Search Results (82)

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

Background/Objectives: The urine sodium/potassium (Na/K) ratio can potentially be used to detect dietary habits that contribute to hypertension. In this prospective cohort interventional trial, we aimed to verify whether private insurance sales staff can help clients change their lifestyle habits based on their urinalysis results. Methods: Clients of the life insurance company (20–65 years old) who were considered to have “high risk” lifestyle factors, which was defined as having high values for two or more of the following indicators: body mass index, blood pressure, triglycerides, liver enzymes, and glucose metabolism, were included. The clients were randomly assigned to three groups: a face-to-face (FF) intervention by sales staff (n = 83), non-FF (Non-FF) intervention via a social networking service (n = 87), and no intervention (Control) (n = 58). Urinalysis and surveys about diet and exercise habits were conducted before and after a 3-month interventional period in all groups. Three interventions were performed for the FF and Non-FF groups, including dietary advice based on urinalysis results, education encouraging reduced salt intake and increased locomotor activity, and viewing an educational video. The Control group only received their urinalysis results by mail. Results: The participants’ mean age was 44.0 years old. Significant improvements in estimated potassium intake were observed in the Non-FF group, and significant reductions in urine Na/K ratios were noted in both the FF and Non-FF groups. Multiple logistic regression analysis indicated that watching the video was the most effective factor for decreasing the urine Na/K ratio (odds ratio = 1.869). The total points for dietary behavior, based on the questionnaire, significantly improved among the individuals who watched the video. Conclusions: This study demonstrates the potential for private health insurance companies to contribute to health promotion and introduces a novel strategy for improving lifestyle habits among individuals at high risk of lifestyle-related diseases. Full article

This study investigates how the timing of self-employment relative to first childbirth shapes long-term entrepreneurial outcomes among Israeli mothers. Drawing on rich administrative panel data from the Israeli National Insurance Institute (N = 73,141 woman-years), we follow a cohort of women who gave birth for the first time in 2010, tracking their employment trajectories over 15 years (2005–2019). Using random-effect logistic regressions, OLS models, and fixed subgroup analyses, this study compares women who entered self-employment before childbirth with those who did so afterward. The results reveal that postnatal entrants are more likely to operate smaller businesses and exit self-employment earlier, yet often earn higher income from wage employment, compared to their prenatal counterparts. By tracing these outcomes over time, this study demonstrates how key life events, such as childbirth, structure women’s employment paths and contribute to differentiated patterns of labor market participation. Situated in a context of near-universal motherhood and limited public support for working parents, the findings offer insight into the dynamic links between family formation, employment timing, and entrepreneurial sustainability. By adopting a life-course perspective, this study demonstrates how the sequencing of family and employment transitions intersect to shape access to economic resources and entrepreneurial sustainability. Full article

(1) Background: Traumatic brain injury (TBI) is caused from rapid head acceleration/deceleration, focal blows, blasts, penetrating forces, and/or shearing forces, whereas hypoxic–anoxic injury (HAI) is caused through oxygen deprivation events, including strangulation. Most service-seeking domestic violence (DV) survivors have prior mechanistic exposures that can lead to both injuries. At the time of our study, some evidence existed about the exposure to both injuries over the course of a survivor’s lifetime from abuse sources, yet little was known about their co-occurrence to the same survivor within the same episode of physical intimate partner violence (IPV). To better understand the lived experience of service-seeking DV survivors and the context in which partner-inflicted brain injury (PIBI) is sustained, we sought to understand intentional brain injury (BI) exposures that may need to be addressed and accommodated in services. Our aims were to 1. characterize the lifetime co-occurrence of strangulation and intentional head trauma exposures from all abuse sources to the same survivor and within select physical episodes of IPV and 2. establish the lifetime prevalence of PIBI. (2) Methods: Survivors seeking DV services in the state of Ohio in the United States of America (U.S.) completed interview-administered surveys in 2019 (n = 47). Community-based participatory action approaches guided all aspects of the study development, implementation, and interpretation. (3) Results: The sample was primarily women. Over 40% reported having Medicaid, the government-provided health insurance for the poor. Half had less than a postsecondary education. Over 80% of participants presented to DV services with both intentional head trauma and strangulation exposures across their lifetime from intimate partners and other abuse sources (i.e., child abuse, family violence, peer violence, sexual assault, etc.), though not always experienced at the same time. Nearly 50% reported an experience of concurrent head trauma and strangulation in either the first or last physical IPV episode. Following a partner’s attack, just over 60% reported ever having blacked out or lost consciousness—44% experienced a loss of consciousness (LOC) more than once—indicating a conservative estimate of a probable brain injury by an intimate partner. Over 80% of service-seeking DV survivors reported either a LOC or two or more alterations in consciousness (AICs) following an IPV attack and were classified as ever having a partner-inflicted brain injury. (4) Conclusions: Most service-seeking IPV survivors experience repetitive and concurrent exposures to abusive strangulation and head trauma through the life course and by intimate partners within the same violent event resulting in brain injury. We propose the use of the term partner-inflicted brain injury (PIBI) to describe the physiological disruption of normal brain functions caused by intentional, often concurrent and repeated, traumatic and hypoxic neurologic insults by an intimate partner within the context of ongoing psychological trauma, coercive control, and often past abuse exposures that could also result in chronic brain injury. We discuss CARE (Connect, Acknowledge, Respond, Evaluate), a brain-injury-aware enhancement to service delivery. CARE improved trauma-informed practices at organizations serving DV survivors because staff felt knowledgeable to address and accommodate brain injuries. Survivor behavior was then interpreted by staff as a “can’t” not a “won’t”, and social and functional supports were offered. Full article

Background. Cow’s Milk Protein Allergy (CMPA) is a prevalent pediatric food allergy affecting 2–5% of infants globally. CMPA presents significant clinical and economic challenges, requiring specialized diagnostic procedures, dietary management with hypoallergenic formulas, and multidisciplinary care. The financial burden on families and healthcare systems includes direct costs (e.g., diagnostic tests, medical consultations, and formula expenses), indirect costs (e.g., caregiver absenteeism and productivity loss), and intangible costs (e.g., psychological distress and impaired quality of life). Economic disparities further exacerbate these challenges, particularly in low-resource settings where access to specialized care is limited. Methods. A systematic review was conducted following PRISMA guidelines using PubMed, CINAHL, Scopus, and Cochrane databases to identify studies on the economic and psychosocial burden of CMPA. Studies published between 2010 and 2024 were analyzed. From an initial search of 11,565 articles, 802 duplicates were removed, leaving 10,763 articles for title and abstract screening. Twenty full-text articles meeting the inclusion criteria were included in the final analysis. Thematic categories focused on direct, indirect, and intangible costs, with findings synthesized to highlight global disparities and policy gaps. Results. CMPA management imposes substantial economic burdens, with hypoallergenic formulas alone accounting for up to 15% of household income in some regions. Indirect costs, including lost workdays and additional childcare expenses, further strain families. Intangible costs, such as heightened caregiver anxiety and reduced social participation, are significant yet frequently overlooked. Healthcare system disparities, particularly regarding insurance coverage for diagnostic tests and therapeutic formulas, contribute to financial inequities. The use of extensively hydrolyzed casein formulas with probiotics has demonstrated cost-effectiveness in promoting immune tolerance while reducing healthcare utilization. Conclusions. Addressing the economic impact of CMPA would benefit from standardized cost assessment frameworks and equitable access to cost-effective therapeutic options. Further analysis of reimbursement policies across diverse healthcare systems may provide insights into optimizing support for essential treatments. Integrating clinical and economic strategies can alleviate the burden on affected families and optimize healthcare resource allocation. Future research should prioritize longitudinal analyses and cross-regional comparisons to guide sustainable and equitable management strategies. Full article

Background: Rare diseases are defined as clinical conditions that affect only a small number of persons in a population, considered fewer than 1 per 2000 in the European Union or fewer than 1 per 1600 in the United States They are serious, often chronic and progressive conditions, characterized by a pronounced clinical polymorphism that crosses all medical specialties. Multiple areas of life beyond just physical health are affected with significant impact on patients, families, and healthcare systems. Objective: To analyze the socio-demographic, medical, and vocational characteristics that correlate with functional status and work disability as a measure of quality of life in rare diseases. Methods: An observational retrospective study of adults with rare diseases evaluated for eligibility for social insurance rights in the National Institute of Medical Assessment and Work Capacity Rehabilitation Bucharest (INEMRCM, the Romanian abbreviation) over a 5-year period was made. Descriptive analysis was used to present sample characteristics. Means and standard deviations (SD) were calculated to describe numerical variables, frequencies were used to describe categorical variables, and logistic regression analysis was conducted to evaluate potential predictors of work capacity. All statistical analyses were performed by PSPP.3 software. p < 0.05 was the cut-off for statistical significance with a 95% confidence interval. Results: 90 consecutive persons were included in the survey. The mean age of the group was 44.5 years ± SD 10.61 years, with a female/male ratio of 48/42 persons. The mean disease duration was 10.61 years ± SD 9.76 years. Men had more severe disease (73.81%); p = 0.018 and significantly younger retirement age, M/F = 39.10 ± 12.26/43.06 ± 9.32; p = 0.037. Less disabling diseases were predominant autoimmune conditions (85.71% of cases); genetic conditions had a more severe functional impact in 63.75% of cases; p = 0.037. People with multisystem diseases but with specific or targeted treatment can work more frequently (76.19%); those with visual impairment have more severe impairments (73.77%); p < 0.001. All individuals who received specific therapy had a better functional status, unlike only 37.21% of those who received symptomatic treatment or treatment for complications; p = 0.023. Logistic regression analysis indicated that the type of impairment and the availability of specific treatments could serve as predictors of a reduced likelihood of employment in rare disease cases. Education level and occupation were not correlated with functional impairment and work disability (NS). Conclusions: Several factors, including some that are modifiable, were associated with better outcomes, such as reduced disability and an increased potential for work participation. Sex, disease etiology, type of impairment, and treatment were all significantly linked to functional capacity. Among these, the type of impairment and the availability of specific treatments might be predictors of employment. Addressing these parameters requires a multidisciplinary team, involving specialized care and comprehensive support services to improve the overall quality of life of individuals affected by rare diseases. Full article

Background/Objectives: Maintaining functional independence and minimizing disability among older adults living in the community is paramount for mitigating rising care demands. Our study focused on shopping as a critical instrumental activity of daily living (ADL) to explore the association between shopping assistance and functional decline among older individuals receiving support through long-term care insurance (LTCI). Methods: This retrospective, cross-sectional study included 6202 participants aged >65 years living in a Japanese regional town receiving LTCI support, suggesting that they required assistance with local community life. Logistic regression analysis identified several factors associated with shopping assistance among the participants, including physical and cognitive functions, functional ADL, and psychobehavioral symptoms. Results: In male participants, walking dysfunction, short-term memory decline, decreased frequency of going outdoors, and decreased engagement in personal grooming were significantly associated with requiring shopping assistance. Conversely, in female participants, reduced physical function and walking performance were significantly associated with requiring shopping assistance, whereas dependence on personal grooming was less pronounced than in male participants. Conclusions: These findings suggest that, in addition to direct shopping assistance, tailored interventions targeting physical, cognitive, and ADL functions—while considering gender-specific needs—may help older adults maintain independence in shopping activities as part of their daily community life. Full article

Background: Obesity is a growing public health concern worldwide, and Saudi Arabia faces rising rates of obesity-related conditions, including diabetes and cardiovascular diseases. Bariatric surgery is a recognized treatment for severe obesity, offering significant health benefits. This study evaluates the Saudi population’s awareness and attitudes towards bariatric surgery, examining knowledge levels, perceptions, and potential barriers. Methods: A cross-sectional survey was conducted among adults in Riyadh using convenience and snowball sampling. The survey included demographic data, awareness of obesity and bariatric surgery, attitudes towards the procedure, perceived barriers, and willingness to consider surgery. Data were analyzed using descriptive statistics and logistic regression. Results: Among 313 participants (mean BMI 26.98 kg/m²), 41.9% identified obesity as a disease, and 48.9% recognized the effectiveness of bariatric surgery for severe obesity. Knowledge scores averaged 4.08 (out of 5) for obesity and 3.28 (out of 6) for bariatric surgery. Significant associations were found between bariatric surgery knowledge and gender (p < 0.001), BMI (p = 0.004), income (p = 0.025), and educational level (p = 0.001). While 71.2% would not consider surgery, misconceptions about risks, stigma, and cost remain common barriers. Conclusions: Although awareness of bariatric surgery in Saudi Arabia is moderate, misconceptions about safety and financial constraints persist. Public education campaigns are necessary to dispel myths, improve understanding, and promote bariatric surgery as a viable treatment option for severe obesity. Expanding insurance coverage and financial support may also enhance accessibility and adoption of this life-saving intervention. Full article

Background: Mental stress plagued type II diabetes (T2DM) patients. The psychological and emotional issues related to diabetes and its effects include depression, anxiety, poor diet, and hypoglycemia fear. Aim: Compare the impact of diabetes on depression and anxiety in Egyptian and Saudi diabetics. Methods: The diabetes, gastroenterology, and hepatology sections of University of Ha’il Clinic, KSA, and the Theodor Bilharz Research Institute, Egypt, conducted this retrospective study. Everyone gave informed consent before participating. Interviews with male and female outpatients and inpatients were conducted from June 2021 to December 2022. The self-administered validated Generalized Anxiety Disorder-7 (GAD-7) and the Patient Health Questionnaire-9 (PHQ-9) scale measured sociodemographic characteristics and symptoms of depression and anxiety. Results: In patients with diabetes, the prevalence of depression was higher in KSA [34.8%] than in Egypt [18%], while anxiety was higher in Egypt [40%] than in KSA [29.1%]. Most depressed patients were 31–55 years old (61.2%) from KSA and 97.8% (41–55 years old) from Egypt. Female anxiety was 70.7% in KSA and 51.0% in Egypt, with no significant difference. The duration of diabetes in depressed patients was 5–10 years ([46.9%, Saudis] vs. [57.8%, Egyptians]), while anxious patients (5–10 years [39.0%, Saudis] vs. >20 years [65.0%, Egyptians]) were mainly type-2. Most depressive patients had an HbA1c (59.2%) from 7–10% (Saudis) and 77.8% [>10% Egyptians] compared to anxiety patients (46.3%) and 48.0% [>10% Egyptians]. Depressed and anxious patients from both nations had higher glucose, triglycerides, and cholesterol levels. Saudis and Egyptians with obesity had higher rates of sadness (75.5% vs. 68.9%) and anxiety (82.9% vs. 69.0%). Treatment adherence and serum glucose monitoring were not significantly different from depression in diabetes individuals in both ethnicities. Conclusions: Anxiety was more common among Egyptian patients because of overcrowding, working whole days to fulfill life requirements, and the unavailability of health insurance to all citizens. Meanwhile, in KSA, obesity, unhealthy food, and less exercise reflect the high percentage of depression among patients with diabetes. The detection of depression and anxiety in the context of DM should be critical for the physical health and quality of life of Saudi and Egyptian diabetics. Further investigation is warranted to encompass anxiety and depression within the scope of future research. Full article

Clinical trials, by contributing to the development of diagnostics and to the search for modern, more effective, and safer therapies, have become one of the most important elements of the healthcare system. They enable the introduction of innovative drugs and treatments that can significantly improve patients’ quality of life. Not only does this research help to understand disease mechanisms, but it also enables the personalization of therapy, which often increases the effectiveness of treatment. Public awareness of clinical trials helps build trust in science and medicine, which is fundamental to the effective functioning of the healthcare system. The aim of this study was to assess Poles’ knowledge and beliefs about clinical trials. Methods: The survey was conducted among Poles aged 18 and over with the help of an external company, Ariadna, which is an independent research panel. The questionnaire contained 22 questions, of which 13 questions concerned beliefs and attitudes towards clinical trials. Results: One thousand and seventy-nine participants took part in the study (n = 1079). The mean age of respondents was 44.96 years (SD = 16.30). Slightly more women (n = 568, 52.6%) than men (n = 511, 47.4%) took part in the study. Among the respondents, 86.5% (n = 933) were aware of clinical trials. The main sources of information about clinical trials were the media (53.8%) including the Internet (n = 355, 32.9%), TV (n = 175, 16.2%), press (n = 30, 2.8%), and radio (n = 21, 1.9%). 43.2% (n = 466) of respondents reported little knowledge of clinical trials, while more than three quarters (n = 805, 75.2%) said they would like to learn more about clinical trials. Most respondents (n = 879, 81.4%) agreed with the statement that participation in a clinical trial is completely voluntary, and more than half (n = 580, 53.7%) agreed with the statement that hospitals participating in clinical trials provide better healthcare. The statement that the results of clinical trials are made available to the public was disagreed with by 37.2% (n = 402) of participants. Only 30.3% (n = 327) of participants agreed that clinical trials should be conducted with children. Most respondents (n = 638, 59.1%) agreed with the statement that a patient in a clinical trial is insured. 48.3% (n = 521) of participants are aware that a clinical trial can be withdrawn from at any time. Conclusions: Poles rate their knowledge of clinical trials as low and would like to learn more. Poles’ knowledge of clinical trials is mainly based on commercial sources. Full article

This essay examines a little-known but important installation entitled Insure the Life of an Ant, conceived by artist Mike Malloy and displayed at the O.K. Harris Gallery in New York in April of 1972. This provocative and idiosyncratic piece confronted gallery-goers, who became viewer–participants, with the option of killing or saving a live ant displayed like a sculpture on a pedestal, either by pushing a button or not. The artist made the piece, which can function almost like a psychology experiment, to engender a “moral dilemma”. I explore the particular role of affect in a participatory art installation, distinct from response to inanimate art. I investigate the roles of emotion and reason in dealing with the work; whether ratiocination can be considered an “anti-affect”; and how the tension between competing thoughts and feelings helped create a psychological drama. The essay looks at how an art space can operate as a zone of moral exceptionalism to encourage questionable actions. It also locates the piece in relation to the emergence of a more behaviorist art in the early 1970s, as discussed by critic Gregory Battcock, and the larger notion of postmodernism. Other contexts investigated include art and animal rights and issues of sentience and speciesism; social and military violence, including capital punishment and the Vietnam War; the 1961 Milgram experiment; Hannah Arendt’s concept of the “banality of evil” as a Nazi war criminal defense; and other works of art involving maltreatment or violence toward both human and non-human animals, including those by Marina Abramović, Marco Evaristti, and Edward and Nancy Reddin Kienholz. Full article

We aimed to examine the prevalence of, and factors associated with, quality of life (QOL) worsening among coronavirus disease 2019 (COVID-19) survivors. This population-based retrospective cohort study used data from the Korea Disease Control and Prevention Agency and the National Health Insurance Service in South Korea. A total of 325,666 COVID-19 survivors were included in this study. Among them, 106,091 (32.6%) survivors experienced worsening QOL after COVID-19. Specifically, 21,223 (6.5%) participants experienced job loss, 94,556 (29.0%) experienced decreased household income, and 559 (0.2%) acquired new disabilities. In the multivariable logistic regression model, living in rural areas (odds ratio [OR]: 1.02; 95% confidence interval [CI]: 1.01, 1.04; p = 0.009), intensive care unit admission (OR: 1.08, 95% CI: 1.02, 1.15; p = 0.028), and increase in self-payment by 100 USD (OR: 1.02, 95% CI: 1.02, 1.02; p < 0.001) were associated with increased QOL worsening after COVID-19. Old age (OR: 0.99, 95% CI: 0.98, 0.99; p < 0.001), first vaccination (OR: 0.89, 95% CI: 0.86, 0.93; p < 0.001), and second vaccination (OR: 0.95, 95% CI: 0.93, 0.96; p < 0.001) were associated with decreased QOL worsening after COVID-19. Approximately one-third of COVID-19 survivors in South Korea who were admitted to hospitals or monitoring centers experienced QOL worsening. Full article

Background: Given the aging of the overall U.S. population, the resulting changes in healthcare needs especially among veterans, and the high prevalence of traumatic brain injury (TBI) among older adults, additional research is needed on community participation after TBI in older veterans. The current study examined predictors of community participation trajectories over the 5 years after TBI in veterans who were 55 years of age or older upon injury. Method: This study included data from 185 participants in the U.S. Department of Veterans Affairs TBI Model System national study who had sustained a TBI at age 55 or older and had completed at least one of each Participation Assessment with Recombined Tools-Objective (PART-O) subscale scores at one or more follow-up time points (1, 2, and 5 years post-TBI). Results: PART-O Productivity, Social, and Out and About scores remained constant over time. Lower PART-O Productivity trajectories were seen among participants who were unemployed at the time of injury (p = 0.023). Lower PART-O Social trajectories were seen among participants who had a lower education level (p = 0.021), were unmarried at injury (p < 0.001), and had private insurance coverage (p < 0.033). Conclusion: These findings add to the growing body of literature on TBI and community participation by focusing on an older adult veteran population. There is an urgency to understand the needs of this group, many of whom are aging with service-connected disabilities including TBI. Veterans with characteristics identified herein as being associated with lower community participation trajectories would be prime candidates for interventions that aim to increase community and social engagement after later-life TBI. Full article

Introduction: The recommended duration for pulmonary rehabilitation stands at a minimum of six weeks; however, this stipulation may pose constraints in various countries due to financial limitations imposed by insurance companies and/or national health funds, as is the case in Poland. Consequently, our study endeavors to analyze the short-term outcomes stemming from a condensed three-week PR regimen administered to patients diagnosed with chronic obstructive pulmonary disease (COPD), asthma, and the concomitance of these conditions (COPD-A)—this is an approach that is standard in the rehabilitation protocols endorsed by our national health fund. Methods: Patients diagnosed with COPD, asthma, and COPD-A, referred to the PR program, underwent retrospective analysis to evaluate the short-term efficacy of a three-week PR program. Patients underwent comprehensive assessment by respiratory physicians and rehabilitation consultants, leading to individualized PR programs. Clinical evaluations occurred at program onset and completion. Results: 125 patients participated: 37 COPD, 61 asthma, and 27 COPD-A. Significant improvements were observed in the COPD Assessment Test (CAT), the consensus-based GINA symptom control tool (GINA-SCT), the Modified Medical Research Council (mMRC) scale, forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), and the 6-min walk test (6 MWT) distance, as well as in the St. George’s Respiratory Questionnaire (SGRQ) scores. All groups experienced reduced dyspnea severity and improved exercise tolerance. FEV1 and FVC improved in asthma and COPD-A, but not significantly in COPD. Multivariable logistic regression identified predictive factors for PR response. Conclusions: The study supports the short-term efficacy of the three-week PR program in improving clinical outcomes, exercise tolerance, and quality of life in COPD and asthma patients. Tailoring interventions based on predictors of PR response can optimize outcomes. Further research, particularly of the COPD-A group, is needed for individualized approaches. Larger sample sizes are necessary to confirm our findings. Full article

Background: Participation in targeted screening reduces lung cancer mortality by 30–60%, but screening is not universally available. Therefore, the study aimed to synthesize the evidence and identify facilitators and barriers to lung cancer screening participation globally. Methods: Two reviewers screened primary studies using qualitative methods published up to February 2023. We used two-phase synthesis consistent with a meta-study methodology to create an interpretation of lung cancer screening decisions grounded in primary studies, carried out a thematic analysis of group themes as specific facilitators and barriers, systematically compared investigations for similarities and differences, and performed meta-synthesis to generate an expanded theory of lung cancer screening participation. We used the Social Ecological Model to organize and interpret the themes: individual, interpersonal, social/cultural, and organizational/structural levels. Results: Fifty-two articles met the final inclusion criteria. Themes identified as facilitating lung cancer screening included prioritizing patient education, quality of communication, and quality of provider-initiated encounter/coordination of care (individual patient and provider level), quality of the patient–provider relationship (interpersonal group), perception of a life’s value and purpose (cultural status), quality of tools designed, and care coordination (and organizational level). Themes coded as barriers included low awareness, fear of cancer diagnosis, low perceived benefit, high perceived risk of low-dose computerized tomography, concern about cancer itself, practical obstacle, futility, stigma, lack of family support, COVID-19 fear, disruptions in cancer care due to COVID-19, inadequate knowledge of care providers, shared decision, and inadequate time (individual level), patient misunderstanding, poor rapport, provider recommendation, lack of established relationship, and confusing decision aid tools (interpersonal group), distrust in the service, fatalistic beliefs, and perception of aging (cultural level), and lack of institutional policy, lack of care coordinators, inadequate infrastructure, absence of insurance coverage, and costs (and organizational status). Conclusions: This study identified critical barriers, facilitators, and implications to lung cancer screening participation. Therefore, we employed strategies for a new digital medicine (artificial intelligence) screening method to balance the cost–benefit, “workdays” lost in case of disease, and family hardship, which is essential to improve lung cancer screening uptake. Full article