Healthcare

13 pages, 1847 KB

Open AccessEditor’s ChoiceReview

Gaps in the Global Regulatory Frameworks for the Use of Artificial Intelligence (AI) in the Healthcare Services Sector and Key Recommendations

by Kavitha Palaniappan, Elaine Yan Ting Lin, Silke Vogel and John C. W. Lim

Healthcare 2024, 12(17), 1730; https://doi.org/10.3390/healthcare12171730 - 30 Aug 2024

Cited by 51 | Viewed by 10096

Abstract

Artificial Intelligence (AI) has shown remarkable potential to revolutionise healthcare by enhancing diagnostics, improving treatment outcomes, and streamlining administrative processes. In the global regulatory landscape, several countries are working on regulating AI in healthcare. There are five key regulatory issues that need to [...] Read more.

Artificial Intelligence (AI) has shown remarkable potential to revolutionise healthcare by enhancing diagnostics, improving treatment outcomes, and streamlining administrative processes. In the global regulatory landscape, several countries are working on regulating AI in healthcare. There are five key regulatory issues that need to be addressed: (i) data security and protection—measures to cover the “digital health footprints” left unknowingly by patients when they access AI in health services; (ii) data quality—availability of safe and secure data and more open database sources for AI, algorithms, and datasets to ensure equity and prevent demographic bias; (iii) validation of algorithms—mapping of the explainability and causability of the AI system; (iv) accountability—whether this lies with the healthcare professional, healthcare organisation, or the personified AI algorithm; (v) ethics and equitable access—whether fundamental rights of people are met in an ethical manner. Policymakers may need to consider the entire life cycle of AI in healthcare services and the databases that were used for the training of the AI system, along with requirements for their risk assessments to be publicly accessible for effective regulatory oversight. AI services that enhance their functionality over time need to undergo repeated algorithmic impact assessment and must also demonstrate real-time performance. Harmonising regulatory frameworks at the international level would help to resolve cross-border issues of AI in healthcare services. Full article

(This article belongs to the Section Artificial Intelligence in Healthcare)

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8 pages, 229 KB

Open AccessEditor’s ChoiceReview

Adenomyosis—A Call for Awareness, Early Detection, and Effective Treatment Strategies: A Narrative Review

by Georgios Kolovos, Ioannis Dedes, Sara Imboden and Michael Mueller

Healthcare 2024, 12(16), 1641; https://doi.org/10.3390/healthcare12161641 - 17 Aug 2024

Cited by 13 | Viewed by 9236

Abstract

Objective: To provide a brief summary of the high incidence, symptomatology, different types, and diagnosis of adenomyosis and to explore various aspects of the disease, with the primary aim of raising awareness among gynecologists for appropriate and early detection. Background: Adenomyosis, a benign [...] Read more.

Objective: To provide a brief summary of the high incidence, symptomatology, different types, and diagnosis of adenomyosis and to explore various aspects of the disease, with the primary aim of raising awareness among gynecologists for appropriate and early detection. Background: Adenomyosis, a benign gynecological condition characterized by the infiltration of endometrial tissue into the myometrium, poses significant challenges to women’s reproductive health. Methods: A narrative review was conducted by searching PubMed, Scopus, and Cochrane databases and offering a non-systematic summary and critical analysis of current knowledge on the impact of adenomyosis on women’s health. Articles published in the English language up to May 2023, including original scientific papers, clinical trials, meta-analyses, and reviews focusing on various aspects of adenomyosis, were included in the synthesis of this review. Conclusions: Approximately 20% of women are affected by adenomyosis, which manifests with various subtypes, distinct epidemiological profiles, symptomatology, and treatment responses. Despite its clinical significance, adenomyosis remains understudied, resulting in a significant disparity in research and the literature compared to other gynecological conditions. The severity of adenomyosis is compounded when coexisting with endometriosis, particularly deep-infiltrating endometriosis (DIE), leading to exacerbated fertility issues and severe symptomatology. The wide range of symptoms, including adverse pregnancy outcomes such as pre-eclampsia, highlights its wider impact and emphasizes the need for increased awareness of the condition. Adenomyosis is frequently associated with treatment failure in endometriosis, contributing to dienogest resistance, elevated discontinuation rates, and persistent pain post-endometriosis surgery. Additionally, the lack of specific treatments tailored to adenomyosis poses a considerable challenge in clinical management. Full article

(This article belongs to the Section Women’s and Children’s Health)

20 pages, 248 KB

Open AccessEditor’s ChoiceArticle

Developing a Theory-Based Instrument for Pre-Exposure Prophylaxis (PrEP) Uptake in People of Color Using a Qualitative Approach

by Siddharth Raich, Christopher Johansen, Neeraj Bhandari, Kavita Batra and Manoj Sharma

Healthcare 2024, 12(16), 1595; https://doi.org/10.3390/healthcare12161595 - 10 Aug 2024

Viewed by 1856

Abstract

There is a large disparity in Pre-exposure Prophylaxis (PrEP) utilization among communities of color compared to White Americans. There is also a lack of theory-based survey instruments to measure the underlying reasons for the disparity among communities of color. The purpose of this [...] Read more.

There is a large disparity in Pre-exposure Prophylaxis (PrEP) utilization among communities of color compared to White Americans. There is also a lack of theory-based survey instruments to measure the underlying reasons for the disparity among communities of color. The purpose of this study was to create an instrument based on a qualitative approach involving community interviews. Semi-structured interviews guided by the Multi-theory Model (MTM) of health behavior change were performed in a sample of 12 members from communities of color. The analysis entailed a directed content analysis along the themes of MTM constructs to develop a survey instrument. The barriers to PrEP that emerged included the cost of PrEP, lack of protection from other sexually transmitted diseases, reduced trust between partners, and the stigma associated with PrEP. The perceived disadvantages included the potential cost of PrEP, partner mistrust when taking PrEP, discussion of sexual behaviors with a provider, and unclear process of acquiring the PrEP prescription. The results guided the development of a survey tool to further investigate aspects of cost, partner relations, stigma, reassurance of safety, and other factors. The tool can be used for future studies as part of guided interventions to increase PrEP uptake. Full article

(This article belongs to the Special Issue Preventive Medicine and Community Health)

14 pages, 1030 KB

Open AccessEditor’s ChoiceArticle

Comparison of Health Parameters in Postpartum Diastasis Recti: A Randomized Control Trial of SEMG Biofeedback-Assisted Core Strengthening Exercises with Kinesiotaping vs. Non-Assisted Exercises

by Ujala Afzal, Quratulain Saeed, Muhammad Nabeel Anwar, Sanna Pervaiz, Manahil Shahid, Rimsha Javed, Muhammad Umair Ali and Seung Won Lee

Healthcare 2024, 12(16), 1567; https://doi.org/10.3390/healthcare12161567 - 7 Aug 2024

Cited by 7 | Viewed by 8755

Abstract

Current medical treatments for diastasis recti often involve exercises to strengthen the core muscles, along with abdominal binders or supports. However, there is limited evidence comparing the effectiveness of surface electromyography (SEMG) biofeedback-assisted core strengthening exercises combined with kinesiotaping to other approaches. This [...] Read more.

Current medical treatments for diastasis recti often involve exercises to strengthen the core muscles, along with abdominal binders or supports. However, there is limited evidence comparing the effectiveness of surface electromyography (SEMG) biofeedback-assisted core strengthening exercises combined with kinesiotaping to other approaches. This study aimed to assess the impact of three interventions on core strength, inter-rectus distance, and quality of life in postpartum women with diastasis recti. The interventions included core strengthening exercises with kinesiotaping and SEMG biofeedback-assisted core strengthening with kinesiotaping. This randomized controlled trial (NCT05897255) included 24 postpartum women divided into three groups. We measured inter-rectus distance, quality of life using the Short Form Health Survey 36, and core strength using the McGill torso battery test. The SEMG biofeedback provided auditory and visual cues. We used one-way analysis of variance to compare outcomes between groups, while a t-test for within-group analysis. Both the SEMG biofeedback-assisted and non-assisted core strengthening exercises with kinesiotaping groups showed significantly greater improvements in energy, bodily pain, general health, physical functioning, and limitations due to physical problems than the core strengthening group. Additionally, the SEMG biofeedback-assisted group demonstrated a greater reduction in inter-rectus distance. There were no statistically significant differences in core strength improvement among the three groups. Core strengthening exercises with SEMG-assisted kinesiotaping were superior to core strengthening alone in reducing inter-rectus distance, enhancing physical function, energy levels, and general health, and decreasing bodily pain and limitations due to physical problems. Core strength improvements were similar across all groups. Full article

(This article belongs to the Special Issue Healthy Lifestyle for Pregnant and Postpartum Women)

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12 pages, 282 KB

Open AccessEditor’s ChoiceArticle

Post-COVID-19 Condition: How Sociodemographic Factors, Physical Well-Being and Functionality Influence Quality of Life and Mental Health Symptoms

by Mᵃ Pilar Rodríguez-Pérez, Marta Pérez-de-Heredia-Torres, Pilar Rodríguez-Ledo, Gemma Fernández-Gómez, Cristina García-Bravo, Roberto Cano-de-la-Cuerda and Patricia Sánchez-Herrera-Baeza

Healthcare 2024, 12(15), 1551; https://doi.org/10.3390/healthcare12151551 - 5 Aug 2024

Viewed by 2636

Abstract

Background: Long COVID-19 syndrome remains a global public health problem, with more than 145 million people affected with multisystemic symptoms. Addressing the requirements of individuals impacted by a syndrome characterised by a complex and variable clinical presentation is of utmost importance. Identifying the [...] Read more.

Background: Long COVID-19 syndrome remains a global public health problem, with more than 145 million people affected with multisystemic symptoms. Addressing the requirements of individuals impacted by a syndrome characterised by a complex and variable clinical presentation is of utmost importance. Identifying the variables that can exert influence and understanding their progression is essential for directing treatment strategies aimed at enhancing both independence and quality of life. Therefore, the aim of this study was to analyse the influence of sociodemographic and clinical variables on existence and their relationship with asthenia, anxiety symptoms and low mood. Methods: An analytical study secondary to an observational cross-sectional descriptive study. Results: Logistic regression showed significant univariate effects on asthenia [sex (p = 0.034); age (p = 0.042); Activities of Daily Living Questionnaire [ADQL (p = 0.002)] [physical functioning (p < 0.001) and general health (p = 0.014)] and multivariate [sex (p = 0.019), adult age (p = 0.01) and physical functioning (p = 0.04)]]; low mood [time of evolution (p = 0.028) and multivariate [time course (p = 0.007), ADLQ (p = 0.011), role physical (p = 0.013) and general health (p = 0.001)]] and anxiety [physical functioning (p = 0.046) and multivariate [physical functioning (p = 0.034), age (p = 0.011), time of evolution (p = 0.001) and ADQL (p = 0.011)]]. Conclusions: Increased age, gender and longer evolution time seem to favour the prevalence and occurrence of mental health symptoms; greater independence and good physical functioning are protective factors with respect to the occurrence of mental health-related symptoms in patients affected by post-COVID-19 condition. Full article

(This article belongs to the Special Issue Human Health Before, During, and After COVID-19)

19 pages, 591 KB

Open AccessEditor’s ChoiceArticle

COVID-19 Vaccine Hesitancy and Misinformation Endorsement among a Sample of Native Spanish-Speakers in the US: A Cross-Sectional Study

by Elizabeth A. Carosella, Maxwell Su, Marcia A. Testa, Guglielmo Arzilli, Alice Conni and Elena Savoia

Healthcare 2024, 12(15), 1545; https://doi.org/10.3390/healthcare12151545 - 5 Aug 2024

Cited by 1 | Viewed by 2336

Abstract

Research on COVID-19 vaccine hesitancy and misinformation endorsement among Spanish-speaking Americans is limited. This cross-sectional study used a Spanish-language survey from May–August 2021 among 483 Spanish speakers living in the US and Puerto Rico. We applied multivariable Poisson regression with robust error variances [...] Read more.

Research on COVID-19 vaccine hesitancy and misinformation endorsement among Spanish-speaking Americans is limited. This cross-sectional study used a Spanish-language survey from May–August 2021 among 483 Spanish speakers living in the US and Puerto Rico. We applied multivariable Poisson regression with robust error variances to assess the association between independent variables and binary outcomes for vaccine acceptance versus hesitance, as well as misinformation endorsement. Vaccine acceptance was associated with COVID-19 risk perception score (PR = 1.7 high vs. low perceived risk), opinion of government transparency (PR = 2.2 very transparent vs. not transparent), and trust in vaccine information (PR = 1.8 high vs. low). There was also an interaction between time spent on social media and social media as a main source of COVID-19 information (p = 0.0484). Misinformation endorsement was associated with opinion about government transparency (PR = 0.5 moderately vs. not transparent), trust in vaccine information (PR = 0.5 high vs. low trust), social media impact on vaccine confidence (PR = 2.1 decreased vs. increased confidence), distrust vaccines (PR = 1.9 distrust vs. trust), using vaccine information from Facebook (PR = 1.4 yes vs. no), and time spent on social media by those using social media as main source of COVID-19 vaccine information (p = 0.0120). Vaccine acceptance in respondents with high misinformation endorsement scores was 0.7 times those with low scores. These findings highlight the importance of effective information dissemination, the positive role of social media, and government transparency in boosting vaccine uptake among Spanish speakers in the US. Full article

(This article belongs to the Section Healthcare in Epidemics and Pandemics)

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15 pages, 1160 KB

Open AccessEditor’s ChoiceArticle

The Perspectives of Individuals with Chronic Stroke on Motor Recovery: A Qualitative Analysis

by Amelia Cain, Carolee J. Winstein and Marika Demers

Healthcare 2024, 12(15), 1523; https://doi.org/10.3390/healthcare12151523 - 31 Jul 2024

Cited by 6 | Viewed by 3972

Abstract

The priorities of individuals with chronic stroke are not always reflected in clinical practice. This study provides insight into meaningful factors related to long-term motor recovery in stroke survivors. Thirty individuals with chronic stroke participated in semi-structured interviews about movement, recovery, and barriers [...] Read more.

The priorities of individuals with chronic stroke are not always reflected in clinical practice. This study provides insight into meaningful factors related to long-term motor recovery in stroke survivors. Thirty individuals with chronic stroke participated in semi-structured interviews about movement, recovery, and barriers to and facilitators of mobility and paretic arm use. The interviews were analyzed using inductive thematic analysis. Three categories, the individual, environment, and task, defined five emergent themes. Individual: (1) mindset is a strong and consistent influencer of daily physical activity and overall recovery; (2) severe physical impairment limits physical activity and recovery, regardless of other factors; and (3) a negative perception of disability impacts mindset and willingness to move in public. Environment: (4) social and physical environments influence physical activity and recovery. Task: (5) participation in meaningful activities increases physical activity and promotes long-term recovery. Strategies to incorporate paretic arm use, exercise, and encouragement from others facilitate physical activity. Insufficient paretic limb function, environmental obstacles, and fear are barriers to physical activity. Neurorehabilitation must address the factors that are meaningful to stroke survivors. Building motor capacity is essential and must be integrated with factors such as a positive mindset and proper environment. Individual differences reinforce the need for personalized care. Full article

(This article belongs to the Special Issue Life after Stroke: Recovery, Roles and Lifestyle)

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19 pages, 1664 KB

Open AccessEditor’s ChoiceArticle

The Effects of Motor Imagery on Static and Dynamic Balance and on the Fear of Re-Injury in Professional Football Players with Grade II Ankle Sprains

by George Plakoutsis, Elias Tsepis, Konstantinos Fousekis, Eleftherios Paraskevopoulos and Maria Papandreou

Healthcare 2024, 12(14), 1432; https://doi.org/10.3390/healthcare12141432 - 17 Jul 2024

Cited by 4 | Viewed by 3853

Abstract

Lateral ankle sprains are one of the most frequent athletic injuries in football, causing deficits in balance. Motor Imagery (MI) has been successively included in sports rehabilitation as a complementary therapeutic intervention. The aim of the present study was to explore the effects [...] Read more.

Lateral ankle sprains are one of the most frequent athletic injuries in football, causing deficits in balance. Motor Imagery (MI) has been successively included in sports rehabilitation as a complementary therapeutic intervention. The aim of the present study was to explore the effects of MI on static and dynamic balance and on the fear of re-injury in professional football players with Grade II ankle sprains. Fifty-eight participants were randomly allocated into two groups: First—MI group (n = 29) and second—Placebo group (n = 29), and they each received six intervention sessions. The first MI group received MI guidance in addition to the balance training program, while the second Placebo group received only relaxation guidance. One-way ANOVA showed statistically significant results for all variables, both before and 4 weeks after the interventions for both groups. The t-test showed statistically significant differences between the two groups for static balance for the right lower extremity (t = 3.25, S (two-tailed) = 0.002, p < 0.05) and also for heart rate (final value) in all time phases. Further research is needed in order to establish MI interventions in sports trauma recovery using stronger MI treatments in combination with psychophysiological factors associated with sports rehabilitation. Full article

(This article belongs to the Special Issue Rehabilitation and Care of Musculoskeletal Disorders)

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10 pages, 246 KB

Open AccessEditor’s ChoiceArticle

Multifaceted Impact of CO₂ Laser Therapy on Genitourinary Syndrome of Menopause, Vulvovaginal Atrophy and Sexual Function

by Svetlana Jankovic, Marija Rovcanin, Milena Zamurovic, Branka Jovanovic, Tatjana Raicevic and Ana Tomic

Healthcare 2024, 12(14), 1385; https://doi.org/10.3390/healthcare12141385 - 11 Jul 2024

Cited by 3 | Viewed by 2729

Abstract

Genitourinary syndrome of menopause (GSM) encompasses a range of distressing symptoms in the vulvovaginal and/or bladder–urethral regions related to menopause changes, negatively influencing woman’s quality of life and sexual activity. Fractional micro-ablative CO₂ laser therapy has shown the potential to reinstate the [...] Read more.

Genitourinary syndrome of menopause (GSM) encompasses a range of distressing symptoms in the vulvovaginal and/or bladder–urethral regions related to menopause changes, negatively influencing woman’s quality of life and sexual activity. Fractional micro-ablative CO₂ laser therapy has shown the potential to reinstate the vaginal epithelium to a condition akin to the premenopausal state, thereby ameliorating the subjective symptoms associated with GSM. We conducted a prospective, pilot study in 73 sexually active postmenopausal women treated with CO₂ laser for their GSM symptoms, while assessing Vaginal Health Index Score (VHIS) and sexual function through the Female Sexual Function Index (FSFI) Questionnaire. The laser treatment resulted in a decrease in VHIS and patient-reported vulvovaginal atrophy (VVA) symptoms, with a significantly lower prevalence of vaginal itching, dryness, and burning (p < 0.001), as well as dyspareunia (p = 0.002). The occurrence of urinary incontinence, urgency, and vaginal heaviness significantly reduced, with an improvement in the staging of cystocele, either to Stage 1 or complete resolution (p < 0.001). FSFI total and domain scores were significantly higher after the treatment, indicating better sexual function, with a post-treatment score median of 25 (p < 0.001). Therefore, using a three-cycle fractional CO₂ laser was an effective choice for reducing urogenital discomfort related to GSM in postmenopausal women. Full article

(This article belongs to the Special Issue Urinary Tract Health and Care)

13 pages, 886 KB

Open AccessEditor’s ChoiceReview

Emotional Dysregulation in Anorexia Nervosa: Scoping Review of Psychological Treatments

by Enrica Cogodi, Jessica Ranieri, Alessandra Martelli and Dina Di Giacomo

Healthcare 2024, 12(14), 1388; https://doi.org/10.3390/healthcare12141388 - 11 Jul 2024

Cited by 5 | Viewed by 5867

Abstract

Eating disorders are complex psychiatric disorders characterized by compensatory and restrictive behavior and a preoccupation with one’s body. Eating and purging behaviors are considered dysfunctional emotional regulation strategies. Therefore, psychological treatment is essential. The most common psychological interventions are dialectical behavior therapy (DBT), [...] Read more.

Eating disorders are complex psychiatric disorders characterized by compensatory and restrictive behavior and a preoccupation with one’s body. Eating and purging behaviors are considered dysfunctional emotional regulation strategies. Therefore, psychological treatment is essential. The most common psychological interventions are dialectical behavior therapy (DBT), cognitive–behavioral therapy (CBT), family therapy (FBT), multi-family group therapy (MFTG) and mentalization-based treatment (MBT). The aim of this study was to summarize the current evidence on the impact of psychological treatments on emotional regulation difficulties and psychological symptoms in patients with eating disorders, especially anorexia nervosa. A search was conducted on PubMed and Web of Science using the terms “anorexia nervosa” and “emotion dysregulation”. Of the 278 initial articles, we included 15 publications. The results indicate that the acquisition of coping strategies, through DBT, leads to an improvement in anxiety and alexithymia. DBT, CBT and MBT lead to a reduction in the use of dysfunctional emotional regulation strategies too. Eating disorders involve both physical and mental health; therefore, it is desirable for future research to focus on the mutual synergy between the mental and physical components by evaluating various factors, such as biomarkers and the most appropriate therapeutic approach, with respect to the treatment setting. Full article

(This article belongs to the Special Issue Health, Social Problems and Well-Being of Patients with Chronic Diseases, Quality of Life, and the Need for Emotional and Social Support)

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12 pages, 1059 KB

Open AccessEditor’s ChoiceArticle

Effectiveness of Treatment Approaches in COVID-19 Pneumonia: A Comparative Evaluation between a Specialized Center and Conventional Hospitals

by Rodolfo Romero Pareja, Martín S. Ruiz Grinspan, María Lorena Castro Arias, Raquel García Hernández, Francisco Javier Martín Sánchez, Esther Álvarez-Rodríguez, Virginia Álvarez Rodríguez, Iria Minguens, Ana María Martínez Molina, Rosario Torres Santos-Olmo, Sixto Aranda, Enrique Torres Rodríguez, Carmen Gimeno Galindo, Israel J Thuissard-Vasallo and Javier Marco Martínez

Healthcare 2024, 12(14), 1365; https://doi.org/10.3390/healthcare12141365 - 9 Jul 2024

Viewed by 2268

Abstract

Background: The early stages of the COVID-19 pandemic overwhelmed general hospitals in Spain. In response, a dedicated hospital for COVID-19 care, the Hospital de Emergencias Enfermera Isabel Zendal (HEEIZ), was established. This study aimed to compare clinical outcomes of COVID-19 patients treated at [...] Read more.

Background: The early stages of the COVID-19 pandemic overwhelmed general hospitals in Spain. In response, a dedicated hospital for COVID-19 care, the Hospital de Emergencias Enfermera Isabel Zendal (HEEIZ), was established. This study aimed to compare clinical outcomes of COVID-19 patients treated at the specialized HEEIZ with those at conventional general hospitals (CGHs) in Madrid, Spain. Methods: The study was a prospective, observational cohort study including COVID-19 patients admitted to the HEEIZ and 14 CGHs (December 2020 to August 2021). Patients were assigned based on hospital preference. Clinical data were collected and analyzed using multivariate regression to assess primary and secondary outcomes, including hospital mortality, need of invasive mechanical ventilation (IMV), and pharmacological treatments. Results: The HEEIZ cohort (n = 2997) was younger and had lower Charlson comorbidity scores than the CGH cohort (n = 1526). Adjusted HEEIZ hospital mortality was not significantly higher compared with CGHs (OR: 1.274; 95% CI: 0.781–2.079; p = 0.332). Conclusions: During the study period, patients admitted to the HEEIZ showed no significant differences in clinical outcomes, compared with patients admitted at CGHs. These results might support the use of specialized centers in managing pandemic surges, allowing CGHs to handle other needs. Full article

(This article belongs to the Collection COVID-19: Impact on Public Health and Healthcare)

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12 pages, 285 KB

Open AccessEditor’s ChoiceArticle

Psychometric Properties of Jebsen Taylor Hand Function Test in an Italian Population with Parkinson’s Disease

by Giovanni Galeoto, Anna Berardi, Rachele Simeon, Francescaroberta Panuccio, Giovanni Fabbrini, Daniele Belvisi, Jerónimo González-Bernal and Jesús Ángel Seco-Calvo

Healthcare 2024, 12(13), 1351; https://doi.org/10.3390/healthcare12131351 - 6 Jul 2024

Cited by 4 | Viewed by 2679

Abstract

Background: Assessment of upper limb function is critical in the rehabilitation process of people with Parkinson’s Disease (PD), and universally validated outcome measures are needed to allow comparisons across the practice. Moreover, the study of psychometric properties of the same tool on different [...] Read more.

Background: Assessment of upper limb function is critical in the rehabilitation process of people with Parkinson’s Disease (PD), and universally validated outcome measures are needed to allow comparisons across the practice. Moreover, the study of psychometric properties of the same tool on different clinical populations guarantees the possibility of reliably evaluating the same rehabilitation treatment in people with different clinical conditions. Aim of the study: The aim of this research was to evaluate the psychometric characteristics of the Italian adaptation of the Jebsen Taylor Hand Function Test (JTHFT) in individuals with PD. Methods: The reliability and validity of the test were assessed in accordance with international standards. Internal consistency was measured using Cronbach’s alpha, and test–retest reliability was determined via the intraclass correlation coefficient (ICC). The construct validity and cross-cultural validity of the test were evaluated using Pearson’s correlation coefficient with three assessment tools on upper limb function, independence, and quality of life, with hand grip power measured by a dynamometer and an Italian pangram. Finally, responsiveness after a one month of rehabilitation treatment was measured using the Wilcoxon rank test. Results: Fifty-two Italian people with PD were recruited. Cronbach’s alpha values ranged from 0.556 (non-dominant hand) to 0.668 (dominant hand); ICC values ranged from 0.754 to 0.988. Construct validity showed that several statistically significant correlations were detected. Wilcoxon’s test showed that the assessment tool can detect a change in this population after treatment. Conclusions: The JTHFT is a reliable, valid, and respondent tool to evaluate the upper limb and hand functionalities in PD patients. It should be added to the toolkit for measuring upper limb performance in this population, adding value to clinical evaluation and ensuring comparable results for different clinical populations and different countries. Full article

(This article belongs to the Special Issue Outcome Measures and Innovative Approaches in Rehabilitation—2nd Edition)

10 pages, 251 KB

Open AccessEditor’s ChoiceArticle

Association between Chronic Pain and Sarcopenia in Greek Community-Dwelling Older Adults: A Cross-Sectional Study

by Maria Tsekoura, Evdokia Billis, Charalampos Matzaroglou, Elias Tsepis and John Gliatis

Healthcare 2024, 12(13), 1303; https://doi.org/10.3390/healthcare12131303 - 29 Jun 2024

Cited by 7 | Viewed by 2598

Abstract

(1) Background: Sarcopenia and chronic pain are prevalent syndromes among older adults that negatively affect their quality of life. The present study aimed to investigate the relationship between chronic pain and sarcopenia among Greek community-dwelling older adults. (2) Methods: Older adults >60 years [...] Read more.

(1) Background: Sarcopenia and chronic pain are prevalent syndromes among older adults that negatively affect their quality of life. The present study aimed to investigate the relationship between chronic pain and sarcopenia among Greek community-dwelling older adults. (2) Methods: Older adults >60 years of age were enrolled in this descriptive, cross-sectional study. Sarcopenia status was assessed according to the EWGSOP2 2019 algorithm. This assessment included the evaluation of muscle strength, body composition and gait speed. Pain location and pain characteristics were assessed using a self-reported questionnaire. Pain severity was assessed via the visual analog scale. The participants were also asked to fill out the SARC-F, the Hospital Anxiety and Depression Scale (HADS) and the Falls Efficacy Scale-International (FES-I) questionnaire. (3) Results: This study included 314 participants with a mean age of 71.3 ± 7.4 years. The prevalence of sarcopenia was 19.4 (n = 61), and 44.26% of the sarcopenic participants recorded chronic pain. Chronic pain was associated with sarcopenia, comorbidities, the number of drugs and HADS. (4) Conclusions: The results demonstrated a high percentage of chronic pain in the sarcopenic population. The results also highlight the importance of the detection of chronic pain in older patients with sarcopenia in order to develop effective preventive and therapeutic strategies. Full article

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

14 pages, 250 KB

Open AccessEditor’s ChoiceArticle

Evaluating Sexual Health in Women with Multiple Sclerosis: A Study on the Interplay of Disability and Quality of Life

by Panagiota Dourou, Kleanthi Gourounti, Aikaterini Lykeridou, Konstantina Gaitanou, Nikolaos Petrogiannis, Chrysoula Rozalia Athanasiadou, Aikaterini Sousamli, Theodoros Xanthos and Antigoni Sarantaki

Healthcare 2024, 12(13), 1239; https://doi.org/10.3390/healthcare12131239 - 21 Jun 2024

Cited by 5 | Viewed by 3135

Abstract

In the context of evolving perceptions of sexuality, particularly within the realm of health and disability, this study investigates the impact of multiple sclerosis (MS) on female sexual function and quality of life. A quantitative study involving 130 female MS patients aged 35 [...] Read more.

In the context of evolving perceptions of sexuality, particularly within the realm of health and disability, this study investigates the impact of multiple sclerosis (MS) on female sexual function and quality of life. A quantitative study involving 130 female MS patients aged 35 to 50 was conducted, employing measures such as The Female Sexual Function Index (FSFI), The Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 (MSISQ-19), and The Fatigue Severity Scale (FSS). Results indicate a significant association between greater sexual dysfunction and poorer quality of sex life, alongside the correlation of increased fatigue with diminished sexual satisfaction. Specifically, the mean FSFI score was 20.8 (SD = 9.36), with 83.8% of participants experiencing severe fatigue (FSS score ≥ 36). Sexual dysfunction demonstrated a strong, negative correlation with all FSFI subscales (p < 0.01). Factors such as education level (p = 0.016), time of diagnosis (p = 0.035), and treatment regimen (p = 0.041) also significantly influenced outcomes. Findings underscore the importance of supportive interventions, including counseling, to enhance the quality of sex life for women with disabilities, particularly those with MS. Full article

(This article belongs to the Special Issue Advancing Health Education: Integrating Education, Evaluation and Intervention for Population Well-Being in Healthcare and Sexuality)

9 pages, 230 KB

Open AccessEditor’s ChoiceArticle

Intravesical Instillations of Hyaluronic Acid as First-Line Treatment in Patients with Interstitial Cystitis/Bladder Pain Syndrome: Use, Efficacy and Effects on Quality of Life

by Francesco Plotti, Gianna Barbara Cundari, Fernando Ficarola, Corrado Terranova, Carlo De Cicco Nardone, Roberto Montera, Daniela Luvero, Federica Guzzo, Adele Silvagni, Amerigo Ferrari, Donatella Caserta and Roberto Angioli

Healthcare 2024, 12(12), 1190; https://doi.org/10.3390/healthcare12121190 - 13 Jun 2024

Cited by 9 | Viewed by 6538

Abstract

The efficacy of hyaluronic acid instillations as therapy for patients with Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS) has been demonstrated in some clinical studies, with response rates up to 70%. The aim of the study is to investigate the change in symptoms and quality [...] Read more.

The efficacy of hyaluronic acid instillations as therapy for patients with Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS) has been demonstrated in some clinical studies, with response rates up to 70%. The aim of the study is to investigate the change in symptoms and quality of life in female patients with IC/BPS after intravesical instillations of hyaluronic acid used as first-line treatment. A retrospective single-center cohort study was conducted. Female patients, whose symptoms were compatible with the diagnosis of IC/BPS as defined by the International Continence Society, were treated with a variable number of intravesical instillations of a hyaluronic acid-based drug. Three validated questionnaires were administered by telephone to all patients, before the beginning of the treatment and 6 months after the last administration of the drug. A total of 50 patients with symptoms compatible with the diagnosis of IC/BPS were included in the study. The median number of instillations performed is 4. For all questionnaires, the median value was significantly reduced following treatment with intravesical instillations (p = 0.000). The present study has shown that intravesical hyaluronic acid treatment results in both statistically and clinically significant symptomatic improvement, thereby improving the quality of life of patients with IC/BPS. Full article

(This article belongs to the Section Women’s and Children’s Health)

27 pages, 2542 KB

Open AccessEditor’s ChoicePerspective

Epistemological Flexibility in Person-Centered Care: The Cynefin Framework for (Re)Integrating Indigenous Body Representations in Manual Therapy

by Rafael Zegarra-Parodi, Giandomenico D’Alessandro, Francesca Baroni, Jaris Swidrovich, Lewis Mehl-Madrona, Travis Gordon, Luigi Ciullo, Emiliano Castel and Christian Lunghi

Healthcare 2024, 12(11), 1149; https://doi.org/10.3390/healthcare12111149 - 5 Jun 2024

Cited by 7 | Viewed by 5541

Abstract

Background: Chiropractic, osteopathy, and physiotherapy (COP) professionals regulated outside the United States traditionally incorporate hands-on procedures aligned with their historical principles to guide patient care. However, some authors in COP research advocate a pan-professional, evidence-informed, patient-centered approach to musculoskeletal care, emphasizing hands-off management [...] Read more.

Background: Chiropractic, osteopathy, and physiotherapy (COP) professionals regulated outside the United States traditionally incorporate hands-on procedures aligned with their historical principles to guide patient care. However, some authors in COP research advocate a pan-professional, evidence-informed, patient-centered approach to musculoskeletal care, emphasizing hands-off management of patients through education and exercise therapy. The extent to which non-Western sociocultural beliefs about body representations in health and disease, including Indigenous beliefs, could influence the patient–practitioner dyad and affect the interpretation of pillars of evidence-informed practice, such as patient-centered care and patient expectations, remains unknown. Methods: our perspective paper combines the best available evidence with expert insights and unique viewpoints to address gaps in the scientific literature and inform an interdisciplinary readership. Results: A COP pan-professional approach tends to marginalize approaches, such as prevention-oriented clinical scenarios traditionally advocated by osteopathic practitioners for patients with non-Western sociocultural health assumptions. The Cynefin framework was introduced as a decision-making tool to aid clinicians in managing complex clinical scenarios and promoting evidence-informed, patient-centered, and culturally sensitive care. Conclusion: Epistemological flexibility is historically rooted in osteopathic care, due to his Indigenous roots. It is imperative to reintroduce conceptual and operative clinical frameworks that better address contemporary health needs, promote inclusion and equality in healthcare, and enhance the quality of manual therapy services beyond COP’s Western-centered perspective. Full article

(This article belongs to the Section Chronic Care)

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14 pages, 833 KB

Open AccessEditor’s ChoiceArticle

Impact of a Rounding Checklist Implementation in the Trauma Intensive Care Unit on Clinical Outcomes

by Dongmin Seo, Inhae Heo, Jonghwan Moon, Junsik Kwon, Yo Huh, Byunghee Kang, Seoyoung Song, Sora Kim and Kyoungwon Jung

Healthcare 2024, 12(9), 871; https://doi.org/10.3390/healthcare12090871 - 23 Apr 2024

Cited by 1 | Viewed by 3884

Abstract

We aimed to evaluate the effectiveness of an intensive care unit (ICU) round checklist, FAST HUGS BID (Feeding, Analgesia, Sedation, Thromboembolic prophylaxis, Head-of-bed elevation, Ulcer prophylaxis, Glycemic control, Spontaneous breathing trial, Bowel regimen, Indwelling catheter removal, and De-escalation of antibiotics—abbreviated as FD hereafter), [...] Read more.

We aimed to evaluate the effectiveness of an intensive care unit (ICU) round checklist, FAST HUGS BID (Feeding, Analgesia, Sedation, Thromboembolic prophylaxis, Head-of-bed elevation, Ulcer prophylaxis, Glycemic control, Spontaneous breathing trial, Bowel regimen, Indwelling catheter removal, and De-escalation of antibiotics—abbreviated as FD hereafter), in improving clinical outcomes in patients with severe trauma. We included patients admitted to our trauma ICU from 2016 to 2020 and divided them into two groups: before (before-FD, 2016–2017) and after (after-FD, 2019–2020) implementation of the checklist. We compared patient characteristics and clinical outcomes, including ICU and hospital length of stay (LOS) and in-hospital mortality. Survival analysis was performed using Kaplan–Meier curves and multivariable logistic regression models; furthermore, multiple linear regression analysis was used to identify independent factors associated with ICU and hospital LOS. Compared with the before-FD group, the after-FD group had significantly lower in-hospital mortality and complication rates, shorter ICU and hospital LOS, and reduced duration of mechanical ventilation. Moreover, implementation of the checklist was a significant independent factor in reducing ICU and hospital LOS and in-hospital mortality. Implementation of the FD checklist is associated with decreased ICU and hospital LOS and in-hospital mortality. Full article

(This article belongs to the Special Issue Acute Care Surgery)

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13 pages, 471 KB

Open AccessEditor’s ChoiceArticle

Blood Transfusion Procedure: Assessment of Serbian Intensive Care Nurses’ Knowledge

by Dragana Simin, Vladimir Dolinaj, Branislava Brestovački Svitlica, Jasmina Grujić, Dragana Živković and Dragana Milutinović

Healthcare 2024, 12(7), 720; https://doi.org/10.3390/healthcare12070720 - 25 Mar 2024

Cited by 4 | Viewed by 4776

Abstract

Many patients require administering one or more blood components during hospitalisation in the Intensive Care Unit (ICU). Therefore, nurses’ knowledge of who is responsible for immediately administering blood transfusions, monitoring patients, and identifying and managing transfusion reactions is crucial. This cross-sectional descriptive-analytical study [...] Read more.

Many patients require administering one or more blood components during hospitalisation in the Intensive Care Unit (ICU). Therefore, nurses’ knowledge of who is responsible for immediately administering blood transfusions, monitoring patients, and identifying and managing transfusion reactions is crucial. This cross-sectional descriptive-analytical study aimed to assess the knowledge of ICU nurses in tertiary healthcare institutions about blood transfusion procedures. The questionnaire about the transfusion procedure was designed and reviewed by experts. The questionnaire consisted of 29 items divided into three domains. The scores on the knowledge test ranged from 10 to 27. Generally, 57.7% of nurses had moderate, 23.4% low, and 18.9% high levels of knowledge about the transfusion procedure. Most nurses answered correctly about refreezing fresh frozen plasma, verifying the transfusion product, and identifying the patient. Of the nurses, 91.0% would recognise mild allergic reactions, and 98.2% knew about the supervision of sedated patients. Nurses showed poor knowledge of the length of usage of the same transfusion system for red blood cells, labelling, and transfusion administration in febrile patients. Nurses with higher education and longer working experience had significantly better outcomes (p = 0.000) on the knowledge test. Continuous education of ICU nurses on safe transfusion usage is recommended. Full article

(This article belongs to the Special Issue Nursing Care in the ICU)

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28 pages, 2204 KB

Open AccessEditor’s ChoiceSystematic Review

Can Digital Technologies Be Useful for Weight Loss in Individuals with Overweight or Obesity? A Systematic Review

by Carmela Protano, Andrea De Giorgi, Federica Valeriani, Elisa Mazzeo, Stefano Zanni, Luigi Cofone, Gabriele D’Ancona, Anis Hasnaoui, Ivano Pindinello, Marise Sabato, Francesca Ubaldi, Veronica Volpini, Vincenzo Romano Spica, Matteo Vitali and Francesca Gallè

Healthcare 2024, 12(6), 670; https://doi.org/10.3390/healthcare12060670 - 16 Mar 2024

Cited by 14 | Viewed by 11985

Abstract

Digital technologies have greatly developed and impacted several aspects of life, including health and lifestyle. Activity tracking, mobile applications, and devices may also provide messages and goals to motivate adopting healthy behaviors, namely physical activity and dietary changes. This review aimed to assess [...] Read more.

Digital technologies have greatly developed and impacted several aspects of life, including health and lifestyle. Activity tracking, mobile applications, and devices may also provide messages and goals to motivate adopting healthy behaviors, namely physical activity and dietary changes. This review aimed to assess the effectiveness of digital resources in supporting behavior changes, and thus influencing weight loss, in people with overweight or obesity. A systematic review was conducted according to the PRISMA guidelines. The protocol was registered in PROSPERO (CRD42023403364). Randomized Controlled Trials published from the database’s inception to 8 November 2023 and focused on digital-based technologies aimed at increasing physical activity for the purpose of weight loss, with or without changes in diet, were considered eligible. In total, 1762 studies were retrieved and 31 met the inclusion criteria. Although they differed in the type of technology used and in their design, two-thirds of the studies reported significantly greater weight loss among electronic device users than controls. Many of these studies reported tailored or specialist-guided interventions. The use of digital technologies may be useful to support weight-loss interventions for people with overweight or obesity. Personalized feedback can increase the effectiveness of new technologies in motivating behavior changes. Full article

(This article belongs to the Special Issue Healthcare Goes Digital: Mobile Health and Electronic Health Technology in the 21st Century)

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21 pages, 631 KB

Open AccessEditor’s ChoiceArticle

Perceptions and Experiences of Parents of Burn-Injured Children during Hospital Stay: A Need for Integrated Care

by Martim Santos, Ana Ferraz, Maria Garcia and M. Graça Pereira

Healthcare 2024, 12(6), 614; https://doi.org/10.3390/healthcare12060614 - 8 Mar 2024

Cited by 13 | Viewed by 5553

Abstract

Pediatric burn injuries are a critical medical condition that triggers a series of ongoing multifactorial stressors that affect both children and their families. To inform healthcare research and clinical practice, this study aimed to understand and describe the perceptions and experiences of the [...] Read more.

Pediatric burn injuries are a critical medical condition that triggers a series of ongoing multifactorial stressors that affect both children and their families. To inform healthcare research and clinical practice, this study aimed to understand and describe the perceptions and experiences of the parents of burn-injured children during hospital stay. Forty-six parents (thirty-eight mothers) of forty-six children (eighteen girls) with a mean age of 2.28 years (SD = 1.52) answered ten open-ended questions. This qualitative study was conducted in a referral hospital in the northern region of Portugal. Qualitative data were analyzed using an inductive content analysis. Five key themes emerged from the data analysis: diving into the crisis of the child burn injury, being together and in good hands, becoming aware of an uncertain future, enhancing supportive care and environment, and finding ways to guide parents. Qualitative findings underlined the pressing need for integrated care within this context. Parents were significantly burdened and distressed during the inpatient phase. These parents should be included in the integrated care plan starting from admission. Understanding and addressing parents’ healthcare needs and psychosocial adjustment difficulties is paramount to the development of future intervention programs and the delivery of suitable integrated healthcare. Full article

(This article belongs to the Special Issue Quality of Life and Health Promotion in Chronic Illness or Critical Medical Conditions: Implications for Integrated Health Care Delivery)

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13 pages, 756 KB

Open AccessEditor’s ChoiceReview

Competencies in the Robotics of Care for Nursing Robotics: A Scoping Review

by Blanca Gonzalo de Diego, Alexandra González Aguña, Marta Fernández Batalla, Sara Herrero Jaén, Andrea Sierra Ortega, Roberto Barchino Plata, María Lourdes Jiménez Rodríguez and José María Santamaría García

Healthcare 2024, 12(6), 617; https://doi.org/10.3390/healthcare12060617 - 8 Mar 2024

Cited by 9 | Viewed by 5303

Abstract

In parallel with the development and design of different technological advances, competencies in nursing have advanced. With the development of robotics, it is expected that nursing robotic competencies will also increase. The aim of this study is to review the competencies in nursing [...] Read more.

In parallel with the development and design of different technological advances, competencies in nursing have advanced. With the development of robotics, it is expected that nursing robotic competencies will also increase. The aim of this study is to review the competencies in nursing robotics. A review was conducted between January 2017 and December 2023. The search strategy was carried out in the MEDLINE database (through PubMed). This review explores the developmental competencies in nursing robotics and informatics. The data extraction in this review included an intentional search for competencies and learning outcomes in engineering and robotic programs. A total of 340 competencies and program outcomes were reviewed. The synthesis of the data established a total of 17 developmental competencies in nursing robotics based on this knowledge extraction, which we organized into five categories: assessment, diagnosis, planning, intervention (implementation) and evaluation. This review suggests that nursing robotic competencies for the development of care robotics are still scarce, and there is an opportunity for the development of competencies and the definition of new roles in the area of nursing informatics in order to adapt to the new health care demands of society. Full article

(This article belongs to the Special Issue Assistive Technologies, Robotics, and Automated Machines in the Health Domain: Second Edition)

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15 pages, 1693 KB

Open AccessEditor’s ChoiceArticle

Perceptions of Quality of Interprofessional Collaboration, Staff Well-Being and Nonbeneficial Treatment: A Comparison between Nurses and Physicians in Intensive and Palliative Care

by Daniel Schwarzkopf, Frank Bloos, Winfried Meißner, Hendrik Rüddel, Daniel O. Thomas-Rüddel and Ulrich Wedding

Healthcare 2024, 12(6), 602; https://doi.org/10.3390/healthcare12060602 - 7 Mar 2024

Cited by 10 | Viewed by 4489

Abstract

This study assessed differences in interprofessional collaboration, perception of nonbeneficial care, and staff well-being between critical care and palliative care teams. In six German hospitals, a staff survey was conducted between December 2013 and March 2015 among nurses and physicians in intensive and [...] Read more.

This study assessed differences in interprofessional collaboration, perception of nonbeneficial care, and staff well-being between critical care and palliative care teams. In six German hospitals, a staff survey was conducted between December 2013 and March 2015 among nurses and physicians in intensive and palliative care units. To allow comparability between unit types, a matching was performed for demographic characteristics of staff. N = 313 critical care and 79 palliative care staff participated, of which 72 each were successfully matched. Critical care nurses perceived the poorest overall quality of collaboration compared with critical care physicians and palliative care physicians and nurses. They also reported less inclusive leadership from attendings and head nurses, and the least collaboration on care decisions with physicians. They were most likely to perceive nonbeneficial care, and they reported the lowest levels of job satisfaction and the highest intention to leave the job. In partial correlations, aspects of high-quality collaboration were associated with less perceived nonbeneficial care and higher staff well-being for both critical care and palliative care staff. Our findings indicate that critical care teams could improve collaboration and enhance well-being, particularly among nurses, by adopting principles of collaborative work culture as established in palliative care. Full article

(This article belongs to the Special Issue Development and Impact of Palliative and End-of-Life Care Services)

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18 pages, 1127 KB

Open AccessEditor’s ChoiceArticle

Personality Traits, Burnout, and Psychopathology in Healthcare Professionals in Intensive Care Units—A Moderated Analysis

by Varvara Pakou, Dimitrios Tsartsalis, Georgios Papathanakos, Elena Dragioti, Mary Gouva and Vasilios Koulouras

Healthcare 2024, 12(5), 587; https://doi.org/10.3390/healthcare12050587 - 4 Mar 2024

Cited by 8 | Viewed by 7315

Abstract

This study explored the associations between personality dimensions, burnout, and psychopathology in healthcare professionals in intensive care units (ICUs). This study further aimed to discern the differences in these relationships when considering the variables of critical care experience (less than 5 years, 5–10 [...] Read more.

This study explored the associations between personality dimensions, burnout, and psychopathology in healthcare professionals in intensive care units (ICUs). This study further aimed to discern the differences in these relationships when considering the variables of critical care experience (less than 5 years, 5–10 years, and more than 10 years), profession (nurses versus intensivists), and the urban size of the city where the ICU is located (metropolitan cities versus smaller urban cities). This cross-sectional investigation’s outcomes are based on data from 503 ICU personnel, including 155 intensivists and 348 nurses, in 31 ICU departments in Greece. Participants underwent a comprehensive assessment involving a sociodemographic questionnaire, the Eysenck Personality Questionnaire (EPQ), the Maslach Burnout Inventory (MBI), and the Symptom Checklist-90 (SCL-90). To analyze the interplay among critical care experience, burnout status, and psychopathology, a moderation analysis was conducted with personality dimensions (i.e., psychoticism, extraversion, and neuroticism) serving as the mediator variable. Profession and the urban size of the ICU location were considered as moderators influencing these relationships. Male healthcare professionals showed higher psychoticism levels than females, aligning with prior research. Experienced nurses reported lower personal achievement, hinting at potential motivation challenges for professional growth. Psychoticism predicted high depersonalization and low personal achievement. Neuroticism and psychoticism negatively impacted ICU personnel’s mental well-being, reflected in elevated psychopathology scores and burnout status. Psychoticism appears to be the primary factor influencing burnout among the three personality dimensions, particularly affecting intensivists. In contrast, nurses are more influenced by their critical care experience on their mental health status. Full article

(This article belongs to the Special Issue Nursing Care in the ICU)

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27 pages, 2509 KB

Open AccessEditor’s ChoiceSystematic Review

Effects of Lifestyle Interventions on the Improvement of Chronic Non-Specific Low Back Pain: A Systematic Review and Network Meta-Analysis

by Pablo Herrero, Paula Val, Diego Lapuente-Hernández, Juan Nicolás Cuenca-Zaldívar, Sandra Calvo and Eva María Gómez-Trullén

Healthcare 2024, 12(5), 505; https://doi.org/10.3390/healthcare12050505 - 20 Feb 2024

Cited by 14 | Viewed by 9512

Abstract

Chronic non-specific low back pain (CNSLBP) is a highly prevalent musculoskeletal condition that has a great socioeconomic impact on health systems. Instead of focusing on mechanical causes and direct workload in the development of CNSLBP, genetics, psychosocial environment, lifestyle and quality of life [...] Read more.

Chronic non-specific low back pain (CNSLBP) is a highly prevalent musculoskeletal condition that has a great socioeconomic impact on health systems. Instead of focusing on mechanical causes and direct workload in the development of CNSLBP, genetics, psychosocial environment, lifestyle and quality of life are coming to the forefront in its approach. The main objective was to analyze whether interventions aimed at modifying lifestyle can be effective in improving pain intensity and functional disability in CNSLBP. A search in PubMed, Web of Science, Scopus and SportDiscus databases was performed. Both a univariate and a multivariate network meta-analysis were applied with the difference pre/post-treatment. A total of 20 studies were included for qualitative analysis, of which 16 were randomized clinical trials with a moderate–high methodological quality and were part of the quantitative analysis. The interventions that had the greatest effect in reducing pain intensity were cognitive therapy combined with functional exercise programs, lumbar stabilization exercise and resistance exercise; meanwhile, for functional disability, they were functional exercise programs, aerobic exercise and standard care. In conclusion, a multimodal intervention aimed at changing one’s lifestyle that encompasses cognitive, behavioral, and physical aspects seems to be highly effective in improving pain intensity and functional disability caused by CNSLBP; however, it is not yet known if these improvements are maintained in the long term. 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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13 pages, 1000 KB

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 20 | Viewed by 7792

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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12 pages, 1228 KB

Open AccessEditor’s ChoiceArticle

The Impact of Australian Bushfires on Asthma Medicine Prescription Dispensing

by Zhihua Zhu, Mark Naunton, Reza Mortazavi and Mary Bushell

Healthcare 2024, 12(4), 428; https://doi.org/10.3390/healthcare12040428 - 7 Feb 2024

Cited by 3 | Viewed by 3906

Abstract

Background: Air pollution can cause numerous health problems and increase the need for medicines to treat and prevent asthma in affected areas. There is limited evidence about the association between airborne particles with a diameter of 2.5 micrometres or smaller (PM_2.5) [...] Read more.

Background: Air pollution can cause numerous health problems and increase the need for medicines to treat and prevent asthma in affected areas. There is limited evidence about the association between airborne particles with a diameter of 2.5 micrometres or smaller (PM_2.5) and asthma medicine usage. This study examined the potential association between the levels of PM_2.5 and the supply of prescription asthma medicines in the Australian Capital Territory (ACT), Australia, during the severe bushfire season between November 2019–January 2020. Methods: Daily data was obtained from an ACT air quality monitoring station from November 2019 to January 2020 (study period) and November 2018 to January 2019 (control period, no bushfire). The number and types of government-funded asthma medicine prescriptions were obtained from the Services Australia (government) website by searching under ‘Pharmaceutical Benefits Scheme Item Reports’ and using relevant item codes during the study and control periods. Results: The medians for PM_2.5 levels for the study period were significantly higher than those for the control period (p < 0.001). There were increases in the number of dispensed prescriptions of short-acting beta-2 agonists (SABA), inhaled corticosteroids, and long-acting beta-2 agonists combined with inhaled corticosteroids. The greatest difference was seen with the inhaled corticosteroids: a 138% increase. Conclusions: The increase in the number of dispensed asthma prescriptions during the bushfire season should be used to inform the stock holdings of these medicines in preparation for future events to ensure access to lifesaving asthma medicines. Full article

(This article belongs to the Special Issue The 10th Anniversary of Healthcare—Medication Management)

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14 pages, 244 KB

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 18 | Viewed by 4462

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 KB

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 18 | Viewed by 13714

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)

15 pages, 600 KB

Open AccessEditor’s ChoiceReview

Third-Generation Antipsychotics and Lurasidone in the Treatment of Substance-Induced Psychoses: A Narrative Review

by Valerio Ricci, Domenico De Berardis and Giuseppe Maina

Healthcare 2024, 12(3), 339; https://doi.org/10.3390/healthcare12030339 - 29 Jan 2024

Cited by 22 | Viewed by 24386

Abstract

This narrative review explores the efficacy and tolerability of third-generation antipsychotics (TGAs)—aripiprazole, cariprazine, brexpiprazole, and lurasidone—for the management of substance-induced psychosis (SIP). SIP is a psychiatric condition triggered by substance misuse or withdrawal, characterized by unique features distinct from those of primary psychotic [...] Read more.

This narrative review explores the efficacy and tolerability of third-generation antipsychotics (TGAs)—aripiprazole, cariprazine, brexpiprazole, and lurasidone—for the management of substance-induced psychosis (SIP). SIP is a psychiatric condition triggered by substance misuse or withdrawal, characterized by unique features distinct from those of primary psychotic disorders. These distinctive features include a heightened prevalence of positive symptoms, such as hallucinations and delusions, in addition to a spectrum of mood and cognitive disturbances. This review comprehensively investigates various substances, such as cannabinoids, cocaine, amphetamines, and LSD, which exhibit a greater propensity for inducing psychosis. TGAs exhibit substantial promise in addressing both psychotic symptoms and issues related to substance misuse. This review elucidates the distinctive pharmacological properties of each TGA, their intricate interactions with neurotransmitters, and their potential utility in the treatment of SIP. We advocate for further research to delineate the long-term effects of TGAs in this context and underscore the necessity for adopting an integrated approach that combines pharmacological and psychological interventions. Our findings underscore the intricate and multifaceted nature of treating SIP, highlighting the potential role of TGAs within therapeutic strategies. Full article

(This article belongs to the Special Issue Addiction, Substance Use, and Mental Illness: A Public Health Perspective)

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13 pages, 549 KB

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 3 | Viewed by 4368

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 KB

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 6 | Viewed by 3653

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 KB

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 39 | Viewed by 15133

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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14 pages, 2645 KB

Open AccessEditor’s ChoiceArticle

Problems and Opportunities of a Smartphone-Based Care Management Platform: Application of the Wald Principles to a Survey-Based Analysis of Patients’ Perception in a Pilot Center

by Stefano Marco Paolo Rossi, Rocco Maria Panzera, Rudy Sangaletti, Luca Andriollo, Laura Giudice, Francesca Lecci and Francesco Benazzo

Healthcare 2024, 12(2), 153; https://doi.org/10.3390/healthcare12020153 - 9 Jan 2024

Cited by 25 | Viewed by 3766

Abstract

(1) Background: Mobile health (mHealth) solutions can become a means of improving functional recovery and reducing the peri-operative burden and costs associated with arthroplasty procedures. The aim of this study is to explore the objectives, functionalities, and outcomes of a platform designed to [...] Read more.

(1) Background: Mobile health (mHealth) solutions can become a means of improving functional recovery and reducing the peri-operative burden and costs associated with arthroplasty procedures. The aim of this study is to explore the objectives, functionalities, and outcomes of a platform designed to provide personalized surgical experiences to qualified patients, along with the associated problems and opportunities. (2) Methods: A survey-based analysis was conducted on patients who were prescribed the use of a specific care management platform and underwent primary robotic total knee arthroplasty (rTKA) between January 2021 and February 2023. (3) Results: Patients registered on the platform who have undergone primary robotic TKA (rTKA) were considered. The mean age of registered patients is 68.6 years. The male (M)/female (F) ratio is 45.1%/54.9%. The patients interviewed were at an average distance of 485 days from the intervention, with a standard deviation of 187.5. The survey highlighted appreciation for the app and its features, but also limitations in its use and in its perception by the patients. All these data were evaluated according to the Wald principles and strategies to improve patient recruitment, enhance adherence, and create a comprehensive patient journey for optimized surgical experiences. (4) Conclusions: This patient care platform may have the potential to impact surgical experiences by increasing patient engagement, facilitating remote monitoring, and providing personalized care. There is a need to emphasize the importance of integrating the recruiting process, improving adherence strategies, and creating a comprehensive patient journey within the platform. Full article

(This article belongs to the Special Issue New Advances in Joint Osteoarthritis)

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17 pages, 4131 KB

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 5 | Viewed by 3773

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 KB

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 4 | Viewed by 4722

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 Digital Health Technologies)

15 pages, 270 KB

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 27 | Viewed by 6928

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 KB

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 23 | Viewed by 20796

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 KB

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 4 | Viewed by 5175

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 KB

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 5 | Viewed by 2866

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 KB

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 37 | Viewed by 28596

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 Digital Health Technologies)

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15 pages, 937 KB

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 18 | Viewed by 8050

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 KB

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 16 | Viewed by 3734

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 KB

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 8 | Viewed by 6895

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 KB

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 10 | Viewed by 6036

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 KB

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 4 | Viewed by 3270

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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22 pages, 25952 KB

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 8 | Viewed by 7016

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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15 pages, 319 KB

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 7 | Viewed by 4684

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)

11 pages, 657 KB

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

Cited by 2 | Viewed by 2338

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 KB

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

Cited by 2 | Viewed by 1978

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 KB

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 16 | Viewed by 8368

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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