Healthcare

26 pages, 793 KiB

Open AccessSystematic Review

Nurse-Led Interventions for Improving Medication Adherence in Chronic Diseases: A Systematic Review

by Daniela Berardinelli, Alessio Conti, Anis Hasnaoui, Elena Casabona, Barbara Martin, Sara Campagna and Valerio Dimonte

Healthcare 2024, 12(23), 2337; https://doi.org/10.3390/healthcare12232337 (registering DOI) - 22 Nov 2024

Abstract

Background: Poor medication adherence results in negative health outcomes and increased healthcare costs. Several healthcare professionals provide interventions to improve medication adherence, with the effectiveness of nurse-led interventions in people with chronic diseases remaining unclear. Objective: This study sought to evaluate [...] Read more.

Background: Poor medication adherence results in negative health outcomes and increased healthcare costs. Several healthcare professionals provide interventions to improve medication adherence, with the effectiveness of nurse-led interventions in people with chronic diseases remaining unclear. Objective: This study sought to evaluate the effectiveness of nurse-led interventions for improving medication adherence in adults with chronic conditions. Methods: Five databases (MEDLINE, CINAHL, EMBASE, Cochrane Library, SCOPUS) were searched without applying a temporal limit. Studies evaluating the effects of nurse-led interventions on medication adherence in adults with one or multiple chronic conditions were included. Interventions only targeting a single acute disease were excluded. Results: A total of twenty-two studies with 5975 participants were included. Statistically significant improvements in adherence were reported in five out of seven studies involving face-to-face visits to patients with heart failure (n = 2), chronic myeloid leukemia (n = 1), hypertension (n = 1) and multimorbidity (n = 1) and in four out of nine studies adopting a mixed method involving face-to-face visits and telephone follow-up for patients with heart failure (n = 1), hypertension (n = 1), coronary disease (n = 1) and multimorbidity (n = 1). Remote interventions were effective in improving medication adherence in one out of six studies. No statistically significant differences were found between tablet computer-based patient education and nurse-led educational sessions. The motivational approach was found to be one of the most common strategies used to promote patient medication adherence. Conclusions: Nurse-led face-to-face visits may be effective in improving medication adherence in people with chronic diseases. However, further research is needed because current methods for measuring medication adherence may not accurately capture patient behaviour and medication consumption patterns. Full article

(This article belongs to the Special Issue Research, Education, Workforce, and Regulation to Transforming Nursing Practice and Leadership: The Future of Nursing)

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14 pages, 444 KiB

Open AccessArticle

Perceived Stress, Resilience and Emotional Intelligence in Romanian Healthcare Professionals

by Lavinia Duică, Elisabeta Antonescu, Maria Totan, Oana Raluca Antonescu, Gabriela Boța, Ionela Maniu, Mihail Cristian Pirlog and Sînziana Călina Silișteanu

Healthcare 2024, 12(23), 2336; https://doi.org/10.3390/healthcare12232336 - 22 Nov 2024

Abstract

Background: Occupational stress and burnout in the medical field are common factors that can have a negative impact on the quality of clinical care. In the Romanian healthcare environment, there exists important financial difficulties contributing additionally to stress in this study, we aimed [...] Read more.

Background: Occupational stress and burnout in the medical field are common factors that can have a negative impact on the quality of clinical care. In the Romanian healthcare environment, there exists important financial difficulties contributing additionally to stress in this study, we aimed to investigate if resilience and emotional intelligence would prove to be protective factors against stress. Methods: In our cross-sectional study, we investigated 189 medical professionals, using convenience sampling, from July 2022 to September 2022 in two university centers. We applied a self-reported questionnaire that included socio-demographic characteristics and three scales that measured perceived stress (the Perceived Stress Scale), resilience to stress (the Connor–Davidson Resilience Scale), and emotional intelligence (the short-form Trait Emotional Intelligence Questionnaire). Results: Age was positively associated with resilience levels, meaning that resilience increases with age. While specialist physicians had the highest emotional intelligence score, nurses and other healthcare workers had the highest resilience scores. Perceived stress level was negatively correlated with resilience to stress and with emotional intelligence levels. Resilience to stress was positively correlated with emotional intelligence. Conclusions: The major strength of this study is the finding that resilience to stress mediated the association between perceived stress and emotional intelligence. Because resilience is negatively associated with burnout, resilience to stress and emotional intelligence are potential targets for training aimed at improving the working environment and reducing current levels of burnout in the Romanian Health System and beyond. Full article

(This article belongs to the Special Issue Psychological Well-Being and Coping in Healthcare Workplace Environments)

14 pages, 3957 KiB

Open AccessArticle

Determinants of Government Expenditures with Health Insurance Beneficiaries in the Brazilian Health System

by Leonardo Moreira, João Vitor Marques Teodoro de Lima, Murilo Mazzotti Silvestrini and Flavia Mori Sarti

Healthcare 2024, 12(23), 2335; https://doi.org/10.3390/healthcare12232335 - 22 Nov 2024

Abstract

Background/Objectives: The Brazilian health system provides healthcare financed by the public and private sector, being the first designed to encompass universal healthcare coverage delivered to the population without charge to patients (Sistema Único de Saúde, SUS), whilst the second refers to healthcare [...] Read more.

Background/Objectives: The Brazilian health system provides healthcare financed by the public and private sector, being the first designed to encompass universal healthcare coverage delivered to the population without charge to patients (Sistema Único de Saúde, SUS), whilst the second refers to healthcare coverage delivered for individuals with the capacity to pay for assistance through health insurance or out-of-pocket disbursements. Health insurance companies with beneficiaries receiving publicly financed healthcare from the SUS are required to provide the reimbursement of healthcare expenditures to the government, considering that the health insurance beneficiaries obtain deductions of income taxes designed to fund the SUS. Therefore, the study investigated patterns of healthcare utilization and public expenditure due to the use of public healthcare by beneficiaries of health insurance between 2003 and 2019. Methods: Datasets including annual information on healthcare utilization by beneficiaries of health insurance from the National Agency of Supplementary Health (Agência Nacional de Saúde Suplementar, ANS) were organized into a single database to allow for the identification of patterns of interest to inform public policies of health. The empirical strategy adopted included the estimation of regression models and agglomerative hierarchical cluster analysis to identify factors associated with public sector expenditure. Results: The regression results indicated lower expenditure with female patients, particularly children and adolescents under 20 years old, receiving treatment in public sector facilities linked to the federal government. The cluster analysis showed five types of health insurance beneficiaries with a higher level of healthcare utilization, being three clusters referring to medium complexity procedures with lower public expenditures, and two clusters with higher public expenditures, one cluster that refers to high complexity procedures, and one cluster referring to health insurance schemes without hospitalization. Conclusions: The findings of the study highlight the existence of patterns of healthcare utilization by health insurance beneficiaries that may compromise the sustainability of public funding within the Brazilian health system. Full article

(This article belongs to the Section Health Policy)

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14 pages, 627 KiB

Open AccessSystematic Review

Profiling the Occupational Injuries Sustained by Custody Officers: A Systematic Review

by Louis Reilly, Jessica Chan, Thevanthi Thevanesan, Robin Orr, Jay Dawes, Robert Lockie, Elisa Canetti and Ben Schram

Healthcare 2024, 12(23), 2334; https://doi.org/10.3390/healthcare12232334 - 22 Nov 2024

Abstract

Background/Objectives: Custody officers (CO) are often exposed to workplace hazards when monitoring prisoners, managing prisoners’ recreational time, or searching for contraband, yet research into their injuries is limited. This review aimed to identify, appraise, and synthesise research investigating injuries in CO. Methods: Following [...] Read more.

Background/Objectives: Custody officers (CO) are often exposed to workplace hazards when monitoring prisoners, managing prisoners’ recreational time, or searching for contraband, yet research into their injuries is limited. This review aimed to identify, appraise, and synthesise research investigating injuries in CO. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol and registration with the Open Science Framework, a systematic search of five databases (PubMed, ProQuest, Embase, CINAHL and SportDiscus) using key search terms was conducted. The identified studies were considered against eligibility criteria, with the remaining studies critically appraised using the appropriate Joanna Briggs Institute checklist. Results: From the 975 identified studies, eight studies (mean critical appraisal score = 69 ± 25%) remained to inform the review. The incidence of fatal injuries ranged from 0.027 to 0.03 per 1000 full-time employees (FTE), whereas that of non-fatal injuries ranged from 15.9 to 44.0 per 1000 FTE. CO aged 31+ years were the most likely to experience injuries (22–44%). Male CO were more commonly injured than female CO in both fatal injuries (male = 89%, female = 11%) and non-fatal injuries (male = 73–74%, female = 26–27%). Assaults (11.5–38%) and slips/trips/falls (23.2–25%) were found to be the most common causes of injuries. The upper extremity was the most commonly injured body part (26–30%), with musculoskeletal sprains and strains (30–60.2%) the most common types of injury. Conclusions: CO injury profiles are similar to those reported in general-duty police officers. As such, musculoskeletal conditioning, reconditioning, and fall prevention practices employed in law enforcement may serve as an initial approach to risk mitigation in this population. Full article

(This article belongs to the Special Issue News Trends in Work-Related Musculoskeletal Disorders and Diseases)

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10 pages, 920 KiB

Open AccessArticle

Enhancing Nurse Practitioners’ Emergency Care Competency and Self-Efficacy Through Experiential Learning: A Single-Group Repeated Measures Study

by Ya-Lun Yang, Li-Chuan Cheng, Chen-Wei Lee, Shih-Chun Lin and Malcolm Koo

Healthcare 2024, 12(23), 2333; https://doi.org/10.3390/healthcare12232333 - 22 Nov 2024

Abstract

Background/objective: Nurse practitioners serve a vital role as first responders in emergencies. This study investigated the effectiveness of experiential learning in enhancing emergency care competency and self-efficacy among nurse practitioners. Methods: A single-group repeated measures design was implemented from June to August 2023 [...] Read more.

Background/objective: Nurse practitioners serve a vital role as first responders in emergencies. This study investigated the effectiveness of experiential learning in enhancing emergency care competency and self-efficacy among nurse practitioners. Methods: A single-group repeated measures design was implemented from June to August 2023 at a regional teaching hospital in southern Taiwan, involving 95 nurse practitioners and NP trainees. Participants completed a baseline (T₀) three-minute emergency simulation test, followed by one-on-one guidance, an immediate post-test (T₁), and a follow-up test one month later (T₂). The “Emergency Care Capability Checklist” (ECCC) was used to assess performance after each test, and the “General Self-Efficacy Scale” at T₁ and T₂. Results: The mean age of the participants was 42.1 years (SD = 6.7), with 91 out of 95 participants (95.8%) being female. ECCC scores increased significantly from a baseline mean of 34.6 (standard deviation [SD] = 8.8 at T₀ to 46.4 (SD = 4.3) at T₁ (p < 0.001). Scores remained elevated at T₂, with a mean of 44.7 (SD = 4.9), which was significantly higher than T₀ (p < 0.001). However, scores at T₂ were slightly lower than at T₁ (p = 0.018). GSES scores also increased significantly from T₁ (mean = 26.2, SD = 0.6) to T₂ (mean = 28.0, SD = 0.6) (p = 0.009). Conclusions: This study found that experiential learning was able to significantly improve nurse practitioners’ emergency care competencies and self-efficacy. Future research should explore the application of experiential learning in diverse clinical settings to further advance emergency preparedness and self-efficacy among nurse practitioners. Full article

(This article belongs to the Collection Current Nursing Practice and Education)

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11 pages, 724 KiB

Open AccessArticle

by Abdullah Alshibani, Saif Osama Alagha, Abdulmohsen Jameel Alshammari, Khaled Jameel Alshammari, Abdulelah Saeed Alghamdi and Khalid Nabil Nagshabandi

Healthcare 2024, 12(23), 2332; https://doi.org/10.3390/healthcare12232332 - 22 Nov 2024

Abstract

Background/Objectives: Dermatological complaints are commonly seen in the emergency department (ED) setting and may be attributed to infectious, inflammatory, allergic, hypersensitivity, or traumatic processes, yet few studies have been carried out in Saudi Arabia addressing this topic. This study, therefore, aimed to [...] Read more.

Background/Objectives: Dermatological complaints are commonly seen in the emergency department (ED) setting and may be attributed to infectious, inflammatory, allergic, hypersensitivity, or traumatic processes, yet few studies have been carried out in Saudi Arabia addressing this topic. This study, therefore, aimed to explore this issue by investigating the most common dermatology-related ED encounters in a large tertiary care center in Riyadh, Saudi Arabia, and estimating the incidence of these encounters. Methods: This was a retrospective cohort study conducted in the ED of King Abdulaziz Medical City, a tertiary care center in Riyadh, Saudi Arabia. Data included all patients with dermatology-related ED visits during the period of 2022–2023. Demographic information including, for example, age and sex was collected. The International Classification of Diseases, 10th Revision (ICD-10) was used for the classification of diagnoses. Results: A total of 11,443 patients were included in the study, with male patients making up the majority (54.9%). The mean age upon diagnosis was 22.4 ± 23.2 years. More than half of the patients (55.3%) were diagnosed during childhood (<18), while proportions of older ages declined gradually. Average monthly presentations ranged from 400 to 560. Rash and non-specific skin eruptions (16%), cellulitis (13.6%), and urticaria (12.2%) were the most frequent dermatological emergencies. Conclusions: This study examined the dermatological conditions commonly seen in the emergency department. The findings highlighted a range of dermatology diseases that are typically seen in the ED. Addressing these prevalent disorders in the future will enhance ER physicians’ understanding and management of such common dermatological problems. Full article

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23 pages, 1325 KiB

Open AccessArticle

Development of a Standard Tool of Pattern Identification for Functional Dyspepsia: A Cross-Sectional Study from Korea

by Na-Yeon Ha, Seok-Jae Ko, Jae-Woo Park and Jinsung Kim

Healthcare 2024, 12(23), 2331; https://doi.org/10.3390/healthcare12232331 - 21 Nov 2024

Abstract

Background/objective: The diagnosis and treatment of functional dyspepsia (FD) require a systematic and tailored approach. In traditional Korean medicine (TKM), pattern-identification tools help analyze clinical information and guide treatment. This study aimed to develop a Korean version of the standard tool of pattern [...] Read more.

Background/objective: The diagnosis and treatment of functional dyspepsia (FD) require a systematic and tailored approach. In traditional Korean medicine (TKM), pattern-identification tools help analyze clinical information and guide treatment. This study aimed to develop a Korean version of the standard tool of pattern identification for functional dyspepsia (STPI-FD) and subsequently assess its reliability and validity. Methods: Common patterns and symptoms were identified through a systematic review of the clinical studies conducted in Korea and China. An importance survey for each pattern and symptom was conducted using the Delphi method and refined through expert consensus. A draft STPI-FD comprising six patterns and 38 items was developed. Ninety-five patients with FD completed the STPI-FD along with the Visual Analog Scale, Total Dyspepsia Symptom scale, Single Dyspepsia Symptom scale, and Functional Dyspepsia-related Quality of Life questionnaire. Results: Two items were excluded from the STPI-FD due to their negative impact on reliability, resulting in a 36-item tool. The revised STPI-FD demonstrated high internal consistency, with an overall Cronbach’s alpha of 0.942. In contrast, the Cronbach’s alpha values for each pattern ranged from 0.7 to 0.9. To assess its validity, significant differences in the pattern characteristics and associated symptoms were confirmed, indicating its clinical relevance. Statistically significant positive correlations between the revised STPI-FD and other dyspepsia-related scales underscore the differentiation between patterns. Conclusion: The final STPI-FD is a moderately reliable and valid tool for diagnosing specific patterns in FD, supporting the selection of interventions and the evaluation of symptom improvement in patients treated with TKM. Full article

(This article belongs to the Special Issue Emerging Developments in Integrative and Complementary Medicine: Advancements in Research and Clinical Applications)

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20 pages, 2518 KiB

Open AccessReview

The Frontiers of Smart Healthcare Systems

by Nan Lin, Rudy Paul, Santiago Guerra, Yan Liu, James Doulgeris, Min Shi, Maohua Lin, Erik D. Engeberg, Javad Hashemi and Frank D. Vrionis

Healthcare 2024, 12(23), 2330; https://doi.org/10.3390/healthcare12232330 - 21 Nov 2024

Abstract

Artificial Intelligence (AI) is poised to revolutionize numerous aspects of human life, with healthcare among the most critical fields set to benefit from this transformation. Medicine remains one of the most challenging, expensive, and impactful sectors, with challenges such as information retrieval, data [...] Read more.

Artificial Intelligence (AI) is poised to revolutionize numerous aspects of human life, with healthcare among the most critical fields set to benefit from this transformation. Medicine remains one of the most challenging, expensive, and impactful sectors, with challenges such as information retrieval, data organization, diagnostic accuracy, and cost reduction. AI is uniquely suited to address these challenges, ultimately improving the quality of life and reducing healthcare costs for patients worldwide. Despite its potential, the adoption of AI in healthcare has been slower compared to other industries, highlighting the need to understand the specific obstacles hindering its progress. This review identifies the current shortcomings of AI in healthcare and explores its possibilities, realities, and frontiers to provide a roadmap for future advancements. Full article

(This article belongs to the Section Artificial Intelligence in Medicine)

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Graphical abstract

24 pages, 907 KiB

Open AccessArticle

How Does the Pre-Registration Midwifery Programme Prepare the Newly Qualified Midwives for Their Post-Registration Perinatal Mental Health Role? A Mixed Methods Study

by Yemi Onilude, Omorogieva Ojo, David Evans, John Crowley, Priti Chopra, Gordon Ade-Ojo and Kate Knightly-Jones

Healthcare 2024, 12(23), 2329; https://doi.org/10.3390/healthcare12232329 - 21 Nov 2024

Abstract

Objective: In the United Kingdom (UK) and most countries worldwide, midwives are professionally required to undertake an initial perinatal mental health (PMH) risk assessment at every maternity contact. However, studies have found that midwives feel that they are not well-equipped to provide effective [...] Read more.

Objective: In the United Kingdom (UK) and most countries worldwide, midwives are professionally required to undertake an initial perinatal mental health (PMH) risk assessment at every maternity contact. However, studies have found that midwives feel that they are not well-equipped to provide effective care for women with PMH needs. This study explores how the newly qualified midwives (NQMs) are prepared through pre-registration midwifery education and placements to have sufficient confidence in their knowledge, attitude, skills, and habits (KASH) for their post-registration PMH role. Methods: This explanatory sequential mixed methods study collected survey data from two independent groups: NQMs (n = 50), who qualified from 10 UK universities, and senior specialist midwives (SSMs) (n = 32). Descriptive and inferential responses were analysed using SPSS. Statistical differences between the ranged Likert scale responses of the NQMs and SSMs were analysed using the Mann-Whitney U test. The p-value of <0.05 was considered statistically significant. The semi-structured interview phase comprised of NQMs (n = 12) and SSMs (n = 8). The qualitative data were thematically analysed using NVivo. Results: The pre-registration midwifery programme significantly prepared the NQMs to have sufficient confidence in their knowledge of the related PMH role, multidisciplinary team (MDT) role, and available services (p < 0.05) and good attitude towards women with varying PMH conditions (p < 0.0005). The NQMs had sufficient confidence in their skills in using the validated tool for PMH assessment, to build rapport to facilitate disclosure, and recognise deteriorating PMH (p < 0.01). They had regular habits of discussing PMH well-being at booking and made prompt referrals (p < 0.05). The NQMs were not prepared to have sufficient knowledge of PMH medications, perinatal suicide prevention, and the impact of maternal mental health on partners (p < 0.01) including children (p < 0.05); skills in managing PMH emergencies (p < 0.05), and to regularly discuss suicidal thoughts (p < 0.01), issues of self-harm, and debrief women following pregnancy or neonatal losses and traumatic births (p < 0.05). Some aspects were either confirmed or contradicted at the interviews. Conclusions and recommendations: The pre-registration midwifery programme prepares the NQMs to some extent for their post-registration PMH role. Perceived areas for improvement suggest implications for the development of educational, practice, policy, and preceptorship to facilitate the NQMs’ sustainable confidence in their KASH. Full article

(This article belongs to the Section Women's Health Care)

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12 pages, 1119 KiB

Open AccessArticle

Validation of a Questionnaire to Assess the Usability of and User Experience with Mobile Health Applications

by Anna de Dios López, Jordi Real, Claudia Meza, Alicia Borras-Santos, Roberto Collado-Borrell, Vicente Escudero-Vilaplana and Mar Gomis-Pastor

Healthcare 2024, 12(23), 2328; https://doi.org/10.3390/healthcare12232328 - 21 Nov 2024

Abstract

Background/objectives: The growing use of mobile health (mHealth) applications needs reliable tools to assess their usability and user experience in clinical practice to improve the digital health (eHealth) interventions and ensure engagement, as higher engagement is often linked to increased efficacy of healthcare [...] Read more.

Background/objectives: The growing use of mobile health (mHealth) applications needs reliable tools to assess their usability and user experience in clinical practice to improve the digital health (eHealth) interventions and ensure engagement, as higher engagement is often linked to increased efficacy of healthcare interventions. This study aimed to validate the patient Satisfaction and Usability with APPs questionnaire (pSUAPP), a multidimensional tool designed for the comprehensive assessment of mHealth applications, particularly for the integrated follow-up of patients with chronic diseases. Methods: A validation study was conducted between August and December 2022 with 85 participants from two hospitals in Spain, who completed the pSUAPP questionnaire, comprising 27 Likert-like items across four dimensions: first contact, registration, features and overall experience, and 1 open question. The questionnaire was validated by a panel of 11 experts and further assessed for psychometric properties. Results: The mean pSUAPP score was 79.0 (SD = 12.0), indicating high usability and positive user experience, with the highest scores in the ‘features’ dimension. The pSUAPP demonstrated moderate correlation with the System Usability Scale (SUS) and high reliability (Cronbach’s alpha and omega t > 0.9). A reproducibility analysis showed negligible changes between repeated measures. Conclusions: The pSUAPP questionnaire was found to be a robust tool for evaluating mHealth app usability and user experience, with potential application across various clinical settings. Full article

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12 pages, 1164 KiB

Open AccessArticle

The Effects of a 12-Week Training Multicomponent Exercise Program on Landing Mechanics in Recreational Athletes

by Adrián Feria-Madueño, Timothy Hewett, Thomas Dos’Santos and Borja Sañudo

Healthcare 2024, 12(23), 2327; https://doi.org/10.3390/healthcare12232327 - 21 Nov 2024

Abstract

Background/Objectives: This study investigated the impacts of a 12-week training program on kinetic parameters during landings in non-professional recreational athletes. Methods: Fifty-seven non-elite recreational athletes performed three unilateral-landing trials from a 30 cm high structure on a force platform. The following outcome measures [...] Read more.

Background/Objectives: This study investigated the impacts of a 12-week training program on kinetic parameters during landings in non-professional recreational athletes. Methods: Fifty-seven non-elite recreational athletes performed three unilateral-landing trials from a 30 cm high structure on a force platform. The following outcome measures were analyzed: the ground reaction forces at initial ground contact (PF1) and the highest value (PF2), impulse (change in the moment of force during landing), stabilization time, and ankle and knee accelerations. The ground reaction forces, momentum, and accelerations were evaluated in the vertical, medio-lateral, and anteroposterior axes. Participants were randomly assigned to two groups. The experimental group (EG) underwent a 12-week intervention, three times per week, consisting of various exercises, such as strength, eccentric, proprioceptive, whole-body vibration (WBV), and neuromuscular exercises. After 12 weeks, the same outcome measures were analyzed. Results: The effects of the training program on vertical ground reaction forces were not clear (0.3% and 0.9%, respectively). Medio-lateral (64.8%, d = 0.51) and anteroposterior (43.9%, d = 1.34) forces were probably reduced due to the training program. The stabilization time was also reduced in the experimental group (44.2%). The training program most likely decreased the vertical impulse (47.3%, d = −1.56), whereas the total ankle acceleration increased (18.4%, d = 0.79). Conclusions: The findings reveal significant improvements in neuromuscular control and stability during landings, specifically demonstrating reduced medio-lateral forces, vertical momentum, and acceleration during monopodal landings. This study focuses on the importance of proper landing techniques in minimizing the risk of knee injuries, emphasizing the falling strategy’s role in injury prevention. Full article

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11 pages, 539 KiB

Open AccessArticle

The Frequency and Main Characteristics of Obesity in Undocumented Migrants Receiving Medical Assistance from a Charitable Organisation in Italy

by Matteo Franchi, Gianfrancesco Fiorini, Claudia Conflitti, Fabio Riccardo Schibuola, Antonello Emilio Rigamonti, Alessandro Sartorio, Giovanni Corrao and Silvano Gabriele Cella

Healthcare 2024, 12(23), 2326; https://doi.org/10.3390/healthcare12232326 - 21 Nov 2024

Abstract

Background: Obesity is continually growing not only in medium- and high-income countries but also in low-income countries, from where increasing numbers of migrants arrive in Western countries. We aimed to investigate the frequency and characteristics of obesity in a sample of undocumented migrants, [...] Read more.

Background: Obesity is continually growing not only in medium- and high-income countries but also in low-income countries, from where increasing numbers of migrants arrive in Western countries. We aimed to investigate the frequency and characteristics of obesity in a sample of undocumented migrants, a population for which official health data are not available. Methods: We collected demographic and socio-economic data and information on medical diagnoses and pharmacologic treatments for 341 undocumented migrants consecutively attending the outpatient clinic of a big non-governmental organisation in Milan, Italy, from March to July 2023. To measure obesity, we used both body mass index (BMI) and waist circumference (WC). We used multivariate robust Poisson regression models to calculate prevalence ratios (PRs) and 95% Confidence Intervals (CIs) of overweight or obesity according to socio-demographic conditions and other risk factors. Results: Using BMI, the proportion of migrants with obesity was 28.7% (95% CI 24.0–33.0%) and those with overweight represented 32.3% (95% CI 27.3–37.5%). Obesity was more frequent among Asians (53.9%, 95% CI 37.2–69.9%), followed by Latinos (38.7%, 95% CI 29.6–48.5%) and Eastern Europeans (38.2%, 95% CI 25.4–52.3%). Using WC, 68.3% (95% CI 63.1–73.2%) of migrants had values suggestive of overweight or obesity. In the multivariate analyses, overweight and obesity were more frequent in migrants with older age, with a stable employment, and who had been present in Italy for a long time, as well as in those with CV diseases. Moreover, individuals with obesity needed more medications for the cardiovascular system and for the alimentary tract and metabolism. Conclusions: In our sample of undocumented migrants, overweight and obesity were frequent, representing an important public health issue, considering the difficulty experienced by such individuals in finding access to both prevention and healthcare services. Full article

(This article belongs to the Special Issue Nutritional and Metabolic Disorders)

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19 pages, 764 KiB

Open AccessSystematic Review

Impacts of Square Stepping Exercise on Physical-Cognitive Function, Biomarkers, Body Composition and Mental Health in Healthy Senior Aged 60 and Above: A Systematic Review

by Juan Manuel Franco-García, Jorge Carlos-Vivas, Antonio Castillo-Paredes, Noelia Mayordomo-Pinilla, Jorge Rojo-Ramos and Jorge Pérez-Gómez

Healthcare 2024, 12(23), 2325; https://doi.org/10.3390/healthcare12232325 - 21 Nov 2024

Abstract

Background: The aim of this systematic review is to analyze the effects of Square Stepping Exercise (SSE) on physical and cognitive function in older people, including its effects on biomarkers, body composition and mental health, focusing only on research that assessed the [...] Read more.

Background: The aim of this systematic review is to analyze the effects of Square Stepping Exercise (SSE) on physical and cognitive function in older people, including its effects on biomarkers, body composition and mental health, focusing only on research that assessed the efficacy of SSE-based interventions. Methods: PubMed, Web of Science, Scopus and Cochrane databases were searched from June 2006 to June 2024 according to the PRISMA guidelines. The main search terms used were related to “older people” and “square-stepping exercise”. Controlled trials that included at least one intervention group focused on SSE were included. Participants had to be healthy, without physical or cognitive impairment, and the studies published in English or Spanish. The methodological quality of the selected research was assessed using the Physiotherapy Evidence Database (PEDro). Results: Twelve studies were selected from a total of 444 original records, with a total sample size of 577 participants. The health parameters of the participants were homogeneous, with ages ranging from 60 to 80 years. Significant gains were reported in certain physical function assessments, including balance, lower body strength and power, gait speed and flexibility. There were also significant findings in cognitive function, particularly in general cognitive status, focused attention, response time, basic task performance, and executive function. In addition, SSE can improve metrics such as body composition, brain-derived neurotrophic factor (BDNF), and mental health characteristics. Conclusions: SSE has the potential to significantly improve physical function, cognitive performance and body composition, as well as provide mental health benefits and have variable effects on biomarkers and cardiovascular health. Full article

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19 pages, 1328 KiB

Open AccessArticle

The Mediating Role of Work–Family Interface in the Relationship Between Quantitative Workload and Interpersonal Strain: A Gender-Based Moderation Analysis

by Jessica Pileri, Marina Mondo, Alice Sgualdini and Silvia de Simone

Healthcare 2024, 12(23), 2324; https://doi.org/10.3390/healthcare12232324 - 21 Nov 2024

Abstract

Purpose: The study investigates the role of work-family interface dimensions (negative work-to-family interface, NEGWIF; negative family-to-work interface, NEGFIW; positive work-to-family interface, POSWIF; and positive family-to-work interface, POSFIW) as mediators in the relationship between workload and interpersonal strain. In addition, we examined the moderating [...] Read more.

Purpose: The study investigates the role of work-family interface dimensions (negative work-to-family interface, NEGWIF; negative family-to-work interface, NEGFIW; positive work-to-family interface, POSWIF; and positive family-to-work interface, POSFIW) as mediators in the relationship between workload and interpersonal strain. In addition, we examined the moderating effect of gender. Design/methodology/approach: 319 Italian employees working in the commercial sector participants completed a self-report questionnaire. The hypothesized models were tested using PROCESS Macro. Findings: Work–family interface dimensions totally mediated the relationship between workload and interpersonal strain. Moderating influence of gender was found. Gender moderated the relationship between workload and three work–family interface dimensions—NEGWIF, POSWIF and POSFIW—in the indirect relationship between workload and interpersonal strain. Research limitations/implications: This study suggests to organizations that moderate workload and family-friendly policies can act as a protective factor against interpersonal strain. The limitations of the study are the use of self-report measures and the cross-sectional design. Originality/value: This research attempted to fill the gap in interpersonal strain and relationships with the work–family interface. Full article

(This article belongs to the Special Issue Employees’ Well-Being: Effective Measures to Cope with Job Stress and Workplace Bullying)

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13 pages, 859 KiB

Open AccessSystematic Review

Dental Anomalies in Saudi Arabia: A Systematic Review

by Khalid Aljohani, Hanan Shanab, Ali Alqarni and Khalid Merdad

Healthcare 2024, 12(23), 2323; https://doi.org/10.3390/healthcare12232323 - 21 Nov 2024

Abstract

Background: Epidemiological studies have shown varying prevalence rates of dental anomalies worldwide, ranging from 5.2% to 56.9%, with a higher rate of 90.4% in patients with cleft lip and palate. In Saudi Arabia, studies have also reported varied prevalence rates, likely due to [...] Read more.

Background: Epidemiological studies have shown varying prevalence rates of dental anomalies worldwide, ranging from 5.2% to 56.9%, with a higher rate of 90.4% in patients with cleft lip and palate. In Saudi Arabia, studies have also reported varied prevalence rates, likely due to genetic differences or sampling variations. However, no research has yet evaluated the quality of these studies or provided an overall prevalence estimate, which is the aim of the present study. This systematic review aims to assess the prevalence and types of dental anomalies across various regions of the Kingdom of Saudi Arabia (KSA). Methods: A comprehensive literature search identified 10 relevant studies on different dental anomalies in Saudi Arabia. The quality of the enrolled studies was assessed using the Newcastle–Ottawa Scale (NOS), showing variability in the methodological quality of the included cohort studies, with several studies demonstrating a moderate to high risk of bias. Results: Common anomalies included hypodontia, hyperdontia, microdontia, and impacted teeth. This study highlights the varying prevalence of dental anomalies in different regions of Saudi Arabia, ranging from 2.6% to 45.1%. Conclusions: This review highlights the need for early diagnosis and tailored treatment approaches to mitigate the clinical challenges posed by these anomalies, underscoring the importance of standardized diagnostic criteria and further research to understand regional and demographic differences in the prevalence of dental anomalies in Saudi Arabia. Full article

(This article belongs to the Collection Dentistry, Oral Health and Maxillofacial Surgery)

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27 pages, 1308 KiB

Open AccessReview

Approaches to Reach Trustworthy Patient Education: A Narrative Review

by Xiafei Lyu, Jing Li and Sheyu Li

Healthcare 2024, 12(23), 2322; https://doi.org/10.3390/healthcare12232322 - 21 Nov 2024

Abstract

Background: Patient education is a cornerstone of modern healthcare. Health literacy improves health-related quality of life and health outcomes of patients, enhanced by effective patient education. Inadequate competency of patient education in healthcare providers triggered this review to summarize common approaches and recent [...] Read more.

Background: Patient education is a cornerstone of modern healthcare. Health literacy improves health-related quality of life and health outcomes of patients, enhanced by effective patient education. Inadequate competency of patient education in healthcare providers triggered this review to summarize common approaches and recent advancements. Methods: This narrative review summarizes common approaches and recent advancements in patient education with their relations to health literacy, their strengths, limitations, and practical issues. Results: This review highlighted the multifaceted approaches to patient education, emphasizing the importance of tailoring methods to meet the diverse needs of patients. By integrating various strategies, including intrapersonal, interpersonal, and societal/community-level interventions, healthcare providers can create a more comprehensive educational experience that addresses the complexities of patient needs, meanwhile improving the health literacy of patients. With the rise of digital media and artificial intelligence, there is an increasing need for innovative educational resources that can effectively reach and engage patients. Ongoing research and collaboration among healthcare professionals and policymakers will be essential to refine educational strategies and adapt to emerging challenges. It is essential to remain vigilant about potential conflicts of interest that may compromise the integrity of educational content. Conclusion: Effective patient education empowers individuals and their contributions to a healthier society by fostering informed decision-making and encouraging proactive health management. Full article

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11 pages, 244 KiB

Open AccessArticle

Predictors of Long COVID Among Symptomatic US Adults Testing Positive for SARS-CoV-2 at a National Retail Pharmacy

by Xiaowu Sun, Manuela Di Fusco, Laura L. Lupton, Alon Yehoshua, Mary B. Alvarez, Kristen E. Allen, Laura Puzniak, Santiago M. C. Lopez and Joseph C. Cappelleri

Healthcare 2024, 12(23), 2321; https://doi.org/10.3390/healthcare12232321 - 21 Nov 2024

Abstract

Background: Long COVID remains a significant public health concern. This study investigated risk factors for long COVID in outpatient settings. Methods: A US-based prospective survey study (clinicaltrials.gov NCT05160636) was conducted in 2022 and replicated in 2023. Symptomatic adults testing positive for SARS-CoV-2 at [...] Read more.

Background: Long COVID remains a significant public health concern. This study investigated risk factors for long COVID in outpatient settings. Methods: A US-based prospective survey study (clinicaltrials.gov NCT05160636) was conducted in 2022 and replicated in 2023. Symptomatic adults testing positive for SARS-CoV-2 at CVS Pharmacies were recruited. CDC-based long COVID symptoms were collected at Week 4, Month 3, and Month 6 following SARS-CoV-2 testing. Logistic regression was used to develop a predictive model for long COVID using data from the 2022 cohort. The model was validated with data from the 2023 cohort. Model performance was evaluated with c-statistics. Results: Patients characteristics were generally similar between the 2022 (N = 328) and 2023 (N = 505) cohorts. The prevalence of long COVID defined as ≥3 symptoms at Month 6 was 35.0% and 18.2%, respectively. The risk factors associated with long COVID were older age, female sex, lack of up-to-date vaccination, number of acute symptoms on the day of SARS-CoV-2 testing, increase in symptoms at Week 1, underlying comorbidities and asthma/chronic lung disease. The c-statistic was 0.79, denoting good predictive power. Conclusions: A predictive model for long COVID was developed for an outpatient setting. This research could help differentiate at-risk groups and target interventions. Full article

(This article belongs to the Special Issue Human Health Before, During, and After COVID-19)

13 pages, 212 KiB

Open AccessArticle

Professional Nurses’ Views and Experiences of Poor Health-Seeking Behavior Among Men in Limpopo Province, South Africa

by Lazarros Chavalala, Rachel Tsakani Lebese and Lufuno Makhado

Healthcare 2024, 12(23), 2320; https://doi.org/10.3390/healthcare12232320 - 21 Nov 2024

Abstract

Background/Objectives: The health-seeking behavior of men is a public health concern and is associated with poor health outcomes and lower life expectancy among men. Masculinity norms are among the factors contributing to men’s poor health-seeking behavior. This study explored the views and experiences [...] Read more.

Background/Objectives: The health-seeking behavior of men is a public health concern and is associated with poor health outcomes and lower life expectancy among men. Masculinity norms are among the factors contributing to men’s poor health-seeking behavior. This study explored the views and experiences of purposively selected nurses on men’s health-seeking behavior. Methods: Through qualitative descriptive design, individual semi-structured interviews were conducted with 14 professional nurses, and collected data were audio recorded and transcribed verbatim. Tech’s eight steps were used to analyze data and guide the development of the main themes and sub-themes. Trustworthiness was ensured through credibility, confirmability, dependability, and transferability. Ethical approval was granted by the University of Venda Research ethics committee with reference number FHS/21/PH/26/1215. Results: Self-medication, a lack of trust in Western medicine, and the use of traditional healers were identified as reasons men underutilize health care services. Men were viewed as people who consult heath care services when illness is severe, feel uncomfortable with female nurses, and value respect from clinicians. Conclusions: Cultural norms still remain a barrier among men in this study setting, as men did not feel comfortable with their private parts being physically examined by female clinicians. There is a need to take note of cultural norms impacting health care service usage by men. Full article

8 pages, 194 KiB

Open AccessArticle

Participation in Tobacco Cessation Programs Among Medicaid Managed Care Enrollees in Florida

by Rahma S. Mkuu, Casey C. Glymph, Peyton A. Lurk, Madison R. McCraney, Jennifer H. LeLaurin, Ramzi G. Salloum, Jaclyn M. Hall and Christopher R. Cogle

Healthcare 2024, 12(22), 2319; https://doi.org/10.3390/healthcare12222319 - 20 Nov 2024

Abstract

Background/Objectives: Tobacco use remains a significant public health issue, particularly among individuals with low incomes, including Medicaid recipients who often face multiple barriers to quitting. This study aimed to identify barriers, from the perspective of Medicaid managed care organizations (MCOs), influencing Medicaid [...] Read more.

Background/Objectives: Tobacco use remains a significant public health issue, particularly among individuals with low incomes, including Medicaid recipients who often face multiple barriers to quitting. This study aimed to identify barriers, from the perspective of Medicaid managed care organizations (MCOs), influencing Medicaid recipient participation in tobacco cessation programs. Methods: Focus group interviews were conducted with Florida Medicaid MCOs to elicit processes for case identification, outreach, referral, program participation, and incentives. Answers were synthesized into themes. Results: Medicaid recipients were primarily identified through nicotine dependency claim codes or Health Risk Assessments (HRAs). Individuals were referred to state and local community tobacco cessation programs through text messaging and outreach by MCO case managers. The MCOs identified the following as barriers: primary care physicians (PCPs) with limited knowledge about cessation programs and pharmacologic treatments for nicotine dependence, low availability of health coaches, long wait times for entry into cessation programs, weak coordination between MCOs and cessation programs, and insufficient incentives for individuals for program participation. Suggested strategies to overcome barriers were continuing medical education (CME) for PCPs about tobacco cessation programs and prescription therapies, increasing the training of health coaches, more investment in quitlines, increasing data sharing between MCOs and cessation programs, and increasing incentives for individuals. Conclusions: These findings highlight the importance of engaging MCOs in discussions about policy and program improvements, as their insights can drive meaningful changes in how tobacco cessation and other preventive health programs are structured and implemented. Targeted interventions are needed to enhance tobacco cessation program participation among Medicaid recipients. Full article

(This article belongs to the Special Issue Medicaid and Public Health: Second Edition)

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