Search Results (262)

Background: Family caregivers are a vital yet often under-recognized part of the healthcare system. They provide essential emotional, physical, and logistical support to individuals with illness, disability, or frailty, and their contributions improve continuity of care and reduce system strain. However, many healthcare and social service providers are not equipped to meaningfully engage caregivers as partners. In Alberta, stakeholders validated the Caregiver-Centered Care Competency Framework and identified the need for a three-tiered education model—Foundational, Advanced, and Champion—to help providers recognize, include, and support family caregivers across care settings. This paper focuses on the development and early evaluation of the Advanced Caregiver-Centered Care Education modules, designed to enhance the knowledge and skills of providers with more experience working with family caregivers. The modules emphasize how partnering with caregivers benefits not only the person receiving care but also improves provider effectiveness and supports better system outcomes. Methods: The modules were co-designed with a 154-member interdisciplinary team and grounded in the competency framework. Evaluation used the first three levels of the Kirkpatrick–Barr health workforce education model. We analyzed pre- and post-surveys from the first 50 learners in each module using paired t-tests and examined qualitative feedback and SMART goals through inductive content analysis. Results: Learners reported a high level of satisfaction with the education delivery and the knowledge and skill acquisition. Statistically significant improvements were observed in 53 of 54 pre-post items. SMART goals reflected intended practice changes across all six competency domains, indicating learners saw value in engaging caregivers as partners. Conclusions: The Advanced Caregiver-Centered Care education improved providers’ confidence, knowledge, and skills to work in partnership with family caregivers. Future research will explore whether these improvements translate into real-world practice changes and better caregiver experiences in care planning, communication, and navigation. Full article

Health literacy improves informal caregivers’ knowledge and ability to provide care. The aim of this study is to analyze the impact of a group-based intervention on the health literacy of informal caregivers of children with special health needs (SHNs). The intervention focuses on movement, hydrotherapy, walking, and relaxation, with three evaluation stages. Participants included 34 informal caregivers of children with SHNs, recruited at a Physical Medicine and Rehabilitation Service. We collected sociodemographic data of the participants and measured their health literacy through the short-form version of the European Health Literacy Survey Questionnaire (HLS-EU-Q16). Around 70% of the participants were female, with a mean age of 41.06 ± 4.98 years, and nearly 85% were married or in a de facto union. About 26% were unemployed, and more than 65% had completed secondary education or higher. The mean scores of the HLS-EU-Q16 were statistically significantly higher throughout the intervention, with differences over the evaluation stages [F(2,56) = 75.55; p < 0.05]. A structured, dynamic, and group-based intervention plan showed improvements in the health literacy of the participants, with an increase in the percentage of participants with sufficient and excellent levels of health literacy at the end of the intervention. Full article

Hope and loneliness are significant psychosocial factors that greatly influence the quality of life (QoL) among older adults. However, few studies have examined these constructs simultaneously in rural aging populations in Southeast Asia. This study aimed to investigate the relationships between hope, loneliness, and QoL among community-dwelling older adults in northeastern Thailand. A cross-sectional study was conducted with 250 participants aged 60 years and older, recruited through convenience sampling. Descriptive statistics summarized participant characteristics, while hierarchical regression identified QoL predictors. The participants (mean age = 70.41 years; 52.8% female) reported a high level of hope (M = 33.35), a moderate level of loneliness (M = 8.81), and a good level of QoL (M = 99.13). Hierarchical regression analysis revealed that age, occupation, monthly income, income source, education, health insurance, comorbidities, hope, and loneliness were significant predictors of QoL. Together, these factors accounted for 55.1% of the variance in QoL. Both hope and loneliness have a significant impact on QoL in older adults. Interventions designed to reduce loneliness and foster hope may prove effective in enhancing the well-being of aging populations. These findings underscore the importance of integrating psychosocial and community-based approaches into geriatric care and public health planning. Full article

Background/Objectives: End-of-life care is a vital part of nursing education that has been overlooked until recent years. Advance care planning should be incorporated into the prelicensure nursing curriculum to build student nurses’ confidence in aiding patients and families with their preferred future care plans. Advance care planning tools, such as the Advance Health Care Directive (AHCD) and Five Wishes, provide experiential learning opportunities that bridge theoretical knowledge with real-world patient advocacy. In this study, students were asked to complete either the AHCD or Five Wishes document as though planning for their own end-of-life care, encouraging personal reflection and professional insight. Embedding these assignments into nursing education strengthens students’ confidence in facilitating end-of-life discussions. This study applied Kolb’s experiential learning theory, including concrete experience, reflective observation, abstract conceptualization, and active experimentation, to explore student nurses’ perspectives on the Advance Health Care Directive and Five Wishes assignments, as well as their understanding of end-of-life care. Methods: This study used an exploratory–descriptive qualitative design featuring one open-ended question to collect students’ views on the assignments. Results: The final sample comprised 67 prelicensure student nurses from Bachelor of Science and Entry-Level Master’s programs. The Advance Health Care Directive and/or Five Wishes assignment enhanced students’ understanding of end-of-life decision-making. Conclusions: It is essential to complete the assignment and immerse oneself in an end-of-life situation to grasp patients’ perspectives and concerns regarding when to engage in difficult conversations with their patients. Full article

Background and aims: Rheumatic diseases are chronic, progressive conditions associated with severe pain, joint damage, disability, and even death. Healthcare interventions play a critical role in symptom management, patient education, and adherence to treatment plans. This study evaluates the role of healthcare interventions in the management of patients with rheumatic diseases, focusing on pain management, functional rehabilitation, patient education, and multidisciplinary collaboration. In addition, barriers to optimal care and potential solutions, including digital health technologies, are explored. Materials and methods: We conducted a narrative review of the scientific literature. Studies published between 2014 and 2025 were selected from PubMed, Scopus, Web of Science, Elsevier, Springer, Frontiers, and Wiley Online Library. Key areas of review included nurse-led pain management, education programs, and the impact of interdisciplinary care on patient outcomes. Results: Nursing interventions significantly improve pain control, treatment adherence, and self-management skills in patients with rheumatic diseases. Multidisciplinary approaches improve functional rehabilitation and increase quality of life in patients with rheumatic conditions. However, barriers such as insufficient health care resources, lack of patient awareness, and disparities in the availability of services hinder effective care delivery. Conclusions: A structured, multidisciplinary approach integrating healthcare interventions, digital health solutions, and patient-centered education is essential to optimize the management of rheumatic diseases. Future research should focus on improving access to non-pharmacological therapies and standardizing healthcare protocols for better patient outcomes. Full article

Objective: This study seeks to analyze the incidence of breastfeeding self-efficacy in postpartum woman who are undergoing prenatal care at the Family Health Strategy Units in the city of Tubarão, Santa Catarina (SC), Southern Brazil, from August to December 2022. Methods: An observational epidemiological study with a cross-sectional design was carried out with puerperal women—either primiparous or multiparous—who were followed in the municipal public network, along with their live-born children delivered at the maternity hospital of Hospital Nossa Senhora da Conceição in Tubarão, SC. Participants agreed to participate in the study. For data collection, an instrument developed by researchers and a validated instrument entitled Breastfeeding Self-Efficacy Scale-Short Form were used to assess the self-efficacy of breastfeeding. Results: The mean score of the Breastfeeding Self-Efficacy Scale (BSES) was 61.75 points (±6.39), indicating high self-efficacy. There was an association between the mean of the general score and/or the domains of the BSES with maternal characteristics. Women with higher education had greater technical mastery (p = 0.010), and those with previous breastfeeding experience and those who breastfed their children during the first hour of life had a higher average in the overall score and in the domains of the scale. In addition, those who planned the pregnancy (p = 0.024) and those who did not receive assistance from the milk bank (p = 0.047) had greater technical domain. Conclusions: In the present study, there was a predominance of high breastfeeding self-efficacy. It was verified that the personal and clinical aspects interfered in the self-efficacy of breastfeeding. Full article

Maternal mortality and morbidity are critical health challenges in the U.S., and building the perinatal workforce is a key to providing high-quality maternal medical care and services. Texas Southern University (TSU), home to a Doctor of Pharmacy program, launched the first Maternal Health Education and Research Training (MHERT) program to educate a cohort of high school, pharmacy, and health sciences students. Aiming to raise awareness of maternal health issues, build research skills, and promote action-based solutions. MHERT integrated online self-paced interactive lessons with hands-on research or community projects. Topics included maternal health epidemiology, causes of morbidity and mortality, research methods, literature reviews, and the development of action plans addressing maternal health challenges. Assessment tools included quizzes, open-ended reflection responses, training surveys, and course evaluations. Running from 3 June to 26 July 2024, the program enrolled 22 students. All participants completed both course components. Course evaluations showed strong and consistent satisfaction with the program, with teaching effectiveness rated at 95% and 96% for mid-program and final evaluations, respectively. MHERT enhanced participants’ understanding of maternal health, improved research skills, and encouraged community engagement and interdisciplinary collaboration. It offers a scalable model to strengthen public health education among high school, pharmacy, and health sciences students. Full article

Background/Objectives: Degenerative joint diseases (DJDs) involve intricate molecular disruptions within bone, cartilage, and synovial tissues, often preceding overt radiographic changes. These tissues exhibit complex biomolecular architectures and their degeneration leads to microstructural disorganization and inflammation that are challenging to detect with conventional imaging techniques. This review aims to synthesize recent advances in imaging, computational modeling, and sequencing technologies that enable high-resolution, non-invasive characterization of joint tissue health. Methods: We examined advanced modalities including high-resolution MRI (e.g., T1ρ, sodium MRI), quantitative and dual-energy CT (qCT, DECT), and ultrasound elastography, integrating them with radiomics, deep learning, and multi-scale modeling approaches. We also evaluated RNA-seq, spatial transcriptomics, and mass spectrometry-based proteomics for omics-guided imaging biomarker discovery. Results: Emerging technologies now permit detailed visualization of proteoglycan content, collagen integrity, mineralization patterns, and inflammatory microenvironments. Computational frameworks ranging from convolutional neural networks to finite element and agent-based models enhance diagnostic granularity. Multi-omics integration links imaging phenotypes to gene and protein expression, enabling predictive modeling of tissue remodeling, risk stratification, and personalized therapy planning. Conclusions: The convergence of imaging, AI, and molecular profiling is transforming musculoskeletal diagnostics. These synergistic platforms enable early detection, multi-parametric tissue assessment, and targeted intervention. Widespread clinical integration requires robust data infrastructure, regulatory compliance, and physician education, but offers a pathway toward precision musculoskeletal care. Full article

Pediatric palliative care (PPC) is an evolving field that focuses on supporting children with life-limiting conditions, where the quality of care is vital. This study is a retrospective observational investigation that examines the experiences of caregivers to inform health and social service planning and enhance PPC quality. Methods: Data of pediatric patients aged 3 months to 18 years admitted to a PPC inpatient unit over two years were retrospectively reviewed. Sociodemographic characteristics of primary caregivers, including age, gender, number of siblings, education, income, occupation, and marital status, were recorded. Caregiver burden and burnout were assessed using the Zarit Burden Interview and the Maslach Burnout Inventory, respectively. Associations between caregiver characteristics and these measures were analyzed. Results: A total of 118 patients and caregivers were evaluated; 54.2% of patients were male. The most common diagnoses were neurological diseases (44.9%), followed by syndromic–genetic disorders (28.8%). About 34% of patients required more than three medical devices. Most caregivers were female (91.5%), mainly mothers and 53% had only primary education. No significant differences in care burden or burnout were found based on caregiver gender, marital status, or child’s diagnosis. However, the use of nasogastric tubes and multiple medical devices was associated with higher burnout. Lower income was significantly linked to higher care burden, while longer caregiving duration correlated with both increased burden and burnout. A moderate positive correlation was found between Zarit and Maslach scores. Conclusions: The complexity of PPC patients’ care increases caregiver burden and burnout. Expanding specialized PPC services is crucial to support caregivers and sustain home-based care. Full article

Introduction: Racial and ethnic disparities in end-of-life (EOL) cancer care persist, leading to lower rates of advance care planning (ACP), reduced access to palliative care, and poorer patient outcomes for minority populations. While previous research has documented these inequities, less is known about the specific interventions developed to address them, necessitating a comprehensive review of existing strategies aimed at improving EOL care for racial and ethnic populations. The objective of this scoping review is to examine the extent and characteristics of interventions and their outcomes designed to address racial and ethnic disparities in EOL cancer care in the United States. Methods: A comprehensive search of EOL cancer care interventions for minority populations was conducted in Ovid MEDLINE, CINAHL with Full Text (EBSCOhost), and Scopus (Elsevier) in September 2024. Two independent reviewers screened titles, abstracts, and full texts following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines, with inclusion limited to studies conducted in the US and published in English. Results: Of 3104 screened studies, 10 met the inclusion criteria. Participants enrolled were only from Latino (n = 6 studies) or Black (n = 4 studies) populations. We identified four types of interventions, including communication skills for patients, caregivers, researchers, and clinicians (n = 2), education programs for patients (n = 1), navigation and support programs for patients and caregivers (n = 3), and training programs for health workers and community leaders (n = 4). The most effective interventions were those that addressed linguistic barriers, integrated cultural values, and involved trusted community figures. Faith-based models were particularly successful among African American patients, while bilingual navigation and family-centered ACP interventions had the greatest impact in Latino populations. Conclusions: This review highlights (1) the importance of culturally tailored interventions for specific minority populations and (2) the limited number of such interventions, which primarily target only the largest minority groups. Full article

Introduction: The clinical syndrome of heart failure (HF) is progressive and disabling for patients who rely on their caregivers for help and support. The caregiving role is inducing major changes in the personal, social, and family life of caregivers and entails a heavy emotional and physical burden, which in turn negatively affects their quality of life (QoL). Purpose: The purpose of this study was to explore the QoL of caregivers of patients with HF as well as the associated caregivers’ and patients’ characteristics. Material and Methods: The sample of the study included 340 caregivers along with their hospitalized patients. Data collection was performed by the method of the interview using the questionnaire “SF-36 Health Survey (SF-36)” to assess caregivers’ QoL. Results: Τhe physical QoL component of caregivers was found to be statistically significantly associated with the type of relationship with their patient (p = 0.001), age (p = 0.001), level of education (p = 0.001), occupation (p = 0.001), information about HF patients (p = 0.001), worry about finances (p = 0.001), and insecurity about the future (p = 0.001). The mental QoL component of caregivers was found to be statistically significantly associated with the type of relationship with their patient (p = 0.001), gender (p = 0.009), age (p = 0.001), level of education (p = 0.001), occupation (p = 0.001), frequency of visits to hospitalized patient (p = 0.001), information about HF (p = 0.029), anxiety about patients’ self-care (p = 0.001), worry about finances (p = 0.001), and insecurity about the future (p = 0.001). In terms of HF patient’s characteristics, the physical QoL component of caregivers was found to be statistically significantly associated with the patients’ age (p = 0.001), patients’ education level (p = 0.001), patients’ occupation (p = 0.006), patients’ family history of cardiac disease (p = 0.006), and patients’ self-reported symptom management before hospital admission (p = 0.022). The mental QoL component of caregivers was found to be statistically significantly associated with the patients’ education level (p = 0.020), the patients’ NYHA stage (p = 0.001), prior hospitalization (p = 0.001), the patients’ family history of cardiac disease (p = 0.012), and the patients’ self-reported symptom management before admission (p = 0.001). Conclusions: In-depth understanding factors affecting QoL in caregivers with HF may enhance plans and actions to attain healthcare goals among societies globally. Full article

We present a systematic evaluation of population health reviews from the Cochrane Database (January 2013–February 2023) to evaluate how indicators of inequity or disadvantage are considered and reported in population health evidence syntheses. Descriptive analyses explored a representation of reviews across health-determinant categories (primary and secondary categories), summarised equity-focused reviews, and examined proportions and types of reviews that planned/completed a subgroup analysis using ≥1 indicators from the PROGRESS-Plus framework. Of 363 reviews included, a minority focused on interventions targeting wider determinants of health (n = 83, 22.9% as primary category), with a predominance related to individual lifestyle factors (n = 155, 42.7%) or health care services intervention (n = 97, 26.7%). An explicit equity focus was evident in 21 (5.8%) reviews that used PROGRESS/PROGRESS-Plus, and 28 (7.7%) targeting vulnerable groups. Almost half (n = 165, 45.6%) planned a subgroup analysis by ≥1 PROGRESS-Plus indicator, which was completed in 63 reviews (38.2% of 165). The non-completion of planned subgroup analyses was attributed to insufficient data (too few primary studies, data not reported by subgroups). Among the 165 reviews planning a subgroup analysis, age was the most cited indicator (n = 91, 55.2%), followed by gender/sex (n = 67, 40.6%), place (n = 47, 28.5%) and socio-economic status (n = 37, 22.4%). This study highlighted missed opportunities for learning about the impacts of health equity in population health evidence syntheses due to insufficient data. We recommend routine use of PROGRESS-Plus and greater consistency in socio-economic proxies (occupation, education, income, disadvantage measures) to facilitate meta-analyses and subgroup analyses. Full article

Aligned with the worldwide shift towards promotional and preventative health care, the South African government has introduced a re-engineered primary health care plan, facilitated through a National Health Insurance (NHI) platform. Community health workers (CHWs) are key role-players in most universal health care systems. This article shares insider perspectives from 31 CHWs in one of the South African NHI pilot districts. Based on their perspectives, the authors share recommendations to strengthen the NHI plan. Recommendations comprise of the inclusion of a dedicated CHW team leader and reporting nurse, ongoing CHW education and training with an accompanying portfolio of evidence, and awareness campaigns on the role of CHWs within the South African re-engineered primary health care plan and NHI platform. Full article

Natural and human-made disasters can severely impact communities and can result in high numbers of human injuries and deaths. Animals, both companion and livestock, are often injured as a result of these disasters and require veterinary care. Veterinarians are not only involved in providing care for these animals but also play important roles in planning and preparedness functions that occur before a disaster strikes. There are several examples of the use of multi-user virtual environments (MUVE) to provide human health care workers with valuable training centered on disaster response and disaster medicine. This communication provides a thorough review of a clinical rotation, as part of a professional veterinary curriculum, that uses a combination of classroom and experiential learning via an MUVE, Second Life^®. This rotation has provided more than 1800 senior veterinary students at a veterinary school in the United States with experiential learning opportunities focused on veterinary disaster preparedness, planning, and response training. The authors have prepared this communication to provide other institutions and educators with information on the practical implementation of Second Life^® in teaching and to offer recommendations based on our institutional experience. Full article

This thought piece exposes the gap in the operationalised support in England for young people within the justice system who have special educational needs and disabilities. It exposes inequity within the system which serves to create barriers for justice-involved young people, who are likely to already be disengaged from education, in accessing appropriate provision. It presents gaps in key educational advice and practice relating to access to Education, Health and Care Plans as a route to support for justice-involved young people, identifying a negative bias for this group of children who are already marginalised. Within the context of an English Special Educational Needs system which is widely recognised as broken, and an ongoing parliamentary consultation into ways to improve the situation, this piece suggests key changes to reduce the inequitable access to special education provision for young people accommodated in the secure estate. These suggestions make a contribution to the agenda of English politicians and the Department of Education. Full article