aged 18 and over where the totals for gender, age and place of residence were selected according to their representation in the total population of adult Poles. The survey was conducted using the Computer Assisted Web Interview (CAWI) technique. Approximately two thirds of respondents N = 701 (66.6%) indicated that they had heard of scientific studies in which samples of biological material such as blood, saliva or urine are collected. More than half of respondents (N = 613, 58.3%) had a positive opinion regarding scientific research in which samples of biological material are taken. Only N = 220 (20.9%) of respondents had previously encountered the term biobanking. More than a half N = 687 (65.3%) of respondents would participate in a scientific study that biobanked biological material and health information. Almost half of the respondents (48.0%) would like specific consent to be used in biobanking. In our study we observed a negligible correlation between socio-demographic factors and a willingness to donate biological material to a biobank. Considering the results presented above, the level of knowledge and awareness of biobanks, and their role in scientific research and the health care system, among Polish citizens is low and requires education and information activities. Full article

(This article belongs to the Special Issue Cost, Economics and Databases of Pharmaceutical Drugs in Public Health)

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12 pages, 611 KiB

Open AccessEditor’s ChoiceArticle

Evaluating Feasibility of a Secondary Stroke Prevention Program

by Stephanie Hunter, Kimberley Vogel, Shane O’Leary and Jannette Maree Blennerhassett

Healthcare 2023, 11(19), 2673; https://doi.org/10.3390/healthcare11192673 - 2 Oct 2023

Cited by 2 | Viewed by 2344

Abstract

Healthy lifestyles including exercise and diet can reduce stroke risk, but stroke survivors often lack guidance to modify their lifestyles after hospital discharge. We evaluated the implementation of a new, secondary stroke prevention program involving supervised exercise, multidisciplinary education and coaching to address [...] Read more.

Healthy lifestyles including exercise and diet can reduce stroke risk, but stroke survivors often lack guidance to modify their lifestyles after hospital discharge. We evaluated the implementation of a new, secondary stroke prevention program involving supervised exercise, multidisciplinary education and coaching to address modifiable risk factors. The group-based program involved face-to-face and telehealth sessions. The primary outcomes were feasibility, examined via service information (referrals, uptake, participant demographics and costs), and participant acceptability (satisfaction and attendance). Secondary outcomes examined self-reported changes in lifestyle factors and pre–post scores on standardized clinical tests (e.g., waist circumference and 6-Minute Walk (6MWT)). We ran seven programs in 12 months, and 37 people participated. Attendance for education sessions was 79%, and 30/37 participants completed the full program. No adverse events occurred. Participant satisfaction was high for ‘relevance’ (100%), ‘felt safe to exercise’ (96%) and ‘intend to continue’ (96%). Most participants (88%) changed (on average) 2.5 lifestyle factors (diet, exercise, smoking and alcohol). Changes in clinical outcomes seemed promising, with some being statistically significant, e.g., 6MWT (MD 59 m, 95% CI 38 m to 80,159 m, p < 0.001) and waist circumference (MD −2.1 cm, 95%CI −3.9 cm to −1.4 cm, p < 0.001). The program was feasible to deliver, acceptable to participants and seemed beneficial for health. Access to similar programs may assist in secondary stroke prevention. Full article

(This article belongs to the Special Issue Stroke and Ageing)

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10 pages, 285 KiB

Open AccessEditor’s ChoiceOpinion

Oral Health Strategies: Surveying the Present to Plan the Future of Community-Based Learning

by Nélio Jorge Veiga, Patrícia Couto, Patrícia Correia, Anna Carolina Volpi Mello-Moura, Pedro Campos Lopes and Maria José Correia

Healthcare 2023, 11(19), 2646; https://doi.org/10.3390/healthcare11192646 - 28 Sep 2023

Cited by 3 | Viewed by 1868

Abstract

Introduction: Oral health literacy relates to the capacity of individuals to acquire, understand and to act upon oral health information to make appropriate health decisions. This scientific review’s main goal is to analyze the strategies that improve oral health literacy within the [...] Read more.

Introduction: Oral health literacy relates to the capacity of individuals to acquire, understand and to act upon oral health information to make appropriate health decisions. This scientific review’s main goal is to analyze the strategies that improve oral health literacy within the community, specifically oriented to a community-based learning model focused on the most vulnerable risk groups in society. Materials and Methods: The current review is based on the literature on oral health literacy within community-based learning strategies. The present review selected scientific studies by searching MEDLINE and related databases, such as Web of Science and PUBMED, and by consulting existing bibliographies. Results: Based on the application of the inclusion criteria to the abstracts, 45 publications were retrieved which explicitly dealt with the definitions of oral health literacy, community-based learning, and service learning. Several studies have demonstrated that health consumers with low health literacy fail to understand the available health information. Therefore, innovative oral health literacy strategies should be undertaken. Service learning is an example of an educational approach where the student learns specific soft skills in the classroom and collaborates directly with an agency or institution and engages in reflection activities to deepen their understanding of what is being taught. Conclusions: One of the main strategies used to incorporate the oral health professional in social responsibility and direct contact in the community is through experiencing community-based learning projects. The future graduate must be an educator capable of educating patients in order to themselves acquire high-level skills in oral health literacy. Full article

(This article belongs to the Section Community Care)

13 pages, 27423 KiB

Open AccessEditor’s ChoiceArticle

Umbilical Cord Diseases Affecting Obstetric and Perinatal Outcomes

by Gabriele Tonni, Mario Lituania, Alessandro Cecchi, Elisa Carboni, Serena Resta, Maria Paola Bonasoni and Rodrigo Ruano

Healthcare 2023, 11(19), 2634; https://doi.org/10.3390/healthcare11192634 - 27 Sep 2023

Cited by 3 | Viewed by 6409

Abstract

Background: (1) The aim of this article is to describe the physiopathology underlying umbilical cord diseases and their relationship with obstetric and perinatal outcomes. (2) Methods: Multicenter case series of umbilical cord diseases with illustrations from contributing institutions are presented. (3) Results: Clinical [...] Read more.

Background: (1) The aim of this article is to describe the physiopathology underlying umbilical cord diseases and their relationship with obstetric and perinatal outcomes. (2) Methods: Multicenter case series of umbilical cord diseases with illustrations from contributing institutions are presented. (3) Results: Clinical presentations of prenatal ultrasound findings, clinical prenatal features and postnatal outcomes are described. (4) Conclusions: Analysis of our series presents and discusses how umbilical cord diseases are associated with a wide variety of obstetric complications leading to a higher risk of poor perinatal outcomes in pregnancies. Knowing the physiopathology, prenatal clinical presentations and outcomes related to umbilical diseases allow for better prenatal counseling and management to potentially avoid severe obstetric and perinatal complications. Full article

(This article belongs to the Special Issue The 10th Anniversary of Healthcare—Perinatal and Neonatal Medicine)

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13 pages, 1056 KiB

Open AccessEditor’s ChoiceArticle

Pharmacologic Stewardship in a Rural Community Pharmacy

by Chrysanthi Sardeli, Theodoros Athanasiadis, Eleni Stamoula and Dimitrios Kouvelas

Healthcare 2023, 11(19), 2619; https://doi.org/10.3390/healthcare11192619 - 25 Sep 2023

Viewed by 1813

Abstract

Background: Pharmacotherapy is an essential part of patient care. In order to achieve optimal health outcomes, safe and effective prescribing and administering of medications is crucial, especially since the process of pharmacotherapy can cause serious problems, mainly adverse events and/or interactions, that often [...] Read more.

Background: Pharmacotherapy is an essential part of patient care. In order to achieve optimal health outcomes, safe and effective prescribing and administering of medications is crucial, especially since the process of pharmacotherapy can cause serious problems, mainly adverse events and/or interactions, that often pass undetected. Objective(s): To investigate the feasibility of using community pharmacies as checkpoints to detect errors and failures in prescribing, as well as patients’ compliance with pharmacotherapy. To this end, analysis and recording of the prescribing process was carried out and error-prone points were identified. Methods: Patients and caregivers filling prescriptions during the first 4 weeks of November 2017 and February 2018 answered questions in order to evaluate their attendance of regular checkups and their compliance with prescribing instructions. All prescriptions filled at the pharmacy were examined for detection of prescription errors and drug–drug interactions. Statistical analyses, including calculations of the correlation coefficient phi (φ), chi-square, and confidence intervals, were carried out. Detected errors and failures were evaluated by application of the Health Failure Mode Effect Analysis (HFMEA) quality tool. Results: A significant number of patients (16.7%) failed to regularly attend checkups regarding known health problems (95% CI: 10.6–22.7%), a corresponding percentage (16%, 95% CI: 10.1–21.9%) did not comply with prescribed pharmacotherapy, and a significant proportion of patients self-medicated regularly (32%, 95% CI: 24.5–39.5%). A total of 8.6% of prescriptions included medication combinations with a potential for severe drug–drug interactions (95% CI: 7.1–10.2%) while 58.7% of the prescriptions included combinations that could lead to moderate ones (95% CI: 56.1–61.4). The HFMEA indicated that all problems recorded required immediate interventions, except for prescribing errors. Conclusions: Community pharmacies can be potential checkpoints for the detection and evaluation of prescribing errors and pharmacotherapy failures. Full article

(This article belongs to the Special Issue Pharmacovigilance and Appropriate Drug Use)

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13 pages, 258 KiB

Open AccessEditor’s ChoiceArticle

Views about Euthanasia and Dementia: Exploring Perceptions Utilising Evidence from the Mass Observation Archive

by Janet Blain, Dean Stevens, Louise Taylor, Paul Kingston and Geoffrey Watts

Healthcare 2023, 11(18), 2552; https://doi.org/10.3390/healthcare11182552 - 15 Sep 2023

Cited by 2 | Viewed by 2382

Abstract

This paper contributes to the ongoing discussion in the United Kingdom regarding euthanasia and assisted dying, using data specifically related to individuals with dementia. A qualitative approach was taken with data captured via a set of written questions in the form of a [...] Read more.

This paper contributes to the ongoing discussion in the United Kingdom regarding euthanasia and assisted dying, using data specifically related to individuals with dementia. A qualitative approach was taken with data captured via a set of written questions in the form of a Mass Observation Archive Directive. The respondents, known as Observers, provided written responses; there was no limit to the length of the responses and the Observers were able to provide as much or as little detail as they chose. The data were analysed thematically utilising NVivo software. One-hundred and seven responses were received, representing a range of beliefs, and with opinions regarding euthanasia and dementia with pro, anti, and uncertain views being expressed. Five main themes emerged during our data analysis: capacity, legislation, agency and personal philosophies, disquietude, and incumbrance. Consistent with previous research capturing public views regarding euthanasia and assisted dying for people with dementia, the findings suggest policy makers may wish to consult the British public regarding legislation regarding euthanasia and dementia. Full article

(This article belongs to the Special Issue Dementia and Care)

14 pages, 275 KiB

Open AccessEditor’s ChoiceArticle

Navigating the Impacts of Dementia: The Experience of Male Spousal Carers

by Edward Tolhurst and Bernhard Weicht

Healthcare 2023, 11(18), 2492; https://doi.org/10.3390/healthcare11182492 - 8 Sep 2023

Cited by 1 | Viewed by 1826

Abstract

This article investigates the experience of male spousal carers for women living with dementia. While cultural discourses on care are highly gendered, social scientific research often addresses care relationships in gender-neutral terms. Setting out to address this matter, this qualitative research study incorporated [...] Read more.

This article investigates the experience of male spousal carers for women living with dementia. While cultural discourses on care are highly gendered, social scientific research often addresses care relationships in gender-neutral terms. Setting out to address this matter, this qualitative research study incorporated semi-structured joint interviews with 10 couples in which a male spouse cared for a woman with dementia. The aim was to explore how couples negotiate relationships and care following a diagnosis of dementia. The focus of this paper is on the perspectives expressed in these joint interviews by the male carers. A thematic analysis was undertaken to establish the key content of the men’s accounts. Three principal themes were identified: making sense of the condition; treating dementia as a problem to be solved; and engaging with professionals and support. The gendered basis of experience for male carers is explored within these themes, demonstrating how societal norms of masculinity intersect with caring roles. The paper concludes that a nuanced research approach to dementia care must continue to be developed, accounting for how gender shapes personal responses to the navigation of care relationships. Practitioners and policymakers must also consider how gendered experience shapes the identities and strategies of male carers. Full article

(This article belongs to the Special Issue Dementia and Care)

17 pages, 944 KiB

Open AccessEditor’s ChoiceArticle

Impact of Voluntary, Community and Social Enterprise (VCSE) Organisations Working with Underserved Communities with Type 2 Diabetes Mellitus in England

by Lucie Nield, Sadiq Bhanbhro, Helen Steers, Anna Young and Sally Fowler Davis

Healthcare 2023, 11(18), 2499; https://doi.org/10.3390/healthcare11182499 - 8 Sep 2023

Cited by 1 | Viewed by 2078

Abstract

The Voluntary, Community and Social Enterprise (VCSE) sector offers services and leadership within the health and care system in England and has a specialist role in working with underserved, deprived communities. This evaluation aims to identify best practices in self-management support for those [...] Read more.

The Voluntary, Community and Social Enterprise (VCSE) sector offers services and leadership within the health and care system in England and has a specialist role in working with underserved, deprived communities. This evaluation aims to identify best practices in self-management support for those living with type 2 diabetes mellitus (T2DM) and to develop a theory of change (TofC) through understanding the impact of VCSE organisations on diabetes management. An appreciative inquiry (AI) was carried out and co-delivered using qualitative interviews and an embedded analysis with VCSE partners. A voluntary service coordinated seven VCSE organisations who assisted with recruiting their service users and undertook interviews to identify the impact of existing activities and programmes. People living with T2DM were interviewed about services. Themes were as follows: (a) individual and group activities; (b) trusted services and relationships across the community; (c) long-term engagement; (d) sociocultural context of diet and nutritional choices; (e) experience of adaptation; and (f) culturally appropriate advice and independent VCSE organisations. The structured educational approach (DESMOND) for T2DM was accessed variably, despite these services being recommended by NICE guidelines as a standard intervention. The VCSE offered continuity and culturally appropriate services to more marginalised groups. This evaluation highlights the importance of targeted engagement with underserved communities, particularly where primary care services are more limited. The TofC is a unique insight into the impact of VCSE services, offering bespoke support to manage T2DM, suggesting areas for improvements in capacity and offering the capability to sustain the VCSE sector as an essential element of the T2DM care pathway in England. Full article

(This article belongs to the Special Issue Ageing and Healthcare Utilisation)

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18 pages, 13808 KiB

Open AccessEditor’s ChoiceReview

New Devices, Innovative Technologies, and Non-Standard Techniques for Airway Management: A Narrative Review

by Tomasz Gaszyński, Manuel Ángel Gómez-Ríos, Alfredo Serrano-Moraza, José Alfonso Sastre, Teresa López and Paweł Ratajczyk

Healthcare 2023, 11(18), 2468; https://doi.org/10.3390/healthcare11182468 - 5 Sep 2023

Cited by 4 | Viewed by 4592

Abstract

A wide range of airway devices and techniques have been created to enhance the safety of airway management. However, airway management remains a challenge. All techniques are susceptible to failure. Therefore, it is necessary to have and know the greatest number of alternatives [...] Read more.

A wide range of airway devices and techniques have been created to enhance the safety of airway management. However, airway management remains a challenge. All techniques are susceptible to failure. Therefore, it is necessary to have and know the greatest number of alternatives to treat even the most challenging airway successfully. The aim of this narrative review is to describe some new devices, such as video laryngeal masks, articulated stylets, and non-standard techniques, for laryngeal mask insertion and endotracheal intubation that are not applied in daily practice, but that could be highly effective in overcoming a difficulty related to airway management. Artificial intelligence and 3D technology for airway management are also discussed. Full article

(This article belongs to the Section Critical Care)

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19 pages, 2004 KiB

Open AccessEditor’s ChoiceSystematic Review

Effectiveness of Osteopathic Manipulative Treatment in Adults with Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis

by Francesca Buffone, Andrea Gianmaria Tarantino, Federico Belloni, Andrea Spadafora, Giorgio Bolzoni, Irene Bruini, Andrea Bergna and Luca Vismara

Healthcare 2023, 11(17), 2442; https://doi.org/10.3390/healthcare11172442 - 31 Aug 2023

Cited by 4 | Viewed by 5094

Abstract

The aim of this systematic review and meta-analysis was to evaluate the effectiveness of the osteopathic manipulative treatment (OMT) in adults with irritable bowel syndrome (IBS). A literature resview was carried out on the following databases: PubMed, Embase, Cochrane, Cinahl, Scopus, PEDro and [...] Read more.

The aim of this systematic review and meta-analysis was to evaluate the effectiveness of the osteopathic manipulative treatment (OMT) in adults with irritable bowel syndrome (IBS). A literature resview was carried out on the following databases: PubMed, Embase, Cochrane, Cinahl, Scopus, PEDro and ClinicalTrials.gov. 350 articles were recovered. Eligibility criteria were evaluated by two independent reviewers, including randomized controlled trials (RCTs), quasi-RCTs, or ongoing RCTs with OMT compared to any kind of control in patients diagnosed with IBS. Six studies (five RCTs and one ongoing RCT) were considered eligible. Four RCTs were classified as some concerns and one as high risk of bias. In the meta-analysis, OMT compared to sham/no intervention showed statistically significant results for abdominal pain (effect size ES = −1.14 [−1.66, −0.62]; p < 0.0001) and constipation (ES = −0.66 [−1.12, −0.20]; p = 0.005). Instead, OMT was not superior to the control for the IBS symptoms measured with the IBS Severity Score and the Likert scale (ES = −0.34 [−0.83, 0.16]; p = 0.19), and diarrhea (ES = −1.20 [−2.84, 0.43]; p = 0.15). The quality of evidence was “low” for IBS symptoms in general for abdominal pain and constipation, while it was judged as “very low” for diarrhea. OMT turns out to be safe in the treatment of IBS without major adverse effects. OMT may be effective in IBS patients, however the results must be interpreted carefully due to the low methodological quality of the studies. Full article

(This article belongs to the Collection Osteopathic and Manual Therapy Healthcare Reconceptualization: Health Needs and New Evidence)

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10 pages, 232 KiB

Open AccessEditor’s ChoiceArticle

The Experiences of Community Health Workers in Preventing Noncommunicable Diseases in an Urban Area, the Philippines: A Qualitative Study

by Yuko Yamaguchi, Lia M. Palileo-Villanueva, Leonor Sanchez Tubon, Eunice Mallari and Hiroya Matsuo

Healthcare 2023, 11(17), 2424; https://doi.org/10.3390/healthcare11172424 - 30 Aug 2023

Cited by 3 | Viewed by 20109

Abstract

(1) Background: Barangay health workers (BHWs) play important roles as community health workers in preventing noncommunicable diseases (NCDs), where the shortage of health professionals is felt more acutely in the Philippines. However, there is little research on the experiences of BHWs as community [...] Read more.

(1) Background: Barangay health workers (BHWs) play important roles as community health workers in preventing noncommunicable diseases (NCDs), where the shortage of health professionals is felt more acutely in the Philippines. However, there is little research on the experiences of BHWs as community health workers in preventing NCDs. This study aimed to clarify the roles and difficulties of BHWs in conducting activities for the prevention of NCDs. (2) Methods: Qualitative data were collected from 25 BHWs. (3) Results: The mean age of the participants was 50.4 ± 9.5 years, 23 were women, and the mean length of time as a BHW was 9.1 ± 7.7 years. Three major themes about the role of BHWs in preventing NCDs—“screening for NCDs”, “assisting patients with management of their conditions”, and “promoting healthy behaviors”—and four major themes about the difficulties—“insufficient awareness of preventative behaviors”, “economic burdens”, “lack of resources for managing NCDs”, and “difficulty of access to medical care facilities”—were identified. (4) Conclusions: Through the findings of this study, focusing interventions aimed at addressing the difficulties for the prevention of NCDs among BHWs may help reduce health inequities. Full article

(This article belongs to the Special Issue Health Education and Promotion in the Community)

15 pages, 664 KiB

Open AccessEditor’s ChoiceSystematic Review

Digital Health for Patients Undergoing Cardiac Surgery: A Systematic Review

by Kevin A. Wu, Sameer Kunte, Shashank Rajkumar, Vishal Venkatraman, Grace Kim, Samantha Kaplan, Syed Omar Anwar-Hashmi, Julie Doberne, Tom C. Nguyen and Shivanand P. Lad

Healthcare 2023, 11(17), 2411; https://doi.org/10.3390/healthcare11172411 - 28 Aug 2023

Cited by 5 | Viewed by 3761

Abstract

Digital health interventions have shown promise in improving patient outcomes and experiences in various healthcare settings. However, their effectiveness in the context of cardiac surgery remains uncertain. This systematic review aims to evaluate the existing evidence on the use of digital health interventions [...] Read more.

Digital health interventions have shown promise in improving patient outcomes and experiences in various healthcare settings. However, their effectiveness in the context of cardiac surgery remains uncertain. This systematic review aims to evaluate the existing evidence on the use of digital health interventions for patients undergoing cardiac surgery. A comprehensive search of PubMed MEDLINE, Elsevier EMBASE, Elsevier Scopus databases, and ClinicalTrials.gov was conducted to identify relevant studies published up to the present. Studies that examined the effects of digital health interventions, including mobile applications and web-based interventions, on perioperative care and patient outcomes in cardiac surgery were included. The data were extracted and synthesized to provide a comprehensive overview of the findings. The search yielded 15 studies composed of 4041 patients, analyzing the feasibility and implementation of mobile or internet applications for patients undergoing cardiac surgery. The studies included the use of mobile applications (ManageMySurgery, SeamlessMD, mHeart, Telediaglog, ExSed, Soulage Tavie, Heart Health application, and Mayo Clinic Health Connection) and web-based interventions (Heartnet and Active Heart). The findings indicated that these digital health interventions were associated with improved patient engagement, satisfaction, and reduced healthcare utilization. Patients reported finding the interventions helpful in their recovery process, and there was evidence of enhanced symptom monitoring and timely intervention. The completion rates of modules varied depending on the phase of care, with higher engagement observed during the acute phase. Interest in using digital health applications was expressed by patients, regardless of age, gender, or complexity of the cardiac defect. The results demonstrated that web-based interventions resulted in improvements in mental health, quality of life, and eHealth literacy. This systematic review highlights the potential benefits of digital health interventions in the context of cardiac surgery. Further research, including randomized controlled trials, is needed to establish the effectiveness, feasibility, and generalizability of digital health interventions in cardiac surgery. Full article

(This article belongs to the Special Issue Digital Therapeutics in Healthcare)

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15 pages, 1478 KiB

Open AccessEditor’s ChoiceSystematic Review

Virtual Reality-Based Exercise Therapy for Patients with Chronic Musculoskeletal Pain: A Scoping Review

by Paraskevi Bilika, Natalia Karampatsou, Giorgos Stavrakakis, Achilleas Paliouras, Yannis Theodorakis, Nikolaos Strimpakos and Eleni Kapreli

Healthcare 2023, 11(17), 2412; https://doi.org/10.3390/healthcare11172412 - 28 Aug 2023

Cited by 11 | Viewed by 4873

Abstract

This scoping review aimed to identify interventions utilizing virtual-reality-based exercise therapy in patients with chronic musculoskeletal pain. Searches were conducted in four databases using descriptors related to virtual reality, exercise, and chronic musculoskeletal pain. Two reviewers screened the titles and abstracts of the [...] Read more.

This scoping review aimed to identify interventions utilizing virtual-reality-based exercise therapy in patients with chronic musculoskeletal pain. Searches were conducted in four databases using descriptors related to virtual reality, exercise, and chronic musculoskeletal pain. Two reviewers screened the titles and abstracts of the studies to assess eligibility, with a third author resolving any discrepancies. Data were extracted and summarized in a narrative format by three independent raters. Clinical trials were evaluated using the PEDro scale to assess the effectiveness of virtual-reality-based exercise therapy in chronic musculoskeletal pain patients. A total of 162 articles were identified from the databases. After applying the inclusion criteria, nine articles were considered suitable for analysis, including six randomized clinical trials. The selected articles were categorized based on study characteristics, virtual-reality-based exercise therapy interventions (including technologies and equipment used), exercise interventions, outcome measures, and effectiveness. The findings indicate that virtual-reality-based exercise therapy shows promising results in reducing pain, improving disability, enhancing range of motion, and increasing treatment satisfaction in patients with chronic musculoskeletal pain. However, it is not possible to conclude that virtual-reality-based exercise therapy is superior to other treatments due to the limited number of available studies, heterogeneity in application protocols, and varying methodological quality. Further research is needed to draw more definitive conclusions. Full article

(This article belongs to the Special Issue New Advances in the Treatment of Chronic Musculoskeletal Pain)

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25 pages, 800 KiB

Open AccessEditor’s ChoiceSystematic Review

Clinically Preferred Videolaryngoscopes in Airway Management: An Updated Systematic Review

by Vikram Nedunchezhian, Ishvar Nedunchezhian and André Van Zundert

Healthcare 2023, 11(17), 2383; https://doi.org/10.3390/healthcare11172383 - 24 Aug 2023

Cited by 5 | Viewed by 2534

Abstract

Videolaryngoscopes (VLs) have emerged as a safety net offering several advantages over direct laryngoscopy (DL). The aim of this study is to expand on our previous study conducted in 2016, to deduce which VL is most preferred by clinicians and to highlight any [...] Read more.

Videolaryngoscopes (VLs) have emerged as a safety net offering several advantages over direct laryngoscopy (DL). The aim of this study is to expand on our previous study conducted in 2016, to deduce which VL is most preferred by clinicians and to highlight any changes that may have occurred over the past 7 years. An extensive systematic literature review was performed on Medline, Embase, Web of Science, and Cochrane Central Database of Controlled Studies for articles published between September 2016 and January 2023. This review highlighted similar results to our study in 2016, with the CMAC being the most preferred for non-channelled laryngoscopes, closely followed by the GlideScope. For channelled videolaryngoscopes, the Pentax AWS was the most clinically preferred. This review also highlighted that there are minimal studies that compare the most-used VLs, and thus we suggest that future studies directly compare the most-used and -preferred VLs as well as the specific nature of blades to attain more useful results. Full article

(This article belongs to the Special Issue New Developments in Endotracheal Intubation and Airway Management)

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19 pages, 1053 KiB

Open AccessEditor’s ChoiceArticle

Young People and the Future: School Students’ Concerns and Hopes for the Future after One Year of COVID-19 in Austria—Findings of a Mixed-Methods Pilot Study

by Sonja Fehkührer, Elke Humer, Stefan Kaltschik, Christoph Pieh, Thomas Probst, Gertraud Diestler and Andrea Jesser

Healthcare 2023, 11(16), 2242; https://doi.org/10.3390/healthcare11162242 - 9 Aug 2023

Cited by 1 | Viewed by 1992

Abstract

The COVID-19 pandemic resulted in enormous changes in everyday life and numerous burdens for adolescents. This pilot study focused on how young people look to the future in the face of these burdens. Responses to two open-ended questions on concerns and hopes for [...] Read more.

The COVID-19 pandemic resulted in enormous changes in everyday life and numerous burdens for adolescents. This pilot study focused on how young people look to the future in the face of these burdens. Responses to two open-ended questions on concerns and hopes for the future that were part of a larger online survey on the mental health of school students in Austria were analyzed using qualitative content analysis. Subsequently, differences in the experiences of boys and girls, young people with and without a migration background and psychologically stressed and non-stressed young people were examined by applying a mixed-methods approach. Data collection took place from 3 February to 28 February 2021. From a total survey sample of 3052 adolescents aged 14–20, a representative sample according to gender and migration background (N = 500) was drawn. Qualitative content analysis revealed several areas of concern about the future, including school-related concerns, concerns about the further development of the pandemic and the associated restrictions, concerns related to a lack of locus of control, health-related concerns and concerns about social relationships. The analysis also indicated young people’s greatest hopes for the future, such as hopes related to further pandemic development, hopes regarding major life goals, school, social relationships and health. Young people’s experiences differ according to gender, migration background and the extent of psychological distress. This study contributes to research on the psychological well-being of adolescents during the pandemic and provides important insights into the subjective experience of young people. It aims to gain a more comprehensive understanding of the concerns and hopes for the future of young people in a time marked by various challenges. The results of the study should be used to develop ideas for measures, such as the expansion of school psychological services and low-threshold support services for students, such as school social work and counseling. Full article

(This article belongs to the Special Issue Research and Survey on Mental Health of Children and Adolescents)

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31 pages, 1330 KiB

Open AccessEditor’s ChoiceReview

The Quiet Epidemic: An Overview of Emerging Qualitative Research Trends on Sedentary Behavior in Aging Populations

by André Ramalho and João Petrica

Healthcare 2023, 11(15), 2215; https://doi.org/10.3390/healthcare11152215 - 6 Aug 2023

Cited by 13 | Viewed by 7261

Abstract

Sedentary behavior poses a significant health risk to older adults. The purpose of this scoping review is to summarize key findings from qualitative research (since 2012), with a focus on explaining prevailing research trends and patterns within the field. This review included 25 [...] Read more.

Sedentary behavior poses a significant health risk to older adults. The purpose of this scoping review is to summarize key findings from qualitative research (since 2012), with a focus on explaining prevailing research trends and patterns within the field. This review included 25 studies that met the strict inclusion criteria. Five key research themes have emerged: (1) defining and shaping perspectives of sedentary behavior, (2) understanding the dynamics of daily routines and contexts, (3) raising awareness of older adults’ perceived advantages and disadvantages of sedentary behavior, (4) identifying its determinants and discouraging factors, and (5) exploring interventions to promote active behaviors and reduce sedentary behavior. These themes highlight the multifaceted nature of SB and underscore the importance of tailoring interventions to address individual, social, and environmental issues. A comprehensive understanding of SB is critical to developing effective strategies to promote active lifestyles and reduce SB in older adults. Further qualitative research is needed to deepen our understanding and develop targeted interventions and strategies. Full article

(This article belongs to the Special Issue Interventions for Sedentary Behavior and Physical Activity in the Ageing Population)

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13 pages, 281 KiB

Open AccessEditor’s ChoiceArticle

The Spousal Unit and Dementia: Investigating the Relational Basis of the Couplehood Concept

by Bernhard Weicht and Edward Tolhurst

Healthcare 2023, 11(15), 2191; https://doi.org/10.3390/healthcare11152191 - 3 Aug 2023

Cited by 2 | Viewed by 1398

Abstract

A strong emphasis is consistently placed upon the relational basis of experience within social scientific dementia research. Within this research corpus, the concept of couplehood is increasingly employed, albeit in rather undefined and loosely theorised ways. Moreover, the evaluation highlights that couplehood is [...] Read more.

A strong emphasis is consistently placed upon the relational basis of experience within social scientific dementia research. Within this research corpus, the concept of couplehood is increasingly employed, albeit in rather undefined and loosely theorised ways. Moreover, the evaluation highlights that couplehood is often defined by a normative position that seeks to convey an affirmative perspective on dementia and spousal relationships. The lack of theoretical foundation, however, weakens the explanatory potential of the concept, both for theorising dementia, as well as for empirical research. This article critically evaluates the utility of the couplehood concept by delineating three underlying theoretical conceptions: phenomenological, interactional and relational perspectives. It will be argued that those theoretical threads offer different analytical angles and research opportunities. More thorough ontological development, however, can guide understandings of the complexities that underpin the relational experience of dementia. This will promote a conceptual starting point that offers a more balanced and multifaceted accommodation of two persons and their relationship. Full article

(This article belongs to the Special Issue Dementia and Care)

11 pages, 284 KiB

Open AccessEditor’s ChoiceReview

Perspectives on Aging and Quality of Life

by Shinichi Noto

Healthcare 2023, 11(15), 2131; https://doi.org/10.3390/healthcare11152131 - 26 Jul 2023

Cited by 39 | Viewed by 6551

Abstract

The aging of the world’s population and the health problems accompanying it are becoming increasingly severe. Healthcare policies in developed countries focus on how to prevent and treat diseases associated with aging and how to maintain quality of life. Typical age-related diseases include [...] Read more.

The aging of the world’s population and the health problems accompanying it are becoming increasingly severe. Healthcare policies in developed countries focus on how to prevent and treat diseases associated with aging and how to maintain quality of life. Typical age-related diseases include deafness, cataracts, osteoarthritis, chronic obstructive pulmonary disease, diabetes mellitus, and dementia. Although the mechanisms by which these diseases develop differ, they are all caused by the accumulation of molecular and cellular damage over time. In addition, age-related diseases can cause a decline in physical and mental functions and the ability to perform activities of daily living, as well as the loss of roles in society and a sense of fulfillment in life. Therefore, there is a need for treatment and measures to accurately grasp and maintain quality of life. This review aims to introduce areas and representative papers expected to be contributed to the special issue of “Aging and Quality of Life”. Full article

(This article belongs to the Special Issue Aging and Quality of Life)

16 pages, 293 KiB

Open AccessEditor’s ChoiceArticle

Essential Skills for Health Communication, Barriers, Facilitators and the Need for Training: Perceptions of Healthcare Professionals from Seven European Countries

by Dina Zota, Dimitrios V. Diamantis, Konstantinos Katsas, Pania Karnaki, Thomas Tsiampalis, Piotr Sakowski, Costas A. Christophi, Eleni Ioannidou, Sara Darias-Curvo, Victoria-Luise Batury, Hendrik Berth, Anja Zscheppang, Maike Linke, Sotiris Themistokleous, Afroditi Veloudaki and Athena Linos

Healthcare 2023, 11(14), 2058; https://doi.org/10.3390/healthcare11142058 - 18 Jul 2023

Cited by 8 | Viewed by 6713

Abstract

Many healthcare professionals are unaware of the necessary skills and barriers hindering interpersonal health communication. This study aimed to evaluate the healthcare professional’s perception regarding health communication training’s necessity, barriers, facilitators and critical skills in health communication. Data from a cross-sectional online survey [...] Read more.

Many healthcare professionals are unaware of the necessary skills and barriers hindering interpersonal health communication. This study aimed to evaluate the healthcare professional’s perception regarding health communication training’s necessity, barriers, facilitators and critical skills in health communication. Data from a cross-sectional online survey in the framework of the H-Com project were utilized. The study included 691 healthcare professionals (physicians, nurses, students and allied health professionals) from seven European countries. Only 57% of participants had participated in health communication training, while 88.1% of them indicated a willingness to be trained in health communication. Nurses were more likely (OR = 1.84; 95% CI 1.16, 2.91) to have received such training, compared to physicians. Most examined communication skills, barriers and facilitators of effective communication, and perceived outcomes of successful communication were considered crucial for most participants, although physicians overall seemed to be less concerned. Most agreed perceived outcomes were improved professional–patient relations, patient and professional satisfaction, physical and psychological health amelioration and patients’ trust. Nurses evaluated the importance of these communication skills and communication barriers, facilitators and outcomes higher than physicians. Physicians may underestimate the importance of communication skills more than nurses. Health communication should become an integral part of training for all health professionals. Full article

(This article belongs to the Special Issue Expanding Competency of Primary Health Care: Emotional and Bio-Social Meanings for General Practice Consultation)

13 pages, 293 KiB

Open AccessEditor’s ChoiceArticle

Infant-Directed Speech to 3-Month-Old Severe Preterm Infants: The Influence of Birth Weight and Maternal Depressive Symptoms

by Alessandra Provera, Erica Neri and Francesca Agostini

Healthcare 2023, 11(12), 1807; https://doi.org/10.3390/healthcare11121807 - 20 Jun 2023

Cited by 4 | Viewed by 2212

Abstract

Severe premature birth (<32 weeks) is a risk factor for the development of maternal perinatal depression, while also affecting dyadic interactions and child outcomes. Although several studies have examined the impacts of prematurity and depression on early interactions, only a few studies have [...] Read more.

Severe premature birth (<32 weeks) is a risk factor for the development of maternal perinatal depression, while also affecting dyadic interactions and child outcomes. Although several studies have examined the impacts of prematurity and depression on early interactions, only a few studies have investigated the features of maternal verbal input. Furthermore, no study has investigated the relationship between the effect of severity of prematurity according to birth weight and maternal input. This study aimed to explore the effects of the severity of preterm birth and postnatal depression on maternal input during early interactions. The study included 64 mother–infant dyads, classified into three groups: 17 extremely low birth weight (ELBW) preterm infants, 17 very low birth weight (VLBW) preterm infants, and 30 full-term (FT) infants. At 3 months postpartum (corrected age for preterm infants), the dyads participated in a 5-min free interaction session. Maternal input was analyzed using the CHILDES system in terms of lexical and syntactic complexity (i.e., word types, word tokens, mean length of the utterance) and functional features. Maternal postnatal depression (MPD) was assessed using the Edinburgh Postnatal Depression Scale. The results showed that in high-risk conditions (i.e., ELBW preterm birth and maternal postnatal depression), maternal input was characterized by a lower frequency of affect-salient speech and a higher proportion of information-salient speech, specifically as directives and questions, suggesting that mothers in these conditions may experience more difficulty in conveying affective content to their infants. Moreover, the more frequent use of questions may reflect an interactive style characterized by a higher level of intrusiveness. These findings provide preliminary evidence of the impacts of prematurity severity and maternal depression on maternal verbal input, highlighting the importance of assessing both factors in clinical practice. Understanding the mechanisms underlying the impacts of prematurity and depression on early interactions may inform the development of tailored interventions aimed at promoting positive parent–infant interactions and child development. Full article

(This article belongs to the Special Issue Safety and Quality in Maternal and Neonatal Care)

19 pages, 941 KiB

Open AccessEditor’s ChoiceReview

Effectiveness of Workplace Interventions to Improve Health and Well-Being of Health and Social Service Workers: A Narrative Review of Randomised Controlled Trials

by Rahman Shiri, Risto Nikunlaakso and Jaana Laitinen

Healthcare 2023, 11(12), 1792; https://doi.org/10.3390/healthcare11121792 - 17 Jun 2023

Cited by 23 | Viewed by 11500

Abstract

Health and social service workers face high levels of workload and job stressors, which can affect their health and well-being. Therefore, it is important to evaluate the effectiveness of workplace interventions that aim to improve their mental and physical health outcomes. This review [...] Read more.

Health and social service workers face high levels of workload and job stressors, which can affect their health and well-being. Therefore, it is important to evaluate the effectiveness of workplace interventions that aim to improve their mental and physical health outcomes. This review summarizes the findings of randomized controlled trials (RCTs) that examined the impact of different types of workplace interventions on various health indicators among health and social service workers. The review searched the PubMed database from its inception to December 2022 and included RCTs that reported on the effectiveness of organizational-level interventions and qualitative studies that explored barriers and facilitators to participation in such interventions. A total of 108 RCTs were included in the review, covering job burnout (N = 56 RCTs), happiness or job satisfaction (N = 35), sickness absence (N = 18), psychosocial work stressors (N = 14), well-being (N = 13), work ability (N = 12), job performance or work engagement (N = 12), perceived general health (N = 9), and occupational injuries (N = 3). The review found that several workplace interventions were effective in improving work ability, well-being, perceived general health, work performance, and job satisfaction and in reducing psychosocial stressors, burnout, and sickness absence among healthcare workers. However, the effects were generally modest and short-lived. Some of the common barriers to participation in workplace interventions among healthcare workers were inadequate staff, high workload, time pressures, work constraints, lack of manager support, scheduling health programs outside work hours, and lack of motivation. This review suggests that workplace interventions have small short-term positive effects on health and well-being of healthcare workers. Workplace interventions should be implemented as routine programs with free work hours to encourage participation or integrate intervention activities into daily work routines. Full article

(This article belongs to the Section Chronic Care)

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14 pages, 485 KiB

Open AccessEditor’s ChoiceSystematic Review

Causes for Medical Errors in Obstetrics and Gynaecology

by Désirée Klemann, Maud Rijkx, Helen Mertens, Frits van Merode and Dorthe Klein

Healthcare 2023, 11(11), 1636; https://doi.org/10.3390/healthcare11111636 - 2 Jun 2023

Cited by 6 | Viewed by 3952

Abstract

Background: Quality strategies, interventions, and frameworks have been developed to facilitate a better understanding of healthcare systems. Reporting adverse events is one of these strategies. Gynaecology and obstetrics are one of the specialties with many adverse events. To understand the main causes of [...] Read more.

Background: Quality strategies, interventions, and frameworks have been developed to facilitate a better understanding of healthcare systems. Reporting adverse events is one of these strategies. Gynaecology and obstetrics are one of the specialties with many adverse events. To understand the main causes of medical errors in gynaecology and obstetrics and how they could be prevented, we conducted this systematic review. Methods: This systematic review was performed in compliance with the Prisma 2020 guidelines. We searched several databases for relevant studies (Jan 2010–May 2023). Studies were included if they indicated the presence of any potential risk factor at the hospital level for medical errors or adverse events in gynaecology or obstetrics. Results: We included 26 articles in the quantitative analysis of this review. Most of these (n = 12) are cross-sectional studies; eight are case–control studies, and six are cohort studies. One of the most frequently reported contributing factors is delay in healthcare. In addition, the availability of products and trained staff, team training, and communication are often reported to contribute to near-misses/maternal deaths. Conclusions: All risk factors that were found in our review imply several categories of contributing factors regarding: (1) delay of care, (2) coordination and management of care, and (3) scarcity of supply, personnel, and knowledge. Full article

(This article belongs to the Special Issue Safety and Quality in Maternal and Neonatal Care)

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11 pages, 577 KiB

Open AccessEditor’s ChoiceArticle

Examining the Public Messaging on ‘Loneliness’ over Social Media: An Unsupervised Machine Learning Analysis of Twitter Posts over the Past Decade

by Qin Xiang Ng, Dawn Yi Xin Lee, Chun En Yau, Yu Liang Lim, Clara Xinyi Ng and Tau Ming Liew

Healthcare 2023, 11(10), 1485; https://doi.org/10.3390/healthcare11101485 - 19 May 2023

Cited by 7 | Viewed by 2964

Abstract

Loneliness is an issue of public health significance. Longitudinal studies indicate that feelings of loneliness are prevalent and were exacerbated by the Coronavirus Disease 2019 (COVID-19) pandemic. With the advent of new media, more people are turning to social media platforms such as [...] Read more.

Loneliness is an issue of public health significance. Longitudinal studies indicate that feelings of loneliness are prevalent and were exacerbated by the Coronavirus Disease 2019 (COVID-19) pandemic. With the advent of new media, more people are turning to social media platforms such as Twitter and Reddit as well as online forums, e.g., loneliness forums, to seek advice and solace regarding their health and well-being. The present study therefore aimed to investigate the public messaging on loneliness via an unsupervised machine learning analysis of posts made by organisations on Twitter. We specifically examined tweets put out by organisations (companies, agencies or common interest groups) as the public may view them as more credible information as opposed to individual opinions. A total of 68,345 unique tweets in English were posted by organisations on Twitter from 1 January 2012 to 1 September 2022. These tweets were extracted and analysed using unsupervised machine learning approaches. BERTopic, a topic modelling technique that leverages state-of-the-art natural language processing, was applied to generate interpretable topics around the public messaging of loneliness and highlight the key words in the topic descriptions. The topics and topic labels were then reviewed independently by all study investigators for thematic analysis. Four key themes were uncovered, namely, the experience of loneliness, people who experience loneliness, what exacerbates loneliness and what could alleviate loneliness. Notably, a significant proportion of the tweets centred on the impact of the COVID-19 pandemic on loneliness. While current online interactions are largely descriptive of the complex and multifaceted problem of loneliness, more targeted prosocial messaging appears to be lacking to combat the causes of loneliness brought up in public messaging. Full article

(This article belongs to the Special Issue Social Media for Health Information Management)

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