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16 pages, 274 KiB  
Article
Exploring an Intervention to Enhance Positive Mental Health in People with First-Episode Psychosis: A Qualitative Study from the Perspective of Mental Health Professionals
by Júlia Rolduà-Ros, Antonio Rafael Moreno-Poyato, Joana Catarina Ferreira Coelho, Catarina Nogueira, Carlos Alberto Cruz Sequeira, Sónia Teixeira, Judith Usall and Maria Teresa Lluch-Canut
Healthcare 2025, 13(15), 1834; https://doi.org/10.3390/healthcare13151834 - 28 Jul 2025
Viewed by 261
Abstract
Background/Objectives: This study explores the perspectives of mental health professionals on tailoring the Mentis Plus intervention to enhance positive mental health (PMH) in individuals experiencing First-Episode Psychosis (FEP). Although the Mentis Plus Program has been previously implemented in other contexts, it has not [...] Read more.
Background/Objectives: This study explores the perspectives of mental health professionals on tailoring the Mentis Plus intervention to enhance positive mental health (PMH) in individuals experiencing First-Episode Psychosis (FEP). Although the Mentis Plus Program has been previously implemented in other contexts, it has not yet been applied to FEP care. Therefore, this study aimed to adapt the intervention for future implementation through expert consultation. Methods: A qualitative exploratory-descriptive design was employed. Data were collected via three focus groups comprising multidisciplinary professionals experienced in FEP care. Qualitative content analysis was used to examine the data. Results: Participants viewed the tailored Mentis Plus intervention as a valuable, recovery-oriented tool. Key recommendations included a flexible, group-based format with eight weekly sessions. Suggested intervention components encompassed gratitude journaling, emotional regulation techniques, and collaborative problem-solving exercises. Group delivery was highlighted as essential for mitigating isolation and promoting peer support. Practical implementation strategies included phased session structures and routine emotional check-ins. Identified barriers to implementation included the need for specialized training, limited therapeutic spaces, and the heterogeneity of participant needs. Facilitators included a person-centered approach, institutional backing, and sufficient resources. Conclusions: The findings support the feasibility and clinical relevance of a tailored Mentis Plus FEP Program—Brief Version. Expert-informed insights provide a foundation for adapting mental health interventions to early-psychosis care and inform future research and implementation strategies. Full article
27 pages, 665 KiB  
Review
On–Off Childhood? A Rapid Review of the Impact of Technology on Children’s Health
by Diana Borges, Inês Pinto, Octávio Santos, Ivone Moura, Iara Rafaela Ferreira, Ana Paula Macedo and Adriana Taveira
Healthcare 2025, 13(14), 1769; https://doi.org/10.3390/healthcare13141769 - 21 Jul 2025
Viewed by 310
Abstract
Background/Objectives: The use of digital technologies among children and adolescents has been increasing exponentially, raising concerns about the potential impacts on physical, mental, cognitive, educational, and social development. Understanding these effects is key to informing clinical and educational practices and public policies [...] Read more.
Background/Objectives: The use of digital technologies among children and adolescents has been increasing exponentially, raising concerns about the potential impacts on physical, mental, cognitive, educational, and social development. Understanding these effects is key to informing clinical and educational practices and public policies that promote digital wellbeing in childhood and adolescence. The main objective of this study was to map the latest available scientific evidence on the patterns of digital technology use by children and adolescents and its main impact, identifying risk factors, opportunities, and strategies for promoting digital wellbeing. Methods: A rapid review was carried out following the Joanna Briggs Institute (JBI) guidelines. Quantitative, qualitative, and mixed studies published between 2020 and 2025, in Portuguese or English, that addressed the use of digital technologies by children and adolescents were included. The assessment of methodological quality was based on JBI’s Critical Appraisal Tools. Results: Ten studies from diverse contexts showed an association between excessive screen time and risks of sedentary lifestyles, sleep disorders, anxiety, depression, attention difficulties, and low academic performance. Occasional benefits arose with adult mediation and educational use; parental mediation and socioeconomic background were key factors. Conclusions: The use of digital technologies is a complex and multifactorial phenomenon that requires integrated approaches; the promotion of digital literacy, public policies for equitable access to quality digital resources, and longitudinal and intercultural studies are recommended to clarify causal relationships and adapt interventions to local contexts. Full article
(This article belongs to the Special Issue Preventive Care in Healthcare—2nd Edition)
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12 pages, 242 KiB  
Article
Knowledge of Homosexuality and Attitudes Toward Lesbian and Gay Parenting Among Israeli Nurses in Mother-Child Health Clinics
by Eitan Gur, Oren Wacht, Dorit Segal-Engelchin and Orli Grinstein-Cohen
Societies 2025, 15(7), 189; https://doi.org/10.3390/soc15070189 - 6 Jul 2025
Viewed by 529
Abstract
The growing number of lesbian and gay (LG) parent families in Israel, along with the increasing involvement of nurses in Mother-Child Health Clinics (MCHCs) in supporting them, served as the impetus for this study. The study aimed to examine (1) MCHC nurses’ knowledge [...] Read more.
The growing number of lesbian and gay (LG) parent families in Israel, along with the increasing involvement of nurses in Mother-Child Health Clinics (MCHCs) in supporting them, served as the impetus for this study. The study aimed to examine (1) MCHC nurses’ knowledge of homosexuality and attitudes toward LG parenting; (2) the association between their knowledge and attitudes; and (3) their association with socio-demographic, professional, and LG-related characteristics. Findings from 65 MCHC nurses revealed moderate levels of knowledge about homosexuality, low levels of negative attitudes, and moderate levels of positive attitudes toward LG parenting. Nurses who were Jewish, secular, or living in a city had greater knowledge about homosexuality and fewer negative beliefs about LG parenting. Acquaintance with LG individuals was associated with fewer negative beliefs about LG parenting. Greater knowledge about homosexuality correlated with fewer negative beliefs and more positive perceptions of LG parenting, suggesting that enhanced knowledge fosters more positive attitudes toward LG parenting. The findings emphasize the need for tailored, knowledge-based training in nursing education for MCHC settings, considering nurses’ diverse cultural backgrounds, level of religiosity, and familiarity with LG individuals. Incorporating content on homosexuality and LG parenting may promote more inclusive and supportive care practices. Full article
(This article belongs to the Special Issue Queer Care: Addressing LGBTQ+ Needs in Healthcare and Social Services)
20 pages, 510 KiB  
Article
The Emotional Universe of Nonbinary Parents: A Hermeneutic Study
by Victoria Emilia Souviron-Dixon, Pablo Martínez-Angulo, María del Rocío Jiménez-Mérida and Pedro E. Ventura-Puertos
Healthcare 2025, 13(12), 1467; https://doi.org/10.3390/healthcare13121467 - 18 Jun 2025
Viewed by 438
Abstract
Introduction: Nonbinary individuals who do not identify as exclusively male or female often face unique emotional challenges due to societal cisheteronormativity and limited recognition of their identities. While existing research has primarily focused on anxiety, depression, and pathways to parenthood among nonbinary [...] Read more.
Introduction: Nonbinary individuals who do not identify as exclusively male or female often face unique emotional challenges due to societal cisheteronormativity and limited recognition of their identities. While existing research has primarily focused on anxiety, depression, and pathways to parenthood among nonbinary people, little attention has been paid to their comprehensive emotional experiences as parents. This study aims to explore the emotional universe of two nonbinary parents from Spain and the United States. Design: Hermeneutic study. Materials and Methods: We implemented purposive sampling, conducted semi-structured virtual interviews, and followed Ricoeur’s theory of interpretation for data analysis. We used the Universe of Emotions affective taxonomy as a starting category in this analysis. Our sample consisted of a 32-year-old white Spanish nurse (she/they/them), assigned female at birth and parent of two one-year-old toddlers, and a 34-year-old white North American physiotherapist (he/they/them) assigned female at birth and parent of a ten-year-old child. Results: Through its four themes (A story of misunderstanding: “What are you, a combat helicopter?”; Clearly, you don’t fit, so…; But (a new) family is there; No monster here: I’m, at the core, a human being), this study reveals the complex emotional journey experienced by two nonbinary parents. Conclusions: Central to this journey are three key emotions: strangeness, belonging, and acceptance. The participants describe an initial stage marked by body and social dysphoria, confusion, and rejection, followed by a transformative process in which parenthood becomes a catalyst for emotional and identity integration. This transition—from alienation to connection—reflects a broader movement from dehumanization to humanization, where the experience of parenting fosters emotional resilience, social recognition, and a renewed sense of self. Implications for the profession and/or patient care: Analyzing their emotions (both negative and positive ones), we obtained robust insights into these parents’ personal and social contexts. Therefore, we can facilitate understanding of the emotional complexity of nonbinary parents by the trans and cisgender communities. Through this understanding, nurses and the organizations they work for can improve their competence in their holistic care. Acceptance from nonbinary parents’ social contexts, of which nursing is a part, is a critical factor in their health and emotional wellbeing. Full article
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20 pages, 523 KiB  
Article
The Mediating Role of Burnout in the Relationship Between Emotional Intelligence and Work Engagement Among Hospital Nurses: A Structural Equation Modeling Approach
by Bushra Alshammari, Petelyne Pangket, Awatif Alrasheeday, Nadiah Baghdadi, Sameer A. Alkubati, Dolores Cabansag, Neriza Gugoy, Sahar Mazied Alshammari, Abdulaziz Alanazi, Mohammed Dhaifallah Alanezi, Tahani Alshammari, Randy Mateo Valdez, Salman Alshammari, Laila Alharbi, Aliyu Alhaji Abubakar, Alia Alshammari and Farhan Alshammari
Nurs. Rep. 2025, 15(6), 208; https://doi.org/10.3390/nursrep15060208 - 9 Jun 2025
Viewed by 1162
Abstract
Aim: This study aimed to explore the relationships between burnout, emotional intelligence (EI), and work engagement (WE) among hospital nurses. Specifically, it examined the mediating role of burnout in the relationship between EI and WE. Background: Nurses are frequently exposed to emotionally [...] Read more.
Aim: This study aimed to explore the relationships between burnout, emotional intelligence (EI), and work engagement (WE) among hospital nurses. Specifically, it examined the mediating role of burnout in the relationship between EI and WE. Background: Nurses are frequently exposed to emotionally and physically demanding environments, which may lead to sustained occupational stress. Prolonged exposure to such conditions can contribute to burnout, adversely affecting both personal well-being and professional performance. EI is increasingly recognised as a protective factor that may alleviate burnout and enhance WE. Methods: A quantitative, cross-sectional correlational design was employed. A quota sampling technique was used to select 336 nurses working in public healthcare facilities in Ha’il, Saudi Arabia. Data were collected using standardised self-report instruments: the 14-item Shirom–Melamed Burnout Questionnaire (SMBM), the short-form Genos Emotional Intelligence Inventory (Genos EI), and the 9-item Utrecht Work Engagement Scale (UWES-9). Structural equation modelling examined associations and the mediating role of burnout between EI and WE. Results: EI was positively associated with WE and negatively with burnout. Burnout, in turn, was negatively associated with WE. Mediation analysis confirmed that burnout partially mediated the effect of EI on WE, indicating that EI nurses were less likely to experience burnout and more likely to remain engaged in their roles. Discussion: The results emphasise the role of EI in reducing burnout and enhancing WE among nurses. Burnout partially mediates this relationship, suggesting that EI influences WE both directly and indirectly. Conclusions and Implications for Nursing: Integrating EI training into professional development and implementing measures to reduce burnout may improve WE and retention. Policy efforts should ensure supportive work environments and adequate staffing to sustain nurse well-being. Full article
(This article belongs to the Section Mental Health Nursing)
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9 pages, 766 KiB  
Article
Prevalence and Intensity of Pediculus humanus capitis in Kindergarten and Primary School Children in Poland
by Marcin Padzik, Gabriela Olędzka, Anita Gromala-Milaniuk, Ewa Kopeć and Edyta Beata Hendiger-Rizo
J. Clin. Med. 2025, 14(11), 3942; https://doi.org/10.3390/jcm14113942 - 3 Jun 2025
Viewed by 510
Abstract
Background/Objectives: Head lice is an ever-present public health issue, especially among the child population. The diagnosis of head lice infestation should be based on direct examination of the scalp, but, in practice, this standard is often not followed, giving way to indirect methods, [...] Read more.
Background/Objectives: Head lice is an ever-present public health issue, especially among the child population. The diagnosis of head lice infestation should be based on direct examination of the scalp, but, in practice, this standard is often not followed, giving way to indirect methods, such as questionnaires or sales reports of delousing shampoos. In Poland, there is no national pediculosis capitis control strategy; therefore, the aim of this study was to determine the prevalence and associated factors of head lice infestation in schools and kindergartens in the years 2021–2023. Methods: Children aged from 3 to 14 years old were directly examined by certified nurses. The same educational institutions were examined across 2021–2023. No personal data of the children were gathered. Results: The prevalence of head lice infestation among children ranged from 8% to 13%, with significantly higher intensity and prevalence observed in girls compared to boys. Conclusions: The prevalence of pediculosis capitis among children in Poland remains persistent and relatively stable over the monitored period. Gender emerged as a significant factor, showing a strong association with both the intensity and extent of head lice infestation. Full article
(This article belongs to the Section Infectious Diseases)
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15 pages, 218 KiB  
Article
Selected Moral Issues and the Stress Experienced by Paediatric Nurses
by Anna Stefanowicz-Bielska, Magdalena Słomion, Agnieszka Olińska, Małgorzata Rąpała, Julia Behling and Joanna Stefanowicz
Healthcare 2025, 13(11), 1306; https://doi.org/10.3390/healthcare13111306 - 30 May 2025
Viewed by 405
Abstract
Background/Objectives: The high sensitivity of paediatric nurses directly influences the quality of nursing care provided to patients. The purpose of this study is to present the most frequent issues faced by paediatric nurses in their everyday work and their responses to difficult [...] Read more.
Background/Objectives: The high sensitivity of paediatric nurses directly influences the quality of nursing care provided to patients. The purpose of this study is to present the most frequent issues faced by paediatric nurses in their everyday work and their responses to difficult situations at work, define the actions applied when a difficult situation occurs, and assess the level of stress and other factors influencing the level of stress experienced by paediatric nurses. Methods: This study was conducted using an original survey form and a standardised psychological questionnaire based on the Perceived Stress Scale (PSS-10) for paediatric nurses. Results: The study involved 416 paediatric nurses and indicated a medium level of stress among the nurses. The median stress level, calculated as the sum of answers to questions based on the PSS-10, was 18 (16.0 ÷ 20.0), and the mean was 17.9 (min–max = 1–30). The median Sten score was 6 (5.0 ÷ 7.0), and the mean Sten score was 5.94 (min–max = 2–9). Nurses aged 21–30 years, who live in a city, have a Bachelor of Science in Nursing or a Master of Science in Nursing, and work ≥ 61 h a week and 161–250 h a month experience a higher level of stress. Factors such as choosing which child to help first, spending a great deal of time filling out medical documentation, obtaining a sick child’s consent to perform nursing procedures which the child does not understand, involving the minor in decision-making, impolite or offensive behaviour from a sick child or their parents, ineffective nursing and treatment methods, providing care against the opinion/views of a sick child or their parents, difficulties in or a lack of understanding of the situation of a sick child and their family, performing nursing procedures that can cause the child pain, and the inability to fulfil a sick child’s request increase the level of stress experienced by paediatric nurses. When a difficult situation occurs at work occurs, the nurses usually meet and talk about the situation with someone close (72.4%) or engage in other activities to avoid thinking about the situation (66.6%). They consult a psychologist/psychotherapist very rarely (9.6%) and a psychiatrist extremely rarely (4.6%). Conclusions: Polish paediatric nurses were found to experience a medium level of stress. Since paediatric nurses are exposed to stress, providing them with psychological care is important. The level of perceived stress is dependent on the nurse’s age, place of residence, and education, as well as weekly and monthly working durations. Paediatric nurses experience many difficult situations in their everyday work that influence their stress levels. Management should pay special attention to difficult workplace situations faced by paediatric nurses and implement regular actions to reduce the levels of stress experienced. Full article
23 pages, 1427 KiB  
Article
Disparities in Healthcare Utilization Among Vulnerable Populations During the COVID-19 Pandemic in Brazil: An Intersectional Analysis
by Letícia Perticarrara Ferezin, Rander Junior Rosa, Heriederson Sávio Dias Moura, Mônica Chiodi Toscano de Campos, Felipe Mendes Delpino, Murilo César do Nascimento, Juliana Soares Tenório de Araújo, Ione Carvalho Pinto and Ricardo Alexandre Arcêncio
Int. J. Environ. Res. Public Health 2025, 22(6), 831; https://doi.org/10.3390/ijerph22060831 - 25 May 2025
Viewed by 1096
Abstract
Background: Brazil’s Unified Health System (Sistema Único de Saúde—SUS) has played a crucial role in reducing health disparities by providing universal and free healthcare to a diverse population. However, the COVID-19 pandemic exposed significant barriers to healthcare access among vulnerable groups, particularly due [...] Read more.
Background: Brazil’s Unified Health System (Sistema Único de Saúde—SUS) has played a crucial role in reducing health disparities by providing universal and free healthcare to a diverse population. However, the COVID-19 pandemic exposed significant barriers to healthcare access among vulnerable groups, particularly due to the intersection of multiple vulnerabilities. This study aimed to examine how intersectionality—specifically sex/gender, race/ethnicity, and education level—has influenced inequalities in healthcare service utilization among vulnerable populations during the COVID-19 pandemic in Brazil. Methods: This cross-sectional study is part of the “COVID-19 Social Thermometer in Brazil” project, conducted between May 2022 and October 2023 in Brazil’s state capitals and the Federal District, focusing on populations considered socially vulnerable during the pandemic. Participants were selected using sequential sampling and completed a structured questionnaire. Statistical analyses—performed using Excel, RStudio (version 4.3.2), and ArcGIS—included sociodemographic profiling, the construction of the Jeopardy Index (a measure of social vulnerability), and binary logistic regression to explore associations between Jeopardy Index and healthcare service utilization. Results: 3406 participants, the majority were men (60%), aged 30 to 59 years (65.1%), and identified as Black or Brown (72.2%). Most participants were concentrated in the Northeast (26.6%) and North (22.3%) macroregions. A high reliance on public healthcare services (SUS) was observed, particularly in the Southeast (96%). According to the Jeopardy Index, the most socially vulnerable groups—such as women, transgender individuals, Black people, and those with no formal education—were significantly more likely to rely on SUS (OR = 3.14; 95% CI: 1.34–7.35) and less likely to use private healthcare (OR = 0.07; 95% CI: 0.02–0.20), reflecting a 214% higher likelihood of SUS use and a 93% lower likelihood of private service utilization compared to the most privileged group. Conclusions: Our findings reveal that individuals experiencing intersecting social vulnerabilities face marked inequalities in healthcare access. Without SUS, these populations would likely have been excluded from essential care. Strengthening SUS and implementing inclusive public policies are critical to reducing disparities and ensuring equitable healthcare access for historically marginalized groups. Full article
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11 pages, 461 KiB  
Review
Spatial, Social and Serological Factors in the Prevalence and Risk of Leprosy in Areas of High Endemicity: An Integrative Review
by Daniele dos Santos Lages, Isabela Cristina Lana Maciel, Sarah Lamas Vidal and Francisco Carlos Félix Lana
Infect. Dis. Rep. 2025, 17(3), 57; https://doi.org/10.3390/idr17030057 - 22 May 2025
Viewed by 470
Abstract
Background/Objectives: Leprosy remains a global public health challenge, especially in hyperendemic areas, where spatial, socioeconomic and serological factors influence its persistence. In this study, an integrative review was carried out to analyze the relationship between these factors and the prevalence of Mycobacterium leprae [...] Read more.
Background/Objectives: Leprosy remains a global public health challenge, especially in hyperendemic areas, where spatial, socioeconomic and serological factors influence its persistence. In this study, an integrative review was carried out to analyze the relationship between these factors and the prevalence of Mycobacterium leprae infection, as well as the risk of falling ill. Methods: The integrative search was conducted in the BVS (Medline and LILACS) and Scopus databases, including studies published between 2010 and 2024; PRISMA was followed. Results: The findings indicate that spatial analysis, using geographic information systems, is essential for identifying transmission clusters and targeting control strategies. Poor socioeconomic conditions, such as low income and inadequate sanitation, significantly increase the risk of infection. In addition, serology, especially the detection of Anti-PGL-1 antibodies, has proved to be a promising tool for tracking subclinical infections and improving epidemiological surveillance. However, the integration of spatial, social and serological factors is still limited in the literature. Conclusions: We conclude that multidisciplinary approaches, combining spatial, socioeconomic and serological factors, are fundamental to optimizing control strategies and reducing leprosy transmission in vulnerable populations. Full article
(This article belongs to the Section Neglected Tropical Diseases)
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20 pages, 257 KiB  
Article
Care Providers’ and Parents’ Experiences with Implementing the Conversational Health Literacy Assessment Tool (CHAT)-Maternity-Care in the Netherlands: A Mixed Methods Study
by Evi M. E. Vlassak, Judit K. J. Keulen, Elina Miteniece, Rianneke de Ritter, Marijke J. C. Hendrix and Marianne J. Nieuwenhuijze
Healthcare 2025, 13(10), 1173; https://doi.org/10.3390/healthcare13101173 - 17 May 2025
Viewed by 521
Abstract
Background/Objectives: Care providers’ understanding of patients’ health literacy is crucial to tailoring care and reducing health inequalities. This study explores the experiences, facilitators, and barriers encountered by maternity care providers when implementing CHAT-maternity-care: a conversational tool that supports care providers in estimating (expectant) [...] Read more.
Background/Objectives: Care providers’ understanding of patients’ health literacy is crucial to tailoring care and reducing health inequalities. This study explores the experiences, facilitators, and barriers encountered by maternity care providers when implementing CHAT-maternity-care: a conversational tool that supports care providers in estimating (expectant) parents’ health literacy. As a secondary objective, the study also examines the experiences of (expectant) parents. Methods: Maternity care providers used CHAT-maternity-care after finalizing an e-learning. Implementation was evaluated among maternity care providers with a questionnaire and in-depth focus group meetings and among (expectant) parents with semi-structured interviews. Results: Providers experienced that using CHAT-maternity-care enhanced their health literacy insight, improved health literacy awareness, and fostered easier, more comprehensive and structured estimation of parents’ health literacy. Key facilitators for implementing CHAT-maternity-care as perceived by providers were the perceived value of health literacy insights; the tool’s relevance, user-friendliness, and familiarity; and social factors. The main barriers were time constraints, the tool’s novelty, and social factors. (Expectant) parents were positive and open to having conversations based on CHAT-maternity-care. Questions based on CHAT-maternity-care were perceived as beneficial by parents in uncovering previously unaddressed concerns. Conclusions: CHAT-maternity-care is mostly well received and assessed as helpful to improving health literacy insights. The findings underscore the importance of education, peer support, and organizational alignment for broader adoption and implementation of CHAT-maternity-care. Full article
(This article belongs to the Special Issue Midwifery-Led Care and Practice: Promoting Maternal and Child Health)
18 pages, 674 KiB  
Article
Diabetes-Related Dietary Patterns and Endometrial Cancer Risk and Survival in the European Prospective Investigation into Cancer and Nutrition Study
by Luisa Torres-Laiton, Leila Luján-Barroso, Núria Nadal-Zaragoza, Carlota Castro-Espin, Paula Jakszyn, Camilla Panico, Charlotte Le Cornet, Christina C. Dahm, Dafina Petrova, Daniel Ángel Rodríguez-Palacios, Franziska Jannasch, Giovanna Masala, Laure Dossus, Lisa Padroni, Marcela Guevara, Matthias B. Schulze, Renée T. Fortner, Rosario Tumino and Marta Crous-Bou
Nutrients 2025, 17(10), 1645; https://doi.org/10.3390/nu17101645 - 12 May 2025
Viewed by 845
Abstract
Background/Objectives: Endometrial cancer (EC)’s major risk factors include obesity and diabetes, both strongly related with lifestyle choices and dietary factors. Our study aimed to evaluate the relationship between diabetes-related dietary patterns, EC risk, and survival in a population of middle-aged European women. Methods: [...] Read more.
Background/Objectives: Endometrial cancer (EC)’s major risk factors include obesity and diabetes, both strongly related with lifestyle choices and dietary factors. Our study aimed to evaluate the relationship between diabetes-related dietary patterns, EC risk, and survival in a population of middle-aged European women. Methods: A total of 285,418 female participants from the European Prospective Investigation into Cancer and Nutrition (EPIC) study were included in the analysis. After a mean time of 10.6 years of follow-up, 1955 incident EC cases were registered; of those, 133 women died from EC. The Empirical Dietary Index for Insulin Resistance (EDIR), the Empirical Dietary Index for Hyperinsulinemia (EDIH), and the Diabetes Risk Reduction Diet (DRRD), were estimated from dietary information collected at baseline from EPIC participants. Cox proportional hazards regression models were used to evaluate the association between the dietary patterns and EC risk, using hazard ratios (HR), 95% confidence intervals (CI), and adjusting for relevant confounders. Cox and Fine–Gray models were used to assess the association with overall and EC-specific mortality, respectively. Results: Higher adherence to EDIR was associated with an increased risk of EC, multivariable HR for T3vsT1 were 1.17 (95% CI = 1.04 to1.31). However, when BMI was included in the models, these associations became weaker and no longer statistically significant. No associations were observed in relation to adherence to EDIH, DRRD, and EC risk. No associations were found in relation to diabetes-related dietary patterns and mortality. Conclusions: This study highlights the potential role of diabetes related dietary patterns and EC etiology and prevention. Further studies are warranted to better understand the role of etiology-derived dietary patterns and disease prevention and prognosis. Full article
(This article belongs to the Special Issue Nutritional Epidemiology of Cancer)
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18 pages, 948 KiB  
Systematic Review
Cancer Symptom Clusters in Children and Adolescents with Cancer Undergoing Chemotherapy: A Systematic Review
by Luís Carlos Lopes-Júnior, Jonathan Grassi, Marcela Bortoleto Freitas, Fernanda Ercília Souza Trigo, Fabrine Aguilar Jardim, Karolini Zuqui Nunes, Karla Anacleto de Vasconcelos and Regina Aparecida Garcia de Lima
Nurs. Rep. 2025, 15(5), 163; https://doi.org/10.3390/nursrep15050163 - 7 May 2025
Viewed by 923
Abstract
Objective: To synthesize and analyze the prevalence, composition, longitudinal stability, and predictors of cancer symptom clusters in children and adolescents undergoing chemotherapy. Method: A systematic literature review was conducted in accordance with the PRISMA 2020 guidelines. Evidence was sourced from MEDLINE/PubMed, Cochrane Library, [...] Read more.
Objective: To synthesize and analyze the prevalence, composition, longitudinal stability, and predictors of cancer symptom clusters in children and adolescents undergoing chemotherapy. Method: A systematic literature review was conducted in accordance with the PRISMA 2020 guidelines. Evidence was sourced from MEDLINE/PubMed, Cochrane Library, Embase, PsycINFO, and Web of Science, as well as clinical trial registries (Clinical Trials WHO-ICTRP) and gray literature. The search was performed in February 2025, with no restrictions on publication date or language. Two independent reviewers screened and selected the studies. The methodological quality of the included studies was assessed using design-specific tools, and the findings were synthesized narratively. Results: A total of 6221 records were identified, with 12 studies meeting the inclusion criteria. These studies were published between 2010 and 2024 in the United States, Brazil, China, and Turkey. Cancer symptom clusters in children and adolescents followed well-defined patterns, with the gastrointestinal, emotional, fatigue-related, somatic, and self-image clusters being the most prevalent. Conclusions: Early identification of these cancer symptom clusters is essential for guiding interprofessional teams in delivering personalized, evidence-based care to children and adolescents with cancer and their families. Full article
(This article belongs to the Special Issue Advances in Nursing Care for Cancer Patients)
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16 pages, 596 KiB  
Article
Experiences and Educational Needs of Hospital Staff Providing Care to Tracheostomy-Dependent Pediatric Patients
by Kathryn L. Palumbo, Desirae Smith, Adrianne Frankel, Laine DiNoto, Taylor Wheaton, Kimberly Buholtz and Rita Dadiz
Children 2025, 12(5), 552; https://doi.org/10.3390/children12050552 - 25 Apr 2025
Viewed by 562
Abstract
Objective: To assess the experience and educational needs of hospital staff who care for pediatric patients with tracheostomies. Study Design: Staff were surveyed and participated in semi-structured, facilitated focus groups regarding their experiences caring for children with tracheostomies and their educational needs. Survey [...] Read more.
Objective: To assess the experience and educational needs of hospital staff who care for pediatric patients with tracheostomies. Study Design: Staff were surveyed and participated in semi-structured, facilitated focus groups regarding their experiences caring for children with tracheostomies and their educational needs. Survey data were analyzed using descriptive statistics and Kruskal–Wallis nonparametric tests. Focus groups were transcribed verbatim and coded for thematic analysis. Results: Pediatric advanced practice providers, nurses, physicians, and respiratory therapists (152/353, 43%) completed the survey. Within the last year, 76% of staff had worked with a tracheostomy-dependent child. However, up to 59% of staff had not performed at least one tracheostomy skill (e.g., tracheostomy site assessment, tube change, etc.). Staff reported the least confidence in changing tracheostomy tubes and using home ventilators and rated these skills as most important for additional education. Forty-three staff members participated in 1 of 10 focus groups. Three themes were identified: building staff competencies in tracheostomy care, promoting the caregiver development of tracheostomy skills, and building caregiver preparedness for home life. Staff emphasized the need for participating in emergency simulations and developing their skills to better prepare caregivers for home life. They indicated a need to streamline the discharge process, gain knowledge of community resources, and develop a standardized team to provide discharge teaching. Conclusions: Hospital staff responsible for providing care to tracheostomy-dependent pediatric patients had limited opportunities to learn and maintain their skills. Survey and focus group findings can guide development of continuing education to optimize the care of tracheostomy-dependent children. Full article
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22 pages, 529 KiB  
Article
Family Self-Care Pattern in Families with Children with Intellectual Disabilities: A Pilot Study
by Teresa Dionísio Mestre, Manuel José Lopes, Ana Pedro Costa and Ermelinda Valente Caldeira
Healthcare 2025, 13(7), 791; https://doi.org/10.3390/healthcare13070791 - 2 Apr 2025
Cited by 1 | Viewed by 963
Abstract
Family self-care emphasizes a family’s role in health promotion and protection, reflecting society’s views on health, illness, and human relationships. In families with children with an intellectual disability, where the child may lack self-care abilities, family self-care becomes crucial, highlighting that self-care needs [...] Read more.
Family self-care emphasizes a family’s role in health promotion and protection, reflecting society’s views on health, illness, and human relationships. In families with children with an intellectual disability, where the child may lack self-care abilities, family self-care becomes crucial, highlighting that self-care needs exceed individual capacity and require family cooperation. Background/Objectives: This pilot study aims to explore the factors influencing family self-care and define attributes of its cognitive, psychosocial, physical, and behavioral domains in families with children with intellectual disabilities. Methods: A descriptive and correlational study with forty-four families was conducted. Exploratory analysis and linear regression analysis were estimated through the assumptions of the Gauss–Markov theorem (specifically homoscedasticity, normality, and model specification adequacy). Multicollinearity was also evaluated. Results: The significant family conditioning factors identified were family income, education level, degree of physical and functional dependence of the child, family household size, and social support. Socioeconomic, demographic, and health-related factors shaped self-care experiences. Conclusions: Family empowerment and the impact of disability are key elements in enabling self-care. Families reporting a greater impact of their child’s condition tended to feel less empowered, directly affecting their ability to perform daily self-care activities. The evidence suggests a pattern in which self-care activities might be reactive rather than proactive and focused on managing immediate challenges rather than long-term well-being. These insights can guide healthcare professionals, especially family nurses, toward a holistic, family-centered approach to supporting families with children with intellectual disabilities. Full article
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Article
Attitudes of Community Health Nurses Towards Postnatal Home Visitation: A Study in the Ashanti Region of Ghana
by Yvonne Agyeman-Duah and Million Bimerew
Int. J. Environ. Res. Public Health 2025, 22(4), 534; https://doi.org/10.3390/ijerph22040534 - 1 Apr 2025
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Abstract
Enhancing maternal and newborn care is a key priority for governments worldwide. World leaders have taken deliberate steps to improve these essential services, with an emphasis on postnatal care, including home visits for mothers and their newborns. However, in the Ashanti Region and [...] Read more.
Enhancing maternal and newborn care is a key priority for governments worldwide. World leaders have taken deliberate steps to improve these essential services, with an emphasis on postnatal care, including home visits for mothers and their newborns. However, in the Ashanti Region and across Ghana, challenges surrounding the delivery and effectiveness of postnatal home visits remain a significant concern. This study aimed to assess the attitudes of Community Health Nurses towards postnatal home visitation in selected districts of the Ashanti Region. A quantitative survey approach was used to gather data from 100 CHNs randomly selected from 10 regional districts. Structured questionnaires were used to gather quantitative data from CHNs. Findings from the study were analysed using descriptive and inferential tests. The study results indicated that most of the CHNs were young adults, 35 years of age (79%), with the majority having 3–5 years of work experience. The respondents generally demonstrated a negative attitude towards PNHV as they believed it was an extra workload, time-consuming, and unnecessary. A Pearson chi-square test indicated strong significant association between CHNs’ attitude towards the components of the attitude scale and years of experience as well as their age. In conclusion, the study revealed that even though CHNs are expected, as part of their job description, to embark on home visitation activities, most of them have a negative attitude towards this professional duty. There should be conscientious, novel ways to ignite the interest of these essential service providers to help improve infant and maternal health. Full article
(This article belongs to the Special Issue The 20th Anniversary of IJERPH)
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