Search Results (653)

Background: Schizophrenia affects patients’ organizational thinking, as well as their ability to identify problems. The main objective of this study was to explore healthcare consultants’ application of AI mind maps to educate patients with schizophrenia regarding their perceptions of family function, social support, quality of life, and loneliness, and to help these patients think more organizationally and understand problems more effectively. Methods: The study used a survey research design and purposive sampling method to recruit 66 participants with schizophrenia who attended the psychiatric outpatient clinic of a hospital in central Taiwan. They needed to be literate, able to respond to the topic, and over 18 years old (inclusive), and they attended individual and group health education using AI mind maps over a 3-month period during regular outpatient clinic visits. Results: The study results show that patients’ family function directly affects their quality of life (p < 0.05) and loneliness (p < 0.05), satisfaction with social support affects quality of life and loneliness directly (p < 0.05), and satisfaction with social support is a mediating factor between family function and quality of life (p < 0.05), as well as a mediating factor between family function and loneliness (p < 0.05). Conclusions: Therefore, this study confirms the need to provide holistic, integrated mental health social care support for patients with schizophrenia, showing that healthcare consultants can apply AI mind maps to empower patients with schizophrenia to think more effectively about how to mobilize their social supports. Full article

Introduction: Low medication adherence and low hypertension control are a public health challenge, particularly in low- and middle-income countries (LMICs). Healthcare system- and patient-related barriers hinder the successful management of hypertension. This study aimed to identify the perceptions of barriers and facilitators to hypertension management among health system stakeholders in Santander, Colombia. Materials and Methods: We conducted a qualitative, phenomenological, and interpretative study, comprising five focus groups, to explore the barriers and facilitators to managing people with hypertension. Each focus group was formed by stakeholders from territorial entities, healthcare insurers, or healthcare providers. Meetings were held between December 2022 and February 2023. The sessions were recorded and transcribed using NVivo Transcription and analyzed using NVivo version 1.6.1. Results: Seven categories of barriers and facilitators were identified: strategies, resources, access, risk assessment, cross-sector collaboration, articulation, and stewardship. Of these categories, articulation and stewardship emerged as the main barriers, as revealed through axial coding and cluster analysis, which highlighted deficiencies in stewardship practices, a lack of clear objectives, and misalignment with public policy frameworks. Conclusions: Multisectoral actions extending beyond healthcare providers and aimed at improving coordination and intersectoral collaboration are essential for enhancing hypertension control in LMICs, such as Colombia. Addressing social determinants and strengthening primary healthcare through community-based strategies are critical, making stewardship and improved access key priorities. Full article

Asthma is the leading chronic condition in children and adolescents, requiring continuous monitoring to effectively prevent and manage symptoms. Symptom monitoring can guide timely and effective self-management actions by children and their parents and inform treatment decisions by healthcare providers. This paper examines two conventional monitoring methods, including symptom-based and peak expiratory flow (PEF) monitoring, reviews early efforts to quantify respiratory symptoms, and introduces an emerging sensor-based mHealth approach. Although symptom-based monitoring is commonly used in clinical practice, its adequacy is a concern due to its subjective nature, as it primarily relies on individual perception. PEF monitoring, while objective, has shown weak correlations with actual asthma activity or lung function and suffers from suboptimal adherence among youth. To enhance objectivity in symptom monitoring, earlier efforts focused on quantifying respiratory symptoms by harnessing mechanical equipment. However, the practicality of these methods for daily use is limited due to the equipment’s bulkiness and the time- and labor-intensive nature of data processing and interpretation. As an innovative alternative, sensor-based mHealth devices have emerged to provide automatic, objective, and continuous monitoring of respiratory symptoms. These wearable technologies offer promising potential to overcome the issues of perceptual inaccuracy and poor adherence associated with conventional methods. However, many of these devices are still in developmental or testing phases, with limited data on their clinical efficacy, usability, and long-term impact on self-management behaviors. Future research and robust clinical trials are warranted to establish their role in asthma monitoring and management and improving asthma outcomes in children and adolescents. Full article

Background and Objectives: Gender disparities in pain management persist, with women frequently receiving inadequate analgesia despite reporting similar or higher pain levels compared with men. This issue is particularly evident across various medical and gynecological procedures. Materials and Methods: This integrative literature review synthesizes recent empirical studies examining gender biases in pain perception and management, focusing specifically on procedural pain in women. It includes an analysis of clinical research, patient-reported outcomes, and healthcare provider behaviors. Results: The findings indicate that unconscious biases, a lack of gender-specific clinical protocols, and prevailing cultural stereotypes contribute to the undertreatment of pain in women during procedures such as intrauterine device insertion and diagnostic hysteroscopy. Additionally, communication gaps between patients and healthcare providers exacerbate these disparities. Conclusions: Addressing gender disparities in pain management necessitates systemic reforms, including the implementation of gender-sensitive clinical guidelines, enhanced provider education, and targeted policy changes. Personalized, gender-informed approaches are essential to improving equity and quality of care in pain treatment. Full article

This study builds on Davis’ TAM by integrating environmental and psychological variables relevant to AI medical diagnostics. This study developed a mathematical theoretical model called the “AI medical diagnosis-acceptance evaluation model” (AMD-AEM) to better understand acceptance behavior intention. Using mathematical modeling, we established reflective measurement model indicators and structural equation relationships, where linear structural equations illustrate the interactions among latent variables. In 2025, we collected empirical data from 2380 patients and medical staff who have experience with AI diagnostic systems in teaching hospitals in central Taiwan. Smart PLS 3 was employed to validate the AMD-AEM model. The results reveal that perceived usefulness (PU) and information quality (IQ) are the primary predictors of acceptance behavior intention (ABI). Additionally, perceived ease of use (PE) indirectly influences ABI through PU and attitude toward use (ATU). AI emotional perception (AEP) notably shows a significant positive relationship with ATU, highlighting that warm and positive human–AI interactions are crucial for user acceptance. IQ was identified as a mediating variable, with variance accounted for (VAF) coefficient analysis confirming its complete mediation effect on the path from ATU to ABI. This indicates that information quality enhances user attitudes and directly increases acceptance behavior intention. The AMD-AEM model demonstrates an excellent fit, providing valuable insights for academia and the healthcare industry. Full article

Introduction: This prospective descriptive study explored the disparities in perceptions and experiences regarding healthcare services between providers and users during the COVID-19 pandemic, with a specific focus on the impact of the digital divide on access to and quality of care. The study revealed significant inconsistencies in the experiences of healthcare providers and patients, particularly regarding the effectiveness of digital health interventions. Methods: This study was a prospective descriptive analysis conducted to evaluate and compare the use of electronic healthcare services between healthcare employees (HΕs) (N = 290) and consumers (Cs) (N = 263) from December 2024 to May 2025, utilizing an electronic survey after the COVID-19 pandemic. To ensure the statistical validity of the sample size, a power analysis was performed using G*Power 3.1.9.2 software. A questionnaire was developed to evaluate the readiness of healthcare employees and consumers for electronic healthcare services. It was validated to ensure reliability within this population and comprised 49 questions. Results: The response rate of the participants was 89.19%, and the Cronbach’s alpha for the questionnaire was 0.738. The study revealed notable differences in perceptions regarding health-related information and digital health technologies across genders and age groups. Specifically, 28.8% of females and 27.3% of males considered it important to be well-informed about health issues (χ² = 8.83, df = 3, p = 0.032). Conclusions: This research contributes to filling a gap in comparative analyses of provider and user perspectives, offering a comprehensive view of how digital health was adopted and experienced during a global crisis. Practically, it provides an evidence base to guide future interventions aimed at fostering more equitable, resilient, and user-friendly digital healthcare systems. Full article

COVID-19 vaccine hesitancy in Pakistan is a barrier to optimal vaccine uptake and has been situated within a context of hesitancy towards other vaccines. A mixed-methods study was conducted during the initial COVID-19 vaccine roll-out in 2021 in four union councils in Peshawar, consisting of a cross-sectional survey, eight focus group discussions (FGDs) with community members and eight in-depth interviews with healthcare workers (HCWs) to assess perceptions toward vaccines. Multivariable logistic regression was used to assess factors associated with COVID-19 vaccine hesitancy. Of 400 survey participants, 57.3% were vaccine acceptant and 42.8% vaccine hesitant. Just over half (56.8%) perceived COVID-19 vaccines to be safe. Most (88%) reported trust in HCWs to provide accurate vaccine information. FGDs revealed that women received less information about the vaccine compared to men and cultural restrictions were barriers even for those willing to be vaccinated. Correlates of vaccine acceptance included male sex (aOR 2.25; 95% CI 1.29–3.91), age 50 years or greater (aOR 1.74; 95% CI 1.19–6.31), social network support (e.g., vaccine acceptance among an individual’s social network) in receiving COVID-19 vaccines (aOR 2.38; 95% CI 1.45–3.89), community concern about COVID-19 spread (aOR 2.84; 95% CI 1.73–4.66), and trust in HCWs to provide vaccine information (aOR 3.47; 95% CI 1.62–7.42). Future vaccine promotion should prioritize engaging community leaders, sharing transparent information, combatting misinformation and rumors, and implementing household-based interventions especially targeting the importance of vaccination among women and young people to increase uptake. Full article

This study aims to explore the walkability of three small areas (basic healthcare areas) of Barcelona city (Catalonia, Spain) for frail older adults. A mixed methods study design was conducted with 132 frail older adults in three primary care centers of Barcelona: Larrard, Barceloneta, and Vila Olímpica. A literature review was conducted to identify urban design indicators related to walkability and the aging population. These were then reflected in the surveys administered to the program participants, capturing information on their preferred routes, usual destinations, and walkability perceptions. Findings reveal significant mobility challenges for older adults, particularly the ones related to safety issues, the adequacy of sidewalk widths, greenery and urban furniture maintenance, and the presence/absence of commercial activities. This research underscores the importance of age-sensitive urban design in healthcare environments and provides a framework for enhancing walkability and accessibility for populations at greater risk of mobility-related health problems, such as frail older adults. Full article

Background/Objectives: Misinformation significantly impacts self-care behaviors and treatment outcomes in patients with type 2 diabetes mellitus (T2DM). We investigated the prevalence and content of diabetes-related misinformation among Thai patients with T2DM, examining the influence on cognitive attitudes and intentions to share such information. Methods: We employed a mixed-methods approach, conducting initial qualitative interviews with healthcare professionals and patients with T2DM to identify key misinformation themes. These themes guided the development of a validated questionnaire that was distributed to 107 patients with T2DM. Spearman’s correlation and multiple linear regression analyses were used to assess the relationships between misinformation exposure, attitudes, and sharing intentions. Results: Misinformation was categorized into four domains: medication side effects, alternative treatments, imbalanced lifestyle, and symptom perception. Exposure to misinformation ranged from 19.6% to 94.4%, with word of mouth identified as the primary source (81.18%). Misconceptions regarding symptom perception and alternative treatments were most prevalent. Information source, especially healthcare providers (β = 0.4); personal attitudes towards misinformation (β = 0.24); and exposure level (β = 0.46) significantly influenced the intention to share misinformation. Conclusions: This study highlights the need for targeted educational interventions to address widespread misconceptions in the management of T2DM, particularly those related to symptom perception and alternative treatments. Addressing these misinformation sources may be associated with improved self-management practices and could inform strategies aimed at enhancing patient outcomes. Full article

Biophilic design has emerged as a multidimensional response to growing concerns about health, well-being, and ecological balance in the built environment. Despite its rising prominence, research on the topic remains fragmented across building typologies, user groups, and geographic contexts. This study presents a comprehensive review of the biophilic design literature, employing a hybrid methodology combining structured content analysis and bibliometric mapping. All peer-reviewed studies indexed in the Web of Science and Scopus were manually screened for architectural relevance and systematically coded. A total of 435 studies were analysed to identify key trends, thematic patterns, and research gaps in the biophilic design discipline. This review categorises the literature by methodological strategies, building typologies, spatial scales, population groups, and specific biophilic design parameters. It also examines geographic and cultural dimensions, including climate responsiveness, heritage buildings, policy frameworks, theory development, pedagogy, and COVID-19-related research. The findings show a strong emphasis on institutional contexts, particularly workplaces, schools, and healthcare, and a reliance on perception-based methods such as surveys and experiments. In contrast, advanced tools like artificial intelligence, simulation, and VR are notably underused. Few studies engage with neuroarchitecture or neuroscience-informed approaches, despite growing recognition of how spatial design can influence cognitive and emotional responses. Experimental and biometric methods remain scarce among the few relevant contributions, revealing a missed opportunity to connect biophilic strategies with empirical evidence. Regarding biophilic parameters, greenery, daylight, and sensory experience are the most studied parameters, while psychological parameters remain underexplored. Cultural and climate-specific considerations appear in relatively few studies, and many fail to define a user group or building typology. This review highlights the need for more inclusive, context-responsive, and methodologically diverse research. By bridging macro-scale bibliometric patterns with fine-grained thematic insights, this study provides a replicable review model and valuable reference for advancing biophilic design as an evidence-based, adaptable, and human-centred approach to sustainable architecture. Full article

Aims: To systematically review and synthesize qualitative research exploring the Breast Cancer Survivors (BCSs)’ perception of health promotion interventions and informing strategies to mitigate recurrence risk within five years post-treatment and improve clinical outcomes. Specifically, this study addresses the question: “How do women diagnosed with breast cancer perceive health promotion interventions for recurrence prevention?” Design: A systematic review and qualitative meta-synthesis were performed. Data Sources: A systematic search of scientific databases (CINAHL, MEDLINE, and Scopus) was undertaken in November 2024. The reference list was cross-referenced and hand-searched to identify additional articles. Review Methods: Studies were included if they met the following criteria: they were primary qualitative studies focusing on BCSs within five years post-treatment, involving participants who had completed surgery, radiotherapy, or chemotherapy in the same time frame, as this period is critical for monitoring recurrence and implementing health promotion interventions. Only studies published in peer-reviewed journals and written in Italian, English, French, or Spanish were considered, provided that an abstract and the full text were available. Moreover, eligible studies had to be conducted in high-income or middle-income countries. Studies were excluded if they focused exclusively on advanced or metastatic breast cancer, if they involved mixed cancer populations without reporting separate data for BCSs, or if they were non-qualitative studies or gray literature. The review study protocol was registered in the PROSPERO database (CRD42024626033). Results: The literature search identified 490 records, 13 articles from databases, and 3 articles identified via other methods (web and citation searching) that met inclusion criteria. A narrative synthesis approach allowed the emerging five themes: (I) Challenges, (II) Self-motivation and empowerment, (III) The relationships as a facilitator, (IV) Barriers to change, and (V) Proactive support strategies. Conclusions: Addressing internal and external factors that influence health behaviors is essential to improve adherence, reduce recurrence risk, and enhance quality of life. Tailored interventions, social support, and healthcare engagement are crucial in this effort. Impact: Our meta-synthesis highlighted significant challenges as well as valuable resources for health promotion among BCSs, suggesting practical and tailored approaches to improving the adoption of healthy behaviors, supported by relationships and targeted support strategies. Full article

Background: Breastfeeding is essential for preventing non-communicable diseases. However, mothers with chronic illnesses tend to breastfeed less, increasing the likelihood of abandoning breastfeeding, especially if they experience gestational complications. Objective: To analyze the association between factors such as prepregnancy maternal characteristics, gestational complications, food security, barriers, and facilitators with the practice of exclusive breastfeeding. Methods: Cross-sectional study with 566 women who had prenatal care and gave birth at the National Institute of Perinatology (Mexico City) between 2021 and 2024. Surveys were administered on breastfeeding practices, food insecurity, barriers, and facilitators of exclusive breastfeeding in mothers. In addition, sociodemographic information, medical history (prepregnancy conditions and complications), gestational weight gain, and neonatal outcomes were recorded. Results: Of the 566 women, only 43.6% practiced exclusive breastfeeding, with a median duration of 4 months. Exclusive breastfeeding was more frequent in young, stay-at-home mothers with lower educational attainment and in those with food insecurity, who also tended to delay the introduction of complementary foods until after six months. Prepregnancy risk conditions (OR 1.56, 95% CI 1.06–2.30) and multiparity (OR 1.64, 95% CI 1.08–2.49) increased the risk of non-exclusive breastfeeding. Conversely, food insecurity (OR 0.40, 95% CI 0.20–0.78) and counseling from healthcare personnel (OR 0.09, 95% CI 0.01–0.51) showed a protective effect. The analysis also showed that paid employment (OR 4.68, 95% CI 1.65–13.21), the perception of low milk production (OR 6.45, 95% CI 2.95–14.10), maternal illness/medication (OR 3.91, 95% CI 1.36–11.28), and fatigue (OR 4.67, 95% CI 1.36–11.28) increased the probability of non-exclusive breastfeeding. Conclusions: In Mexico, the promotion of exclusive breastfeeding faces challenges, especially in mothers who begin pregnancy with significant chronic conditions such as diabetes, hypertension, obesity, advanced maternal age, and hypothyroidism, among others. Healthcare personnel should provide personalized advice to each woman from the prenatal stage on strategies to achieve and maintain exclusive breastfeeding. Full article

Background/Objective: Non-specific chronic neck pain (CNP) greatly affects the social dynamics, the work performance, and the personal independence of patients. Research emphasizes the significant role of sociological factors, psychological stress, and emotional conflicts in the development, regulation, and endurance of chronic pain. This study aims to explore the influence of emotional conflicts on pain experience among CNP patients, drawing from their experiences. Methods: A phenomenological investigation was conducted, grounded in Heideggerian philosophy, involving CNP patients and healthcare professionals in Madrid, Spain. Participants were recruited from Primary Health Care centers. Data collection methods included semi-structured in-depth interviews, focus groups with patients, focus groups with healthcare providers, participant observation, and reflective diaries. Hermeneutic phenomenology guided the data interpretation. Thematic analysis was applied to transcribed audio recordings. Results: This study included 12 patients with CNP who participated in two in-depth interviews conducted at different time points—before and after receiving physiotherapy treatment. Additionally, 23 CNP patients took part in four focus groups, and 46 healthcare professionals (including physicians, nurses, and physiotherapists) participated in three focus groups. A hermeneutic analysis revealed the following three main categories: “Self-concept and pain experience”, “Daily life obligations and pain perception”, and “Emotional conflicts related to CNP”. Patients described themselves as nervous, having communication difficulties, and often prioritizing family or work tasks, leading to stress. They indicated that their interpersonal conflicts with close relations intensified their perceived pain in the neck, head, shoulders, and arms. Conclusions: From the perspective of the participants in this study, interpersonal and emotional conflicts appear to influence their perception of CNP. Full article

Generative artificial intelligence (GAI) is emerging as a disruptive force, both economically and socially, with its use spanning from the provision of goods and services to everyday activities such as healthcare and household management. This study analyzes the enabling and inhibiting factors of GAI use in Spain based on a large-scale survey conducted by the Spanish Center for Sociological Research on the use and perception of artificial intelligence. The proposed model is based on the Theory of Planned Behavior and is fitted using machine learning techniques, specifically decision trees, Random Forest extensions, and extreme gradient boosting. While decision trees allow for detailed visualization of how variables interact to explain usage, Random Forest provides an excellent model fit (R² close to 95%) and predictive performance. The use of Shapley Additive Explanations reveals that knowledge about artificial intelligence, followed by innovation orientation, is the main explanatory variable of GAI use. Among sociodemographic variables, Generation X and Z stood out as the most relevant. It is also noteworthy that the perceived privacy risk does not show a clear inhibitory influence on usage. Factors representing the positive consequences of GAI, such as performance expectancy and social utility, exert a stronger influence than the negative impact of hindering factors such as perceived privacy or social risks. Full article

Background: Violence against healthcare professionals is a growing public health concern. In Spain, the National Observatory of Aggressions recorded 16,866 cases in 2024, marking a 103.06% increase since 2017. This phenomenon has intensified in recent years, with serious repercussions for both the physical and psychological well-being of healthcare workers, as well as for the quality of care provided. Objectives: This descriptive study examines the knowledge, perceptions, and experiences of workplace aggression among undergraduate students at the University School of Nursing of the Nuestra Señora de Candelaria University Hospital. Materials and Methods: A self-administered ad hoc questionnaire was distributed to 266 students across all academic years to assess their knowledge and to explore their perceptions and experiences of aggression witnessed or experienced during clinical placements. This study was guided by the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Results: The findings revealed significant educational gaps among students regarding how to manage aggressive situations, as well as high levels of concern and an aggression exposure rate exceeding 30%. A statistically significant association was also observed in relation to the academic year. Conclusions: This study provides a foundation for the development of specific training programmes tailored to the needs identified and for enhancing occupational safety in healthcare settings. Full article