Search Results (454)

Practical training and recruitment strategies are critical for the sustainable implementation of psychosocial interventions. However, few studies have examined how to prepare community partners and doctoral students to support culturally adapted psycho-oncology interventions. This pre-pilot study aims first to evaluate two distinct training programs and recruitment procedures, and second to explore preliminary pre-post outcomes of the Caregiver-Patients Support to Cope with Advanced Cancer (CASA) intervention, using the Consolidated Framework for Implementation Research (CFIR). Three clinical psychology graduate students received CASA training, and two community partners completed Recruitment training. We present descriptive pre- and post-assessments, along with qualitative feedback, for both training and institutional (Puerto Rico Biobank) and community-based recruitment outcomes. A related-samples nonparametric analysis examined pre- and post-CASA intervention signals. Results indicated knowledge gains among doctoral students (pre-test M = 3.3; post-test M = 9.3) and community partners (pre-test M = 4.5; post-test M = 9.5). Preliminary outcomes revealed significant improvements in spiritual well-being (Z = −2.618, p = 0.009) and quality of life (Z = −2.957, p = 0.003) and a reduction in depressive (Z = −2.764, p = 0.006), anxiety (Z = −2.667, p = 0.008), and distress (Z = −2.195, p = 0.028) symptoms following CASA. Of 26 recruited dyads, institutional referrals enrolled 16 dyads (61.5%), while community partners referred 10 dyads with a 90.9% success rate. Findings support the feasibility of both training and CASA exploratory outcomes suggest meaningful psychosocial benefits for Latino dyads coping with advanced cancer. Combining institutional infrastructure with community engagement may enhance sustainability and equitable access to psycho-oncology care. Full article

Recognizing cervical cancer as a major public health concern, Romania was among the first EU countries to introduce human papilloma virus (HPV) vaccination in 2008. Despite multiple strategies implemented over the past 17 years, HPV vaccine coverage remains one of the lowest in the EU, while cervical cancer mortality rates are among the highest. To explore the underlying factors, we conducted a cross-sectional study involving 209 family physicians at the national level. The study assessed their attitudes, practice, knowledge, and training needs related to HPV vaccination. The majority of physicians (90%) reported that they provide HPV vaccination services, and 88.5% considered themselves to have good and very good knowledge about HPV, which they routinely share during consultations with patients. However, respondents noted that both physician and public attitudes toward HPV vaccination are only moderately positive, which limits vaccine uptake and the success of prevention efforts. Parental hesitation was the main barrier, mentioned by 81.8% of respondents. The majority (71.3%) of doctors indicated that they were able to adequately respond to patients’ questions, but 81.4% of respondents expressed the view that additional training is needed for healthcare professionals on HPV infection and vaccination. These findings highlight the need for coordinated efforts to increase demand and trust in HPV vaccination. Recommended strategies include targeted professional training, public information campaigns, and the development of strong cross-sector partnerships to support vaccination efforts. Full article

Background/Objectives: Chronic kidney disease is more prevalent among women, and there are significant disparities in the management of female patients. Our study aimed to assess the clinical experience and educational needs of physicians in the treatment of reproductive and sex and gender-related health problems in patients with CKD. Methods: The three-part survey was distributed among nephrologists and other internal medicine specialists in Poland, both online and in paper form. Results: A total of 116 physicians participated in the survey, including 81 nephrologists. Most respondents (64.7%) were female and practiced in multispecialty hospitals (72.4%). While 97.4% managed patients with CKD, only 37.9% reported caring for pregnant women. Experience in sex-specific and pregnancy-related issues was limited—56.9% reported low or minimal experience in managing CKD during pregnancy. Residency training lacked coverage of crucial topics, with 66.2% reporting limited teaching on sex-related CKD progression. Over 90% supported integrating reproductive planning and interdisciplinary care into nephrology, favoring guidelines, conferences, and webinars for education. Conclusions: Our study has highlighted a critical discrepancy between the importance of sex-specific and reproductive health considerations in the management of CKD and the current level of clinical experience among Polish doctors. Full article

Background/Objectives: Nowadays, the importance of educating and ensuring communication with patients is also emphasized in groups of patients undergoing anesthesia. The safety and quality of services provided to this group of patients may be related to the information received by them. Therefore, the aim of this review is to explore the patients’ knowledge observed globally and discuss the potential influencing factors. Methods: This review was based on a search of PubMed using MeSH terms and keywords. Additionally, citation searching for relevant articles was performed. Results: The related literature illustrates high heterogeneity among studies with varying results. The knowledge concerning appropriate recognition of anesthesiologists as doctors ranged from 32,8% to 90.5%. However, most studies concluded that patients’ knowledge regarding anesthesia is poor. There was no homogenous pattern regarding the possible impact of age, sex, education, profession or previous anesthesia on patients’ knowledge. Patients’ most common concern was not waking up after anesthesia. The response to patients’ varying knowledge may be the use of educational aids including online alternatives. This approach limits the use of medical resources and may help to alleviate patients’ anxiety. Conclusions: Future studies may focus on a thorough analysis of knowledge in a representable population followed by an observation of aspects shaping the level of education. The precise influence of patients’ education on anesthesia outcomes is yet to be determined. However, further investigation may bring appropriate clinical guidance and help to ensure the best quality of anesthesia services is provided. Full article

This study focuses on doctor recommendation mechanisms for online consultation platforms (OCPs), and aims to develop a lightweight multi-criteria decision framework that enhances doctor–patient matching efficiency by mitigating patients’ disproportionate preference for renowned physicians from tertiary hospitals. The proposed framework operates in two stages. In the first stage, symptom-related keywords provided by patients in their consultation comments are extracted using a text presentation model selected through comparative experiments. Based on these extracted features, a pool of candidate physicians is constructed by matching patient symptoms with physicians’ professional expertise, utilizing both historical consultation records and physicians’ background information. In the second stage, the recommendation priority is determined using an entropy-weighted TOPSIS model, which evaluates multiple criteria including the alignment between physician competencies and patient needs, while simultaneously promoting the utilization of underused medical resources. Experiments conducted on historical data from HaoDaiFu, a representative Chinese OCP, demonstrate that the proposed framework significantly increases the exposure opportunities for lower-usage and newly registered physicians, alleviates consultation congestion around highly reputed doctors, and maintains comparable recommendation accuracy. Consequently, the developed multi-criteria decision framework effectively improves doctor–patient matching efficiency and contributes to more balanced medical resource allocation and enhanced service accessibility. Full article

The rapid integration of artificial intelligence (AI) into healthcare has reshaped medical education and clinical practice. While technological innovation is vital, soft skills are essential for preserving trust, ethical accountability, and humanistic care. This study explores the evolving role of soft skills in medical education in the AI era by examining definitional challenges, pedagogical strategies, and the integration of AI-related literacy. A narrative review methodology synthesized evidence across seven thematic domains, focusing on curricular integration, pedagogical strategies, and assessment approaches in medical education within AI-enabled learning environments. The findings demonstrated that soft skills improve patient adherence, satisfaction, safety, and trust; strengthen physicians’ professional identity, collaboration, and resilience; and enhance system-level outcomes, such as resilience, safety, and public trust. Experiential, reflective, and competency-based pedagogies remain the most effective instructional strategies, while AI-supported tools, including virtual patients, adaptive simulations, large language models (LLMs), and Retrieval-Augmented Generation systems (RAG), offer complementary benefits by enhancing doctor-patient communication, providing real-time personalized feedback, and strengthening clinical reasoning. Soft skills function as an interconnected and synergistic ecosystem that is reinforced by cognitive, affective, humanistic, and ethical mechanisms. Integrating these competencies with AI literacy promotes theoretical clarity, supports programmatic assessment, and fosters responsible innovation, ensuring that technological advancement enhances rather than diminishes the humanistic foundations of medicine. Full article

Placebo, nocebo, and lessebo effects are very frequent in patients with both neurological and psychiatric disorders. Interestingly, the neural mechanisms underlying placebo effects have been found to be the same as or similar to mechanisms targeted by active pharmaceutical interventions for many of these disorders. In the case of functional neurological disorders (FNDs), there are shared neural substrates between the central nervous system “placebo network” and the dysfunctional networks implicated in the pathophysiology. These networks are primarily involved in emotion regulation, stress responses, and the sense of self-agency. Therefore, placebo effects have also been discussed as therapeutic interventions in FNDs. Such an approach, however, has a variety of ethical implications evolving around informed consent, autonomy, nonmaleficence, beneficence, and justice. In this paper, we discuss the use of placebo, nocebo, and lessebo in FNDs as well as related ethical issues. Overall, the use of placebo in FNDs is currently still considered controversial both for diagnostic as well as therapeutic purposes. Although it is a safe and almost unique intervention, its use violates the core principles of medical ethics and doctor–patient interactions involving autonomy or openness in the therapeutic relationship. Full article

Background/Objectives: Parents’ vaccine hesitancy constitutes a global challenge, strongly associated with trust in healthcare professionals. This study aimed to identify socio-demographic predictors of parental pro- and anti-vaccination behaviors and investigate the association between these factors and intentions regarding children’s future immunizations. Methods: We conducted a cross-sectional online survey using the Parent Attitudes about Childhood Vaccines (PACV) questionnaire. Participants were recruited purposively and via snowballing through parenting groups and educational institutions. Results: We surveyed 1.046 parents and provided attitudes for 1.701 children; 85.1% of child-specific responses reflected positive attitudes (PACV ≤ 50; median 16.7). In univariate regression, employment (OR = 2.172, 95% CI: 1.530–3.084; p < 0.001) and healthcare employment (OR = 2.907, 95% CI: 1.983–4.262; p < 0.001) increased the odds of positive attitudes, whereas each additional household member (OR = 0.693, 95% CI: 0.597–0.805; p < 0.001) and child (OR = 0.677, 95% CI: 0.579–0.792; p < 0.001) reduced them. Multivariable models confirmed higher odds for suburban/rural residence (OR = 1.614, 95% CI: 1.037–2.513; p = 0.034), employment (OR = 1.869, 95% CI: 1.284–2.721; p = 0.001), and healthcare employment (OR = 2.785, 95% CI: 1.872–4.144; p < 0.001). Among prior non-vaccinators (n = 114), 39.5% planned to vaccinate, 41.2% did not. Those who planned showed greater trust than non-planners in the child’s doctor (mean: 7.49 vs. 3.74) and schedule (mean: 7.89 vs. 1.40), p < 0.001, with lower trust correlating with greater hesitancy and safety concerns. Conclusions: Trust in physicians was strongly associated with both current attitudes and future intentions. Trust-focused, patient-centered communication may be related to more positive vaccination attitudes among parents. However, longitudinal research is needed to determine whether such trust could influence changes in vaccination behavior, especially since parents’ attitudes toward vaccinations can evolve with the arrival of subsequent children. Full article

People with disabilities (PWDs) face unique challenges in accessing equitable medical care, due in part to physicians’ limited training in disability-related competencies. This study explored a novel approach to bridging this gap by integrating selected videos and reflective essays into medical education. Third- and fourth-year medical students watched four videos depicting diverse experiences of PWDs and submitted reflective essays, resulting in the analysis of 90 essays by six investigators. Through thematic analysis, 50 concept codes were distilled into six key themes: recovery process, student insight, adjustment to disability, patient-doctor relationship, social model of disability, and support systems. The reflections revealed a growing awareness among students of the need to individualize care and address systemic barriers, though some medicalized views of disability were noted. These findings underscore the potential of video-based education to enhance disability competence in medical training by fostering critical reflection and empathy. However, to maximize impact, educators should prioritize diverse portrayals of disability and challenge sensationalized or “overcoming” narratives common in such media. Overall, this study demonstrates that widely available media can be a valuable, scalable tool for advancing disability education in medical curricula. Full article

The global prevalence of type 2 diabetes is alarmingly high, and a considerable proportion of diabetes patients suffer from anxiety and depression. The presence of anxiety and depression worsens the prognosis of diabetes; it increases non-compliance to the treatment and mortality rate. A cross-sectional study of adults ages 20 years or older was conducted in 24 districts of Khyber Pakhtunkhwa (KP). Individuals diagnosed by a certified medical doctor with type 2 diabetes were recruited using multistage stratified cluster sampling. The Agha Khan University Anxiety and Depression Scale (AKUADS) was used for assessment. Chi-square and logistic regression were used to assess the association between depressive disorder and characteristics of the study participants. The results showed that 31.64% of type 2 diabetic patients suffered from anxiety and depression. Prevalence was higher in individuals aged ≤40 years (37.75%), females (40.58%) compared to males (26.48%), individuals without formal education (38.48%), and underweight participants (55%). Anxiety and depression were also prevalent among housewives (38.04%), rural residents (34.76%), and current smokers (43.14%). Multivariate logistic regression indicated significantly higher odds of anxiety and depression among individuals with primary education (OR = 4.73, p-value = 0.03), underweight individuals (OR = 4.46, p-value = 0.001), and those reporting pain (OR = 2.82, p-value < 0.001). The high prevalence of anxiety and depression in the known diabetic population in the KP province of Pakistan requires the development of strategies for screening, awareness related to the contributing factors, and treatment of co-morbid depression at community level. Full article

Introduction: Tuberculosis (TB) remains a public health concern, and people at risk for TB are hesitant to seek care. The first South African National TB prevalence survey, conducted in 2017–2019, found that most participants with TB symptoms did not seek care for TB. In 2022, an estimated 23% of people with TB in South Africa were undiagnosed, contributing to the country’s burden of “missing” TB cases. This study explores health-seeking behaviour among people with TB (PwTB) in South Africa, focussing on barriers and facilitators to care-seeking and the quantification of TB-related stigma from a patient and community perspective. Methods: We conducted a mixed-method study in the City of Johannesburg (COJ) Metropolitan Municipality from February to March 2022. PwTB aged 18 and older initiating TB treatment for microbiologically confirmed pulmonary TB were recruited from three primary healthcare facilities in the COJ. After providing written informed consent, they participated in a one-time, in-depth, face-to-face interview. The interviews were digitally recorded and conducted by trained facilitators. We used thematic analysis with deductive approaches to develop themes. We used the Van Rie TB stigma assessment scale to quantify perceived stigma. Results: We interviewed 23 PwTB with an overall median age of 39 years and 14 (61%) males. Patient-level barriers to accessing TB care included visiting traditional healers and pharmacists before their TB diagnosis; wrong or missed diagnosis by private doctors; work commitments; scarcity of resources to attend the clinic or walk long distances; perceived and experienced stigma; and a lack of TB knowledge. Facility-level barriers included long clinic queues and uncertainty about where to receive TB care in the clinic. Facilitators for TB care-seeking included being in contact with someone who had TB, receiving encouragement from family, or having knowledge about TB transmission and early diagnosis. The overall median total stigma score among 21 PwTB was 53 (IQR: 46–63), with median community and patient stigma scores of 25 (IQR: 22–30) and 31 (IQR: 21–36), respectively. Conclusions: We found important considerations for the TB programme to improve the uptake of services. Since PwTB consult elsewhere before visiting a facility for TB care, TB programmes could establish private–public partnerships. TB programmes could also increase TB awareness in the community, especially among males, and mobile clinics could be considered to assist with TB case detection and treatment provision. Applying behavioural design techniques and co-designing interventions with patients and providers could improve TB health-seeking behaviours. Full article

Medical doctors are at risk of poor mental health, linked to their working conditions. However, little distinction is made between private and public practice where working conditions differ. This review examines the relationship between perceived working conditions, psychological health, and patient care among doctors in private practice, considering how differences between private and public practice impact these outcomes and the implications of working across sectors. We conducted a systematic literature review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The search encompassed Academic Search Premier, Business Source Premier, PsycInfo, PsycArticles, and Medline. Included studies were coded in line with the Job Demands–Resources model. The initial search identified 309 papers, with 14 being selected for final full-text review. Higher job demands were associated with higher levels of burnout, while social resources, job crafting, and healthy coping mechanisms were linked with lower levels of burnout. Working in private practice was associated with higher demands. Doctors in private practice had more negative perceptions of performance, less satisfactory leadership, and a lack of feedback. However, private practice also offered better work–life balance, more control, and greater reward. Notably, no study was found that examined the implications of dual roles where doctors worked across both sectors, which is common. A clear definition of private practice as well as a more granular understanding of work-related risks posed to private practice and dual roles should be the focus of future research. Full article

Background: Artificial intelligence (AI) is increasingly integrated into healthcare, offering transformative potential across diagnostics, treatment, and clinical decision-making. As its adoption grows, understanding how medical doctors perceive and respond to AI, particularly in relation to their specialty, experience, and job security, is critical for effective implementation and acceptance. This study investigates the confidence of medical doctors in AI technologies and their role in healthcare, focusing on the impact of specialty, experience, and perceived job security. Method: A cross-sectional survey was conducted among 187 medical doctors across various specialties in Riyadh, Saudi Arabia, with a final sample of 176 participants. The survey assessed awareness, confidence, and concerns regarding AI integration into clinical practice. The survey was conducted across multiple healthcare hospitals in Riyadh, Saudi Arabia. Hospitals from both public and private sectors were included to ensure a diverse sample of healthcare professionals from different organizational structures. Results: A statistically significant association was found between specialty and confidence level (χ² = 14.5, p = 0.001). Among specialists, the majority (80%) reported high confidence in AI use compared to 45% of general practitioners and 38% of surgeons. Conversely, moderate confidence was most common among surgeons (46%), followed by general practitioners (35%) and specialists (13%). Additionally, participants with 11–20 years of experience reported the highest confidence, whereas those aged 55+ years showed the lowest perceived impact of AI on patient outcomes. Multivariate regression analysis identified specialty as the strongest predictor of AI confidence, with specialists being four times more likely to express high confidence in AI use (β = 0.89, p = 0.001) compared to general practitioners. Job displacement concerns negatively influenced confidence in AI, while age and years of experience had less impactful effects. Conclusions: The study concludes that addressing barriers to AI adoption will be crucial for enhancing its integration into healthcare and improving patient care. These findings underscore the importance of specialty-specific training and highlight the need for targeted educational programs, particularly for lower confidence groups such as general practitioners and surgeons. Lower confidence levels in these groups may result in a hesitant or incorrect use of AI tools, potentially compromising patient safety. Therefore, equipping all healthcare professionals with the necessary knowledge and confidence is essential for the safe and effective use of AI in clinical practice. Full article

Background: This paper aims to outline an ethical overview of the potential challenges related to AI technologies in the doctor–patient relationship. Methods: This study is structured as a narrative review of the literature (2015–2025), based on searches conducted in the main scientific databases (PubMed, Scopus, Web of Science, Google Scholar), supplemented by official documents issued by the following international organizations: World Health Organization (WHO), United Nations Educational, Scientific and Cultural Organization (UNESCO), and the World Medical Association (WMA), as well as key regulatory frameworks of the European Union, China, and the United States. The selection included academic contributions, guidelines, and institutional reports relevant to the clinical applications of AI and their ethical and regulatory implications. Specifically, the analysis herein presented is grounded on four key aspects: the rationale for AI in patient care, informed consent about AI use, confidentiality, and the impact on the therapeutic alliance and medical professionalism. Results and Conclusions: Depending on their application, AI systems may offer benefits regarding the management of administrative burdens and in supporting clinical decisions. However, their applications in diagnostics, particularly in fields as radiology and dermatology, may also adversely impact the patient–doctor relationship and professional autonomy. Specifically, the implementation of these systems, including generative AI, may lead to increased healthcare costs and jeopardise the patient–doctor relationships by exposing patients’ confidentiality to new risks and reducing space for healthcare empathy and personalisation. The future of the medical profession and the doctor–patient relationship will largely depend on the types of artificial intelligence that are integrated into clinical practice and how effectively such additions are reconciled with core ethical values on which healthcare rests within our systems and societies. Full article

Conventional medicine relies solely on the interaction between the doctor and the patient, not necessarily including the family in discussions about therapy and diagnosis. Nevertheless, recent research indicates that the presence of a family member during a doctor’s visit improves both communication between the doctor and the patient, as well as the patient’s understanding of information related to their health condition. Additionally, by adopting this approach, family members can better understand what obligations arise at this stage and the patient’s needs. Studies have shown that collaboration with family members has significantly reduced mortality rate and improved their quality of life, as the family strengthened their confidence in their abilities by providing moral and emotional support. Even though family support and involvement seem to be very important, sometimes patients have reported that overly active family involvement becomes intrusive, as it violates their privacy and disrupts their autonomy. That is why it is important for family members directly involved in recovery to learn to respect the boundaries set by the patient. Both the patient and their family experience stressful moments during this recovery period, which necessitate their attention. The involvement of family members in the recovery process reduces their levels of anxiety and stress, as they can closely monitor the patient’s progress. Additionally, integrating family members into the rehabilitation program can provide further benefits for the patient, as the presence of a family member leads to increased comfort and motivation. Full article