Healthcare

Research

15 pages, 251 KiB

Open AccessArticle

Evaluation of Online Counseling through the Working Experiences of Mental Health Therapists Amidst the COVID-19 Pandemic

by Maria Moudatsou, Areti Stavropoulou, Michael Rovithis and Sofia Koukouli

Healthcare 2024, 12(4), 495; https://doi.org/10.3390/healthcare12040495 - 19 Feb 2024

Viewed by 2166

Abstract

This study aimed to reflect on mental health professionals’ experiences with online counseling during the COVID-19 pandemic, as well as their perceptions and recommendations for the future. The method of qualitative research with semi-structured interviews was used. The sample consisted of 17 mental [...] Read more.

This study aimed to reflect on mental health professionals’ experiences with online counseling during the COVID-19 pandemic, as well as their perceptions and recommendations for the future. The method of qualitative research with semi-structured interviews was used. The sample consisted of 17 mental health professionals working in the public or private sectors. A framework analysis revealed four main themes, namely (a) the evaluation of online counseling; (b) comparing in-person and online counseling; (c) factors influencing the effectiveness of online counseling; and (d) suggestions for the future use of online counseling. Most therapists reported that their overall experience with online counseling was positive. The main advantages cited were the accessibility for everyone and the reductions in time, money, and distance. Its primary drawbacks included less nonverbal communication, the inability to employ certain therapeutic tools, problems with confidentiality, lack of experience, and technical difficulties during online sessions. Its effectiveness depends on contextual factors and factors related to the therapeutic process itself. Organizational planning, training, and a solid implementation strategy may help ensure that this communication medium is used to its fullest potential. In addition, the possible utilization of remote counseling combined with in-person psychotherapeutic intervention methods will provide solutions for the future, especially in crisis situations. Full article

(This article belongs to the Special Issue Health and Social Care Policy)

12 pages, 255 KiB

Open AccessArticle

Fatigue among Greek Parents of Children with Autistic Spectrum Disorder: The Roles of Spirituality and Social Support

by Eugenia Halki, Maria Kapiri, Sotirios Plakas, Chrysoula Tsiou, Ourania Govina, Petros Galanis and Victoria Alikari

Healthcare 2024, 12(4), 455; https://doi.org/10.3390/healthcare12040455 - 10 Feb 2024

Viewed by 1067

Abstract

The high demands of caring for and raising a child with autism spectrum disorder on a daily basis may lead parents to physical and mental fatigue. This study aimed to assess the effect of social support and spirituality on the fatigue of parents [...] Read more.

The high demands of caring for and raising a child with autism spectrum disorder on a daily basis may lead parents to physical and mental fatigue. This study aimed to assess the effect of social support and spirituality on the fatigue of parents with children with autistic spectrum disorder. A cross-sectional study with a convenience sample was conducted in Schools of Special Education in Attica (Greece). The sample consisted of 123 parents who completed The Fatigue Assessment Scale (FAS), the Multidimensional Scale of Perceived Social Support (MSPSS), and the Functional Assessment of Chronic Illness Therapy Spiritual Well-Being Scale (FACIT Sp-12) to measure the levels of fatigue, social support, and spirituality, respectively. The Pearson correlation coefficient was used to investigate the relationship between the quantitative variables. To study the effect of social support and spirituality on fatigue, multivariable linear regression was applied. The mean age was 47.3 years old, 81.3% were women, and 38.9% stated “Close/Very close faith toward God”. Higher levels of total MSPSS and FACIT Sp-12 were associated with lower total FAS (r = −0.50, p < 0.001 and r = −0.49, p < 0.001, respectively). Social support and spirituality were significant predictors of fatigue. Full article

(This article belongs to the Special Issue Health and Social Care Policy)

12 pages, 430 KiB

Open AccessArticle

Mental Healthcare through Cognitive Emotional Regulation Strategies among Prisoners

by Younyoung Choi, Mirim Kim and Jeongsoo Park

Healthcare 2024, 12(1), 6; https://doi.org/10.3390/healthcare12010006 - 19 Dec 2023

Cited by 1 | Viewed by 1268

Abstract

Prisoners are exposed to a deprived environment, which triggers mental illness and psychological problems. Abundant research has reported that mental illness problems, suicide, aggression, and violent behaviors occur in incarcerated people. Although the mental healthcare system for incarcerated people is emphasized, little research [...] Read more.

Prisoners are exposed to a deprived environment, which triggers mental illness and psychological problems. Abundant research has reported that mental illness problems, suicide, aggression, and violent behaviors occur in incarcerated people. Although the mental healthcare system for incarcerated people is emphasized, little research has been conducted due to their limited environment. In particular, the regulation of negative emotion is significantly associated with mental illness and anti-social and violent behaviors. However, mental healthcare through cognitive emotional regulation based on cognitive behavioral therapy has not been fully investigated. This study identified four different patterns in cognitive strategies for regulating negative emotions. Cognitive emotional regulation strategies (i.e., self-blame, other-blame, rumination, catastrophizing, putting into perspective, positive refocusing, positive reappraisal, acceptance, and refocus on planning) were examined and addressed their vulnerable psychological factors. We analyzed a total of 500 prisoners’ responses to the cognitive emotional regulation questionnaire (CERQ) by latent class profiling analysis. A four-class model was identified based on the responses of CERQ. In addition, the significant effect of depression on classifying the four classes was found. Furthermore, differences in the average number of incarcerations were also shown across four classes. In conclusion, Class 2 (Negative Self-Blamer) uses dysfunctional/negative strategies that may place the group at a high risk of psychological disorder symptoms, including depression and post-traumatic stress. Class 3 (Distorted Positivity) uses positive/functional strategies but seems to utilize the positive strategies in distorted manners to rationalize their convictions. Class 1 (Strong Blamer) and Class 4 (Moderator Blamer) showed similar patterns focused on the “other-blame” strategy for regulating negative emotion, but they are at different levels, indicating that they attribute incarceration to external factors. These findings provide useful information for designing mental healthcare interventions for incarcerated people and psychological therapy programs for clinical and correctional psychologists in forensic settings. Full article

(This article belongs to the Special Issue Health and Social Care Policy)

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25 pages, 342 KiB

Open AccessArticle

Maternal Health Care Service Utilization in the Post-Conflict Democratic Republic of Congo: An Analysis of Health Inequalities over Time

by Dieudonne Bwirire, Inez Roosen, Nanne de Vries, Rianne Letschert, Edmond Ntabe Namegabe and Rik Crutzen

Healthcare 2023, 11(21), 2871; https://doi.org/10.3390/healthcare11212871 - 31 Oct 2023

Viewed by 1015

Abstract

This study assessed inequality in maternal healthcare service utilization in the Democratic Republic of the Congo, using the Demographic and Health Surveys of 2007 and 2013–2014. We assessed the magnitude of inequality using logistical regressions, analyzed the distribution of inequality using the Gini [...] Read more.

This study assessed inequality in maternal healthcare service utilization in the Democratic Republic of the Congo, using the Demographic and Health Surveys of 2007 and 2013–2014. We assessed the magnitude of inequality using logistical regressions, analyzed the distribution of inequality using the Gini coefficient and the Lorenz curve, and used the Wagstaff method to assess inequality trends. Women were less likely to have their first antenatal care visit within the first trimester and to attend more antenatal care visits when living in eastern Congo. Women in rural areas were less likely to deliver by cesarean section and to receive postnatal care. Women with middle, richer, and richest wealth indexes were more likely to complete more antenatal care visits, to deliver by cesarean section, and to receive postnatal care. Over time, inequality in utilization decreased for antenatal and postnatal care but increased for delivery by cesarean sections, suggesting that innovative strategies are needed to improve utilization among poorer, rural, and underserved women. Full article

(This article belongs to the Special Issue Health and Social Care Policy)

9 pages, 247 KiB

Open AccessArticle

Use of Advance Directives in US Veterans and Non-Veterans: Findings from the Decedents of the Health and Retirement Study 1992–2014

by Ho-Jui Tung and Ming-Chin Yeh

Healthcare 2023, 11(13), 1824; https://doi.org/10.3390/healthcare11131824 - 22 Jun 2023

Cited by 1 | Viewed by 1060

Abstract

Evidence shows that older patients with advance directives such as a living will, or durable power of attorney for healthcare, are more likely to receive care consistent with their preferences at the end of life. Less is known about the use of advance [...] Read more.

Evidence shows that older patients with advance directives such as a living will, or durable power of attorney for healthcare, are more likely to receive care consistent with their preferences at the end of life. Less is known about the use of advance directives between veteran and non-veteran older Americans. Using data from the decedents of a longitudinal survey, we explore whether there is a difference in having an established advance directive between the veteran and non-veteran decedents. Data were taken from the Harmonized End of Life data sets, a linked collection of variables derived from the Health and Retirement Study (HRS) Exit Interview. Only male decedents were included in the current analysis (N = 4828). The dependent variable, having an established advance directive, was measured by asking the proxy, “whether the deceased respondent ever provided written instructions about the treatment or care he/she wanted to receive during the final days of his/her life” and “whether the deceased respondent had a Durable Power of Attorney for healthcare?” A “yes” to either of the two items was counted as having an advance directive. The independent variable, veteran status, was determined by asking participants, “Have you ever served in the active military of the United States?” at their first HRS core interview. Logistic regression was used to predict the likelihood of having an established advance directive. While there was no difference in having an advance directive between male veteran and non-veteran decedents during the earlier follow-up period (from 1992 to 2003), male veterans who died during the second half of the study period (from 2004 to 2014) were more likely to have an established advance directive than their non-veteran counterparts (OR = 1.24, p < 0.05). Other factors positively associated with having an established advance directive include dying at older ages, higher educational attainment, needing assistance in activities of daily living and being bedridden three months before death, while Black decedents and those who were married were less likely to have an advance directive in place. Our findings suggest male veterans were more likely to have an established advance directive, an indicator for better end-of-life care, than their non-veteran counterparts. This observed difference coincides with a time when the Veterans Health Administration (VHA) increased its investment in end-of-life care. More studies are needed to confirm if this higher utilization of advance directives and care planning among veterans can be attributed to the improved access and quality of end-of-life care in the VHA system. Full article

(This article belongs to the Special Issue Health and Social Care Policy)

14 pages, 758 KiB

Open AccessArticle

Understanding the Experience of Long COVID Symptoms in Hospitalized and Non-Hospitalized Individuals: A Random, Cross-Sectional Survey Study

by Jacqueline A. Krysa, Mikayla Buell, Kiran Pohar Manhas, Katharina Kovacs Burns, Maria J. Santana, Sidney Horlick, Kristine Russell, Elizabeth Papathanassoglou and Chester Ho

Healthcare 2023, 11(9), 1309; https://doi.org/10.3390/healthcare11091309 - 3 May 2023

Cited by 5 | Viewed by 1815

Abstract

The relationship between initial COVID-19 infection and the development of long COVID remains unclear. The purpose of this study was to compare the experience of long COVID in previously hospitalized and non-hospitalized adults in a community-based, cross-sectional telephone survey. Participants included persons with [...] Read more.

The relationship between initial COVID-19 infection and the development of long COVID remains unclear. The purpose of this study was to compare the experience of long COVID in previously hospitalized and non-hospitalized adults in a community-based, cross-sectional telephone survey. Participants included persons with positive COVID-19 test results between 21 March 2021 and 21 October 2021 in Alberta, Canada. The survey included 330 respondents (29.1% response rate), which included 165 previously hospitalized and 165 non-hospitalized individuals. Significantly more previously hospitalized respondents self-reported long COVID symptoms (81 (49.1%)) compared to non-hospitalized respondents (42 (25.5%), p < 0.0001). Most respondents in both groups experienced these symptoms for more than 6 months (hospitalized: 66 (81.5%); non-hospitalized: 25 (59.5), p = 0.06). Hospitalized respondents with long COVID symptoms reported greater limitations on everyday activities from their symptoms compared to non-hospitalized respondents (p < 0.0001) and tended to experience a greater impact on returning to work (unable to return to work—hospitalized: 20 (19.1%); non-hospitalized: 6 (4.5%), p < 0.0001). No significant differences in self-reported long COVID symptoms were found between male and female respondents in both groups (p > 0.05). This study provides novel data to further support that individuals who were hospitalized for COVID-19 appear more likely to experience long COVID symptoms. Full article

(This article belongs to the Special Issue Health and Social Care Policy)

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12 pages, 276 KiB

Open AccessArticle

Clinical and Social Features of Patients with Eye Injuries Admitted to a Tertiary Hospital: A Five-Year Retrospective Study from Crete, Greece

by Elli D. O. Kyriakaki, Efstathios T. Detorakis, Antonios K. Bertsias, Nikolaos G. Tsakalis, Ioannis Karageorgiou, Gregory Chlouverakis and Emmanouil K. Symvoulakis

Healthcare 2023, 11(6), 885; https://doi.org/10.3390/healthcare11060885 - 18 Mar 2023

Cited by 2 | Viewed by 1341

Abstract

Eye injuries are a major cause of visual disability worldwide and may present a burden to both quality of life of the sufferers and healthcare services. The aim of this study was to extract and triangulate information on the demographic, clinical, and social [...] Read more.

Eye injuries are a major cause of visual disability worldwide and may present a burden to both quality of life of the sufferers and healthcare services. The aim of this study was to extract and triangulate information on the demographic, clinical, and social features of eye-injured adult patients admitted to a tertiary hospital in Greece. The design was a five-year retrospective study of eye-injured adult patients, admitted to the General University Hospital of Heraklion, Crete (GUHH), the single tertiary referral hospital on the island. Drawing the profile of eye-injured patients may add to future health planning. Data collected from 1 January 2015 to 31 December 2019, such as sociodemographic features and clinical information, were extracted. One hundred twenty-eight patients were included. Of those, there was no available information on activity during injury for 6 patients, 78 (60.9%) had work-related ocular injuries, and 44 (34.4%) had non-work-related ocular injuries. Patients with no current formal employment, those who were retired, and formally unemployed and manual force workers had the higher rates of work-related injuries. The most common work-related injuries were closed globe injuries, specifically contusions, while ruptures and penetrating wounds were the most frequent of the open globe injuries. Within the univariate analyses, work-related eye injuries were significantly associated with male gender, middle age, and the place related to daily work activity. Determinants of poor final visual acuity (VA) were the initial VA, the type of injury (p < 0.0001), the distance of the place of residence from the hospital, and the time to hospital admission (p < 0.013). In a multivariate analysis, referred patients and those with open globe injuries arrived at hospital after a two-hour interval compared with those who were not referred and those with closed globe injuries (p ≤ 0.05). A reduction in the time to hospital admission deserves further attention. The interconnection of community and health system services through a capacity increase and networking needs further research in order to obtain targeted and viable access for eye-injured patients. Full article

(This article belongs to the Special Issue Health and Social Care Policy)

13 pages, 609 KiB

Open AccessArticle

Cultural Adaptation of a Health Literacy Toolkit for Healthcare Professionals Working in the Primary Care Setting with Older Adults

by Areti Efthymiou, Argyroula Kalaitzaki and Michael Rovithis

Healthcare 2023, 11(5), 776; https://doi.org/10.3390/healthcare11050776 - 6 Mar 2023

Cited by 4 | Viewed by 2043

Abstract

Healthcare professionals’ health literacy (HL) knowledge and skills influence their interaction with older adults. Healthcare professionals, when effectively communicating with older adults, can empower and enhance patients’ skills to make informed decisions about their health. The study aimed to adapt and pilot test [...] Read more.

Healthcare professionals’ health literacy (HL) knowledge and skills influence their interaction with older adults. Healthcare professionals, when effectively communicating with older adults, can empower and enhance patients’ skills to make informed decisions about their health. The study aimed to adapt and pilot test a HL toolkit to enhance the HL skills of health professionals working with older adults. A mixed methodology of three phases was used. Initially, the healthcare professionals’ and older adults’ needs were identified. Following a literature review of existing tools, a HL toolkit was selected, translated, and adapted into Greek. The HL toolkit was introduced to 128 healthcare professionals as part of 4 h webinars; 82 healthcare professionals completed baseline and post assessments, and 24 healthcare professionals implemented it in their clinical practice. The questionnaires used included an interview on HL knowledge, communication strategies, and self-efficacy using a communication scale. HL and communication strategies knowledge (13 items) and self-efficacy in communication (t = −11.127, df = 81, p < 0.001) improved after the end of the HL webinars, and improvement was retained during the follow-up after 2 months (H = 8.99, df = 2, p < 0.05). A culturally adapted HL toolkit was developed to support the needs of healthcare professionals working with older adults, taking into consideration their feedback in all phases of the development. Full article

(This article belongs to the Special Issue Health and Social Care Policy)

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8 pages, 1036 KiB

Open AccessArticle

The Effects of the Ukrainian Conflict on Oncological Care: The Latest State of the Art

by Emma Altobelli, Paolo Matteo Angeletti, Giovanni Farello and Reimondo Petrocelli

Healthcare 2023, 11(3), 283; https://doi.org/10.3390/healthcare11030283 - 17 Jan 2023

Cited by 1 | Viewed by 2066

Abstract

Background: The COVID-19 pandemic has dramatically affected all aspects of the patient’s pathway to cancer diagnosis and subsequent treatment. Our main objective was to evaluate the status of cancer trials in Ukraine as of September 2022. Methods: Initially, we examined with a narrative [...] Read more.

Background: The COVID-19 pandemic has dramatically affected all aspects of the patient’s pathway to cancer diagnosis and subsequent treatment. Our main objective was to evaluate the status of cancer trials in Ukraine as of September 2022. Methods: Initially, we examined with a narrative review the state of breast, colorectal, and cervical cancer population-based screening. Subsequently, we assessed each trial status for the years 2021 and 2022. Results: Estimates of participation in breast and cervical cancer screening are different from region to region. Moreover, regarding cervical cancer screening, extremely different participation estimates were reported: 73% in 2003 vs. <10% 2020. Our data show that from 2014 to 2020, despite the pandemic, cancer trials in Ukraine significantly increased from 27 to 44. In 2021 no trials were completed; in fact, we observed that out of 41 trials, 8 were active not recruiting, 33 were recruiting, and 0 were completed or terminated. In 2022 in Ukraine, for oncological pathologies, only 3 trials were registered, while in 2021, 41 trials were registered. The suspension of trials regarded above all concern hematological tissue (66.7%) and the genitourinary tract (60%). Conclusions: Our work has highlighted how the areas most affected by the conflict present criticalities in oncological care. Full article

(This article belongs to the Special Issue Health and Social Care Policy)

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21 pages, 1480 KiB

Open AccessArticle

Intensive Care Nurses’ Experience of Caring in Greece; A Qualitative Study

by Stelios Parissopoulos, Fiona Timmins, Meropi Mpouzika, Marianna Mantzorou, Theodore Kapadochos and Eleni Papagaroufali

Healthcare 2023, 11(2), 164; https://doi.org/10.3390/healthcare11020164 - 5 Jan 2023

Viewed by 3229

Abstract

Background: Whilst nurses and critical care services have been at the forefront of the COVID-19 pandemic, it has become more apparent that intensive care nurses are presented with challenging ethical and clinical decisions and are required to care for individuals with critical illnesses [...] Read more.

Background: Whilst nurses and critical care services have been at the forefront of the COVID-19 pandemic, it has become more apparent that intensive care nurses are presented with challenging ethical and clinical decisions and are required to care for individuals with critical illnesses under high-pressure conditions. This is not a new phenomenon. The aim of this study, which was conducted before the outbreak of COVID-19, was to explore the experience of caring through the narratives of intensive care nurses in Greece. Methods: A qualitative study was conducted through in-depth, semi-structured interviews with nineteen ICU nurses in Athens. Transcripts were subjected to Braun and Clarke’s thematic analysis and organised with Atlas.ti v8 QDA software. Results: The intensive care nurses’ experience of caring in Greece encompassed four themes: (A) being “proximal”, “co-present” and caring with empathy, (B) being “responsible” for your patient and negotiating with the doctors, (C) technology and “fighting with all you’ve got”, and (D) “not being kept informed” and disappointment. Conclusions: The narratives of this study highlight that ICU nurses in Greece provide patient-centred and compassionate care. Nurse leaders should develop appropriate healthcare policies so as to ensure the adequate provision of staff, specialist education, and support to nurses working in critical care. Failure to address these issues may lead to poor quality of care and negative patient outcomes. Full article

(This article belongs to the Special Issue Health and Social Care Policy)

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12 pages, 686 KiB

Open AccessArticle

Violence, Harassment, and Turnover Intention in Home and Community Care: The Role of Training

by Firat K. Sayin, Margaret Denton, Catherine Brookman, Sharon Davies and Isik U. Zeytinoglu

Healthcare 2023, 11(1), 103; https://doi.org/10.3390/healthcare11010103 - 29 Dec 2022

Viewed by 1865

Abstract

Background: Violence and harassment affect healthcare workers’ well-being and career decisions in the home and community care sector. Purpose: The objective of this study is to assess the role of training in alleviating the relationship between violence and harassment at work and turnover [...] Read more.

Background: Violence and harassment affect healthcare workers’ well-being and career decisions in the home and community care sector. Purpose: The objective of this study is to assess the role of training in alleviating the relationship between violence and harassment at work and turnover intention among personal support workers (PSWs). Methodology/Approach: Cross-sectional survey data from 1401 PSWs in Ontario, Canada are analyzed with structural equation modeling. Utilizing a resource perspective, the associations between job demands (i.e., violence and harassment at work), personal resources (i.e., self-esteem), job resources (i.e., workplace violence training and challenging task training), stress, and intention to stay among personal support workers (PSWs) are examined. Results: Challenging task training is positively associated with self-esteem and negatively associated with stress, whereas workplace violence training does not have a significant association with either variable. Stress has a negative relationship with intention to stay. Self-esteem is the mediator of both associations between violence and harassment at work and stress and between challenging task training and stress. Discussion: The results point to varied degrees of training effectiveness that may be shaping turnover decisions of PSWs who experience violence and harassment in home and community care organizations. Practice implications: There seems to be a need to assess and redesign workplace violence training. Home and community care managers might be able to lower the impact of violence and harassment on PSWs’ turnover by providing training that is not directly related to workplace violence and harassment. Full article

(This article belongs to the Special Issue Health and Social Care Policy)

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14 pages, 1824 KiB

Open AccessArticle

A Longitudinal Study of the Impact of Personal and Professional Resources on Nurses’ Work Engagement: A Comparison of Early-Career and Mid-Later-Career Nurses

by Satoko Nagai, Yasuko Ogata, Takeshi Yamamoto, Mark Fedyk and Janice F. Bell

Healthcare 2023, 11(1), 76; https://doi.org/10.3390/healthcare11010076 - 27 Dec 2022

Cited by 4 | Viewed by 3033

Abstract

To predict and ensure a healthy and high-performing nursing workforce, it is necessary to identify the antecedents that promote work engagement, especially among early-career nurses. To date no study has focused on this. This longitudinal survey, administered to 1204 nurses working in seven [...] Read more.

To predict and ensure a healthy and high-performing nursing workforce, it is necessary to identify the antecedents that promote work engagement, especially among early-career nurses. To date no study has focused on this. This longitudinal survey, administered to 1204 nurses working in seven general hospitals with 200 or more beds in four prefectures in Japan at two different times in 2019, aims to examine the causal relationship between the personal and professional resources for nurses to work vigorously (PPR-N) and work engagement among nurses in the early stages of their careers, considering time as a key mediating factor. The analysis of structural equation modeling using the cross-lagged effect model supported that PPR-N had significant and positive effects on work engagement after 3 months among early-career nurses with less than 10 years of nursing experience. The PPR-N is a reliable antecedent of work engagement, which is typical of early-career nurses. These results may be provided guidance for managers in overseeing the work environment to ensure a thriving sustainable nursing workforce. Full article

(This article belongs to the Special Issue Health and Social Care Policy)

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22 pages, 4268 KiB

Open AccessArticle

Hospital Management and Public Health Role of National Hospitals after Transformation into Independent Administrative Agencies

by Yoshiaki Nakagawa, Kaoru Irisa, Yoshinobu Nakagawa and Yasuhiro Kanatani

Healthcare 2022, 10(10), 2084; https://doi.org/10.3390/healthcare10102084 - 19 Oct 2022

Cited by 4 | Viewed by 2057

Abstract

The development of medical care, technological advances, and the ageing of society have led to rising medical costs. As a result, there is a demand to improve the efficiency of healthcare delivery systems, including public healthcare institutions, in order to ensure the sustainability [...] Read more.

The development of medical care, technological advances, and the ageing of society have led to rising medical costs. As a result, there is a demand to improve the efficiency of healthcare delivery systems, including public healthcare institutions, in order to ensure the sustainability of healthcare functions. In 2004, as part of national civil service reform in Japan, national hospitals were merged in order to form the National Hospital Organization (NHO). The NHO used new public management methods and was required to be self-financing and to maintain critical functions under a five-year management plan. The objective of this study was to examine whether the NHO was able to maintain its key function in the national infrastructure in terms of management. An analysis of the business conditions of the NHO was performed based on the financial statements from FY 2004 to FY 2018 using evaluation indexes. In the first and second periods, the NHO achieved its targeted management improvements. However, since FY 2014, even with the utmost restrictions on capital investment, the profits have not increased, and the free cash flow has been negative. Our results suggest that further organizational reforms are needed in order to sustain the NHO infrastructure in the long term and to withstand health crisis management during periods such as the COVID-19 pandemic. Full article

(This article belongs to the Special Issue Health and Social Care Policy)

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10 pages, 257 KiB

Open AccessArticle

Investigation of Mental and Physical Health of Nurses Associated with Errors in Clinical Practice

by Despoina Pappa, Ioannis Koutelekos, Eleni Evangelou, Evangelos Dousis, Georgia Gerogianni, Evdokia Misouridou, Afroditi Zartaloudi, Nikoletta Margari, Georgia Toulia, Polyxeni Mangoulia, Eftychia Ferentinou, Anna Giga and Chrysoula Dafogianni

Healthcare 2022, 10(9), 1803; https://doi.org/10.3390/healthcare10091803 - 19 Sep 2022

Cited by 3 | Viewed by 2045

Abstract

Background: Errors are common among all healthcare settings. The safety of patients is linked directly with nursing errors because nurses stand by them more often than any other healthcare professional. The role of mental and physical health of nurses is of great interest [...] Read more.

Background: Errors are common among all healthcare settings. The safety of patients is linked directly with nursing errors because nurses stand by them more often than any other healthcare professional. The role of mental and physical health of nurses is of great interest for a good and efficient job performance, but also for maintaining good patient care delivery. This study aimed to investigate the association between nurses’ general health and making errors during clinical practice. Methods: A total of 364 nurses completed a specially designed questionnaire anonymously and voluntarily. The sample consisted of nurses with all educational degrees. The questionnaire included demographic data and questions about general health issues, resilience status and nurses’ possible experience with errors within a hospital. Results: 65,8% of the participants stated that at least one error had happened at their workplace, and 49,4% of them reported that the error was caused by them. Somatic symptoms were found to have a positive correlation with making errors (p < 0.001). However, the other aspects of general health, which were anxiety/insomnia, social dysfunction and severe depression, had no statistical significance with adverse events. The most common type of error reported (65,5%) was a medication adverse event. Resilience level was found to be statistically significant (p < 0.001) when correlated with all aspects of general health (anxiety/insomnia, severe depression, somatic symptoms), but not with social dysfunction. Conclusion: Nurses are affected by their somatic symptoms in their daily clinical practice, making them vulnerable to making errors that compromise patient safety. A high resilience level could help them cope with unfavorable situations and prevent them from doing harm to a patient or themselves. Full article

(This article belongs to the Special Issue Health and Social Care Policy)

14 pages, 290 KiB

Open AccessArticle

Perceptions, Knowledge and Attitudes among Young Adults about Prevention of HPV Infection and Immunization

by Maria Sidiropoulou, Georgia Gerogianni, Freideriki Eleni Kourti, Despoina Pappa, Afroditi Zartaloudi, Ioannis Koutelekos, Evangelos Dousis, Nikoletta Margari, Polyxeni Mangoulia, Eftychia Ferentinou, Anna Giga, Michail Zografakis-Sfakianakis and Chrysoula Dafogianni

Healthcare 2022, 10(9), 1721; https://doi.org/10.3390/healthcare10091721 - 8 Sep 2022

Cited by 5 | Viewed by 2901

Abstract

Introduction: Human papilloma virus (HPV) is one of the most common sexually transmitted infections and is widely known as the main causative agent for cervical cancer. The aim of this study was to investigate the perceptions, knowledge and attitudes of young Greek adults [...] Read more.

Introduction: Human papilloma virus (HPV) is one of the most common sexually transmitted infections and is widely known as the main causative agent for cervical cancer. The aim of this study was to investigate the perceptions, knowledge and attitudes of young Greek adults concerning prevention of HPV infection and HPV immunization. Material and Methods: This constitutes a cross-sectional online survey. A convenience sample of young Greek adults (n = 883) residing in Greece, aged 17 to more than 35 years was surveyed from December 2020 to March 2021. Two validated questionnaires were used to collect data. Results: Participants demonstrated moderate knowledge about HPV infection and vaccination, with a mean knowledge score of 53.26 (SD ± 20.65) and 38.92 (SD ± 17.58), respectively. Cronbach’s alpha value was 0.77 and 0.80. Female participants were better informed than males. Approximately 52.3% of respondents had been vaccinated and 65.5% were willing to get vaccinated in the future. Vaccination rate was significantly associated with gender (OR = 11.99; 99% CI = 6.59–21.84), knowledge about the HPV vaccine (OR = 1.04; 99% CI = 1.03–1.04) and age (OR = 0.07; 99% CI = 0.03–0.15). Reasons for vaccine refusal were insufficient information (36.8%) and fear of side effects (19%). Correlates of positive vaccination intention were knowledge about HPV (OR = 1.02; 99% CI = 1.01–1.02). Conclusions: The findings suggest that the Greek government’s continuing HPV promotion efforts and education on the risks of HPV infection among young people are likely to increase vaccination acceptance among this group. Full article

(This article belongs to the Special Issue Health and Social Care Policy)

13 pages, 282 KiB

Open AccessArticle

Exploring Nurses’ Working Experiences during the First Wave of COVID-19 Outbreak

by Areti Stavropoulou, Michael Rovithis, Evangelia Sigala, Maria Moudatsou, Georgia Fasoi, Dimitris Papageorgiou and Sofia Koukouli

Healthcare 2022, 10(8), 1406; https://doi.org/10.3390/healthcare10081406 - 27 Jul 2022

Cited by 7 | Viewed by 2512

Abstract

During the COVID-19 outbreak, nurses employed in the clinical sector faced a number of difficulties associated with excessive workload, increased stress, and role ambiguity, which impacted nurses themselves and patient care. The aim of the present study was to investigate how Greek hospital [...] Read more.

During the COVID-19 outbreak, nurses employed in the clinical sector faced a number of difficulties associated with excessive workload, increased stress, and role ambiguity, which impacted nurses themselves and patient care. The aim of the present study was to investigate how Greek hospital nurses working in non-COVID units experienced the virus outbreak during the first wave of the pandemic. A descriptive qualitative research design was applied using a content analysis approach. To recruit the study participants a purposive sampling strategy was used. Ten nurses participated in the study. Data collection was conducted through semi-structured interviews. Content analysis revealed three themes namely, (a) emotional burden, (b) professional commitment, and (c) abrupt changes. Six subthemes were formulated and assimilated under each main theme respectively. Organizational changes, emotional burdens and feelings of fear and uncertainty, appeared to have a crucial effect on nurses and patient care. However, the professional commitment and the nurses’ effort to provide excellent nursing care remained high. Nurses demonstrated that despite the burdens caused by the COVID-19 outbreak, the pandemic era created opportunities for thoroughness and accuracy in nursing care. Full article

(This article belongs to the Special Issue Health and Social Care Policy)

12 pages, 268 KiB

Open AccessArticle

Care and Safety of Schoolchildren with Type 1 Diabetes Mellitus: Parental Perceptions of the School Nurse Role

by Marianna Drakopoulou, Panagiota Begni, Alexandra Mantoudi, Marianna Mantzorou, Georgia Gerogianni, Theodoula Adamakidou, Victoria Alikari, Ioannis Kalemikerakis, Anna Kavga, Sotirios Plakas, Georgia Fasoi and Paraskevi Apostolara

Healthcare 2022, 10(7), 1228; https://doi.org/10.3390/healthcare10071228 - 30 Jun 2022

Cited by 3 | Viewed by 2809

Abstract

Schoolchildren with type 1 diabetes mellitus (T1DM) need supervision in the management of their disorder by the school nurse, securing proper care and safety in the school environment. The aim of this study was to investigate the parents’ perceptions regarding the care and [...] Read more.

Schoolchildren with type 1 diabetes mellitus (T1DM) need supervision in the management of their disorder by the school nurse, securing proper care and safety in the school environment. The aim of this study was to investigate the parents’ perceptions regarding the care and safety of their children with T1DM at school. In this cross-sectional study, 356 parents of children with T1DM attending primary and secondary school (convenience sample) completed the “Parents’ Opinions about School-based Care for Children with Diabetes” and the “Safety of children with T1DM at school”. The majority (58.8%) noted that their children received some care from a school nurse, less than half (44.6%) declared feeling very safe concerning diabetes care, and 42.5% reported high levels of diabetes management satisfaction. Younger age of the child (p < 0.001), school nurses’ advanced diabetic care skills (p < 0.001), existence of school nurse’s office (p < 0.05) and higher educational level of the father were positively correlated with higher parental feelings of safety and satisfaction. The presence of a school nurse was associated with higher academic performance (p < 0.001), significantly fewer absences due to the disorder (p < 0.001) and better diabetes management (p < 0.043). The daily presence of a school nurse in school decreases absenteeism, greatly improves school performance and enhances diabetic management of schoolchildren with T1DM. Full article

(This article belongs to the Special Issue Health and Social Care Policy)

Review

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9 pages, 560 KiB

Open AccessReview

School Health Services and Health Education Curricula in Greece: Scoping Review and Policy Plan

by Pelagia Soultatou, Stamatis Vardaros and Pantelis G. Bagos

Healthcare 2023, 11(12), 1678; https://doi.org/10.3390/healthcare11121678 - 7 Jun 2023

Cited by 2 | Viewed by 2061

Abstract

The new generation’s health and wellbeing is of paramount importance: it constitutes United Nations’ priority, complies with Children’s Rights and responds to the Sustainable Development Goals of the United Nations. In this perspective, school health and health education, as facets of the public [...] Read more.

The new generation’s health and wellbeing is of paramount importance: it constitutes United Nations’ priority, complies with Children’s Rights and responds to the Sustainable Development Goals of the United Nations. In this perspective, school health and health education, as facets of the public health domain targeted at young people, deserve further attention after the unprecedented COVID-19 pandemic crisis in order to revise policies. The key objectives of this article are (a) to review the evidence generated over a span of two decades (2003–2023), identifying the main policy gaps by taking Greece as a case study, and (b) to provide a concrete and integrated policy plan. Following the qualitative research paradigm, a scoping review is used to identify policy gaps in school health services (SHS) and school health education curricula (SHEC). Data are extracted from four databases: Scopus, PubMed, Web of Science and Google Scholar, while the findings are categorized into the following themes following specific inclusion and exclusion criteria: school health services, school health education curricula, school nursing, all with reference to Greece. A corpus of 162 out 282 documents in English and Greek initially accumulated, is finally used. The 162 documents consisted of seven doctoral theses, four legislative texts, 27 conference proceedings, 117 publications in journals and seven syllabuses. Out of the 162 documents, only 17 correspond to the set of research questions. The findings suggest that school health services are not school-based but a function of the primary health care system, whereas health education retains a constantly changing position in school curricula, and several deficiencies in schoolteachers’ training, coordination and leadership impede the implementation. Regarding the second objective of this article, a set of policy measures is provided in terms of a problem-solving perspective, towards the reform and integration of school health with health education. Full article

(This article belongs to the Special Issue Health and Social Care Policy)

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20 pages, 1334 KiB

Open AccessReview

Basics of Sustainable Diets and Tools for Assessing Dietary Sustainability: A Primer for Researchers and Policy Actors

by Ioanna Alexandropoulou, Dimitrios G. Goulis, Theodora Merou, Tonia Vassilakou, Dimitrios P. Bogdanos and Maria G. Grammatikopoulou

Healthcare 2022, 10(9), 1668; https://doi.org/10.3390/healthcare10091668 - 31 Aug 2022

Cited by 6 | Viewed by 3648

Abstract

Climate change can have economic consequences, affecting the nutritional intake of populations and increasing food insecurity, as it negatively affects diet quality parameters. One way to mitigate these consequences is to change the way we produce and consume our food. A healthy and [...] Read more.

Climate change can have economic consequences, affecting the nutritional intake of populations and increasing food insecurity, as it negatively affects diet quality parameters. One way to mitigate these consequences is to change the way we produce and consume our food. A healthy and sustainable diet aims to promote and achieve the physical, mental, and social well-being of the populations at all life stages, while protecting and safeguarding the resources of the planet and preserving biodiversity. Over the past few years, several indexes have been developed to evaluate dietary sustainability, most of them based on the EAT-Lancet reference diet. The present review explains the problems that arise in human nutrition as a result of climate change and presents currently available diet sustainability indexes and their applications and limitations, in an effort to aid researchers and policy actors in identifying aspects that need improvement in the development of relevant indexes. Overall, great heterogeneity exists among the indicators included in the available indexes and their methodology. Furthermore, many indexes do not adequately account for the diets’ environmental impact, whereas others fall short in the economic impact domain, or the ethical aspects of sustainability. The present review reveals that the design of one environmentally friendly diet that is appropriate for all cultures, populations, patients, and geographic locations is a difficult task. For this, the development of sustainable and healthy diet recommendations that are region-specific and culturally specific, and simultaneously encompass all aspects of sustainability, is required. Full article

(This article belongs to the Special Issue Health and Social Care Policy)

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9 pages, 198 KiB

Open AccessReview

The Experience and Enlightenment of the Community-Based Long-Term Care in Japan

by Yun-Ru Zhou and Xiao Zhang

Healthcare 2022, 10(9), 1599; https://doi.org/10.3390/healthcare10091599 - 23 Aug 2022

Cited by 6 | Viewed by 2298

Abstract

(1) Background: China’s population aging situation is severe, but the construction of the long-term care insurance system is still in its infancy. Through summarizing the long-term care experience in Japan, this paper explores the suggestions for the development of long-term care in China. [...] Read more.

(1) Background: China’s population aging situation is severe, but the construction of the long-term care insurance system is still in its infancy. Through summarizing the long-term care experience in Japan, this paper explores the suggestions for the development of long-term care in China. (2) Methods: Based on literature research and policy review, we sorted out the relevant practices and safeguard measures of the long-term care insurance system in Japan, and summarized the characteristics of Japanese community care. (3) Results: In the development of long-term care services, Japan has gradually established a multi-level, systematic, and precise elderly care service model. Its community care has the characteristics of policy support, intensive intervention, complete elements, and strict evaluation. China’s long-term care services should learn from Japan’s experience, strengthen institutional guarantees, improve relevant supporting policies, encourage multiple subjects to participate in community care based on integrating community resources, and establish community care evaluation mechanism. Full article

(This article belongs to the Special Issue Health and Social Care Policy)

Other

Jump to: Research, Review

13 pages, 1136 KiB

Open AccessSystematic Review

Association between Organizational Support and Turnover Intention in Nurses: A Systematic Review and Meta-Analysis

by Petros Galanis, Ioannis Moisoglou, Ioanna V. Papathanasiou, Maria Malliarou, Aglaia Katsiroumpa, Irene Vraka, Olga Siskou, Olympia Konstantakopoulou and Daphne Kaitelidou

Healthcare 2024, 12(3), 291; https://doi.org/10.3390/healthcare12030291 - 23 Jan 2024

Cited by 3 | Viewed by 2622

Abstract

Although recent studies suggest a negative relationship between organizational support and turnover intention among nurses, there has been no systematic review on this issue. The aim of this systematic review and meta-analysis was to synthesize and evaluate the association between organizational support and [...] Read more.

Although recent studies suggest a negative relationship between organizational support and turnover intention among nurses, there has been no systematic review on this issue. The aim of this systematic review and meta-analysis was to synthesize and evaluate the association between organizational support and turnover intention in nurses. The review protocol was registered with PROSPERO (CRD42023447109). A total of eight studies with 5754 nurses were included. All studies were cross-sectional and were conducted after 2010. Quality was moderate in five studies and good in three studies. We found a moderate negative correlation between organizational support and turnover intention since the pooled correlation coefficient was −0.32 (95% confidence interval: −0.42 to −0.21). All studies found a negative correlation between organizational support and turnover intention ranging from −0.10 to −0.51. A leave-one-out sensitivity analysis showed that our results were stable when each study was excluded. Egger’s test and funnel plot suggested the absence of publication bias in the eight studies. Subgroup analysis showed that the negative correlation between organizational support and turnover intention was stronger in studies in China and Australia than those in Europe. Organizational support has a moderate negative correlation with turnover intention in nurses. However, data regarding the impact of organizational support on turnover intention are limited. Moreover, our study had several limitations, and thus, we cannot generalize our results. Therefore, further studies should be conducted to assess the independent effect of organizational support on turnover intention in a more valid way. In any case, nursing managers should draw attention to organizational support by developing effective clinical practice guidelines for nurses so as to reduce turnover intention. Full article

(This article belongs to the Special Issue Health and Social Care Policy)

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