Search Results (1,364)

Background/Objectives: Nurses are susceptible to compassion fatigue due to the nature of their professional responsibilities. Factors contributing to this vulnerability include daily patient interactions and organizational elements within their work environment, as well as work-related stress and sociodemographic characteristics, including age, marital status, years of professional experience, and, notably, gender. This research investigates the relationship between compassion fatigue and the levels of anxiety and depression, as well as the professional quality of life among nurses providing care to dementia patients in Greece. Methods: A cross-sectional survey was carried out with 115 nurses working in dementia care centers in Greece. The Hospital Anxiety and Depression Scale (HADS), the Professional Quality of Life Scale (ProQOL-5), and the participants’ personal, demographic, and professional information were all included in an electronic questionnaire. Multiple regression analysis was used. Results: A total of 42.6% of nurses rated their working environment as favorable. Additionally, 23.5% of the sample exhibited high levels of compassion satisfaction, whereas 46.1% demonstrated low levels of burnout. Female gender (p = 0.022) and a higher family income (p = 0.046) was positively associated with compassion satisfaction. Regression analysis indicated that elevated symptoms of anxiety and depression were found to correlate with decreased compassion satisfaction, increased burnout, and heightened secondary post-traumatic stress. Conclusions: Engaging in the care of patients with dementia, particularly throughout the pandemic period, has underscored a pronounced susceptibility to compassion fatigue, physical fatigue, pain, psychological stress, and a reduced quality of life. These results highlight the importance for nursing management to adopt specific organizational measures, including proper staffing levels, balancing workloads, and conducting routine mental health assessments. Full article

Low-income individuals are unlikely to save relatively large sums on a regular basis; however, many still fall short of even the modest threshold required for long-term financial security. This study examines the determinants of benchmark-defined undersaving among retail e-payment agents (REAs) operating in the urban slums of Lagos, Nigeria. We use a contingent valuation survey, descriptive analysis, and logistic regression to examine how selected behavioural and demographic factors, alongside a 60-day experimental intervention—the Programmed Microsaving Scheme (PMSS), a hard daily commitment savings device—affect the likelihood of undersaving, defined as saving less than 12% of each REA’s average daily income. While the PMSS appears to have contributed to improvements in post-treatment saving participation and performance among REAs, it did not significantly increase the likelihood of reaching or exceeding the benchmark savings threshold. Consistent with this, average daily income, age, gender, marital status, education, and religion are statistically insignificant predictors of benchmark-defined undersaving. In contrast, self-control, measured using a literature-validated instrument, exhibits a statistically significant negative association with benchmark-defined undersaving, indicating that higher self-control reduces the likelihood of failing to meet the benchmark. Measured risk aversion similarly shows no significant association. Notably, this study introduces a novel 60-day PMSS, co-designed with REAs and neobanks to accommodate daily income savings—a characteristic of the informal sector largely overlooked in the literature on commitment savings devices. From a policy perspective, the findings suggest that while short-horizon commitment devices (such as the 60-day PMSS) and financial literacy are associated with improvements in microsavings among low-income daily earners, achieving benchmark-level saving might require longer-term and more adaptive mechanisms that address income volatility and mitigate other inherent risks. Full article

Background/Objective: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have received widespread attention as effective obesity treatments. However, limited research has examined the perspectives of patients contemplating GLP-1RAs. This study explored perceptions, motivations, and barriers among individuals considering GLP-1RA therapy for obesity treatment, with the goal of informing patient-centered care and enhancing clinician engagement. Methods: Adults completed surveys and interviews between June and November 2025. In this pragmatic mixed-methods study, both survey and interview questions explored perceived benefits, barriers, and decision-making processes. Qualitative data, describing themes based on the Health Belief Model, were analyzed using Dedoose (version 9.0.107), and quantitative data were analyzed using SAS (version 9.4). Participant characteristics included marital status, income, educational attainment, employment status, insurance status, age, race/ethnicity, and sex. Anticipated length on GLP-1RA medication and selected self-reported health conditions (depression, anxiety, hypertension, heart disease, back pain, joint pain), reported physical activity level, and perceived weight loss competency were also recorded. Results: Among the 31 non-diabetic participants who were considering GLP-1RA medication for weight loss, cost emerged as the most significant barrier. Life course events, particularly (peri)menopause among women over 44, were commonly cited as contributors to weight gain. Participants expressed uncertainty about eligibility, long-term safety, and treatment expectations. Communication gaps were evident, as few participants initiated discussions and clinician outreach was rare, reflecting limited awareness and discomfort around the topic. Conclusions: Findings highlight that individuals considering GLP-1RA therapy face multifaceted emotional, financial, and informational barriers. Proactive, empathetic clinician engagement, through validation of prior efforts, clear communication of risks and benefits, and correction of misconceptions, can support informed decision-making and align treatment with patient goals. Full article

Background: Computerized Provider Order Entry (CPOE) systems are critical for medication safety, but their effectiveness relies heavily on the completeness of entered data. Incomplete clinical and anthropometric information can disable Clinical Decision Support Systems (CDSSs), compromising patient safety. Objective: This study aimed to assess the longitudinal evolution of CPOE data completeness, specifically focusing on “Breadth Completeness” (the presence of essential clinical variables), and to identify factors predicting data integrity in a tertiary care setting. Methods: A retrospective cross-sectional study was conducted at a 500-bed tertiary referral center in Riyadh. Data were extracted from the Cerner Millennium CPOE system for three “steady-state” years (2015, 2017, and 2019); years involving major system overhauls (2016 and 2018) were excluded to avoid structural bias. A total of 600 unique patient encounters (200 per year) were selected using systematic random sampling from a chronologically ordered sampling frame to minimize temporal bias. The primary outcome was “Breadth Completeness,” defined as the presence of eight key variables: age, gender, marital status, weight, height, diagnosis, vital signs, and allergies. Secondary outcomes included documentation consistency (daily notes). Multivariable logistic regression, adjusted for potential confounders, was used to determine predictors of completeness. Results: The rate of primary data completeness (Breadth) improved significantly over the study period, rising from 5.5% in 2015 to 26% in 2017 and 49.5% in 2019. In the multivariable analysis, the year of documentation (OR = 17.47 for 2019 vs. 2015, p < 0.0001) and length of hospitalization (OR = 1.04, p = 0.045) were significant predictors of completeness. Pharmacist-led medication reconciliation was associated with a 2.5-fold increase in data completeness in bivariate analysis (p < 0.0001). Conclusions: While system maturity has driven substantial improvements in CPOE documentation, critical gaps persist, particularly in anthropometric data required for safety alerts. The study underscores the necessity of mandating “hard stops” for core variables and formalizing pharmacist involvement in data reconciliation to ensure patient safety. Full article

The COVID-19 pandemic has been one of the most globally disruptive social events in recent history, bringing widespread lockdowns, restrictions on movement, remote work, mass vaccination campaigns, and millions of deaths worldwide. These unprecedented circumstances have reshaped many aspects of social life, including perceptions of safety and firearm ownership. This study examines changes in reported gun ownership before and during the COVID-19 pandemic in the United States, using binary logistic regression analyses of General Social Survey (GSS) data from 2018 and 2021. Analysis revealed that reported gun ownership remained stable at approximately 35% in both years. However, the demographic and social profile of gun owners shifted significantly. Demographic factors such as sex, US birth, marital status, and income consistently predicted ownership in both years, while race, middle-class identification, and political party affiliation emerged as significant predictors only during the pandemic, with Democrats becoming significantly less likely to report gun ownership. The results demonstrate how social crises can reshape the composition of firearm owners rather than overall rates, with implications for public policy and safety. Full article

Background and Objectives: The COVID-19 pandemic had a significant impact on physical activity among various populations. Due to a lack of country-representative studies on the prevailing trends in leisure-time physical activity since the COVID-19 pandemic, the aim of this study was to assess the temporal, social, and demographic inequalities in the prevalence of engagement in exercise and sports among working-age citizens of Lithuania from 2021 to 2024. Materials and Methods: This study included four samples of working-age citizens (1600 per year, 6400 in total). Four surveys were conducted, and the distribution of respondents among the groups was compared. Results: In general, the prevalence of engagement in exercise and sports did not change over a four-year period (48.8%, p = 0.256). The prevalence of regular exercise and sports increased, while engagement in irregular exercise and sports decreased (p = 0.014). Binary logistic regression analysis showed that younger age, male sex, being single, having no children under 18 years of age, selecting foods for health strengthening, positive self-assessment of nutrition and health status, use of dietary supplements, attention to purchasing healthy products, and university education attainment were associated with engagement in exercise and sports (regular or irregular) (p < 0.05). Analysis focused specifically on regular exercise and sports revealed associations with a longer time since the onset of the COVID-19 pandemic, younger age, urban residence, selection of foods for health strengthening, positive assessment of nutrition and health status, and university education attainment (p < 0.05), while no significant associations were observed with sex, marital status, presence of children under 18 years of age, use of dietary supplements, or attention to purchasing healthy products (p > 0.05). Conclusions: The overall prevalence of physical activity engagement among working-aged Lithuanian citizens did not change from 2021 to 2024, engagement in regular and irregular exercise and sports has changed. Engagement in regular and irregular exercise and sports is associated with different social profiles. Full article

Introduction: Personality disorders are enduring, maladaptive patterns that impair social and vocational functioning. The DSM-5 Alternative Model for Personality Disorders (AMPD) distinguishes Criterion A (personality functioning: identity, self-direction, empathy, intimacy) from Criterion B (maladaptive trait domains: negative affectivity, detachment, antagonism, disinhibition, psychoticism). We frame this study within Criterion B, supporting the use of a dimensional approach that complements (rather than replaces) normative models like the Five-Factor Model (FFM) and addresses cross-cultural gaps amid Saudi Arabia’s rapid sociocultural change such as the reforms associated with Vision 2030. Given Saudi Arabia’s collectivist orientation and evolving sociocultural norms under Vision 2030, the dimensional approach of the AMPD Criterion B offers a culturally sensitive lens for capturing personality pathology beyond Western-centric diagnostic models. Aim: We aimed to examine how PID-5-BF maladaptive trait domains vary across key sociodemographic factors in Saudi adults. Subjects and Methods: This was a quantitative, cross-sectional analytical study conducted among Saudi adults using the PID-5-BF Convenience sampling was performed via the dissemination of an online survey; we aimed for 377 participants and obtained 343 completed responses (~91% of the target sample). For trait assessment, we used the PID-5-BF; analyses compared domains across sociodemographic groups. Results: Females showed a higher negative affect; participants ≤ 30 years exhibited higher psychoticism than those >40; and single individuals reported lower detachment and psychoticism than their married peers. Conclusions: Gender, age, and marital status are associated with differences in maladaptive trait expression, supporting the need for culturally tailored screening and interventions in Saudi mental health services. These findings should be interpreted with caution given the fact that WhatsApp-based convenience sampling was used, which may bias the results as the respondents were more likely to live in urban areas, be educated, and be technologically proficient. Full article

Background: Physiotherapy University students frequently experience psychological challenges such as depression, anxiety, and stress. These issues are shaped by various individual, health-related, and social factors. Understanding these influences is essential for identifying vulnerable subgroups and guiding effective support strategies. Aim and Objectives: This study aims to assess the prevalence and severity of depression, anxiety, and stress among physiotherapy students. Specific objectives include (1) analyzing mental health variations across demographic variables such as gender, nationality, marital status, and year of study; (2) evaluating the impact of physical and mental health conditions on psychological distress; and (3) investigating the protective role of perceived social support from family, friends, and faculty. Methods: A cross-sectional study was conducted among 282 physiotherapy students at Kuwait University, focusing on students from the Physical Therapy Department in the College of Allied Health Sciences, of whom 89% were aged 18–22 years and 10% were aged 23–27 years. Participants were selected through purposive and convenience sampling, including second-, third-, and fourth-year students. Data were collected using the DASS-21 scale along with demographic, health, and social support information. Descriptive statistics and ANOVA tests were used to analyze associations between psychological outcomes and the studied variables. Results: Anxiety was the most prevalent condition, with 39.4% of students reporting extremely severe levels. Depression and stress affected 14.2% and 11.3% of students at the same severity level, respectively. Gender differences were examined among the participants (259 females and 23 males), with female students showing significantly higher stress levels than males and second-year students reporting greater depression and stress compared to their senior peers. Students who received support from family and friends exhibited lower levels of psychological distress. Conclusions: This is the first study in Kuwait to examine mental health among physiotherapy students, revealing a high prevalence of depression, anxiety, and stress in this group. The findings highlight the unique academic and clinical pressures faced by physiotherapy students, including intensive coursework, frequent assessments, physically demanding clinical placements, close patient interaction, and the need to integrate theoretical knowledge with hands-on clinical practice, while also emphasizing the protective role of social support. These insights call for targeted mental health strategies and support systems within physiotherapy education to promote student well-being and foster a healthier learning environment. Full article

Attention deficit hyperactivity disorder (ADHD) presents significant challenges in all age groups, affecting various aspects of daily functioning and quality of life. Objective: This study aims to explore the rate and associated factors of unemployment among ADHD in adults. A retrospective cohort study was conducted, including 179 adults diagnosed with ADHD seeking consultation at a comprehensive ADHD clinic at a tertiary hospital in urban Oman. Sociodemographic characteristics, clinical presentations, and factors associated with employment status were collected. 41% of the participants were actively seeking employment. Among the correlates of unemployment is obesity (OR 5.64, p = 0.011, 95% CI 1.49–21.43). Other variables, including education level and marital status, also influenced employment rates, with bachelor’s degree holders showing higher chances of unemployment (OR 5.35, p = 0.009, 95% CI 1.52–18.88). Marital status was closely associated with unemployment, with 39.5% of married individuals unemployed (p = 0.022). Furthermore, anxiety disorders were closely associated with unemployment (p = 0.026). Nearly one-third of the cohort had a comorbid substance use disorder (30%), and 6% reported suicidal attempts. This study highlights the significantly high prevalence of job seeking among adults with ADHD. Obesity, education level, marital status, and anxiety disorders were strongly associated with job search. Full article

Background: Childhood undernutrition and overnutrition continue to be major public health challenges in South Africa. There is limited evidence on how socio-economic factors and dietary behaviors influence nutritional outcomes among school-aged children, particularly in rural areas such as Thulamela Municipality. Objective: This study aimed to examine the socio-demographic determinants, dietary patterns, and nutritional status among school-aged children in Thulamela Municipality, Limpopo Province, South Africa. Methods: A cross-sectional survey was conducted with 347 children aged 8–12 years. Simple random sampling was used to select eight villages from a total of 227 within the municipality. A snowball sampling method was used to recruit eligible children. Data on socio-demographic characteristics, including the child’s sex, parental education level, marital status, and employment status, were collected. Additionally, their dietary habits and meal frequency patterns were collected using structured questionnaires. Anthropometric measurements including height, weight, and BMI-for-age were obtained following WHO growth standards. Associations between variables were assessed using chi-square tests, with p-values < 0.05 considered statistically significant. Results: The prevalence of severe and moderate stunting was 20.5% and 21.0%, respectively. Overweight conditions and obesity affected 32.6% and 16.2% of participants, respectively. Parental education (p = 0.027), marital status (p = 0.001), and household income (p = 0.043) showed significant associations with height-for-age and BMI-for-age Z-scores. Additionally, regular breakfast consumption and the frequent intake of vegetables and dairy products were positively associated with improved nutritional outcomes (p < 0.05). Conclusions: The nutritional profile of school-aged children in Thulamela Municipality reflects a double burden of malnutrition, with concurrent high rates of stunting, overweight conditions, and obesity. Interventions that promote balanced diets and address socio-economic disparities are crucial for improving child growth and overall health. Socio-economic factors, including parental education, marital status, and household income, were significantly associated with children’s height-for-age and BMI-for-age. Furthermore, the regular consumption of breakfast, vegetables, and dairy products was associated with better nutritional outcomes, highlighting the influence of both dietary behaviors and socio-demographic determinants on child growth and health. Implementing nutrition education programs within schools that emphasize the value of balanced diets and highlighting the significance of eating breakfast regularly and incorporating vegetables and dairy products into daily meals is important. These programs should include both children and their caregivers to support regular healthy eating behaviors at home and in school. Additionally, schools should carry out regular growth monitoring and nutritional assessments to identify early indications of undernutrition or overnutrition, enabling prompt referrals and interventions for children who may be at risk. Full article

Caregiving for visually impaired individuals imposes substantial psychological, social, and financial burdens. This study examined depressive symptoms among family caregivers in rural Limpopo, South Africa, and their associations with sociodemographic and socioeconomic factors. A cross-sectional survey was conducted among 253 informal caregivers (response rate: 85.5%). Data on age, gender, marital status, education, employment, income, and socioeconomic status were collected. Depressive symptoms were assessed using the full 20-item Centre for Epidemiologic Studies Depression Scale (CES-D), and associations were analysed using chi-square tests, Cramer’s V, and logistic regression. Moderate-to-severe depressive symptoms were reported by 29.2% of caregivers, with 28.1% experiencing mild-to-moderate symptoms. Male caregivers were less likely to report minimal symptoms (OR = 0.3; 95% CI: 0.12–0.65). Caregivers aged 50–59 years were more likely to report lower depressive symptoms (OR = 1.3). Unmarried caregivers had higher odds of depressive symptoms compared with married caregivers (OR = 2.3). Education was protective: secondary education was associated with lower odds of severe symptoms, while primary education significantly increased risk (OR = 18.1). Lower-income caregivers tended to report higher depressive symptoms. Depressive symptoms among caregivers are influenced by gender, age, marital status, education, and income. Interventions such as psychosocial support, financial assistance, and community-based respite services are essential to reduce caregiver burden. Full article

Background/Objectives: Although implantable cardioverter defibrillators (ICDs) play a critical role in reducing the risk of sudden cardiac death, patients may report various physical and psychological symptoms during the implantation process. This study aimed to examine ICD patients’ retrospective reports of pre-implantation symptoms, their concurrent assessment of post-implantation symptom experiences, and the non-pharmacological methods they used to cope with these symptoms. Methods: A cross-sectional study was conducted with ICD patients who visited the arrhythmia clinic between May and August 2022. Data were collected using a questionnaire developed by the researchers and medical records. The study analyzed changes in symptoms reported by patients, individual coping methods used, the perceived effectiveness of these methods, and comparisons of methods used according to descriptive and clinical characteristics. Results: Patients reported a decrease in chest pain, palpitations, dizziness, syncope, and shortness of breath after ICD implantation (p < 0.001). However, they reported an increase in fatigue and anxiety levels (p < 0.001); no significant change was reported for insomnia (p = 0.473) and fear (p = 0.082). Furthermore, no significant difference was observed between patients who received shock therapy and those who did not in terms of changes in anxiety and fatigue levels, and the increase in anxiety was similar in both groups. The most frequently reported coping method among patients was praying, followed by drinking herbal tea and walking. A significant relationship was found between marital status and coping method preference, while no relationship was found with other descriptive and clinical characteristics. Conclusions: Although ICD implantation reduces cardiac symptoms, anxiety and fatigue continue to increase. Patients’ tendency to turn to cultural and spiritual coping methods such as prayer indicates that post-ICD care should be conducted with a holistic approach that also covers psychological and spiritual needs. Full article

Background/Objectives: Successful and sustained breastfeeding depends on maternal, psychological, metabolic and obstetric factors including hydration status, body composition, gestational age at delivery and mode of delivery, which are rarely assessed together in routine postpartum care. Bioelectrical impedance analysis (BIA) provides a non-invasive assessment of hydration and tissue composition, yet its potential to support lactation outcomes remains insufficiently studied. This study aimed to evaluate the relationship between postpartum body composition, hydration status assessed with BIA, and breastfeeding duration. Methods: A total of 122 women in the early postpartum period after term singleton deliveries were enrolled, of whom 50 completed the full protocol, including a 7-month follow-up. BIA and anthropometric measurements were performed on postpartum days 2 and 3. Breastfeeding duration was assessed at 7 months via telephone interview and categorized as <6 months or ≥6 months. Two indices (PLBI and sPLBI) were calculated to describe BMI change from pre-pregnancy to 7 months postpartum. Results: Breastfeeding for ≥6 months was significantly associated with marital status, mode of delivery, lower BMI on postpartum day 2, and a positive change in the overhydration index (ΔOH). Women in this group exhibited significantly lower PLBI and sPLBI values, indicating more effective postpartum weight recovery and a greater return toward pre-pregnancy BMI. Hydration parameters derived from BIA differentiated between shorter and longer breastfeeding duration. Conclusions: Positive postpartum hydration balance (ΔOH ≥ 0) and efficient metabolic recovery, reflected by lower PLBI and sPLBI values, may support longer breastfeeding. BIA-based assessment of hydration and body composition could help identify women at higher risk of early breastfeeding cessation. Further longitudinal research is warranted to confirm the clinical utility of BIA in postpartum care and its potential role in early lactation support. Full article

Background: Accurate prognostication is essential for clinical decision-making in palliative radiotherapy (RT). The Palliative Performance Scale (PPS) is a validated tool for assessing functional status and estimating survival in palliative care, yet its prognostic value in patients receiving palliative RT for bone metastases remains insufficiently explored. This study aimed to evaluate the association between PPS and overall survival (OS) in a real-world cohort of cancer patients undergoing palliative RT. Methods: This retrospective, single-center study included 153 patients who received palliative RT for bone metastases between 2021 and 2025 at the Department of Radiation Oncology, University Hospital Halle (Saale), Germany. Clinical, demographic, and treatment data were extracted from institutional databases. The primary endpoint was OS, defined as the time from the end of RT to death. Univariable and multivariable Cox proportional hazards regression models were used to identify prognostic factors associated with OS, including PPS, sex, age, marital status, BMI, Charlson Comorbidity Index (CCI), and RT completion. Due to violation of the proportional hazards assumption, PPS (<60% vs. ≥60%) was used as a stratification factor in the final Cox model. Logistic regression was performed to explore predictors of discharge to home. Results: The median OS for the entire cohort was 108 days (3.6 months; 95% CI 78–143 days). Male sex (HR 1.61, 95% CI 1.06–2.46, p = 0.027) and older age (HR 0.98, 95% CI 0.96–1.00, p = 0.050) were associated with shorter survival, whereas completion of the prescribed RT course was strongly associated with improved OS (HR 0.06, 95% CI 0.03–0.12, p < 0.001). Patients with PPS ≥60% had significantly better survival compared to those with lower PPS (HR 0.62, 95% CI 0.41–0.93, p = 0.021). After stratification by PPS, no violation of the proportional hazards assumption was detected (global p = 0.55). The stratified model confirmed that male sex, age, and RT completion remained independent predictors of survival. No significant predictors were identified for discharge destination in logistic regression analysis. Conclusions: The PPS is a valuable prognostic tool for patients receiving palliative RT for bone metastases. A PPS of ≥60% was associated with prolonged survival, supporting its use in clinical prognostication and treatment planning. Completion of RT emerged as a strong independent predictor of survival, underscoring the importance of treatment adherence even in palliative settings. Stratification by PPS further improved model validity and prognostic accuracy. Full article

Nutrition is a fundamental aspect of consumer behavior, closely linked to the satisfaction of basic household needs and strategies for purchasing food products. This study aimed to examine how fundamental food needs—specifically survival (daily food) and food security (food stocks)—shape purchasing behaviors, enabling the identification of vulnerable consumer segments and the delineation of patterns useful for producers and retailers. Data were collected through a cross-sectional survey (N = 1060) and analyzed using the Rao & Scott-adjusted Pearson chi-square test (R, version 4.4.3), considering key socio-demographic factors including gender, age, educational level, marital status, residence, and income. Results indicate that gender, age, and education significantly influence food purchases driven by the need for food security, whereas marital status is a significant factor only for survival-related purchases. Differences observed in other contexts were not statistically significant. Additionally, two multinomial logistic regression models were developed to predict consumer food purchases driven by fundamental needs, demonstrating high explanatory power. Each socio-demographic factor emerged as a significant predictor for at least one response category on the Likert scale, and the relative influence of each predictor was quantified. These models provide actionable insights for marketing strategies, including the identification of optimal store locations and the adjustment, diversification, or optimization of product ranges based on the characteristics of specific consumer segments and geographic areas. Full article