Search Results (356)

Background/Objectives: Older adults (65+) are the fastest growing age group in Canada, comprising 18.8% of the country’s population. During the COVID-19 pandemic, use of virtual care, including telehealth and tele-medicine, increased dramatically among older adults in Canada who often face higher health risks, mobility limitations, and many barriers to accessing healthcare. Despite the rapid expansion in virtual care, no systematic review has focused specifically on virtual care among older adults in Canada. This review aims to explore the factors influencing virtual care adoption and the experiences of older Canadians during the pandemic through a systematic review. Methods: Conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, the review involved a comprehensive search of PubMed, Scopus, ESCBOHost, and Web of Science on 2 May 2025, yielding 281 unique citations. After screening and applying eligibility criteria, 15 studies employing quantitative, qualitative, or mixed-methods designs, with sample sizes ranging from 15 to 2,282,798, were included and appraised using the Mixed Methods Appraisal Tool (MMAT). Results: The review identified three domains of factors and the ways in which each factor shapes older adults’ virtual care experiences: (1) personal factors influencing virtual care use and demand (e.g., age, education, language, income, immigration status, community sizes), (2) resource factors impacting virtual care adoption (e.g., technology access, support), and (3) varying virtual care experiences among older adults (e.g., in assessment and communication efficacy, privacy, care quality, convenience, safety, and costs). Conclusions: This review highlights the complexities of virtual care engagement among older adults and underscores the need for inclusive, tailored strategies to improve the accessibility and effectiveness of virtual care delivery in both pandemic and post-pandemic contexts. Full article

Hospital in the Home (HITH) programs are emerging as a key pillar of smart city healthcare infrastructure, leveraging technology to extend care beyond traditional hospital walls. The global healthcare sector has been conceptualizing the notion of a care without walls hospital, also called HITH, where virtual care takes precedence to address the multifaceted needs of an increasingly aging population grappling with a substantial burden of chronic disease. HITH programs have the potential to significantly reduce hospital bed occupancy, enabling hospitals to better manage the ever-increasing demand for inpatient care. Although many health providers and hospitals have established their own HITH programs, there is a lack of research that provides healthcare executives and HITH program managers with management models and frameworks for such initiatives. There is also a lack of research that provides strategies for improving HITH management in the health sector. To fill this gap, the current study ran a systematic literature review to explore state-of-the-art with regard to this topic. Out of 2631 articles in the pool of this systematic review, 20 articles were deemed to meet the eligibility criteria for the study. After analyzing these studies, nine management models were extracted, which were then categorized into three categories, namely, governance models, general models, and virtual models. Moreover, this study found 23 strategies and categorized them into five groups, namely, referral support, external support, care model support, technical support, and clinical team support. Finally, implications of findings for practitioners are carefully provided. These findings provide healthcare executives and HITH managers with practical frameworks for selecting appropriate management models and implementing evidence-based strategies to optimize program effectiveness, reduce costs, and improve patient outcomes while addressing the growing demand for home-based care. Full article

Background/Objectives: The aim of this systematic review was to compare the effectiveness of virtual reality (VR)-based training with conventional exercise programs in improving functional outcomes related to fall risk among older adults with various health conditions. Methods: The review was conducted in accordance with the PRISMA 2020 guidelines and registered in PROSPERO (registration number CRD42022345678). The databases Scopus, PubMed, Web of Science, and EBSCO were searched up to 31 March 2025. Randomized controlled trials (RCTs) were included if they involved participants aged ≥60 years, a VR intervention lasting ≥6 weeks, and a control group performing traditional exercises or receiving usual care. Methodological quality was assessed using the PEDro scale, and a narrative synthesis was performed across four outcome domains: balance, mobility, cognitive function, and fall risk. Results: Seven RCTs were included in the analysis (totaling 664 participants). VR training was found to be at least as effective as conventional exercise in improving balance (e.g., Berg Balance Scale) and mobility (e.g., Timed Up and Go), with some studies showing superior effects of VR. One RCT demonstrated that combining VR with balance exercises (MIX) yielded the greatest improvements in muscle strength and physical performance. Additionally, two studies reported cognitive benefits (e.g., MoCA) and a 42% reduction in fall incidence within six months following VR intervention. The methodological quality of the included studies was moderate to high (PEDro score 5–9/10). Conclusions: VR-based training represents a safe and engaging supplement to geriatric rehabilitation, effectively improving balance, mobility, and, in selected cases, cognitive function, while also reducing fall risk. Full article

Background/Objectives: Health education plays a vital role in training health professionals and caregivers, supporting both prevention and the promotion of self-care. In this context, technology serves as a valuable ally by enabling continuous and flexible learning. Among the various domains of health education, nutrition stands out as a key element in the management of Amyotrophic Lateral Sclerosis (ALS), helping to prevent malnutrition and enhance patient well-being. Accordingly, this study aimed to evaluate the effectiveness of the teaching and learning processes within a learning pathway focused on food and nutrition in the context of ALS. Methods: This study adopted a longitudinal, quantitative design. The learning pathway, titled “Food and Nutrition in ALS,” consisted of four self-paced and self-instructional Massive Open Online Courses (MOOCs), offered through the Virtual Learning Environment of the Brazilian Health System (AVASUS). Participants included health professionals, caregivers, and patients from all five regions of Brazil. Participants had the autonomy to complete the courses in any order, with no prerequisites for enrollment. Results: Out of 14,263 participants enrolled nationwide, 182 were included in this study after signing the Informed Consent Form. Of these, 142 (78%) completed at least one course and participated in the educational intervention. A significant increase in knowledge was observed, with mean pre-test scores rising from 7.3 (SD = 1.8) to 9.6 (SD = 0.9) on the post-test across all courses (p < 0.001). Conclusions: The self-instructional, technology-mediated continuing education model proved effective in improving participants’ knowledge about nutrition in ALS. Future studies should explore knowledge retention, behavior change, and the impact of such interventions on clinical outcomes, especially in multidisciplinary care settings. Full article

This study aims to understand the meaning nursing professionals attribute to their lived experiences of providing humanized care within a public hospital setting. Grounded in Jean Watson’s theory of human caring, the research adopts a qualitative, descriptive phenomenological design to capture the perceptions and emotions of nurses regarding humanized care. Data were collected through semi-structured interviews with nine experienced nurses, selected through purposive sampling. The interviews, conducted virtually between July and December 2024, were analyzed using Colaizzi’s method and supported by Atlas.ti software. Four main thematic categories emerged: institutional health policies, professional image and identity, strengths and challenges in care, and essential competencies for humanized care. The findings highlight the critical role of empathy, cultural sensitivity, ethical commitment, and emotional presence in delivering compassionate care. Participants emphasized that, beyond clinical procedures, humanized care requires relational and contextual sensitivity, often hindered by institutional limitations and excessive administrative burdens. The study concludes that nursing professionals are key agents in promoting ethical, empathetic, and culturally respectful practices that humanize health services. These insights offer valuable contributions for designing policies and training strategies aimed at strengthening humanized care as a cornerstone of quality healthcare systems. Full article

The incorporation of digital health into the medical curricula is becoming more important to better prepare doctors in the future. Digital health comprises a wide range of tools such as electronic health records, health information technology, telemedicine, telehealth, mobile health applications, wearable devices, artificial intelligence, and virtual reality. The present study aimed to explore the medical and biomedical students’ perspectives on the integration of digital health in medical curricula. A cross-sectional study was conducted on the medical and biomedical undergraduate students at the College of Medicine and Health Sciences at Sultan Qaboos University. Data was collected using a self-administered questionnaire. The response rate was 37%. The majority of respondents were in the MD (Doctor of Medicine) program (84.4%), while 29 students (15.6%) were from the BMS (Biomedical Sciences) program. A total of 55.38% agreed that they were familiar with the term ‘e-Health’. Additionally, 143 individuals (76.88%) reported being aware of the definition of e-Health. Specifically, 69 individuals (37.10%) utilize e-Health technologies every other week, 20 individuals (10.75%) reported using them daily, while 44 individuals (23.66%) indicated that they never used such technologies. Despite having several benefits, challenges exist in integrating digital health into the medical curriculum. There is a need to overcome the lack of infrastructure, existing educational materials, and digital health topics. In conclusion, embedding digital health into medical curricula is certainly beneficial for creating a digitally competent healthcare workforce that could help in better data storage, help in diagnosis, aid in patient consultation from a distance, and advise on medications, thereby leading to improved patient care which is a key public health priority. Full article

Background: Perioperative care is an integral part of the procedure of a surgical operation, with strictly defined rules. The need to upgrade and improve some individual long-term processes aims at optimal patient care and the provision of high-level health services. Therefore, preoperative care is drawn up with new data resulting from the evolution of technology to upgrade the procedures that need improvement. According to the international literature, a factor considered to be of major importance is high preoperative anxiety and its effects on the patient’s postoperative course. High preoperative anxiety is postoperatively responsible for prolonged hospital stays, increased postoperative pain, decreased effect of anesthetic agents, increased amounts of analgesics, delayed healing of surgical wounds, and increased risk of infections. The use of Virtual Reality technology appears as a new method of managing preoperative anxiety. Objective: This study investigates the effect and effectiveness of Virtual Reality (VR) technology in managing preoperative anxiety in adult patients. Methods: A literature review was performed on 193 articles, published between 2017 and 2024, sourced from the scientific databases PubMed and Cochrane, as well as the trial registry ClinicalTrials, with a screening and exclusion process to meet the criterion of investigating VR technology’s effectiveness in managing preoperative anxiety in adult patients. This systematic review was conducted under the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) guidelines. Results: Out of the 193 articles, 29 were selected. All articles examined the efficacy of VR in adult patients (≥18) undergoing various types of surgery. The studies represent a total of 2.354 participants from 15 countries. There are two types of VR applications: distraction therapy and patient education. From the studies, 14 (48%) used the distraction VR intervention, 14 (48%) used the training VR intervention, and 1 (4%) used both VR interventions, using a range of validated anxiety scales such as the STAI, VAS-A, APAIS, and HADS. Among the 29 studies reviewed, 25 (86%) demonstrated statistically significant reductions in preoperative anxiety levels following the implementation of VR interventions. VR technology appears to manage preoperative anxiety effectively. It is a non-invasive and non-pharmacological intervention with minimal side effects. Conclusions: Based on the review, the management of preoperative anxiety with VR technology shows good levels of effectiveness. Further investigation of the efficacy by more studies and randomized controlled trials, with a larger patient population, is recommended to establish and universally apply VR technology in the preoperative care process as an effective method of managing preoperative anxiety. Full article

With the rapid digital transformation of healthcare services in India, this study investigates the factors influencing the behavioral shift from traditional hospital visits to e-health consultations. The primary objective was to analyze patient attitudes, satisfaction, and perceived barriers to adopting virtual healthcare, especially in urban and semi-urban settings. Methods: The methodology adopted in the study was descriptive, and a convenience sampling technique was used for data collection because the feasible times of the patients’ availabilities were taken into consideration for data collection. Both primary and secondary data were collected using questionnaires and literature. A sample size of 385 participants was used in this study. Various statistical tools, such as frequency, ANOVA, and Chi-square tests, were used to test the hypotheses. Results: It was observed from ANOVA and Chi-square tests that the factors for switching from traditional consultation to e-health services have a positive association. It was found that integrating data through influencing factors significantly (p < 0.001) improved decisions on e-health services. Conclusion: This study highlights the shift from in-person to e-health consultations driven by convenience, flexibility, and pandemic-related needs while acknowledging barriers such as digital literacy, infrastructure gaps, and trust issues. It recommends strategies, such as secure platforms, training, and integrated care models, for a more inclusive digital health future. Full article

Background/Objectives: Telehealth enhances access to specialty care, but stakeholder perspectives are often overlooked. The objective was to evaluate participant and provider satisfaction with a novel telehealth-enabled home safety program. Methods: This is a sub-investigation of a non-randomized pilot study of a novel telehealth-enabled home safety program that enrolled 23 persons with Parkinson’s Disease (PwPs) at risk for falls and their respective care partners (CPs). Dyads participated in four to six televisits over three months, where they performed “virtual home tours” using a mobile platform (tablet mounted on a rolling stand) with a physical therapist to identify and mitigate environmental fall hazards. Satisfaction was assessed using PI-developed surveys and open feedback. Mobile platform usability was assessed with the System Usability Scale (SUS). Results: A total of 95.65% of dyads were very to extremely satisfied with the entire program overall, and the therapist indicated the same for 73.91% of the dyads. Additionally, 95.65% of dyads reported gaining new awareness of home fall hazards. Difficulties maneuvering the mobile platform, using a tablet, and connectivity issues were common challenges noted. The mean score on SUS for the mobile platform was 65, indicating poor perceived usability, and most dyads indicated they would have preferred using a smartphone for the program. Other priorities, including competing health and personal obligations, along with resistance to change, were the primary barriers to implementing program recommendations. Conclusions: Our novel telehealth-enabled home safety program was well-received by patients and the study therapist. Using a smartphone and troubleshooting connectivity issues might help further improve the usability and accessibility of this program. Full article

Background: Chronic pain affects one in five youth globally and is frequently accompanied by mental health challenges that extend into adulthood. Caregivers play a vital role in supporting youth with chronic pain, yet their own mental and physical health needs are often overlooked. While caregiver well-being is linked to child outcomes, few interventions directly address caregivers’ health, especially among those facing systemic barriers. This study explored the lived experiences of caregivers to better understand their unmet needs and inform the co-design of a supportive digital health solution. Methods: We conducted a qualitative exploratory study involving 32 caregivers of youth with chronic pain across Canada and Australia. Semi-structured interviews were co-facilitated by caregiver partners. Thematic analysis was applied to interview data. Results: Two overarching themes were identified: (1) bearing the weight and sacrifice of caregiving and (2) deep interrelatedness and blurred boundaries. Caregivers reported profound emotional, physical, and financial burdens; strained relationships; and social isolation. Many struggled with self-neglect, prioritizing their child’s needs over their own. Fathers’ evolving caregiving roles challenged traditional gender norms, though mothers continued to bear a disproportionate load. Despite challenges, caregivers demonstrated resilience and recognized their well-being as interconnected with their child’s health. Conclusions: Findings underscore the need for systemic investment in caregiver well-being. Digital health solutions, including virtual peer networks, mental health resources, and tailored education, offer scalable, accessible pathways for support. These insights will inform the development of Power over Pain for Primary Caregivers, a digital solution and knowledge hub aimed at improving caregiver well-being and family outcomes, aligning with global efforts to enhance family-centred pediatric pain care. Full article

Sexual dysfunction is a prevalent and often under-addressed concern among prostate cancer survivors, significantly affecting quality of life for patients and their partners. The True North Sexual Health and Rehabilitation eClinic (SHAReClinic) is a virtual, biopsychosocial intervention developed to improve access to sexual health support for prostate cancer survivors and their partners. This study used a qualitative descriptive design to examine barriers and facilitators influencing the integration of SHAReClinic into oncology care across nine Canadian health care centres. Semi-structured interviews were conducted with 17 knowledge users, including health care providers and institutional leaders. Data were analyzed using a hybrid deductive–inductive thematic approach guided by the Consolidated Framework for Implementation Research (CFIR) 2.0. Participants described SHAReClinic as a much-needed resource, particularly in the absence of standardized sexual health pathways in oncology care. The virtual format was seen as accessible and well suited to addressing sensitive topics. However, limited funding, lack of institutional support, and workflow integration challenges emerged as primary barriers to implementation. Findings offer practical, theory-informed guidance for integrating SHAReClinic into oncology care and highlight key considerations for developing sustainable and scalable survivorship care models. Full article

Gender inequality remains a persistent issue in healthcare, especially in ophthalmology, where women face systemic barriers such as pay gaps, limited surgical opportunities, harassment, and unequal family expectations. Despite increasing entry into the field, women remain underrepresented in leadership, affecting career advancement and patient care. This study examines how virtual platforms, and co-led initiatives can address gender disparities in eye health. In 2021, Women in Ophthalmology, Seva Foundation, and Orbis International launched the Women’s Leaders in Eye Health (WLEH) initiative—a global community promoting mentorship, networking, and leadership development. Starting with virtual webinars and informal networking, the initiative expanded to in-person events in 2023 due to strong global engagement and demand. Early virtual programming, including webinars and “Coffee Hour” sessions, proved effective and laid the groundwork for broader offerings such as mentorship and professional development grants. WLEH’s success underscores the power of collaboration in promoting gender equity. By fostering connections and leadership pathways, WLEH offers a scalable model to break down gender challenges and uplift the next generation of women leaders to deliver more accessible eyecare globally. Full article

Background: Alternative therapies, such as non-invasive neuromodulation techniques, cognitive therapies, virtual reality-based interventions, and psychological support, represent promising approaches for treating and supporting the management plan for patients with neurodegenerative disorders. Recent research has focused on the effectiveness of neuromodulation therapies, as they show improvements in both emotional and cognitive functions in patients with neurodegenerative disorders. Material and Methods: A literature review was conducted by searching Google Scholar, PubMed, Scopus, and Web of Science in February 2025. In total, 20 studies that met the inclusion criteria were considered for the present review, and the studies included were conducted between 2020 and 2025. Results: Innovative neuromodulation therapies have demonstrated their high potential in the management care plan of neurodegenerative disorders and as non-invasive neuromodulation therapies, both in the emotional manifestations of the patients and in the cognitive ones, with a direct impact on their caregivers’ experience. Although research is ongoing, the following preliminary findings are encouraging, suggesting that these methods may complement or even replace certain traditional interventions. Conclusions: Alternative therapies (non-invasive neuromodulation techniques, cognitive therapies, virtual reality-based interventions, and psychological support) represent promising approaches for treating and supporting the management care plan for neurodegenerative disorders, even in the cases where no other drug-based treatment option can be applied. Each method has its unique advantages, but further studies are needed to create treatment protocols and confirm their long-term effectiveness. Integrating these strategies into personalized management care plans can significantly improve cognitive function and emotional health and increase the quality of life of patients with cognitive and neurodegenerative disorders. Full article

Background: As national and international reports reveal, significant health care transition (HCT) service disparities exist for youth and young adults with intellectual and developmental disabilities (YYAs with IDD). The development of the HCT model necessitates informed perspectives from a broad constituency, including consumers and families. Parents’ retrospective perspectives of their sons’ or daughters’ HCT experiences are presented to enlarge the understanding of the service need. Methodology: Eleven parents were recruited virtually from parent support/disability advocate groups via an email distribution list of the Children’s Hospital Los Angeles University Center for Excellence in Developmental Disabilities. Parents who consented to participate were interviewed by phone using an interview guide with 11 open-ended items. Three questions focused on the barriers and facilitators associated with the HCT experience are reported. Findings: Four major themes were generated from the analysis of data gathered from parents pertaining to their sons’ or daughters’ health care transition experiences, focusing on the transfer of care. Two major themes were related to HCT barriers—Pediatric Care Contrasted with Adult-Focused Care and Transfer of Care Barriers—and two were related to HCT facilitators—Transfer of Care Facilitators and Transfer of Care Recommendations. Each of the major themes included subthemes. Conclusions: Parents openly shared their sons’ or daughters’ HCT experiences, which illuminated the scope of their challenges and the assistance received. These insights provide rich descriptions of the barriers they and their adult children faced as they proceeded with navigating new systems of health care. The reported data find support in other previously conducted studies. Full article

Mental health disparities among those who self-identify as gay men in Peru remain a pressing public health concern, yet predictive models for early identification remain limited. This research aims to (1) develop machine learning and deep learning models to predict mental health issues in those who self-identify as gay men, and (2) evaluate the influence of demographic, economic, health-related, behavioral and social factors using interpretability techniques to enhance understanding of the factors shaping mental health outcomes. A dataset of 2186 gay men from the First Virtual Survey for LGBTIQ+ People in Peru (2017) was analyzed, considering demographic, economic, health-related, behavioral, and social factors. Several classification models were developed and compared, including Logistic Regression, Artificial Neural Networks, Random Forest, Gradient Boosting Machines, eXtreme Gradient Boosting, and a One-dimensional Convolutional Neural Network (1D-CNN). Additionally, the Shapley values and Layer-wise Relevance Propagation (LRP) heatmaps methods were used to evaluate the influence of the studied variables on the prediction of mental health issues. The results revealed that the 1D-CNN model demonstrated the strongest performance, achieving the highest classification accuracy and discrimination capability. Explainability analyses underlined prior infectious diseases diagnosis, access to medical assistance, experiences of discrimination, age, and sexual identity expression as key predictors of mental health outcomes. These findings suggest that advanced predictive techniques can provide valuable insights for identifying at-risk individuals, informing targeted interventions, and improving access to mental health care. Future research should refine these models to enhance predictive accuracy, broaden applicability, and support the integration of artificial intelligence into public health strategies aimed at addressing the mental health needs of this population. Full article