Healthcare

13 pages, 264 KiB

Open AccessArticle

Assessment of Oral Health Knowledge, Attitudes, and Behaviours among University Students in the Asir Region—Saudi Arabia: A Cross-Sectional Study

by Geetha Kandasamy and Tahani Almeleebia

Healthcare 2023, 11(23), 3100; https://doi.org/10.3390/healthcare11233100 - 4 Dec 2023

Cited by 2 | Viewed by 2270

Abstract

Background: The purpose of this study is to evaluate the knowledge, attitudes, and behaviours (KAB) of health and non-health-related students at university concerning oral health. Materials and Methods: This cross-sectional study with a 3-month duration in 2023 was conducted amongst King Khalid University [...] Read more.

Background: The purpose of this study is to evaluate the knowledge, attitudes, and behaviours (KAB) of health and non-health-related students at university concerning oral health. Materials and Methods: This cross-sectional study with a 3-month duration in 2023 was conducted amongst King Khalid University (KKU) students. This study used a self-administered, anonymous web-based survey with a simple random sampling strategy as part of its cross-sectional design. The questionnaire had four sections totalling 26 questions to evaluate KAB. A chi-square test was used to evaluate significant differences between categories. Results: Of the 845 respondents who completed the survey, 43.78% were health-related students, while 56.21% were non-health-related students. The completed responses included bacteria causing gingival problems (60.81% vs. 36%), fizzy soft drinks adversely affecting teeth (67.83% vs. 40%), tobacco chewing or smoking possibly causing oral cancer (68.37% vs. 44%), white patches or dental plaque on teeth (61.89% vs. 41.47%), brushing teeth twice a day to improve oral health (81.62% vs. 42.52%), keeping teeth clean (64.86% vs. 41.68%), improper brushing leading to gum disease (70% vs. 40.63%), brushing with fluoridated toothpaste to prevent tooth decay (63% vs. 40%), bleeding gums denoting gum infection (26.98% vs. 21.30%), the importance of teeth similar to any body part (61.62% vs. 37.89%), prioritising teeth as other parts of the body (61.05% vs. 36.21%), brushing teeth twice daily (55.67% vs. 37.05%), and routine dental check-ups (55.40% vs. 14.10%) for health and non-health-related students, respectively (p < 0.05). Conclusion: The results of the current study demonstrated less oral health KAB in non-health-related students than in health-related students. Nonetheless, healthcare students provided erroneous information regarding oral health. Therefore, we urge the appropriate authorities to offer health and non-health-related students the best oral health promotion programmes and services, thereby seeking to improve their oral health knowledge while stressing the importance of practising excellent oral hygiene. Full article

13 pages, 3378 KiB

Open AccessArticle

Measurement of Three-Dimensional Back Shape of Normal Adults Using a Novel Three-Dimensional Imaging Mobile Surface Topography System (MSTS): An Intra- and Inter-Rater Reliability Study

by Gok Kandasamy, Josette Bettany-Saltikov and Paul Van Schaik

Healthcare 2023, 11(23), 3099; https://doi.org/10.3390/healthcare11233099 - 4 Dec 2023

Viewed by 1165

Abstract

Postural and spinal deformities are major contributing factors to musculoskeletal (MSK) disorders. Posture screening and assessment can help to identify early morphological deformities, thereby preventing progression and reducing or correcting them with effective treatments. The study evaluates both intra- and inter-repeatability of using [...] Read more.

Postural and spinal deformities are major contributing factors to musculoskeletal (MSK) disorders. Posture screening and assessment can help to identify early morphological deformities, thereby preventing progression and reducing or correcting them with effective treatments. The study evaluates both intra- and inter-repeatability of using a mobile structured light sensor with a structured light pattern for building an accurate 3D human model and its use in postural screening. 16 young males (age: 25 ± 5.6 years, height: 172 ± 5.3 cm, mass: 69 ± 8.6 kg) participated without any musculoskeletal pain or pre-existing leg or spinal abnormalities. An iPad-based 3D mobile scanning tool, Structure Sensor^TM (2018 version), was used to capture the participants’ back and whole-body shape. The collected data (3D model) were realigned and processed in the open-source software, Netfabb Basic^TM (7.2 version). For each participant, five trained raters individually measured three trials of standing back and body posture on two separate occasions to calculate both intra- and inter-rater reliability. With the use of this software, nine postural variables and angular displacements were individually measured by the raters. The results indicated good to excellent intra-rater and good to moderate inter-rater reliability for measuring 78% (7 out of 9) of postural variables with an ICC ranging from 0.70 to 0.98. The remaining 22% of variables (2 out of 9; lateral pelvic tilt and right frontal knee angle) showed moderate to low inter- and intra-rater reliability, with ICCs ranging from 0.26 to 0.79. Full article

(This article belongs to the Special Issue Advances and Innovations in the Management of Spinal Conditions and Disorders)

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12 pages, 1445 KiB

Open AccessReview

Situational Awareness in the Context of Clinical Practice

by Shani Feller, Liviu Feller, Ahmed Bhayat, Gal Feller, Razia Abdool Gafaar Khammissa and Zunaid Ismail Vally

Healthcare 2023, 11(23), 3098; https://doi.org/10.3390/healthcare11233098 - 4 Dec 2023

Cited by 2 | Viewed by 2495

Abstract

In the context of clinical practice, situational awareness refers to conscious awareness (knowledge), which is a mental model of a given clinical situation in terms of its elements and the significance of their interrelation. Situational awareness (SA) facilitates clinical reasoning, diagnostic accuracy, and [...] Read more.

In the context of clinical practice, situational awareness refers to conscious awareness (knowledge), which is a mental model of a given clinical situation in terms of its elements and the significance of their interrelation. Situational awareness (SA) facilitates clinical reasoning, diagnostic accuracy, and appropriate goal-directed performance, and it enables clinicians to immediately adapt treatment strategies in response to changes in clinical situational actualities and to modify the course of goal-directed activities accordingly. It also helps clinicians prepare future operational plans and procedures based on the projection of situational developments. SA, therefore, is an important prerequisite for safe clinical procedures. The purpose of this narrative review is to highlight certain cognitive and external (environmental) situational factors that influence the development of situational awareness. Understanding the dynamic, adaptive, and complex interactions between these factors may assist clinicians and managers of healthcare systems in developing methods aimed at facilitating the acquisition of accurate clinical situational awareness and, in turn, may bring about a reduction in the incidence of SA, diagnostic, and operational errors. Full article

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11 pages, 491 KiB

Open AccessArticle

Depression Moderates the Relationship between Trait Anxiety, Worry and Attentional Control in Melanoma Survivors

by Elizabeth J. Edwards, Khanh Linh Chu, Nikeith John, Mark S. Edwards and Michael Lyvers

Healthcare 2023, 11(23), 3097; https://doi.org/10.3390/healthcare11233097 - 4 Dec 2023

Cited by 1 | Viewed by 2026

Abstract

Cancer survivors commonly contend with concurrent cognitive difficulties such as problems with attention and concentration, and psychological distress, including anxiety and depression. However, the associations between attentional and emotional difficulties within the specific context of melanoma survivors remain relatively unexplored. Premised on attentional [...] Read more.

Cancer survivors commonly contend with concurrent cognitive difficulties such as problems with attention and concentration, and psychological distress, including anxiety and depression. However, the associations between attentional and emotional difficulties within the specific context of melanoma survivors remain relatively unexplored. Premised on attentional control theory, the current study employed a cross-sectional design to explore the interplay among trait anxiety (dispositional) and situational anxiety (cancer-related worry), depression and attentional control (ability to inhibit distractors and flexibly shift within and between tasks) in a sample of 187 melanoma survivors aged 18 to 58 years (M_age = 36.83 years, SD_age = 5.44 years; 93% female). Data were analyzed using a moderated multiple regression, with anxiety, cancer worry and depression as predictors, and attentional control as the criterion variable. After statistically controlling for the variance of chemotherapy, we found that individuals with higher trait anxiety and higher cancer-related worry reported greater attentional control at low levels of depression, yet poorer attentional control at high depression, relative to individuals with low anxiety. Our findings suggest that anxiety and depression are differentially related to attentional control in melanoma survivors. The results provide a marker for clinicians addressing anxiety and depression in this population. Implications for primary healthcare are discussed. Full article

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15 pages, 853 KiB

Open AccessArticle

Evaluation of the Efficacy of UV-C Radiation in Eliminating Microorganisms of Special Epidemiological Importance from Touch Surfaces under Laboratory Conditions and in the Hospital Environment

by Anna Różańska, Monika Walkowicz, Małgorzata Bulanda, Tomasz Kasperski, Edyta Synowiec, Piotr Osuch and Agnieszka Chmielarczyk

Healthcare 2023, 11(23), 3096; https://doi.org/10.3390/healthcare11233096 - 4 Dec 2023

Cited by 1 | Viewed by 1936

Abstract

Introduction: Healthcare-associated infections in the post-pandemic era are as important as they were before COVID-19. The dominant route of transmission of microorganisms in health care units is the contact route, for which hand hygiene is of cardinal importance, but also effective disinfection of [...] Read more.

Introduction: Healthcare-associated infections in the post-pandemic era are as important as they were before COVID-19. The dominant route of transmission of microorganisms in health care units is the contact route, for which hand hygiene is of cardinal importance, but also effective disinfection of touch surfaces. Traditional disinfection based on chemical compounds is sensitive to human errors. Therefore, a valuable supplement to it can be contactless disinfection methods, including the use of UV-C. The aim of the study was to assess the effectiveness of UV-C radiation in eliminating selected, most important pathogens of particular epidemic importance from surfaces made of various materials: stainless steel, plastic and glass, most often found in hospital conditions. Material and Method: In laboratory conditions, the study was conducted using bacterial strains of great epidemiological importance and Candida auris. In hospital wards, samples were taken before and after disinfection for comparisons of the composition and quantity of bacteria. In laboratory conditions, carriers made of steel, plastic and glass were contaminated with a bacterial suspension with a density of approx. 0.5 McFarland, and then the density of persistent microorganisms was assessed after 10 min of UV-C irradiation. Results: The high effectiveness of UV-C radiation in eliminating bacteria contaminating touch surfaces in hospital wards and in laboratory conditions has been confirmed. The elimination efficiency in laboratory conditions was slightly lower (statistically insignificant) on the plastic surface, which is probably related to subtle differences in the thickness of the contaminating layer. Hydrophobic properties and the smallest suspension diameter were confirmed for the tested plastic carriers. Conclusions: UV-C disinfection is a desirable element to support traditional, chemical methods of disinfection in hospital conditions, effective against multidrug-resistant bacteria and C. auris. Full article

(This article belongs to the Special Issue Old and New Challenges for Infection Control in the Post Pandemic Era)

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15 pages, 716 KiB

Open AccessArticle

Exploring Safety Culture in the ICU of a Large Acute Teaching Hospital through Triangulating Different Data Sources

by Ellen Liston, Enda O’Connor and Marie E. Ward

Healthcare 2023, 11(23), 3095; https://doi.org/10.3390/healthcare11233095 - 4 Dec 2023

Cited by 1 | Viewed by 1620

Abstract

Safety Culture (SC) has become a key priority for safety improvement in healthcare. Studies have identified links between positive SC and improved patient outcomes. Mixed-method measurements of SC are needed to account for diverse social, cultural, and subcultural contexts within different healthcare settings. [...] Read more.

Safety Culture (SC) has become a key priority for safety improvement in healthcare. Studies have identified links between positive SC and improved patient outcomes. Mixed-method measurements of SC are needed to account for diverse social, cultural, and subcultural contexts within different healthcare settings. The aim of the study was to triangulate data on SC from three sources in an Intensive Care Unit (ICU) in a large acute teaching hospital. A mixed-methods approach was used, including analysing the Hospital Survey for Patient Safety Culture results, retrospective chart reviews using the Global Trigger Tool (GTT) for the ICU, and staff reporting of adverse events (AE). There was a 47% (101/216) response rate for the survey. Further, 98% of respondents stated a positive patient safety rating. The GTT identified 16 AEs and 11 AEs that were reported in the same timeframe. The triangulation of the data demonstrates the complexity of understanding components of SC in particular: learning, reporting, and just culture. Full article

(This article belongs to the Special Issue Innovative Approaches for Safety Culture Improvement in Healthcare Systems)

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14 pages, 2771 KiB

Open AccessSystematic Review

E-Learning in Nursing and Midwifery during the COVID-19 Pandemic

by Nataša Mlinar Reljić, Maja Drešček Dolinar, Gregor Štiglic, Sergej Kmetec, Zvonka Fekonja and Barbara Donik

Healthcare 2023, 11(23), 3094; https://doi.org/10.3390/healthcare11233094 - 4 Dec 2023

Cited by 2 | Viewed by 1853

Abstract

As the COVID-19 pandemic continues to spread, e-learning has increased. This is a challenge for nursing and midwifery students, as clinical training is an essential part of their education. The aim of this review was to identify the advantages and limitations of e-learning [...] Read more.

As the COVID-19 pandemic continues to spread, e-learning has increased. This is a challenge for nursing and midwifery students, as clinical training is an essential part of their education. The aim of this review was to identify the advantages and limitations of e-learning for nursing and midwifery students during the COVID-19 pandemic. A systematic review of the literature was conducted following the PRISMA guidelines. The international databases PubMed, CINAHL/MEDLINE, Web of Science, and ScienceDirect were searched. Articles were critically appraised. Thematic analysis was used to synthesise the data. The search resulted in 91 hits. Thirteen studies were included in the final analysis. Three main themes were identified: (1) the benefits of e-learning; (2) the challenges/limitations of e-learning; and (3) recommendations for e-learning. E-learning in nursing and midwifery is an effective alternative learning process during the COVID-19 pandemic. Students perceive several benefits and challenges related to internet access, technical equipment, financial aspects, and work and family commitments. Full article

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10 pages, 455 KiB

Open AccessArticle

Adult Attachment and Fear of Missing Out: Does the Mindful Attitude Matter?

by Matteo Perazzini, Danilo Bontempo, Marco Giancola, Simonetta D’Amico and Enrico Perilli

Healthcare 2023, 11(23), 3093; https://doi.org/10.3390/healthcare11233093 - 4 Dec 2023

Cited by 1 | Viewed by 1990

Abstract

Fear of missing out (FoMO) involves the desire or urge to stay continuously connected to and kept up-to-date with a social reference group. The present study explored the relationships between adult attachment and FoMO and the potential mediating effect of a mindful attitude. [...] Read more.

Fear of missing out (FoMO) involves the desire or urge to stay continuously connected to and kept up-to-date with a social reference group. The present study explored the relationships between adult attachment and FoMO and the potential mediating effect of a mindful attitude. The present study was carried out on 192 participants (mean_age = 23.24 years; SD_age = 4.33 years), of whom 151 (78.6%) were female and the remaining 41 (21.4%) were male. The participants completed the Adult Attachment Scale—Revised (AAS-R), which evaluates Close, Depend, and Anxiety attachment, the Cognitive and Affective Mindfulness Scale—Revised (CAMS-R) and the Fear of Missing Out Scale (FoMOs). The results indicated that the three forms of adult attachment (Close, Depend, and Anxiety) were associated with FoMO through the indirect effect of mindful attitudes. This study yielded relevant theoretical and practical implications regarding the critical role of a mindful attitude as a protective factor against FoMO. Limitations and future research directions were also discussed. Full article

(This article belongs to the Special Issue Risk and Protective Factors for Promoting Psychological Health and Preventing Psychological Disorders in Emerging Adulthood)

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12 pages, 1209 KiB

Open AccessArticle

Task-Oriented Training with Abdominal Drawing-in Maneuver in Sitting Position for Trunk Control, Balance, and Activities of Daily Living in Patients with Stroke: A Pilot Randomized Controlled Trial

by Seunghoon Jeong and Yijung Chung

Healthcare 2023, 11(23), 3092; https://doi.org/10.3390/healthcare11233092 - 4 Dec 2023

Cited by 1 | Viewed by 1794

Abstract

In many patients with stroke, trunk stabilization and balance are decreased. Trunk stabilization and balance are important to perform posture control and functional movement. This study investigates the effects of task-orientated training with the abdominal drawing-in maneuver in a sitting position on trunk [...] Read more.

In many patients with stroke, trunk stabilization and balance are decreased. Trunk stabilization and balance are important to perform posture control and functional movement. This study investigates the effects of task-orientated training with the abdominal drawing-in maneuver in a sitting position on trunk control, balance, and activities of daily living in patients with chronic stroke. The study design is a randomized controlled trial. Thirty-eight patients with chronic stroke participated in this study. The task-oriented training combined with the abdominal drawing-in maneuver group (n = 13), the task-oriented training group (n = 13), and the control group (n = 12) received traditional physical therapy. Three groups participated in a total of 20 sessions, four times a week for five weeks. After the five-week training period, trunk control, balance, and activities of daily living were assessed. The task-oriented training combined with the abdominal drawing-in maneuver group demonstrated significant improvements in trunk control, balance, and activities of daily living compared to the task-oriented training and control groups (p < 0.05). These results have implications for improving trunk control, balance, and activities of daily living for patients with stroke, and support the integration of this training method into standard clinical practice. Full article

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11 pages, 252 KiB

Open AccessArticle

Comprehensive Evaluation of Quality of Life in Penile Cancer Patients following Surgical Treatment

by Darko Jovanović, Miodrag Aćimović, Tomislav Pejčić, Bogomir Milojević, Bojan Čegar, Milica Zeković, Nikola Lisičić, Zoran Džamić and Gorica Marić

Healthcare 2023, 11(23), 3091; https://doi.org/10.3390/healthcare11233091 - 4 Dec 2023

Cited by 1 | Viewed by 1282

Abstract

Background: Penile cancer (PC) is a highly aggressive disease, with a significant tendency for lymphatic spreading and subsequent development of distant metastases. The mutilating nature of PC surgical treatment has profound implications on the patient’s body integrity and self-image, sexual life and intimacy, [...] Read more.

Background: Penile cancer (PC) is a highly aggressive disease, with a significant tendency for lymphatic spreading and subsequent development of distant metastases. The mutilating nature of PC surgical treatment has profound implications on the patient’s body integrity and self-image, sexual life and intimacy, voiding and mental health. The aim of our study was to comprehensively evaluate PC patients’ post-treatment quality of life (QoL), sexual activity, self-esteem, fatigue and fear of disease recurrence. (2) Methods: A cross-sectional study was conducted at the Clinic of Urology, University Clinical Centre of Serbia, and included 31 PC patients. Data were collected by means of a questionnaire. (3) Results: The average score on the Global health status scale was 67.2 out of 100 (ranging from 16.7 to 100), and the SD was 22.5. Hierarchical linear regression analysis showed that demographic characteristics, Hospital Anxiety and Depression scale (HADS) anxiety and depression scores, total Multidimensional Fatigue Inventory, Fear of cancer recurrence and Rosenberg scores and erectile function score explained a total of 78.2% of the variance in the global health status/QoL scale of PC patients. (4) Conclusions: Efforts should be made not only to increase the survival of PC patients after surgical treatment but also to enable the best possible level of QoL in the post-operative period. Full article

(This article belongs to the Special Issue Urological Cancer Care—Improving Patient Outcomes)

11 pages, 455 KiB

Open AccessArticle

Validation of the Arabic Version of the Patient Activation Measure (PAM-13) for Application within the Primary Healthcare Context in Saudi Arabia

by Ali Kerari, Malak Almalki, Ghareeb Bahari and Manal F. Alharbi

Healthcare 2023, 11(23), 3090; https://doi.org/10.3390/healthcare11233090 - 4 Dec 2023

Cited by 2 | Viewed by 1494

Abstract

Background: Empowering patients with behavioral issues or chronic conditions to actively participate in their healthcare can help improve health outcomes. However, in the Saudi Arabian context, evaluation tools for achieving this goal are lacking, considering cultural and healthcare system factors. Therefore, this study [...] Read more.

Background: Empowering patients with behavioral issues or chronic conditions to actively participate in their healthcare can help improve health outcomes. However, in the Saudi Arabian context, evaluation tools for achieving this goal are lacking, considering cultural and healthcare system factors. Therefore, this study aimed to determine the psychometric properties of the Arabic version of the Patient Activation Measure. Methods: This cross-sectional validation study was conducted on a sample of 225 patients receiving treatment from primary healthcare centers located in Riyadh, Saudi Arabia. Item analyses and reliability and construct validity testing of the tool were conducted. Results: The item–total correlation coefficients ranged from 0.31 (item 2) to 0.57 (item 11). The item–total correlation coefficients for all 13 items were above 0.30. The reliability was 0.80. A two-factor model (“knowledge and beliefs” and “confidence and skills”) reflecting the instrument was constructed. The raw model did not sufficiently fit the data (χ² = 170.98, degree of freedom (df) = 64, p < 0.001; Tucker–Lewis index (TLI) = 0.79; comparative fit index (CFI) = 0.83; root mean square error of approximation (RMSEA) = 0.86 [90% confidence interval {CI} = 0.07–0.10]). After all significant correlations between the items’ error terms were modeled, an adequate fit was achieved (χ² = 76.76, df = 51, p < 0.01; TLI = 0.94; CFI = 0.96; RMSEA = 0.04 [90% CI = 0.02–0.07]). Conclusions: the Arabic version of the Patient Activation Measure can be utilized by healthcare providers to assess the activation levels and unique needs and preferences of Arabic-speaking individuals and tailor interventions accordingly to provide necessary support. Full article

(This article belongs to the Section Nursing)

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11 pages, 1348 KiB

Open AccessArticle

Assessing Tele-Oral Medicine in Saudi Arabia: A Cross-Sectional Study on Specialists’ Experiences and Effectiveness in Oral Healthcare

by Sara Akeel, Soulafa Almazrooa, Sarah Alfarabi Ali, Nada A. Alhindi, Sana Alhamed, Osama M. Felemban, Ghada Mansour, Dania Sabbahi, Nada Binmadi and Hani Mawardi

Healthcare 2023, 11(23), 3089; https://doi.org/10.3390/healthcare11233089 - 2 Dec 2023

Cited by 1 | Viewed by 1436

Abstract

Introduction: Teledentistry is an emerging tool to exchange medical information and clinical images to facilitate the diagnosis, prevention, and treatment of oral diseases and patient assurance and education. Considering the shortage of oral medicine specialists in Saudi Arabia, this study aims to assess [...] Read more.

Introduction: Teledentistry is an emerging tool to exchange medical information and clinical images to facilitate the diagnosis, prevention, and treatment of oral diseases and patient assurance and education. Considering the shortage of oral medicine specialists in Saudi Arabia, this study aims to assess the experiences of dental specialists with tele-oral medicine and its potential applicability in addressing this shortage. Materials and methods: This was a pilot, cross-sectional study conducted among specialists in the field of oral medicine from January 2020 to March 2020. A total of 16 preselected cases with oral lesions, including clinical history and images, were developed, validated, and shared via email with study participants. Each case included questions on differential diagnosis, provisional diagnosis, and management. The responses were recorded, analyzed, and presented as means and percentages. Results: A total of 49 subjects participated in this study and more than half were under 40 years of age and two-thirds were women. A total of 23 participants had prior experience with tele-oral medicine, mainly via WhatsApp (95.7%), and these cases were received from patients, their families, friends, or other dentists. For all study cases, the correct diagnosis score ranged between 73.50 and 100%, and correct management ranged between 51 and 98%. Conclusions: Tele-oral medicine is an effective tool that may play an important role in patient management in rural regions with a shortage of oral medicine services. Further studies with larger sample sizes and in collaboration with international centers are warranted to confirm these findings. Full article

(This article belongs to the Special Issue Telehealth and Remote Patient Monitoring)

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16 pages, 3860 KiB

Open AccessArticle

Changes in the Impacts of COVID-19 over Time on Families with Older Adults Living on Remote Islands in Japan: A Study in Family Ethnographic Research

by Naohiro Hohashi, Mikio Watanabe, Minami Taniguchi and Shiho Araki

Healthcare 2023, 11(23), 3088; https://doi.org/10.3390/healthcare11233088 - 2 Dec 2023

Viewed by 1252

Abstract

Coronavirus disease 2019 (COVID-19) affected not only individuals but also families. The purpose of this study was to clarify the temporal changes in the impact of the COVID-19 pandemic on entire families with older adults susceptible to infection living on small islands in [...] Read more.

Coronavirus disease 2019 (COVID-19) affected not only individuals but also families. The purpose of this study was to clarify the temporal changes in the impact of the COVID-19 pandemic on entire families with older adults susceptible to infection living on small islands in Japan over the duration of the pandemic. Family ethnographic research was conducted from 2021 to 2023, using the Concentric Sphere Family Environment Theory as the theoretical framework. Formal interviews were conducted with 20 families. In addition, data from informal interviews, participant observation and other sources were compiled into field notes. All data on the impact on the entire family were extracted and content analysis was conducted. Six categories (family internal environmental system, family system unit, micro system, macro system, supra system, and family chrono-environment system) and a total of 85 subcategories were extracted. The results show that COVID-19 exerted not only negative but also positive impacts on the entire family, and their temporal changes are clarified. The impact on families is believed to have been influenced by the family external environment, such as increases and decreases of infection cases or events that occurred outside the family. The knowledge acquired from these studies will help healthcare professionals in providing appropriate family support. Full article

(This article belongs to the Collection COVID-19: Impact on Public Health and Healthcare)

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16 pages, 664 KiB

Open AccessArticle

Perceived Benefits of Magdalena Energy Healing Sessions: An Exploratory Study of Clients’ Perspectives

by Alvina D. Brueggemann and Angela U. Ekwonye

Healthcare 2023, 11(23), 3087; https://doi.org/10.3390/healthcare11233087 - 2 Dec 2023

Cited by 1 | Viewed by 1462

Abstract

Background: Energy healing techniques are associated with many physical and mental benefits. A qualitative study was conducted to understand clients’ experiences of a new energy healing modality called Magdalena Energy Healing. Methods: Semi-structured qualitative interviews were conducted after clients experienced 60 min Magdalena [...] Read more.

Background: Energy healing techniques are associated with many physical and mental benefits. A qualitative study was conducted to understand clients’ experiences of a new energy healing modality called Magdalena Energy Healing. Methods: Semi-structured qualitative interviews were conducted after clients experienced 60 min Magdalena energy healing session(s). Twenty-five adults participated in the study. All participants received Magdalena energy healing from a certified, trained practitioner. Thematic analysis was conducted to determine clients’ perceived benefits of the Magdalena energy healing session(s). Results: Four themes emerged from the data: Physical, Mental, Social, and Spiritual Benefits. Physical health benefits included relief from a variety of medical symptoms, improved sleep quality, and physical body awareness. Mental Health benefits included relaxation and peace, decision-making clarity, relief of mental health symptoms, and an increased ability to cope with life. Social Benefits included improved attitudes in relationships. Spiritual Benefits included optimism, gratitude, self-acceptance, and increased spiritual connection. Conclusions: Participants’ perceptions are that Magdalena energy healing sessions offer peace, symptom relief, and gratitude. Magdalena energy healing can address priorities of The National Center for Complementary and Integrative Health (NCCIH). Sessions can be seamlessly integrated into traditional medical care as a useful complementary/integrative healing option to improve physical, mental, and/or spiritual wellbeing across a variety of diseases. Full article

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16 pages, 2201 KiB

Open AccessReview

Research Trends in Motivation and Weight Loss: A Bibliometric-Based Review

by Uroš Železnik, Peter Kokol, Jasmina Starc, Danica Železnik, Jernej Završnik and Helena Blažun Vošner

Healthcare 2023, 11(23), 3086; https://doi.org/10.3390/healthcare11233086 - 1 Dec 2023

Cited by 6 | Viewed by 2418

Abstract

Obesity is a complex disease that, like COVID-19, has reached pandemic proportions. Consequently, it has become a rapidly growing scientific field, represented by an extensive body of research publications. Therefore, the aim of this study was to present the research trends in the [...] Read more.

Obesity is a complex disease that, like COVID-19, has reached pandemic proportions. Consequently, it has become a rapidly growing scientific field, represented by an extensive body of research publications. Therefore, the aim of this study was to present the research trends in the scientific literature on motivation and weight loss. Because traditional knowledge synthesis approaches are not appropriate for analyzing large corpora of research evidence, we utilized a novel knowledge synthesis approach called synthetic knowledge synthesis (SKS) to generate new holistic insights into obesity research focusing on motivation. SKS is a triangulation of bibliometric analysis, bibliometric mapping, and content analysis. Using it, we analyzed the corpus of publications retrieved from the Scopus database, using the search string TITLE-ABS-KEY((obesity or overweight) and “weight loss” and motiv*) in titles, keywords, and abstracts, without any additional inclusion or exclusion criteria. The search resulted in a corpus of 2301 publications. The United States of America, the United Kingdom, and Australia were the most productive countries. Four themes emerged, namely, weight loss and weight-loss maintenance through motivational interventions, lifestyle changes supported by smart ICT, maintaining sustainable weight with a healthier lifestyle, and weight management on the level of primary healthcare and bariatric surgery. Further, we established that the volume of research literature is growing, as is the scope of the research. However, we observed a regional concentration of research and its funding in developed countries and almost nonexistent research cooperation between developed and less-developed countries. Full article

(This article belongs to the Topic Public Health and Healthcare in the Context of Big Data)

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10 pages, 1552 KiB

Open AccessCase Report

Manual Lymph Drainage for Post-COVID-19 Related Cough, Breathlessness, and Fatigue; Two Case Reports

by Bronwyn Overall, Kaori Langley and Janet Douglass

Healthcare 2023, 11(23), 3085; https://doi.org/10.3390/healthcare11233085 - 1 Dec 2023

Viewed by 2160

Abstract

Background: Persistent symptoms after SARS CoV-2 infection such as fatigue, shortness of breath, and cognitive dysfunction that cannot be explained by an alternative diagnosis have been termed long COVID and present a significant emerging public health problem. Current approaches include rehabilitation and symptom [...] Read more.

Background: Persistent symptoms after SARS CoV-2 infection such as fatigue, shortness of breath, and cognitive dysfunction that cannot be explained by an alternative diagnosis have been termed long COVID and present a significant emerging public health problem. Current approaches include rehabilitation and symptom management involving multiple health disciplines and as yet there are no pharmaceutical approaches other than routine symptom management. Manual lymph drainage (MLD) has been used to support recovery during pulmonary rehabilitation and reduce chronic inflammation including symptoms associated with long COVID. Case description and outcomes: Two adult females who had reported long-COVID symptoms more than 10 weeks after the resolution of the acute infection were treated with MLD by Remedial Therapists trained in the Dr Vodder method of MLD. Respiratory function (Peak Flow Meter) and blood oxygen levels (Oximeter) were recorded before and after a one-minute sit-to-stand test prior to the treatment. The Dyspnea-12 Questionnaire, the Revised Piper Fatigue Scale, and Likert scales were used to collect client-reported outcomes. Six 45-min treatments were applied weekly, with a follow-up review and treatment at three months. In both cases, all outcomes improved after the third treatment with further improvement noted at three months. Conclusions: MLD may offer a non-invasive, non-pharmaceutical approach to the resolution of long-COVID symptoms such as cough, breathlessness, and fatigue. Full article

(This article belongs to the Section Chronic Care)

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10 pages, 982 KiB

Open AccessArticle

Psychological Distress in Alzheimer’s Disease Family Caregivers: Gender Differences and the Moderated Mediation of Resilience

by José Manuel Ponsoda, María Ángeles Beleña and Amelia Díaz

Healthcare 2023, 11(23), 3084; https://doi.org/10.3390/healthcare11233084 - 1 Dec 2023

Cited by 1 | Viewed by 1801

Abstract

Different studies have reported gender differences in the variables of psychological distress, burden, social support, and resilience in family caregivers of relatives with Alzheimer’s disease; however, there is no clear evidence of the specific role of burden, social support, and resilience between gender [...] Read more.

Different studies have reported gender differences in the variables of psychological distress, burden, social support, and resilience in family caregivers of relatives with Alzheimer’s disease; however, there is no clear evidence of the specific role of burden, social support, and resilience between gender and psychological distress. The aim of the present study is to clarify the role of these variables. Burden, psychological distress, social support, and resilience have been assessed in a cross-sectional design with a convenience sample of 140 family caregivers of relatives with Alzheimer’s disease. Our results confirm gender differences in terms of psychological distress, with higher scores found in female than in male caregivers, whilst male caregivers showed higher scores in terms of resilience than female caregivers. No gender differences have been found in terms of burden and social support. In addition, moderated mediation was obtained via the interaction of gender and social support on resilience, which plays a mediating role in psychological distress. Social support and resilience have shown a protective role concerning the mental health of caregivers, but female caregivers need higher social support to present a similar level of resilience to male caregivers. Full article

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16 pages, 1824 KiB

Open AccessSystematic Review

The Effectiveness of Pilates Training Interventions on Older Adults’ Balance: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

by Tatiana Sampaio, Samuel Encarnação, Olga Santos, Diogo Narciso, João P. Oliveira, José E. Teixeira, Pedro Forte, Jorge E. Morais, Catarina Vasques and António Miguel Monteiro

Healthcare 2023, 11(23), 3083; https://doi.org/10.3390/healthcare11233083 - 1 Dec 2023

Cited by 3 | Viewed by 2649

Abstract

Background and Objectives: Pilates training intervention programs have gained attention as a potential approach to enhancing balance in older adults, thereby reducing the risk of falls. In light of these considerations, this systematic review and meta-analysis aimed to critically evaluate the existing evidence [...] Read more.

Background and Objectives: Pilates training intervention programs have gained attention as a potential approach to enhancing balance in older adults, thereby reducing the risk of falls. In light of these considerations, this systematic review and meta-analysis aimed to critically evaluate the existing evidence and determine the effect of Pilates training intervention programs on older adults’ balance. Materials and Methods: The literature was searched through the PubMed, Web of Science, and Scopus databases from inception until July 2023. The primary keywords used for the literature search included “elderly” or “older adults” and “pilates training” and “balance”. Results: The systematic review through qualitative analysis showed robust evidence about the efficacy of Pilates intervention programs in improving older adults’ balance. The pooled meta-analysis of static and dynamic balance showed that eight (53%) out of a total fifteen analyzed interventions presented a significant effect of Pilates in improving the participants’ balance, without between-study heterogeneity. In addition, the meta-analysis regarding dynamic balance showed that six (67%) out of nine analyzed interventions presented a significant effect of Pilates in improving the participants’ balance, without heterogeneity between studies. Similarly, the meta-analysis regarding static balance showed that four (50%) out of eight analyzed studies presented significant effects on the older adults’ balance, where moderate between-study heterogeneity was found. Sensitivity analysis showed that three studies reduced the between-study heterogeneity (19, 17.6, and 17%), regressing from moderate to low heterogeneity, p < 0.05. Conclusions: This systematic review and meta-analysis underscores the potential of Pilates training as a valuable intervention to enhance balance in the elderly population. Full article

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13 pages, 957 KiB

Open AccessArticle

Beyond Hypoglossal Hype: Social Media Perspectives on the Inspire Upper Airway Stimulation System

by Nicholas A. Rossi, Bridget A. Vories, Samuel E. Razmi, Nishat A. Momin, Zachary S. Burgess, Harold S. Pine, Sepehr Shabani, Rizwana Sultana and Brian J. McKinnon

Healthcare 2023, 11(23), 3082; https://doi.org/10.3390/healthcare11233082 - 1 Dec 2023

Cited by 1 | Viewed by 1435

Abstract

In the landscape of sleep surgery, the Inspire^® Upper Airway Stimulation (UAS) device has gained prominence as an increasingly popular treatment option for obstructive sleep apnea, prompting significant discourse across social media platforms. This study explores the social media narrative of the [...] Read more.

In the landscape of sleep surgery, the Inspire^® Upper Airway Stimulation (UAS) device has gained prominence as an increasingly popular treatment option for obstructive sleep apnea, prompting significant discourse across social media platforms. This study explores the social media narrative of the UAS device, particularly the nature of multimedia content, author demographics, and audience engagement on Instagram, Facebook, and TikTok. Our analysis encompassed 423 public posts, revealing images (67.4%) and videos (28.1%) as the dominant content types, with over a third of posts authored by physicians. A notable 40% of posts were advertisements, whereas patient experiences comprised 34.5%. TikTok, although presenting a smaller sample size, showed a substantially higher engagement rate, with posts averaging 152.9 likes, compared with Instagram and Facebook at 32.7 and 41.2 likes, respectively. The findings underscore the need for otolaryngologists and healthcare professionals to provide clear, evidence-based information on digital platforms. Given social media’s expanding role in healthcare, medical professionals must foster digital literacy and safeguard the accuracy of health information online. In this study, we concluded that maintaining an evidence-based, transparent digital dialogue for medical innovations such as the UAS device necessitates collaborative efforts among physicians, health institutions, and technology companies. Full article

(This article belongs to the Special Issue The 10th Anniversary of Healthcare—TeleHealth and Digital Healthcare)

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13 pages, 991 KiB

Open AccessArticle

Variables Associated with Attitudes toward Biodebridement Using Lucilia sericata Larvae in a Group of Nurses

by Dariusz Bazaliński, Kamila Pytlak, Joanna Przybek-Mita, Paulina Szymańska, Anna Wójcik, Aneta Zymon, Ronald Sherman, Albert Nguyen, Izabela Sałacińska and Paweł Więch

Healthcare 2023, 11(23), 3081; https://doi.org/10.3390/healthcare11233081 - 1 Dec 2023

Cited by 2 | Viewed by 1227

Abstract

Despite numerous studies and recommendations, the acceptance of treatments involving medicinal maggots in many clinics has been slow. Several factors may account for this, including the gender of nurses administering the treatment, their level of work experience, and their perceived level of personal [...] Read more.

Despite numerous studies and recommendations, the acceptance of treatments involving medicinal maggots in many clinics has been slow. Several factors may account for this, including the gender of nurses administering the treatment, their level of work experience, and their perceived level of personal stress. The aim of the study was to assess the impact of selected variables (gender, work experience, stress level) on the readiness of nurses to administer maggot debridement therapy (MDT), which is a form of biodebridement. The study population was a cohort of 290 wound care nurses providing specialist care for patients with chronic wounds. It was assumed that the identified variables may determine the implementation of larval therapy in everyday professional practice. A subsample of 35 men and 35 women was further analyzed to determine if gender, work experience, and/or personal stress levels were correlated with attitudes towards the utilization of maggots in biodebridement. Assessment tools included the Perceived Stress Scale (PSS-10) and the MDT 10 Perception Assessment Questionnaire, a protocol by which the subject ranked six wound photographs in order of repulsiveness and responded to questions regarding demographic variables, which include education and work experience. The visual perception of pictures of a wound with larvae is indirectly an indicator of the attitude towards larval therapy. Selection of the photograph with maggots on the wound as the most repulsive image was associated with a personal appraisal of not being ready to implement maggot therapy (chi-square = 8.430, p = 0.015). Low work experience (chi-square = 14.039, df = 4, p = 0.007), and low readiness for MDT (chi-square = 8.430, df = 2, p = 0.015) were also associated with unpreparedness to administer maggot therapy. Neither gender nor perceived stress level were exclusively associated with disgust for maggots or lack of readiness to implement MDT. Low professional experience and a deficit of knowledge in maggot therapy may negatively affect the readiness of nurses to administer biodebridement. Gender and personal stress levels do not affect nurses’ readiness to utilize larval therapy. Full article

(This article belongs to the Special Issue Clinical Nursing in Healthcare)

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16 pages, 1039 KiB

Open AccessProtocol

A Network of Sites and Upskilled Therapists to Deliver Best-Practice Stroke Rehabilitation of the Arm: Protocol for a Knowledge Translation Study

by Leeanne M. Carey, Liana S. Cahill, Jannette M. Blennerhassett, Michael Nilsson, Natasha A. Lannin, Vincent Thijs, Susan Hillier, Dominique A. Cadilhac, Geoffrey A. Donnan, Meg E. Morris, Leonid Churilov, Marion Walker, Shanthi Ramanathan, Michael Pollack, Esther May, Geoffrey C. Cloud, Sharon McGowan, Tissa Wijeratne, Marc Budge, Fiona McKinnon, John Olver, Toni Hogg, Michael Murray, Brendon Haslam, Irene Koukoulas, Brittni Nielsen, Yvonne Mak-Yuen, Megan Turville, Cheryl Neilson, Anna Butler, Joosup Kim and Thomas A. Matyas Show full author list Hide full author list

Healthcare 2023, 11(23), 3080; https://doi.org/10.3390/healthcare11233080 - 1 Dec 2023

Viewed by 2091

Abstract

Implementation of evidence-informed rehabilitation of the upper limb is variable, and outcomes for stroke survivors are often suboptimal. We established a national partnership of clinicians, survivors of stroke, researchers, healthcare organizations, and policy makers to facilitate change. The objectives of this study are [...] Read more.

Implementation of evidence-informed rehabilitation of the upper limb is variable, and outcomes for stroke survivors are often suboptimal. We established a national partnership of clinicians, survivors of stroke, researchers, healthcare organizations, and policy makers to facilitate change. The objectives of this study are to increase access to best-evidence rehabilitation of the upper limb and improve outcomes for stroke survivors. This prospective pragmatic, knowledge translation study involves four new specialist therapy centers to deliver best-evidence upper-limb sensory rehabilitation (known as SENSe therapy) for survivors of stroke in the community. A knowledge-transfer intervention will be used to upskill therapists and guide implementation. Specialist centers will deliver SENSe therapy, an effective and recommended therapy, to stroke survivors in the community. Outcomes include number of successful deliveries of SENSe therapy by credentialled therapists; improved somatosensory function for stroke survivors; improved performance in self-selected activities, arm use, and quality of life; treatment fidelity and confidence to deliver therapy; and for future implementation, expert therapist effect and cost-effectiveness. In summary, we will determine the effect of a national partnership to increase access to evidence-based upper-limb sensory rehabilitation following stroke. If effective, this knowledge-transfer intervention could be used to optimize the delivery of other complex, evidence-based rehabilitation interventions. Full article

(This article belongs to the Special Issue Stroke and Ageing)

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8 pages, 243 KiB

Open AccessOpinion

Surviving the Storm: The Impact of COVID-19 on Cervical Cancer Screening in Low- and Middle-Income Countries

by Mandana Vahabi, Anam Shahil-Feroz, Aisha Lofters, Josephine Pui-Hing Wong, Vijayshree Prakash, Sharmila Pimple, Kavita Anand and Gauravi Mishra

Healthcare 2023, 11(23), 3079; https://doi.org/10.3390/healthcare11233079 - 1 Dec 2023

Cited by 2 | Viewed by 1613

Abstract

According to the Center for Disease Control and Prevention’s National Breast and Cervical Cancer Early Detection Program, the cervical cancer screening rate dropped by 84% soon after the declaration of the COVID-19 pandemic. The challenges facing cervical cancer screening were largely attributed to [...] Read more.

According to the Center for Disease Control and Prevention’s National Breast and Cervical Cancer Early Detection Program, the cervical cancer screening rate dropped by 84% soon after the declaration of the COVID-19 pandemic. The challenges facing cervical cancer screening were largely attributed to the required in-person nature of the screening process and the measures implemented to control the spread of the virus. While the impact of the COVID-19 pandemic on cancer screening is well-documented in high-income countries, less is known about the low- and middle-income countries that bear 90% of the global burden of cervical cancer deaths. In this paper, we aim to offer a comprehensive view of the impact of COVID-19 on cervical cancer screening in LMICs. Using our study, “Prevention of Cervical Cancer in India through Self-Sampling” (PCCIS), as a case example, we present the challenges COVID-19 has exerted on patients, healthcare practitioners, and health systems, as well as potential opportunities to mitigate these challenges. Full article

(This article belongs to the Topic Women's Health and Aging)

13 pages, 303 KiB

Open AccessArticle

Podiatric Skin and Nail Involvement and Biomechanical Pathology in Renal Transplant Recipients: Assessment of the Foot as a Contributing Factor to Their Health

by Cristina González-Martín, Vanesa Balboa-Barreiro, Mª Teresa Garcia-Rodriguez, Raquel Veiga-Seijo, Teresa Seoane-Pillado and Estefanía Couceiro-Sanchez

Healthcare 2023, 11(23), 3078; https://doi.org/10.3390/healthcare11233078 - 30 Nov 2023

Viewed by 1005

Abstract

Although several studies show the prevalence of podiatric conditions in people with end-stage renal disease or renal replacement therapy with hemodialysis, there is little scientific literature on this when subjects are undergoing kidney transplantation. The aim of this study is to determine the [...] Read more.

Although several studies show the prevalence of podiatric conditions in people with end-stage renal disease or renal replacement therapy with hemodialysis, there is little scientific literature on this when subjects are undergoing kidney transplantation. The aim of this study is to determine the prevalence of podiatric skin and nail pathology in renal transplant recipients. A descriptive, observational, prevalence study was conducted at the Nephrology Department of the University Hospital of A Coruña. A total of 371 subjects were studied. The variables studied were sociodemographic (age, sex), anthropometric (Body Mass Index), comorbidity (Charlson Comorbidity Index), and podological (skin and nail alterations). A high presence of skin (83.1%) and nail pathology (85.4%) was observed, with hyperkeratosis (68.8%), onychogryphosis (39.4%), and onychocryptosis (36.9%) being the most predominant alterations. Although it was not significant, patients with a higher risk of presenting podiatric pathology were of female sex and had a high BMI, and both age and the Charlson comorbidity index were significantly associated with this risk. There was an increased risk of both skin and nail pathology at older age and in the presence of diabetes mellitus. Full article

14 pages, 2308 KiB

Open AccessArticle

Colorectal Cancer: 35 Cases in Asbestos-Exposed Workers

by Antonietta Porzio, Alessandro Feola, Giuseppe Parisi, Angelo Lauro and Carlo Pietro Campobasso

Healthcare 2023, 11(23), 3077; https://doi.org/10.3390/healthcare11233077 - 30 Nov 2023

Cited by 4 | Viewed by 2046

Abstract

Background: Asbestos is considered one of the major global work-related carcinogens. Some studies suggest a potential causal relationship between asbestos exposure and colorectal cancer (CRC). However, the role of asbestos in CRC carcinogenesis is still controversial. Methods: 35 claims of occupational CRC among [...] Read more.

Background: Asbestos is considered one of the major global work-related carcinogens. Some studies suggest a potential causal relationship between asbestos exposure and colorectal cancer (CRC). However, the role of asbestos in CRC carcinogenesis is still controversial. Methods: 35 claims of occupational CRC among asbestos-exposed workers were reviewed. All claims were rejected by the Italian National Institute for Insurance against Accidents (INAIL) due to the “lack of scientific evidence in the causality” between asbestos exposure and CRC; causality was finally assessed in civil trials. All cases were categorized by age, gender, industry type, task, exposure and latency periods, anatomical location, and histopathological characteristics of CRC and concomitant respiratory diseases. Results: Most workers were males aged 60 years or more and employed in occupational activities with extensive use of asbestos for over 20 years. In 31 out of 35 cases, CRC was diagnosed over 39 years after employment. Right-sided colic adenocarcinoma was diagnosed in nine cases; rectum was involved in eight cases. Respiratory comorbidities were observed in 22 workers. Conclusions: Our study provides some interesting points in the assessment of the causal relationship between asbestos exposure and CRC. Full article

(This article belongs to the Special Issue Forensic Science and Legal Medicine: A Multidisciplinary Puzzle 2.0)

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12 pages, 749 KiB

Open AccessArticle

Effects of Different Protocols of Moderate-Intensity Intermittent Hypoxic Training on Mental Health and Quality of Life in Brazilian Adults Recovered from COVID-19: The AEROBICOVID Double-Blind Randomized Controlled Study

by Eugenio Merellano-Navarro, Marta Camacho-Cardenosa, Gabriel Peinado Costa, Ester Wiggers, Germano Marcolino Putti, Jonatas Evandro Nogueira, Elisangela Aparecida da Silva Lizzi and Átila Alexandre Trapé

Healthcare 2023, 11(23), 3076; https://doi.org/10.3390/healthcare11233076 - 30 Nov 2023

Cited by 3 | Viewed by 1968

Abstract

The aim of this study was to investigate the effects of different protocols of moderate-intensity intermittent hypoxic training in patients who had recovered from COVID-19 on quality of life (QoL) and mental health. The sample of this clinical trial-controlled double-blind study consisted of [...] Read more.

The aim of this study was to investigate the effects of different protocols of moderate-intensity intermittent hypoxic training in patients who had recovered from COVID-19 on quality of life (QoL) and mental health. The sample of this clinical trial-controlled double-blind study consisted of 67 participants aged 30–69 years, who were organized randomly according to Normoxia, Hypoxia, Hypoxia Recovery or Control Group. Eight weeks of cycle ergometer training were performed with a frequency of three training sessions per week in normoxic or hypoxic conditions (with or without hypoxic recovery). Health-related QoL and Mental Health Status were evaluated by 12-Item Short Form Survey and Depression Anxiety and Stress Scale instruments, respectively. All training groups improved the QoL’s physical dimensions (Baseline–Post: Normoxia Group 42.1 (11.0)–48.7 (7.0), Hypoxia Group 46.9 (11.8)–53.5 (6.6) and Hypoxia Recovery Group 45.8 (9.2)–51.1 (5.3)) and mental dimensions (Baseline–Post: Normoxia Group 48.8 (7.9)–54.6 (4.6), Hypoxia Group 45.2 (7.7)–53.2 (3.8) and Hypoxia Recovery Group 46.5 (9.7)–52.0 (9.9)). Regarding mental health outcomes, all training groups decreased depressive symptoms (66.7% Normoxia, 31.2% Hypoxia Recovery and 31% Hypoxia groups), anxiety symptoms (46.5% Normoxia, 45.9% Hypoxia Recovery and 39.5% in the Hypoxia groups) and stress symptoms (40.6% Normoxia, 36.3% Hypoxia Recovery and 22.1% Hypoxia groups). Significant statistical difference was not found between groups. Normoxic and hypoxic training showed a similar effect on QoL and the mental health of Brazilian adults who had recovered from COVID-19. Full article

(This article belongs to the Special Issue Physical Activity, Cardiorespiratory Fitness, Respiratory Infections, COVID-19, and “Long COVID”)

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16 pages, 1653 KiB

Open AccessArticle

A Pilot Study on the Association of Internet Use with Sports Practice and Sex in Italian Adolescents

by Stefania Toselli, Alessia Grigoletto, Luciana Zaccagni, Emanuela Gualdi-Russo and Natascia Rinaldo

Healthcare 2023, 11(23), 3075; https://doi.org/10.3390/healthcare11233075 - 30 Nov 2023

Cited by 1 | Viewed by 1238

Abstract

The use of the Internet has several positive functions, but at the same time it also represents a health risk, especially for adolescents. The increased use of the Internet in recent decades has also been linked to an increase in problematic Internet use, [...] Read more.

The use of the Internet has several positive functions, but at the same time it also represents a health risk, especially for adolescents. The increased use of the Internet in recent decades has also been linked to an increase in problematic Internet use, which has now become a global social issue. During the COVID-19 pandemic, Internet use increased even more and influenced adolescents’ habits, leading to an increase in sedentary behaviors. The aim of this study was to understand whether Internet addiction differed between sportive and nonsportive adolescents and between males and females. We analyzed two samples of adolescents, with different behaviors regarding sports practice. Internet addiction was assessed by the administration of a validated questionnaire (UADI) via an online survey. Although all the mean values of both the subgroups fell into the “non-pathological” category, differences between sports groups and sexes were found, with different trends for each one of the five dimensions of Internet use. In conclusion, sportive adolescents generally showed less severe Internet addiction; therefore, encouraging sports practice can help to fight wrong habits related to a sedentary lifestyle. The promotion of sports practice in these ages is therefore a priority aspect, especially in females, who showed a general predisposition to escape from reality in comparison to males. Full article

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13 pages, 989 KiB

Open AccessArticle

Workout with a Smartwatch: A Cross-Sectional Study of the Effects of Smartwatch Attributes on Flow Experience and Exercise Intentions Depending on Exercise Involvement

by Jihyeon Oh and Daehwan Kim

Healthcare 2023, 11(23), 3074; https://doi.org/10.3390/healthcare11233074 - 30 Nov 2023

Cited by 4 | Viewed by 2074

Abstract

Smartwatches are emerging as effective tools to promote exercise and physical activities in the healthcare industry. However, little is known about how smartwatch attributes facilitate exercise and for whom such attributes are more effective for exercise. Accordingly, the purpose of this study was [...] Read more.

Smartwatches are emerging as effective tools to promote exercise and physical activities in the healthcare industry. However, little is known about how smartwatch attributes facilitate exercise and for whom such attributes are more effective for exercise. Accordingly, the purpose of this study was to explore the structural relationship between smartwatch attributes, flow experience, and continued exercise intentions and to examine the moderating role of exercise involvement in the structural relationship. For this, a total of 600 participants were recruited via a professional survey firm in South Korea based on a multi-stage random sampling method and used for data analyses, including confirmatory factor analysis (CFA), structural equation modeling (SEM), and multi-group SEM. All survey items were adopted from the existing literature on healthcare, flow experience, and wearable device technologies. The results revealed that smartwatch attributes, including interactivity (γ = 0.234, p < 0.001/γ = 0.235, p < 0.001), autonomy (γ = 0.225, p < 0.001/γ = 0.172, p < 0.001), wearability (γ = 0.104, p < 0.05/γ = 0.106, p < 0.05), convenience (γ = 0.209, p < 0.001/γ = 0.214, p < 0.001), and experiential novelty (γ = 0.221, p < 0.001/γ = 0.281, p < 0.001) enhanced flow experience (absorption/enjoyment) during exercise. Furthermore, flow experience (absorption/enjoyment) was found to positively influence exercise intention (β = 0.511, p < 0.001/β = 0.239, p < 0.001). Lastly, exercise involvement was found to modulate the structural relationships among smartwatch attributes, flow experience, and exercise intention (∆χ² = 23.231, ∆df = 12, p < 0.05). By investigating these dynamics, this study contributes to shared knowledge not only in the healthcare literature but also in the wearable-technology literature. The results of the current study also provide useful guidelines for practitioners in the wearable-device and healthcare industries to develop optimal features of smartwatches for exercise and physical activities. Full article

(This article belongs to the Section TeleHealth and Digital Healthcare)

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10 pages, 272 KiB

Open AccessArticle

Knowledge, Attitude and Practice of the Community General Practice Teams on Dysphagia Complicated with Aspiration Pneumonia after Stroke

by Daikun He, Xueting Shen, Lina Wang and Zhigang Pan

Healthcare 2023, 11(23), 3073; https://doi.org/10.3390/healthcare11233073 - 30 Nov 2023

Viewed by 1527

Abstract

This cross-sectional study investigated the knowledge, attitude and practice (KAP) of community general practice (GP) team members on dysphagia complicated with aspiration pneumonia after stroke in Shanghai between October 2022 and November 2022 using a self-administered questionnaire. A total of 551 questionnaires were [...] Read more.

This cross-sectional study investigated the knowledge, attitude and practice (KAP) of community general practice (GP) team members on dysphagia complicated with aspiration pneumonia after stroke in Shanghai between October 2022 and November 2022 using a self-administered questionnaire. A total of 551 questionnaires were collected (mean age: 37.59 ± 8.86 years, 443 (80.40%) females), including 383 (69.51%) physicians. The mean KAP scores were 6.30 ± 1.54 (possible range: 0–12), 40.32 ± 5.11 (possible range: 9–45), and 72.54 ± 13.99 (possible range: 18–90), respectively. Multivariable linear regression analyses suggested that attitude (Coef = 1.29, 95%CI: 1.09–1.50), and holding research funding (Coef = −2.70, 95%CI: −5.00–−0.50) were significantly associated with practice toward dysphagia complicated with aspiration pneumonia after stroke of community GP team members. The structural equation model (SEM) indicated that knowledge had a direct influence on attitude (β = 2.029, p < 0.001) and attitude had a direct impact on practice (β = 0.710, p < 0.001). Additionally, knowledge exerted both direct (β = 0.935, p = 0.016) and indirect effects (β = 1.442, p < 0.001) on practice. In conclusion, this study showed that the community GP team members had poor knowledge, favorable attitudes, and proactive practices. Education and training on the management of dysphagia complicated with aspiration pneumonia after stroke are urgently needed. Full article

14 pages, 1092 KiB

Open AccessArticle

The Scale of Perceptions and Self-Participation in Hemodialysis: Development and Psychometric Evaluation

by Li-Yun Szu, Suh-Ing Hsieh, Whei-Mei Shih, Mei-Chu Tsai and Su-Mei Tseng

Healthcare 2023, 11(23), 3072; https://doi.org/10.3390/healthcare11233072 - 30 Nov 2023

Cited by 1 | Viewed by 1503

Abstract

Hemodialysis patients undergo hemodialysis two to three times a week and must live together with the dialysis machine. The patient’s self-participation is to combine the patient’s own experience and professional knowledge to influence the care. A successful self-participation experience empowers patients to adapt [...] Read more.

Hemodialysis patients undergo hemodialysis two to three times a week and must live together with the dialysis machine. The patient’s self-participation is to combine the patient’s own experience and professional knowledge to influence the care. A successful self-participation experience empowers patients to adapt to living with hemodialysis. However, few studies have been conducted regarding the subjective experiences of such patient participation. There is a lack of a self-participation dialysis life scale for hemodialysis patients. Therefore, this study aims to develop and evaluate a self-participation dialysis life scale for hemodialysis patients. The items for the self-participation dialysis life scale were confirmed through qualitative interviews based on grounded theory. After expert content validity evaluation, 435 hemodialysis patients were purposively sampled from hemodialysis centers in two regional teaching hospitals in Taiwan. Descriptive statistics, principal axis factoring, reliability analysis, Pearson’s correlation, and one-way ANOVA were used for data analysis. The results show that the item- and scale-content validity indices are 0.96 and 0.73, respectively. This scale is divided into two scales. The first part is “Scale of Perceptions of Hemodialysis”, including two factors. The overall can explain 66.34% of the cumulative variances. The second part is the “Scale of Self-Participation in Hemodialysis”, including four factors. The overall can explain 58.91% of the cumulative variances. The Cronbach’s α is 0.812 for “Perceptions of Hemodialysis” and 0.959 for “Self-Participation in Hemodialysis”, respectively. The self-participation dialysis life scale has good reliability and validity and can be used to evaluate the implementation of a patient’s self-participation in their hemodialysis life. Discussing or consulting with patients based on their characteristics, life priorities, and their desired life on dialysis is essential for a high-quality of clinical care among hemodialysis patients. Full article

(This article belongs to the Special Issue Clinical Nursing in Healthcare)

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12 pages, 288 KiB

Open AccessArticle

by Theodoula Adamakidou, Eleni Ntempeli, Petros Galanis, Alexandra Mantoudi, Christos Kleisiaris, Marianna Mantzorou, Afroditi Zartaloudi, Chrysoula Tsiou and Paraskevi Apostolara

Healthcare 2023, 11(23), 3071; https://doi.org/10.3390/healthcare11233071 - 30 Nov 2023

Cited by 1 | Viewed by 1787

Abstract

Assessing knowledge, attitudes and practices towards evidence-based practice (EBP) is a challenge for healthcare professionals. However, the existing literature focuses on nurses working in acute hospital settings, with nurses working in community and primary healthcare settings receiving comparatively less attention. The purpose of [...] Read more.

Assessing knowledge, attitudes and practices towards evidence-based practice (EBP) is a challenge for healthcare professionals. However, the existing literature focuses on nurses working in acute hospital settings, with nurses working in community and primary healthcare settings receiving comparatively less attention. The purpose of the study was to explore factors that related to attitudes, knowledge and practice of community nurses toward EBP. A cross-sectional study was conducted with a sample of community nurses in Greece. Community nurses around the country were invited to complete an online questionnaire during the period of February to April 2022. To measure nurses’ attitudes, practices and knowledge/skills regarding EBP, the Evidence-Based Practice Questionnaire was used. A total of 164 nurses took part in the study. The mean age of nurses was 41.6 years, with 42.7% having either an MSc or a PhD degree. The overall internal consistency for the EBPQ questionnaire was 0.91. The sample demonstrated a high level of knowledge/skills (mean score of 5.5 on a 7-point scale) and positive attitudes (mean score of 5.5 on a 7-point scale) towards EBP, while the level of EBP practice was moderate (mean score of 4.5 on a 7-point scale). A higher educational level showed a positive relationship with the “practice of EBP” subscale (p = 0.005) and the “knowledge/skills about EBP” subscale (p = 0.003). Additionally, an increase in the knowledge/skills score was associated with a more positive attitude towards EBP (p < 0.001) and better practice of EBP (p = 0.003). The identification of educational level as the main factor related to the knowledge/skills and implementation of EBPs in community nurses emphasizes the necessity for educational initiatives in EBP at both undergraduate and postgraduate levels. Informed nurses who are familiar with current guidelines and evidence can effectively train patients about chronic disease management and prevention. Additionally, creating incentives to motivate participation in lifelong learning programs can indeed play a crucial role in enhancing the proficiency of community nurses in evidence-based practice. Full article

(This article belongs to the Special Issue Nursing Care for Patients with Diabetes)

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