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Healthcare
Number of Followers: 2  Open Access journalISSN (Online) 2227-9032 Published by MDPI  [258 journals]
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- Healthcare, Vol. 12, Pages 1552: A Scoping Review on Staff Attitudes
towards the Use of Coercion in Mental Healthcare
Authors: Simone Agnes Efkemann, Jakub Lickiewicz, Paul Doedens, Tella Lantta, Panagiota Bali, Tonje Lossius Husum
First page: 1552
Abstract: Attitudes of mental health professionals towards the use of coercion are highly relevant concerning its use coercion in mental healthcare, as mental health professionals have to weigh ethical arguments and decide within a legal frame in which situations to use coercion or not. Therefore, assessment of those attitudes is relevant for research in this field. A vital instrument to measure those attitudes towards the use of coercion is the Staff Attitude to Coercion Scale. This scoping review aims to provide a structured overview of the advantages and limitations in the assessment of attitudes toward coercion. We conducted a scoping review in Medline, PsycINFO, CINAHL, and Web of Science, based on the PRISMA-ScR. Inclusion criteria were empirical studies on the attitudes of mental health professionals. We included 80 studies and systematically mapped data about the main results and limitations in assessing attitudes toward coercion. The main results highlighted the relevance and increased interest in staff attitudes towards coercion in mental healthcare. Still, the majority of the included studies relied on a variety of different concepts and definitions concerning attitudes. The data further indicated difficulties in developing new and adapting existing assessment instruments because of the equivocal definitions of underlying concepts. To improve the research and knowledge in this area, future studies should be based on solid theoretical foundations. We identified the need for methodological changes and standardized procedures that take into account existing evidence from attitude research in social psychology, nursing science, and other relevant research fields. This would include an update of the Staff Attitude to Coercion Scale based on the limitations identified in this review.
Citation: Healthcare
PubDate: 2024-08-06
DOI: 10.3390/healthcare12161552
Issue No: Vol. 12, No. 16 (2024)
- Healthcare, Vol. 12, Pages 1553: Posterior Cruciate Buckling Angle
Variations Are Associated with Different Patterns of Medial Meniscus Tears
in Anterior-Cruciate-Deficient Knees: Results of a Prospective Comparative
Magnetic Imaging Resonance Study
Authors: Simone Cerciello, Michele Mercurio, Katia Corona, Lorenzo Proietti, Giovanni Di Vico, Matthew Charles Giordano, Brent Joseph Morris
First page: 1553
Abstract: Background: The diagnosis of anterior cruciate ligament (ACL) tear relies on clinical evaluation and magnetic resonance imaging (MRI). Direct and indirect signs of ACL tear have been described with MRI evaluation. Posterior cruciate ligament (PCL) buckling has been described as an indirect radiographic sign of an ACL tear. Purpose: The aim of the present study was to assess the variations in PCL buckling angles in patients with ACL tears and in patients with isolated lesions in the posterior horn of the medial meniscus. In addition, the influence of different patterns of medial meniscus tears in ACL-deficient knees was investigated. Finally, the influences of risk factors such as tibial slope, delay from injury to surgery, absence of medial meniscus tear, degree of Lachman and pivot shift testing were also assessed. Study design: This was a cohort study. Methods: A total of 154 patients (78 in the group with ACL tear and 76 in the control group) were assessed with MRI and lateral weight-bearing X-ray to assess PCL buckling angle and tibial slope by two independent observers. The presence of a medial meniscus bucket handle or ramp lesion of the medial meniscus was assessed and recorded at the time of surgery. Results: PCL buckling angle measurement was highly reliable, with an ICC of 0.866 and 0.894, respectively, in the study group and the control group for interobserver reliability. The intrarater reliability was found to be high in PCL buckling angle for the study group [ICC = 0.955] and the control group [ICC = 0.943]. The mean angle in patients with ACL tear was 110.7 ± 15.2° and 115.3 ± 16.2° (for the two examiners) and 111.4 ± 12° and 114 ± 14.5° (for the two examiners) in patients with an intact, healthy ACL. An association emerged between bucket handle tears of the medial meniscus (p = 0.010) and a decreased PCL buckling angle and between ramp lesions of the medial meniscus and increased PCL buckling angle both (p = 0.024). Conclusions: Good inter- and intraobserver reliability for the measurement of the PCL buckling angle was observed. Increased PCL buckling angle values were observed in patients with concomitant ACL and bucket handle tears of the medial meniscus, while decreased angle values were observed in those who had ACL tear and ramp lesion of the medial meniscus. No statistically significant difference in the PCL buckling angle emerged between patients with ACL tears and those who had a healthy, intact ACL.
Citation: Healthcare
PubDate: 2024-08-06
DOI: 10.3390/healthcare12161553
Issue No: Vol. 12, No. 16 (2024)
- Healthcare, Vol. 12, Pages 1554: Mobile Applications for Learning Hand
Hygiene: A Comparative Analysis
Authors: Dominika Muršec, Adrijana Svenšek, Lucija Gosak, Sonja Šostar Turk, Urška Rozman, Gregor Štiglic, Mateja Lorber
First page: 1554
Abstract: Infection control is crucial for high-quality patient care. One of the most effective and commonly used infection control procedures is hand hygiene which, it is known, requires repeated refresher training. There are many ways to educate healthcare professionals about hand hygiene, including the use of mobile applications (apps). Our aim is to review such hand hygiene apps, and to identify which have been available since 2021 and to assess their quality. We conducted a review using the PRISMA diagram to document our app selection process in the Google Play Store and Apple store in March 2024. For the evaluation of apps, we used the user version of the Mobile Application Rating Scale questionnaire (uMARS). Of 16 apps only five adhere to WHO hand hygiene guidelines. Timers were included in 12 of the 16 apps and reminders were included in 10 of 16 apps. The highest overall uMARS scoring app was Give Me 5–Hand Hygiene (4.31 ± 0.28), while Wash your hands! (1.17 ± 0.14) had the lowest score. We found that more than half of the apps were unavailable from the 2021 review. We believe that app-based education could effectively sustain hand hygiene knowledge in healthcare settings.
Citation: Healthcare
PubDate: 2024-08-06
DOI: 10.3390/healthcare12161554
Issue No: Vol. 12, No. 16 (2024)
- Healthcare, Vol. 12, Pages 1555: A Concept Analysis of Maternal Resilience
against Pregnancy-Related Mental Health Challenges in Low- and
Middle-Income Countries
Authors: Anila Naz AliSher, Samia Atta, Adnan Yaqoob, Tanseer Ahmed, Salima Meherali
First page: 1555
Abstract: Suicide accounts for 33% of deaths of women during the postnatal period in many low- and middle-income countries (LMICs). Resilience refers to an ability to adapt and recover from adversity or misfortune. Resilience building against mental health challenges during pregnancy and the postnatal period is critical for women to raise their child efficiently and maintain a healthy life. The exploration of maternal resilience against mental health challenges including its developmental processes and the determinants of its successful or unsuccessful cultivation among mothers during pregnancy and childbirth is of paramount importance. Understanding why a subset of mothers effectively develops resilience while others significantly struggle is critical for devising targeted interventions and support mechanisms aimed at improving maternal well-being. This inquiry not only seeks to delineate the factors that contribute to or hinder the development of resilience but also aims to inform the creation of comprehensive support systems that can bolster maternal health outcomes. This paper endeavors to present a comprehensive analysis of maternal resilience, aiming to cultivate a nuanced and profound understanding of the concept within the framework of previous traumatic events and adverse pregnancy outcomes in LMICs. The eight-step method approach proposed by Walker and Avant was utilized for this concept analysis. Several defining attributes were identified in the analysis including social adaptation, support system, optimistic approach, and mindfulness. This analysis contributes to knowledge advancement regarding maternal resilience and provides nurses and other healthcare professionals with a clear understanding of the concept of maternal resilience to help promote resilience among mothers.
Citation: Healthcare
PubDate: 2024-08-06
DOI: 10.3390/healthcare12161555
Issue No: Vol. 12, No. 16 (2024)
- Healthcare, Vol. 12, Pages 1556: Supporting Infants’ Motor
Development through Water Activities: A Preliminary Case–Control
Study
Authors: Oliwia Jakobowicz, Anna Ogonowska-Slodownik
First page: 1556
Abstract: The first twelve months of an infant’s life are the most dynamic time in the development of motor activities. Water activities can positively stimulate the motor skills, visual perception, and cognitive abilities of infants. The purpose of this study was to evaluate the motor development of infants aged 3–12 months participating in water activities. Participants in the study included 43 infants aged 3–12 months who attended water activities classes at Warsaw City swimming pools (n = 21) and infants not attending any classes (n = 22). Two methods of assessing motor development were used in the study: the Alberta Infant Motor Scale (AIMS) and the Early Motor Development Questionnaire (EMQ). The raw scores of the AIMS test and the EMQ questionnaire were statistically significantly different (p < 0.05) in both groups between the first and second examinations. In contrast, there was a statistically significant improvement in motor development measured by AIMS and expressed in percentiles (p = 0.002) and in percentiles for Polish children (p = 0.030) in the water group. The age-independent total score of the EMQ before and after the intervention did not change significantly (p = 0.149). The water environment has the potential to support the motor development of infants aged 3–12 months.
Citation: Healthcare
PubDate: 2024-08-06
DOI: 10.3390/healthcare12161556
Issue No: Vol. 12, No. 16 (2024)
- Healthcare, Vol. 12, Pages 1557: Pre-Stroke Frailty and Outcomes following
Percutaneous Endoscopic Gastrostomy Tube Insertion
Authors: Karan Gupta, Eleanor Williams, Elizabeth A. Warburton, Nicholas Richard Evans
First page: 1557
Abstract: Background: Frailty is common in stroke, where it exerts disease- and treatment-modifying effects. However, there has been little work evaluating how frailty influences outcomes after percutaneous endoscopic gastrostomy (PEG) tube insertion. This study investigates the relationship between pre-stroke frailty and one-year mortality following PEG insertion. Methods: A pre-stroke frailty index (FI) was calculated for individuals with post-stroke dysphagia who underwent PEG insertion between March 2019 and February 2021. Mortality was recorded at one year, as well as instances of post-PEG pneumonia and discharge destination. Results: Twenty-nine individuals underwent PEG insertion, eleven (37.9%) of whom died in the subsequent year. The mean (SD) FI for those who survived was 0.10 (0.09), compared to 0.27 (0.19) for those who died (p = 0.02). This remained significant after adjustment for age and sex, with each 0.1 increase in the FI independently associated with an increased odds of one-year mortality (aOR 1.39, 95% CI 1.17–1.67). There was no association between frailty and post-PEG pneumonia (0.12 (0.21) in those who aspirated versus 0.11 (0.18) in those who did not, p = 0.75). Conclusions: Pre-stroke frailty is associated with increased one-year mortality after PEG, a finding that may help inform shared clinical decision-making in complex decisions regarding PEG feeding.
Citation: Healthcare
PubDate: 2024-08-06
DOI: 10.3390/healthcare12161557
Issue No: Vol. 12, No. 16 (2024)
- Healthcare, Vol. 12, Pages 1558: Non-Adherence to Peripheral Venous
Catheter Care Protocols Significantly Decreases Patient Safety and Impacts
Costs: A Retrospective Observational Study
Authors: María Bibiano Guillén, Jose Tolsdorf Rodríguez, Javier Nuñez-Alfonsel, José Miguel Cárdenas-Rebollo, Ángel Ayuso-Sacido
First page: 1558
Abstract: In the healthcare field, the effective implementation of clinical protocols is crucial to ensuring patient safety and well-being. In this context, this study evaluates nurses’ adherence to the maintenance and replacement protocol of peripheral venous catheters (PVCs) in a university hospital in Spain, examining the impact of compliance with the protocol on the loss of PVCs and on patient safety in addition to analyzing the related costs. A retrospective observational study was conducted with 590 patients who were admitted in 2018 and 2019. The chi-square test or Fisher’s exact test, as appropriate, was used to see the association between the study variables; with the dependent variable being the loss of PVCs (including, as a dependent variable, the loss of PVCs before 48 h). The patients’ electronic and physical medical records were reviewed to analyze nursing interventions related to the management of PVCs. A total of 24% of patients experienced PVC loss within the first 24 h after insertion. Failure to comply with the protocol resulted in 80% more catheter loss and increased the cost of cannulation by 46.84%. Low compliance with PVC care protocols significantly increases the risk of catheter loss, suggesting the need for increased training and strict protocol implementation. The findings emphasize the critical role of nursing in ensuring patient safety through adherence to evidence-based protocols. Continuing education and diligent protocol implementation are essential to reducing healthcare costs and improving patient outcomes.
Citation: Healthcare
PubDate: 2024-08-06
DOI: 10.3390/healthcare12161558
Issue No: Vol. 12, No. 16 (2024)
- Healthcare, Vol. 12, Pages 1559: Perceived Relational Empathy and
Resilience in People with Spinal Cord Injury at the End of Acute Care: A
Cross-Sectional Study
Authors: Monika Zackova, Paola Rucci, Rossana Di Staso, Silvia Ceretti, Giuseppe Bonavina, Eric Delmestro
First page: 1559
Abstract: In patients with spinal cord injury (SCI), patient-reported outcomes (PROMs) and experience of care measures (PREMs) are extremely relevant for the prognosis. However, there is a paucity of research on these topics. We conducted a cross-sectional study to investigate the relationships between these patient outcomes and other demographic and clinical variables in adult SCI patients discharged from the intensive care unit of an Italian tertiary rehabilitation hospital. We administered the Consultation and Relational Empathy (CARE) for perceived relational empathy, the Spinal Cord Independence Measure III self-report (SCIM-SR) for functional autonomy, the Numeric Rating Scale (NRS) for pain, and the Connor–Davidson Resilience Scale (CD-RISC-10) for resilience. Study participants consisted of 148 adults with SCI; 82.4% were male, with a mean age of 49.9 years (SD = 16.6). The lesion was traumatic in 82.4% and complete in 74.3% of cases. The median length of hospital stays was 35 days (interquartile range—IQR = 23–60). Perceived relational empathy was positively associated with resilience (r = 0.229, p = 0.005) and negatively associated with the length of the stay and lesion completeness. Resilience had a weak negative association with pain (r = −0.173, p = 0.035) and was unrelated to other variables. Clinicians should consider the routine assessment of PREMs and PROMs in order to personalize post-discharge therapeutic plans and identify appropriate measures to ensure continuity of care.
Citation: Healthcare
PubDate: 2024-08-06
DOI: 10.3390/healthcare12161559
Issue No: Vol. 12, No. 16 (2024)
- Healthcare, Vol. 12, Pages 1560: The Efficacy of Ketamine for Acute and
Chronic Pain in Patients with Cancer: A Systematic Review of Randomized
Controlled Trials
Authors: Leila Azari, Homa Hemati, Ronia Tavasolian, Sareh Shahdab, Stephanie M. Tomlinson, Margarita Bobonis Babilonia, Jeffrey Huang, Danielle B. Tometich, Kea Turner, Kimia Saleh Anaraki, Heather S. L. Jim, Amir Alishahi Tabriz
First page: 1560
Abstract: Managing cancer-related pain poses significant challenges, prompting research into alternative approaches such as ketamine. This systematic review aims to analyze and summarize the impact of ketamine as an adjuvant to opioid therapy for cancer-related pain. We conducted a literature review in MEDLINE, EMBASE, and Scopus from 1 January 1982 to 20 October 2023. Abstracts were screened against inclusion criteria, and eligible studies underwent a full-text review. Data was extracted from the included studies, and a framework analysis approach summarized the evidence regarding ketamine’s use in patients with cancer. A total of 21 randomized clinical trials were included, and the quality of all the included studies was good or fair. Significant improvements in pain scores and reduced morphine consumption were consistently observed with intravenous ketamine administration for postoperative pain control, particularly when combined with other analgesics such as morphine. Ketamine was less effective when used as an analgesic for chronic pain management, with several studies on neuropathic pain or chemotherapy-induced neuropathy finding minimal significant effect on reduction of pain scores or morphine requirements. The efficacy of ketamine in pain management appears to depend on factors such as dosage, route of administration, and patient population.
Citation: Healthcare
PubDate: 2024-08-06
DOI: 10.3390/healthcare12161560
Issue No: Vol. 12, No. 16 (2024)
- Healthcare, Vol. 12, Pages 1561: Correction: Zamfir et al. Trends in
Coronary Artery Anomalies Detection by Coronary Computed Tomography
Angiography (CCTA): A Real-Life Comparative Study before and during the
COVID-19 Pandemic. Healthcare 2024, 12, 1091
Authors: Alexandra-Simona Zamfir, Tudor-Andrei Cernomaz, Bogdan Mihnea Ciuntu, Doina Azoicăi, Carmen Lăcrămioara Zamfir, Raluca Ozana Chistol, Anca Sava
First page: 1561
Abstract: In the original publication [...]
Citation: Healthcare
PubDate: 2024-08-07
DOI: 10.3390/healthcare12161561
Issue No: Vol. 12, No. 16 (2024)
- Healthcare, Vol. 12, Pages 1562: Concussion in Parasport: A Narrative
Review of Research Published since the Concussion in Para Sport (CIPS)
Group Statement (2021)
Authors: Tansy Ryan, Lisa Ryan, Ed Daly
First page: 1562
Abstract: Sports-related concussion (SRC) is an injury whereby impact to the face/head/neck impairs cognitive functioning. Parasport athletes have an increased risk for SRC. The Previous Concussion in Sport Group iterations lack guidance for parasport SRC assessment, management, and return-to-play. This article aims to investigate the research relating to parasport SRCs published since the 2021 Concussion in Para Sport (CIPS) position statement and highlights possible new recommendations. A literature review of parasport concussions was conducted. Articles citing the 2021 publication and/or published since then were reviewed. Relevant data were extracted and discussed in this article. Since 2021, twelve (n = 12) articles emerged investigating parasport SRC. Parasport athletes experience greater concussion symptoms and severity scores compared to able-bodied athletes. Visually impaired athletes account for >50% of parasport SRCs. Wheelchair basketball and rugby have the highest SRC incidence rates across parasports. Current SRC assessment methodologies are not designed with consideration of parasport athletes’ unique experiences. Guidelines lack a return-to-learning protocol, making returning to education/work challenging for such athletes. Understanding these athletes’ SRC experiences is paramount in supporting their recovery. Specific guidelines for SRC assessment, management, return-to-play, and return-to-learn for parasport athletes are necessary to enhance their rehabilitation and avoid the occurrence of long-term symptoms.
Citation: Healthcare
PubDate: 2024-08-07
DOI: 10.3390/healthcare12161562
Issue No: Vol. 12, No. 16 (2024)
- Healthcare, Vol. 12, Pages 1563: Comparative Evaluation of
Temporomandibular Joint Parameters in Unilateral and Bilateral Cleft Lip
and Palate Patients Using Cone-Beam CT: Focus on Growing vs. Non-Growing
Subjects
Authors: Ahmed Z. Abdelkarim, Ahmed A. Almeshari, Duygu Celik Ozen, Ayman R. Khalifa, Nader N. Rezallah, Suayip Burak Duman, Sonam Khurana
First page: 1563
Abstract: Background: Morphological differences in the temporomandibular joint (TMJ) are crucial for the treatment of patients with cleft lip and palate (CLP). This study aims to evaluate and compare the TMJ parameters in patients with unilateral and bilateral CLP across growing and non-growing age groups using cone-beam computed tomography (CBCT). Methods: CBCT records from 57 patients (23 males and 34 females) aged 6–50 years with a diagnosed unilateral or bilateral CLP were analyzed. Patients were categorized into four groups: growing unilateral (UGCLP), growing bilateral (BGCLP), non-growing unilateral (UNGCLP), and non-growing bilateral (BNGCLP). Measurements of TMJ parameters, including the mandibular fossa, articular eminence inclination, joint spaces, and roof thickness of the glenoid fossa, were conducted using CBCT images. Results: Significant differences were observed in the anterior joint space (AJS) and the roof of the glenoid fossa (RGF) between growing and non-growing unilateral cleft patients. Additionally, significant discrepancies were found in the articular eminence angle when comparing the cleft and non-cleft sides within the unilateral growing group. No significant differences were observed in TMJ parameters between the right and left sides among bilateral cleft patients. Conclusions: The study highlights distinct TMJ morphological differences between growing and non-growing patients with CLP, emphasizing the importance of age-specific considerations in the treatment planning and growth monitoring of these patients.
Citation: Healthcare
PubDate: 2024-08-07
DOI: 10.3390/healthcare12161563
Issue No: Vol. 12, No. 16 (2024)
- Healthcare, Vol. 12, Pages 1564: Impact of Social Support and
Self-Efficacy on Activity of Daily Living among Post-Stroke Patients in
Saudi Arabia: A Cross-Sectional Study
Authors: Ahmed Nahari, Ali Matoug Alsaleh
First page: 1564
Abstract: This study employed a cross-sectional design to explore the impact of social support and self-efficacy on activity of daily living (ADL) among post-stroke patients in Saudi Arabia and investigate the mediating role of self-efficacy. Data were collected from 158 post-stroke patients across six healthcare facilities in three regions of Saudi Arabia using convenience sampling, between February 2023 and July 2023. The analysis included descriptive statistics, variance analysis, and linear regression using bootstrap methods. PROCESS Macro was used for the mediation model. This study revealed that most participants had high ADL, social support, and self-efficacy levels. Significant negative associations were found between ADL and age (p < 0.001), time since stroke (p = 0.009), and stroke history (p < 0.001), while significant positive associations were observed with educational background (p = 0.049), employment status (p < 0.001), and self-efficacy (p < 0.001). ADL in post-stroke patients was significantly influenced negatively by age (p = 0.025), time since stroke (p = 0.027), and stroke history (p < 0.001), while self-efficacy (p < 0.001) had a positive impact and moderated the relationship between social support and ADL. This study highlights the physical and psychosocial aspects affecting post-stroke patients, identifies key areas for enhancing their experiences, and informs the development of targeted interventions to address their comprehensive needs.
Citation: Healthcare
PubDate: 2024-08-07
DOI: 10.3390/healthcare12161564
Issue No: Vol. 12, No. 16 (2024)
- Healthcare, Vol. 12, Pages 1565: Perceptions of Dementia among Nursing
Students in South Korea: A Phenomenological Study
Authors: So-Hee Lim
First page: 1565
Abstract: This study aimed to determine nursing students’ perceptions of dementia and patients with dementia. Specifically, this study sought to illuminate the essential meaning of dementia among nursing students to uncover insights useful for developing patient-centered care rooted in empathy for patients with dementia. This study used a descriptive phenomenological research method. Between August and September 2023, semi-structured interviews were conducted with 15 nursing students. Colaizzi’s method was used for the manual analysis. After analyzing the interview data on nursing students’ awareness of dementia, four categories, nine theme clusters, and 28 formulated meanings were derived. The four categories were “View of dementia”, “Feelings about dementia”, “Efforts made regarding dementia”, and “Dementia as a nursing student”. Although nursing students’ perceptions of dementia resulted in negative perspectives and emotions, by looking into coping methods and wishes for dementia, this study also confirmed that nursing students had an awareness of caring for patients with dementia.
Citation: Healthcare
PubDate: 2024-08-07
DOI: 10.3390/healthcare12161565
Issue No: Vol. 12, No. 16 (2024)
- Healthcare, Vol. 12, Pages 1566: The Knowledge and Attitude of
Undergraduate Dental Students toward Dental Ergonomic Principles in
Occupational Health
Authors: Monika Tysiąc-Miśta, Maja Kruplewicz, Aleksandra Grzyb, Arkadiusz Dziedzic, Marta Tanasiewicz
First page: 1566
Abstract: Background: Undergraduate dental curricula and courses containing ergonomic principles are introduced to students from the very beginning of dental education. Still, dentists present a high prevalence of musculoskeletal disorders, which are a direct burden on quality of life, leading to early retirement from the profession. This study aimed to assess the state of students’ knowledge and awareness regarding the role of ergonomics in dentistry and its practical implementation. Methods: a cross-sectional study using a predesigned self-administered questionnaire was conducted among fourth- and fifth-year dental students of the Medical University of Silesia in Katowice, Poland (response rate of 69.2%). Results: A total of 94.6% of students declared a good, fair, or moderate level of knowledge of the subject, with a significant difference in favor of the fifth-year students (p = 0.008). Moreover, 76.1% of respondents showed a good or very good attitude toward ergonomics as a university curriculum subject. A total of 72.3% of respondents declared that the practical application of ergonomic rules in clinical dentistry is very important (five in a five-point scale). Women found dental ergonomics more important than men (p < 0.001). However, 79.3% of participants admitted not following basic ergonomic principles during clinical procedures. Conclusion: The research revealed a discrepancy between theoretical knowledge and awareness and the practical application of ergonomics in a clinical environment. Only by inculcating correct occupational standards and abiding by them from the commencement of dental education can consistency between theory and practice be achieved. This will hopefully ensure the health and well-being of dental team members throughout their professional lives.
Citation: Healthcare
PubDate: 2024-08-07
DOI: 10.3390/healthcare12161566
Issue No: Vol. 12, No. 16 (2024)
- Healthcare, Vol. 12, Pages 1567: Comparison of Health Parameters in
Postpartum Diastasis Recti: A Randomized Control Trial of SEMG
Biofeedback-Assisted Core Strengthening Exercises with Kinesiotaping vs.
Non-Assisted Exercises
Authors: Ujala Afzal, Quratulain Saeed, Muhammad Nabeel Anwar, Sanna Pervaiz, Manahil Shahid, Rimsha Javed, Muhammad Umair Ali, Seung Won Lee
First page: 1567
Abstract: Current medical treatments for diastasis recti often involve exercises to strengthen the core muscles, along with abdominal binders or supports. However, there is limited evidence comparing the effectiveness of surface electromyography (SEMG) biofeedback-assisted core strengthening exercises combined with kinesiotaping to other approaches. This study aimed to assess the impact of three interventions on core strength, inter-rectus distance, and quality of life in postpartum women with diastasis recti. The interventions included core strengthening exercises with kinesiotaping and SEMG biofeedback-assisted core strengthening with kinesiotaping. This randomized controlled trial (NCT05897255) included 24 postpartum women divided into three groups. We measured inter-rectus distance, quality of life using the Short Form Health Survey 36, and core strength using the McGill torso battery test. The SEMG biofeedback provided auditory and visual cues. We used one-way analysis of variance to compare outcomes between groups, while a t-test for within-group analysis. Both the SEMG biofeedback-assisted and non-assisted core strengthening exercises with kinesiotaping groups showed significantly greater improvements in energy, bodily pain, general health, physical functioning, and limitations due to physical problems than the core strengthening group. Additionally, the SEMG biofeedback-assisted group demonstrated a greater reduction in inter-rectus distance. There were no statistically significant differences in core strength improvement among the three groups. Core strengthening exercises with SEMG-assisted kinesiotaping were superior to core strengthening alone in reducing inter-rectus distance, enhancing physical function, energy levels, and general health, and decreasing bodily pain and limitations due to physical problems. Core strength improvements were similar across all groups.
Citation: Healthcare
PubDate: 2024-08-07
DOI: 10.3390/healthcare12161567
Issue No: Vol. 12, No. 16 (2024)
- Healthcare, Vol. 12, Pages 1568: Lessons of the COVID-19 Pandemic for
Ambulance Service in Kazakhstan
Authors: Assylzhan Messova, Lyudmila Pivina, Diana Ygiyeva, Gulnara Batenova, Almas Dyussupov, Ulzhan Jamedinova, Marat Syzdykbayev, Saltanat Adilgozhina, Arman Bayanbaev
First page: 1568
Abstract: Background: Emergency medical services (EMS) are intended to provide people with immediate, effective, and safe access to the healthcare system. The effects of pandemics on emergency medical services (EMS) have not been studied sufficiently. The aim of this paper is to assess the frequency and structure of calls at an ambulance station in Kazakhstan during the period of 2019–2023. Methods: A retrospective analysis was conducted to estimate the incidence of emergency assistance cases from 2019 to 2023. Results: An analysis of the structure and number of ambulance calls before the pandemic, during the pandemic, and post-pandemic period did not reveal significant changes, except for calls in urgency category IV. Patients of urgency category IV handled by an ambulance decreased by 2 and 1.7 times in 2020 and 2021, respectively, which appears to be related to quarantine measures. In 2022 and 2023, category IV calls were 4.7 and 4.5 times higher than in 2019. Conclusions: This study’s findings suggest no changes in the dynamics of ambulance calls, except urgency category IV calls. The number of category IV urgent calls decreased significantly during the COVID-19 pandemic and increased in the post-pandemic period.
Citation: Healthcare
PubDate: 2024-08-08
DOI: 10.3390/healthcare12161568
Issue No: Vol. 12, No. 16 (2024)
- Healthcare, Vol. 12, Pages 1569: Disparities and Determinants of Online
Medical Record Access among Cancer Survivors
Authors: Safa Elkefi
First page: 1569
Abstract: Access to online medical records (OMRs) can help enhance cancer patient engagement and improve their health outcomes. This study investigates disparities in OMR access among cancer survivors and examines the association between OMR access and health perceptions. We conducted a cross-sectional analysis using data from the National Cancer Institute’s Health Information National Trends Survey (HINTS) from 2017 to 2022. The sample included 4713 cancer survivors. We employed regression analysis to assess the associations between the different factors. Overall, 18.78% of participants accessed their OMRs once or twice, while 36.69% accessed them three times or more. Gender minority groups (β = −0.0038, p = 0.01), older adults (β = −0.1126, p < 0.001), and racial minority groups (β = −0.059, p < 0.001) were less likely to access their OMRs. Additionally, higher education levels (β = 0.274, p < 0.001), insurance coverage (β = 0.365, p < 0.001), and higher incomes (β = 0.115, p < 0.001) were associated with increased OMR access. Positive health perceptions were significantly associated with OMR usage, including perceived good health (β = 0.148, p < 0.001), quality of care (β = 0.15, p = 0.026), and self-efficacy (β = 0.178, p = 0.002). Disparities in OMR access among cancer survivors are influenced by socio-economic factors and health perceptions. Interventions targeting vulnerable groups, enhancing digital health literacy, and improving health perceptions could promote equitable OMR usage.
Citation: Healthcare
PubDate: 2024-08-08
DOI: 10.3390/healthcare12161569
Issue No: Vol. 12, No. 16 (2024)
- Healthcare, Vol. 12, Pages 1570: Intersecting Pathways: Treating Cocaine
Withdrawal and Restless Leg Syndrome with Iron and Buproprion
Authors: Sarah Hughes, Olivia Hill, Raja Mogallapu
First page: 1570
Abstract: Many drastic actions are taken by cocaine users for the sake of experiencing high levels of dopamine, which depends on iron for its synthesis. Dopamine depletion and iron deficiency are also involved in the symptoms of restless leg syndrome (RLS). The intersecting biochemical pathways of cocaine use, iron deficiency, and RLS have not been adequately investigated. This case report reveals the successful treatment of a patient experiencing these conditions. A 63-year-old male with a history of cocaine use disorder, insomnia, and RLS sought emergency care for suicidality. Upon admission, he was also found to be iron deficient. He revealed that his RLS worsened when he attempted to abstain from cocaine. He also used alcohol to sustain the effects of cocaine when the cost of cocaine was too high. During hospitalization, his mood, cravings, and RLS were resolved with adjunctive iron supplementation, as well as treatment with 300 mg of Wellbutrin (bupropion hydroxychloride). If iron deficiency is present, the replenishment of the adequate dopaminergic receptor density and function via supplementation may play an essential role in the prevention of cocaine use and the cessation of cocaine withdrawal symptoms. Further research is warranted to validate these findings and to investigate the implications of iron supplementation in addiction medicine.
Citation: Healthcare
PubDate: 2024-08-08
DOI: 10.3390/healthcare12161570
Issue No: Vol. 12, No. 16 (2024)
- Healthcare, Vol. 12, Pages 1571: Enhancing Parental Understanding of
Emotions in Children with Developmental Language Disorder: An Online
Parent-Led Intervention Program
Authors: Fatma Canan Durgungoz, Michelle C. St Clair
First page: 1571
Abstract: Many children with developmental language disorder (DLD) have emotion recognition and regulation difficulties, but there are currently no known interventions enhancing emotional awareness in this population. This study explores the impact of parents’ perspectives regarding children with DLD emotional understanding through a parent-led online emotion recognition (ER) intervention. Ten parents of children with DLD aged 6–11 participated in the study. A nonconcurrent multiple baseline design was employed, allowing for a rigorous analysis of changes in parental beliefs over time. Weekly data were collected through the Parents’ Beliefs About Children’s Emotions Questionnaire. Interviews were also conducted to gain deeper insights into parents’ perceptions regarding the ER skills of their children. Results indicated that parents’ beliefs about the need for guiding and supporting their child’s ER skills increased over the intervention. Interviews also supported this, and three main themes were generated. The intervention program increased parents’ awareness of (a) the importance of ER for children with DLD, (b) emotion-focused communication and engagement with their child, and (c) the integration of emotions into daily life. This study is the first known study that explores parents’ beliefs about children with DLD ER skills, highlighting the importance of supporting parents through accessible interventions.
Citation: Healthcare
PubDate: 2024-08-08
DOI: 10.3390/healthcare12161571
Issue No: Vol. 12, No. 16 (2024)
- Healthcare, Vol. 12, Pages 1572: Assessment of Park Paths and Trails for
Physical Activity Promotion among Older Adults in Saudi Arabia:
Feasibility and Future Directions
Authors: Tracy Chippendale, Hadeel R. Bakhsh, Najat A. Alhaizan, Bodor H. Bin Sheeha
First page: 1572
Abstract: Chronic diseases affect more than 80% of older adults. One modifiable risk factor for secondary prevention is physical activity. Public parks are an essential resource for physical activity, but environmental features may limit participation. Our aims were (1) to assess the feasibility and utility of the Path Environment Audit Tool (PEAT) for use in a larger-scale study focused on older adults and (2) to examine the physical activity-promoting features of five public parks. Methods: A descriptive study design was used to assess five public parks in Riyadh, Saudi Arabia, from April to June 2022. Additionally, process, resource, and management assessments were also conducted. Results: The PEAT was easy to use, but additions are recommended to increase relevance to older adults with chronic disease. Descriptive analyses revealed positive features, such as adequate lighting, but other features such as path slope were more variable. Conclusions: Study findings can guide the future use of the PEAT for older adult participants and inform environmental modifications.
Citation: Healthcare
PubDate: 2024-08-08
DOI: 10.3390/healthcare12161572
Issue No: Vol. 12, No. 16 (2024)
- Healthcare, Vol. 12, Pages 1573: End-of-Life Care during the COVID-19
Pandemic: Decreased Hospitalization of Nursing Home Residents at the End
of Life
Authors: Helena Bárrios, José Pedro Lopes Nunes, João Paulo Araújo Teixeira, Guilhermina Rêgo
First page: 1573
Abstract: (1) Background: Nursing homes (NHs) face unique challenges in end-of-life care for their residents. High rates of hospitalization at the end of life are frequent, often for preventable conditions. The increased clinical uncertainty during the pandemic, the high symptom burden of the COVID-19 disease, and the challenges in communication with families and between care teams might impact the option to hospitalize NH residents at the end of life. (2) Materials and methods: The study covered a 3-year period and compared the hospitalization rates of the NH residents of a sample of Portuguese NH during the last year of life before and during the pandemic. A total of 387 deceased residents were included in the study. (3) Results: There were fewer hospitalizations in the last year of life during the pandemic period, although the proportion of deaths at hospitals was the same. Hospitalizations occurred closer to death, and with more serious clinical states. The lower rate of hospitalization was due to lower hospitalization due to infection; (4) Conclusions: The data suggest an improvement in end-of-life care practices during the pandemic period, with the decrease in hospitalizations being due to potentially burdensome hospitalizations. The importance of the role of physicians, nurses, and caregivers in this setting may be relatively independent of each other, and each may be targeted in end-of-life care training. Further study is recommended to clarify the implications of the results and if the changes can be sustained in the long term.
Citation: Healthcare
PubDate: 2024-08-08
DOI: 10.3390/healthcare12161573
Issue No: Vol. 12, No. 16 (2024)
- Healthcare, Vol. 12, Pages 1574: AF among Nurses Working in Neonatal and
Paediatric Intensive Care Units: A Cross-Sectional Study
Authors: Taibah M. Ali, Manal F. Alharbi
First page: 1574
Abstract: Aim: This research study aims to determine nurses’ alarm fatigue (AF) levels in paediatric critical care units in two governmental hospitals and to examine the significant differences in the mean between nurses’ attributes, nurses’ working environment, and nurses’ alarm management with the level of fatigue caused by the alarm. Background: In recent years, AF has become a significant and growing concern among nurses. However, in the Saudi Arabian paediatrics context, the impact of AF on nurses working in intensive care units remains unexplored. Method: A descriptive cross-sectional survey was conducted using a non-probability purposive sampling method. Data were collected from 216 nurses in two governmental hospitals through self-administered questionnaires comprised of four sections: individual attributes, work environment, alarm management, and AF scale. Data analysis: The Statistical Package of Social Science (SPSS) was used to analyse the data, and ANOVA was utilised to describe the sample’s demographic characteristics and determine any differences. Results: Most participants were female, held a bachelor’s degree, and were aged 31 to 35. Of the participants, 62.5% reported experiencing a medium level of AF, 29.2% reported a low level, and 8.3% reported a high level. Participants expressed that recurrent false alarms disrupt patient care and decrease trust in alarm systems. Significant differences in AF levels were observed based on marital status and the percentage of non-actionable alarms. Conclusions: Nurses working in paediatric critical units with high rates of false alarms, the frequent de-activation of alarms, and decreased trust in alarm systems are more likely to experience AF. Addressing AF is crucial for patient safety; nurse training on alarm management, the collaboration between biomedical and nursing staff, and technological advancements can help mitigate this issue. Implications for Practice: To minimise the adverse effects of AF, policymakers, biomedical experts, and nursing administrators must establish comprehensive policies and protocols concerning alarms. These measures aim to ensure secure and efficient care for the well-being of patients and nurses.
Citation: Healthcare
PubDate: 2024-08-08
DOI: 10.3390/healthcare12161574
Issue No: Vol. 12, No. 16 (2024)
- Healthcare, Vol. 12, Pages 1575: Anxiety in Nursing Students during the
COVID-19 Pandemic: Systematic Review and Meta-Analysis
Authors: Aroa García-Rivas, María Begoña Martos-Cabrera, María José Membrive Jiménez, Raimundo Aguayo-Estremera, Nora Suleiman Martos, Luis Albendín-García, José L. Gómez-Urquiza
First page: 1575
Abstract: Objectives: To analyse the influence of the COVID-19 pandemic on the development of anxiety in nursing students and the factors involved. Design: A systematic review and meta-analysis. Data source: PubMed, CINAHL, Scopus and Web of Science. Background: Nursing students are at an increased risk of developing mental overload, due to the presence of many sources of stress during their academic training. Therefore, the COVID-19 pandemic has had an impact on the mental health of the general population, especially on healthcare workers and consequently on students undertaking placements in healthcare settings. Methods: A systematic review was conducted using PubMed, CINAHL, Scopus and Web of Science databases. A total of 24 articles were included in the review, and 20 articles were selected for the meta-analysis. Results: We found that the anxiety scores of nursing students during the COVID-19 pandemic were slightly higher (50%) than before the pandemic. The most influential risk factors for developing anxiety were academics, age, gender, having children, living in urban areas or with family, having an addiction to social networks, and having a fear of becoming infected with COVID-19. Resilience, spiritual support and feelings of happiness protected students against the risk of developing high levels of anxiety. Conclusions: The COVID-19 pandemic has led to increased levels of anxiety in nursing students. Thirty-five percent of the meta-analytically analysed sample had elevated levels of anxiety.
Citation: Healthcare
PubDate: 2024-08-08
DOI: 10.3390/healthcare12161575
Issue No: Vol. 12, No. 16 (2024)
- Healthcare, Vol. 12, Pages 1576: Dental Aesthetics and Self-Esteem of
Patients Seeking Orthodontic Treatment
Authors: Aufa Dahlia Bahar, Muhammad Syafiee Sagi, Faris Azim Mohd Zuhairi, Wan Nurazreena Wan Hassan
First page: 1576
Abstract: (1) Objective: This study aimed to investigate how patients’ perceptions of their dental aesthetics and their sense of self-esteem are related. (2) Methods: This cross-sectional survey recruited 141 new patients seeking orthodontic treatment. Patients completed a self-administered questionnaire consisting of three parts: the Malaysian Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ), Rosenberg Self-esteem Scale (RSES-M), and Aesthetics Component of the Index of Orthodontics Treatment Need (IOTN-AC). Clinical assessment comprised the Dental Health Component of the Index of Orthodontics Treatment Need (IOTN-DHC). Multiple linear regression was performed, with self-esteem as the dependent variable, while the independent variables comprised the domains of PIDAQ; IOTN-AC; IOTN-DHC; and patients’ demographics, such as age, gender, and their level of education. (3) Results: The response rate was 96.5% (n = 136 respondents). The multiple linear regression found that, when the other predictors in the model are held constant, Social Impact, Aesthetic Concern, and Dental Self-Confidence are the factors that significantly contributed to explaining the variation in self-esteem, accounting for, 3.9%, 2.3%, and 2.0%, respectively. The entire model explained 23% of the variation in self-esteem. (4) Conclusions: Domains of the psychosocial impact of dental aesthetics act as predictors of self-esteem in orthodontic treatment-seeking patients.
Citation: Healthcare
PubDate: 2024-08-08
DOI: 10.3390/healthcare12161576
Issue No: Vol. 12, No. 16 (2024)
- Healthcare, Vol. 12, Pages 1577: Interaction Processes between Health
Professionals and Moroccan Immigrant Women in Reproductive Healthcare: The
Disagreement in the Encounter—A Qualitative Study
Authors: María Idoia Ugarte-Gurrutxaga, Sara María Ulla Diez, Brígida Molina-Gallego, María Humanes-García, Gonzalo Melgar de Corral, Fernando Jesús Plaza del Pino
First page: 1577
Abstract: Introduction: Spain is a multicultural society and has been defined by several authors as an immigrant-receiving country. Moroccan women of childbearing age constitute 28.20% of Moroccan immigrants. Objectives: describe the interaction processes that occur between health professionals and Moroccan immigrant women in reproductive healthcare. Methods: Qualitative descriptive study based on Grounded Theory. Thirty immigrant women from Morocco and thirty-five health professionals participated in the study. Specific dimensions of analysis were defined and used to design the interview guide and focus groups. Results: In the healthcare encounter, the construction of an effective communicative space between the people involved in it is essential; however, the language barrier and the interpersonal relationships characterized by silence in the encounter make a meaningful healthcare relationship difficult for those who participate in it. Conclusions: There are communication and relationship problems that alter healthcare and the professional–patient relationship which require the use of translation programs, the incorporation of intercultural meters, and the development of cultural competence in health professionals.
Citation: Healthcare
PubDate: 2024-08-08
DOI: 10.3390/healthcare12161577
Issue No: Vol. 12, No. 16 (2024)
- Healthcare, Vol. 12, Pages 1578: Experimental Analysis of a Failed Gamma
Nail: A Case Report and Literature Review
Authors: Mihai Alexandru Cordunianu, Alina Georgiana Vulcu Cordunianu, Iulian Antoniac, Andrei Luca, Marius Niculescu, Cristian Ovidiu Chiriac, Iuliana Corneschi, Cosmin Ioan Mohor
First page: 1578
Abstract: The Gamma Nail represents one of the most popular and efficient implants for treating proximal femoral fractures. Our paper reports a case of a failed Gamma Nail which was used for the surgical treatment of a 69-year-old woman with a right femoral trochanteric fracture due to a car accident. After the surgical intervention, 6 months later, the patient presented to the hospital reporting pain and limited mobility of the right hip. An X-ray was performed at the level of the pelvis, which highlighted the fracture nonunion and the implant failure. The implant removal and its replacement with a dynamic condylar screw system (DCS) was decided. Because Gamma Nail failures are rare occurrences, the implant was subjected to analyses and experimental determinations to find out the cause. For the implant analyses, a stereomicroscope, an optical microscope, and scanning electron microscopy were used. After the tests were conducted, preparation and processing irregularities as causes of the implant failure were eliminated. Also, the experimental analyses showed that the Gamma Nail did comply with chemical composition and microstructure regulations. Thus, it was concluded that the implant failed due to the mechanical overloading caused by surgical technique errors.
Citation: Healthcare
PubDate: 2024-08-08
DOI: 10.3390/healthcare12161578
Issue No: Vol. 12, No. 16 (2024)
- Healthcare, Vol. 12, Pages 1579: Recreational Physical Activity and the
Mediterranean Diet: Their Effects on Obesity-Related Body Image
Dissatisfaction and Eating Disorders
Authors: Ioannis Tsartsapakis, Panagiotis Papadopoulos, Dionisis Stavrousis, Athanasios A. Dalamitros, Athanasia Chatzipanteli, Georgios Chalatzoglidis, Maria Gerou, Aglaia Zafeiroudi
First page: 1579
Abstract: Obesity is a non-communicable disease that is associated with a number of serious physical and mental health conditions. The present study examines the effect of recreational physical activity and the Mediterranean diet on body image dissatisfaction and propensity for eating disorders. It is based on 1311 participants categorized by body mass index (BMI) into a normal ΒΜΙ group (NBG; N = 513), an overweight and obese ΒΜΙ group (OBG; N = 492), and a control group (CG; N = 309). All participants completed the Multidimensional Body-Self Relations Questionnaire-Appearance Scale (MBSRQ-AS), Rosenberg Self-esteem Scale (RSES), Eating Attitudes Test-26 (EAT-26), Mediterranean Diet Score (MedDietScore), and Fitness Evaluation and Fitness Orientation subscales from the original Multidimensional Body-Self Relations Questionnaire (MBSRQ). The results of the multiple regression analysis indicated that the overall prediction of the variables was statistically significant. A multivariate analysis of variance (MANOVA) demonstrated the existence of significant interactions between groups and gender across a range of scales. Despite higher body image dissatisfaction in the OBG group, they maintained positive self-esteem and did not exhibit eating disorder tendencies. Notably, women reported greater dissatisfaction than men across all three groups. Our findings have practical implications for public health promotion strategies, policymaking, future research, and clinical practice. Encouraging regular exercise and adherence to the Mediterranean diet could improve body satisfaction and reduce eating disorder risk. Policymakers can advocate for community-based policies promoting physical activity and healthy eating habits.
Citation: Healthcare
PubDate: 2024-08-08
DOI: 10.3390/healthcare12161579
Issue No: Vol. 12, No. 16 (2024)
- Healthcare, Vol. 12, Pages 1580: Development and Psychometric Evaluation
of the End-of-Life Nursing Competency Scale for Clinical Nurses
Authors: Ji-yeon Kim, Hyun-sun Kim, Mi-jung Kang, Hee-young Oh, Mi-rae Jo
First page: 1580
Abstract: This study aimed to develop and establish psychometric properties of the End-of-Life Nursing Competency Scale for Clinical Nurses. The initial items were derived from an in-depth literature review and field interviews. The content validation of these items was assessed over three rounds by experts in end-of-life nursing care. The study included 437 clinical nurses from four hospitals in S, E, and D cities in South Korea. The final exploratory factor analysis resulted in a scale consisting of 21 items with the following five factors that explained 68.44% of the total variance: Physical care—imminent end-of-life, legal and administrative processes, psychological care—patient and family, psychological care—nurses’ self, and ethical nursing. The final model with these five subscales was validated through confirmatory factor analysis. Both item convergent-discriminant validity and known-group validity, which compared two groups based on clinical experience (p < 0.008) and working department (p < 0.008), were satisfactory. The internal consistency, as measured by Cronbach’s α, ranged from 0.62 to 0.89 for the subscales and was 0.91 for the total scale. This scale has been validated as a reliable and effective instrument for clinical nurses to self-assess their end-of-life nursing competencies in a clinical setting.
Citation: Healthcare
PubDate: 2024-08-08
DOI: 10.3390/healthcare12161580
Issue No: Vol. 12, No. 16 (2024)
- Healthcare, Vol. 12, Pages 1581: Effects of Virtual Reality (VR)-Based
Meditation on Sleep Quality, Stress, and Autonomic Nervous System Balance
in Nursing Students
Authors: Ki-Yong Kim, Myung-Haeng Hur, Won-Jong Kim
First page: 1581
Abstract: This study aimed to determine the effects of virtual reality (VR)-based meditation on the sleep quality, stress, and autonomic nervous system balance of nursing students. Nursing students were categorized into experimental groups I (VR-based meditation) and II (concentration meditation) and a control group. Before the study’s initiation, we measured the participants’ general characteristics, and a sleep measurement device was used to measure sleep quality. Stress levels and heart rate variability were measured before and after study completion. On the first day, all three groups slept without any intervention. On days 2–6, only experimental groups I and II implemented the intervention before sleeping. We found that the subjective sleep quality, wakefulness after sleep onset, sleep efficiency, deep sleep quality, subjective stress, objective stress, and autonomic nervous system balance of the VR meditation group were significantly better than those of the other groups. Our results reveal that the participants who underwent VR-based meditation experienced better sleep quality, lower stress levels, and improved autonomic nervous system balance compared with those in the concentration meditation and control groups. Thus, VR-based meditation effectively enhances sleep quality, lowers stress levels, and improves autonomic nervous system balance in nursing students.
Citation: Healthcare
PubDate: 2024-08-08
DOI: 10.3390/healthcare12161581
Issue No: Vol. 12, No. 16 (2024)
- Healthcare, Vol. 12, Pages 1582: Facial and Emotion Recognition Deficits
in Myasthenia Gravis
Authors: Maddalen García-Sanchoyerto, Monika Salgueiro, Javiera Ortega, Alicia Aurora Rodríguez, Pamela Parada-Fernández, Imanol Amayra
First page: 1582
Abstract: Myasthenia gravis (MG) is a neuromuscular disease of autoimmune etiology and chronic evolution. In addition to the muscle weakness and fatigue that characterize MG, in some studies patients show an inferior performance in cognitive tasks and difficulties in recognizing basic emotions from facial expressions. However, it remains unclear if these difficulties are due to anxious–depressive symptoms that these patients present or related to cognitive abilities, such as facial recognition. This study had a descriptive cross-sectional design with a sample of 92 participants, 52 patients with MG and 40 healthy controls. The data collection protocol included measures to assess recognition of facial expressions (BRFT), facial emotional expression (FEEL), and levels of anxiety and depression (HADS). The MG group had worse performance than the control group in recognizing “fear” (p = 0.001; r = 0.344), “happiness” (p = 0.000; r = 0.580), “disgust” (p = 0.000; r = 0.399), “surprise” (p = 0.000; r = 0.602), and “anger” (p = 0.007; r = 0.284). Likewise, the MG group also underperformed in facial recognition (p = 0.001; r = 0.338). These difficulties were not related to their levels of anxiety and depression. Alterations were observed both in the recognition of facial emotions and in facial recognition, without being mediated by emotional variables. These difficulties can influence the interpersonal interaction of patients with MG.
Citation: Healthcare
PubDate: 2024-08-09
DOI: 10.3390/healthcare12161582
Issue No: Vol. 12, No. 16 (2024)
- Healthcare, Vol. 12, Pages 1583: Remote Patient Monitoring Is Associated
with Improved Outcomes in Hypertension: A Large, Retrospective, Cohort
Analysis
Authors: Wesley Smith, Brett M. Colbert, Tariq Namouz, Dean Caven, Joseph A. Ewing, Andrew W. Albano
First page: 1583
Abstract: Hypertension (HTN) is a chronic condition that requires careful monitoring and management. Blood pressure readings in the clinic and self-reported blood pressure readings are often too intermittent to allow for careful management. Remote patient monitoring is a solution that may have positive impacts on HTN management. Individuals at cardiac and primary care clinics were prescribed a remote patient-monitoring (RPM) program. Patients were sent blood pressure monitors that were enabled to transmit data over cellular networks. We reviewed trends in HTN management retrospectively in patients who had previously been on conventional therapy for a year and participated in RPM for a minimum of 90 days. There were 6595 patients enrolled, and the mean duration on RPM was 289 days. A total of 4370 participants (66.3%) had uncontrolled HTN, and 2476 (37.5%) had stage 2 HTN. After at least 90 days on the RPM program, the number of patients with uncontrolled HTN reduced to 2648 (40.2%, p < 0.01), and the number of patients with stage 2 HTN reduced to 1261 (19.1%, p < 0.01). Systolic blood pressure improved by 7.3 mmHg for all patients and 16.7 mmHg for stage 2 HTN. There was improvement in mean arterial pressure (MAP) in all patients with uncontrolled HTN by 8.5 mmHg (p < 0.0001). RPM is associated with improved HTN control and provides further evidence supporting telehealth programs which can aid in chronic disease management.
Citation: Healthcare
PubDate: 2024-08-09
DOI: 10.3390/healthcare12161583
Issue No: Vol. 12, No. 16 (2024)
- Healthcare, Vol. 12, Pages 1584: Spiritual Care for Cancer Patients at the
End-of-Life
Authors: Gema Bacoanu, Vladimir Poroch, Maria-Gabriela Aniței, Mihaela Poroch, Eliza Maria Froicu, Bianca Hanganu, Beatrice-Gabriela Ioan
First page: 1584
Abstract: Background: Spiritual care for patients at the end of life is an important element in their holistic care. The aim of this study is to assess the opinions of cancer patients with limited prognosis about the importance of faith in fighting illness and the factors contributing to a better adjustment to illness and to their self-reconciliation and spiritual well-being. Material and Methods: This study used a specially designed questionnaire for cancer patients with limited prognosis. The 30 respondents were patients with an estimated prognosis of less than 1 month, cared for in a unit with palliative and home care beds. Results: The patients emphasized the importance of family as a supporter in the fight against disease (90%), followed by faith (66.7%) and a care team (63.3%). The most common concerns expressed were related to the course of their disease, family distress, fear of death, and the Russian–Ukrainian war. Conclusion: Family and faith represent important factors in supporting and caring for a patient at the end-of-life. Patients who felt spiritually at peace and were supported in their faith by family and a priest had a better spiritual state.
Citation: Healthcare
PubDate: 2024-08-09
DOI: 10.3390/healthcare12161584
Issue No: Vol. 12, No. 16 (2024)
- Healthcare, Vol. 12, Pages 1585: Ethical and Legal Challenges in Caring
for Older Adults with Multimorbidities: Best Practices for Nurses
Authors: Abdulaziz M. Alodhialah, Ashwaq A. Almutairi, Mohammed Almutairi
First page: 1585
Abstract: This study explores the ethical and legal challenges faced by nurses in caring for older adults with multimorbidities, focusing on issues related to patient autonomy, polypharmacy, and end-of-life care. Through semi-structured interviews with 15 nurses in Riyadh, Saudi Arabia, the research highlights the complexities of obtaining informed consent from patients with cognitive impairments and the ethical dilemmas of balancing autonomy and safety. The management of polypharmacy emerged as a significant concern, with nurses emphasizing the importance of thorough documentation and coordination among healthcare providers to prevent adverse drug interactions. End-of-life care and advance directives posed further challenges, particularly when family members disagreed with patients’ documented wishes. The study underscores the need for comprehensive strategies, including ongoing education, clear communication, and supportive institutional policies, to address these issues effectively. The findings suggest that enhancing nurses’ understanding of ethical principles and legal requirements is crucial for improving patient care and ensuring compliance with regulatory standards. Future research should aim to develop evidence-based guidelines to support nursing practice in managing these ethical and legal challenges.
Citation: Healthcare
PubDate: 2024-08-09
DOI: 10.3390/healthcare12161585
Issue No: Vol. 12, No. 16 (2024)
- Healthcare, Vol. 12, Pages 1586: Adapting the PEERS® for Young Adults
Program for Autistic Adults across the Lifespan
Authors: Samantha A. Harker, Leslie C. Baxter, Stephen M. Gallegos, Melissa M. Mitchell, Lillian Zerga, Nicole L. Matthews, B. Blair Braden
First page: 1586
Abstract: The Program for the Education and Enrichment of Relational Skills (PEERS®) is an evidence-based intervention developed for autistic individuals to support social communication, peer interactions, independence, and interpersonal relationships. Despite a demonstrated effectiveness for young autistic individuals in the US and several other countries, PEERS has yet to be modified to support the needs of autistic adults across the lifespan. The present study describes how our team sought autistic voices to adapt PEERS for adults of any age. Specifically, we aimed to address the needs of middle-aged and older adults and adapt the curriculum to be more neurodiversity-affirming. Between two cohorts that completed the program consecutively, we evaluated the acceptability of the adapted PEERS program and made refinements based on feedback from autistic participants and their study partners. Results indicated that Cohort 2 reported higher satisfaction with the PEERS components and overall program than Cohort 1, suggesting effective refinement. We present a framework of adaptations that more specifically address the needs of middle-aged and older adults in a neurodiverse-affirming way compared to previous iterations. Our approach to implementing an adapted PEERS curriculum across the adult lifespan may serve as a model for improved clinical care and cultivate the acceptance of neurodiversity in the interpersonal domains of autistic adults’ lives.
Citation: Healthcare
PubDate: 2024-08-09
DOI: 10.3390/healthcare12161586
Issue No: Vol. 12, No. 16 (2024)
- Healthcare, Vol. 12, Pages 1587: Patient Perspectives on Social and
Identity Factors Affecting Multiple Myeloma Care: Barriers and
Opportunities
Authors: Natalia Neparidze, Amandeep Godara, Dee Lin, Hoa H. Le, Karen Fixler, Lisa Shea, Stephanie Everson, Christine Brittle, Kimberly D. Brunisholz
First page: 1587
Abstract: Patients living with multiple myeloma (MM) have a substantial disease burden and face multiple barriers to care. Building upon our previous research using mixed methods, this focus group research aimed to identify patients’ priorities regarding specific social and identity-related needs, map these prioritized needs to the disease journey, and describe patient-generated ideas to improve patient support. Participants noted that patients with MM need a range of emotional, social, and financial support throughout the disease journey. They identified initial MM diagnosis and treatment adherence as two critical points in the MM journey where patients need the most support and assistance. The findings of this research suggest that overall, patients with MM need comprehensive support, ideally from a multidisciplinary team consisting of health care providers, patient advocates, social workers, and psychologists to help patients understand their disease and treatment options, make informed treatment decisions, adhere to treatment, and ultimately reduce their disease burden and improve outcomes. This research revealed that patients with MM need varying types and levels of support, with the most common needs including information on disease and treatment, connections to financial resources and support systems, assistance with navigating insurance options, and transportation and logistical support for medical appointments.
Citation: Healthcare
PubDate: 2024-08-09
DOI: 10.3390/healthcare12161587
Issue No: Vol. 12, No. 16 (2024)
- Healthcare, Vol. 12, Pages 1588: Bullying Behaviors and Stress (Acute and
Perceived) among Undergraduate Nursing and Midwifery Students: The
Moderating Role of Gender and Academic Majors
Authors: Abdulaziz Mofdy Almarwani, Atallah Alenezi, Mohammed Almutairi, Fahad M. Alhowaymel, Naif S. Alzahrani, Hanan F. Alharbi, Abdulaziz Fahad Abaoud
First page: 1588
Abstract: Background: Nursing and midwifery professionals’ well-being may be affected by various factors, including the bullying of new nurses. Purpose: To analyze the relationship between bullying behaviors, perceived stress, and acute stress among undergraduate nursing and midwifery students in Saudi Arabia, as well as the moderating role of gender and academic majors in this relationship. Method: A cross-sectional correlation design was used, and data were collected from 322 undergraduate nursing and midwifery students enrolled in four major nursing universities in Saudi Arabia. Results: Educational level, environment, and personal attacks had a significant negative impact on perceived and acute stress (social and non-social), while hostility toward academic achievement and direct negative behaviors had significant positive impacts on perceived and acute stress (social and non-social). Female nursing students reported a stronger impact of bullying behavior on their perceived stress, while male students reported a greater impact on social and non-social stress. Nursing students reported a stronger impact of bullying on perceived stress, while midwifery students reported a greater impact on social and non-social stress. Discussion: Nursing educators should raise awareness about the harmful effects of bullying and emphasize the importance of creating a safe, supportive learning environment.
Citation: Healthcare
PubDate: 2024-08-09
DOI: 10.3390/healthcare12161588
Issue No: Vol. 12, No. 16 (2024)
- Healthcare, Vol. 12, Pages 1589: Unlocking the Potential of Vessel Density
and the Foveal Avascular Zone in Optical Coherence Tomography Angiography
as Biomarkers in Alzheimer’s Disease
Authors: Iordanis Vagiakis, Christos Bakirtzis, Athina Andravizou, Demetrios Pirounides
First page: 1589
Abstract: Alzheimer’s disease is the most prevalent form of dementia. Apart from its traditional clinical diagnostic methods, novel ocular imaging biomarkers have the potential to significantly enhance the diagnosis of Alzheimer’s disease. Ophthalmologists might be able to play a crucial role in this multidisciplinary approach, aiding in the early detection and diagnosis of Alzheimer’s disease through the use of advanced retinal imaging techniques. This systematic literature review the utilization of optical coherence tomography angiography biomarkers, specifically vessel density and the foveal avascular zone, for the diagnosis of Alzheimer’s disease. A comprehensive search was performed across multiple academic journal databases, including 11 relevant studies. The selected studies underwent thorough analysis to assess the potential of these optical coherence tomography angiography biomarkers as diagnostic tools for Alzheimer’s disease. The assessment of vessel density and the foveal avascular zone have emerged as a promising avenue for identifying and diagnosing Alzheimer’s disease. However, it is imperative to acknowledge that further targeted investigations are warranted to address the inherent limitations of the existing body of literature. These limitations encompass various factors such as modest sample sizes, heterogeneity among study populations, disparities in optical coherence tomography angiography imaging protocols, and inconsistencies in the reported findings. In order to establish the clinical utility and robustness of these biomarkers in Alzheimer’s disease diagnosis, future research endeavors should strive to overcome these limitations by implementing larger-scale studies characterized by standardized protocols and comprehensive assessments.
Citation: Healthcare
PubDate: 2024-08-09
DOI: 10.3390/healthcare12161589
Issue No: Vol. 12, No. 16 (2024)
- Healthcare, Vol. 12, Pages 1590: Comfortable Seatbelts for Pregnant Women
with Twins in Japan: A Cross-Sectional Observational Study on Seatbelt
Usage
Authors: Sachi Tsuchikawa, Yui Miyajima, Yumiko Tateoka, Masahito Hitosugi
First page: 1590
Abstract: Optimal seatbelt practices for pregnant women with twins at different gestational ages remain uncertain. To offer recommendations for a comfortable seatbelt system, this cross-sectional observational study explored seatbelt usage and driving habits among women with twins across various pregnancy stages through an online survey that explored driving conditions and comfortable seatbelts at different stages of pregnancy. Women who drove daily before their pregnancy with twins decreased their driving frequency as the pregnancy progressed. Correct seatbelt usage was lower and no seatbelt usage was higher among pregnant women with twins than those with singleton pregnancies. They adapted their seatbelt-wearing techniques to minimise pressure on the chest in the first and third trimesters and the abdomen from the second trimester onwards. The comfortable seatbelts were those that could alleviate belt pressure, featuring waist belts to reduce pressure, wider belts to avoid localised pressure, and shoulder belts resembling a backpack type. When wearing a seatbelt, avoiding pressure on the thorax and abdomen is key for pregnant women with twins. This study suggests that the suitability of driving for pregnant women with twins in their last trimester and the reliability of seatbelts designed for such women should be further examined and validated.
Citation: Healthcare
PubDate: 2024-08-09
DOI: 10.3390/healthcare12161590
Issue No: Vol. 12, No. 16 (2024)
- Healthcare, Vol. 12, Pages 1591: Caregiver Burden among Patients with
Authors: Shailja Vaghela, Verna L. Welch, Anup Sinh, Manuela Di Fusco
First page: 1591
Abstract: Influenza and influenza-like illness (ILI) pose significant clinical and economic burdens globally each year. This systematic literature review examined quantitative studies evaluating the impact of patients’ influenza/ILI on their caregivers’ well-being, focusing on health-related quality of life (HRQoL), work productivity, and activity impairment. A comprehensive search across six databases, including the Cochrane Database of Systematic Reviews, Embase, MEDLINE via PubMed, Ovid, PsycNet, and Web of Science, yielded 18,689 records, of which 13,156 abstracts were screened, and 662 full-text articles were reviewed from January 2007 to April 2024. Thirty-six studies [HRQoL: 2; productivity: 33; both: 1] covering 22 countries were included. Caregivers of 47,758 influenza or ILI patients across 123 study cohorts were assessed in the review. The mean workday loss among caregivers ranged from 0.5 to 10.7 days per episode, influenced by patients’ influenza status (positive or negative), disease severity (mild or moderate-to-severe), age, viral type (influenza A or B), and vaccination/treatment usage. The HRQoL of caregivers, including their physical and emotional well-being, was affected by a patient’s influenza or ILI, where the severity and duration of a patient’s illness were associated with worse HRQoL. This review shows that the consequences of influenza or ILI significantly affect not only patients but also their caregivers.
Citation: Healthcare
PubDate: 2024-08-09
DOI: 10.3390/healthcare12161591
Issue No: Vol. 12, No. 16 (2024)
- Healthcare, Vol. 12, Pages 1592: Population-Level Impacts of Alcohol Use
on Mental and Physical Health Outcomes
Authors: Janet L. Fanslow, Ladan Hashemi, Pauline J. Gulliver, Tracey K. D. McIntosh, David A. L. Newcombe
First page: 1592
Abstract: This study explores patterns of alcohol drinking within a representative New Zealand sample (2887 participants (1464 female, 1423 male)). Alcohol use and drinking patterns across the population are described. Multivariable logistic regressions document associations between alcohol use and drinking patterns and the likelihood of experiencing different health outcomes. Alcohol use, early drinking initiation, frequent drinking, and heavy episodic drinking (HED) are prevalent in New Zealand and vary in relation to gender, age, and socioeconomic characteristics. Those who reported alcohol-related problems were more likely to report poor mental health (AOR: 2.21; 95% CI: 1.42–3.46) and disability (AOR: 1.79, 95% CI: 1.06–3.00), and less likely to experience positive mental health (AOR: 0.28, 95% CI: 0.18–0.42). Those who reported HED were also less likely to experience good general health (AOR: 0.61, 95% CI: 0.47–0.81) and positive mental health (AOR: 0.67, 95% CI: 0.53–0.84). Younger age cohorts were more likely to engage in early drinking, and those who initiated regular drinking before age 18 were more likely to report HED and alcohol-related problems. Findings indicate that problem drinking and HED are not only associated with poor physical health, but also reduce the likelihood of individuals experiencing positive mental health. This provides information to enable public health practitioners to target alcohol prevention strategies at the entire population of drinkers.
Citation: Healthcare
PubDate: 2024-08-09
DOI: 10.3390/healthcare12161592
Issue No: Vol. 12, No. 16 (2024)
- Healthcare, Vol. 12, Pages 1593: Therapeutic Obstinacy in End-of-Life
Care—A Perspective of Healthcare Professionals from Romania
Authors: Gema Bacoanu, Vladimir Poroch, Maria-Gabriela Aniței, Mihaela Poroch, Eliza Maria Froicu, Alina Mihaela Pascu, Beatrice Gabriela Ioan
First page: 1593
Abstract: Background: End-of-life care raises ethical, moral, legal and economic dilemmas, especially when physicians have to decide whether to initiate or to stop treatments that may be considered disproportionate and futile. Aim: To explore the opinion of health care professionals involved in end-of-life patient care on interventions considered disproportionate and futile at this stage of care, the causes and factors of pressure leading to such situations, and possible solutions to reduce the phenomenon. Material and method: The study used an adapted, designed questionnaire intended for health professionals caring for patients at the end of life. The 128 respondents were physicians, nurses, psychologists and social workers who expressed their opinions about therapeutic obstinacy in end-of-life care. Results: The results of the research highlight the role of the family as a pressure factor, the causes related to the non-acceptance of the prognosis and diagnosis of a terminal condition, fear of death and ignorance of the patient’s wishes. Interventions considered disproportionate at the end of life were cardiopulmonary resuscitation, mechanical ventilation, transfusion of blood derivatives, complex diagnostic investigations and the establishment of gastrostomy/jejunostomy in the last days of life. Conclusions: End-of-life therapeutic obstinacy is a reality in end-of-life care, and healthcare professionals face many ethical challenges in this process. Care decisions must be made together with the patient and their family, respecting the rights, dignity and respect of all parties involved in the process.
Citation: Healthcare
PubDate: 2024-08-10
DOI: 10.3390/healthcare12161593
Issue No: Vol. 12, No. 16 (2024)
- Healthcare, Vol. 12, Pages 1594: ChatGPT as an Information Source for
Patients with Migraines: A Qualitative Case Study
Authors: Pascal Schütz, Sina Lob, Hiba Chahed, Lisa Dathe, Maren Löwer, Hannah Reiß, Alina Weigel, Joanna Albrecht, Pinar Tokgöz, Christoph Dockweiler
First page: 1594
Abstract: Migraines are one of the most common and expensive neurological diseases worldwide. Non-pharmacological and digitally delivered treatment options have long been used in the treatment of migraines. For instance, migraine management tools, online migraine diagnosis or digitally networked patients have been used. Recently, applications of ChatGPT are used in fields of healthcare ranging from identifying potential research topics to assisting professionals in clinical diagnosis and helping patients in managing their health. Despite advances in migraine management, only a minority of patients are adequately informed and treated. It is important to provide these patients with information to help them manage the symptoms and their daily activities. The primary aim of this case study was to examine the appropriateness of ChatGPT to handle symptom descriptions responsibly, suggest supplementary assistance from credible sources, provide valuable perspectives on treatment options, and exhibit potential influences on daily life for patients with migraines. Using a deductive, qualitative study, ten interactions with ChatGPT on different migraine types were analyzed through semi-structured interviews. ChatGPT provided relevant information aligned with common scientific patient resources. Responses were generally intelligible and situationally appropriate, providing personalized insights despite occasional discrepancies in interaction. ChatGPT’s empathetic tone and linguistic clarity encouraged user engagement. However, source citations were found to be inconsistent and, in some cases, not comprehensible, which affected the overall comprehensibility of the information. ChatGPT might be promising for patients seeking information on migraine conditions. Its user-specific responses demonstrate potential benefits over static web-based sources. However, reproducibility and accuracy issues highlight the need for digital health literacy. The findings underscore the necessity for continuously evaluating AI systems and their broader societal implications in health communication.
Citation: Healthcare
PubDate: 2024-08-10
DOI: 10.3390/healthcare12161594
Issue No: Vol. 12, No. 16 (2024)
- Healthcare, Vol. 12, Pages 1595: Developing a Theory-Based Instrument for
Pre-Exposure Prophylaxis (PrEP) Uptake in People of Color Using a
Qualitative Approach
Authors: Siddharth Raich, Christopher Johansen, Neeraj Bhandari, Kavita Batra, Manoj Sharma
First page: 1595
Abstract: There is a large disparity in Pre-exposure Prophylaxis (PrEP) utilization among communities of color compared to White Americans. There is also a lack of theory-based survey instruments to measure the underlying reasons for the disparity among communities of color. The purpose of this study was to create an instrument based on a qualitative approach involving community interviews. Semi-structured interviews guided by the Multi-theory Model (MTM) of health behavior change were performed in a sample of 12 members from communities of color. The analysis entailed a directed content analysis along the themes of MTM constructs to develop a survey instrument. The barriers to PrEP that emerged included the cost of PrEP, lack of protection from other sexually transmitted diseases, reduced trust between partners, and the stigma associated with PrEP. The perceived disadvantages included the potential cost of PrEP, partner mistrust when taking PrEP, discussion of sexual behaviors with a provider, and unclear process of acquiring the PrEP prescription. The results guided the development of a survey tool to further investigate aspects of cost, partner relations, stigma, reassurance of safety, and other factors. The tool can be used for future studies as part of guided interventions to increase PrEP uptake.
Citation: Healthcare
PubDate: 2024-08-10
DOI: 10.3390/healthcare12161595
Issue No: Vol. 12, No. 16 (2024)
- Healthcare, Vol. 12, Pages 1496: Effects of Immunotherapy on
Quality-of-Life Outcomes in Patients with Gastroesophageal Cancers: A
Meta-Analysis of Randomized Controlled Trials
Authors: Kush Gupta, Arya Mariam Roy, Kristopher Attwood, Ryan David Nipp, Sarbajit Mukherjee
First page: 1496
Abstract: Background: Immune checkpoint inhibitors (ICIs) have revolutionized cancer care, with increasing data demonstrating improved survival outcomes using ICIs among patients with advanced gastroesophageal cancer (GEC). ICIs are also associated with a lower incidence of grade ≥ 3 adverse events (AEs) compared to chemotherapy, suggesting that ICIs may have favorable effects on health-related quality of life (HRQoL). This meta-analysis sought to evaluate the effects of ICIs on the HRQoL of patients with advanced GEC. Methods: We conducted an online bibliographic search on Medline via PubMed using MeSH-based terms to retrieve randomized controlled trials (RCTs) that evaluated the effects of ICIs on HRQoL in patients with advanced GEC (we searched for all studies between 2018 and 2021). We included RCTs that incorporated ICIs as part of the intervention arm either as monotherapy (first or second line) or as a combination therapy (first-line) with another ICI or chemotherapy. We combined the HRQoL measures into a meta-analysis using standard random effects models, from which estimates of the average mean difference (MD) were obtained with 95% confidence intervals. We assessed the heterogeneity of the study outcomes using the Q and I2 statistics. Results: We identified 11 phase 3 RCTs that met the inclusion criteria, with a mean enrollment of 820 patients. Eight RCTs used an ICI plus chemotherapy combination in the intervention arm, three had ICIs as monotherapy, and one had doublet ICI therapy in the intervention arm. All RCTs used chemotherapy for the control arm. Collectively, the trials reported 37 HRQoL measures using five different HRQoL tools. The pooled analysis favored the intervention over the control arm in terms of the Functional Assessment of Cancer Therapy-Esophageal (FACT-E) scores [MD 2.7 (95% CI 0.1 to 5.3), p < 0.041]. In a subgroup analysis of eight RCTs comparing combination therapy with ICIs plus chemotherapy versus chemotherapy alone, the effect estimates favored the ICI arm regarding the FACT-E [MD 2.7 (95% CI 0.1 to 5.3), p < 0.041] and the EORTC QLQ-OES18 pain scale [MD −2.2 (95% CI −4.3 to −0.2), p < 0.030]. Likewise, the effect estimates favored the ICI monotherapy arm over the chemotherapy arm regarding the QLQ-STO22 hair loss subscale [MD −23.2 (95% CI −29.7 to −16.7), p < 0.001], QLQ-STO22 dysphagia subscale [MD 6.7 (95% CI 1.7 to 11.7), p = 0.009], EQ-5D pain scale [MD 6.9 (95% CI 2.9 to 10.9), p < 0.001], and QLQ-OES18 saliva subscale [MD 5.8 (95% CI 0.1 to 11.6), p = 0.046]. Conclusions: In this meta-analysis, we found that the inclusion of ICIs as a first-line treatment for advanced GEC yielded better HRQoL outcomes than chemotherapy alone. Further research on the impact of ICIs on HRQoL is needed, with increasing evidence that ICIs improve the survival outcomes in patients with advanced GEC.
Citation: Healthcare
PubDate: 2024-07-28
DOI: 10.3390/healthcare12151496
Issue No: Vol. 12, No. 15 (2024)
- Healthcare, Vol. 12, Pages 1497: Machine Learning-Based Prediction of
Readmission Risk in Cardiovascular and Cerebrovascular Conditions Using
Patient EMR Data
Authors: Prasad V. R. Panchangam, Tejas A, Thejas B U, Michael J. Maniaci
First page: 1497
Abstract: The primary objective of this study was to develop a risk-based readmission prediction model using the EMR data available at discharge. This model was then validated with the LACE plus score. The study cohort consisted of about 310,000 hospital admissions of patients with cardiovascular and cerebrovascular conditions. The EMR data of the patients consisted of lab results, vitals, medications, comorbidities, and admit/discharge settings. These data served as the input to an XGBoost model v1.7.6, which was then used to predict the number of days until the next readmission. Our model achieved remarkable results, with a precision score of 0.74 (±0.03), a recall score of 0.75 (±0.02), and an overall accuracy of approximately 82% (±5%). Notably, the model demonstrated a high accuracy rate of 78.39% in identifying the patients readmitted within 30 days and 80.81% accuracy for those with readmissions exceeding six months. The model was able to outperform the LACE plus score; of the people who were readmitted within 30 days, only 47.70 percent had a LACE plus score greater than 70, and, for people with greater than 6 months, only 10.09 percent had a LACE plus score less than 30. Furthermore, our analysis revealed that the patients with a higher comorbidity burden and lower-than-normal hemoglobin levels were associated with increased readmission rates. This study opens new doors to the world of differential patient care, helping both clinical decision makers and healthcare providers make more informed and effective decisions. This model is comparatively more robust and can potentially substitute the LACE plus score in cardiovascular and cerebrovascular settings for predicting the readmission risk.
Citation: Healthcare
PubDate: 2024-07-28
DOI: 10.3390/healthcare12151497
Issue No: Vol. 12, No. 15 (2024)
- Healthcare, Vol. 12, Pages 1498: Motivational Barriers and Facilitators
for Older Adults’ Engagement in Exercise during Depressive Episodes:
A Network Meta-Analysis of Randomized Controlled Trials
Authors: Mei-Ling Dai, Berne Ting, Ikbal Andrian Malau, Suet-Kei Wu, Chia-Ching Lin, Pan-Yen Lin, Min-Hsiung Chen
First page: 1498
Abstract: This study aims to assess the motivational factors influencing the participation of older adults in various exercise interventions during depressive episodes and to identify which types of exercise are most effective in alleviating depressive symptoms in this population. Therefore, randomized controlled trials (RCTs) focusing on exercise interventions and their impact on depression in older adult patients, identified by the terms “exercise” AND “depression” AND “elderly” OR “geriatric”, were selected from primary electronic databases to conduct this network meta-analysis (NMA). The primary outcome was the effect on depressive symptoms, while the secondary outcome was the comparison of dropout rates between the intervention groups and the usual care control groups, as a measure of sustained motivation and engagement. Standardized mean difference (SMD) values and the corresponding 95% confidence intervals (CIs) were computed for effect evaluation. This study protocol has been registered in IPLASY (INPLASY 202460035). The results of 31 RCTs with 3238 participants indicated that qigong (SMD −1.17, −2.28 to −0.06), Otago Exercise (SMD −1.15, −2.29 to −0.01), and yoga (SMD −0.88, −1.55 to −0.21) significantly alleviate depressive symptoms in older adults. Walking (SMD −0.82, −1.34 to −0.31) and strength training (SMD −0.67, −1.05 to −0.30) also showed significant effects. Aerobic, physical training, and tai chi had moderate effects, while multisport showed a weaker impact with no significant improvement. In summary, our research findings demonstrate that exercise can effectively alleviate depressive symptoms in older adults, with low dropout rates likely due to interconnected physiological, psychological, and social mechanisms. This is crucial for enhancing treatment strategies for older adults’ depression.
Citation: Healthcare
PubDate: 2024-07-28
DOI: 10.3390/healthcare12151498
Issue No: Vol. 12, No. 15 (2024)
- Healthcare, Vol. 12, Pages 1499: Exploration of Therapeutic Strategies of
Herbal Prescriptions for Carbuncle Treatment to Suggest Modern Approaches
to Inflammatory Bowel Disease: Cluster and Network Analyses of the Book
«Liu Juan Zi Gui Yi Fang»
Authors: Dasol Park, Heonyoung Jeong, Jungtae Leem
First page: 1499
Abstract: Inflammatory bowel disease (IBD) treatments in East Asian traditional medicine (EATM) originate from principles for treating abscesses and carbuncles. Understanding the therapeutic principles of Liu Juan Zi Gui Yi Fang (GYF) is essential for optimizing EATM treatment strategies for IBD, but quantitative analysis is lacking. This study aims to extract quantitative information on therapeutic strategies from GYF and present the EATM conceptual framework for IBD treatment. Oral prescriptions for carbuncles were selected, and their constituent herbs and indications were standardized and tokenized for analysis. An EATM expert group classified prescriptions based on the similarity of herbs and indications. Hierarchical and k-means cluster analyses were performed based on herb similarity. The herb–indication (H-I) network for all prescriptions was constructed. Additionally, H-I subnetworks based on the expert group’s classifications and the k-means clustering results were constructed and compared to identify treatment goals and the herbs used for each goal. The results showed that the treatment focused on abscess status, wound healing, and patient’s recovery capacity, with ‘fever’ and ‘deficiency’ as the main indications addressed by tonifying and anti-inflammatory herbs. The therapeutic principles identified in this study can serve as a foundation for developing future herbal intervention units. Further preclinical and clinical research is needed to validate these findings.
Citation: Healthcare
PubDate: 2024-07-28
DOI: 10.3390/healthcare12151499
Issue No: Vol. 12, No. 15 (2024)
- Healthcare, Vol. 12, Pages 1500: A Study on the Effectiveness of VR
Rehabilitation Training Content for Older Individuals with Total Knee
Replacement: Pilot Study
Authors: DooChul Shin, SoungKyun Hong
First page: 1500
Abstract: There is a paucity of research applying fully immersive virtual reality (VR) training to older adults with degenerative joint disease. This study investigated the effects of a training program utilizing fully immersive VR games on proprioception and gait ability in older patients with degenerative arthritis who had undergone total knee arthroplasty. This randomized controlled trial enrolled patients aged ≥65 years who were diagnosed with knee joint arthritis and had undergone knee arthroplasty followed by physical therapy. Participants were randomly assigned to an experimental group (receiving training using fully immersive VR games along with regular physical therapy) and a control group (receiving only regular physical therapy). The intervention was conducted five times a week for four weeks. Knee joint proprioception was measured using Biodex before and after the intervention. Spatial–temporal gait variables were collected using OptoGait for gait assessment. There was a significant decrease in the absolute error values of proprioception after the intervention in the experimental group, compared to before (p < 0.05), indicating improvement in proprioception. Gait speed, step count, and stride length improved significantly (p < 0.05, p < 0.01), demonstrating an enhancement in gait ability. The experimental group showed significantly greater improvements in gait speed, step count, and stride length than the control group (p < 0.01). Training using a fully immersive VR exercise program may have potential benefits for improving proprioception and gait parameters in patients who have undergone total knee arthroplasty. Fully immersive VR game-based training can be utilized as an effective rehabilitation intervention for patients undergoing knee arthroplasty in the future.
Citation: Healthcare
PubDate: 2024-07-29
DOI: 10.3390/healthcare12151500
Issue No: Vol. 12, No. 15 (2024)
- Healthcare, Vol. 12, Pages 1501: Analysis of Urinary Incontinence in the
Neurogenic Bladder and Its Relationship with the Satisfaction and
Lifestyle of People with SCI
Authors: Lorena Gomes Neves Videira, Letícia Noelle Corbo, Marla Andreia Garcia de Avila, Giovana Pelosi Martins, Soraia Dornelles Schoeller, Christoph Kappler, Fabiana Faleiros
First page: 1501
Abstract: One of the most common complications of neurogenic bladder secondary to spinal cord injury (SCI) is urinary incontinence, which is possibly related to bladder-emptying methods and changes in quality of life. This study aimed to identify the occurrence of this complication in adults with SCI and analyze its relationship with bladder-emptying methods, satisfaction, and lifestyle. This is a quantitative, exploratory, and cross-sectional study. The variables were collected using the Bowel and Bladder Treatment Index during a telephone interview with 290 participants from February to November 2021. According to the results, 70% of the participants were male and 74.1% performed clean intermediate catheterization (CIC) as the main bladder-emptying method. Moreover, 55.6% were considered incontinent in the last year. Emptying by normal urination and bladder reflex triggering had a statistically significant relationship with urinary incontinence. A statistical association was observed between all the variables of satisfaction and lifestyle with urinary incontinence. Although CIC reduced urine leakage, a considerable number of participants still presented with frequent urine leakage. Urinary incontinence had a negative impact on satisfaction with the bladder-emptying method, effectiveness of bladder management, quality of life, and personal and social relationships.
Citation: Healthcare
PubDate: 2024-07-29
DOI: 10.3390/healthcare12151501
Issue No: Vol. 12, No. 15 (2024)
- Healthcare, Vol. 12, Pages 1502: Perceptions of the Impact of Artificial
Intelligence among Internal Medicine Physicians as a Step in Social
Responsibility Implementation: A Cross-Sectional Study
Authors: Luminița-Mihaela Dumitrașcu, Delia-Andreea Lespezeanu, Corina-Aurelia Zugravu, Ciprian Constantin
First page: 1502
Abstract: Artificial Intelligence (AI) has emerged as an essential tool in healthcare for optimizing healthcare delivery and improving patient outcomes. This study is motivated by using AI in healthcare as a step for social responsibility implementation. The research aimed to investigate the attitudes of healthcare professionals on this issue, and it assessed physicians’ opinions regarding their perceptions of AI and their intention to use and implement AI tools in their activity. An electronic survey was proposed during February–June 2024 to a sample of healthcare professionals (309 were admitted into the study, 62 males and 247 females, with a mean age of 42). The results of the survey highlighted both groups’ excellent perceptions of AI and the low perceived knowledge of AI, which arises from more technical questions. The use of AI in healthcare represents a step for social responsibility implementation; it is an unstoppable process, and stakeholders should take into consideration investing more in monitoring and training activities.
Citation: Healthcare
PubDate: 2024-07-29
DOI: 10.3390/healthcare12151502
Issue No: Vol. 12, No. 15 (2024)
- Healthcare, Vol. 12, Pages 1503: The Effectiveness of Exercise Programs in
Adolescents with Thoracic Kyphosis: A Narrative Review
Authors: Seoyon Yang, You Gyoung Yi, Min Cheol Chang
First page: 1503
Abstract: Thoracic kyphosis is a common postural problem affecting over 20% of adolescents. This condition can contribute to various spinal problems, leading to a decreased ability to perform daily activities, reduced quality of life, and impaired pulmonary function. This review aimed to investigate the effectiveness of exercise programs in adolescents with thoracic kyphosis. We systematically searched the PubMed, Embase, Cochrane Library, and Scopus databases for articles relevant to adolescents with thoracic kyphosis that had been published up to 14 May 2024. Our inclusion criteria focused on studies investigating the effects of exercise on improving thoracic kyphosis. A total of 1883 articles was identified using the search terms. After the titles and abstracts had been screened, 1868 articles were found not to meet our inclusion criteria and were excluded. The remaining 15 articles were then assessed for eligibility. Finally, only seven studies were included in this systematic review. Exercises targeting the entire spinal curvature demonstrated efficacy in enhancing the strength and function of the cervical, thoracic, lumbar, and pelvic muscles, resulting in a corrective effect on thoracic kyphosis in adolescents. Consequently, exercise programs have emerged as potentially beneficial treatment approaches to improve poor posture and reduce adolescent thoracic kyphosis.
Citation: Healthcare
PubDate: 2024-07-29
DOI: 10.3390/healthcare12151503
Issue No: Vol. 12, No. 15 (2024)
- Healthcare, Vol. 12, Pages 1504: Transition, Adjustment, and Healthcare
Avoidance: African Immigrant Women’s Experiences and Perceptions of
Navigating Primary Healthcare in the USA
Authors: Gashaye M. Tefera, Mansoo Yu, Erin L. Robinson, Virginia Ramseyer Winter, Tina Bloom
First page: 1504
Abstract: This study explores the transition and adjustment of African immigrant women, particularly Ethiopian immigrant women (EIW), as they navigate the U.S. healthcare system and their ability to access and utilize healthcare services. A qualitative cross-sectional design with a mix of purposive and snowball sampling techniques was utilized to recruit EIW (N = 21, ≥18 years) who arrived in the U.S. within the last five years. One-on-one in-depth interviews were conducted to collect data. The interviews were audio-recorded, transcribed verbatim, and analyzed thematically using Nvivo12 software. The thematic analysis revealed three major themes: (1) settling into new life in the U.S. delays EIWs’ ability to access primary healthcare; (2) adjusting to the U.S. healthcare system: confusions and mixed perceptions; and (3) avoidance of care: EIW’s reasons for PHC visits changed in the U.S. Participants avoided healthcare, except for life-threatening conditions, general check-ups, and maternal healthcare services. Transitional support for legal, residential, employment, and health information could help tackle the challenges of accessing primary healthcare for EIW. Future research should analyze access to healthcare in relation to the everyday struggles of immigrant women, as well as legal and complex structural issues beyond acculturative issues.
Citation: Healthcare
PubDate: 2024-07-29
DOI: 10.3390/healthcare12151504
Issue No: Vol. 12, No. 15 (2024)
- Healthcare, Vol. 12, Pages 1505: Factors Associated with Uptake of Patient
Portals at a Federally Qualified Health Care Center
Authors: Alicia K. Matthews, Alana D. Steffen, Jennifer Akufo, Larisa Burke, Hilda Diaz, Darcy Dodd, Ashley Hughes, Samantha Madrid, Enuma Onyiapat, Hope Opuada, Jessica Sejo, Brittany Vilona, Barbara J. Williams, Geri Donenberg
First page: 1505
Abstract: Federally qualified health centers (FQHC) aim to improve cancer prevention by providing screening options and efforts to prevent harmful behavior. Patient portals are increasingly being used to deliver health promotion initiatives. However, little is known about patient portal activation rates in FQHC settings and the factors associated with activation. This study examined patient portal activation among FQHC patients and assessed correlations with demographic, clinical, and health service use variables. We analyzed electronic health record data from adults >18 years old with at least one appointment. Data were accessed from the electronic health records for patients seen between 1 September 2018 and 31 August 2022 (n = 40,852 patients). We used multivariate logistic regression models to examine the correlates of having an activated EPIC-supported MyChart patient portal account. One-third of patients had an activated MyChart portal account. Overall, 35% of patients with an activated account had read at least one portal message, 69% used the portal to schedule an appointment, and 90% viewed lab results. Demographic and clinical factors associated with activation included younger age, female sex, white race, English language, being partnered, privately insured, non-smoking, and diagnosed with a chronic disease. More frequent healthcare visits were also associated with an activated account. Whether or not a patient had an email address in the EHR yielded the strongest association with patient portal activation. Overall, 39% of patients did not have an email address; only 2% of those patients had activated their accounts, compared to 54% of those with an email address. Patient portal activation rates were modest and associated with demographic, clinical, and healthcare utilization factors. Patient portal usage to manage one’s healthcare needs is increasing nationally. As such, FQHC clinics should enhance efforts to improve the uptake and usage of patient portals, including educational campaigns and eliminating email requirements for portal activation, to reinforce cancer prevention efforts.
Citation: Healthcare
PubDate: 2024-07-30
DOI: 10.3390/healthcare12151505
Issue No: Vol. 12, No. 15 (2024)
- Healthcare, Vol. 12, Pages 1506: A Case Report and Review of the
Literature of ICU Delirium
Authors: Alejandro E. Brice, Roanne G. Brice
First page: 1506
Abstract: This case report focuses on what patients and family members may experience when a neurological trauma transpires and resultant intensive care (ICU) delirium occurs. It is the personal account of the patient (A.B.) and spouse’s (R.G.B.) perspectives when the patient (A.B) suffered a vertebral artery aneurysm and hemorrhage and experienced intensive care unit (ICU) delirium after being in the ICU for 22 days. This case report provides the patient’s and spouse’s perspectives regarding delirium, i.e., A.B.’s inability to discern reality, loss of memory, paranoia and hallucinations, agency and recovery, post-ICU syndrome, and post-traumatic stress disorder (PTSD). Clinical diagnosis by the neurosurgeon indicated delirium, with treatment consisting of sleep sedation and uninterrupted sleep. A.B. was able to regain consciousness yet experienced post-traumatic stress disorder up to one year afterward. Consistent family participation in the patient’s delirium care is crucial. Family member care and family-centered strategies are provided with implications for future research and health care.
Citation: Healthcare
PubDate: 2024-07-30
DOI: 10.3390/healthcare12151506
Issue No: Vol. 12, No. 15 (2024)
- Healthcare, Vol. 12, Pages 1507: The Connection between Sleep Patterns and
Mental Health: Insights from Rural Chinese Students
Authors: Jiayang Lyu, Songqing Jin, Chen Ji, Ru Yan, Cindy Feng, Scott Rozelle, Huan Wang
First page: 1507
Abstract: Background: The association between sleep patterns and young students’ mental health, which is crucial for their development, remains understudied in rural China. Therefore, the relationship between sleep patterns and mental health among primary and junior high school students in rural China was examined. Method: A total of 1592 primary and junior high school students from rural areas of Gansu Province were surveyed, and the Depression Anxiety and Stress Scale (DASS) was utilized to assess mental health, alongside self-reported data on their daily sleep patterns. Results: Significant sleep inadequacies were identified: 28% of students received less than 8 h of sleep on weekdays, and 19% went to bed later than recommended. On weekends, 38% of students had delayed bedtimes, though only 7.2% received less than 8 h of sleep. Notably, a “U-shaped” relationship was uncovered between sleep duration and mental health for students on weekends, with optimal mental health correlated with receiving 10–11 h of sleep, while both shorter and longer sleep durations on weekends worsened outcomes. This pattern is absent on weekdays. Additionally, adequate sleep and an earlier bedtime was linked to a 6–8% decrease in mental health risks. Conclusions: These findings provide valuable insights for policymakers seeking to enhance student mental well-being in rural settings, emphasizing the importance of implementing measures that promote balanced sleep habits among young students.
Citation: Healthcare
PubDate: 2024-07-30
DOI: 10.3390/healthcare12151507
Issue No: Vol. 12, No. 15 (2024)
- Healthcare, Vol. 12, Pages 1508: Computer Simulation of Catheter
Cryoablation for Pulmonary Vein Isolation
Authors: Solange I. Rivera, Clara P. Bernal, Rafael Martínez-Peláez, Rogelio Robledo-Nolasco, Gerardo De León-Larios, Vanessa G. Félix, Rodolfo Ostos, Gladys E. Maestre, Jesús D. Melgarejo, Luis J. Mena
First page: 1508
Abstract: Cryoablation is a well-established medical procedure for surgically treating atrial fibrillation. Cryothermal catheter therapy induces cellular necrosis by freezing the insides of pulmonary veins, with the goal of disrupting abnormal electrical heart signals. Nevertheless, tissue damage induced by cold temperatures may also lead to other complications after cardiac surgery. In this sense, the simulation of catheter ablation can provide safer environments for training and the performance of cryotherapy interventions. Therefore, in this paper, we propose a novel approach to help better understand how temperature rates can affect this procedure by using computer tools to develop a simulation framework to predict lesion size and determine optimal temperature conditions for reducing the risk of major complications. The results showed that a temperature profile of around −40 °C caused less penetration, reduced necrotic damage, and smaller lesion size in the tissue. Instead, cryotherapy close to −60 °C achieved a greater depth of temperature flow inside the tissue and a larger cross-section area of the lesion. With further development and validation, the framework could represent a cost-effective strategy for providing personalized modeling, better planning of cryocatheter-based treatment, and preventing surgical complications.
Citation: Healthcare
PubDate: 2024-07-30
DOI: 10.3390/healthcare12151508
Issue No: Vol. 12, No. 15 (2024)
- Healthcare, Vol. 12, Pages 1509: Successful Intraosseous (IO) Adenosine
Administration for the Termination of Supraventricular Tachycardia (SVT)
in a 3.5-Year-Old Child—Case Report and Literature Review
Authors: Jakub Zachaj, Łukasz Kręglicki, Tomasz Sikora, Katarzyna Moorthi, Filip Jaśkiewicz, Klaudiusz Nadolny, Robert Gałązkowski
First page: 1509
Abstract: Paediatric supraventricular tachycardia (SVT) is a common arrhythmia of great clinical significance. If not treated promptly, it can cause heart failure and cardiogenic shock. Depending on the patient’s condition, SVT treatment involves vagal manoeuvres, pharmacological, or direct current cardioversion. The goal of acute SVT management is to immediately convert SVT to a normal sinus rhythm (NSR) and prevent its recurrence. Adenosine is recommended as the first-line treatment for stable SVT by the European Resuscitation Council (ERC) and American Heart Association (AHA) guidelines, when vagal manoeuvres have proven ineffective. The ERC and AHA guidelines recommend the intravenous route of administration. The intraosseous (IO) administration technique is also possible, but still relatively unknown. The aim of this paper is to describe a 3.5-year-old child with SVT that was converted to NSR following IO administration of adenosine. Successful conversion was achieved after the second attempt with the adenosine dose. In the described case, there was no recurrence of SVT.
Citation: Healthcare
PubDate: 2024-07-30
DOI: 10.3390/healthcare12151509
Issue No: Vol. 12, No. 15 (2024)
- Healthcare, Vol. 12, Pages 1510: Cybernetic Principles in
Psychophysiology: Their Significance and Conclusions for Palliative Care
Authors: Michael Brinkers, Giselher Pfau, Beatrice Thielmann, Irina Böckelmann
First page: 1510
Abstract: Palliative care is dedicated to terminally ill patients with advanced disease, regardless of diagnosis, under the overarching premise of optimizing quality of life. This narrative review examines the extent to which principles of cybernetics and psychophysiology underlie this approach. Psychophysiology researches the physiological equivalents of psychological states and traits such as activation and individual reactivity, the interoception and the personal characteristics. Cybernetics specifies these principles, which are possible by understanding terms such as “psychophysiology” or “cybernetics” or “self-organization/autopoiesis”. The meaning of these terms for palliative care can also be elucidated in relation to the terms “biofeedback”, “consciousness”, “pain”, and “anxiety”. The common themes of cybernetics and psychophysiology are environment, subjectivity, personality characteristics, the difference between time scale separation in cybernetic systems, and real-time procedures in environment and rhythm. These lead to special therapies based on psychophysiology, such as consciousness training. The concepts of quality of life, causality, the biopsychosocial model, therapy, and autonomy are examined as palliative care concepts. The equivalents can be described from the perspective of cybernetics. For some palliative care-related terms, cybernetic thinking is already present (quality of life, autonomy, symptom control), while for others, it is not (biopsychosocial). Cybernetic terms (complexity, stability, identity, rhythm) are still used to a lesser extent in palliative care. Terms like genetic basis are common in cybernetics and psychophysiology to explain the identity of the subject in transition. Identity, on the other hand, is the basis of the concept of dignity in palliative care. Psychophysiology investigates disturbances like pain and psychological illnesses, which are also present in palliative care. Psychophysiology, cybernetics, and palliative care have subjectivity and resources in common. Therapies based on cybernetic principles of psychophysiology can also be used for symptom control in palliative care in the oncology setting.
Citation: Healthcare
PubDate: 2024-07-30
DOI: 10.3390/healthcare12151510
Issue No: Vol. 12, No. 15 (2024)
- Healthcare, Vol. 12, Pages 1511: Diagnostic Values of Serum Inflammatory
Biomarkers after Hip and Knee Arthroplasty in Patients with Periprosthetic
Joint Infection
Authors: Bogdan-Axente Bocea, Mihai-Dan Roman, Nicolas Catalin Ionut Ion, Sorin Radu Fleaca, Cosmin-Ioan Mohor, Darius Alexandru Popa, Romeo-Gabriel Mihaila
First page: 1511
Abstract: One of the complications after total hip arthroplasty (THA) or total knee arthroplasty (TKA) is periprosthetic joint infection (PJI). Numerous studies have been performed to explore the value of biological parameters in the early identification of infection rates after THA and TKA. This study investigates alterations in inflammatory markers associated with PJI. This retrospective study focused on a cohort of patients with hip and knee arthroplasty treated between 2016 and 2022. CRP, ESR, and fibrinogen were observed preoperatively, on days one, three, six, and twenty-one postoperatively. From a total of 4076 THA and TKA performed during this period, 62 patients were identified with periprosthetic infections. We also identified the pathogens responsible for infections in order to assess if asymptomatic preoperative infections were involved in PJI. In patients with acute infections following TKA, days one and three postoperative recorded a CRP value below the expected range. The value of CRP in patients with early infection after THA was significantly increased on day six postoperative. ESR and fibrinogen values were not statistically significantly correlated with early PJI. The CRP level in acute PJI shows different patterns than those shown in the literature.
Citation: Healthcare
PubDate: 2024-07-30
DOI: 10.3390/healthcare12151511
Issue No: Vol. 12, No. 15 (2024)
- Healthcare, Vol. 12, Pages 1512: Physical Activity and Perceived Support
among Adolescents According to Sex and Municipality
Authors: Daniel Sanz-Martín, Germán Ruiz-Tendero, José Manuel Alonso-Vargas, Eduardo Melguizo-Ibáñez
First page: 1512
Abstract: A cross-sectional study was conducted with three aims: (1) to determine the degree of compliance with physical activity recommendations among adolescents according to sex and place of residence, (2) to determine the perceived support of family and friends for physical activity among adolescents according to sex and place of residence, and (3) to analyse the influence of family and friends support on compliance with physical activity recommendations among adolescents according to sex and place of residence. A total of 694 adolescents from an inland area of Spain (14.06 ± 1.27 years) participated. Four one-day physical activity questionnaires were administered to assess physical activity and the Parental Support Scale and Peer Support to measure perceived support from family and friends regarding physical activity. Chi-square, Crammer’s V and Student’s tests were calculated to identify differences between variables according to sex and municipality of residence. Moreover, the initial binary logistic regression model was constructed to predict the physical activity compliance. Differences in adherence to physical activity recommendations were found according to the sex of the students (rural area: x2 = 4.192, p < 0.05; V = 0.106, p < 0.05; urban area: x2 = 8.999, p < 0.05; V = 0.167, p < 0.01). There were also sex differences in rural areas on items related to families providing transport (t = 3.878, p ≤ 0.001; d = 0.40) and doing physical activity together (t = 4.974, p ≤ 0.001; d = 0.50). It is concluded that most adolescents do not comply with physical activity recommendations. In addition, 30.4% of urban girls’ compliance was predicted by the perception that their family members saw them doing physical activity and doing it with friends.
Citation: Healthcare
PubDate: 2024-07-30
DOI: 10.3390/healthcare12151512
Issue No: Vol. 12, No. 15 (2024)
- Healthcare, Vol. 12, Pages 1513: Racial Disparities in Bowel Preparation
and Post-Operative Outcomes in Colorectal Cancer Patients
Authors: Alexandra E. Hernandez, Matthew Meece, Kelley Benck, Gianna Bello, Carlos Theodore Huerta, Brianna L. Collie, Jennifer Nguyen, Nivedh Paluvoi
First page: 1513
Abstract: Background: Combined pre-operative bowel preparation with oral antibiotics (OAB) and mechanical bowel preparation (MBP) is the current recommendation for elective colorectal surgery. Few have studied racial disparities in bowel preparation and subsequent post-operative complications. Methods: This retrospective cohort study used 2015–2021 ACS-NSQIP-targeted data for elective colectomy for colon cancer. Multivariate regression evaluated predictors of post-operative outcomes: post-operative ileus, anastomotic leak, surgical site infection (SSI), operative time, and hospital length of stay (LOS). Results: 72,886 patients were evaluated with 82.1% White, 11.1% Black, and 6.8% Asian or Asian Pacific Islander (AAPI); 4.2% were Hispanic and 51.4% male. Regression accounting for age, sex, ASA classification, comorbidities, and operative approach showed Black, AAPI, and Hispanic patients were more likely to have had no bowel preparation compared to White patients receiving MBP+OAB. Compared to White patients, Black and AAPI patients had higher odds of prolonged LOS and pro-longed operative time. Black patients had higher odds of post-operative ileus. Conclusions: Racial disparities exist in both bowel preparation administration and post-operative complications despite the method of bowel preparation. This warrants exploration into discriminatory bowel preparation practices and potential differences in the efficacy of bowel preparation in specific populations due to biological or social differences, which may affect outcomes. Our study is limited by its use of a large database that lacks socioeconomic variables and patient data beyond 30 days.
Citation: Healthcare
PubDate: 2024-07-30
DOI: 10.3390/healthcare12151513
Issue No: Vol. 12, No. 15 (2024)
- Healthcare, Vol. 12, Pages 1514: Overcommitment, Work-Related Behavior,
and Cognitive and Emotional Irritation in Veterinarians: A Comparison of
Different Veterinary Working Fields
Authors: Beatrice Thielmann, Robert Pohl, Irina Böckelmann
First page: 1514
Abstract: Mental health is a serious problem among veterinarians. The aim of this study was to analyze work-related behaviors and experience (AVEM), overcommitment (OC), and cognitive and emotional irritation (IS) in different veterinary working fields. The survey included 724 German veterinarians (average age 41.0 ± 9.72 years). Validated questionnaires were used to assess overcommitment, work-related behavior and experience patterns (health-promoting pattern G or S; health-hazardous risk pattern A or B), and irritation in several working fields. A correlation analysis and a multivariate test were performed. Increased OC was observed in 35.8% of veterinarians (mixed animals vs. inspectors, p = 0.042; small vs. mixed animals, p = 0.001). A total of 66% of veterinarians exhibited AVEM risk pattern A or B. There was no significant association of AVEM risk patterns and veterinary specialty. Only the AVEM dimension “tendency toward resignation in the face of failure” differed among working fields (p = 0.04). Regardless of direct animal contact, German veterinarians showed increased psychological stress. Inadequate compensation and prolonged stress are significant factors that can lead to burnout or depression. These risks should be considered in the context of occupational healthcare.
Citation: Healthcare
PubDate: 2024-07-30
DOI: 10.3390/healthcare12151514
Issue No: Vol. 12, No. 15 (2024)
- Healthcare, Vol. 12, Pages 1515: Clinical Signs and Symptoms of Anxiety
Due to Adverse Childhood Experiences: A Cross-Sectional Trial in
Adolescents
Authors: Aikaterini Marini, Ignatia Farmakopoulou, Ioannis Dritsas, Evgenia Gkintoni
First page: 1515
Abstract: Background: Adverse Childhood Experiences (ACEs) are linked to the development of anxiety in adolescence. According to recent studies, the COVID-19 pandemic represents a novel ACE that is associated with anxiety among adolescents. This study investigates the relationship between ACEs, COVID-19, and anxiety in adolescents. Methods: A cross-sectional study was conducted using a community sample of 248 boys and girls ages 12 to 15 years (mean = 13.50 years) from five high schools in Eastern Attica. A total of four questionnaires were used: (1) Demographic Questionnaire, (2) State–Trait Anxiety Inventory for Children—STAIC, (3) Adverse Childhood Experiences Scale, and (4) COVID-19 Impact Scale. Results: The results demonstrated a moderate association between the total number of ACEs and anxiety (trait and state) in adolescence (trait anxiety: ρ = 0.37, p < 0.001; state anxiety: ρ = 0.29, p < 0.001). Girls scored significantly higher than boys on both trait anxiety (U = 4353, p < 0.001; mean difference = 5.5) and state anxiety (U = 5822.5, p = 0.014; mean difference = 2). The number of ACEs was found to be significantly related to the impact of COVID-19 (β = 0.025, p < 0.001). Conclusions: This study highlights the significant link between ACEs and increased anxiety in adolescents, which is further exacerbated by the COVID-19 pandemic. The findings indicate that girls are more affected than boys. These results emphasize the need for targeted mental health interventions to enhance coping mechanisms, reduce stress, and address anxiety in adolescents, particularly during global crises like the pandemic. Developing such programs is essential for supporting the mental well-being of youth facing multiple stressors.
Citation: Healthcare
PubDate: 2024-07-30
DOI: 10.3390/healthcare12151515
Issue No: Vol. 12, No. 15 (2024)
- Healthcare, Vol. 12, Pages 1516: Are Nurses Aware of Their Contribution to
the Antibiotic Stewardship Programme' A Mixed-Method Study from Qatar
Authors: Nesiya Hassan, Albara Mohammad Ali Alomari, Jibin Kunjavara, Kalpana Singh, George V. Joy, Kamaruddeen Mannethodi, Badriya Al Lenjawi
First page: 1516
Abstract: The antibiotic stewardship programme (ASP) is a new concept initiated by WHO, but nurses are not yet ready to adopt the program. The training and empowerment of nurses are the best strategies for enhancing their knowledge and engagement in ASP. This mixed-method study was used to assess perceived roles and barriers of nurses’ involvement in ASP. An online survey was conducted among 420 clinical nurses to identify their role, and 23 individual interviews were performed among nurses and infection control practitioners to explore the barriers and recommendations to overcome the identified barriers. The majority of the nurses agreed with the sixteen identified roles in ASP, of which ‘antibiotic dosing and de-escalation’ (82.61%), ‘IV to PO conversion of antibiotic, outpatient antibiotic therapy’ (85.23%), and ‘outpatient management, long-term care, readmission’ of the patients (81.19%) had the lowest agreement from the participants. The major themes generated through the qualitative interviews were a lack of knowledge about ASP, poor communication between multidisciplinary teams, lack of opportunity and multidisciplinary engagement, lack of formal education and training about ASP, lack of ASP competency and defined roles in policy, role conflict or power/position, availability of resources, and lack of protected time. Nurses play an integral role in the successful implementation of antibiotic stewardship programs. The empowerment of nurses will help them to adopt the unique role in ASP. Nurses can significantly contribute to antibiotic stewardship efforts and improve patient outcomes through addressing these challenges.
Citation: Healthcare
PubDate: 2024-07-31
DOI: 10.3390/healthcare12151516
Issue No: Vol. 12, No. 15 (2024)
- Healthcare, Vol. 12, Pages 1517: Treatment of Superficial Vein Thrombosis:
Recent Advances, Unmet Needs and Future Directions
Authors: Marcello Di Nisio, Giuseppe Camporese, Pierpaolo Di Micco, Romeo Martini, Walter Ageno, Paolo Prandoni
First page: 1517
Abstract: Once considered relatively benign, superficial vein thrombosis (SVT) of the lower limbs is linked to deep vein thrombosis (DVT) or pulmonary embolism (PE) in up to one fourth of cases. Treatment goals include alleviating local symptoms and preventing SVT from recurring or extending into DVT or PE. Fondaparinux 2.5 mg once daily for 45 days is the treatment of choice for most patients with SVT. Potential alternatives include intermediate-dose low-molecular-weight heparin or the direct oral factor Xa inhibitor rivaroxaban, however, these require further evidence. Despite these treatment options, significant gaps remain, including the role of systemic or topical anti-inflammatory agents alone or combined with anticoagulants, and the optimal duration of anticoagulation for patients at varying risk levels. Additionally, the efficacy and safety of factor Xa inhibitors other than rivaroxaban, management of upper extremity SVT, and optimal treatment for SVT near the sapheno-femoral or sapheno-popliteal junctions are not well understood. This narrative review aims to summarize current evidence on anticoagulant treatment for SVT, highlight key unmet needs in current approaches, and discuss how ongoing studies may address these gaps.
Citation: Healthcare
PubDate: 2024-07-31
DOI: 10.3390/healthcare12151517
Issue No: Vol. 12, No. 15 (2024)
- Healthcare, Vol. 12, Pages 1518: Transforming Veteran Rehabilitation Care:
Learnings from a Remote Digital Approach for Musculoskeletal Pain
Authors: Anabela C. Areias, Dan Doverspike, Daniel F. Brostek, Dora Janela, Michael S. Erwin, John M. Pinter, James R. Ficke, Fabíola Costa
First page: 1518
Abstract: While musculoskeletal pain (MSP) stands as the most prevalent health condition among Veterans, timely and high-quality care is often hindered due to access barriers. Team Red, White & Blue (Team RWB), a nonprofit organization dedicated to promoting a healthier lifestyle among Veterans, aimed to assess innovative approaches to veteran care. This is a single-arm pilot study investigating the feasibility, clinical outcomes, engagement, and satisfaction of a remote multimodal digital care program among Veterans with MSP. The impact of deployment experience on outcomes was explored as a secondary aim. From 75 eligible Veterans, 61 started the program, reporting baseline pain frequently comorbid with mental distress. Program acceptance was suggested by the high completion rate (82%) and engagement levels, alongside high satisfaction (9.5/10, SD 1.0). Significant improvements were reported in all clinical outcomes: pain (1.98 points, 95%CI 0.13; 3.84, p = 0.036); mental distress, with those reporting at least moderate baseline depression ending the program with mild symptoms (8.50 points, 95%CI: 6.49; 10.51, p = 0.012); daily activity impairment (13.33 points, 95%CI 1.31; 25.34, p = 0.030). Deployed Veterans recovered similarly to their counterparts. Overall, the above results underscore the potential of a remote digital intervention to expand Veterans’ access to timely MSP care.
Citation: Healthcare
PubDate: 2024-07-31
DOI: 10.3390/healthcare12151518
Issue No: Vol. 12, No. 15 (2024)
- Healthcare, Vol. 12, Pages 1519: Strengthening the Voices of
Hispanic/Latine Immigrants Managing Chronic Disease: A Mixed Methods
Approach to Understanding Perspectives of Health
Authors: Kathy Zamarripa, Ambria Crusan, Kerrie Roozen, Clara Godoy-Henderson, Angela Evans
First page: 1519
Abstract: Individuals who migrate from their home country face a variety of challenges while adapting to the culture in the United States. Immigrant communities are at a significantly higher risk for poor health outcomes; therefore, assessing healthcare treatment for diverse and resilient immigrant populations, including Hispanic/Latine communities, is crucial to preserving their health, culture, and spirit. A paucity of literature exists surrounding perceptions of well-being in immigrant, Hispanic/Latine adults managing chronic diseases. Past studies have shown a discrepancy between providers’ and patients’ perceptions of healthcare options for overall well-being. We aim to share varying perspectives found within our work geared towards improving the quality of life for Hispanic/Latine immigrants managing chronic disease, especially type 2 diabetes mellitus and hypertension. The primary objective of this article is to strengthen the understanding of intersections between social, physical, financial, and spiritual health within an (im)migrant Hispanic/Latine community using semi-structured ethnographic interviews. These interviews have highlighted community resilience, demonstrating that individuals can adapt to major life transitions while maintaining balance across dimensions of health. This knowledge could be implemented by actively listening to patient concerns regarding their health dimensions to improve individualized and patient-centric care.
Citation: Healthcare
PubDate: 2024-07-31
DOI: 10.3390/healthcare12151519
Issue No: Vol. 12, No. 15 (2024)
- Healthcare, Vol. 12, Pages 1520: Self-Perceived Quality of Life
(WHOQOL-Bref), and Self-Reported Health, Social and Environmental Factors
Related to Its Improvement among Residents of Anil, Rio de
Janeiro—Cross-Sectional Study
Authors: Rosemerie Barros, Alfredo Akira Ohnuma, Maria Conceição Manso
First page: 1520
Abstract: This study aims to assess the self-perception of the QoL (WHOQOL-bref) in the Canal of Anil zone and its neighbor zone of the center of the District of Anil in Rio de Janeiro and to identify which factors are associated with the population self-perception of the need to “improve” their quality of life (QoL). A cross-sectional observational analytical study was carried out after approval by the competent ethics committee (CEP/CONEP) approval. A non-probabilistic sampling of residents of the Canal of Anil (n = 494) and the central district of Anil (n = 250) was used. A questionnaire was administered in person to collect data on self-reported sociodemographic characteristics, general health, sanitation, lifestyle in the residential area, and the WHOQOL-Bref. Although with a worse self-perceived water/sanitation participants in the Anil Canal community report fewer allergies, less medication, fewer skin diseases, less Zika virus, and less Chikungunya, among others. The self-perception of the need to improve the QoL in the Anil Canal community and the zone at the central District of Anil has proved to be influenced by several social and economic factors as well as residential practices and conditions. The multivariate analysis allowed us to identify both modifiable and non-modifiable risk factors for the need to improve physical QoL: taking medication, respiratory problems, skin disease diagnosed by a doctor, having a water tank at home or having filtered water at home, unpleasant odor of the water of the Anil Canal and the level of education, and age. Regarding the need to improve the environmental QoL, both areas are largely modifiable (e.g., having had ascariasis/roundworm; having a water tank in the house; not drinking bottled water; not having pavements in the street). Sociodemographic and environmental factors, in addition to health conditions, play a pivotal role in influencing individuals’ perceptions of the necessity for enhanced physical and environmental well-being.
Citation: Healthcare
PubDate: 2024-07-31
DOI: 10.3390/healthcare12151520
Issue No: Vol. 12, No. 15 (2024)
- Healthcare, Vol. 12, Pages 1521: Evaluating Student Satisfaction and
Self-Confidence in Simulation-Based Anesthesiology Training among
Final-Year Medical Students
Authors: Abdullah Shbeer
First page: 1521
Abstract: Simulation-based training (SBT) is increasingly recognized in medical education for enhancing clinical skills and confidence. This study evaluated the impact of SBT on satisfaction and self-confidence among final-year medical students at Jazan University, Saudi Arabia. A total of 117 students participated in a cross-sectional study after attending SBT sessions focused on anesthesiology. Data were collected via a questionnaire assessing satisfaction and self-confidence. Statistical analyses included descriptive and inferential statistics. Results showed mean satisfaction and self-confidence scores of 3.64 ± 0.79 and 3.70 ± 0.90, respectively, with no significant differences by gender or age. A strong association was noted between the learning experience ratings and both satisfaction and self-confidence (p < 0.001). The highest satisfaction was with the instructor’s teaching style, whereas the lowest was with the motivation provided by teaching materials. For self-confidence, the highest scores related to the instructor’s guidance, while the lowest concerned the application of SBT to critical skills learning. A strong positive correlation was found between satisfaction and self-confidence (R = 0.847, p < 0.001). The study concludes that SBT significantly enhances student satisfaction and self-confidence, emphasizing the importance of learner-centered methods and interactive learning in medical education.
Citation: Healthcare
PubDate: 2024-07-31
DOI: 10.3390/healthcare12151521
Issue No: Vol. 12, No. 15 (2024)
- Healthcare, Vol. 12, Pages 1522: What’s the Impact of Safety
Authors: Alberto Arceri, Antonio Mazzotti, Sofia Gaia Liosi, Simone Ottavio Zielli, Elena Artioli, Davide Golinelli, Lorenzo Brognara, Cesare Faldini
First page: 1522
Abstract: Background: This study aims to assess the impact of safety footwear (SF) on workers concerning foot-related problems, especially regarding discomfort, foot pain, and skin lesions. Methods: A literature search of PubMed, Embase, Scopus, and Cochrane databases was performed according to PRISMA guidelines. Studies reporting foot-related problems in workers wearing SF were included. Exclusion criteria included non-English papers, reviews, laboratory and animal studies, expert opinions, letters to the editor, and grey literature. The quality assessment was performed using the Newcastle–Ottawa Scale. Descriptive statistic was used to present data. Result: The initial search results yielded 483 articles; 7 articles were included in the review process. Despite the extensive variety of SF, all studies consistently reported symptomatic discomfort and pain. The discomfort factors included heat, sweating, heaviness, and footwear flexibility, with primary issues in the toes, toecaps, or metatarsal–toe crease region. The pain prevalence ranged from 42.3% to 60.8% in various anatomical regions. Irritant Contact Dermatitis was the most common (97.9%) foot dermatosis, but other foot lesions were reported: dry skin (30.2%), calluses (30%), hard nails (28%), corns (27%), and blisters. Conclusions: Current SFs are designed to comply with safety regulations but are influenced by the frequent occurrence of discomfort and foot problems. The literature review identified weaknesses in certain design features. Recommendations have been proposed to improve SF development. These include addressing issues such as the selection of specific types and designs of SF based on task performance and the working environment, footwear weight, and breathable materials for moisture permeation. Considerations should also encompass distinct sizing for an optimal fit, insole application, especially for prolonged standing users, and education programs to prevent foot-related issues.
Citation: Healthcare
PubDate: 2024-07-31
DOI: 10.3390/healthcare12151522
Issue No: Vol. 12, No. 15 (2024)
- Healthcare, Vol. 12, Pages 1523: The Perspectives of Individuals with
Chronic Stroke on Motor Recovery: A Qualitative Analysis
Authors: Amelia Cain, Carolee J. Winstein, Marika Demers
First page: 1523
Abstract: The priorities of individuals with chronic stroke are not always reflected in clinical practice. This study provides insight into meaningful factors related to long-term motor recovery in stroke survivors. Thirty individuals with chronic stroke participated in semi-structured interviews about movement, recovery, and barriers to and facilitators of mobility and paretic arm use. The interviews were analyzed using inductive thematic analysis. Three categories, the individual, environment, and task, defined five emergent themes. Individual: (1) mindset is a strong and consistent influencer of daily physical activity and overall recovery; (2) severe physical impairment limits physical activity and recovery, regardless of other factors; and (3) a negative perception of disability impacts mindset and willingness to move in public. Environment: (4) social and physical environments influence physical activity and recovery. Task: (5) participation in meaningful activities increases physical activity and promotes long-term recovery. Strategies to incorporate paretic arm use, exercise, and encouragement from others facilitate physical activity. Insufficient paretic limb function, environmental obstacles, and fear are barriers to physical activity. Neurorehabilitation must address the factors that are meaningful to stroke survivors. Building motor capacity is essential and must be integrated with factors such as a positive mindset and proper environment. Individual differences reinforce the need for personalized care.
Citation: Healthcare
PubDate: 2024-07-31
DOI: 10.3390/healthcare12151523
Issue No: Vol. 12, No. 15 (2024)
- Healthcare, Vol. 12, Pages 1524: Psychometric Evaluation of the Decision
Fatigue Scale among Korean Registered Nurses
Authors: Yujin Hur, Ronald L. Hickman
First page: 1524
Abstract: Nurses make decision for patients and the quality of nurses’ decision making can affect patient outcomes. For some reason, nurses are experiencing impaired decision making and it can negatively impact patient care. A valid and reliable instrument to assess decision fatigue may let people know about the concept and guide the development of new policies or interventions for Korean nurses’ decision fatigue. This study aimed to evaluate the psychometric properties of the Korean version of the decision fatigue scale. The design was a cross-sectional descriptive study and convenience sampling was used to recruit participants. A total of 247 nurses from across South Korea participated in an online survey. The survey consisted of demographic questionnaires, decision fatigue scale, nursing practice environment scale, and compassion fatigue scale. It was validated through confirmatory factor analysis that the Korean version of the decision fatigue scale was a single factor with the same structure as the original scale. The Korean version of the decision fatigue scale showed significant correlations with compassion fatigue, and the scale showed appropriate internal consistency. This study established well enough the psychometric characteristics of the Korean version of decision fatigue.
Citation: Healthcare
PubDate: 2024-07-31
DOI: 10.3390/healthcare12151524
Issue No: Vol. 12, No. 15 (2024)
- Healthcare, Vol. 12, Pages 1525: Oral Health-Related Quality of Life among
Refugees: A Questionnaire-Based Study
Authors: Katharina Fink, Kais Alkayed, Franz Sebastian Schwindling, Vera Wiesmüller
First page: 1525
Abstract: Objectives: The issue of oral health problems among refugees, not only during their journey but also once they arrive at their destination, is a current one. This study aimed to evaluate the oral health-related quality of life (OHRQoL) of refugees, with the intention of highlighting a potential need for improved education and easier access to dental care. Materials and methods: A questionnaire based on the Oral Health Impact Profile (OHIP-14) was distributed via hyperlink on social media, targeting individuals with a refugee background to collect data on their OHRQoL. Results: A total of 401 participants completed the questionnaire. The median OHIP score for all participants was 8 (IQR 2–17) out of a maximum of 56, with 0 representing the best possible OHRQoL. The median OHIP score was 6 (IQR 2–16) for male and 8 (IQR 2–18) for female participants. Conclusions: A comparison of the OHIP score from this study with reference values from non-refugee populations shows an elevated score and, thus, a lower oral quality of life. Clinical relevance: The findings of this study indicate a clear need for enhanced access to dental care for refugees, coupled with an educational initiative aimed at fostering an appreciation of the importance of daily dental hygiene.
Citation: Healthcare
PubDate: 2024-07-31
DOI: 10.3390/healthcare12151525
Issue No: Vol. 12, No. 15 (2024)
- Healthcare, Vol. 12, Pages 1526: The Impact of Statins on Disease Severity
and Quality of Life in Patients with Psoriasis: A Systematic Review and
Meta-Analysis
Authors: Abdulsalam Mohammed Aleid, Ghadah Almutairi, Rudhab Alrizqi, Houriah Yasir Nukaly, Jomanah Jamal Alkhanani, Deemah Salem AlHuraish, Hawazin Yasser Alshanti, Yaser Sami Algaidi, Hanan Alyami, Awatif Alrasheeday, Bushra Alshammari, Kawthar Alsaleh, Abbas Al Mutair
First page: 1526
Abstract: Background: Psoriasis, a chronic autoimmune condition, imposes significant burdens on patients’ well-being. While corticosteroid medications are commonly used, their prolonged use presents risks. Statins, known for their immunoregulatory and anti-inflammatory properties, have emerged as potential alternatives. Previous reviews indicated that statins might improve psoriasis symptoms but showed inconsistent results and lacked meta-analyses that generated pooled effect estimates. Therefore, this study addresses this gap by providing a comprehensive overview of the impact of statins on psoriasis severity and quality of life (QoL) for patients with psoriasis. Methods: A thorough search of four electronic databases (PubMed, Cochrane Central Register of Controlled Trials, Scopus, and Science Direct) was conducted for relevant studies published before April 2024. Results: Seven studies involving 369 patients were included. This meta-analysis showed a statistically significant reduction in PASI scores at week 8 with statin treatment (MD = −1.96, 95% CI [−3.14, −0.77], p = 0.001). However, no statistically significant difference was found between statins and placebo at week 12 (MD = 0.19, 95% CI [−0.18, 0.55]). Additionally, DLQI scores indicated a significant improvement in quality of life with statins compared to placebo (MD = −3.16, 95% CI [−5.55, −0.77]). Conclusions: Statins can improve disease severity and quality of life in psoriasis patients, suggesting the potential benefits of statin therapy. However, further research is needed to determine the optimal treatment duration, address outcome heterogeneity, and explore additional benefits such as cholesterol and triglyceride reduction.
Citation: Healthcare
PubDate: 2024-07-31
DOI: 10.3390/healthcare12151526
Issue No: Vol. 12, No. 15 (2024)
- Healthcare, Vol. 12, Pages 1527: The Hemianopia Reading Questionnaire
Authors: Sarah Tol, Marieke E. Timmerman, Alina Goltermann, Joost Heutink, Gera A. de Haan
First page: 1527
Abstract: The ability to read is important for daily life functioning. Individuals with homonymous visual field defects (iwHs) after brain injury experience frequent reading difficulties. The current study presents a novel self-report questionnaire aimed at measuring the wide variety of reading difficulties iwHs can experience: the Hemianopia Reading Questionnaire (HRQ). The 24-item HRQ was developed with help from clinical experts and experts by experience and was inspired by existing reading questionnaires for adults. The three tested subscales of the HRQ assess the relationship to reading, reading skills and daily life functional reading. The factor structure, reliability, convergent validity and divergent validity were examined in a large community sample (i.e., individuals without homonymous visual field defects) with a comparable distribution of age, gender and level of education to those who have suffered a stroke (N = 998). Two competing hypothesized models were tested and a good fit was found for a three-bifactor model of the HRQ. The reliability of the three subscales was found to be good (ω range 0.93–0.99), as well as the convergent and divergent validity (9 out of 12 Spearman’s correlations, according to expectations). The results support further use of the HRQ in iwHs, especially in the context of reading rehabilitation. Suggestions for clinical and scientific use and future psychometric research on the HRQ are provided.
Citation: Healthcare
PubDate: 2024-07-31
DOI: 10.3390/healthcare12151527
Issue No: Vol. 12, No. 15 (2024)
- Healthcare, Vol. 12, Pages 1528: Sex-Specific Variations in Glycated
Hemoglobin Responses to Structured Exercise in Type 2 Diabetes: Healthcare
Implications of Walking and Strength Training on Glycemic Control
Authors: Alexis C. King, Cynthia Villalobos, Paul Vosti, Courtney D. Jensen
First page: 1528
Abstract: Type 2 diabetes mellitus (T2DM) affects one in ten individuals in the United States, with rates expected to rise significantly. This novel study aimed to evaluate the impact of a structured exercise program on glycated hemoglobin (HbA1c) levels among males and females with T2DM, and to compare the effects of different volumes of combined aerobic and resistance exercise. A total of 67 adult participants with T2DM were randomly assigned to two groups: Group 1 (exercise classes and walking sessions) and Group 2 (exercise classes only). After 10 weeks, 39 participants completed the intervention and 34 had complete HbA1c records. Results indicated a significant improvement in HbA1c levels overall, with males exhibiting a greater decrease compared to females. Minimal baseline differences were observed between the walking and non-walking groups and improvements in HbA1c were noted in both groups with no significant differences. These findings suggested potential sex-specific differences in response to structured exercise programs. The study highlighted the importance of tailored exercise interventions in healthcare while managing T2DM. Further research is necessary to optimize exercise prescriptions and evaluate long-term benefits, but the current evidence supports structured exercise as a valuable component of comprehensive diabetes care. This research underscores the need for personalized approaches in exercise regimens, contributing to the growing body of knowledge on sex-specific responses to T2DM interventions.
Citation: Healthcare
PubDate: 2024-08-01
DOI: 10.3390/healthcare12151528
Issue No: Vol. 12, No. 15 (2024)
- Healthcare, Vol. 12, Pages 1529: Intensity of Symptoms and Perception of
Quality of Life on Admission to Palliative Care: Reality of a Portuguese
Team
Authors: Florbela Gonçalves, Margarida Gaudêncio, Ivo Cristiano Soares Paiva, Francisca Rego, Rui Nunes
First page: 1529
Abstract: Background: Palliative care (PC) corresponds to an approach that enhances the quality of life for patients facing life-threatening diseases, such as cancer, as well as for their families. There are various models for providing palliative care. Early referral to PC of patients with advanced cancer has a significant positive impact on their quality of life. However, the criteria for early referral still remain controversial. Objectives: To evaluate patients’ symptomatic intensity and perception of quality of life on admission to a PC unit and to analyze these two variables according to different models of approach (outpatient and inpatient care). Methods: A cross-sectional, descriptive, and correlational study was conducted with a sample of 60 patients sequentially admitted to a PC unit from palliative outpatient consultations or other inpatient services in a tertiary hospital dedicated to oncology care. The evaluation protocol included a sociodemographic and medical questionnaire, the Edmonton Symptom Assessment Scale (ESAS), and the Palliative Care Outcome Scale (POS) completed by patients within the first 24 h after admission. Results: The participants were mostly male (61.7%), with a median age of 72 years. The majority of patients (n = 32; 53.3%) were undergoing outpatient treatment, while the remaining individuals (n = 28; 46.7%) were transferred from other hospital services (inpatient care). In the outpatient care group, higher scores for fatigue and dyspnea were observed. Conversely, in the inpatient care group, higher scores were observed for pain, depression, and anxiety. There were significant differences between the two groups regarding the POS dimensions of meaning of life, self-feelings, and lost time. In the inpatient group, there was a longer time between diagnosis and referral to PC; however, it was also in the inpatient group that there was less time between PC referral and first PC evaluation, between PC referral and PC unit admission, and between PC referral and death. There were no significant correlations between referral times and ESAS/POS scores in the inpatient and outpatient groups. Conclusions: The patients admitted to the Palliative Care Unit presented a high symptom burden and changes in the perception of quality of life. However, there are no statistically significant differences between one model of approach in relation to the other. It was found that poorer symptom control and quality of life were associated with a shorter referral time for PC, because this was only initiated after curative care was suspended, particularly in our institutional context. Early referrals to the PC team are essential not only to relieve symptom-related distress but also to improve treatment outcomes and quality of life for people with cancer.
Citation: Healthcare
PubDate: 2024-08-01
DOI: 10.3390/healthcare12151529
Issue No: Vol. 12, No. 15 (2024)
- Healthcare, Vol. 12, Pages 1530: Smart Operating Room in Digestive
Surgery: A Narrative Review
Authors: Vito Laterza, Francesco Marchegiani, Filippo Aisoni, Michele Ammendola, Carlo Alberto Schena, Luca Lavazza, Cinzia Ravaioli, Maria Clotilde Carra, Vittore Costa, Alberto De Franceschi, Belinda De Simone, Nicola de’Angelis
First page: 1530
Abstract: The introduction of new technologies in current digestive surgical practice is progressively reshaping the operating room, defining the fourth surgical revolution. The implementation of black boxes and control towers aims at streamlining workflow and reducing surgical error by early identification and analysis, while augmented reality and artificial intelligence augment surgeons’ perceptual and technical skills by superimposing three-dimensional models to real-time surgical images. Moreover, the operating room architecture is transitioning toward an integrated digital environment to improve efficiency and, ultimately, patients’ outcomes. This narrative review describes the most recent evidence regarding the role of these technologies in transforming the current digestive surgical practice, underlining their potential benefits and drawbacks in terms of efficiency and patients’ outcomes, as an attempt to foresee the digestive surgical practice of tomorrow.
Citation: Healthcare
PubDate: 2024-08-01
DOI: 10.3390/healthcare12151530
Issue No: Vol. 12, No. 15 (2024)
- Healthcare, Vol. 12, Pages 1531: Investigating Physicians’ Adoption
of Telemedicine in Romania Using Technology Acceptance Model (TAM)
Authors: Abigaela Bîlbîie, Andreea-Ionela Puiu, Viorel Mihăilă, Marin Burcea
First page: 1531
Abstract: This study investigates Romanian physicians’ acceptance of telemedicine using the Technology Acceptance Model. We analyzed 1093 responses to an online survey distributed nationwide to physicians via email by the National Authority of Quality Management in Health, employing the partial least squares algorithm to estimate the relationship between the behavioral intention to adopt telemedicine and its potential determinants. Our findings reveal that the model accounts for 84.6% of the variance in behavioral intention to use telemedicine. Among the two constructs of the TAM model, perceived usefulness is a stronger predictor of behavioral intention than perceived ease of use. Additionally, subjective norms positively and significantly influence physicians’ intention to use telemedicine and their perception of its usefulness. Furthermore, perceived incentives and accessibility to medical records also positively impact the behavioral intention to use telemedicine.
Citation: Healthcare
PubDate: 2024-08-01
DOI: 10.3390/healthcare12151531
Issue No: Vol. 12, No. 15 (2024)
- Healthcare, Vol. 12, Pages 1532: Sailing Too Close to the Wind' How
Harnessing Patient Voice Can Identify Drift towards Boundaries of
Acceptable Performance
Authors: Siri Wiig, Catherine Jane Calderwood, Jane O’Hara
First page: 1532
Abstract: This opinion paper investigates how healthcare organizations identify and act upon different types of risk signals. These signals may generally be acknowledged, but we also often see with hindsight that they might not be because they have become a part of normal practice. Here, we detail how risk signals from patients and families should be acknowledged as system-level safety critical information and as a way of understanding and changing safety culture in healthcare. We discuss how healthcare organizations could work more proactively with patient experience data in identifying risks and improving system safety.
Citation: Healthcare
PubDate: 2024-08-01
DOI: 10.3390/healthcare12151532
Issue No: Vol. 12, No. 15 (2024)
- Healthcare, Vol. 12, Pages 1533: Critical Care Experience Shapes
Respiratory Therapists’ Attitudes toward Death: A Survey Study
Authors: Ting-Ling Lee, Jui-O Chen, Nan-Wei Liu, Hui-Chin Chen, Yi-Ling Hsieh, Shih-Feng Liu, Jui-Fang Liu, Hui-Ling Lin
First page: 1533
Abstract: Respiratory therapists (RTs) frequently encounter death in their work with critically ill patients. Healthcare providers’ attitudes toward death significantly affect their approach to caring for dying patients; however, there is a lack of knowledge on RTs’ attitudes toward death. This study examines how the work environment and personal characteristics of RTs influence their attitudes toward death. Utilizing the Death Attitude Profile-Revised-Chinese questionnaire, a cross-sectional survey compared non-critical care RTs (non-CCRTs, N = 86) to critical care RTs (CCRTs, N = 85). Non-CCRTs displayed significantly lower scores in overall acceptance of death compared to CCRTs (p = 0.015) and a tendency to actively avoid thoughts about death (p = 0.005). CCRTs scored higher in “neutral acceptance” (p = 0.015), and non-CCRTs exhibited higher scores on items reflecting a negative attitude toward death. RTs with shorter professional tenures showed heightened fear of death and avoidance tendencies. Perception of life and death education correlated with higher “fear of death” and “death avoidance” scores (p = 0.001). The findings indicate that CCRTs demonstrate a more neutral acceptance of death. Additionally, experience, sex, mental health status, and life–death education exposure significantly influence RTs’ attitudes toward death.
Citation: Healthcare
PubDate: 2024-08-01
DOI: 10.3390/healthcare12151533
Issue No: Vol. 12, No. 15 (2024)
- Healthcare, Vol. 12, Pages 1534: Technological Developments, Exercise
Training Programs, and Clinical Outcomes in Cardiac Telerehabilitation in
the Last Ten Years: A Systematic Review
Authors: Marina Garofano, Carmine Vecchione, Mariaconsiglia Calabrese, Maria Rosaria Rusciano, Valeria Visco, Giovanni Granata, Albino Carrizzo, Gennaro Galasso, Placido Bramanti, Francesco Corallo, Carmine Izzo, Michele Ciccarelli, Alessia Bramanti
First page: 1534
Abstract: Background: Cardiovascular diseases (CVDs) are associated with very high rates of re-hospitalization and mortality worldwide, so the complexity of these pathologies requires frequent access to hospital facilities. The guidelines also emphasize the importance of cardiac rehabilitation (CR) programs, which have demonstrated a favorable effect on outcomes, and cardiac telerehabilitation (CTR) could represent an innovative healthcare delivery model. The aim of our review is to study how technologies used in rehabilitation have changed over time and also to understand what types of rehabilitation programs have been used in telerehabilitation. Methods: We searched randomized controlled trials (RCTs) in three electronic databases, PubMed, Web of Science, and Scopus, from January 2015 to January 2024, using relevant keywords. Initially, 502 articles were found, and 79 duplicates were identified and eliminated with EndNote. Results: In total, 16 RCTs fulfilled the pre-defined criteria, which were analyzed in our systematic review. The results showed that after CTR, there was a significant improvement in main outcome measures, as well as in relation to technological advances. Conclusions: Moreover, compared to center-based rehabilitation, CTR can offer further advantages, with better cost-effectiveness, the breakdown of geographical barriers, and the improvement of access to treatment for the female population, which is traditionally more socially committed.
Citation: Healthcare
PubDate: 2024-08-02
DOI: 10.3390/healthcare12151534
Issue No: Vol. 12, No. 15 (2024)
- Healthcare, Vol. 12, Pages 1535: Variations in the Five Facets of
Mindfulness in Italian Oncology Nurses according to Sex, Work Experience
in Oncology, and Shift Work
Authors: Elsa Vitale, Karen Avino, Rocco Mea, Maria Colomba Comes, Samantha Bove, Luana Conte, Roberto Lupo, Ivan Rubbi, Maicol Carvello, Stefano Botti, Giorgio De Nunzio, Raffaella Massafra
First page: 1535
Abstract: Background: Oncology nurses support cancer patients in meeting their self-care needs, often neglecting their own emotions and self-care needs. This study aims to investigate the variations in the five facets of holistic mindfulness among Italian oncology nurses based on gender, work experience in oncology, and shift work. Method: A cross-sectional study was carried out in 2023 amongst all registered nurses who were employed in an oncology setting and working in Italy. Results: There were no significant differences in all five facets of holistic mindfulness (p ≥ 0.05) according to gender, work experience in the oncology field, and shift work. Conclusion: Could holistic mindfulness be defined as an intrinsic individual characteristic' Surely, more insights will be necessary to better define the holistic trend in oncology nursing.
Citation: Healthcare
PubDate: 2024-08-02
DOI: 10.3390/healthcare12151535
Issue No: Vol. 12, No. 15 (2024)
- Healthcare, Vol. 12, Pages 1536: Assessment of Knowledge, Attitudes, and
Vaccination Practices Regarding the New RSV Vaccine among Health
Professionals in Greece
Authors: Dimitrios Papagiannis, Nikolaos Tiganis, Ourania S. Kotsiou, Ioannis C. Lampropoulos, Evangelos C. Fradelos, Foteini Malli, Konstantinos I. Gourgoulianis
First page: 1536
Abstract: The introduction of a new vaccine into immunization programs represents a significant advancement in the global effort to combat vaccine-preventable diseases. Data from the World Health Organization support that immunization prevents between 2 and 3 million deaths each year across various diseases, underscoring its pivotal role in global health. The present study aims to assess the knowledge, attitudes, and anticipated vaccination practices among health professionals in Central Greece in response to the potential introduction of new Respiratory Syncytial Virus (RSV) vaccination guidelines by the National Vaccines Committee. Among the 450 health professionals solicited for the study, 219 provided responses, yielding a response rate of approximately 55%. A substantial majority (70.3%) accurately identified the vaccine’s current availability, and 62.1% were aware of the current recommendation for RSV vaccination in pregnant women. In response to whether health professionals support the inclusion of an RSV vaccine in the national vaccination program if it becomes commercially available and is recommended by the Greek National Immunization Program, general practitioners showed the most support, with an average score of 4.86 (95% CI, 4.69–5.00), followed by pediatricians at 4.76 (95% CI, 4.63–4.89), pulmonologists at 4.68 (95% CI, 4.36–5.00), and obstetricians at 4.33 (95% CI, 3.95–4.71). Concerning general opinions on vaccinations, a high level of agreement was noted among the majority of health professionals, excluding nurses. Pharmacists recorded the highest agreement, with a perfect score of 5 (CI, 5.00–5.00), followed closely by pediatricians at 4.99 (CI, 4.97–5.00), GPs at 4.95 (CI, 4.85–5.00), pulmonologists at 4.93 (CI, 4.83–5.00), obstetricians at 4.74 (CI, 4.42–5.00), and nurses at 3.80 (CI, 3.06–4.54). A tailored approach to education is needed to ensure that healthcare professionals can communicate more effectively about RSV risks and vaccination benefits, fostering a proactive stance towards disease prevention and patient care. In essence, our study underscores the importance of knowledge in shaping a compassionate and responsive healthcare environment, ready to meet the challenges of RSV head-on.
Citation: Healthcare
PubDate: 2024-08-02
DOI: 10.3390/healthcare12151536
Issue No: Vol. 12, No. 15 (2024)
- Healthcare, Vol. 12, Pages 1537: Management of Patients Receiving
Anticoagulation Therapy in Dental Practice: A Systematic Review
Authors: Francesco Inchingolo, Angelo Michele Inchingolo, Fabio Piras, Laura Ferrante, Antonio Mancini, Andrea Palermo, Alessio Danilo Inchingolo, Gianna Dipalma
First page: 1537
Abstract: Background: Anticoagulant drugs are a valuable tool for minimizing thrombotic risks in at-risk patients. The purpose of this study is to conduct a literature review highlighting the management of these drugs during daily clinical dental practice. Materials and Methods: We limited our search to English-language papers published between 1 January 1989, and 7 March 2024, in PubMed, Scopus and Web of Science that were relevant to our topic. In the search approach, the Boolean keywords “anticoagulant AND dentistry” were used. Results: Twenty-five clinical trials were included for final review from 623 articles obtained from the databases Web of Science (83), PubMed (382), and Scopus (158), eliminating duplicates and 79 off-topic items, resulting in 419 articles after removing 315 entries and confirming eligibility. Overall, these studies support the use of local hemostatic measures to manage the risk of bleeding in patients on anticoagulant therapy undergoing dental procedures and highlight the importance of greater education and collaboration among healthcare professionals. Conclusions: Research and clinical investigation have improved understanding and management of dental procedures in patients undergoing anticoagulant or antiplatelet therapy. Hemostatic agents, clinical protocols, risk factors, and continuous education are essential for navigating the complexities of anticoagulant therapy, ensuring optimal outcomes and enhancing patient well-being.
Citation: Healthcare
PubDate: 2024-08-02
DOI: 10.3390/healthcare12151537
Issue No: Vol. 12, No. 15 (2024)
- Healthcare, Vol. 12, Pages 1538: Driving Stress-Induced Effects on the
Orofacial Region and Its Functions and Health Behaviors in Riyadh: A
Cross-Sectional Survey
Authors: Cristalle Soman, Aya Tarek Faisal, Malak Mohamed Alsaeygh, Abdulrahman Dahham Al Saffan, Ra’ed Ghaleb Salma
First page: 1538
Abstract: Driving stress is a multifaceted phenomenon, and the experience of driving invokes stress. Driving causes the activation of stress-response mechanisms, leading to short-term and long-term stress responses resulting in physiological and behavioral changes. The aim of this study was to evaluate driving stress-initiated effects on orofacial functions and health behaviors in the Riyadh population. A cross-sectional survey was conducted in Riyadh using a pre-validated set of questionnaires for habitual information, a driving stress assessment using a driving-behavior inventory, and an assessment of parafunctional habits and effects on orofacial functions. The results indicate that nearly 50% of the sample spends more than two hours commuting, and more than 50% of the sample has inadequate sleep and insufficient exercise. Oral parafunctional habits like nail biting (p = 0.039) and lip or object biting (p = 0.029) had a significant correlation with aggressive driving behaviors, whereas the grinding of teeth (p = 0.011), the clenching of jaws (p = 0.048), lip or object biting (p = 0.018), and pain in mastication (p = 0.036) had a positive correlation with driving dislikes. Driving stress can be detrimental to one’s health and not only impacts health behaviors but also induces oral parafunctional habits and adversely affects orofacial regions and functions. Acute driving stress responses may be transient. However, prolonged driving stress can be maladaptive and can increase the risk of chronic diseases including chronic temporomandibular joint disorders and parafunctional habit-related changes in the oral cavity.
Citation: Healthcare
PubDate: 2024-08-02
DOI: 10.3390/healthcare12151538
Issue No: Vol. 12, No. 15 (2024)
- Healthcare, Vol. 12, Pages 1539: Tailored Physical Activity Interventions
for Long COVID: Current Approaches and Benefits—A Narrative Review
Authors: Guhua Jia, Chun-Hsien Su
First page: 1539
Abstract: This narrative review explores the essential role of physical activity in managing long COVID, which is characterized by persistent symptoms such as fatigue, breathlessness, and cognitive impairments following SARS-CoV-2 infection. In this context, “physical activity” includes various exercises, such as aerobic and resistance training, as well as flexibility and balance exercises, thereby encompassing the subset known as “exercise”. The methodology involved a comprehensive literature search across PubMed, EBSCO (EDS), and Google Scholar, selecting peer-reviewed articles from December 2019 to June 2024 focusing on long COVID physical activity interventions. The review highlights that tailored exercise programs, adjusted to individual health status and abilities, significantly alleviate symptoms and enhance psychological well-being. Key findings emphasize the importance of personalized exercise prescriptions due to the variability in patient responses and the need for a multidisciplinary approach in developing and monitoring interventions. Despite promising outcomes, the review identifies research gaps, including the need for long-term studies, randomized controlled trials, and deeper mechanistic insights. It suggests that standardized reporting, templates like the Consensus on Exercise Reporting Template (CERT), and integrating digital health tools are essential for optimizing interventions. Overall, the review advocates including personalized physical activity or exercise programs in standard care for long COVID to improve patient outcomes and quality of life.
Citation: Healthcare
PubDate: 2024-08-03
DOI: 10.3390/healthcare12151539
Issue No: Vol. 12, No. 15 (2024)
- Healthcare, Vol. 12, Pages 1540: Platelet/High-Density Lipoprotein Ratio
(PHR) Predicts Type 2 Diabetes in Obese Patients: A Retrospective Study
Authors: Alshuweishi, Abudawood, Alfayez, Almufarrih, Alanazi, Alshuweishi, Almuqrin
First page: 1540
Abstract: Background: Obesity and type 2 diabetes (T2D) pose global health problems that continue to rise. A chronic low-grade inflammation and activation of the immune system are well established in both conditions. The presence of these factors can predict disease development and progression. Emerging evidence suggests that platelet–high density lipoprotein ratio (PHR) is a potential inflammatory marker. The purpose of this study was to investigate the relationship between PHR and T2D among obese patients. Methods: 203 patients with BMI ≥30 kg/m2 participated in the study. Patients were categorized into two groups: non-diabetic obese and diabetic obese. Comorbidities, baseline characteristics, laboratory data, as well as PHR levels of the study groups were analyzed. Medians, risk assessment, and the diagnostic performance of PHR values were examined in both groups. Results: In obese patients, the median PHR were significantly increased in obese patients with T2D compared to non-diabetic obese (p < 0.0001). Furthermore, T2D obese with high PHR had a significantly higher FBG and HbA1c (p < 0.05). Although PHR was weakly yet significantly correlated with glycemic markers, ROC curve analysis of the PHR indicated an AUC of 0.700 (p < 0.0001) in predicting T2D in obese patients, and the cutoff value was 6.96, with a sensitivity and specificity of 53.4% and 76.1%, respectively. Moreover, increased PHR (OR = 4.77, p < 0.0001) carried a significantly higher risk for developing T2D in obese individuals. Conclusions: The PHR is a convenient and cost-effective marker that can reliably predict the presence of T2D in high-risk obese population.
Citation: Healthcare
PubDate: 2024-08-03
DOI: 10.3390/healthcare12151540
Issue No: Vol. 12, No. 15 (2024)
- Healthcare, Vol. 12, Pages 1541: Effects of a Multifactorial Program with
Case Management for Falls Prevention on Functional Outcomes in
Community-Dwelling Older People: A Randomized Clinical Study
Authors: Areta Dames Cachapuz Novaes, Juliana Hotta Ansai, Silsam Napolitano Alberto, Maria Joana Duarte Caetano, Paulo Giusti Rossi, Mariana Luiz de Melo, Karina Gramani-Say
First page: 1541
Abstract: Falls are among the top 10 causes of years lived with disability in people aged 75 and over. Preventive programs like case management (CM) are crucial. Objectives: To evaluate the effects of a multifactorial fall prevention program based on CM on physical performance, the presence of pain, and the risk of falls and fractures in older people who have suffered falls. Methods: This randomized, single-blind clinical trial with parallel groups, Intervention Group (IG) and Control Group (CG), was composed of 55 older people with a history of falling, living in the community. All participants underwent an initial assessment via video call (containing anamnesis, timed up-and-go test, falls risk score, short physical performance battery, and clinical frax). The IG underwent CM, the physical exercise protocol, and the cognitive stimulation protocol. The CG was monitored through telephone calls and received general health and fall guidance. Results: No significant results were found in the physical capacity, the presence of pain, the risk of falls, or the fractures between the Intervention and Control Groups and between assessments. Conclusion: This program was not effective in improving functional performance, but it was important for characterizing pain and the probability of fracture in the next 10 years in this population.
Citation: Healthcare
PubDate: 2024-08-03
DOI: 10.3390/healthcare12151541
Issue No: Vol. 12, No. 15 (2024)
- Healthcare, Vol. 12, Pages 1542: Potential Benefits of Continuous Glucose
Monitoring for Predicting Vascular Outcomes in Type 2 Diabetes: A Rapid
Review of Primary Research
Authors: Radhika Kiritsinh Jadav, Kwang Choon Yee, Murray Turner, Reza Mortazavi
First page: 1542
Abstract: (1) Background: Chronic hyperglycaemia is a cause of vascular damage and other adverse clinical outcomes in type 2 diabetes mellitus (T2DM). Emerging evidence suggests a significant and independent role for glycaemic variability (GV) in contributing to those outcomes. Continuous glucose monitoring (CGM) provides valuable insights into GV. Unlike in type 1 diabetes mellitus, the use of CGM-derived GV indices has not been widely adopted in the management of T2DM due to the limited evidence of their effectiveness in predicting clinical outcomes. This study aimed to explore the associations between GV metrics and short- or long-term vascular and clinical complications in T2DM. (2) Methods: A rapid literature review was conducted using the Cochrane Library, MEDLINE, and Scopus databases to seek high-level evidence. Lower-quality studies such as cross-sectional studies were excluded, but their content was reviewed. (3) Results: Six studies (five prospective cohort studies and one clinical trial) reported associations between GV indices (coefficient of variation (CV), standard deviation (SD), Mean Amplitude of Glycaemic Excursions (MAGE), Time in Range (TIR), Time Above Range (TAR), and Time Below Range (TBR)), and clinical complications. However, since most evidence came from moderate to low-quality studies, the results should be interpreted with caution. (4) Conclusions: Limited but significant evidence suggests that GV indices may predict clinical compilations in T2DM both in the short term and long term. There is a need for longitudinal studies in larger and more diverse populations, longer follow-ups, and the use of numerous CGM-derived GV indices while collecting information about all microvascular and macrovascular complications.
Citation: Healthcare
PubDate: 2024-08-04
DOI: 10.3390/healthcare12151542
Issue No: Vol. 12, No. 15 (2024)
- Healthcare, Vol. 12, Pages 1543: Corporate Social Responsibility and
Social Needs in Health Care Sectors—A Critical Analysis of Social
Innovation in the Health Sector in Taiwan
Authors: Winnie Chu, Nain-Feng Chu
First page: 1543
Abstract: Background: Social innovation is often used as a mechanism to jump-start public–private partnerships to leverage resources to achieve social impact; the analysis of sustainability and the impact of corporate social responsibility (CSR) cannot be emphasized enough. Due to advances in the information and communication technology industry in Taiwan, this paper aims to explore whether these advancements drive CSR as a form of social innovation to meet health needs in Taiwan. Methodology: This paper uses a case study to look at CSR programs in the health sector in Taiwan. Corporations with diverse missions and different CSR approaches that are available on the internet are selected. The analysis of the case study takes a qualitative, exploratory approach to shed light on current initiatives. Results: The majority of CSR programs in Taiwan are private sector activities that emerged during the COVID-19 pandemic; current CSR activities in Taiwan are driven by awards, public relations, and external interests. Corporations in Taiwan have the potential to address the health care gaps of urban–rural health utilization among Taiwanese indigenous communities. It is recommended for corporations to (1) develop partnerships with public health experts or to (2) employ CSR personnel with health care backgrounds who can navigate the intersection between health, business, and policies to develop CSR strategies. Conclusions: Further evaluation of the projects mentioned in this paper to assess the direct and indirect impact on health outcomes could provide a more comprehensive understanding of the field of CSR in the health sector in Taiwan.
Citation: Healthcare
PubDate: 2024-08-05
DOI: 10.3390/healthcare12151543
Issue No: Vol. 12, No. 15 (2024)
- Healthcare, Vol. 12, Pages 1544: Navigating Uncertainty with Compassion:
Healthcare Assistants’ Reflections on Balancing COVID-19 and Routine
Care through Adversity
Authors: Alice Yip, Jeff Yip, Zoe Tsui, Graeme Drummond Smith
First page: 1544
Abstract: The coronavirus disease 2019 pandemic created unprecedented challenges for healthcare systems around the world. Healthcare assistants played a vital role in the provision of frontline patient care during this crisis. Despite their important contribution, there exists limited research that specifically examines the healthcare assistant’s experiences and perspectives of care provision during the COVID-19 pandemic. This study explored healthcare assistants’ caring experiences and perspectives on resilience and self-efficacy during the COVID-19 pandemic in Hong Kong. A qualitative descriptive study with semi-structured interviews was conducted with 25 healthcare assistants from public hospitals. Interview recordings were analyzed using thematic analysis. Five main themes emerged from the data: frontline reinforcement: supporting HCAs through resourcing and education amidst the COVID-19 crisis, confronting uncertainty: building personal fortitude in the face of the COVID-19 pandemic, fostering collective resilience through shared support, self-efficacy as a catalyst for adaptive growth, and paving the way for transformation. These findings advocate for the resilience and self-efficacy of healthcare assistants; this may potentially strengthen healthcare system preparedness for navigating unpredictable challenges in the future.
Citation: Healthcare
PubDate: 2024-08-05
DOI: 10.3390/healthcare12151544
Issue No: Vol. 12, No. 15 (2024)
- Healthcare, Vol. 12, Pages 1545: COVID-19 Vaccine Hesitancy and
Misinformation Endorsement among a Sample of Native Spanish-Speakers in
the US: A Cross-Sectional Study
Authors: Elizabeth A. Carosella, Maxwell Su, Marcia A. Testa, Guglielmo Arzilli, Alice Conni, Elena Savoia
First page: 1545
Abstract: Research on COVID-19 vaccine hesitancy and misinformation endorsement among Spanish-speaking Americans is limited. This cross-sectional study used a Spanish-language survey from May–August 2021 among 483 Spanish speakers living in the US and Puerto Rico. We applied multivariable Poisson regression with robust error variances to assess the association between independent variables and binary outcomes for vaccine acceptance versus hesitance, as well as misinformation endorsement. Vaccine acceptance was associated with COVID-19 risk perception score (PR = 1.7 high vs. low perceived risk), opinion of government transparency (PR = 2.2 very transparent vs. not transparent), and trust in vaccine information (PR = 1.8 high vs. low). There was also an interaction between time spent on social media and social media as a main source of COVID-19 information (p = 0.0484). Misinformation endorsement was associated with opinion about government transparency (PR = 0.5 moderately vs. not transparent), trust in vaccine information (PR = 0.5 high vs. low trust), social media impact on vaccine confidence (PR = 2.1 decreased vs. increased confidence), distrust vaccines (PR = 1.9 distrust vs. trust), using vaccine information from Facebook (PR = 1.4 yes vs. no), and time spent on social media by those using social media as main source of COVID-19 vaccine information (p = 0.0120). Vaccine acceptance in respondents with high misinformation endorsement scores was 0.7 times those with low scores. These findings highlight the importance of effective information dissemination, the positive role of social media, and government transparency in boosting vaccine uptake among Spanish speakers in the US.
Citation: Healthcare
PubDate: 2024-08-05
DOI: 10.3390/healthcare12151545
Issue No: Vol. 12, No. 15 (2024)
- Healthcare, Vol. 12, Pages 1546: Determining the Key Education Priorities
Related to Heart Failure Care in Nursing Homes: A Modified Delphi Approach
Authors: James McMahon, David R. Thompson, Christine Brown Wilson, Loreena Hill, Paul Tierney, Jan Cameron, Doris S. F. Yu, Debra K. Moser, Karen Spilsbury, Nittaya Srisuk, Jos M. G. A. Schols, Mariëlle van der Velden-Daamen, Gary Mitchell
First page: 1546
Abstract: There is currently a limited understanding of what nurses in nursing homes view as the key education priorities to support their ability to provide the appropriate care for residents with heart failure (HF). A modified Delphi technique was utilized to gain a consensus on the key education priorities for nurses working in nursing homes in Northern Ireland. An initial list of items (n = 58), across 19 domains, was generated using the findings of a scoping review and stakeholder interviews, and a review of available clinical guidelines. Two rounds of surveys were undertaken. Items were presented using a 5-point Likert scale, with an additional exercise in the second round to rank the domains in order of importance. Fifty-four participants completed the first-round survey and 34 (63%) returned to complete the second. The findings highlight the importance of providing nurses in nursing home settings with general HF education and the delivery of person-centered care. Participants perceived education around technology for the management of HF and quality improvement or research methodologies associated with HF in nursing homes as lower priorities. This study illuminates key priorities from nursing home nurses regarding HF education that are applicable to this care setting.
Citation: Healthcare
PubDate: 2024-08-05
DOI: 10.3390/healthcare12151546
Issue No: Vol. 12, No. 15 (2024)
- Healthcare, Vol. 12, Pages 1547: Complementary and Alternative Medicine
(CAM) Practices: A Narrative Review Elucidating the Impact on Healthcare
Systems, Mechanisms and Paediatric Applications
Authors: Patricia Anaid Romero-García, Sergio Ramirez-Perez, Jorge Javier Miguel-González, Sandra Guzmán-Silahua, Javier Adan Castañeda-Moreno, Sophia Komninou, Simón Quetzalcoatl Rodríguez-Lara
First page: 1547
Abstract: While research on complementary and alternative medicine (CAM) for the general population is expanding, there remains a scarcity of studies investigating the efficacy and utilisation of CAM practices, specifically in the paediatric population. In accordance with the World Health Organization (WHO), the prevalence of the parental utilisation of CAM in their dependents is estimated to reach up to 80%. This literature review identified broad, heterogeneous, and inconclusive evidence regarding CAM’s applications and effectiveness, primarily attributed to variance in sociodemographic factors and differences in national healthcare systems. Additionally, the review identified a lack of consensus and polarised positions among mainstream professionals regarding the mechanisms of action, applications, and effectiveness of CAM. This narrative review presents varied results concerning the efficacy of most CAM therapies and their applications; however, some evidence suggests potential benefits for acupuncture, yoga, tai chi, and massage in improving physical and mental health. Moreover, the available evidence indicates that meditation may enhance mental health, while reiki may only influence patients’ perceptions of comfort. In light of the intricate and multifaceted nature of herbal medicine, it is imperative to assess its efficacy on a case-by-case basis, taking into account the specific compounds and procedures involved. This comprehensive review serves as a valuable resource for health professionals, offering guidance for personalised healthcare approaches that consider the values and beliefs of patients, thereby facilitating integrated, evidence-based practices aimed at enhancing the quality of healthcare services and patient satisfaction.
Citation: Healthcare
PubDate: 2024-08-05
DOI: 10.3390/healthcare12151547
Issue No: Vol. 12, No. 15 (2024)
- Healthcare, Vol. 12, Pages 1548: The Potential Impact of Large Language
Models on Doctor–Patient Communication: A Case Study in Prostate
Cancer
Authors: Marius Geantă, Daniel Bădescu, Narcis Chirca, Ovidiu Cătălin Nechita, Cosmin George Radu, Stefan Rascu, Daniel Rădăvoi, Cristian Sima, Cristian Toma, Viorel Jinga
First page: 1548
Abstract: Background: In recent years, the integration of large language models (LLMs) into healthcare has emerged as a revolutionary approach to enhancing doctor–patient communication, particularly in the management of diseases such as prostate cancer. Methods: Our paper evaluated the effectiveness of three prominent LLMs—ChatGPT (3.5), Gemini (Pro), and Co-Pilot (the free version)—against the official Romanian Patient’s Guide on prostate cancer. Employing a randomized and blinded method, our study engaged eight medical professionals to assess the responses of these models based on accuracy, timeliness, comprehensiveness, and user-friendliness. Results: The primary objective was to explore whether LLMs, when operating in Romanian, offer comparable or superior performance to the Patient’s Guide, considering their potential to personalize communication and enhance the informational accessibility for patients. Results indicated that LLMs, particularly ChatGPT, generally provided more accurate and user-friendly information compared to the Guide. Conclusions: The findings suggest a significant potential for LLMs to enhance healthcare communication by providing accurate and accessible information. However, variability in performance across different models underscores the need for tailored implementation strategies. We highlight the importance of integrating LLMs with a nuanced understanding of their capabilities and limitations to optimize their use in clinical settings.
Citation: Healthcare
PubDate: 2024-08-05
DOI: 10.3390/healthcare12151548
Issue No: Vol. 12, No. 15 (2024)
- Healthcare, Vol. 12, Pages 1549: The Impact of Prescription Time Limits on
Phosphate Administration in the Intensive Care Unit: A Before–After
Quality Improvement Study
Authors: Rajiv Rooplalsingh, Felicity Edwards, Julia Affleck, Patrick Young, Alexis Tabah, Sinead Carmichael, Belinda Chappell, Andrea Fung, Kylie Jacobs, Kevin Laupland, Mahesh Ramanan
First page: 1549
Abstract: (1) Background: We aim to examine and improve phosphate prescribing as part of a quality assurance program by examining the change in the proportion of patients receiving phosphate with normal or high preceding serum phosphate concentrations before and after the introduction of the 24 h time limit to default phosphate prescription. (2) Methods: This was a quality assurance study conducted across three Australian adult intensive care units (ICUs). All adult patients with ICU lengths of stay greater than or equal to 48 h who had their serum phosphate concentrations measured were included. A 24 h time limit was introduced to the protocolised prescription in the electronic clinical information system for enteral and intravenous phosphate at participating ICUs. Patient characteristics, phosphate administration, and outcomes were compared before and after this time limit was introduced. The primary outcome was the proportion of patients to whom phosphate was prescribed after measurement of a normal or high serum phosphate level. Secondary outcomes were ICU length of stay, mortality, and discharge destination. (3) Results: A total of 1192 patients were included from three ICUs over the two periods. The proportion of patients with a normal or high measured phosphate level who then received phosphate supplementation was significantly lower in the second study period (30.3% vs. 9.9%; p < 0.001). This difference persisted when adjusted for potential confounders in a mixed-effects logistic regression model (an adjusted odds ratio for receiving phosphate with normal or high serum concentration 0.214, 95% confidence interval of 0.132–0.347; p < 0.001). No significant difference was seen in the typical ICU length of stay, in-hospital case–fatality rate, and hospital discharge destination between these groups. (4) Conclusions: This multicentre before–after study has demonstrated that the introduction of a 24 h limit on electronic phosphate prescriptions resulted in significantly fewer patients receiving phosphate when their serum phosphate concentration was normal or high, without any adverse impact on patient outcomes.
Citation: Healthcare
PubDate: 2024-08-05
DOI: 10.3390/healthcare12151549
Issue No: Vol. 12, No. 15 (2024)
- Healthcare, Vol. 12, Pages 1550: Using Immersive Environments in E-Mental
Health Rehabilitation Programs Directed to Future Health Professionals to
Promote Empathy and Health Literacy about Schizophrenia
Authors: Paulo Veloso Gomes, António Marques, Javier Pereira, Rui Pimenta, João Donga, Raquel Simões de Almeida
First page: 1550
Abstract: Rehabilitation involves all types of patients, including people with schizophrenia. Schizophrenia is considered a complex syndrome characterized in general by fundamental and characteristic distortions of thinking and perception. The quality of life of a person with schizophrenia can be compromised by difficulty in carrying out their daily tasks and by the social stigma of their condition. The importance of training and sensitizing students in rehabilitation areas to this type of problem to improve the rehabilitation processes in which they will participate as future professionals involves empathy and the ability to communicate with these populations. It is possible through virtual reality to create immersive environments to simulate some psychotic symptoms characteristic of people with schizophrenia, such as visual hallucinations and hearing voices. The aim of this study was to test the effect of exposure to experiences characteristic of schizophrenia through two different types of immersive environments, graphical computational virtual reality and 360° video, on students from areas of social rehabilitation regarding empathy, social distance, and attitudes towards people with schizophrenia. Although the results were positive for the three parameters under study, no significant differences were found for each of them between the environments to which the participants were exposed. This study concluded that the choice between the two types of immersive environments should be based on the project’s objectives, the target audience’s needs, and available resources, rather than the type of environment itself, as their impact was similar.
Citation: Healthcare
PubDate: 2024-08-05
DOI: 10.3390/healthcare12151550
Issue No: Vol. 12, No. 15 (2024)
- Healthcare, Vol. 12, Pages 1551: Post-COVID-19 Condition: How
Sociodemographic Factors, Physical Well-Being and Functionality Influence
Quality of Life and Mental Health Symptoms
Authors: Mᵃ Pilar Rodríguez-Pérez, Marta Pérez-de-Heredia-Torres, Pilar Rodríguez-Ledo, Gemma Fernández-Gómez, Cristina García-Bravo, Roberto Cano-de-la-Cuerda, Patricia Sánchez-Herrera-Baeza
First page: 1551
Abstract: Background: Long COVID-19 syndrome remains a global public health problem, with more than 145 million people affected with multisystemic symptoms. Addressing the requirements of individuals impacted by a syndrome characterised by a complex and variable clinical presentation is of utmost importance. Identifying the variables that can exert influence and understanding their progression is essential for directing treatment strategies aimed at enhancing both independence and quality of life. Therefore, the aim of this study was to analyse the influence of sociodemographic and clinical variables on existence and their relationship with asthenia, anxiety symptoms and low mood. Methods: An analytical study secondary to an observational cross-sectional descriptive study. Results: Logistic regression showed significant univariate effects on asthenia [sex (p = 0.034); age (p = 0.042); Activities of Daily Living Questionnaire [ADQL (p = 0.002)] [physical functioning (p < 0.001) and general health (p = 0.014)] and multivariate [sex (p = 0.019), adult age (p = 0.01) and physical functioning (p = 0.04)]]; low mood [time of evolution (p = 0.028) and multivariate [time course (p = 0.007), ADLQ (p = 0.011), role physical (p = 0.013) and general health (p = 0.001)]] and anxiety [physical functioning (p = 0.046) and multivariate [physical functioning (p = 0.034), age (p = 0.011), time of evolution (p = 0.001) and ADQL (p = 0.011)]]. Conclusions: Increased age, gender and longer evolution time seem to favour the prevalence and occurrence of mental health symptoms; greater independence and good physical functioning are protective factors with respect to the occurrence of mental health-related symptoms in patients affected by post-COVID-19 condition.
Citation: Healthcare
PubDate: 2024-08-05
DOI: 10.3390/healthcare12151551
Issue No: Vol. 12, No. 15 (2024)
