Sign in to use this feature.

Years

Between: -

Subjects

remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline

Journals

remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline

Article Types

Countries / Regions

remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline

Search Results (4,804)

Search Parameters:
Keywords = Patient Health Questionnaire-9

Order results
Result details
Results per page
Select all
Export citation of selected articles as:
19 pages, 1645 KB  
Article
A Pilot Study on the Evaluation of an Inpatient Glycaemic Management Protocol for Enteral Feeding in People with Diabetes
by Shayna Xueli Lin, Di Zhang, Khee Ling Choo, Qinghua Tan, Puja Sharda, Nur Kalimallah Khairul Anwar, Xin Yi Hannah Luah, Zongwen Wee, Priscilla Chiam Pei Sze, Angela Koh Fang Yung, Sueziani Bte Zainudin and Ling-Jun Chen
Diseases 2026, 14(9), 312; https://doi.org/10.3390/diseases14090312 - 26 Aug 2026
Abstract
Aims: International diabetes guidelines recommend inpatient glycaemic management protocols for bolus enteral feeding in people with diabetes to improve clinical outcomes. This study aims to evaluate before and after hospital-wide implementation of an inpatient bolus enteral feeding protocol: (1) the incidence of hyperglycaemia [...] Read more.
Aims: International diabetes guidelines recommend inpatient glycaemic management protocols for bolus enteral feeding in people with diabetes to improve clinical outcomes. This study aims to evaluate before and after hospital-wide implementation of an inpatient bolus enteral feeding protocol: (1) the incidence of hyperglycaemia (>13.9 mmol/L) and hypoglycaemia (<4.0 mmol/L), (2) medication prescribing practices and capillary blood glucose monitoring and (3) health care professionals’ knowledge and confidence levels. Methods: We implemented an inpatient glycaemic management protocol for bolus enteral feeding developed by a multidisciplinary team of diabetes nurse educators and endocrinologists and approved by the institutional medical board in July 2024. This before-and-after quality improvement study was conducted over 3 months across eight inpatient wards. Adult inpatients were consecutively enrolled if they met the inclusion criteria: (1) a documented diagnosis of diabetes mellitus, (2) receiving bolus enteral feeding and (3) treatment with glucose-lowering medication. Patients listed as critically ill were excluded. Nurses working in the pilot wards were also recruited. Before implementing the protocol, diabetes nurse educators trained inpatient nurses on understanding and executing the protocol for administering capillary blood glucose monitoring and medications for patients with diabetes on enteral feeding. Nurses’ pre- and post-knowledge levels and perceived confidence were assessed using a structured questionnaire. Electronic medical records were reviewed to evaluate the incidence rates of hypoglycaemia and hyperglycaemia before and during the 3 months following protocol implementation. We also assessed adherence to protocol-recommended capillary blood glucose monitoring frequencies based on the diabetes medication regimen. Results: A total of 31 patients were observed during the 6-week baseline period and 28 patients following protocol implementation. A total of 192 clinical care episodes were audited, comprising 78 in the pre-intervention phase and 114 in the post-intervention phase. The incidence of hyperglycaemia decreased from 43.6% to 10.5%, while hypoglycaemia decreased from 3.8% to 2.6%. After adjusting for protocol adoption rates, protocol implementation was associated with significantly lower odds of hyperglycaemia (odds ratio [OR] 0.22, 95% CI [0.07, 0.65], p = 0.006). A significant increase in appropriate nursing practices was observed post-intervention (p < 0.001). Adoption of the protocol by nurses decreased the odds of hyperglycaemia by 70% (p = 0.014). Nurses’ knowledge scores improved significantly from baseline to 3 months post-implementation (p < 0.001). Conclusions: Implementation of a standardised inpatient glycaemic management protocol for PWD receiving bolus enteral feeding was associated with reduced rates of hyperglycaemia and hypoglycaemia. Larger-scale studies are warranted to evaluate the effectiveness and sustainability of wider implementation in improving clinical outcomes. Full article
Show Figures

Figure 1

17 pages, 2197 KB  
Article
Longitudinal Analysis of Associations Between Dietary Patterns and Incident Suicidal Ideation
by Yulian Kang, Yunzhe Lv, Chenyun Jiang, Qingyue Meng, Ruining Xie, Qin Gao and Yan Liu
Nutrients 2026, 18(17), 2792; https://doi.org/10.3390/nu18172792 - 26 Aug 2026
Abstract
Background/Objectives: Diet is a key modifiable determinant of mental health; however, the prospective association between dietary patterns and new-onset suicidal ideation remains poorly elucidated. Methods: We enrolled 7480 participants from demolition resettlement communities in Jining, Zoucheng, and Weifang in Shandong Province, [...] Read more.
Background/Objectives: Diet is a key modifiable determinant of mental health; however, the prospective association between dietary patterns and new-onset suicidal ideation remains poorly elucidated. Methods: We enrolled 7480 participants from demolition resettlement communities in Jining, Zoucheng, and Weifang in Shandong Province, China, during 2021–2023. Data were used from two waves (baseline and 1-year follow-up) in this study. Dietary patterns were determined using principal component analysis based on food frequency questionnaire data. Incident suicidal ideation was assessed using the ninth item of the Patient Health Questionnaire-9. Multivariable logistic regression, stratified analysis, and sensitivity analysis were used to examine associations of different dietary patterns with the risk of incident suicidal ideation. Results: Among participants, 193 (2.58%) reported incident suicidal ideation. After full multivariable adjustment, the livestock–poultry–seafood dietary pattern was significantly inversely associated with incident suicidal ideation (Q3 vs. Q1; odds ratio = 0.67; 95% confidence interval: 0.45–0.97), whereas no significant association was identified when the pattern score was modelled continuously (OR = 0.92; 95% CI: 0.79–1.06; p = 0.239). Stratified analyses revealed stronger inverse associations among men, older adults, overweight individuals, and participants who did not use dietary supplements, but all interaction p-values exceeded 0.05, with no statistically confirmed subgroup disparities. After excluding participants with baseline depression, participants with baseline anxiety, and individuals with missing covariates in sensitivity analysis, the inverse association remained statistically stable. Conclusions: Our findings suggested a modest inverse association between higher adherence to the livestock–poultry–seafood dietary pattern and new-onset suicidal ideation in this observational cohort. Full article
(This article belongs to the Section Nutritional Epidemiology)
Show Figures

Figure 1

17 pages, 768 KB  
Article
The Relationship Between Multidimensional Poverty and Depression Among Single-Parent Families: A Comparative Analysis by Gender of the Household Head
by Jinkyung Park, Donghyeon Kim and Daeyeon Jang
Healthcare 2026, 14(17), 2723; https://doi.org/10.3390/healthcare14172723 - 26 Aug 2026
Abstract
Background/Objectives: This study examines gender differences in the relationship between multidimensional poverty and depression among single-parent families, drawing on the concepts of the feminization of poverty and dual vulnerability to inform gender-sensitive policy. Methods: Using a cross-sectional design, this study analyzed data from [...] Read more.
Background/Objectives: This study examines gender differences in the relationship between multidimensional poverty and depression among single-parent families, drawing on the concepts of the feminization of poverty and dual vulnerability to inform gender-sensitive policy. Methods: Using a cross-sectional design, this study analyzed data from the 2024 Korean National Survey on Single-Parent Families, with a sample size of 3315 single-parent families. Multidimensional poverty was assessed across five domains: income, employment, housing, health, and social relations. Depression was measured using the Patient Health Questionnaire-9 (PHQ-9). Results: Poverty levels were highest in income, followed by housing, health, social relations, and employment. Female single parents experienced significantly higher poverty in income, employment, and social domains compared to males, while male single parents showed higher asset poverty. The proportion of respondents in the depressed group did not differ significantly by gender, though male and female single parents reached this similar overall level through partly different configurations of risk. Employment, health, and discrimination were common predictors of depression across genders, while lower education was an additional risk factor specific to female single parents. Depression scores rose in a linear, dose-dependent manner with the accumulation of multidimensional poverty for both genders, with a formal test indicating no significant overall difference in this pattern by gender. Conclusions: The findings suggest a critical need to shift policy from simple cash transfers to an integrated, multidimensional paradigm encompassing housing, employment, health, and stigma reduction. Policy interventions must prioritize gender-sensitive approaches tailored to the distinct risk configurations identified for male and female single parents. Full article
(This article belongs to the Section Mental Health and Psychosocial Well-being)
Show Figures

Figure 1

15 pages, 1181 KB  
Article
Work-Related Musculoskeletal Disorders Among Radiology and Ultrasound Technologists During Ramadan in Madinah, Saudi Arabia: A Cross-Sectional Study
by Abdulkareem Algahtani, Jory Alluhaibi, Monaya Altamimi, Nada Almutairi, Manar Alrehaili, Dalia Alsahli, Bashair Alhummayani, Mohammed Asiri, Abdulhadi Alkulib, Sultan Alshoabi, Awadia Gareeballah, Awatif M. Omer, Moawia Gameraddin, Reem Elkady and Kinan Mokbel
Healthcare 2026, 14(17), 2718; https://doi.org/10.3390/healthcare14172718 - 26 Aug 2026
Abstract
Background: Radiology and ultrasound technologists are exposed to sustained static postures, repetitive movements, equipment handling, and patient-positioning tasks that increase the risk of work-related musculoskeletal disorders (WRMSDs). During Ramadan, increased healthcare demand associated with Umrah may further increase occupational workload in Madinah. Objective: [...] Read more.
Background: Radiology and ultrasound technologists are exposed to sustained static postures, repetitive movements, equipment handling, and patient-positioning tasks that increase the risk of work-related musculoskeletal disorders (WRMSDs). During Ramadan, increased healthcare demand associated with Umrah may further increase occupational workload in Madinah. Objective: To estimate the 7-day prevalence of WRMSDs and identify occupational factors associated with pain intensity among radiology and ultrasound technologists working during Ramadan in Madinah. Methods: A cross-sectional online survey was conducted among 237 radiology and ultrasound technologists working in Madinah during Ramadan 1447/2026. Participants were recruited using online convenience and snowball sampling through professional networks and social-media platforms. The survey included the Nordic Musculoskeletal Questionnaire (NMQ), a 0–10 Numeric Pain Rating Scale (NPRS), and demographic and occupational variables. Bivariate analyses and multivariable linear regression with robust standard errors were used to examine factors associated with pain intensity. Results: Overall, 89.5% of participants reported WRMSDs during the preceding 7 days. The lower back (56.5%) and neck (40.5%) were the most affected regions. Mean pain intensity was 5.55 ± 2.28. Higher pain intensity was associated, after adjustment for the variables included in the model, with older age, working as an ultrasound technologist, managing 11–20 or more than 30 patients per shift, and frequent night-shifts, with the strongest association observed among participants working at least three-night-shifts per week (B = 3.27, 95% CI 2.43–4.10). BMI, sex, years of experience and shift duration were not independently associated with pain intensity after adjustment. Conclusions: WRMSDs were highly prevalent among radiology and ultrasound technologists working during Ramadan in Madinah. Night-shift frequency and very high patient workload showed the largest occupational associations with pain intensity. These findings identify workload distribution and night-shift scheduling as potential areas for occupational health evaluation during periods of increased healthcare demand. Because of the cross-sectional design, the findings should be interpreted as associations rather than causal effects. Full article
(This article belongs to the Section Healthcare Organizations, Systems, and Providers)
Show Figures

Figure 1

16 pages, 890 KB  
Article
Real-World Effectiveness and Safety of Esketamine Nasal Spray in Treatment-Resistant Depression: A Retrospective Observational Study
by Mostafa A. Sayed Ali, Palanisamy Amirthalingam, Hanan Alshareef, Mohammed Zayed Alassiry, Ahmed Samir Elshenawy, Sayed Hosam Eldin Mansour and Ahmed Aljabri
Healthcare 2026, 14(17), 2717; https://doi.org/10.3390/healthcare14172717 - 26 Aug 2026
Abstract
Background/Objectives: This study evaluated the real-world effectiveness and safety of intranasal esketamine plus oral antidepressants compared with venlafaxine-based oral antidepressant therapy in adults with moderate-to-severe treatment-resistant depression (TRD). Methods: This retrospective cohort study used electronic medical records from a mental health [...] Read more.
Background/Objectives: This study evaluated the real-world effectiveness and safety of intranasal esketamine plus oral antidepressants compared with venlafaxine-based oral antidepressant therapy in adults with moderate-to-severe treatment-resistant depression (TRD). Methods: This retrospective cohort study used electronic medical records from a mental health hospital between January 2023 and December 2025. Adults with moderately severe or severe major depressive disorder who had not responded adequately to at least two antidepressant trials received esketamine plus oral antidepressants or venlafaxine-based therapy. The outcomes were changes in the Patient Health Questionnaire-9 (PHQ-9) score, remission, response, minimal clinically important difference (MCID) without response or remission, and documented adverse events at 28 days, 3 months, and 6 months. Propensity score matching was used for continuous follow-up of the PHQ-9 outcomes. Results: The analytic baseline cohort included 82 patients treated with intranasal esketamine-based therapy and 87 treated with venlafaxine-based therapy. The esketamine group had greater baseline depression severity and more previous antidepressant failures. At 3 months, no patients who continued treatment in either group met the remission criterion, one esketamine-treated patient achieved a response, and 37/61 (60.7%) esketamine-treated patients and 23/72 (31.9%) venlafaxine-treated patients achieved MCID without response or remission. At 6 months, remission remained absent; 27/61 (44.3%) esketamine-treated patients and 9/72 (12.5%) venlafaxine-treated patients met the response criterion, whereas 34/61 (55.7%) and 63/72 (87.5%) achieved MCID without response or remission, respectively. In propensity score-matched analyses, follow-up PHQ-9 scores were 1.02 points lower at 3 months (average treatment effect [ATE], −1.02; 95% CI, −1.70 to −0.35; p = 0.003) and 1.94 points lower at 6 months (ATE, −1.94; 95% CI, −3.17 to −0.71; p = 0.002) in the esketamine group than in the venlafaxine group. Dissociation and dizziness were documented more often in the esketamine group, whereas sexual dysfunction was documented more often in the venlafaxine group. Conclusions: In this retrospective routine care cohort, esketamine was used in patients with more complex TRD and was associated with modestly lower matched follow-up PHQ-9 scores. The observational design, baseline imbalance, and attrition precluded causal conclusions. Full article
Show Figures

Figure 1

13 pages, 249 KB  
Article
Nurse–Patient Mutuality and Health-Related Quality of Life Among Nurses Caring for People with Chronic Illness: A Multicentre Cross-Sectional Study
by Camilla Ripari, Silvia Cilluffo, Barbara Bassola, Rosario Caruso, Stefano Terzoni and Maura Lusignani
Nurs. Rep. 2026, 16(9), 300; https://doi.org/10.3390/nursrep16090300 - 25 Aug 2026
Abstract
Background: Although nurses’ health-related quality of life (HRQoL) is critical for mitigating the growing intention to leave the profession, the association between nurse–patient mutuality and nurses’ HRQoL remains unexplored. Therefore, this study aims to examine the association between nurse–patient mutuality and nurses’ [...] Read more.
Background: Although nurses’ health-related quality of life (HRQoL) is critical for mitigating the growing intention to leave the profession, the association between nurse–patient mutuality and nurses’ HRQoL remains unexplored. Therefore, this study aims to examine the association between nurse–patient mutuality and nurses’ HRQoL. Methods: A cross-sectional, multicentre study was conducted across four tertiary hospitals in Italy. Data were collected from a sample of 726 nurses working in medical and surgical inpatient and outpatient wards. Mutuality was measured using the Nurse–patient Mutuality in Chronic Illness scale, comprising three dimensions: developing and going beyond, being a point of reference, deciding and sharing care; HRQoL was assessed via the Short Form-12 Health Status Questionnaire (SF-12), providing Physical (PCS) and Mental (MCS) Component Summaries. Two multiple linear regression models were conducted to evaluate the impact of mutuality dimensions on HRQoL components. Results: Among the 726 participants, none of the three mutuality dimensions were significantly associated with physical HRQoL (PCS). Conversely, two mutuality dimensions were significantly and positively associated with higher MCS scores: developing and going beyond (B = 0.54, 95% CI [0.14, 0.95], p = 0.009) and being a point of reference (B = 0.38, 95% CI [0.09, 0.68], p = 0.010). However, the overall regression model demonstrated a modest explanatory value for MCS (R2 = 0.075). Among covariates, female sex (ref: male; B = −2.29, 95% CI [−4.10, −0.49], p = 0.013) and taking care of relatives (B = −2.07, 95% CI [−3.55, −0.60], p = 0.006) were associated with lower MCS, whereas older age (B = 0.17, 95% CI [0.01, 0.34], p = 0.039) was related to higher MCS. Regarding physical health (R2 = 0.261), having chronic conditions (B = −5.08, 95% CI [−6.48, −3.69], p < 0.001), previous experience as a patient (B = −1.88, 95% CI [−3.07, −0.69], p = 0.002), and taking care of relatives (B = −1.49, 95% CI [−2.62, −0.36], p = 0.010) were significantly associated with lower PCS scores. Conclusions: The reciprocal nature of mutuality could be a potential relational resource for nurses’ mental HRQoL. Healthcare organizations should prioritize structural frameworks and interventions that allow nurses the time and resources to cultivate these essential clinical connections. Full article
12 pages, 979 KB  
Article
Health-Related Quality of Life and Mid-Term Oncological Outcomes After Subcostal Uniportal Robot-Assisted Lung Cancer Surgery: A Secondary Analysis of a Clinical Trial
by Chuan Cheng, Ya-Chun Hsu and Yin-Kai Chao
Cancers 2026, 18(17), 2763; https://doi.org/10.3390/cancers18172763 - 25 Aug 2026
Abstract
Objective: Subcostal uniportal robot-assisted thoracic surgery (URATS) using the da Vinci Single-Port (SP) system avoids intercostal placement of the main robotic access. This prespecified secondary analysis of a prospective trial characterized chronic postsurgical pain and health-related quality of life (HRQOL) as primary patient-reported [...] Read more.
Objective: Subcostal uniportal robot-assisted thoracic surgery (URATS) using the da Vinci Single-Port (SP) system avoids intercostal placement of the main robotic access. This prespecified secondary analysis of a prospective trial characterized chronic postsurgical pain and health-related quality of life (HRQOL) as primary patient-reported outcomes after subcostal URATS for early-stage lung cancer, with mid-term oncological outcomes as an exploratory endpoint. Methods: Patients from the parent trial (NCT05535712) undergoing subcostal URATS were assessed at 3, 6, and 12 months by structured telephone interviews. Chronic postsurgical pain was defined by the ICD-11 criterion (Numerical Rating Scale [NRS] > 0 on any of four activity-specific items). Neuropathic features were assessed with the painDETECT Questionnaire (PDQ), and HRQOL with EORTC QLQ-C30 summary score and selected domains. Results: In 33 patients, chronic postsurgical pain declined from 33.3% at 3 months to 6.1% at 12 months (p = 0.004), was mild among symptomatic patients (median NRS 1), and showed no PDQ-defined neuropathic features. Two patients received a 7-day course of gabapentin at 3 months. Baseline HRQOL (median QLQ-C30 summary score 91.5) increased at all postoperative time points (p < 0.001). At a median 40-month follow-up, one patient had bilateral pulmonary recurrence at 13 months, all remained alive, and no delayed hernia or other access-related complication was identified. Conclusions: Subcostal URATS was feasible in this prospective cohort. Chronic postsurgical pain was mild and decreased over time, HRQOL remained well preserved, although data on mid-term oncological outcomes were preliminary. Full article
(This article belongs to the Special Issue World Lung Cancer Awareness Month: 2nd Edition)
Show Figures

Figure 1

14 pages, 242 KB  
Article
Psychometric Validation of the Kazakh Version of the Patient Health Questionnaire-9 (PHQ-9)
by Nursultan Seksenbayev, Timur Moldagaliyev, Lazzat Zhamaliyeva, Akmaral Baspakova, Assel Baibussinova, Nabi Yessimov, Kamila Akkuzinova, Yelaman Toleuov, Shynargul Zhakiyeva, Sandugash Kudaibergenova and Ken Inoue
Healthcare 2026, 14(17), 2713; https://doi.org/10.3390/healthcare14172713 - 25 Aug 2026
Abstract
Background: Depression is a major global health burden, requiring culturally appropriate assessment instruments, but no validated Kazakh-language version of the Patient Health Questionnaire-9 (PHQ-9) is available. This study aimed to translate, culturally adapt, and evaluate the psychometric properties of the Kazakh PHQ-9 in [...] Read more.
Background: Depression is a major global health burden, requiring culturally appropriate assessment instruments, but no validated Kazakh-language version of the Patient Health Questionnaire-9 (PHQ-9) is available. This study aimed to translate, culturally adapt, and evaluate the psychometric properties of the Kazakh PHQ-9 in a community-based, non-clinical sample. Methods: This cross-sectional study included 503 Kazakh-speaking adults (mean age = 24.0 years, SD = 10.1; 51.3% women and 48.7% men) who completed the Kazakh PHQ-9 and Generalized Anxiety Disorder-7 (GAD-7) questionnaires. Internal consistency, structural validity, measurement invariance across genders, and convergent validity were assessed. Results: Internal consistency was excellent (Cronbach’s α = 0.91), and both one-factor and correlated two-factor models showed excellent fit (CFI = 0.998; TLI = 0.997–0.998; RMSEA = 0.046–0.048; SRMR = 0.050–0.052), with a slightly better fit for the latter. Measurement invariance across genders was supported, and PHQ-9 and GAD-7 scores were strongly correlated (r = 0.68, p < 0.001). Conclusions: The Kazakh PHQ-9 demonstrated excellent internal consistency and structural validity, measurement invariance across genders, and strong convergent validity in this non-clinical sample. These findings support its use for assessing depressive symptoms in Kazakh-speaking adults. Clinical validation is needed to establish diagnostic validity and screening performance. Full article
21 pages, 1925 KB  
Article
Burnout Dimensions and Associated Factors Among Orthopedic and Traumatology Physicians: A Cross-Sectional Study from Türkiye
by Ahmet Yiğitbay, Muhammet Can Ari, Başak Özge Yiğitbay, Cemal Kural and Nezih Ziroğlu
Healthcare 2026, 14(17), 2696; https://doi.org/10.3390/healthcare14172696 - 24 Aug 2026
Viewed by 138
Abstract
Background/Objectives: Burnout is an important occupational health concern among orthopedic and traumatology physicians. This study aimed to evaluate the individual dimensions of burnout and identify their demographic and occupational correlates among orthopedic and traumatology physicians practicing in Türkiye. Methods: This cross-sectional study used [...] Read more.
Background/Objectives: Burnout is an important occupational health concern among orthopedic and traumatology physicians. This study aimed to evaluate the individual dimensions of burnout and identify their demographic and occupational correlates among orthopedic and traumatology physicians practicing in Türkiye. Methods: This cross-sectional study used an anonymous online survey distributed through the Turkish Society of Orthopaedics and Traumatology electronic mailing group between October 2024 and June 2026. Burnout was assessed using the Turkish adaptation of the 22-item Maslach Burnout Inventory, comprising the Emotional Exhaustion (EE), Depersonalization (DP), and Personal Accomplishment (PA) subscales. Unadjusted group comparisons, Spearman correlation analyses, and separate multivariable linear regression models with HC3 heteroscedasticity-consistent standard errors were performed. Results: A total of 320 complete questionnaires were analyzed. The mean EE, DP, and PA scores were 20.17 ± 6.83, 7.40 ± 3.58, and 20.37 ± 4.19, respectively. The subscale scores were analyzed as continuous dimensions rather than classified using low-, moderate-, or high-burnout thresholds. In unadjusted comparisons, residents had higher EE and DP scores and lower PA scores than specialists. After adjustment, resident status remained associated with higher DP (B = 2.14, p = 0.010) and lower PA (B = −1.92, p = 0.018). Seeing more than 120 patients per day was associated with higher EE (B = 4.22, p = 0.023) and DP (B = 2.49, p = 0.018), while working more than 100 h per week was associated with higher EE (B = 4.47, p = 0.009). Individual predictor effect sizes and the explanatory power of the models were generally modest. Conclusions: Daily patient volume, weekly working hours, and professional status showed distinct associations with the individual dimensions of burnout. These findings suggest that workload organization and support for resident physicians warrant consideration. However, because of the cross-sectional design and voluntary non-probability sampling, the findings should not be interpreted as causal or nationally representative. Full article
Show Figures

Figure 1

13 pages, 622 KB  
Article
Health-Promoting Lifestyle and Psychosocial Correlates in Patients with NAFLD/MASLD and Family Members: A Comparative Cross-Sectional Study of Independent Samples
by Yuhuan Yu and Lili Ji
Healthcare 2026, 14(17), 2686; https://doi.org/10.3390/healthcare14172686 - 24 Aug 2026
Viewed by 102
Abstract
Background/Objectives: Lifestyle modification is central to non-alcoholic fatty liver disease, now termed metabolic dysfunction-associated steatotic liver disease (NAFLD/MASLD), yet comparable health-promoting lifestyle (HPL) data for patients and family members are limited. This study compared two independent samples and examined psychosocial correlates. Methods: Two [...] Read more.
Background/Objectives: Lifestyle modification is central to non-alcoholic fatty liver disease, now termed metabolic dysfunction-associated steatotic liver disease (NAFLD/MASLD), yet comparable health-promoting lifestyle (HPL) data for patients and family members are limited. This study compared two independent samples and examined psychosocial correlates. Methods: Two convenience samples recruited at one tertiary hospital were analyzed: 305 adults with NAFLD/MASLD and 299 adult family members of affected patients. A self-administered electronic questionnaire comprised the Health-Promoting Lifestyle Profile II (HPLP-II), the Self-Rated Abilities for Health Practices scale, autonomous-motivation items from the Treatment Self-Regulation Questionnaire, the Medical Outcomes Study Social Support Survey, and sociodemographic items. Group comparisons used parametric and non-parametric tests. HPL correlates were examined using complete-case regression, HC3 inference, and rank-based sensitivity analysis. Cross-sectional indirect-association decompositions used 5000 bootstrap resamples. Results: HPLP-II scores were 102.2 ± 17.5 in patients and 104.2 ± 17.4 in family members (p = 0.171; Mann–Whitney p = 0.166); the adjusted patient-minus-family difference was −1.14 (HC3 95% CI −3.89 to 1.60; p = 0.413). Physical activity was the lowest-scoring dimension. Self-efficacy was the most robust correlate in both samples; social support was associated in the primary models but weakened under rank transformation in family members. Group-by-correlate interactions were not significant. Exploratory indirect associations through self-efficacy were 0.355 (95% bootstrap CI 0.234–0.512) in patients and 0.163 (0.071–0.287) in family members; reverse-order models were also non-zero. Conclusions: The independent unmatched samples reported similar moderate, physically inactive lifestyles. The results identify associations, not shared-household effects or causal mechanisms; objectively characterized, dyad-matched longitudinal studies are needed. Full article
Show Figures

Figure 1

15 pages, 281 KB  
Article
Comparative Effectiveness of Mebeverine and Otilonium Bromide on Health-Related Quality of Life in Patients with Irritable Bowel Syndrome: A Prospective Cohort Study
by Anh Thi Phuong Luu and Thong Duy Vo
Life 2026, 16(9), 1390; https://doi.org/10.3390/life16091390 - 24 Aug 2026
Viewed by 81
Abstract
Irritable bowel syndrome (IBS) is a common chronic gastrointestinal disorder that significantly impairs patients’ quality of life. Antispasmodics such as mebeverine and otilonium bromide (OB) are commonly used as first-line therapies; however, comparative evidence regarding their effectiveness and safety profile remains limited. This [...] Read more.
Irritable bowel syndrome (IBS) is a common chronic gastrointestinal disorder that significantly impairs patients’ quality of life. Antispasmodics such as mebeverine and otilonium bromide (OB) are commonly used as first-line therapies; however, comparative evidence regarding their effectiveness and safety profile remains limited. This study aimed to compare short-term changes in health-related quality of life and the occurrence of adverse events among IBS patients receiving mebeverine or otilonium bromide. A prospective cohort study was conducted from December 2024 to July 2025 among 110 IBS patients meeting the Rome IV criteria who received either mebeverine 200 mg or OB 40 mg twice daily for 4 weeks. The IBS-specific quality-of-life questionnaire (IBS-QOL) was interviewer-administered at baseline and after treatment (week 4). Adverse drug events were documented and classified according to the Common Terminology Criteria for Adverse Events (CTCAE). After 4 weeks, significant within-group improvements in the overall IBS-QOL score and most domain scores were observed in both treatment groups. In the unadjusted between-group analysis, the mean improvement in the overall IBS-QOL score was greater in the mebeverine group than in the otilonium bromide group (20.31 ± 13.17 vs. 14.62 ± 14.61; p = 0.034). However, treatment group was not independently associated with change in the overall IBS-QOL score after multivariable adjustment (OB vs. mebeverine: B = −4.63, 95% CI −10.28 to 1.02; p = 0.107). Nominal differences in activity interference and health worry did not remain statistically significant after Holm correction for multiple domain-level comparisons. Adverse events occurred in 9 of 110 patients (8.2%), with no significant difference between the mebeverine and otilonium bromide groups (11.7% vs. 4.0%; Fisher’s exact p = 0.178). All reported events were mild. In this prospective observational cohort, both mebeverine and otilonium bromide use was associated with short-term improvement in health-related quality of life and low rates of mild adverse events. Although the unadjusted change in the overall IBS-QOL score favored mebeverine, the adjusted analysis did not establish an independent difference between the two treatments. Full article
13 pages, 262 KB  
Article
Association Between Periodontitis Severity and Oral Health-Related Quality of Life: A Cross-Sectional Study Using the 2017 Periodontitis Classification
by Gabriela Zambrano Manzaba, Jazmin Rodríguez Grajales, Hector Alfredo Lema Gutierrez, Luis Chauca Bajaña, Mónica Gabriela Magaña Pérez, Gema Nallely Mendoza Manzaba, Rito Alfonso Salazar Roman, Daniela Galicia-Diez Barroso and Luis David Abeijon Malvaez
Healthcare 2026, 14(17), 2678; https://doi.org/10.3390/healthcare14172678 - 23 Aug 2026
Viewed by 157
Abstract
Background: Periodontitis is a chronic inflammatory disease characterized by progressive destruction of the tooth-supporting tissues and may substantially impair oral health-related quality of life (OHRQoL). Although the clinical consequences of periodontitis are well documented, the extent to which disease severity is associated with [...] Read more.
Background: Periodontitis is a chronic inflammatory disease characterized by progressive destruction of the tooth-supporting tissues and may substantially impair oral health-related quality of life (OHRQoL). Although the clinical consequences of periodontitis are well documented, the extent to which disease severity is associated with patient-reported outcomes remains insufficiently understood. This study aimed to evaluate the association between periodontitis severity and OHRQoL and to examine sociodemographic, behavioral, and systemic factors associated with poorer OHRQoL. Methods: A cross-sectional analytical study was conducted among 136 adult patients diagnosed with stage II or stage IV periodontitis at the Periodontology Clinic of Universidad Tecnológica de México (UNITEC). OHRQoL was assessed using the Oral Health Impact Profile for Periodontal Disease (OHIP-14-PD). Sociodemographic characteristics, smoking status, and diabetes mellitus were recorded using a structured questionnaire. Periodontal status was determined through standardized clinical and radiographic examinations. The internal consistency of the OHIP-14-PD was evaluated using Cronbach’s alpha coefficient. Bivariate analyses were performed using non-parametric tests. An exploratory, partially adjusted multivariable linear regression model including sex, marital status, diabetes mellitus, and periodontitis stage was also performed. Results: Stage IV periodontitis was more prevalent than stage II periodontitis (55% vs. 45%). The mean OHIP-14-PD score was 24.9 ± 13.7, and the instrument demonstrated excellent internal consistency (Cronbach’s α = 0.89). Patients with stage IV periodontitis had significantly higher OHIP-14-PD scores than those with stage II disease (30.1 ± 12.4 vs. 18.6 ± 12.6; p < 0.001), indicating poorer OHRQoL. In the bivariate analyses, poorer OHRQoL was also observed among current smokers, participants with diabetes mellitus, those with lower educational attainment, and those with lower socioeconomic status (p < 0.05). In the exploratory partially adjusted model, male sex (β = 4.2; 95% CI: 0.1–8.2; p = 0.042), diabetes mellitus (β = 6.5; 95% CI: 2.1–10.9; p = 0.004), and stage IV periodontitis (β = 4.6; 95% CI: 0.4–8.7; p = 0.031) were associated with higher OHIP-14-PD scores. Conclusions: In this single-center cross-sectional sample, patients with stage IV periodontitis reported higher OHIP-14-PD scores than those with stage II periodontitis. These findings indicate an association within the studied clinical population and should not be interpreted as evidence of a causal effect or as directly generalizable to broader populations. Larger multicenter longitudinal studies including patients across all periodontitis stages are required to confirm the magnitude and external validity of this association. Full article
17 pages, 370 KB  
Article
Depression and Anxiety Symptoms Among Combustible Cigarette Smokers, Heated Tobacco Users, and Non-Smokers: A Cross-Sectional Study in Lithuania
by Liudas Vincentas Sinkevicius, Sandra Sakalauskaite, Karolis Rakauskas, Margus Lõokene, Rasa Pilkauskaite Valickiene and Danielius Serapinas
Medicina 2026, 62(9), 1618; https://doi.org/10.3390/medicina62091618 - 22 Aug 2026
Viewed by 121
Abstract
Background and Objectives: Tobacco smoking is associated with an increased risk of depression and anxiety symptoms, but it remains unclear whether this relationship differs according to the type of nicotine product used. The increasing popularity of heated tobacco products has created a [...] Read more.
Background and Objectives: Tobacco smoking is associated with an increased risk of depression and anxiety symptoms, but it remains unclear whether this relationship differs according to the type of nicotine product used. The increasing popularity of heated tobacco products has created a need to better understand their association with mental health, particularly in comparison with combustible cigarettes. Therefore, this study aimed to compare the prevalence of depression and anxiety symptoms among combustible cigarette (CC) users, heated tobacco product (HTP) users, and non-smokers. Materials and Methods: A cross-sectional study was conducted among 497 adults. Participants were classified into three groups according to their tobacco-use status: combustible cigarette smokers, heated tobacco users, and non-smokers. Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9), and anxiety symptoms were assessed using the Generalized Anxiety Disorder-7 (GAD-7). Group differences were evaluated using hierarchical linear regression analyses adjusted for sociodemographic, health, and lifestyle factors. Results: Tobacco-use group significantly improved the model fit for PHQ-9 (ΔR2 = 0.0575, p < 0.001) and GAD-7 (ΔR2 = 0.0764, p < 0.001). In non-smokers, scores of depression were 3.48 lower than in CC users and 1.42 lower than in the HTP users’ group. In HTP users, these scores were 2.06 lower than in the CC users’ group. Anxiety scores were 3.71 lower in non-smokers than in CC users, and 1.29 lower than in the HTP users’ group. In the HTP users’ group, this score was 2.42 lower than in the CC users’ group. HC3 robust standard errors with 5000-sample BCa bootstrap confidence intervals and reduced-adjustment sensitivity analyses confirmed the primary pattern. Conclusions: Our study results showed that combustible cigarette users had the highest adjusted depression and anxiety scores, HTP users had intermediate scores, and non-smokers had the lowest. In both tobacco-using groups, greater product-specific nicotine dependence was associated with higher PHQ-9 and GAD-7 scores. Further interdisciplinary studies incorporating biomarkers of nicotine exposure, HPA axis function, inflammation, and oxidative stress are needed to clarify whether the observed differences reflect the characteristics of individuals who choose specific tobacco products or are partly attributable to product-specific effects. Full article
(This article belongs to the Special Issue Mental Illness and Mental Health: Challenges, Trends and Perspectives)
23 pages, 1641 KB  
Article
Dietary Habits, Nutritional Knowledge, and Quality of Life Among Patients with Gastrointestinal Cancers: An Exploratory Cross-Sectional Survey
by Katarzyna Antosik, Damian Dyńka, Elżbieta Krzęcio-Nieczyporuk, Maja Księżopolska, Milena Kobylińska and Katarzyna Kurowska
J. Clin. Med. 2026, 15(17), 6508; https://doi.org/10.3390/jcm15176508 - 22 Aug 2026
Viewed by 130
Abstract
Background: Cancer is one of the leading causes of morbidity and mortality worldwide, and epidemiological projections indicate that its incidence will continue to increase. Gastrointestinal cancers are among the most frequently diagnosed malignant neoplasms. Quality of life is a key component of [...] Read more.
Background: Cancer is one of the leading causes of morbidity and mortality worldwide, and epidemiological projections indicate that its incidence will continue to increase. Gastrointestinal cancers are among the most frequently diagnosed malignant neoplasms. Quality of life is a key component of oncology care and is significantly influenced by nutritional status and dietary habits. Methods: The study included 52 adult patients diagnosed with gastrointestinal cancer. Data were collected using an anonymous questionnaire based on the QEB (Questionnaire of Eating Behaviour) and WHOQOL-BREF (World Health Organization Quality of Life—BREF) instruments, supplemented with questions regarding changes in dietary habits and the use of dietary counseling following diagnosis. Nutritional knowledge, dietary habits, and quality of life across four domains (physical, psychological, social, and environmental) were assessed. Statistical analysis was performed using descriptive statistics and appropriate tests of statistical significance. Results: Cancers of the colon and rectum—reported either as unspecified colorectal cancer or as separately specified colon or rectal cancer—together accounted for the largest share of diagnoses (26 diagnoses, representing 44.8% of the 58 total reported diagnoses). Quality-of-life assessment revealed the lowest scores in the physical domain and the highest scores in the social domain. The youngest participants achieved the highest scores in the psychological domain, whereas the lowest scores across all domains were observed among individuals aged over 60 years. Following diagnosis, 63.5% of participants reported reviewing and modifying their dietary habits; however, the majority had not received dietary counseling. Women reported higher fruit and vegetable consumption than men, while higher educational attainment was associated with greater self-assessed nutritional knowledge. Conclusions: Among patients with gastrointestinal cancers surveyed in this study, the physical domain of quality of life had the lowest WHOQOL-BREF score. Most participants reported modifying their dietary habits after diagnosis, although most had not received formal dietary counseling. Higher educational attainment was associated with higher self-assessed nutritional knowledge. Given the small convenience sample and cross-sectional design, these findings should be considered exploratory. Full article
(This article belongs to the Section Gastroenterology & Hepatopancreatobiliary Medicine)
Show Figures

Figure 1

24 pages, 1050 KB  
Article
Usability and Technology Acceptance of a Wearable Monitoring System Among Patients with Cardiovascular Diseases: A Cross-Sectional Study
by Marian Morenci, Diana Carina Iovanovici, Carmen Delia Cseppento Nistor, Sebastian Tirla, Anett Jolán Karetka, Rareș Gheorghe Mihuț, Akos Tiboldi, Lisa Lichtenegger, Laura Ioana Bondar and Tünde Jurca
Medicina 2026, 62(8), 1607; https://doi.org/10.3390/medicina62081607 - 21 Aug 2026
Viewed by 254
Abstract
Background and Objectives: Wearable health technologies have become increasingly important in the remote management of cardiovascular diseases (CVDs); however, their successful implementation depends not only on technical performance but also on patient usability and technology acceptance. This study aimed to evaluate the perceived [...] Read more.
Background and Objectives: Wearable health technologies have become increasingly important in the remote management of cardiovascular diseases (CVDs); however, their successful implementation depends not only on technical performance but also on patient usability and technology acceptance. This study aimed to evaluate the perceived usability and technology acceptance of a wearable monitoring system among patients with CVDs and to investigate whether demographic and clinical characteristics influenced these outcomes. Materials and Methods: A cross-sectional observational study was conducted among 60 patients with CVDs enrolled in a six-month wearable monitoring program at the Medical Rehabilitation Outpatient Clinic of the Avram Iancu Clinical Hospital, Oradea, Romania. Participants used a Garmin vívosmart® 5 fitness tracker to continuously monitor physiological and behavioral parameters. At the end of the monitoring period, perceived ease of use (PEU) was assessed using the System Usability Scale (SUS), while technology acceptance was evaluated using a Technology Acceptance Model (TAM)-based questionnaire. Descriptive statistics, reliability analysis, Spearman’s rank correlation, and multiple linear regression analyses were performed. Results: The wearable monitoring system demonstrated high PEU, with a median SUS score of 82.5 (IQR = 23.1) and a mean score of 75.5 ± 17.6. Overall, 75.0% of participants rated the system as having good or excellent usability. The SUS questionnaire demonstrated acceptable internal consistency (Cronbach’s α = 0.730; McDonald’s ω = 0.741). Technology acceptance was generally favorable, with an overall median TAM-based score of 1.33 (IQR = 0.78). Age and comorbidity burden were not associated with PEU, and no participant characteristics independently predicted SUS scores. Although the overall regression model was not statistically significant, age showed a statistically significant association with the overall TAM-based score (β = 0.328, p = 0.037). Significant positive correlations were observed between PU, self-efficacy (SE), and reverse-scored technology anxiety (TA) measure (p < 0.001). Conclusions: Patients with CVDs reported high PEU and favorable acceptance of wearable monitoring technology. While usability appeared independent of demographic and clinical characteristics, technology acceptance showed an exploratory association with age, although the overall regression model was not statistically significant. These findings support the integration of wearable monitoring systems into routine cardiovascular care and highlight the importance of patient-centered implementation strategies to promote long-term engagement. Full article
Show Figures

Figure 1

Back to TopTop