Advances in Primary Health Care and Community Health

Objectives: In this study, we aimed to assess the effects of complete decongestive therapy (CDT) on reducing lymphedema and enhancing gross motor strength (GMS), functional ability in the upper arm, quality of life (QoL), and pain relief among women who had undergone breast cancer surgery and chemo/radiotherapy in Montenegro. Methods: This prospective observational/pilot study included 50 women with breast cancer-related arm lymphedema, with an average age of 60.88 ± 12.78 years. The four-week Phase1-CDT program involved manual lymphatic drainage, compression bandaging, skin care, tailored kinesitherapy and patient education. Measurements included arm edema circumference compared to the contralateral arm, pain severity (VAS), arm muscle strength (MMT), functional ability (QDASH), and overall QoL (WHOQOL-BREF). Results: Following CDT, significant reductions in lymphedema circumference were observed in various areas and overall (p = 0.002), along with improvements in overall upper-arm GMS (p = 0.002) and specific upper-extremity movements such as wrist and forearm flexion, supination, and external rotation (p < 0.001). Significant improvements were also observed in pain severity and QDASH scores (p < 0.001), and overall QoL significantly increased (p < 0.001). Muscle strength in the hand, wrist, forearm, and shoulder also improved significantly (p < 0.05). We found a negative correlation between edema size and motor function in different muscle groups of the upper extremities, as well as between the QDASH score, quality of life, and overall upper-arm gross motor strength. Conclusions: It was observed that the four-week Phase 1-CDT program significantly improved lymphedema severity, functional abilities, gross motor strength, quality of life, and pain levels in Montenegrin women with breast cancer who had undergone mastectomy and chemo/radiotherapy. Our findings are limited to the immediate post-intervention period. This study is the first of its kind in Montenegro, suggesting the need for future randomized studies with a larger number of participants are needed. Full article

Background: Globally, uncorrected refractive errors are recognized as the primary cause of visual impairment and blindness. According to a report by the World Health Organization (WHO), providing spectacle lenses at an affordable cost remains a significant challenge, particularly for underprivileged populations in developing countries. This challenge contributes to the low compliance with spectacle wear worldwide. However, the benefits of wearing spectacles are influenced by the perceptions of the population regarding spectacle use. Methods: A quantitative, cross-sectional survey-based study was conducted at a superior educative center in Oman, the University of Buraimi. Participants were recruited from the four major colleges, namely, the College of Health Sciences (COHS), College of Business (COB), College of Engineering (COE), and College of Law (COL), and the Center for Foundation Studies (CFS). This study was conducted over the period from 18 December 2022 to 18 December 2023. Essential data were collected using an electronic questionnaire facilitated by the Google platform. The initial section of the questionnaire outlines this study’s objectives and its benefits to the community. The digital survey comprises three sections: the first section addresses the sociodemographic profile of the participants; the second section explores perceptions related to spectacles; and the third section examines visual symptoms associated with spectacle wear. In this study, a pre-tested survey was administered following consultation with a panel of three subject matter experts who reviewed the clarity and content validity of the test items. Data analyses were performed using descriptive statistics, and linear regression was applied to assess the effect of socioeconomic profile on perceptions of spectacles. Additionally, data entry, processing, and analysis were conducted using SPSS 25 software. The overall mean score for spectacle-related visual symptoms was 2.51 ± 0.75, indicating a moderate level of symptom occurrence. Results: A total of 415 participants (N = 415) were included in this study, comprising 133 males (32.0%) and 282 females (68.0%). The most prominent symptoms related to spectacle perception were “light sensitivity” and “eye pain”, with mean values of 3.03 ± 1.30 and 3.04 ± 1.25, respectively. Additionally, 249 participants (60%) reported moderate concern regarding spectacle-related visual symptoms. Among female participants, 118 (41.8%) exhibited little concern about visual symptoms associated with spectacle wear, whereas this was observed in 25.6% of male participants. Descriptive statistics indicated the mean perceived spectacle-related disadvantages score measured on a scale of 0 to 4 was 2.88 ± 1.16 (57.69% ± 23.15% in percentages), reflecting a moderate perception of such disadvantages. The linear regression model demonstrated statistical significance, as indicated by the likelihood ratio chi-square = 199.194 (df = 15, p < 0.001). The most significant predictor was study major (χ² = 72.922, p < 0.001). Conclusions: The present study indicates that undergraduate students generally exhibit a low perception of the disadvantages associated with wearing spectacles. Randomized sampling should be preferred in future studies to the convenience sampling technique. The most frequently reported visual symptoms include “light sensitivity and eye pain” among spectacle wearers. Therefore, it is imperative to implement health education programs and foundational studies across colleges to address these issues among undergraduate university students. Full article

Background/Objectives: The consumption of opioids is a public health problem that significantly affects quality of life. In Spain, 7585 people are enrolled in the Methadone Maintenance Programme (MMP), which is an effective intervention with a low adherence rate. In this study, factors associated with the quality of life of MMP users, especially perceived social support and treatment adherence, were analysed. We hypothesised that low levels of adherence and social support would be associated with poorer quality of life. Methods: This was a cross-sectional observational study with an analytical approach. Quality of life (WHOQoL-BREF), perceived social support (DUKE-UNC-11), and treatment adherence (MMAS-8) among MMP users were studied, and data on sociodemographic and clinical characteristics were collected through ad hoc questionnaires and a review of electronic medical records. Linear and logistic regression models were used. Results: A total of 70 individuals were included in this study. The mean age was 56.9 years, and 83% of the participants were male. The perceived quality of life was low in the four domains evaluated (range of 47.4–48.2). A total of 38.57% of the participants had low perceived social support. Treatment adherence was low or moderate in 77.1% of the participants. Greater perceived social support was associated with better quality of life in all domains (p < 0.05). Quality of social life was negatively associated with the use of nonbenzodiazepine neuroleptics and HIV status. Treatment adherence was lower in insulin therapy users. Conclusions: Social support is a key determinant of the quality of life of MMP users. Health policies should promote social support networks as a strategy to improve the well-being of this population. Full article

Background/Objectives: Patient trust and satisfaction are critical components of effective healthcare delivery, particularly within health welfare social cooperatives. This study investigates the impacts of administrative procedures, courtesy, physical accessibility, collaborative management, and community health relations on patient trust and satisfaction. Methods: Using Partial Least Squares Structural Equation Modeling (PLS-SEM), we analyzed survey data collected from 658 members of a health welfare social cooperative to assess the hypothesized relationships. Results: The findings reveal that administrative procedures significantly enhance trust but do not directly affect satisfaction. Courtesy and community health relations positively influence both trust and satisfaction. Physical accessibility, collaborative management, and trust also significantly enhance patient satisfaction. Conclusions: These results highlight the multifaceted nature of patient trust and satisfaction, emphasizing the importance of efficient administrative practices, respectful treatment, collaborative decision-making, and strong community engagement. For practitioners, the study underscores the need for a comprehensive approach to healthcare management that integrates operational efficiency with patient-centered care. Full article

Background: Previous studies have shown that intrinsic capacity changes over time and can independently predict adverse outcomes such as mortality and care dependence in older adults. However, explorations of the heterogeneity in the developmental trajectories of intrinsic capacity are limited. Aim: This study aimed to identify potential intrinsic capacity trajectory groups and the factors impacting different trajectory groups among older adults. Methods: We utilized data from 2454 older adults aged 60 and above, sourced from the Chinese Longitudinal Healthy Longevity Survey. Our analyses were conducted using growth mixture modeling, chi-square tests, and multinomial logistic regression analysis. Results: We identified four intrinsic capacity trajectory groups among older adults in China: low-level intrinsic capacity (3.2%), medium-level increasing intrinsic capacity (13.0%), medium-level decreasing intrinsic capacity (12.0%), and stable high intrinsic capacity (71.8%). Age was an influencing factor of the medium-level increasing intrinsic capacity, medium-level decreasing intrinsic capacity, and stable high intrinsic capacity trajectory groups. Compared to individuals in the low-level intrinsic capacity trajectory group, individuals in the medium-level decreasing intrinsic capacity group were more likely to regularly exercise and participate in social activity, and those in the stable high intrinsic capacity group were more likely to be male, drink, participate in social activity, and have good self-rated health. Conclusions: Understanding the developmental trajectories of the intrinsic capacity of the older adults can contribute to formulating personalized intervention planning. We identified four intrinsic capacity trajectories in a cohort of older adults in China, which highlights significant heterogeneity in intrinsic capacity development. Our findings suggest that age, gender, exercise, drinking, social activity, and self-rated health of older adults have important effects on different intrinsic capacity development trajectories. Full article

Background: Community needs assessments can provide valuable insights concerning the health of communities. This study aims to measure health priorities according to community members in Jazan, Saudi Arabia, to assess healthcare service utilization, barriers to accessing these services, and preferences for utilizing government or private healthcare services. Method: Multistage sampling was utilized to reach a sample of adults in community settings. The assessment was performed via personal interviews utilizing a structured questionnaire to measure demographics, health priorities, service utilization, barriers, and preferences for healthcare settings. Chi-squared tests, Student’s t-tests, and multivariate regression analysis were used to assess the differences between demographics and service utilization according to the preferred healthcare settings. Results: A total of 3411 participants were recruited for the assessment. The mean age of the participants was 34 years, and 51% were male. The participants viewed diabetes as the most important health condition. Emergency services and primary care were viewed as the most important healthcare services, and time constraints were the main barriers to healthcare accessibility. Thirty-six percent of the participants preferred to utilize healthcare services in the private sector, where age, gender, nationality, education, income, housing type, and family size were statistically associated with the preference for seeking healthcare in either the private or government sectors (p < 0.05). Conclusions: Future assessment is required to recruit healthcare providers and decision-makers to understand the process of strengthening multidisciplinary collaboration to tackle chronic diseases such as diabetes, strengthen the role of emergency and primary healthcare services, and address time constraints pertaining to healthcare accessibility. Full article

The importance of health promotion for health professional students is increasingly crucial, as the rising requirements for those students can have a negative impact on their health. Despite this awareness, there is still limited knowledge in Germany about the specific health needs of this group of students. This study’s aim was, therefore, to assess the subjective health of first-year students and to identify health needs. Thus, this study is based on an online survey using standardized measurement instruments. First-year students from three degree programs were included. The data were analyzed descriptively. A total of n = 98 (72.6%) participated in the survey. The results showed that a major proportion of participants (80.3%) rated their health positively, but a significant proportion reported weight disorders (24%) and pre-existing health conditions (62.1%) at baseline. Interestingly, a high proportion (59%) reported a high level of mental well-being at the time of the survey. However, worrying findings regarding lifestyle behaviors, including physical inactivity (40.6%), smoking (20%), risky alcohol use (24%), and unhealthy eating habits (37%) were determined. In terms of health literacy, around 45% of students rated their health competencies as problematic. Furthermore, it was found that students with low health literacy had a significantly higher prevalence of low mental well-being (53.3% vs. 30.8%, p = 0.036) and unhealthy eating habits (48.8% vs. 26.5%, p = 0.027) compared to students with sufficient health literacy. Health professional students should be considered a relevant target group for health and health competence promotion from the beginning of their studies. The identified fields of action should be addressed in the context of health promotion. This is of particular importance as they are not only aimed at improving the students’ well-being but also will later work directly with patients and, therefore, have a direct influence on the health of others. Full article

Background: Health literacy and eHealth literacy play a crucial role in improving a community’s ability to take care of themselves, ultimately leading to a reduction in disparities in health. Embracing a healthy way of living is vital in lessening the impact of illnesses and extending one’s lifespan. This research delves into the link between the health and eHealth literacy levels of individuals accessing primary healthcare services and investigates how this relates to adopting a health-conscious lifestyle. Methods: The approach involves a cross-sectional examination carried out at a healthcare facility in the Madrid region of Spain, focusing on adult patients who are in need of primary care nursing services. Health and eHealth literacy and a healthy lifestyle were measured using the Health Literacy Questionnaire (HLQ), the eHealth Literacy Questionnaire (eHLQ), and the “PA100” questionnaire, respectively. Results: Only some of the dimensions of the HLQ and eHLQ were significantly related to a healthy lifestyle, predominantly with a very low or low relationship. Dimension three of the HLQ and dimension five of the eHLQ acquired more importance and were positioned as positive predictors of a healthy lifestyle. Conclusions: This study helps comprehend the relationship between health and eHealth literacy and a healthy lifestyle, which provides information that contributes to understanding the factors that might have a higher impact on lifestyles. Full article