Search Results (2,283)

Background: Live music, understood as real-time musical performance delivered in the physical presence of patients or other participants, is increasingly incorporated into healthcare settings as an arts-based, non-pharmacological practice intended to support well-being and humanize care. While previous reviews have examined a broad range of music-based interventions in healthcare, limited attention has been given specifically to live music, its contextual characteristics, and the values attributed to its use within hospital environments. Objectives: This scoping review aims to map and synthesize the literature on live music in healthcare settings, focusing on clinical contexts, populations involved, and the therapeutic, psychosocial, and environmental values reported. Methods: A scoping review was conducted following the framework of Arksey and O’Malley. Searches were performed in Web of Science, Scopus and Pubmed using terms related to live music and healthcare settings. Studies published in English or Spanish over the past 20 years were considered. After screening titles, abstracts, and full texts, 81 studies met the inclusion criteria. Results: The studies covered diverse hospital units and patient groups, particularly oncology, neonatal and intensive care, palliative care, and haemodialysis. Reported outcomes were mainly psychological and emotional, including reductions in anxiety, stress, and distress, alongside improvements in mood, well-being, and quality of life. Cognitive, physiological, and environmental benefits were also identified, emphasizing the role of live music in creating supportive and humanized care environments. Most studies were conducted in Europe and North America. Conclusions: Live music is widely implemented in healthcare settings and is associated with benefits extending beyond symptom reduction to experiential and humanizing dimensions of care. This scoping review provides an overview of the existing evidence base and identifies directions for future research in arts and health. Full article

Background and Objectives: Psychological resilience is central to emotional adaptation in patients undergoing maintenance hemodialysis (HD). Although psychosocial determinants have been widely studied, the role of routinely monitored biochemical markers remains insufficiently defined. Materials and Methods: This study examined the associations between selected metabolic–inflammatory biomarkers and psychological resilience in adults receiving maintenance HD and explored potential gender-related differences. Resilience was assessed using the Resilience Scale–14 (RS-14). β₂-microglobulin, serum albumin, calcium, and 25-hydroxyvitamin D were analyzed as continuous predictors. Multiple linear regression models with heteroscedasticity-consistent robust standard errors (HC3) were adjusted for age, HD vintage, diabetes, and cardiovascular disease. Two interaction terms (Gender × β₂-microglobulin and Gender × albumin) were specified a priori. Model stability was evaluated using nonparametric bootstrap resampling (5000 iterations) and penalized regression with cross-validation. Results: In bivariate analyses, higher β₂-microglobulin levels were associated with lower resilience (ρ = −0.24; p = 0.041), whereas serum albumin showed a positive but non-significant association (p = 0.14). These relationships did not remain statistically significant in fully adjusted models (β₂-microglobulin: p = 0.107). No Gender × Biomarker interaction reached statistical significance (p = 0.162). Stratified analyses showed consistent directional patterns across gender groups. Conclusions: Metabolic–inflammatory biomarkers, particularly β₂-microglobulin and serum albumin, may be associated with psychological resilience in HD. However, gender-specific effects were not supported in adjusted analyses. These findings require validation in larger, longitudinal, multicenter studies. Full article

Background: Population ageing increases the burden of chronic diseases, multimorbidity, and functional limitations, making nutrition and lifestyle important modifiable determinants of healthy ageing. Universities of the Third Age (U3A) provide an educational and social environment for older adults, but multidimensional relationships between nutrition knowledge, diet quality, lifestyle, and health status in this population remain insufficiently characterized. This study aimed to assess these associations among older adults attending U3A in Poland. Methodology: A cross-sectional online survey was conducted between January and April 2026 among community-dwelling older adults participating in U3A programs. Of 700 distributed invitations and 520 returned questionnaires, 450 complete and eligible responses were included. The questionnaire was based on the KomPAN^® framework and expanded with items on health, lifestyle, psychosocial resources, barriers to healthy eating, and sources of health information. Diet quality was assessed using the pro-Healthy Diet Index, non-Healthy Diet Index, and overall Diet Quality Index (DQI). Nutrition knowledge was measured using a 24-item scale. Analyses included distributional diagnostics, non-parametric group comparisons, FDR-corrected Spearman correlations, psychometric assessment, principal component analysis, multivariable regression with model diagnostics, and profile segmentation. Results: The mean age was 73.63 ± 5.73 years, and most participants were women. The median DQI was 15.59 [3.93–24.86], with a predominance of neutral diet quality. Nutrition knowledge was moderate, with a median score of 12.00 [9.00–15.00], and the scale showed very good internal consistency. PCA identified three dietary patterns: convenience/ultra-processed, prudent/health-promoting, and traditional meat-and-fat. Higher DQI was associated with better nutrition knowledge, greater physical activity, a more favorable sleep profile, regular meal timing, and lower disease burden. Participants with multimorbidity had significantly lower DQI. Segmentation distinguished a health-engaged/higher-resource profile and a lower-resource/nutritionally vulnerable profile. Conclusions: U3A participants in Poland are educationally and socially active but nutritionally heterogeneous. The predominance of neutral diet quality, moderate nutrition knowledge, and identifiable knowledge gaps indicates the need for targeted, practical, and behavior-oriented nutrition education supporting healthy ageing. Full article

Gestational Diabetes Mellitus (GDM) represents a significant public health concern due to its association with adverse maternal and neonatal outcomes, as well as elevated long-term metabolic risks. Its prevalence varies substantially depending on the diagnostic criteria used and the population studied. Women with GDM frequently experience heightened stress, anxiety, and uncertainty, underscoring the need for accessible information, counseling, and ongoing support to navigate glucose monitoring, dietary adjustments, and treatment regimens. Although clinical management has been extensively studied, research has largely focused on metabolic monitoring and therapeutic interventions, often underemphasizing prevention strategies, women’s informational needs, and maternal psychological well-being. Emerging evidence and international guidelines increasingly advocate for integrating these components into structured, woman-centered GDM care plans that actively involve families. Such approaches empower women to engage in self-management, enhance health literacy, support adherence to lifestyle and pharmacological interventions, and promote sustainable behavioral changes. This narrative review presents a comprehensive, holistic model of care across the perinatal continuum, emphasizing early risk identification, preventive strategies, and multidisciplinary coordination. Core elements include individualized antenatal education, empathetic communication, and family engagement, fostering self-efficacy, continuity of care, and integration of medical, educational, and psychosocial interventions. Equipping healthcare professionals with the competencies to deliver this holistic, woman-centered framework is essential to optimize maternal and neonatal outcomes and mitigate the long-term health consequences of GDM. Full article

Background and Objectives: Syndactyly is a common congenital hand anomaly that may affect hand appearance, function, and psychosocial well-being. This study aimed to evaluate long-term patient-centered outcomes after congenital syndactyly reconstruction, including aesthetic, functional, and psychosocial domains. Methods: This retrospective study included 53 patients with 90 reconstructed web spaces. Aesthetic outcomes were assessed using the Withey score, functional outcomes using the QuickDASH questionnaire, and psychosocial outcomes using an exploratory patient-centered survey developed by the authors. Results: The median follow-up duration was 10 years. The median outcome scores suggested generally favorable long-term results, with a Withey score of 2, a QuickDASH score of 14, and a psychosocial survey score of 29, all within the favorable range of their respective scales. Poorer aesthetic outcomes were observed in patients with complicated syndactyly, those who underwent surgery between 1 and 5 years of age, and those who underwent multiple surgeries. Female sex was associated with poorer functional and psychosocial scores. Complicated syndactyly was associated with less favorable outcomes across all domains. The psychosocial survey demonstrated high internal consistency and significant correlations with both functional and aesthetic outcomes. Conclusions: Congenital syndactyly reconstruction was associated with generally favorable long-term patient-centered outcomes. Less favorable results were observed particularly in patients with complicated syndactyly, while age- and surgery-related associations should be interpreted cautiously because of the retrospective design. These findings support the importance of individualized counseling and long-term assessment that includes aesthetic, functional, and psychosocial dimensions. Full article

Background/Objectives: The rising prevalence of multimorbid and complex chronically ill young and middle-aged adults necessitates the implementation of innovative care models and the creation of roles that can meet the complex healthcare needs of this patient group. Advanced Practice Nurses (APNs) can play a crucial role in the care of multimorbid and complex chronically ill young and middle-aged adults in APN-led clinics; however, in Switzerland, these roles are still evolving. The aim of this study was to explore APNs’ perspectives on the planned development of their roles in an APN-led clinic. Methods: To gain insights into the experiences of APNs in caring for this patient group, a qualitative study design was chosen. Data were collected through interviews with APNs from Switzerland, the USA, and Canada. In total, 19 APNs (12 from Switzerland and 7 from the United States and Canada) participated in the study. The data were collected through semi-structured online interviews. These data were analyzed using reflective thematic analysis in accordance with the approach presented by Braun and Clarke. Results: The analysis identified 10 themes that describe the competencies, components, and framework conditions required for the work of APNs in an APN-led clinic for multimorbid and complex chronically ill young and middle-aged adults within the Swiss clinical context. Required competencies include direct clinical practice, guidance and coaching, collaboration, and psychosocial support. Essential components include person-centered care, transitional care, and continuity of care. Key framework conditions include regulations of the legal and regulatory framework and eligibility for reimbursement of services, resources, and extended competencies and scope of practice. Conclusions: The perspectives of the APNs involved in this study show that multimorbid and complexly chronically ill young and middle-aged adults require complex and long-term care that extends beyond the hospital setting. The findings of this study show that Swiss APNs may be well positioned to contribute to this role. Full article

Background/Objectives: Grief following the death of a partner is a complex psychosocial process associated with an increased risk of prolonged grief, depression and suicidal ideation. Among lesbian, gay, bisexual, transgender, intersex, and queer (LGBTIQ+) individuals, these risks are exacerbated by stigma, relational invisibility and family rejection, often resulting in unrecognized or disenfranchised grief. This scoping review aimed to map the available evidence on the experiences of bereavement following the death of a partner among LGBTIQ+ individuals between 2016 and 2026, identifying study types, recurring themes and knowledge gaps relevant to nursing practice. Methods: A scoping review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) extension and the methodology of the Joanna Briggs Institute. Searches were planned in PubMed/MEDLINE, Scopus, CINAHL, PsycINFO and Web of Science (2016–March 2026) using combined terms for grief, partner and LGBTIQ+ populations. Primary qualitative, quantitative and mixed-methods studies, as well as selected grey literature that explicitly addressed grief following the death of a partner in LGBTIQ+ individuals were considered. Results: The search identified 1032 records; after removing duplicates (n = 356), 676 titles/abstracts were screened, and 94 full texts were assessed. Eighteen studies were included, mainly qualitative, and conducted in high-income countries. Key themes included invisibility and lack of recognition of the relationship, managing the disclosure of sexual orientation and gender identity, social isolation and the role of chosen families, and intersectional vulnerabilities in subgroups such as older adults, bisexual people and trans people. Conclusions: The available evidence reflects specific bereavement experiences among LGBTIQ+ individuals that are not adequately captured in traditional models of bereavement care. Significant gaps remain, particularly in Spanish-speaking contexts and in the design and evaluation of nurse-led interventions. This scoping review provides a conceptual basis for future research and for the development of culturally safe clinical practices in supporting LGBTIQ+ individuals through bereavement. Full article

Background/Aims: The increasing complexity of disasters requires effective integration of nurses into Civil Defense (CD) systems. Despite their crucial role, the competencies needed to operate within these multi-agency frameworks remain fragmented and insufficiently defined. The main aim of the study was to map nursing competencies for disaster response within the CD context, identifying essential skills, contextual variations, and barriers to application. Methods: A scoping review was conducted following the JBI methodology and reported according to PRISMA-ScR guidelines. Major databases (PubMed, CINAHL, Scopus, Embase) were searched without time limits, resulting in the inclusion of 27 studies published between 2011 and 2025. Results: 12 core competency domains were identified. Clinical care was the most cited competency (70% of studies), followed by communication (63%), leadership (60%), triage (48%), and psychosocial support (48%). The lack of specific training emerged as the primary individual barrier (44%), while the absence of standardized curricula was the leading systemic obstacle (41%). Competency requirements varied significantly based on the hazard type and organizational setting. Conclusions: Disaster nursing is emerging as an essential specialized field in response to the increasing frequency of climate-related events and global conflicts. There is an urgent need to move beyond purely clinical training to integrate “organizational literacy” and psychological resilience, harmonizing educational pathways with national CD policies and competency-based disaster preparedness programs. Full article

Background: As understanding of addiction extends beyond substance misuse, various behavioral disorders may emerge as recognized mental health conditions, including social media use disorder (SMUD). To date, however, empirical research supporting SMUD as a distinct disorder is limited and inconsistent. The present study set out to compare the relative prevalence of elevated symptoms suggestive of SMUD between those with no mental health history and affective disorders (both unipolar depression and bipolar disorder). Methods: Participants were recruited online and completed questionnaires measuring social media use (SMU), symptoms of SMUD, depression and various psychosocial factors associated with social media use (i.e., loneliness, social support). Among those with affective disorders, we set out to identify sociodemographic and clinical features that distinguish those with comorbid SMUD (i.e., above the cut-off on the SMUD screening measure). Results: Five main findings emerged from our analyses: (1) SMUD appears unrelated to known forms of SMU; (2) Among those with no mental health history, SMUD does not present independently of elevated depressive symptoms; (3), No sociodemographic or clinical features distinguish those with clinical depression reporting comorbid SMUD; (4), Among those with bipolar disorder (BD), symptoms of hypo/mania do not distinguish those also reporting elevated SMUD symptoms; (5) And SMUD symptoms no longer differ across clinical groups after adjusting for depressive symptoms. Conclusions: Our findings suggest that SMUD is unrelated to active or passive SMU. Symptoms suggestive of SMUD may instead be a contemporary manifestation of depressive symptomology. These findings do not support the existence of SMUD as a bona fide mental health condition. Full article

Background and Objectives: Quality of life (QoL) has become an essential outcome in patients with metastatic prostate cancer, particularly in the era of androgen receptor (AR)-targeted therapies. Although these agents improve survival, their differential impact on QoL and the role of psychological factors remain incompletely understood. This study aimed to evaluate QoL, functional outcomes, and psychological status, and to identify factors associated with poor QoL in a real-world cohort. Materials and Methods: This prospective cross-sectional, single-center observational study included 130 patients with metastatic prostate cancer receiving AR-targeted therapies (abiraterone, enzalutamide, or apalutamide/darolutamide). QoL was assessed using the EORTC QLQ-C30 questionnaire, and psychological status was evaluated using the Hospital Anxiety and Depression Scale (HADS). Patients were stratified according to treatment groups, and comparisons were performed using appropriate statistical tests. Logistic regression analyses were conducted to determine factors independently associated with poor QoL. Results: Exploratory differences in global QoL were observed among treatment groups (p = 0.007), with lower global QoL scores in the abiraterone group and numerically higher emotional and cognitive functioning scores in the enzalutamide group. Symptom analysis demonstrated higher nausea/vomiting scores in the abiraterone group (p = 0.022), whereas other symptom domains were comparable across treatment groups. In multivariable analysis, anxiety (odds ratio [OR]: 6.62) and depression (OR: 3.40) were independently associated with poor QoL, while treatment type was not independently associated with poor QoL after multivariable adjustment. Conclusions: Although unadjusted QoL scores differed across AR-targeted therapy groups, psychological factors—particularly anxiety and depression—were significantly associated with poorer QoL in patients with metastatic prostate cancer. These findings highlight the importance of integrating routine psychosocial assessment and supportive care strategies into clinical practice to optimize patient-centered outcomes. However, given the cross-sectional and exploratory nature of the study, the findings should be interpreted cautiously. Full article

Background: Understanding the psychological and spiritual needs of family caregivers, including their experiences of death anxiety and levels of death literacy, is essential for delivering holistic palliative care. This study aimed to examine the relationships between death anxiety, spiritual well-being, and death literacy among relatives of patients receiving palliative care in Türkiye. Methods: A cross-sectional correlational study was conducted with 160 relatives of patients receiving treatment in a palliative care unit in Türkiye. The participants had a mean age of 47.56 ± 12.33 years, and 62.5% were male. Data were obtained using the Abdel-Khalek Death Anxiety Scale (ASDA), the Three-Factor Spiritual Well-Being Scale (SWBS), and the Death Literacy Index (DLI). Results: The mean scores were 61.34 ± 17.45 for ASDA, 122.94 ± 15.84 for SWBS, and 96.13 ± 16.36 for DLI. Participants exhibited relatively elevated death anxiety scores, comparatively higher spiritual well-being scores, and moderate death literacy scores within the study sample. Correlation analyses showed that death anxiety was positively associated with spiritual well-being and negatively associated with death literacy, whereas death literacy was positively associated with spiritual well-being. Regression analyses further indicated that spiritual well-being was independently and positively associated with both death anxiety and death literacy, whereas death literacy was independently and negatively associated with death anxiety. Conclusions: The findings suggest that psychosocial, spiritual, and informational dimensions should be considered together in holistic palliative care. Supporting death literacy and spiritual well-being may contribute to better coping with death-related concerns among relatives of patients receiving palliative care. Full article

Eosinophilic esophagitis (EoE) and inflammatory bowel disease (IBD) are immune-mediated disorders of the gastrointestinal (GI) tract that, despite involving different tissues, are increasingly recognized to coexist. Epidemiologic studies demonstrate a bidirectional association, with patients affected by one condition showing a higher-than-expected prevalence of the other, suggesting shared susceptibility rather than incidental overlap. Genetic and epigenetic data support partial convergence in immune regulatory pathways, while epithelial barrier dysfunction and antigen-driven immune activation emerge as common upstream features. Overlapping cytokine networks, including IL-4, IL-13, and IL-23 signaling, contribute to chronic inflammation in both diseases, although differences in tissue environment and immune dominance give rise to distinct inflammatory phenotypes and clinical behavior. Clinical outcomes in patients with dual diagnoses appear heterogeneous, with available data suggesting neither uniformly worsened nor clearly protective disease courses, underscoring the complexity of shared immune mechanisms operating within different anatomic contexts. Beyond inflammatory activity, coexistence of EoE and IBD poses important nutritional and quality-of-life challenges, as overlapping dietary restrictions and chronic symptoms increase the risk of malnutrition, micronutrient deficiencies, and psychosocial burden. Current therapies remain disease-specific, with strong evidence supporting proton pump inhibitors, swallowed topical steroids, dietary therapy, and dupilumab in EoE, and biologics and small molecules targeting TNF-α, IL-12/23, IL-23, integrins, and JAK–STAT signaling in IBD, while evidence guiding treatment in patients with dual diagnosis remains limited. Together, current evidence supports a framework of shared immune machinery with tissue-specific expression that explains coexistence while preserving the distinct identities of EoE and IBD. By integrating emerging genetic, immunologic, and clinical evidence, this review aims to provide a framework for understanding and managing patients with coexisting EoE and IBD. Full article

As the global population continues to age, mental health issues such as depression, anxiety, stress, loneliness, and social isolation among older adults are receiving increasing attention. The built environment is closely associated with older adults’ daily mobility, environmental perception, social participation, and mental health and well-being, but the evidence remains heterogeneous across spatial contexts, environmental indicators, and study designs. Previous umbrella reviews have summarized broad links between the built environment and healthy aging, but less attention has been paid to recent original empirical studies published after the COVID-19 pandemic, the distinction between objective environmental exposure and subjective environmental perception, and the role of social participation as a pathway linking environmental conditions to mental health and well-being. This study employs a systematic literature review approach, searching and screening peer-reviewed empirical studies published between 2015 and January 2026 that focus on the associations between the built environment and older adults’ mental health and well-being. PubMed, Scopus, and Web of Science databases were used for searching, supplemented by manual searching. After title and abstract screening and full-text evaluation, a total of 60 studies were included. Subsequently, a comprehensive analysis was conducted on aspects such as research design, spatial scale, environmental indicators, types of mental health outcomes, and potential pathways of action. In this review, core mental health and well-being outcomes included negative outcomes, such as depression, anxiety, stress, psychological distress, loneliness, and social isolation, and positive outcomes, such as life satisfaction, subjective well-being, psychological well-being, and mental well-being. Social participation was examined as a behavioral and psychosocial pathway rather than as a core outcome. Emerging methods, including street-view image analysis, FCN-based semantic segmentation, and XGBoost-SHAP, were examined because they can refine environmental exposure measurement and support variable-importance interpretation, rather than because they provide causal evidence. The main synthesis suggests that several built environment factors are associated with older adults’ mental health and well-being, although the strength and consistency of evidence vary across outcome types, spatial contexts, and study designs. (1) Exposure to green and blue spaces, quality of public open spaces, walkability and accessibility, accessibility of neighborhood facilities and services, housing and living conditions, and positive environmental perception are mostly associated with lower levels of depression, anxiety, stress, and loneliness, as well as higher levels of life satisfaction, subjective well-being, and psychological well-being. (2) Conversely, adverse environmental exposures such as proximity to roads, pollution, non-vegetated spaces, and high-intensity urbanization are more likely to exacerbate negative psychological outcomes. Existing evidence also suggests that social participation is one of the important behavioral pathways through which the built environment is linked to the mental health of older adults, but it is not the only mechanism. (3) In addition, the direction and intensity of environmental associations remain heterogeneous under different spatial scales, indicator types, and research methods. Overall, this review contributes by organizing recent empirical evidence into a built environment–social participation–mental health and well-being framework, while emphasizing that most findings should be interpreted primarily as evidence of association rather than as stable or uniform causal effects. Full article

Background: Alcohol use disorder (AUD) is a grave mental health condition that can result in significant health and social consequences. The medications Naltrexone and Nalmefene are indicated for the treatment of AUD, with Naltrexone having received the most extensive research attention. Methods: The majority of papers assessing universal measures of alcohol consumption employed two primary metrics: total alcohol consumption (TAC) and the number of days per month where individuals engaged in heavy drinking (HDD). Indicators pertaining to the maintenance of complete abstinence were excluded due to the absence of sufficient data. The safety of both substances was also assessed, as were the frequency of side effects and independent patient dropout. The study also incorporated practical factors of the therapy, such as the route of administration, dosage regimen, and the drug’s patient convenience, which can have a significant impact on adherence to therapy. Results: Nalmefene, administered in an “as needed” regimen, demonstrated statistically significant activity in reducing HDD and total alcohol consumption (TAC) among patients with AUD, particularly those with elevated World Health Organization (WHO) DRL risk. Preliminary findings from the ESENSE1 (Efficacy of Nalmefene in Alcohol Dependence; the first phase III study), ESENSE 2 (Efficacy of Nalmefene in Alcohol Dependence, the second phase III study), and SENSE (the final phase III long term-safety and cost-effectiveness study) studies indicate a substantial decrease in HDD and TAC following the initial month of treatment. These effects persist throughout the subsequent follow-up period. Several Japanese studies have corroborated the effectiveness of Nalmefene, demonstrating its efficacy across both short-term and long-term applications. Furthermore, these studies have substantiated its safety profile, indicating that there is no inherent risk of addiction or the emergence of withdrawal symptoms. The mild nature of adverse events (most commonly nausea and dizziness) led to a relatively low discontinuation rate of Nalmefene treatment. A subsequent study, employing a recognized methodology, corroborated the efficacy of psychosocial support in enhancing treatment outcomes. Meta-analyses demonstrate that Naltrexone exhibits comparable efficacy in reducing the frequency and severity of alcohol consumption. In select populations, the injectable form (LAI) of this pharmaceutical agent facilitates less frequent dosing, which is advantageous for the treatment process. A comparison of Nalmefene and Naltrexone reveals that the latter does not demonstrate a significant impact on the likelihood of individuals returning to heavy alcohol consumption. Conclusions: In the treatment of AUD, both naltrexone and nalmefene have been shown to yield positive outcomes, particularly in terms of reducing the HDD and TAC. According to the World Health Organization (WHO) classification, Nalmefene is indicated for individuals with a high risk of developing serious conditions. It has been demonstrated to produce rapid and sustained results while exhibiting a favorable safety profile, characterized by the absence of significant adverse effects. Naltrexone is a medication that has proven to be effective. LAI may have a positive impact on the efficacy of treatment. Full article