Search Results (1,268)

Background: Malnutrition is a universal challenge in long-term care, significantly affecting vulnerable populations. Residents with Intellectual Developmental Disability (IDD) rely heavily on Direct Support Professionals (DSPs) for assisted feeding. Understanding DSP’s mealtime experiences is essential for improving nutritional care and well-being. Objective: To examine multilevel factors associated with DSPs’ mealtime experiences. Methods: This exploratory cross-sectional case study used a survey administrated to DSPs working in a long-term residential setting. Statistical analyses examined the associations between multilevel factors and DSP’s positive and negative mealtime experiences. Results: The sample included 46 DSP’s (98% women) from a single facility in Israel. Although DSPs reported high levels of positive feelings and satisfaction with their daily work efficacy, negative feelings were significantly associated with some organizational, environmental and resident-related factors. Negative feelings were higher among DSPs caring for residents who use wheelchairs compared to those working with residents who do not use wheelchairs (t = −2.99, p < 0.01). Negative feelings were negatively associated with institutional support (r = −0.49, p < 0.001), and perceived accessibility and adaptability of the environment (r = −0.46, p = 0.001), and showed a more modest association with communication with residents (r = −0.38, p = 0.01). DSPs’ seniority, education level, and prior feeding-related training were not significantly associated with mealtime experience. Conclusions: The findings highlight that negative mealtime experiences among DSPs are associated with organizational, environmental, and resident-related factors, rather than with individual DSP’s characteristics. Policy and practical adjustments to address mealtime experiences for residents with IDD are suggested. Full article

Background/Objectives: The coronavirus disease 2019 (COVID-19) pandemic presented significant psychosocial challenges to intensive care unit health care workers (ICU HCW). Prior studies typically used single cross-sectional samples to focus on elements of burnout and psychological stress. We sought to serially assess quality of life and willingness to work before, during, and after the first peak of COVID-19. Methods: Two survey instruments were prospectively administered at regular intervals to multidisciplinary ICU HCWs, initiating at the local onset of COVID-19 and ending 6 months after the first peak ICU census of COVID-19 patients. Results: ICU HCWs reported high levels of compassion satisfaction, burnout, and secondary traumatic stress before, during and after the first peak of COVID-19. Motivation to work declined, and hesitation to work increased from study initiation to the peak ICU census of COVID-19 patients. Hesitation to work was greater in female HCWs and cardiothoracic ICU HCWs. Motivation to work was higher in those working in operating rooms compared to those in the ICU. Concerns about becoming infected, feelings of isolation, and exhaustion were associated with high hesitation to work. Feeling protected by the government and hospital was associated with decreased hesitation and increased motivation to work. Conclusions: ICU HCWs experienced high levels of stress throughout the first year of COVID-19, while satisfaction with work remained high. Willingness to work was associated with gender, work location, ICU subtype, concerns about infection risk, feelings of exhaustion, and feelings of institutional protection. Because the study methodology precludes causal inference and low survey response rates indicate that findings should be interpreted with caution, these results are best viewed as hypothesis-generating for future work aimed at improving stress mitigation in ICU HCWs. Full article

The digital transformation of healthcare requires stronger digital competencies among pharmacists, yet evidence on the effectiveness of structured training remains scarce. This study examines the impact of a blended digital health training programme delivered to practicing pharmacists in Bihor County, Romania, as part of the Romanian pilot of the EU-funded European Health Professionals’ and the DigitAl team SkillS (H-PASS) project. A single-group pre–post educational design was applied to pharmacists from Bihor County, Romania, participating in a modular digital health training programme delivered between May and July 2025. A total of 84 pharmacists completed both pre-training and post-training self-reported competency assessments comprising 18 items across three modules: digital innovation and change management, communication and collaboration, and data management and digital literacy. Paired samples t-tests, Cohen’s d effect sizes, Cronbach’s alpha, moderator analyses, and ceiling effect analyses were conducted using Python-based statistical workflows. Statistically significant improvements were observed across all three modules (all p < 0.0001), with large effect sizes (d = 1.04–1.30). Post-training internal consistency increased substantially, with overall Cronbach’s alpha reaching 0.74. The greatest item-level gains were recorded in adaptive communication, cultural adaptation of care, and data protection ethics. No significant moderation effects were found for age, gender, or years of experience. Course satisfaction showed a moderate positive correlation with competency gains (r = 0.528), while perceived improvement was not significantly associated with observed score change. A ceiling effect indicated greater gains among participants with lower baseline competencies. The Romanian implementation of the H-PASS training programme was associated with improved self-reported digital health competencies among practicing pharmacists, high-lighting its potential as a scalable model for digital upskilling in healthcare. Full article

This study aimed to explore athletes’ experiences of transitioning out of sport following spinal cord injury (SCI). Using a multiple-case study design, three former nondisabled competitive athletes participated in one-on-one semi-structured interviews. The participants’ interview responses were informed by quantitative measure data collected prior to the interviews using the Athletic Identity Measurement Scale, the Social Support Questionnaire-6, and the Satisfaction with Life Scale. The thematic analysis of the interviews revealed that participants experienced a range of cognitive, emotional, social, and behavioral influences during the transition process. These influences contributed to outcome-related appraisals of post-SCI transition. Balanced self-identity, adaptive sport participation, and peer-mentor relationships were common factors influencing athletes’ transition with spinal cord injury. The results partially support the conceptual model of adaptation to career transition and extend it to account for athletes’ experiences following SCI. The results also benefit rehabilitation professionals and athletes with spinal cord injury by providing insight into psychosocial factors and resources that may influence the transition experience. Full article

Background: Effective communication improves patient satisfaction and reduces stress for both patients and physicians. Surveys consistently highlight the importance of strong communication skills among physicians, especially in oncologic settings. Yet, communication training is neither ubiquitous nor standardized in medical studies or residency, and physicians report that this task represents a burden for them. Given the limited data addressing the observations and expectations of patients with gynecologic malignancies when receiving bad news, this survey aimed to assess their perspective on this topic. Methods: We examined throughout an anonymous questionnaire how patients with gynecological and breast cancer experienced the delivery of bad news. Data were collected in Germany from July 2024 to September 2025. The questionnaire was available online and in paper form in four languages (German, English, Turkish, Arabic), with the purpose of recording culture-specific data. Results: A total of 249 patients completed the survey. Regarding the overall need for improvement in delivering bad news, 222 women (94.5%) declared that improvement was necessary, with 92 (39.1%) of them indicating that substantial improvement was required. While 67.9% of patients were content with the physician’s professional competence, 30.5% stated a lack of empathy, and 32.9% stated insufficient time for conversation. When comparing satisfied and dissatisfied patients, significant differences were observed across several aspects, such as consultation length, nonverbal communication, calmness of the setting, stress level after the conversation, and the offer to bring a trusted person or arrange a follow-up conversation. Conclusions: This patient survey highlights a persistent gap between patients’ expectations and physicians’ performance when it comes to delivering bad news. The findings underline the urgent need for the implementation of systematic training programs and structured communication protocols in gynecologic oncology. Full article

Background: Family caregivers remain closely involved in communication, care planning, and shared decision-making in long-term care (LTC) facilities. In this context, the quality of the relationship between family caregivers and professional staff may influence trust, collaboration, and satisfaction with care. However, few instruments have been specifically adapted to assess caregiver–staff relationship quality in Taiwanese LTC settings. Objectives: This study aimed to culturally adapt and preliminarily validate the Family Caregiver Relationship Quality (FCRQ) Scale for use in Taiwanese LTC facilities. Methods: A cross-sectional psychometric validation study was conducted with 205 primary family caregivers recruited from 20 LTC facilities in Taiwan. The original Relationship Quality Scale was adapted to the LTC context through contextual revision, expert review, bilingual verification, and pilot testing. Psychometric evaluation included confirmatory factor analysis, internal consistency assessment, convergent validity, and structural equation modelling with Bollen–Stine bootstrap correction to address potential non-normality. Results: The initial 16-item model required refinement, and three items with low standardized factor loadings were removed. The revised 13-item model met the prespecified fit criteria and showed acceptable internal consistency and convergent validity. The retained items reflected three conceptually related domains of relationship quality: trust, commitment, and satisfaction. Overall, the findings provided preliminary psychometric support for the adapted scale in Taiwanese LTC settings. Conclusions: The adapted FCRQ Scale may be a useful tool for assessing caregiver–staff relationship quality in Taiwanese long-term care facilities, particularly in the context of shared decision-making and family-centred care. Nevertheless, the findings should be interpreted as preliminary, and further validation in larger and more diverse samples is needed before broader clinical or research application. Full article

Background: Healthcare professionals are exposed to high emotional demands, including repeated contact with suffering, death, moral distress, and organizational pressure. These factors are associated with psychological distress, burnout, and secondary traumatic stress. Expressive Writing (EW) has been proposed as a psychological intervention, but evidence of its effectiveness among healthcare professionals remains heterogeneous. Objectives: To examine the effects of EW on psychological health, psychophysical well-being, and professional satisfaction among healthcare professionals. Methods: A systematic review was conducted in accordance with the Cochrane Handbook for Systematic Reviews of Interventions and the PRISMA 2020 guidelines. Searches were performed in PubMed, CINAHL, CENRAL, CENTRAL Scopus, Embase, and PsycINFO from database inception to January 2025. Quantitative studies involving healthcare professionals and evaluating structured expressive writing interventions were considered for inclusion, including randomized and non-randomized, controlled and uncontrolled designs. Studies reporting psychological, psychophysical, or work-related outcomes were eligible. Only full-text articles published in English or Italian were considered. The review protocol was registered and archived in the Open Science Framework. Methodological quality was assessed using CASP checklists, the RoB 2 tool, and the Newcastle–Ottawa Scale. Results: Seven studies published between 2017 and 2023 were included. EW interventions were associated with reductions in psychological distress, particularly perceived stress, depressive symptoms, and post-traumatic stress symptoms. Findings regarding burnout and compassion fatigue were mixed. Organizational and job-related outcomes, such as job satisfaction and organizational commitment, showed limited and heterogeneous improvements. No consistent effects were observed for resilience or social support. Overall, the methodological quality of the included studies was generally good. Conclusions: EW appears to be a promising, low-cost intervention for reducing psychological distress among healthcare professionals. However, heterogeneity in study designs, intervention protocols, and outcome measures limits the strength of the evidence. Further high-quality, controlled studies using standardized EW protocols are needed. Full article

This study examines how protective factors contribute to teacher resilience and sustainable wellbeing during remote teaching, focusing specifically on parent-teachers who are balancing professional responsibilities with childcare. Within the broader context of research on educator resilience and professional practice, it explores the associations between social and organizational support, work–family conflict (WFC), and parenting self-efficacy (SE) and satisfaction, factors linked to educators’ capacity to manage dual roles effectively. The hypotheses were that (1) WFC would negatively correlate with parenting SE and satisfaction; (2) support from friends and family and from the workplace would be associated with lower WFC and higher parenting SE and satisfaction; and (3) WFC would mediate the relationship between support and parenting outcomes. Using a mixed-methods design with quantitative scales combined with open questions, data were collected through retrospective self-report questionnaires in relation to the COVID-19 lockdowns. The sample included 474 teachers who teach in schools in Israel and have children aged 0–12. The predictive mediation model confirmed the first two hypotheses, with partial support for the third. Qualitative findings provide insight into parent-teachers’ experiences, including gender-based differences, and emphasize factors associated with their adjustment to remote instruction. These findings contribute to understanding how social and organizational support—forms of collaborative and resilience-promoting mechanisms—may have an important role in promoting educator wellbeing through their negative association with work–family conflict. The findings should be examined further in longitudinal or experimental research and in additional cultural and educational contexts to examine their generalizability, as well as causality. Nonetheless, the findings provide possible directions for policy and interventions aimed at fostering resilience and sustainable wellbeing among teachers, particularly those navigating dual roles in their personal and professional lives. Full article

Knowledge sharing (KS) among healthcare professionals is essential for sustaining organisational learning and facilitating the transfer of expertise between experienced and less experienced professionals, thereby supporting workforce stability and retention in healthcare organisations (HCOs). However, despite its importance, high turnover among healthcare professionals remains a significant and persistent challenge in public HCOs, indicating a potential gap in understanding the mechanisms that support workforce stability. To address this gap, this study examines the interplay between work performance (WP), satisfaction with co-workers (CW), KS and turnover intention (TI) among healthcare professionals. Data from 220 respondents were analysed using Partial Least Squares Structural Equation Modelling (PLS-SEM) within the Input–Process–Output (IPO) framework. The results indicate that CW positively influences KS, while KS has a negative effect on TI, thereby reducing TI. In contrast, WP does not have a statistically significant effect on KS, nor does it indirectly influence TI through KS. Furthermore, although both WP and CW were hypothesised to be predictors of KS, only CW demonstrates a significant indirect effect on TI through KS. Grounded in Social Exchange Theory (SET) and the Knowledge-Based View (KBV), the results highlight the role of KS and interpersonal relationships in supporting sustainable human resource management (SHRM). Although sustainability-related dimensions were not directly measured, the results suggest potential implications for the Sustainable Development Goals (SDGs), particularly SDG 3, SDG 8, and SDG 9. Full article

Employee loyalty in hospitality settings is influenced by a combination of economic, relational, and developmental factors, including remuneration, recognition, interpersonal relationships, and opportunities for career advancement. This study explores managerial perceptions of the key organizational drivers that enhance employee satisfaction and foster employee loyalty in luxury hospitality settings. Focusing on five-star hotels located in the Heraklion Prefecture of Crete, Greece, the research addresses a context characterized by high service expectations, strong cultural traditions of hospitality, and pronounced seasonal labor dynamics. While previous studies have predominantly examined employee attitudes and outcomes, limited attention has been given to how decision-makers perceive and prioritize the factors influencing employee loyalty in luxury hospitality environments. To address this gap, the study adopts a mixed-method approach, combining structured Likert-scale questionnaires and qualitative insights collected from senior managers and owners representing 28 luxury hotels. The quantitative component provides descriptive insights into managerial consensus regarding organizational practices, while the qualitative analysis offers deeper interpretation of perceived challenges and priorities. Findings indicate that managers consider leadership style, working conditions, professional development, and employee welfare as central drivers of satisfaction and loyalty, although variation exists regarding the role of benefits and technology. The study contributes to hospitality management literature by highlighting the managerial perspective as a distinct analytical lens and offers practical implications for strategic human resource practices in high-end tourism contexts. Full article

Digital transformation in the interior design industry has opened new opportunities for innovation; however, many cost-conscious homeowners still face difficulties in selecting and customizing design packages that achieve a balance between overall cost and sustainable quality. Existing interior design platforms lack seamless support and often require homeowners to invest considerable time and effort to tailor services to their needs while staying within budget. To address these challenges, this paper explores the use of machine learning to build a predictive modelling framework that supports personalized and value-driven interior design recommendations. The proposed approach uses a hybrid recommendation system that combines content-based and collaborative filtering. It also incorporates lightweight techniques such as TF–IDF (Term Frequency–Inverse Document Frequency) and logistic regression to more effectively capture user preferences, budget limits, and several interior-design service categories. Primary data was collected from small to medium-sized interior design companies. To demonstrate the proposed approach, a user-friendly web application tool is developed to integrate machine learning-enabled recommendation services. The resulting solution provides access to professional interior design services, enhancing customization and customer satisfaction while reducing the time and effort required from homeowners. To validate and compare the performance of the proposed approach, several machine learning models including Random Forest, XGBoost and KNN (K-Nearest Neighbors) were tested using standard metrics such as accuracy, precision, recall, and ROC-AUC (Receiver Operating Characteristic-Area Under the Curve). The proposed logistic regression hybrid model achieved the strongest overall results, with an accuracy of 83.62%. These findings demonstrate the significant contribution of this work to enhancing personalization and accessibility in the interior design sector via machine learning-enabled recommendation systems. The proposed approach bridges the gap between expert-level services and financial limits, making it a practical choice for cost-conscious homeowners. Full article

Background: This study investigated the clinical characteristics of consultands and examined their perceived personal control, satisfaction, and decision-making regarding genetic testing, as well as the factors influencing these outcomes, at a tertiary care center in northwestern India. Methods: Detailed clinical and family histories were recorded, and trained genetic professionals provided genetic counseling. Perceived personal control (PPC) was assessed pre- and post-counseling using the PPC (nine-item) questionnaire, while post-counseling satisfaction was measured using the six-item Genetic Counseling Satisfaction Scale (GCSS). Outcomes included awareness of genetic disorders, uptake of genetic testing, and reproductive decision-making. Results: A total of 225 consultands (125 pediatric and 100 antenatal) were enrolled. The most common systemic disorders were: inborn errors of metabolism (21.3%), congenital anomalies (15.2%), neurological disorders (15%), primary immunodeficiencies (12.3%), renal genetic disorders (12.2%), respiratory disorders (12%), thalassemia (9%), endocrine disorders (3.9%), and cardiovascular anomalies (3%). In the pediatric group, socioeconomic status (p = 0.048) and higher education levels (p = 0.02) were significantly associated with higher perceptions of adequate counseling time and overall GCSS. None of the examined factors in the prenatal group showed a statistically significant association with satisfaction scores. Consultands primarily concerned with preventing recurrence in future pregnancies showed significantly higher PPC scores both before (p = 0.026) and after counseling (p = 0.009), with the greatest overall improvement in satisfaction (p = 0.044). In the pediatric group, those with an affected family member showed the greatest post-counseling improvement in PPC. Conclusions: Low education, limited awareness, socioeconomic constraints, delayed presentation and low referral rates were key barriers to effective genetic counseling. Addressing these factors can improve consultand awareness, satisfaction, decision-making, and uptake of genetic testing, thereby enhancing reproductive outcomes in high-risk families. Full article

Background: Job satisfaction among nursing staff is a key determinant of workforce stability, quality of care, and healthcare system sustainability. Nurses are increasingly exposed to high workload, staffing shortages, and complex organizational demands, which may adversely affect satisfaction and retention. The aim of this study was to examine job satisfaction among nursing staff working across different levels of healthcare in Slovenia and to identify organisational and sociodemographic factors associated with job satisfaction. Methods: A cross-sectional quantitative study was conducted among nursing staff employed in Slovenian healthcare settings. Data were collected using an online questionnaire that included the Job Satisfaction Survey (JSS) and sociodemographic, occupational, and organizational variables. Differences in job satisfaction across professional groups were examined using non-parametric tests. Associations between job satisfaction dimensions and explanatory variables were analysed using Spearman’s correlation coefficients, and multiple linear regression analyses were performed to identify independent predictors of job satisfaction. Results: Organizational and workload-related factors emerged as the most consistent determinants of job satisfaction across all JSS dimensions and total satisfaction. Unclear job task definitions, high workload, insufficient staffing, continuous healthcare provision, unfavourable work schedules, and limited opportunities for rest were associated with lower job satisfaction. In contrast, financially compensated overtime, supportive supervision, higher perceived employer quality, longer tenure in the current position were associated with higher satisfaction in several domains. Sociodemographic variables showed weaker and less consistent effects after adjustment for organizational characteristics. Intentions to change jobs within or outside the healthcare system were strongly associated with lower satisfaction across nearly all dimensions. Conclusions: Job satisfaction among nursing staff is shaped predominantly by modifiable organizational factors rather than demographic characteristics. Interventions aimed at improving task clarity, staffing adequacy, work organization, leadership practices, and recovery opportunities may enhance job satisfaction and contribute to a more sustainable nursing workforce. Full article

Background: Mental health needs are rising globally, while workforce shortages constrain access to timely care. Israel launched formal training for Psychiatric–Mental Health Nurse Practitioners (PMHNPs) in 2023 as part of broader efforts to strengthen the public mental health system. This narrative review provides a focused synthesis of international and Israeli literature on PMHNP roles, models of practice, outcomes, and implementation considerations relevant to the Israeli context. Methods: We conducted a narrative, non-systematic literature review of international and Israeli literature on Psychiatric–Mental Health Nurse Practitioners (PMHNPs). Searches were conducted in PubMed/MEDLINE, CINAHL, PsycINFO, and Scopus (January 2000–December 2024), alongside targeted policy and regulatory documents. Eligible sources addressed NP/PMHNP roles, scope of practice, clinical and service outcomes, implementation processes, workforce implications, or policy considerations in high-income health systems. Findings were synthesized thematically. Results: Across the reviewed literature, particularly in primary care and community-based settings, PMHNP/NP-delivered care was generally associated with comparable outcomes on selected quality and safety indicators, alongside improved accessibility, continuity, and high patient satisfaction. Successful implementation depended on regulatory clarity, organizational readiness, interprofessional collaboration, and the development of a clear professional identity. In Israel, the role is emerging within a cautious regulatory framework and may face early barriers related to role ambiguity, variable organizational support, and limited stakeholder awareness. Conclusions: PMHNP implementation may offer an important strategy for strengthening mental health service capacity in Israel. However, the extent of its contribution will depend on regulatory clarity, organizational support, implementation quality, and future empirical evaluation in the Israeli context. Full article

Background/Objectives: Emergency Services (ESs) are highly demanding clinical settings where Nursing Practice Environments (NPEs) play a critical role in shaping professional- and care-related outcomes. International evidence suggests that unfavorable NPEs are associated with reduced job satisfaction, compromised care quality, and increased safety risks. This study aimed to describe NPEs and selected professional and care-related outcomes among ESs nurses in Portugal in 2018 and 2022. Methods: A descriptive, cross-sectional study was conducted using data from two national surveys of ESs nurses collected in 2018 (n = 390) and 2022 (n = 434). Data were collected through an online questionnaire including the Practice Environment Scale of the Nursing Work Index (PES-NWI), measures of job satisfaction, intention to leave, perceived quality and safety of care, safety culture, incident occurrence, and missed nursing care. Descriptive statistics were used to summarize results across both samples. Results: NPEs were predominantly classified as unfavorable in both samples, with around 70% of nurses working in unfavorable environments. The most compromised dimensions were staffing and resource adequacy, nurses’ participation in hospital affairs, and nurse manager ability, leadership, and support of nurses. Job satisfaction was low in both samples, and a high proportion of nurses reported an intention to leave the organization. Differences were observed between samples in perceived quality and safety of care, incident occurrence, and missed nursing care, particularly in relational and autonomous interventions. Collegial nurse–physician relations emerged as the only favorable dimension in both samples. Conclusions: The findings indicate that NPEs in Portuguese ESs were predominantly unfavorable in both study periods, reflecting structural and organizational challenges. These findings may be associated with nurses’ professional outcomes and perceived care quality and safety, highlighting the importance of targeted organizational interventions to improve practice environments. Full article