Search Results (77)

Introduction: Assessing the quality of patient care within healthcare systems remains a multifaceted challenge due to varying definitions of “quality” and the complexity of care delivery structures worldwide. Patient-centeredness, institutional responsiveness, and contextual adaptability are increasingly recognized as core pillars in quality assessment. Objective: This narrative literature review aims to explore conceptual models and practical frameworks for evaluating healthcare quality, emphasizing tools that integrate technical, functional, and emotional dimensions and proposing a comprehensive model adaptable to diverse health system contexts. Methodology: A systematic literature search was conducted in the PubMed, Scopus, and Cochrane Library databases, covering the years 2000 to 2024. Studies were selected based on relevance to quality assessment models, patient satisfaction, accreditation, and strategic improvement methodologies. The review followed a thematic synthesis approach, integrating structural, process-based, and outcome-driven perspectives. Results: Core frameworks such as Donabedian’s model and balancing measures were reviewed alongside evaluation tools like the Dutch Consumer Quality Index, SERVQUAL, and Importance–Performance Analysis (IPA). These models revealed significant gaps between patient expectations and actual service delivery, especially in functional and emotional quality dimensions. This review also identified limitations related to contextual generalizability and bias. A novel integrative model is proposed, emphasizing the dynamic interaction between institutional structure, clinical processes, and patient experience. Conclusions: High-quality healthcare demands a multidimensional approach. Integrating conceptual frameworks with context-sensitive strategies enables healthcare systems to align technical performance with patient-centered outcomes. The proposed model offers a foundation for future empirical validation, particularly in resource-limited or hybrid settings. 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: To identify factors influencing the structure and functioning of long-term residential care facilities for older adults worldwide, in order to uncover practices and support evidence-based improvements in care delivery. Method: An overview of systematic reviews was performed according to the PRISMA protocol and registered on the PROSPERO platform (no. CRD42023486204). Research was carried out on 21 September 2023, using the following databases: PubMed (via MedLine), EMBASE, Web of Science, Scopus, Virtual Health Library (VHL), and Epistemonikos. Results: The search yielded 12,040 articles, including 61 systematic reviews. Analyzing the primary outcomes, personnel structure, and risk management were the most-studied outcomes of the systematic reviews, followed by pharmaceuticals, food services, mobility/accessibility, and technological and physical structures. In terms of primary outcomes of the systematic reviews, the personnel structure was the most highlighted (in 39.34%), followed by risk management (in 32.79%), while the least highlighted was physical structure (in 9.84%). Conclusions: Personnel are critical to the safe and effective functioning of Long-Term Care Facility (LTCF) operations. Future research is needed to identify associations between models of care and structural concerns, including physical environment, as they relate to quality of care in LTCFs, particularly in low and middle-income countries (LMIC). Full article

In the Industry 4.0 era, digital transformation is crucial for college libraries aiming to improve reader service quality. The current research proposes various digital transformation initiatives for college libraries but ignores readers’ willingness to use digital services, which is key to a successful digital transformation. To better help college libraries in their digital transformation, this study explores readers’ willingness to use digital services from a perceived benefit–risk perspective. Using structural equation modeling, it examines factors that influence this willingness, like readers’ attitudes, trust, perceived benefit, and perceived risk. The results show that perceived benefits positively affect the willingness to adopt, while perceived risks have a negative effect. Readers’ attitudes and trust indirectly influence this willingness by affecting their benefit–risk perceptions. This study is practically significant for guiding strategies to boost readers’ willingness to use digital services, offering valuable insights for universities in digital transformation complexity. Full article

Over recent years, digital and intelligent technologies have been driving the transformation of discipline-specific information services in academic libraries toward user experience optimization and service innovation. This study constructs a quality evaluation framework for discipline-specific information services in academic libraries, incorporating digital-intelligence characteristics to provide theoretical references and evaluation guidelines for enhancing service quality and user satisfaction in an information-ubiquitous environment. Drawing on LibQual+TM, WebQUAL, and E-SERVQUAL service quality evaluation models and integrating expert interviews with the contextual characteristics of academic library discipline-specific information services, this study develops a comprehensive evaluation system comprising six dimensions—Perceived Information Quality, Information Usability, Information Security, Interactive Feedback, Tool Application, and User Experience—with fifteen specific indicators. The analytic hierarchy process (AHP) was applied to determine the weight of these indicators. To validate the practicality of the evaluation system, a fuzzy comprehensive evaluation method was employed for an empirical analysis using discipline-specific information services at Tsinghua University Library in China as a case study. The evaluation results indicate that the overall quality of discipline-specific information services at Tsinghua University Library is satisfactory, with Tool Application, Perceived Information Quality, and Information Usability identified as key factors influencing service quality. To further enhance discipline-specific information services in academic libraries, emphasis should be placed on service intelligence and precision-driven optimization, strengthening user experience, interaction and feedback mechanisms, and data security measures. These improvements will better meet the diverse needs of users and enhance the overall effectiveness of discipline-specific information services. Full article

Background: Early cognitive training is important to prevent cognitive decline in patients with mild cognitive impairment (MCI) or dementia. Therefore, developing an application that can provide evidence-based cognitive training is necessary for patients with MCI or dementia. Method: This study aimed to develop and evaluate Smart Brain, an evidence-based application that provides comprehensive cognitive training tailored to this population. The application was developed using an ADDIE (analysis, design, development, implementation, and evaluation) model. A systematic review of databases, including Ovid-MEDLINE, Ovid-EMBASE, Cochrane Library, and CINAHL, was conducted up to April 15, 2021, to identify key content areas. Additionally, a survey of 100 participants highlighted the need for features such as cognitive games, health notes, social networking services, and goal achievement. Result: The application was developed with distinct user and administrator interfaces to support engagement and monitoring. Usability testing involved 7 experts and 11 elderly individuals with MCI or dementia from a daycare center. Based on usability feedback, features such as the time limits for cognitive games were refined. The final application integrates cognitive games, physical exercises, emotional support, and health management tools to address user needs comprehensively. Conclusion: Smart Brain holds significant potential to improve the quality of life and cognitive health of elderly individuals with MCI or dementia. Its usability and functionality make it a promising tool for community-based interventions. Full article

Background: Primary health care (PHC) systems and their successes and challenges vary between and within countries. We elucidate the role of PHC on health status and universal health coverage (UHC) by describing the achievements and challenges of PHC systems in seven countries representing the three economic levels: high-income (Belgium, Australia), middle-income (South Africa, Thailand), and low-income countries (Cambodia, Ethiopia, and Nepal). Methods: We adopted a mixed-methods approach and (a) extracted quantitative data on the key health and universal health coverage index of countries and (b) conducted a scoping review of the PHC systems in these countries. We used key terms related to the following eight domains: service delivery, health workforce, health information system, health financing, medicines, and leadership and governance (the WHO’s building blocks for national health systems) and community participation and multisectoral actions (other pillars of PHC) to identify the relevant literature and searched six databases: PubMed, Scopus, Embase, PsycINFO, CINAHL, and Cochrane Library. A total of 58 articles were identified and included in this review; data were charted and synthesised narratively. Results: There is variation in health services coverage and health status across the three economic levels. Countries expanded access to PHC services using strategies like telehealth and CHWs but faced challenges in sustainability, workforce retention, and service quality. Community engagement and multisectoral actions helped, though gaps in governance, resources, and essential medicines hindered progress towards UHC. Conclusions: By addressing the challenges and leveraging successful strategies, countries can move closer to achieving the goal of universal health coverage and improving health outcomes for all. Full article

Background: Patient safety is an important component of healthcare service quality, and there are numerous instruments in the literature that measure patient safety. This scoping reviewaims to map the instruments/scales for assessing patient safety in healthcare services. Method: This scoping review follows the JBI methodology. The protocol was registered on the Open Science Framework. Eligibility criteria were defined based on studies that include instruments or scales for assessing patient safety in healthcare services, in any language, and without temporal restrictions. It adhered to all scoping review checklist items [PRISMA-ScR], with searches in the Embase, Lilacs, MedLine, and Scopus databases, as well as the repository of the Brazilian Digital Library of Theses and Dissertations. Two independent reviewers performed selection and data extraction in July 2023. Results: Of the 4019 potential titles, 63 studies reported on a total of 47 instruments/scales and 71 dimensions for patient safety assessment. The most-described dimensions were teamwork, professional satisfaction, safety climate, communication, and working conditions. Conclusion: The diversity of instruments and dimensions for patient safety assessment characterizes the multidimensionality and scope of patient safety. However, it hinders benchmarking between institutions and healthcare units. Full article

Malaria and Typhoid fever are prevalent diseases in tropical regions, and both are exacerbated by unclear protocols, drug resistance, and environmental factors. Prompt and accurate diagnosis is crucial to improve accessibility and reduce mortality rates. Traditional diagnosis methods cannot effectively capture the complexities of these diseases due to the presence of similar symptoms. Although machine learning (ML) models offer accurate predictions, they operate as “black boxes” with non-interpretable decision-making processes, making it challenging for healthcare providers to comprehend how the conclusions are reached. This study employs explainable AI (XAI) models such as Local Interpretable Model-agnostic Explanations (LIME), and Large Language Models (LLMs) like GPT to clarify diagnostic results for healthcare workers, building trust and transparency in medical diagnostics by describing which symptoms had the greatest impact on the model’s decisions and providing clear, understandable explanations. The models were implemented on Google Colab and Visual Studio Code because of their rich libraries and extensions. Results showed that the Random Forest model outperformed the other tested models; in addition, important features were identified with the LIME plots while ChatGPT 3.5 had a comparative advantage over other LLMs. The study integrates RF, LIME, and GPT in building a mobile app to enhance the interpretability and transparency in malaria and typhoid diagnosis system. Despite its promising results, the system’s performance is constrained by the quality of the dataset. Additionally, while LIME and GPT improve transparency, they may introduce complexities in real-time deployment due to computational demands and the need for internet service to maintain relevance and accuracy. The findings suggest that AI-driven diagnostic systems can significantly enhance healthcare delivery in environments with limited resources, and future works can explore the applicability of this framework to other medical conditions and datasets. Full article

This study provides an overview of trends and evolution in International Organization for Standardization (ISO) implementation in healthcare over the past three decades, useful for researchers, practitioners, and policymakers in the sector. As an additional contribution, we propose the NU-index, which allows the evaluation of authors’ scientific output in a comprehensive way that will be valuable for researchers, institutions, and funding agencies seeking to assess researcher performance more accurately and understandably. A bibliometric analysis of 476 scientific articles from the Scopus Database was conducted, examining the scientific output, key authors, high-impact journals, and frequent keywords using VOSviewer, Bibliometrix library, and statistical analysis. Results reveal a significant increase in publications on ISO standards in healthcare since 2009, particularly in areas such as telemedicine, artificial intelligence, and information security. The emergence of ISO 11073 (health informatics) and ISO 13606 (electronic health records) highlights a growing trend towards information and communication technologies. Despite reported implementation barriers, such as lack of top management commitment and associated costs, adoption of these standards is increasing due to the demand for high-quality healthcare services and the need to comply with regulatory requirements. Full article

This is a systematic literature review on the impact of pharmacists in rheumatology, conducted using the PubMed^®, CINAHL^®, Cochrane Library^®, and Web of science^® databases and using the PRISMA 2020 checklist. This review was conducted from 2000 to June 2024. A quality analysis was performed. The selection of articles, as well as all analyses, including quality analyses, were conducted by a pair of pharmacists with experience in rheumatology, and included 24 articles. This study highlights the growth of clinical pharmacy activities in rheumatology and the positive influence of clinical pharmacists on patient care. The implementation of such initiatives has the potential to improve medication adherence, reduce medication-related risks, and optimize associated healthcare costs. All these pharmaceutical interventions aim to make the patient care journey smoother and safer. Additionally, the diversity of available pharmaceutical services caters to the varied needs of rheumatology. Furthermore, outpatient clinical pharmacy is also explored in this field and garners interest from patients. The vast majority of studies demonstrate significant improvement in patient care with promising performance outcomes when pharmacists are involved. This review highlights the diverse range of interventions by clinical pharmacists in rheumatology, which is very promising. However, to better assess the benefits of clinical pharmacists, this activity needs further development and evaluation through controlled and randomized clinical research programs. Full article

This study explores the public library service evaluation domain through user-generated content on Google Maps, highlighting digital feedback’s significant yet underexplored potential in understanding public library patronage across Taiwan’s six major cities. Utilizing a mixed-methods research design, this study integrates Google Maps review content analysis with social network analysis to delineate public perceptions and identify areas for service enhancement in public libraries. It innovatively leverages personal experiences extracted from over 60,000 Google Maps reviews to evaluate public library services in cities such as Taipei, New Taipei, Taoyuan, Taichung, Tainan, and Kaohsiung. The research taps into the National Library of Taiwan’s National Library Statistics System to provide a robust analysis of library performance and user satisfaction, offering a novel perspective by emphasizing user-centric feedback from Google Maps as a primary data source. This approach provides quantitative data on library usage and geographic distribution and enriches our understanding of the qualitative experiences of library users. In analyzing the keywords from Google Maps reviews of public libraries, we categorize and interpret these under the three core LibQUAL+ dimensions—Affect of Service, Information Control, and Library as Place. The findings expose variances in perceived service quality among the cities, with Kaohsiung and Taichung receiving the highest accolades for service satisfaction. Simultaneously, the study identifies potential areas for improvement, particularly in cities with lower satisfaction ratings like Taipei. This personalized feedback illustrates the intimate relationship between public libraries and their communities, offering invaluable insights for policymakers and library management to enhance service delivery and user experience. Full article

OBJECTIVE: Understand and explore the childbirth experiences of pregnant women living with HIV (PWLWHIV). With the advent of several measures to decrease the intrapartum HIV infection and a strong emphasis on the humanization of childbirth, there is a growing focus on providing positive childbirth experiences for pregnant women. Indeed, a positive childbirth experience is even more important in the group of pregnant women living with HIV (PWLWHIV) as it plays a pivotal role in enhancing the mother’s adherence to her postpartum treatment and the newborn’s engagement in Infectious Disease services. METHODOLOGY: A scoping review was conducted. Searches were performed on databases, such as MEDLINE, PUBMED, WEB OF SCIENCE and Cochrane Library, using the following keywords: childbirth, birth, parturition, HIV, humaniz*, perceived safety, experience, maternal satisfaction, healthcare professional and midwi*. Articles meeting pre-established criteria were selected within the timeframe of 2013 to 2023 for inclusion in the review. RESULTS: Out of a total of 2,340,391 articles, 4 were chosen based on our defined criteria. Three primary themes emerged from the selected articles: the assessment of childbirth experience quality, vulnerability and autonomy. CONCLUSIONS: The four studies identified had a small sample size and were not adequately conducted with a specific focus on studying the childbirth experience of pregnant women living with HIV (PWLWHIV). This scoping review revealed a gap in the existing literature, indicating a need for further research and clarification in the identified area. Full article

Adaptive Mobile Learning Systems (AMLSs) are technological tools that incorporate adaptive learning to generate an individual teaching–learning process for each student. Despite the proliferation of AMLS, their development is often hindered by a lack of standardization and the poor quality of existing software architectures in terms of requirements correctness and coverage. This paper presents a systematic literature review (SLR) of software architectures oriented to developing AMLS reported in the state of the art. For this SLR, we searched the ACM Digital Library, IEEE Xplore, Science Direct, Springer, and SCOPUS. Studies published in English that describe and evaluate a software architecture to develop AMLS were included. Twenty-two primary works were relevant to the present study. Based on the obtained results, we have identified key aspects that must be considered in a software architecture proposed for developing an AMLS in terms of requirements, quality attributes, stakeholders, services provided to users, views and architectural styles, components, and implementation technologies. The main finding of this work is the lack of a reference software architecture that considers all the requirements and quality attributes needed for developing AMLS. This gap hinders the effective development and standardization of quality AMLSs, suggesting a critical need for a comprehensive reference software architecture. Full article

The heritage science sector is facing a critical need for accessible and comprehensive data resources to facilitate research, preservation efforts, and interdisciplinary collaboration. The concept of FAIR data management involves embracing principles and practices that ensure that data are Findable, Accessible, Interoperable, and Reusable. This work presents an overview of the latest updates on the INFRA-ART Spectral Library, an open access spectral database of cultural-heritage-related materials that was designed as a digital support tool for heritage research specialists that work with (portable) non- or minimally invasive spectroscopic techniques such as X-ray fluorescence (XRF), attenuated total reflectance–Fourier transform infrared (ATR-FTIR) spectroscopy, or Raman spectroscopy, among others. The database is an ongoing compilation of high-quality curated data that currently incorporates primary ATR-FTIR and XRF spectra and a preliminary dataset of Raman and short-wave infrared (SWIR) reflectance spectra on over 900 different materials typically found in painted works of art. For increased and sustainable accessibility, the database follows the European Commission’s recommendations on access to scientific information, as well as the FAIR guiding principles on research data that result from publicly funded research. The INFRA-ART Spectral Library is registered as a resource within the Open Science Cloud (EOSC) Portal and is among the services offered by the Romanian hub within E-RIHS (European Research Infrastructure for Heritage Science) DIGILAB. Full article