Search Results (539)

Background/Objectives: Autonomy and the ability to live independently are priority goals for older adults and are closely linked to healthy aging and quality of life (QoL). However, nutrition, although a crucial and modifiable determinant, remains undervalued. Cardiovascular diseases are highly prevalent in middle-aged and older adults and increase the risk of functional impairment, burdening the economy and limiting the patient’s autonomy. This study aimed to analyse the quality of life in older adults and its relationship with functional impairment and nutritional status. Methods: This was a cross-sectional study that included 359 patients with a mean age of 71.52 years who were admitted to the National Institute of Gerontology and Geriatrics “Ana Aslan”, between January 2024 and April 2025. Data were collected through interviews, medical records, and standardized instruments, including the Up and Go Test, Tinetti Test, Downton Fall Risk Index, and handgrip strength assessment. Quality of life was assessed using the EQ-5D-5L and the visual analog scale (VAS). Results: Nutritional status assessed using MNA showed significant moderate-to-strong correlations with EQ-5D-5L mobility (r = −0.326, p = 0.007 in the ≥80 years’ group), anxiety/depression (r = −0.544, p < 0.001 in the ≥80 years’ group), self-care (r = −0.271 to −0.311, p < 0.05 in patients over 65), and usual activities (r = −0.294, p = 0.016 in the ≥80 years’ group). In contrast, BMI showed moderate positive correlations with EQ-5D-5L pain/discomfort across all age groups (r = 0.365 to 0.524, p < 0.002). Functional assessment revealed strong negative correlations between EQ-5D-5L mobility and the Tinetti Test (r = −0.583 to −0.728, p < 0.001), with weaker correlations for pain/discomfort and anxiety/depression dimensions. While BMI-EQ-5D-5L pain/discomfort correlations were consistent across age groups, a stronger correlation was observed in the ≥80 years’ group for MNA-EQ-5D-5L anxiety/depression. Conclusions: In this exploratory cross-sectional study, MNA and BMI were associated with different quality of life domains. Lower MNA scores were more frequently associated with anxiety/depression and certain functional domains, particularly in the ≥80 years’ group, whereas higher BMI was more consistently associated with pain/discomfort across age groups. Full article

Background: Dementia is one of the most common diseases of the elderly worldwide. Sharing experiences of caring for patients with dementia with other carers is essential to improve the quality of care, promote better outcomes, and learn from others. Aim: to explore nurses’ experiences of working with patients with dementia in Lithuanian supportive treatment and nursing hospitals. Methods: A qualitative descriptive design was employed in this study, with data collected through semi-structured interviews. Nurses with direct experience caring for patients with dementia in supportive treatment and nursing hospitals were recruited through purposive sampling. This sampling strategy was chosen to ensure that participants could provide rich, contextual, and experience-based insights into the phenomenon under investigation. Open-ended questions were divided into three themes: 1. Identifying nursing needs. 2. Care for people with dementia. 3. Patient behavior management and situation management. To ensure methodological rigor and transparency, the Consolidated Criteria for Reporting Qualitative Research (COREQ) were applied throughout the study’s planning, data collection, and analysis processes. Results: Nine nurses working in three different Lithuanian hospitals participated in the study. Theme 1: respondents reported that the needs of patients with dementia depend on their previous lifestyle and hobbies, as well as on essential physiological needs such as eating and drinking, bathing and personal hygiene, and the absence of pain. Theme 2: All participants emphasized that ensuring a safe environment is crucial for people with dementia. Theme 3: When faced with inappropriate patient behaviour, nurses attempt to calm the patient, speak gently, provide distraction, or, when necessary, temporarily separate the patient from others. Additional actions include administering medication and stabilizing the patient. Overall, these findings illustrate that dementia care requires continuous emotional presence, situational judgment, and adaptation to each patient’s individual needs. Conclusions: Patients with dementia require highly individualized care focused on nutrition, hygiene, pain control, and communication. Nurses’ daily activities centered on essential bodily care, medication management, and mobility support to maintain safety and prevent complications. Full article

Background/Objections: One of the most common surgical procedures performed internationally is the cesarean section. It is known to be associated with intense postoperative pain and a slow recovery process. Focusing on surgical techniques, especially the type of fascial closure, is an area that has received very little attention when it comes to postoperative pain and rapid recovery. Using a mixed-methods approach, the primary objective of this study was to assess the impact of guide-suture-assisted modified fascial closure on postoperative pain and early mobilization after cesarean sections. Methods: Women undergoing elective cesarean sections with Pfannenstiel’s incision were the study participants of this prospective, single-center, randomized mixed-methods study. Participants were enrolled in the study and randomized to either classical continuous fascial closure or guide-suture-assisted modified fascial closure, which was carried out in a 1:1 ratio. Quantitative data assessed postoperative pain through the Visual Analog Scale (VAS), a Numeric Rating Scale (NRS), and the Short-Form McGill Pain Questionnaire (SF-MPQ), and functional recovery was assessed through walking distances at postoperative 6, 12, 24, and 48 h. Qualitative data were collected via semi-structured interviews and analyzed through conventional content analysis to understand the patients’ perceptions of pain and recovery experiences. Results: The first 24 h postoperative period pain levels were significantly lower for the modified fascial closure group versus the classical closure group (p < 0.05). Moreover, the modified closure group had a significantly better functional recovery, evidenced by walking greater distances at 12, 24, and 48 h postoperative. Qualitative results indicated improved comfort and stronger early mobilization confidence, in addition to less movement apprehension, consistent with the above results, among those with the modified technique. Conclusions: The modified fascial closure technique with guide suture was linked to less pain in the early postoperative period and better functional recovery after cesarean section. This technique is a good candidate for addition to standard obstetric procedures since it is cost effective, easily added, and surgical practice will improve comfort for mothers and assist with early mobilization. Full article

Background: Women with endometriosis frequently experience mobility limitations that affect daily functioning. A specific tool to assess these restrictions would help clinicians to better understand patients’ functional challenges, facilitating more effective communication and shared decision making. Addressing this gap is essential for strengthening patient–professional dialogue and improving individualized care. Objective: To develop the new instrument MobEndo and to perform initial psychometric testing of the tool. Methods: The initial domains and items were generated through semi-structured interviews with patients and based on experts’ advice. Guided by the International Classification of Functioning, Disability, and Health (ICF) framework, exploratory factor analysis was conducted on data from patients diagnosed with endometriosis. Internal consistency was assessed using Cronbach’s alpha, considering values ≥ 0.70 as acceptable. Test–retest reliability was examined using intraclass correlation coefficients (ICCs), and ICC values were judged as excellent if >0.75. Construct validity was evaluated through concurrent, discriminant, and known-groups validity. For the known-groups validity hypothesis, participants were categorized by baseline pain levels. Results: The final questionnaire included 18 items, developed from responses from 301 women (mean age 38.96 ± 6.85). Factor analysis revealed two components—transitioning between body positions and performing movements requiring stabilization and executing load-bearing tasks involving the upper limbs—with the model explaining 71.78% of the total variance. Reliability was excellent, with a Cronbach’s alpha of 0.977. The ICC for the total score was 0.976 (95% CI 0.949–0.988), with similarly high values for each component. Concurrent validity correlations were significant, while discriminant validity showed no relevant associations. Known-groups analyses showed clear differences across pain-level groups. Conclusions: The questionnaire is a valid and reliable tool for capturing women’s perceived mobility limitations in endometriosis. Full article

Background: Childhood vaccination remains the cornerstone of public health strategies, substantially reducing global morbidity and mortality, yet suboptimal uptake persists in many settings. In South Africa, the challenge is evident, with persistent outbreaks of vaccine-preventable diseases. Addressing localised immunisation shortfalls requires elucidating the complex interplay of factors beyond conventional access barriers. This qualitative study provides context-specific insights into the behavioural and social drivers influencing childhood vaccination uptake among caregivers in Cape Town, South Africa. Methods: Utilising an exploratory qualitative research design, thematic analysis was applied to interview data (n = 25 caregivers) collected via a purposive sampling strategy designed to capture maximum variation in experiences within targeted low-uptake subdistricts. Interpretation of the data was systematically guided by the World Health Organization’s Behavioural and Social Drivers (BeSD) framework. The latter consists of four domains, namely, “Thinking and Feeling”, “Social Processes”, “Motivation”, and “Practical Factors”. Findings: Analysis across BeSD domains reflected a pattern of the intention–behaviour gap, where caregivers are motivated for vaccination but face structural and practical barriers affecting timely uptake. In the Thinking and Feeling domain, widespread conviction regarding the vital benefits of vaccination co-existed with significant anxiety concerning minor side effects (e.g., pain and fever), which sometimes precipitated missed subsequent appointments. Caregivers frequently accept immunisation as a social routine despite having limited knowledge of the diseases it prevents. Social Processes demonstrated that while decision-making authority rested primarily with mothers, compliance relied on the delegation of logistical responsibilities to extended family members. Critically, reports of poor communication, judgment, or negative attitudes among healthcare workers undermined trust and acted as barriers to sustained engagement. Within the Practical Factors domain, structural constraints frequently overshadowed high intent, with pervasive issues such as long waiting times and financial costs cited as the main reasons for missed appointments. Conclusions: Participants generally expressed strong acceptance of vaccination, but attainment of optimal coverage is constrained by systemic failures in patient–provider communication and persistent logistical barriers within the public healthcare delivery system. Strategic public health interventions must therefore move beyond addressing only attitudinal opposition to prioritise targeted efforts that mitigate structural constraints and reinforce personalised, empathetic communication to sustain caregiver confidence and adherence. Full article

Background/Objectives: Chemotherapy-induced peripheral neuropathy (CIPN) is a painful, debilitating condition that significantly impairs patient quality of life and often necessitates dose modification or discontinuation of chemotherapy, which can adversely impact patient outcomes and overall survival. This study aims to explore the experiences of cancer patients affected by CIPN and identify the challenges encountered in managing this condition. Methods: Data were collected through qualitative semi-structured interviews with 20 cancer patients with confirmed CIPN. The semi-structured interviews were held between April and June 2025 at a cancer center in the Qassim Region, Saudi Arabia, and were audio-recorded, transcribed, and analyzed using thematic analysis following Braun and Clarke. Results: Patients reported experiencing a considerable burden of CIPN symptoms, particularly during the early phases of chemotherapy, with some reporting gradual changes over time. Symptom unpredictability was reported across different types of cancer and regimens, regardless of age or gender. Sensory disruptions and functional impairments were prominent among many participants. Patients with higher levels of education, including those with family members in healthcare, demonstrated a stronger understanding of their condition and treatment explanations. Across cancer groups, patients expressed dissatisfaction with the prescribed therapies’ side effects. A subset of patients expressed a strong willingness to participate in clinical trials. Conclusions: The findings highlight the need for improved patient education, early symptom recognition, and comprehensive supportive care strategies. Healthcare providers should proactively address CIPN in treatment discussions and offer tailored interventions that go beyond physical symptoms. Additionally, further research is needed to identify and prevent CIPN across diverse populations. Full article

Rapid urban densification has intensified the scarcity of urban green space and challenged residents’ health and well-being. Pocket parks, as micro-scale infill green spaces embedded in the urban fabric, are increasingly adopted to expand everyday access to nature. Using three representative pocket parks in Nanjing, China, this study draws on self-reported data from questionnaire surveys and semi-structured interviews to characterize spatiotemporal use patterns and examine their links to perceived psychological, physiological, and social benefits through quantitative statistical analysis and modeling. Results show that pocket park use is highly routinized. Temporal patterns were evident, with weekend and autumn visits associated with improvements in emotional well-being, pain relief, and parent–child interaction. Perceived benefits were generally positive across psychological, physiological, and social domains, with psychological benefits—especially emotional relief and reduced loneliness—reported most strongly. Benefit levels varied across parks and user groups. Mechanism analysis reveals that the park supply factor, reflecting accessibility and basic facility provision, showed the most consistent direct paths to perceived benefits, whereas facility use and length of stay had no significant direct effects. These findings suggest that pocket park planning should prioritize accessibility and adequate basic provision, while strengthening activity support in ways that align with local use rhythms to enhance health-oriented performance in high-density cities. Full article

Trichocentrum ascendens, commonly known as “cola de rata”, is an orchid traditionally used by Indigenous communities to remove warts and heal wounds and in cultural cleansing rituals (“limpia”). However, additional medicinal uses preserved by the Chinantec people of Oaxaca, Mexico, remain largely undocumented and are at risk of disappearing, as this knowledge is now held by only a few individuals. This study gathered information on the therapeutic applications of T. ascendens in the Chinantla region through semi-structured interviews with key collaborators. Information was collected regarding the socio-demographic profiles of the collaborators, as well as the conditions treated, plant parts used, preparation modes, and doses. The species is used to alleviate headaches, toothaches, stomach pains, menstrual pains, body aches, kidney diseases, and inflammation, as well as to treat cultural diseases known as “mal de orin” and “sangre sucia”. Infusions made from mature or developing leaves, along with topical application of crushed leaves, are the main forms of administration. The traditional knowledge documented here underscores the importance of further research to identify the bioactive compounds in T. ascendens and to evaluate their potential inflammatory and analgesic effect. Such studies could lead to the discovery of new pharmacologically active molecules while preserving valuable traditional knowledge. Full article

This study explored the experiences, perspectives and confidence of teaching and research staff of discussing race and ethnicity, and associated equalities matters, at a post-1992 university in North West England, UK. In particular, it studied whether colleagues, who were largely white, had the understanding and personal skills to deliver on race equity in teaching and learning in a Higher Education Institution (HEI). Further, it examined whether there was a disconnect between the intention of an HEI working towards the Race Equality Charter (REC) mark and the detrimental effects this may have on its minoritised ethnic staff. The study was based on focus groups and interviews of 43 academic staff as participants using Critical Race Theory (CRT) and Intersectionality as the theoretical lens. These address discrepancies between institutional declarations and realities within higher education, which is important, as HEIs are increasingly positioning themselves as committed to diversity and equity, while the practical implementation often remains inconsistent. The findings demonstrate that the white participants were not confident, competent or pro-active enough to effect any meaningful change in race equity. At the same time, the minoritised ethnic participants often felt the burden of having to relive the trauma and pain of racism and take the lead in any race equity initiatives. In sum, the study demonstrates that HEI initiatives that purport to tackle systemic racism through decolonisation and the REC mark have little chance of effecting institutional change if the staff do not have the confidence, competence and necessary skills to make it happen. Full article

Background: Chronic pain following thoracotomy remains a common and clinically significant complication that adversely affects functional recovery and quality of life. Despite advances in perioperative analgesic techniques, chronic post-thoracotomy pain continues to be under-recognized and insufficiently managed in routine clinical practice. In this study, we aimed to determine the incidence of chronic pain after thoracotomy and evaluate its impact on daily activities and postoperative pain management behaviors. Methods: This retrospective observational study was conducted after institutional ethics committee approval was received (approval no. 2023/61). Patients aged ≥15 years who underwent thoracotomy between 15 June 2022 and 15 June 2023 and had undergone an operation at least three months prior to the study were included. Patients who underwent video-assisted thoracoscopic surgery were excluded. Demographic, surgical, anesthetic, and postoperative analgesia data were obtained from medical records. Patients were contacted by telephone to assess pain intensity using a Numeric Rating Scale (NRS), functional impact on daily activities, and analgesic medication use. The primary outcome was the incidence of chronic post-thoracotomy pain, defined as pain persisting beyond three months and reported at the time of the interview. Results: A total of 56 patients were included in the analysis. Chronic pain was reported by 55.4% of the patients. Pain that interfered with daily activities and required medication use was reported by 51.5% of the patients. Thirty-three patients (57.9%) reported an NRS score > 3 during movement. Among patients with chronic pain, 64.7% reported self-medication without physician consultation, whereas only 11.8% sought medical advice for pain management. Conclusions: Chronic pain remains highly prevalent after thoracotomy and substantially interferes with daily functioning. A considerable proportion of patients self-manage their pain without medical supervision, underscoring the need for structured postoperative follow-up, early identification of high-risk patients, and individualized multimodal analgesic strategies to reduce the burden of chronic post-thoracotomy pain. Full article

Background/Objectives: Gastrointestinal (GI) manifestations may persist in COVID-19 survivors, potentially worsening pre-existing conditions and increasing the risk of malnutrition. Understanding the long-term association between GI symptoms and nutritional risk is essential. This study aimed to investigate this relationship in COVID-19 survivors, regardless of comorbidities. Methods: A retrospective cohort study with prospective follow-up was conducted among 103 adults (52 males and 51 females) with PCR-confirmed COVID-19 admitted to King Salman Specialist Hospital, Ha’il, Saudi Arabia, between January 2021 and January 2023. Participants were grouped based on the presence of comorbidities, mainly type 2 diabetes mellitus (DM) and hypertension (HTN), and GI symptoms. Demographic characteristics, COVID-19 severity, and clinical data were obtained from medical records and structured interviews. Nutritional risk was assessed using the Malnutrition Screening Tool (MST). Statistical analysis was performed using Chi-Square tests, with p < 0.05 considered significant. Results: Over a mean follow-up of 26.6 months, 40.8% of participants reported at least one persistent GI symptom. Patients with comorbidities were older than those without comorbidities (mean age 58.24 ± 13.23 vs. 48.22 ± 14.83 years), and malnutrition risk was commonly observed in both groups during hospitalization and follow-up. The most frequently reported symptoms were abdominal pain (15.5%), diarrhea (12.6%), appetite loss (9.7%), and vomiting (7.8%), with no significant differences between groups. GI symptoms were significantly associated with reduced food intake, weight loss, and increased malnutrition risk (p < 0.05). Conclusions: Some COVID-19 survivors reported persistent GI symptoms during long-term follow-up, with no significant differences based on comorbidity status. GI symptoms were associated with nutritional risk and lifestyle changes, supporting the need for nutritional screening in post-COVID-19 care. Full article

Background: Feasibility studies enable the refinement of complex interventions and procedures prior to definitive trials. To establish robust evidence for clinical applications, this study evaluated the feasibility, acceptability and safety of an evidence-based breathing exercise (BE) intervention protocol among breast cancer survivors experiencing chronic pain. Methods: In an open-label pilot randomised controlled trial with a nested qualitative evaluation, 72 women were randomised into a BE plus routine care group (n = 36) or a routine care alone group (n = 36). Feasibility and acceptability outcomes included recruitment, retention, instrument completeness and suitability, intervention adherence, safety, and participants’ perceived experience of practicing BE and participating in this study. Outcome assessments occurred at baseline (week 0), post-intervention (week 5), and follow-up (week 9). Quantitative data were analysed descriptively. Qualitative interviews (n = 20) explored participant experiences, and the data were analysed thematically. Results: The feasibility was high, with an 84% recruitment (72/86) and 94% retention (68/72), and the recruitment process took 19 weeks. The overall BE intervention adherence was 82.4%. Questionnaire completion was satisfactory, with minimal missing values reported in the questionnaire. No serious adverse events occurred. Evidence from qualitative evaluation reinforced the feasibility from quantitative data. Conclusions: The BE protocol and study procedures were feasible, acceptable, and safe in this population. A fully powered RCT is warranted to determine the effectiveness and durability of the outcomes. Full article

Background: Sickle cell disease (SCD) is a hereditary blood disorder marked by the production of abnormally shaped, rigid red blood cells that obstruct blood flow, resulting in pain, organ damage, and increased infection risk. SCD poses a significant public health challenge in Nigeria, which has the highest global burden, with about 150,000 affected children born annually. The high prevalence is exacerbated by limited healthcare infrastructure, low public awareness, and socio-economic barriers, making effective disease management difficult. Understanding the knowledge of home-based caregivers is essential to identify gaps that may impact care quality. This study was performed within the African Research and Innovative Initiative for Sickle Cell Education (ARISE, EC GA No 824021) project to develop best practice in the clinical management of SCD. Aim: This study explores the knowledge, experiences, and educational needs of home-based caregivers of children with SCD attending the Paediatric Haematology Clinic, ABUTH, Zaria. Methods: A qualitative case study design was used, involving in-depth interviews with ten purposively selected caregivers. Interviews were conducted in Hausa, transcribed, and translated into English. Thematic analysis was performed. Results: Four themes emerged: 1. Understanding of SCD aetiology 2. Knowledge of symptoms 3. Awareness of complications and 4. Knowledge of SCD type. Conclusions: Home-based caregivers had limited knowledge of the genetic basis of the disease, but possess some knowledge of SCD key symptoms, enabling basic disease management and healthcare seeking. However, there is a need to enhance caregiver education to improve care quality and health-seeking behaviour for children with SCD. Full article

Recreational weightlifting has become increasingly popular in Kuwait, yet limited data exist regarding musculoskeletal pain (MSP) associated with it. This study aimed to assess the prevalence and anatomical distribution of MSP among recreational resistance trainers (RRTs) in Kuwait and to examine pain patterns according to gender, age, and training history. A total of 642 RRTs (304 males and 341 females) who practiced resistance training for at least 6 months 2 times a week were surveyed using the Nordic Musculoskeletal Questionnaire (NMQ) through face-to-face interviews. MSP prevalence over the previous 12 months was analyzed by anatomical region, and binary logistic regression was applied to investigate predictors of low back pain (LBP). The results indicated a high prevalence of MSP, particularly in the lower back and shoulders, with increased reports among older participants and those with longer training histories. Logistic regression analysis revealed that age and years of practice were significant predictors of LBP, while female gender was associated with higher odds of reporting symptoms. These findings highlight the substantial burden of MSP among RRTs in Kuwait and underscore the importance of targeted preventive strategies, including training supervision, technique optimization, and age-specific interventions, to reduce injury risk and promote long-term musculoskeletal health. Full article

The goal of antiretroviral therapy (ART) is to achieve viral suppression and improve the quality of life in people living with HIV (PLWH). Targeting the determinants of self-rated health in virally suppressed PLWH could significantly contribute towards sustaining the quality of life and health gains from ART. A qualitative study was conducted to investigate the determinants of excellent self-rated health in PLWH who are virally suppressed in the Eastern Cape province. A descriptive cross-sectional study using qualitative approach was conducted among 26 consenting adults living with HIV who have achieved viral load suppression in the rural province of the Eastern Cape using in-depth interviews. Themes were generated from the qualitative data using thematic analysis in NVivo 13^®. All participants described what they perceived as excellent quality of life as mostly determined by self-system (downward counterfactual thinking and pain discounting), perceived improved health, and adherence to recommended healthy behaviours (ART, diet, physical activity, and non-use of tobacco and alcohol products). Income/financial support availability and good healthcare access emerged as indispensable prerequisites for achieving and maintaining good health or adherence to healthy behaviours. Targeting the determinants of Self-Rated Health (SRH) has the potential to greatly improve physical and mental well-being of PLWH beyond viral suppression. Interventions can be more effective by drawing from evidence generated from context-based research. Full article