Healthcare

10 pages, 2135 KiB

Open AccessArticle

Deviation of the Nail Lamina after Unilateral Partial Matricectomy

by Álvaro Saura-Sempere, Rubén Sánchez-Gómez, José Manuel Reguera-Medina, Salvador Márquez-Reina, Rafael Rodríguez-León and Álvaro Gómez-Carrión

Healthcare 2024, 12(16), 1681; https://doi.org/10.3390/healthcare12161681 - 22 Aug 2024

Viewed by 626

Abstract

Deviation of the nail plate in the transverse plane has traditionally been regarded as a postoperative complication following the definitive surgical treatment of ingrown toenails, particularly when only a single nail fold is addressed. The quantification and longitudinal comparison of the operated versus [...] Read more.

Deviation of the nail plate in the transverse plane has traditionally been regarded as a postoperative complication following the definitive surgical treatment of ingrown toenails, particularly when only a single nail fold is addressed. The quantification and longitudinal comparison of the operated versus non-operated nail folds could elucidate potential transverse deviations of the nail plate. The objective of this study was to assess the presence or absence of transverse nail plate deviation following ingrown toenail surgery on a single nail fold. Methods: A cohort of 11 patients (three males, eight females) with recurrent ingrown toenails undergoing unilateral partial matricectomy were included in this study. Preoperative measurements were compared to those taken at 7, 14, 21, 28, and 35 days postoperatively. Results: The analysis revealed no statistically significant differences in measurements between the operated and non-operated nail folds, nor were there significant changes in the measurements over time within each group (p > 0.05). Conclusions: Despite the absence of visible deviations in the orientation of the nail plate, the angular measurements post-surgery at 35 days showed no statistically significant alterations. The angular values observed across all time points appeared to be influenced by the intrinsic morphological characteristics of each nail plate. Full article

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11 pages, 832 KiB

Open AccessArticle

Geriatric Trauma Outcome Score as a Mortality Predictor in Isolated Moderate to Severe Traumatic Brain Injury: A Single-Center Retrospective Study

by Ching-Ya Huang, Yuan-Hao Yen, Ching-Hua Tsai, Shiun-Yuan Hsu, Po-Lun Tsai and Ching-Hua Hsieh

Healthcare 2024, 12(16), 1680; https://doi.org/10.3390/healthcare12161680 - 22 Aug 2024

Viewed by 750

Abstract

Background: Traumatic brain injury (TBI) is a major cause of mortality and disability worldwide, with severe cases significantly increasing the risk of complications and long-term mortality. The Geriatric Trauma Outcome Score (GTOS), based on age, injury severity, and transfusion need, has been validated [...] Read more.

Background: Traumatic brain injury (TBI) is a major cause of mortality and disability worldwide, with severe cases significantly increasing the risk of complications and long-term mortality. The Geriatric Trauma Outcome Score (GTOS), based on age, injury severity, and transfusion need, has been validated for predicting mortality in older trauma patients, but its utility in predicting mortality for TBI patients remains unexplored. Methods: This retrospective study included 5543 adult trauma patients with isolated moderate to severe TBI, defined by head Abbreviated Injury Scale (AIS) scores of ≥ 3, from 1998 to 2021. GTOS was calculated with the following formula: age + (Injury Severity Score × 2.5) + 22 (if transfused within 24 h). The area under the receiver operating characteristic curve (AUROC) assessed GTOS’s ability to predict mortality. The optimal GTOS cutoff value was determined using Youden’s index. Mortality rates were compared between high- and low-GTOS groups, separated by the optimal GTOS cutoff value, including a propensity score-matched analysis adjusting for baseline characteristics. Results: Among 5543 patients, mortality was 8.3% (462 deaths). Higher mortality is correlated with male sex, older age, higher GTOS, and comorbidities like hypertension, coronary artery disease, and end-stage renal disease. The optimal GTOS cut-off for mortality prediction was 121.5 (AUC = 0.813). Even when the study population was matched by propensity score, patients with GTOS ≥121.5 had much higher odds of death (odds ratio 2.64, 95% confidence interval 1.93–3.61, p < 0.001) and longer hospital stays (mean 16.7 vs. 12.2 days, p < 0.001) than those with GTOS < 121.5. Conclusions: These findings support the idea that GTOS is a useful tool for risk stratification of in-hospital mortality in isolated moderate to severe TBI patients. However, we encourage further research to refine GTOS for better applicability in TBI patients. Full article

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17 pages, 2320 KiB

Open AccessSystematic Review

Healing the Whole: An International Review of the Collaborative Care Model between Primary Care and Psychiatry

by Veronica Hernandez, Lucy Nasser, Candice Do and Wei-Chen Lee

Healthcare 2024, 12(16), 1679; https://doi.org/10.3390/healthcare12161679 - 22 Aug 2024

Viewed by 2238

Abstract

The collaborative care model (CCM) was created to improve the delivery of mental health care and is reported to improve access, enhance treatment outcomes, and reduce healthcare costs. To understand the impacts of the CCM on symptom management, diverse populations, and sustainability in [...] Read more.

The collaborative care model (CCM) was created to improve the delivery of mental health care and is reported to improve access, enhance treatment outcomes, and reduce healthcare costs. To understand the impacts of the CCM on symptom management, diverse populations, and sustainability in healthcare systems, a systematic review was conducted. Several databases were searched for articles assessing the CCM. The inclusion criteria limited the studies to those (1) published between January 2008 and January 2024; (2) written in the English language; (3) analyzing adult patients; (4) analyzing symptom improvement in major depressive disorder, generalized anxiety disorder, or post-traumatic stress disorder; and (5) fitting the given definition of a CCM. We identified 9743 articles. Due to missing information or duplication, 4702 were excluded. The remaining articles were screened, yielding 468 articles for full-text analysis, of which 16 articles met the inclusion criteria. Of these articles, five primarily focused on individual patient outcomes, five focused on specific populations, and six reviewed system impacts; eleven articles studied US populations and five studied international populations. An analysis revealed that in 12 of the final articles, the CCM led to a statistically significant improvement in anxiety and depression symptoms with viable implementation and sustainability strategies. The CCM is an effective method for improving patient symptoms and can be potentially affordable in healthcare systems. Full article

(This article belongs to the Special Issue Research on Health Disparities in the Global Population)

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14 pages, 4596 KiB

Open AccessArticle

Understanding the Associations between Executive Function and Psychological Variables in Fibromyalgia Syndrome: A Network Analysis Approach

by Juan C. Pacho-Hernández, Francisco G. Fernández-Palacios, Ángela Tejera-Alonso, César Fernández-de-las-Peñas, Umut Varol, Juan A. Valera-Calero, Luis M. Fernández-Méndez and Margarita Cigarán-Mendez

Healthcare 2024, 12(16), 1678; https://doi.org/10.3390/healthcare12161678 - 22 Aug 2024

Viewed by 795

Abstract

The aim of this study was to quantify the multivariate relationships between clinical, cognitive performance, executive functioning, and psychological outcomes in women with fibromyalgia (FMS) using network analyses. Demographic (age, height, weight), clinical (pain history, pain intensity, and related disability), neurocognitive (D2 Attention [...] Read more.

The aim of this study was to quantify the multivariate relationships between clinical, cognitive performance, executive functioning, and psychological outcomes in women with fibromyalgia (FMS) using network analyses. Demographic (age, height, weight), clinical (pain history, pain intensity, and related disability), neurocognitive (D2 Attention test, Rey-Osterrieth Complex Figure for visual perception, “Digits D/R/I” tests of the WAIS-IV battery for working memory, the 5-Digit Test for mental inhibition, the Symbol Search for processing speed and the Zoo Test for planning/decision making) and psychological (depressive symptoms, anxiety levels, sleep quality, pain hypervigilance) variables were collected in 129 women with FMS and 111 healthy women. Network analyses were conducted separately for each group to quantify the adjusted correlations between the modeled variables and to assess their centrality indices (i.e., connectivity with other symptoms in the network and their importance in the network). The network identified 74 associations in FMS women and 46 associations in controls with small differences. The strongest correlations in both groups were found between different attention variables: d2_CON with d2_C, d2_O with d_2TR, and d2_CON with d2_TA. The most central variables were d2_TA, d2_C, and d2_CON (highest strength centrality in both groups) and anxiety levels and pain hypervigilance (highest harmonic centrality in FMS women). The strength centrality of the network was stable for women with FMS (CScor0.7: 0.68) but not for healthy women (CScor0.7: 0.28). This study found that attention variables are most relevant within a neurocognitive network and that psychological variables are most important for the treatment of women with FMS. The clinical implications of the current findings, such as the development of treatments targeting these variables, are discussed. Full article

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10 pages, 254 KiB

Open AccessArticle

Impact of the COVID-19 Pandemic on the Diagnosis of Malignant Neoplasia of the Bronchus and Lung in the Burgos Region

by Gustavo Gutiérrez Herrero, Sandra Núñez-Rodríguez, Sergio Álvarez-Pardo, Jessica Fernández-Solana, Carla Collazo-Riobó, Álvaro García-Bustillo, Mirian Santamaría-Peláez, Jerónimo J. González-Bernal and Josefa González-Santos

Healthcare 2024, 12(16), 1677; https://doi.org/10.3390/healthcare12161677 - 22 Aug 2024

Viewed by 720

Abstract

Purpose: To retrospectively analyze the impact of the COVID-19 pandemic on the diagnosis, mortality rate, and survival period of malignant bronchial and lung neoplasms in the Burgos region, with the aim of promoting the development of strategies to improve cancer care management during [...] Read more.

Purpose: To retrospectively analyze the impact of the COVID-19 pandemic on the diagnosis, mortality rate, and survival period of malignant bronchial and lung neoplasms in the Burgos region, with the aim of promoting the development of strategies to improve cancer care management during health crises, highlighting the importance of non-pharmacological approaches to mitigate the negative impacts of future pandemics on lung cancer patients. Methods: This retrospective, longitudinal, single-center study was conducted in Burgos from 2019 to 2021. Participants included all patients diagnosed with malignant bronchial and lung neoplasms by the Pneumology unit of Complejo Asistencial Universitario de Burgos during the year immediately before and the year immediately after 31 March 2020, the official start date of the pandemic. Inclusion criteria encompassed patients diagnosed through histological or clinicoradiological methods, who provided informed consent. Data were systematically gathered using a specific template that included demographic information, disease stage, death, and survival time. Statistical analysis involved descriptive methods, ANOVA, and chi-square tests to assess differences in survival time and associations between categorical variables. Results: The results reveal a decrease in the number of patients diagnosed during the pandemic period (154 vs. 105), which could indicate delays in detection. However, there were no significant differences between the two periods, in which more than 60% of cases were detected in stage IV, being incompatible with survival. Although fewer patients died during the pandemic than expected (p = 0.015), patients diagnosed after the onset of the pandemic had a shorter survival time (182.43 ± 142.63 vs. 253.61 ± 224.30; p = 0.038). Specifically, those diagnosed in stage I during the pre-pandemic had a much longer survival time (741.50 days) than the rest of the patients (p < 0.05). In addition, among those diagnosed in stage IV, those diagnosed after the beginning of the pandemic had a shorter survival time (157.29 ± 202.36 vs. 241.18 ± 218.36; p = 0.026). Conclusions: Understanding these changes can support both medical strategies and non-pharmacological therapies to improve cancer care management during health crises, thus contributing to the optimization of public health. Full article

(This article belongs to the Collection The Impact of COVID-19 on Healthcare Services)

18 pages, 2156 KiB

Open AccessReview

Trends in Physiotherapy of Chronic Low Back Pain Research: Knowledge Synthesis Based on Bibliometric Analysis

by Urška Šajnović, Peter Kokol, Jernej Završnik and Helena Blažun Vošner

Healthcare 2024, 12(16), 1676; https://doi.org/10.3390/healthcare12161676 - 22 Aug 2024

Viewed by 3081

Abstract

Background: Physiotherapy and chronic low back pain (CLBP) form a broad and quickly developing research area. The aim of this article was to holistically, thematically and chronologically analyze and synthesize the literature production in this research area and identify the most prolific research [...] Read more.

Background: Physiotherapy and chronic low back pain (CLBP) form a broad and quickly developing research area. The aim of this article was to holistically, thematically and chronologically analyze and synthesize the literature production in this research area and identify the most prolific research entities and research themes. Methods: This article quantitatively and qualitatively analyzed research literature production harvested from the Scopus bibliometric database, using a triangulation of bibliometric and thematic analysis. For this, Excel 2024, Bibliometrix Biblioshiny 4.1 and VOSviewer version 1.6.20 softwares were used. Results: In the Scopus database, 2843 data sources were found, which were published between 1974 and 26 February 2024. The growth trend has been linearly positive since the beginning of publication, and after 2018 exponential growth began. A review of the most prolific entities showed that the most literature was published in America, Europe and Australasia. The thematic analysis of the information sources identified six main themes (pathophysiology of CLBP and the quantification assessment tools, diagnostics and CLBP treatment, CLBP questionnaires and surveys, quality of life, complementary methods in physiotherapy and psychosocioeconomic aspects), while the chronological analysis revealed three main areas of development: assessment tools, CLBP processing and study methodology. Conclusions: The results of this bibliometric study present a good starting point for further research, providing taxonomy and research landscapes as a holistic framework offering multidisciplinary knowledge about CLBP, while chronological analysis provides a basis for identifying prospective research trends. This article offers an interdisciplinary view of the current issue of public health. The results of this study provide a basis for the development of both the physiotherapy and epidemiological fields. Full article

(This article belongs to the Section Pain Management)

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11 pages, 260 KiB

Open AccessArticle

Descriptive Study on the Relationship between Dyspnea, Physical Performance, and Functionality in Oncology Patients

by Diego Lucas-Ruano, Celia Sanchez-Gomez, María Isabel Rihuete-Galve, Alberto Garcia-Martin, Emilio Fonseca-Sanchez and Eduardo José Fernández-Rodríguez

Healthcare 2024, 12(16), 1675; https://doi.org/10.3390/healthcare12161675 - 22 Aug 2024

Viewed by 778

Abstract

Background: Cancer is a leading cause of morbidity and mortality globally. Dyspnea, affecting up to 60% of cancer patients, exacerbates physical and psychological distress, reducing quality of life. This study aims to explore the relationship between dyspnea and factors such as age, sex, [...] Read more.

Background: Cancer is a leading cause of morbidity and mortality globally. Dyspnea, affecting up to 60% of cancer patients, exacerbates physical and psychological distress, reducing quality of life. This study aims to explore the relationship between dyspnea and factors such as age, sex, clinical diagnosis, and treatment lines in cancer patients, with the goal of improving understanding and management of this debilitating symptom to enhance patient care and quality of life. Methods: This study employed an observational, cross-sectional, and descriptive approach to investigate patients with oncological disease at the University Hospital of Salamanca between March 2021 and April 2024. A convenience sample was selected, including patients over 18 years old with a pathological diagnosis of cancer, experiencing any degree of dyspnea, and who consented to participate by signing the informed consent. Exclusion criteria included lack of consent and clinical conditions that prevented an interview. The studied variables encompass sociodemographic (age, gender, diagnosis, tumor stage, number of treatment lines) and clinical aspects (daily activities, degree of dyspnea, functional capacity, physical performance), evaluated using the Barthel Index, the mMRC Dyspnea Scale, the ECOG Scale, and the Short Physical Performance Battery (SPPB). Data were collected through semistructured interviews and medical records, and analyzed using specialized software. This research has ethical approval CEiM Code 2023 12 1472, Reference 2024/01. Results: The mean age was 66.82 years. Lung cancer was predominant (60.2%), with most patients in stage 3 (65.7%) and receiving three treatment lines (68.7%). Higher age, advanced disease stage, and more treatment lines correlated with lower Barthel and SPPB scores, and higher ECOG and mMRC scores, indicating worse functionality, physical performance, and greater dyspnea. No significant correlations were found between gender or pathological diagnosis and the studied variables. Conclusions: Advanced age, higher disease stage, and more treatment lines are associated with decreased functionality, poorer physical performance, and increased dyspnea in cancer patients. Gender and specific cancer diagnosis do not significantly affect these relationships. Addressing dyspnea is crucial to improving the quality of life and physical performance in this population. Future studies should explore additional factors like treatment types and nutritional status. Full article

(This article belongs to the Special Issue Global Perspectives on Nursing and Palliative Care for Cancer Survivors)

12 pages, 411 KiB

Open AccessArticle

Determinants Affecting the Awareness of Hypertension Complications within the General Population in Saudi Arabia

by Muffarah Hamid Alharthi, Elhadi Miskeen, Eman Abdullah Alotaibi, Ibrahim Awad Eljack Ibrahim, Mohannad Mohammad S. Alamri, Mohammad S. Alshahrani, Dina S. Almunif and Abdullah Almulhim

Healthcare 2024, 12(16), 1674; https://doi.org/10.3390/healthcare12161674 - 22 Aug 2024

Viewed by 818

Abstract

Background: Hypertension imposes a significant public health burden. An increased awareness of hypertension complications within a population can positively impact patient care and prevent complications. This study seeks to assess the awareness of hypertension complications among the population of Bisha in Saudi Arabia [...] Read more.

Background: Hypertension imposes a significant public health burden. An increased awareness of hypertension complications within a population can positively impact patient care and prevent complications. This study seeks to assess the awareness of hypertension complications among the population of Bisha in Saudi Arabia in 2020. Methods: A cross-sectional study was conducted in 2020. A validated self-administered online-based questionnaire was sent to a sample of the adult population of Bisha to measure their awareness of hypertension complications. Results: Almost three-quarters of the population (72.2%) were aware of hypertension complications. The awareness level was significantly higher among male participants (p < 0.001), those aged 31–40 years, those who were married, those working as police officers or in civilian jobs, those living in urban areas (p = 0.04), those with a university-level education (p = 0.03), those with a medium family income (SAR 5000–14,999) (p = 0.001), and those with a history of hospitalization because of causes other than hypertension (p = 0.05). Marital status was independently predictive of awareness (B = 0.851, Wald test = 12.179, p = 0.000) among the respondents. Conclusion: The study concludes that the awareness of hypertension complications among the Bisha population in Saudi Arabia was deemed acceptable. Factors such as marital status, age, gender, a family history of hypertension, the duration of hypertension, and medication adherence positively influenced this awareness and served as predictors of hypertensive awareness. The findings highlight the importance of health authorities in ensuring the widespread awareness of hypertension complications, particularly among hypertensive individuals. Full article

(This article belongs to the Special Issue Ageing, Chronicity and End of Life Care)

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9 pages, 1258 KiB

Open AccessArticle

Prevalence, Characteristics, and Management of Pediatric Ocular Trauma in Riyadh, Saudi Arabia: A Retrospective Analysis

by Balsam Alabdulkader, Yara Alsiwat, Hessa Almatar, Bayan Albdah, Ali Almustanyir, Essam Almutleb, Norah Alkanhal and Ahmed Almazroa

Healthcare 2024, 12(16), 1673; https://doi.org/10.3390/healthcare12161673 - 22 Aug 2024

Viewed by 764

Abstract

Purpose: Ocular trauma is a major cause of visual impairment; however, little is known about its burden in Saudi Arabia. Therefore, this study aimed to determine the epidemiological characteristics of ocular trauma in pediatric patients in Riyadh, Saudi Arabia. Patients and methods: Medical [...] Read more.

Purpose: Ocular trauma is a major cause of visual impairment; however, little is known about its burden in Saudi Arabia. Therefore, this study aimed to determine the epidemiological characteristics of ocular trauma in pediatric patients in Riyadh, Saudi Arabia. Patients and methods: Medical records of pediatric patients diagnosed with eye injuries between January 2016 and December 2020 were retrospectively reviewed. Demographic and injury characteristics were collected, and ocular trauma injuries were classified according to the Birmingham Eye Trauma Terminology. Results: A total of 855 injured patients were included in the study, of whom 525 (61.4%) were boys. Patient age ranged from one month to 18 years. Most ocular injuries occurred in children aged 5–9 years. The injuries were more prevalent in boys than in girls. Closed globe injuries accounted for 70% of cases, open globe injuries for 21%, and other injuries for 9%. Most ocular injuries occurred at home (n = 87, 42%), followed by school (n = 61, 30%). Conclusions: These results may inform the implementation and targeting of interventions to reduce or prevent eye injuries in children. Further, they highlight the importance of well-planned prevention programs to prevent eye injuries from occurring in children’s daily lives. Full article

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17 pages, 1854 KiB

Open AccessArticle

Healthcare Outcomes of Patients and Antecedents via Teleophthalmology in Eastern Taiwan during COVID-19

by Hsing-Chu Chen, Ching-Yu Chang, Chung-Hung Tsai, Wei-Lin Hsu, Wen-Fang Sung and Yu-Xuan Wu

Healthcare 2024, 12(16), 1672; https://doi.org/10.3390/healthcare12161672 - 21 Aug 2024

Viewed by 862

Abstract

Objective: The coronavirus disease 2019 (COVID-19) pandemic has caused significant transformations in healthcare. Many countries began the rapid development and adoption of telemedicine to avoid the spread of the pandemic and created an innovative model for healthcare delivery. This study identified the critical [...] Read more.

Objective: The coronavirus disease 2019 (COVID-19) pandemic has caused significant transformations in healthcare. Many countries began the rapid development and adoption of telemedicine to avoid the spread of the pandemic and created an innovative model for healthcare delivery. This study identified the critical antecedents that affected the considered healthcare outcomes via teleophthalmology in Eastern Taiwan during the COVID-19 pandemic. Methods: This study’s participants included residents of five towns in Taitung County who had experience with teleophthalmology. This study analyzed the structured questionnaires completed by the participants to validate the proposed research framework. Statistical methods were used to verify the research models, including descriptive statistical analysis, confirmatory factor analysis, and structural equation modeling. The date of this study was from 1 October 2020 to 31 July 2023. Results: The results of this study reveal that the average monthly use of teleophthalmology by individuals in rural areas increased annually. Females tended to utilize teleophthalmology services more than males. There were no significant differences across any of the constructs with respect to age or educational level. Additionally, the patients’ awareness of healthcare accessibility via and the communication quality of teleophthalmology simultaneously affected teleophthalmology’s adoption and service quality, which in turn jointly affected health outcomes. Both healthcare accessibility and communication quality were the antecedents of the healthcare outcomes. The health outcomes refer to the impact of teleophthalmology on the quality of the patients’ health and well-being. Additionally, teleophthalmology’s adoption and service quality acted as mediators. Conclusions: This study’s findings are expected to increase attention to the healthcare outcomes and antecedents of teleophthalmology to promote better telemedicine practices and services for rural residents. Full article

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

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20 pages, 1084 KiB

Open AccessReview

Polycystic Ovary Syndrome and the Internet of Things: A Scoping Review

by Sandro Graca, Folashade Alloh, Lukasz Lagojda, Alexander Dallaway, Ioannis Kyrou, Harpal S. Randeva and Chris Kite

Healthcare 2024, 12(16), 1671; https://doi.org/10.3390/healthcare12161671 - 21 Aug 2024

Viewed by 3001

Abstract

Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder impacting women’s health and quality of life. This scoping review explores the use of the Internet of Things (IoT) in PCOS management. Results were grouped into six domains of the IoT: mobile apps, social [...] Read more.

Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder impacting women’s health and quality of life. This scoping review explores the use of the Internet of Things (IoT) in PCOS management. Results were grouped into six domains of the IoT: mobile apps, social media, wearables, machine learning, websites, and phone-based. A further domain was created to capture participants’ perspectives on using the IoT in PCOS management. Mobile apps appear to be useful for menstrual cycle tracking, symptom recording, and education. Despite concerns regarding the quality and reliability of social media content, these platforms may play an important role in disseminating PCOS-related information. Wearables facilitate detailed symptom monitoring and improve communication with healthcare providers. Machine learning algorithms show promising results in PCOS diagnosis accuracy, risk prediction, and app development. Although abundant, PCOS-related content on websites may lack quality and cultural considerations. While patients express concerns about online misinformation, they consider online forums valuable for peer connection. Using text messages and phone calls to provide feedback and support to PCOS patients may help them improve lifestyle behaviors and self-management skills. Advancing evidence-based, culturally sensitive, and accessible IoT solutions can enhance their potential to transform PCOS care, address misinformation, and empower women to better manage their symptoms. Full article

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16 pages, 4078 KiB

Open AccessArticle

Measuring the Effect of an Ergonomic Lecture on the Rapid Upper Limb Assessment Scores of Dental Assistant Students Using Inertial Sensor-Based Motion Capture—A Randomized Controlled Study

by Steven Simon, Laura Laurendi, Jonna Meining, Jonas Dully, Carlo Dindorf, Lukas Maurer and Michael Fröhlich

Healthcare 2024, 12(16), 1670; https://doi.org/10.3390/healthcare12161670 - 21 Aug 2024

Viewed by 842

Abstract

Individuals working in the field of dentistry have a high prevalence of musculoskeletal disorders (MSDs) owing to monotonous and one-sided physical exertion. Inertial measurement units (IMU) are increasingly shifting into focus for assessing postural risk at work. Therefore, the present study aimed to [...] Read more.

Individuals working in the field of dentistry have a high prevalence of musculoskeletal disorders (MSDs) owing to monotonous and one-sided physical exertion. Inertial measurement units (IMU) are increasingly shifting into focus for assessing postural risk at work. Therefore, the present study aimed to evaluate the effects of an ergonomic lecture and training intervention on postural risk and MSDs in dental assistant students using inertial sensor-based motion capture (MoCap). Eighteen female dental assistant students (age: 19.44 ± 6.83 years; height: 164.59 ± 5.32 cm; weight: 64.88 ± 16.52 kg; BMI: 19.70 ± 4.89 kg/m²), randomly divided into intervention (n = 9) and control (n = 9) groups, participated in the present study. The participants completed the Nordic Questionnaire on MSD prevalence, after which a 90 s MoCap with Xsens IMU was performed. A lecture on ergonomics was provided, followed by a five-week intervention for the intervention group. Follow-up assessments were performed, and 5- and 18-week follow-up MSD questionnaires were administered. Mixed analysis of variance (MANOVA) showed a significant difference in the Rapid Upper Limb Assessment (RULA) and part-scores of the upper arm and wrist. Despite a reduction in MSDs, no significant differences in the time of measurement and groups were detected after the five-week training intervention and the 18-week follow-up questionnaire. A targeted ergonomics lecture was effective for dental assistant students, and technologies such as IMU improved workplace ergonomics in dentists. Further studies with a longer measurement periods, follow-up, and larger sample sizes are recommended. Full article

(This article belongs to the Topic Advances in Dental Health)

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24 pages, 2472 KiB

Open AccessArticle

Spatial Allocation Rationality Analysis of Medical Resources Based on Multi-Source Data: Case Study of Taiyuan, China

by Lujin Hu and Shengqi Cai

Healthcare 2024, 12(16), 1669; https://doi.org/10.3390/healthcare12161669 - 21 Aug 2024

Viewed by 1050

Abstract

Reasonably allocating medical resources can effsectively optimize the utilization efficiency of such resources. This paper took Taiyuan City as an example and established a model to evaluate the rationality of medical resource spatial allocation, incorporating two key dimensions: the spatial layout and the [...] Read more.

Reasonably allocating medical resources can effsectively optimize the utilization efficiency of such resources. This paper took Taiyuan City as an example and established a model to evaluate the rationality of medical resource spatial allocation, incorporating two key dimensions: the spatial layout and the supply and demand of medical resources. In terms of the spatial layout, three indexes were included: Firstly, the service coverage rates of different levels of medical institutions, based on residents’ medical orientations, were calculated using network analysis methods. Secondly, the Huff-2SFCA method was improved to calculate the accessibility of medical resources for four different modes of transportation. Then, the Health Resource Agglomeration Degree (HRAD) and Population Agglomeration Degree (PAD) were used to quantify the equity of medical resources. In terms of the supply and demand of medical resources, one index was included: the supply–demand ratio of medical resources during sudden public health events, which was calculated using the number of beds per thousand people as an indicator. These four indexes were weighted using the entropy weight method to obtain the rationality grade of medical resource spatial allocation in Taiyuan City. The study found that the rationality evaluation level of medical resource allocation in the central urban area of Taiyuan City followed a “concentrically decreasing” pattern. The rating ranged from “very reasonable” to “less reasonable”, with the area of each level expanding gradually. The areas rated within the top two categories only accounted for 19.92% of the study area, while the area rated as “less reasonable” occupied 38.73% of the total area. These results indicate that the model accounted for residents’ travel for various medical orientations and the availability of resources during public health emergencies. It considered both the spatial layout and supply and demand of medical resources, offering recommendations for the precise allocation of urban medical resources. Full article

(This article belongs to the Special Issue Implementation of GIS (Geographic Information Systems) in Health Care)

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10 pages, 1154 KiB

Open AccessArticle

Outcomes of a Self-Management Program for People with Non-Communicable Diseases in the Context of COVID-19

by Rodrigo Cesar León Hernández, Jorge Luis Arriaga Martínez, Martha Arely Hernández Del Angel, Isabel Peñarrieta de Córdova, Virginia Solís Solís and María Elena Velásquez Salinas

Healthcare 2024, 12(16), 1668; https://doi.org/10.3390/healthcare12161668 - 21 Aug 2024

Viewed by 969

Abstract

Objective: To evaluate the effectiveness of the online version of the Chronic Disease Self-Management Program (CDSMP) on physical activity and depressive symptoms in individuals with non-communicable diseases (NCDs) in Mexico and Peru during the COVID-19 pandemic. Materials and Methods: Quasi-experimental study with a [...] Read more.

Objective: To evaluate the effectiveness of the online version of the Chronic Disease Self-Management Program (CDSMP) on physical activity and depressive symptoms in individuals with non-communicable diseases (NCDs) in Mexico and Peru during the COVID-19 pandemic. Materials and Methods: Quasi-experimental study with a non-probability sample of 114 people with NCDs, recruited by invitation in Mexico and by convenience in Peru. The participants were assigned to intervention (n = 85) and control (n = 29) groups. The Personal Health Questionnaire (PHQ-8) and the Physical Activity Scale were used to assess the outcomes. Measurements were taken before and after the intervention. The CDSMP comprises six sessions that take place once per week and last 2.5 h each. Results: The intervention group showed a significant reduction in depressive symptoms and an increase in physical activity (PA) at the end of the program. In contrast, the control group showed no significant improvement in depression and presented a significant decrease in PA. Full article

(This article belongs to the Special Issue Healthcare Strategies for Patients with Chronic Diseases in an Ageing Society)

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13 pages, 2284 KiB

Open AccessArticle

The Effects of Prolonged Indoor Inhalation of Nature-Derived Odors on Menopausal Women

by Choyun Kim, Gayoung Lee and Chorong Song

Healthcare 2024, 12(16), 1667; https://doi.org/10.3390/healthcare12161667 - 21 Aug 2024

Viewed by 727

Abstract

This study aimed to investigate the effects of prolonged inhalation of nature-derived odors indoors on humans. Twenty-six women participated in this study. Heart rate variability, heart rate, blood pressure, pulse rate, estradiol, testosterone, and cortisol were used as indicators of autonomic nervous system [...] Read more.

This study aimed to investigate the effects of prolonged inhalation of nature-derived odors indoors on humans. Twenty-six women participated in this study. Heart rate variability, heart rate, blood pressure, pulse rate, estradiol, testosterone, and cortisol were used as indicators of autonomic nervous system and endocrine system activities. Profile of mood state, state–trait anxiety inventory, menopause rating scale and general sleep disturbance scale were used as psychological indicators. The order was as follows: After the participants relaxed in a chair for 5 min, their heart rate variability and heart rate were measured for 3 min with their eyes closed. Subsequently, blood pressure and pulse rate were measured, salivary samples were collected for estradiol, testosterone, and cortisol analyses, and a subjective assessment was conducted. The participants received a diffuser containing fir essential oil and were instructed on its usage and precautions. Subsequently, they returned home and inhaled the fir oil for a week. After 7 days, participants revisited the laboratory for posttest measurements, conducted at the same time as the pretest. Prolonged inhalation of the fir essential oil resulted in increased estradiol concentration, decreased systolic and diastolic blood pressure, relief of menopausal symptoms, reduced anxiety levels, improved sleep quality and mood states. Prolonged inhalation of the fir essential oil induced physiological and psychological relaxation on menopausal women. Full article

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12 pages, 259 KiB

Open AccessArticle

Frailty Assessment and Its Impact on Loneliness among Older Adults Receiving Home-Based Healthcare during the COVID-19 Pandemic

by Maria Klesiora, Konstantinos Tsaras, Ioanna V. Papathanasiou, Maria Malliarou, Nikolaos Bakalis, Lambrini Kourkouta, Christos Melas and Christos Kleisiaris

Healthcare 2024, 12(16), 1666; https://doi.org/10.3390/healthcare12161666 - 21 Aug 2024

Viewed by 943

Abstract

The purpose of this study was to identify the effect of frailty on loneliness among older adults receiving home care, in correlation to their socioeconomic and homebound statuses. This cross-sectional study recruited 218 individuals aged ≥65 years receiving home-based health services from the [...] Read more.

The purpose of this study was to identify the effect of frailty on loneliness among older adults receiving home care, in correlation to their socioeconomic and homebound statuses. This cross-sectional study recruited 218 individuals aged ≥65 years receiving home-based health services from the “Help at Home” program in the Region of Evrytania, Greece through an open invitation from the municipality authorities from March to June 2022. The Tilburg Frailty Indicator (TFI) was used for the evaluation of frailty, the UCLA Loneliness Scale version 3 was used for loneliness, and social isolation was accessed through five questions (living alone, frequency of interaction with children, relatives, friends, and participation in social organizations). The mean age of the participants was 81.48 ± 9.06, 61.9% were female, 54.1% experienced high levels of loneliness (UCLA-3 mean 45.76 ± 11.10 [range 20–68]), and 46.3% of the participants were found to be socially isolated. Also, 58.3% of the individuals were identified as frail (TFI mean 5.95 ± 3.07) [TFI range 0–13], with 57.3% experiencing physical frailty, 43.6% experiencing psychological frailty, and 27.1% experiencing social frailty. An analysis of covariance (ANCOVA) using UCLA-3 as the dependent variable revealed that loneliness across all domains of TFI was significantly higher in participants with frailty (total frailty [Yes] 49.27 vs. [No] 40,87 p < 0.001) (physical frailty [Yes] = 48.99 vs. [No] = 41.42, p < 0.001, psychological: 48.60 vs. 43.57 p < 0.001, and social: 53.38 vs. 42.94 p < 0.001), particularly compared to non-frail individuals, even after adjusting for potential confounding effects (covariates: gender, age, marital status, family status, living status, educational level, annual income, chronic diseases, homebound status, and social isolation). Our findings indicate that frail older adults experienced higher levels of loneliness, suggesting that frailty and loneliness are independently associated among older adults who receive home-based healthcare. Full article

9 pages, 211 KiB

Open AccessOpinion

The Right to Oncological Oblivion: A Legislative Response to Cancer Survivor Discrimination in Italy

by Gianpiero D’Antonio, Ginevra Bolino, Letizia Sorace, Gianpietro Volonnino, Lavinia Pellegrini, Nicola Di Fazio and Paola Frati

Healthcare 2024, 12(16), 1665; https://doi.org/10.3390/healthcare12161665 - 21 Aug 2024

Viewed by 744

Abstract

Despite the increasing efficacy of modern medicine in diagnosing and treating cancer, survivors often face discrimination in employment, economics, insurance, and society. Law no. 193/2023, also known as the “Oncological Oblivion Law”, aims to provide an initial legislative response to discrimination against cancer [...] Read more.

Despite the increasing efficacy of modern medicine in diagnosing and treating cancer, survivors often face discrimination in employment, economics, insurance, and society. Law no. 193/2023, also known as the “Oncological Oblivion Law”, aims to provide an initial legislative response to discrimination against cancer survivors in Italy. After defining oncological oblivion in Article 1, the Law provides, in Articles 2, 3, and 4, directives to prevent discrimination against cancer survivors in the area of access to banking and insurance services, adoption procedures and access to or retention in employment. The aim of this work is to illustrate the content and the critical aspects of the recent Law 193/2023 in the landscape of European directives. The legislative process at the Chamber of Deputies and the Senate of the Italian Republic has been retraced through the consultation of preparatory works and bills registered on institutional databases. Law 193/2023 represents the first initiative in Italy aimed at the recognition of the right to oncological oblivion, not only in access to banking and insurance services as in other countries, but also in adoption, employment, and re-employment. Our opinion piece highlights the need for further clarification and expansion to prevent discrimination and protect the social–work–relational rights of people who have been affected by oncological diseases. Full article

(This article belongs to the Special Issue Policy Interventions to Promote Health and Prevent Disease)

12 pages, 1362 KiB

Open AccessArticle

Determining the Best Noninvasive Test for Peripheral Arterial Disease Diagnosis to Predict Diabetic Foot Ulcer Healing in Patients Following Endovascular Revascularization

by Francisco Javier Álvaro-Afonso, Yolanda García-Álvarez, Esther Alicia García-Morales, Sebastián Flores-Escobar, Luis De Benito-Fernández, Jesús Alfayate-García, Juan Pedro Sánchez-Ríos, Enrique Puras-Mallagray, Esteban Javier Malo-Benages, Marta Ramírez-Ortega, Sandra Redondo-López, Almudena Cecilia-Matilla and José Luis Lázaro-Martínez

Healthcare 2024, 12(16), 1664; https://doi.org/10.3390/healthcare12161664 - 20 Aug 2024

Viewed by 1199

Abstract

Background/Objectives: To analyze the best noninvasive tests prognosis marker in patients with diabetic foot ulcer (DFU) who underwent endovascular revascularization based on clinical outcomes, such as healing rate, time to heal, and free amputation survival after at least a six-month follow-up. Methods: A [...] Read more.

Background/Objectives: To analyze the best noninvasive tests prognosis marker in patients with diabetic foot ulcer (DFU) who underwent endovascular revascularization based on clinical outcomes, such as healing rate, time to heal, and free amputation survival after at least a six-month follow-up. Methods: A multicentric prospective observational study was performed with 28 participants with ischemic or neuroischemic DFU who came to the participant centers and underwent endovascular revascularization between January 2022 and March 2023. Toe systolic pressure (TP), ankle systolic pressure (AP), the ankle brachial pressure index (ABPI), the toe brachial pressure index (TBPI), transcutaneous pressure of oxygen (TcPO₂), and skin perfusion pressure (SPP) were evaluated using PeriFlux 6000 System, Perimed, Sweden, before (Visit 0) and four weeks after revascularization (Visit 1). The primary clinical outcome was an evaluation of the clinical evolution of noninvasive tests comparing Visit 0 and Visit 1, estimating the sensitivity for predicting wound healing of noninvasive tests at six months following initial recruitment. Results: After six months, 71.43% (n = 20) of DFU healed, four patients (14.3%) received major amputations, and one (3.5%) died. The two tests that best predicted wound healing after revascularization according to the ROC curve were TcPO₂ and TP with sensitivities of 0.89 and 0.70 for the cut-off points of 24 mmHg and 46 mmHg, respectively. Conclusions: TcPO₂ and TP were the two tests that best predicted wound healing in patients who underwent endovascular revascularization. Clinicians should consider the importance of the evaluation of microcirculation in the healing prognosis of patients with diabetic foot ulcers. Full article

(This article belongs to the Special Issue Research on Podiatric Medicine and Healthcare)

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14 pages, 893 KiB

Open AccessArticle

It Is Not Just a Matter of Motivation: The Role of Self-Control in Promoting Physical Activity in Older Adults—A Bayesian Mediation Model

by Nicola Camp, Roberto Vagnetti, Samuel Penner, Catarina Ramos, Kirsty Hunter, John Hough and Daniele Magistro

Healthcare 2024, 12(16), 1663; https://doi.org/10.3390/healthcare12161663 - 20 Aug 2024

Viewed by 928

Abstract

This study aimed to understand how psychological factors affect regular exercise in older adults, hypothesising that trait self-control mediates the relationship between motivation types (intrinsic, extrinsic, and amotivation) and exercise time. In this cross-sectional study, 430 older adults (mean age = 68.8 ± [...] Read more.

This study aimed to understand how psychological factors affect regular exercise in older adults, hypothesising that trait self-control mediates the relationship between motivation types (intrinsic, extrinsic, and amotivation) and exercise time. In this cross-sectional study, 430 older adults (mean age = 68.8 ± 6.72) completed questionnaires regarding their perceived trait self-control, motivation towards leisure activities, and level of physical activity. A Bayesian mediation analysis was performed, controlling for demographics. We documented positive direct (c′ = 0.021, 95%CI [0.001, 0.043]) and indirect (ab = 0.028, 95%CI [0.014, 0.043]) effects of intrinsic motivation on exercise, a fully mediated indirect effect of extrinsic motivation on exercise (ab = 0.027, 95%CI [0.011, 0.046]), and negative direct (c′ = −0.281, 95%CI [−0.368, −0.194]) and indirect (ab = −0.161, 95%CI [−0.221, −0.105]) effects of amotivation on exercise. There was no direct association between extrinsic motivation and exercise (c′ = 0.013, 95% CI [−0.013, 0.037]). In conclusion, trait self-control mediates motivation to influence exercise behaviour in older adults. Intrinsically motivated individuals resist sedentary living and show higher self-control, while extrinsically motivated ones rely on self-control and are more susceptible to non-adherence during mental fatigue. High amotivation is linked to less exercise and reduced self-control, suggesting potential non-compliance with structured exercise interventions. Full article

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13 pages, 717 KiB

Open AccessArticle

Path to Suicidality in Korean Adolescents: Mediating Role of Self-Esteem, Somatic Symptoms, and Self-Harm Amid Depressive Symptoms

by Jiyeon Kim and Myongsun Cho

Healthcare 2024, 12(16), 1662; https://doi.org/10.3390/healthcare12161662 - 20 Aug 2024

Viewed by 912

Abstract

This study explored the relationship between depressive symptoms and suicidality among community-dwelling adolescents aged 10–18 years, examining whether self-esteem, somatic symptoms, and self-harm mediate this relationship. Utilizing a pre-existing dataset from a nationwide adolescent mental health survey conducted in Korea in 2021, data [...] Read more.

This study explored the relationship between depressive symptoms and suicidality among community-dwelling adolescents aged 10–18 years, examining whether self-esteem, somatic symptoms, and self-harm mediate this relationship. Utilizing a pre-existing dataset from a nationwide adolescent mental health survey conducted in Korea in 2021, data were collected using several standardized self-administered instruments: the Korean version of Rosenberg’s self-esteem scale, Korean Children’s Somatization Inventory, Korean version of the Self-Harm Inventory, Mental Health Screening for Depressive Disorders, and Mental Health Screening for Suicide Risk. A path model was constructed and validated, followed by path analysis to assess the effects. Data from 6689 adolescents, including 5937 students and 752 out-of-school adolescents, revealed that 18.7% were in the suicidality group, 11.8% experienced depressive symptoms, 57.9% exhibited somatic symptoms, and 27.4% engaged in self-harm. Depressive symptoms had a positive direct effect on suicidality (β = 0.166, p < 0.001, 95% confidence interval = 0.159–0.172). Bootstrapping tests showed a statistically significant indirect effect of self-esteem, somatic symptoms, and self-harm on the relationship between depressive symptoms and suicidality (β = 0.021, 95% confidence interval = 0.013–0.029). Our findings suggest that self-esteem, somatic symptoms, and self-harm mediate the relationship between depressive symptoms and suicidality, and comprehensive mental health management strategies addressing these factors are recommended. Full article

(This article belongs to the Special Issue Research and Survey on the Mental Health of Children and Adolescents: Second Edition)

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19 pages, 728 KiB

Open AccessArticle

Needs-Assessment for an Artificial Intelligence-Based Chatbot for Pharmacists in HIV Care: Results from a Knowledge–Attitudes–Practices Survey

by Moustafa Laymouna, Yuanchao Ma, David Lessard, Kim Engler, Rachel Therrien, Tibor Schuster, Serge Vicente, Sofiane Achiche, Maria Nait El Haj, Benoît Lemire, Abdalwahab Kawaiah and Bertrand Lebouché

Healthcare 2024, 12(16), 1661; https://doi.org/10.3390/healthcare12161661 - 20 Aug 2024

Viewed by 1324

Abstract

Background: Pharmacists need up-to-date knowledge and decision-making support in HIV care. We aim to develop MARVIN-Pharma, an adapted artificial intelligence-based chatbot initially for people with HIV, to assist pharmacists in considering evidence-based needs. Methods: From December 2022 to December 2023, an online needs-assessment [...] Read more.

Background: Pharmacists need up-to-date knowledge and decision-making support in HIV care. We aim to develop MARVIN-Pharma, an adapted artificial intelligence-based chatbot initially for people with HIV, to assist pharmacists in considering evidence-based needs. Methods: From December 2022 to December 2023, an online needs-assessment survey evaluated Québec pharmacists’ knowledge, attitudes, involvement, and barriers relative to HIV care, alongside perceptions relevant to the usability of MARVIN-Pharma. Recruitment involved convenience and snowball sampling, targeting National HIV and Hepatitis Mentoring Program affiliates. Results: Forty-one pharmacists (28 community, 13 hospital-based) across 15 Québec municipalities participated. Participants perceived their HIV knowledge as moderate (M = 3.74/6). They held largely favorable attitudes towards providing HIV care (M = 4.02/6). They reported a “little” involvement in the delivery of HIV care services (M = 2.08/5), most often ART adherence counseling, refilling, and monitoring. The most common barriers reported to HIV care delivery were a lack of time, staff resources, clinical tools, and HIV information/training, with pharmacists at least somewhat agreeing that they experienced each (M ≥ 4.00/6). On average, MARVIN-Pharma’s acceptability and compatibility were in the ‘undecided’ range (M = 4.34, M = 4.13/7, respectively), while pharmacists agreed to their self-efficacy to use online health services (M = 5.6/7). Conclusion: MARVIN-Pharma might help address pharmacists’ knowledge gaps and barriers to HIV treatment and care, but pharmacist engagement in the chatbot’s development seems vital for its future uptake and usability. Full article

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12 pages, 596 KiB

Open AccessArticle

Impact of Social Needs and Identity Experiences on the Burden of Illness in Patients with Multiple Myeloma: A Mixed-Methods Study

by Natalia Neparidze, Amandeep Godara, Dee Lin, Hoa H. Le, Karen Fixler, Lisa Shea, Stephanie Everson, Christine Brittle and Kimberly D. Brunisholz

Healthcare 2024, 12(16), 1660; https://doi.org/10.3390/healthcare12161660 - 20 Aug 2024

Cited by 1 | Viewed by 818

Abstract

Multiple myeloma (MM) is a common hematologic malignancy, but due to its incurable nature, patients experience many relapses in their lifetime and hence face unique challenges. This mixed-methods study consisting of an online survey and subsequent focus groups aimed to understand how social [...] Read more.

Multiple myeloma (MM) is a common hematologic malignancy, but due to its incurable nature, patients experience many relapses in their lifetime and hence face unique challenges. This mixed-methods study consisting of an online survey and subsequent focus groups aimed to understand how social and identity experiences affected the diagnostic, treatment, and care journey for patients with MM. Twenty-three adult patients with MM participated in this study. The survey participants identified common determinants negatively impacting their health, including mental health concerns (experienced by 90.5% of respondents), worries about food shortage (42.9%), and transportation concerns (28.6%). Focus group participants described high physical and mental health burdens associated with MM. Frequent monitoring, fear of a relapse, and unpredictable side effects contributed to high anxiety. Participants indicated that MM differed from other types of cancer and chronic health conditions in many ways, particularly how and where the diagnosis was made, disease progression and relapse, treatments and side effects, and financial concerns. Most participants (65.0%) reported ≥1 social need that negatively impacted health outcomes including lack of knowledge about MM, financial instability, and lack of insurance, transportation, and social support. The findings reveal that patients with MM continually experience patient-specific mental and physical health burdens indicating high unmet needs throughout the disease journey. Full article

(This article belongs to the Special Issue Narrative in Health and Social Care: 2nd Edition)

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9 pages, 261 KiB

Open AccessArticle

Quality of Life of the Primary Caregivers of Children with Cleft Lip and Palate in Guanajuato, Mexico: A Cross-Sectional Study

by María del Carmen Villanueva-Vilchis, Karen Esperanza Almanza-Aranda, Luis Alberto Gaitán-Cepeda, Rubén Rangel-Salazar, María de los Ángeles Ramírez-Trujillo, Fátima del Carmen Aguilar-Díaz and Javier de la Fuente-Hernández

Healthcare 2024, 12(16), 1659; https://doi.org/10.3390/healthcare12161659 - 20 Aug 2024

Viewed by 704

Abstract

Comprehensive treatment is crucial for patients with a cleft lip/palate. While studies have investigated its impact on children’s quality of life, few have examined the effects on primary caregivers. The aim of the study was to compare the quality of life of caregivers [...] Read more.

Comprehensive treatment is crucial for patients with a cleft lip/palate. While studies have investigated its impact on children’s quality of life, few have examined the effects on primary caregivers. The aim of the study was to compare the quality of life of caregivers of children with cleft lip/palate to a control group at the National School for Higher Studies, National Autonomous University of Mexico, Guanajuato. A cross-sectional study was conducted at a teaching dental clinic of the National School of Higher Studies, National Autonomous University of Mexico, Guanajuato, México, from May to December 2021 involving 140 caregivers (70 in each group). The WHOQoL Bref instrument assessed the quality of life. In addition to the descriptive analysis, a binary logistic regression analysis was carried out, taking dichotomized reported quality of life as the dependent variable. Among the caregivers, 88.6% were female (p > 0.05), and 45 (64.8%) from the study group reported poor quality of life (p < 0.05). A multivariate analysis indicated that caring for a child with cleft lip/palate raised the likelihood of poor quality of life (p < 0.05). The findings emphasize the need for comprehensive support for both patients and caregivers, as their well-being affects patient outcomes. Full article

8 pages, 213 KiB

Open AccessArticle

Novel Approaches Needed: An Experimental Study with an Alternative to Mechanical Restraint

by Tilman Steinert, Bernd Maierhofer, Peter Schmid and Sophie Hirsch

Healthcare 2024, 12(16), 1658; https://doi.org/10.3390/healthcare12161658 - 20 Aug 2024

Viewed by 780

Abstract

Despite many calls to reduce or eliminate the use of mechanical restraint, it is still widely used in many countries. Studies using patient interviews have a very clear message: Patients experience mechanical restraint as the most humiliating intervention. There seems to be a [...] Read more.

Despite many calls to reduce or eliminate the use of mechanical restraint, it is still widely used in many countries. Studies using patient interviews have a very clear message: Patients experience mechanical restraint as the most humiliating intervention. There seems to be a lack of alternatives for violent patients if all other approaches to prevent the use of coercion have failed. We developed a method using 30 kg bags, originally designed for fitness purposes, to be attached to a patient’s wrist or ankle under 1:1 supervision. The method was tested with 10 experienced nurses and de-escalation trainers. A video was made and presented to six outpatients who had previously experienced mechanical restraint. All participants were interviewed. Transcribed interviews were analysed using qualitative content analysis. All participants approved of the method as a milder and less humiliating alternative to mechanical restraint. The nurses’ main concerns were the risk of falls and the use of the bags as weapons. The latter could be controlled by using an additional bag. Patients were generally positive, especially if there was a history of abuse. The method should be further developed to replace at least some mechanical restraints. As with all ‘milder means’, care should be taken to really replace restraint and not to introduce additional coercion. Full article

(This article belongs to the Topic Ethical, Legal and Forensic Issues regarding Vulnerable Populations)

15 pages, 215 KiB

Open AccessArticle

Campaign Governance and Playfulness: Unraveling Chinese HPV Immunization Promotion Efforts on Douyin

by Jiaji Wu and Ronghui Yang

Healthcare 2024, 12(16), 1657; https://doi.org/10.3390/healthcare12161657 - 20 Aug 2024

Viewed by 702

Abstract

(1) Background: Playful immunization promotion helps to approach persuasive efforts and raise vaccine acceptance. However, playful promotion in the field of HPV immunization has not been explored. (2) Methods: To address this gap, we analyzed data gleaned from 73 short videos posted by [...] Read more.

(1) Background: Playful immunization promotion helps to approach persuasive efforts and raise vaccine acceptance. However, playful promotion in the field of HPV immunization has not been explored. (2) Methods: To address this gap, we analyzed data gleaned from 73 short videos posted by state media and from semi-structured interviews with 37 Chinese stakeholders using thematic analysis. (3) Results: The analysis revealed that state media promoted HPV immunization using celebrity endorsement, anthropomorphism techniques and entertainment performance strategies. Additionally, state media engaged in circle mobilization and livestreamed on Douyin to reach wider audiences. Although playful strategies increased the popularity of HPV vaccine promotion, insufficient multi-stakeholder partnerships and homogeneous message delivery decreased the efficiency of HPV immunization promotion campaigns. (4) Conclusions: The strengthening of multi-stakeholder partnerships and the optimization of the public service provision of HPV vaccination are expected. Our research will not only deepen the global audience’s understanding of Chinese immunization promotion campaigns, but also offer insights for implementing future global health promotion. Full article

(This article belongs to the Topic The Promotion and Development of Community Health for Personal Health: Theories and Applications)

10 pages, 947 KiB

Open AccessArticle

Foot Anthropometry Measures in Relation to Treatment in Patients with Rheumatoid Arthritis: A Longitudinal Study

by Maria Gamez-Guijarro, Andres Reinoso-Cobo, Maria Jose Perez-Galan, Ana Belen Ortega-Avila, Laura Ramos-Petersen, Marcelino Torrontegui-Duarte, Gabriel Gijon-Nogueron and Eva Lopezosa-Reca

Healthcare 2024, 12(16), 1656; https://doi.org/10.3390/healthcare12161656 - 20 Aug 2024

Cited by 1 | Viewed by 770

Abstract

Approximately 90% of patients with arthritis exhibit forefoot deformities, including deformities within the metatarsophalangeal and proximal interphalangeal joints. Current pharmacological treatment with Disease Modifying Antirheumatic Drugs (DMARDs) consists of two groups: synthetic drugs (sDMARDs) and biological drugs (bDMARDs). The objective of our study [...] Read more.

Approximately 90% of patients with arthritis exhibit forefoot deformities, including deformities within the metatarsophalangeal and proximal interphalangeal joints. Current pharmacological treatment with Disease Modifying Antirheumatic Drugs (DMARDs) consists of two groups: synthetic drugs (sDMARDs) and biological drugs (bDMARDs). The objective of our study was to investigate foot anthropometry changes in RA patients based on the administered treatment over a five-year period Method: A longitudinal analysis was conducted with RA patients who were grouped based on their pharmacological treatment. The pharmacological treatment groups were categorized into (I) methotrexate (MTX), (II) MTX plus biological treatments (including all variables), (III) biological treatment alone, and (IV) a miscellaneous group comprising patients with diverse treatments, including patients for whom various drugs had failed or who had not achieved remission with pharmacological treatment. For the anthropometric measurements, a foot measurement platform validated by McPoil et al. was used. Post hoc analyses with Bonferroni correction were performed to identify pairwise differences between the treatment groups while controlling for Type I errors due to multiple comparisons. Results: In the period from 2018 to 2023, significant changes were observed in several foot measurements. For instance, the MTX group showed a statistically significant increase in left heel width (p = 0.026). The MTX group experienced a slight increase in left foot length, while the Biologics and MTX + Bio groups exhibited more substantial increases in both maximum medial arch height and midfoot width. Conclusions: Different RA treatments can have a significant impact on foot structure over a five-year period, showing notable changes in heel width and overall foot morphology. Combined treatments with MTX and biologics potentially offer better management of RA. Full article

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11 pages, 269 KiB

Open AccessArticle

Positive Association between Patients’ Perception of Chronic Pain Rehabilitation as a Personally Meaningful Experience and the Flourishing Aspect of Well-Being

by Katrina J. Liddiard, Cary A. Brown and Annette J. Raynor

Healthcare 2024, 12(16), 1655; https://doi.org/10.3390/healthcare12161655 - 20 Aug 2024

Viewed by 752

Abstract

Chronic pain rehabilitation helps to reduce pain and restore valued life roles. Patients may have more positive outcomes when they perceive rehabilitation to be personally meaningful. This study examined associations between self-reported, personally meaningful rehabilitation and well-being. A pilot study was conducted using [...] Read more.

Chronic pain rehabilitation helps to reduce pain and restore valued life roles. Patients may have more positive outcomes when they perceive rehabilitation to be personally meaningful. This study examined associations between self-reported, personally meaningful rehabilitation and well-being. A pilot study was conducted using an online survey of people with chronic pain and experiences of rehabilitation. The PROMIS Pain Interference Short Form 8a and The Flourishing Scale were used to explore well-being. A modified self-report measure, the Meaningfulness in Rehabilitation Scale, was pilot-tested for construct validity and used in the survey. Of the 48 participants (81% female; 19% male), most attended a generalist therapy practice (62%) once per week (33%) or once per fortnight (29%). No statistically significant relationship was found between self-reported meaningfulness in rehabilitation and pain interference or other patient and therapy characteristics (duration of chronic pain category, type of therapy practice, resolution of rehabilitation category, and frequency of appointments). The nonparametric analysis identified a statistically significant moderate positive correlation between self-reported meaningfulness in rehabilitation and the flourishing aspect of well-being. This raises important questions and suggests that patients’ perception of rehabilitation as meaningful warrants further research. This pilot study provides valuable guidance to inform a larger investigation. Full article

(This article belongs to the Section Pain Management)

13 pages, 1603 KiB

Open AccessArticle

Public and Patient Involvement in Migration Health Research: Eritrean and Syrian Refugees’ and Asylum Seekers’ Views in Switzerland

by Afona Chernet, Daniel H. Paris, Lujain Alchalabi, Jürg Utzinger and Elisabeth Reus

Healthcare 2024, 12(16), 1654; https://doi.org/10.3390/healthcare12161654 - 20 Aug 2024

Viewed by 796

Abstract

Prior research has highlighted important healthcare access and utilization issues among new forced immigrants. We aimed to explore the role that public and patient involvement (PPI) might play in enhancing accessibility and specific contributions to migration health studies. We conducted open and in-depth [...] Read more.

Prior research has highlighted important healthcare access and utilization issues among new forced immigrants. We aimed to explore the role that public and patient involvement (PPI) might play in enhancing accessibility and specific contributions to migration health studies. We conducted open and in-depth interactive virtual discussions with asylum seekers and refugees from Eritrea and Syria in Switzerland. The PPI establishment consisted of three phases: inception, training and contribution. Prior to training, the concept of PPI was not straightforward to grasp, as it was a new approach—however, after training and consecutive discussions, participants were ardent to engage actively. We conclude that PPI holds promise in regard to raising awareness, improving healthcare system accessibilities and utilization, and enhancing and strengthening migration health research. Indeed, PPI volunteers were keen to raise their community’s awareness through their networks and bridge an important gap between researchers and the public. Full article

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14 pages, 1432 KiB

Open AccessArticle

Effect of Tai Chi Compared to Running on Drug Cravings, Attention Bias, and Physical Fitness in Men with Methamphetamine Use Disorder

by Ling Zhang, Haiqi Zeng, Yuliang Sun, Huiheng Xue, Liquan Gao and Wenfei Zhu

Healthcare 2024, 12(16), 1653; https://doi.org/10.3390/healthcare12161653 - 20 Aug 2024

Viewed by 1080

Abstract

Background: Methamphetamine use disorder (MUD) is a global health problem. Studies have shown Tai Chi is a potential treatment for MUD. We aimed to explore the effectiveness of Tai Chi in improving drug cravings, attention bias, and physical fitness in men with MUD [...] Read more.

Background: Methamphetamine use disorder (MUD) is a global health problem. Studies have shown Tai Chi is a potential treatment for MUD. We aimed to explore the effectiveness of Tai Chi in improving drug cravings, attention bias, and physical fitness in men with MUD compared with aerobic exercise. Methods: A total of forty-eight participants (mean age 39.1 ± 8.7 years) were randomly assigned to either the Tai Chi group (TC) or the running group (RG). The TC performed 60 min of moderate-intensity (65–75% HR_max) Tai Chi exercise three times a week. The RG performed 60 min of moderate-intensity (65–75% HR_max) running on a treadmill three times a week. Before and after the intervention, drug cravings, attention bias, and physical fitness were evaluated. Results: After 12 weeks, we found the TC significantly improved in attention bias (F (1, 43) = 6.023, p = 0.019, d = −0.42) and reaction time (F (1, 43) = 6.181, p = 0.017, d = −0.72). No significant improvement was found in other variables in the TC, compared to the RG (p > 0.05). Conclusions: The 12-week Tai Chi intervention improved attention bias and reaction time, compared to RG. Tai Chi exercise might be a potential auxiliary method for the rehabilitation for men with MUD. Full article

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14 pages, 268 KiB

Open AccessArticle

Development of Valid and Reliable Questionnaire to Evaluate Knowledge, Attitude, and Practices (KAP) of Lifestyle Medicine Domains

by Abeer Salman Alzaben, Mohammed Almansour, Hayat Saleh Alzahrani, Nouf Adnan Alrumaihi, Nesrain Mubarak Alhamedi, Nawaf Abdulaziz Albuhayjan and Sadeem Abdulaziz Aljammaz

Healthcare 2024, 12(16), 1652; https://doi.org/10.3390/healthcare12161652 - 20 Aug 2024

Viewed by 1673

Abstract

Lifestyle medicine (LM) should be incorporated as part of routine clinical work and medical education programs. Objective: To develop and test the validity and reliability of a questionnaire that measures the level of knowledge, attitude, and practice (KAP) of LM domains among medical [...] Read more.

Lifestyle medicine (LM) should be incorporated as part of routine clinical work and medical education programs. Objective: To develop and test the validity and reliability of a questionnaire that measures the level of knowledge, attitude, and practice (KAP) of LM domains among medical trainees through practicing physicians. Methods: The KAP questionnaire sections covered the nine domains of LM. The validation process included face and content validity. A total of 151 individuals from the medical field residing in Saudi Arabia were recruited through a convenient sampling technique to participate in the study. Item response theory (IRT) was applied to validate the knowledge domain, while exploratory factor analysis (EFA) was used to assess attitude and practice. Cronbach’s alpha was performed to test the reliability of the three sections. Results: The questionnaire contained 37 items of knowledge, 45 attitudes, and 28 practice items. According to the IRT analysis, 27 items of knowledge were within the acceptable range of difficulty and discrimination. The EFA analysis resulted in 6 factors, including all the items in the attitude domain, and 4 factors, for a total of 27 items in the practice domain, with satisfactory factor loading (>0.4). The Cronbach’s alpha for the three domains was very high (≥0.88). Conclusions: The KAP questionnaire for LM is valid and reliable across a spectrum, from medical trainees to practicing physicians. This tool could serve as an instrument to evaluate and develop adequate educational programs for medical doctors. Full article

(This article belongs to the Special Issue Preventive Potential of Modifiable Risk Factors)

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Healthcare, Volume 12, Issue 16 (August-2 2024) – 130 articles

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