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Effects of Water Immersion Versus Epidural as Analgesic Methods during Labor among Low-Risk Women: A 10-Year Retrospective Cohort Study
Adenomyosis—A Call for Awareness, Early Detection, and Effective Treatment Strategies: A Narrative Review

Journal Description

Healthcare

Healthcare is an international, scientific, peer-reviewed, open access journal on health care systems, industry, technology, policy, and regulation, and is published semimonthly online by MDPI. Ocular Wellness & Nutrition Society (OWNS) is affiliated with Healthcare and its members receive discounts on article processing charges.

Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
High Visibility: indexed within Scopus, SCIE and SSCI (Web of Science), PubMed, PMC, and other databases.
Journal Rank: JCR - Q2 (Health Care Sciences and Services) / CiteScore - Q2 (Leadership and Management)
Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 20.3 days after submission; acceptance to publication is undertaken in 2.6 days (median values for papers published in this journal in the second half of 2024).
Recognition of Reviewers: reviewers who provide timely, thorough peer-review reports receive vouchers entitling them to a discount on the APC of their next publication in any MDPI journal, in appreciation of the work done.
Companion journals for Healthcare include: Trauma Care and European Burn Journal.

Impact Factor: 2.4 (2023); 5-Year Impact Factor: 2.5 (2023)

Imprint Information Journal Flyer Open Access ISSN: 2227-9032

Latest Articles

15 pages, 762 KiB

Open AccessArticle

Assessing Population Well-Being in Saudi Arabia: A Comprehensive National Survey Using the WHO-05 Index and Self-Rated Health Metrics

by Abdulaziz Alahmadi, Yasir Almuzaini, Majed Alosaimi, Ahmed Alahmari, Fahad Alamri, Haytham Sheerah, Mariyyah Alburayh and Anas Khan

Healthcare 2025, 13(3), 310; https://doi.org/10.3390/healthcare13030310 (registering DOI) - 3 Feb 2025

Introduction: The well-being of populations is crucial for understanding nations’ public health and progress. With its ongoing transformation and development objectives, Saudi Arabia emphasizes its residents’ quality of life and well-being. Recent surveys and health indicators have underlined the nation’s focus on enhancing [...] Read more.

Introduction: The well-being of populations is crucial for understanding nations’ public health and progress. With its ongoing transformation and development objectives, Saudi Arabia emphasizes its residents’ quality of life and well-being. Recent surveys and health indicators have underlined the nation’s focus on enhancing population well-being. Aim: This study aimed to assess the overall level of well-being of the population living in Saudi Arabia using the WHO-5 index and self-rated health (SRH) metrics. Subject and methods: This cross-sectional study was conducted among thirty-nine thousand five hundred and sixty-two people from the general population in Saudi Arabia, citizens and residents, including all adult age groups (>18 years) and both genders. A self-administered questionnaire was sent to the Saudi adult population using an online survey. The questionnaire includes socio-demographic characteristics, the five-item Well-Being Index (WHO-5), and the self-rated health status. Results: Based on SRH, 77.4% were considered a healthy group. Male gender participants who had a better education were more likely to report a favorable SRH. According to WHO-5, poor well-being was seen in 26% of the population, and the rest had good well-being (74%). Independent predictors for good well-being include increasing age and educational level and being unemployed. Interestingly, we found a positive significant correlation between SRH and WHO-5 scores (r = 0.371; p < 0.001). Conclusions: Poor well-being was common among the general population. Independent risk factors for poor well-being include female gender and Saudi nationality, while increasing age, male gender, and higher education were significant predictors of healthy SRH. More longitudinal studies are needed to extract more data on this nation’s growing prevalence of poor self-rated health status. Full article

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11 pages, 1777 KiB

Open AccessArticle

Work-Related Low Back Pain Among Physical Therapists in the Makkah Region, Saudi Arabia: A Cross-Sectional Study

by Hebah Ameen Takrouni, Gihan Mousa, Khalid Mohammed Yaseen and Mansour Abdullah Alshehri

Healthcare 2025, 13(3), 309; https://doi.org/10.3390/healthcare13030309 (registering DOI) - 3 Feb 2025

Background/Objectives: Low back pain (LBP) is a major work-related musculoskeletal disorder experienced globally, significantly limiting individuals’ daily activities and work performance. This study aimed to assess the prevalence of work-related LBP among physical therapists in the Makkah region of Saudi Arabia. Methods: A [...] Read more.

Background/Objectives: Low back pain (LBP) is a major work-related musculoskeletal disorder experienced globally, significantly limiting individuals’ daily activities and work performance. This study aimed to assess the prevalence of work-related LBP among physical therapists in the Makkah region of Saudi Arabia. Methods: A cross-sectional survey was conducted using an online self-reported questionnaire, which covered three domains: demographic information, history of LBP prior to joining the physical therapy field, and work-related LBP experienced during their current job. The questionnaire was distributed to 300 physical therapists in the Makkah region, yielding 151 responses. Data were analyzed to explore associations between LBP and various categorical and continuous factors. Results: Among the respondents, 78.1% reported experiencing LBP during their work as physical therapists, while 21.9% did not. Of those with LBP, 53.4% reported mild pain, 39.8% reported moderate pain, and smaller proportions reported severe pain (4.2%) or no pain (2.5%). Additionally, 52.5% of respondents with LBP indicated that it negatively affected their daily activities. Conclusions: Work-related LBP is highly prevalent among physical therapists in the Makkah region of Saudi Arabia, significantly impacting both patient care and the therapists’ daily functioning. Full article

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14 pages, 710 KiB

Open AccessArticle

Prognostic Factors for Responders of Home-Based Pulmonary Rehabilitation—Secondary Analysis of a Randomized Controlled Trial

by Chul Kim, Hee-Eun Choi, Chin Kook Rhee, Jae Ha Lee, Ju Hyun Oh and Jun Hyeong Song

Healthcare 2025, 13(3), 308; https://doi.org/10.3390/healthcare13030308 (registering DOI) - 3 Feb 2025

Background: Home-based pulmonary rehabilitation (PR) is an effective alternative to center-based PR. However, not all participants exhibit sufficient therapeutic improvement, highlighting the need to identify appropriate candidates to maximize cost-effectiveness. This study aimed to identify the factors associated with favorable outcomes in home-based [...] Read more.

Background: Home-based pulmonary rehabilitation (PR) is an effective alternative to center-based PR. However, not all participants exhibit sufficient therapeutic improvement, highlighting the need to identify appropriate candidates to maximize cost-effectiveness. This study aimed to identify the factors associated with favorable outcomes in home-based PR, focusing on the role of digital therapeutics (DTx). Methods: This secondary analysis used data from a randomized controlled trial. Participants with chronic respiratory disease (CRD) were divided into responders and non-responders based on a change in 6 min walk distance (6MWD) and patient-reported outcome measures (PROM) representing dyspnea and health-related quality of life. Factors such as baseline 6MWD, DTx use, and pulmonary function were analyzed for their predictive value in improving 6MWD and PROM scores. Results: Responders, particularly those using DTx, showed significantly greater improvements in 6MWD than non-responders. Participants with a baseline 6MWD under 500 m demonstrated a higher likelihood of exceeding the minimum clinically important difference in 6MWD. DTx use strongly predicted improvements in both 6MWD and PROM scores. The baseline diffusing capacity of the lungs for carbon monoxide was also a significant factor influencing improvements in the modified Medical Research Council scale. Conclusions: Responders to 8-week program of home-based PR exhibited a relatively lower baseline health status. Encouraging participants with poorer baseline health could improve adherence to PR and enhance cost-effectiveness. Additionally, improvements in 6MWD and PROM scores were associated with the use of DTx. Considering the functions of DTx, proper supervision for home-based exercise may be crucial for achieving optimal outcomes. Full article

(This article belongs to the Special Issue Application of Digital Services to Improve Patient-Centered Care)

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17 pages, 1285 KiB

Open AccessArticle

Validation of a Questionnaire of Motivations for Moderated and Severe Alcohol Consumption Among College Students

by Abel Lerma, Jorge Alberto Soto-Huerta, Cristina J. González-Flores, Rebeca María Elena Guzmán-Saldaña, Diego Aguirre-Villegas and Claudia Lerma

Healthcare 2025, 13(3), 307; https://doi.org/10.3390/healthcare13030307 (registering DOI) - 2 Feb 2025

Objective: This work aimed to develop and validate a scale to assess motivations for alcohol drinking among Mexican college students. Methods: The scale design consisted of applying a stimulus phrase to assess motivations for moderate alcohol drinking (up to three drinks [...] Read more.

Objective: This work aimed to develop and validate a scale to assess motivations for alcohol drinking among Mexican college students. Methods: The scale design consisted of applying a stimulus phrase to assess motivations for moderate alcohol drinking (up to three drinks per occasion) and severe alcohol consumption (four or more drinks) in 130 college students. The semantic network technique was applied to identify 15 defining motivations (with more considerable semantic weight) for each drinking level, constituting the pilot scale. The pilot scale was validated on 307 students from a public university in Mexico (255 with moderate drinking and 82 with severe consumption). Results: The final number of items per level of drinking was 10 (moderate drinking) and 13 (severe consumption). Internal reliability (Cronbach’s alpha) for the first one was 0.886 with three factors that explain 57.5% of the total variance; the second had an alpha of 0.884 with four factors that explain 70.5% of the total variance. All the factors had positive correlations with the risk perception for alcohol drinking, and there was a positive correlation between severe consumption motivation and the risk perception for consumption of other substances. The confirmatory factor analysis showed that the proposed theoretical models adjust to the data with an error of approximately zero (i.e., RMSEA of 0.088 for moderate consumption and 0.074 for severe consumption), which also carefully measures the motivation for moderate and severe alcohol consumption among college students. Conclusions: The new scale is valid and reliable for assessing motivations for moderate and severe alcohol consumption in Mexican college students. This may be a valuable tool to design and evaluate interventions for the prevention of alcohol use among college students. Full article

(This article belongs to the Special Issue Caring for the Mental Health of Higher Education Students: Coping Strategies and Well-Being Support)

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14 pages, 241 KiB

Open AccessArticle

Personal and Organizational Factors as Predictors of Life Satisfaction Among Older Adults in Long-Term Care Settings

by Xiaoli Li, Cheng Yin, Juliana O. Abude-Aribo, Reagen Conklin and Elias Mpofu

Healthcare 2025, 13(3), 306; https://doi.org/10.3390/healthcare13030306 (registering DOI) - 2 Feb 2025

Background and Aims: Resident satisfaction is a critical indicator of the quality of care in long-term care facilities (LTCFs). Yet, the relative importance quality of care factors in predicting resident satisfaction remains unclear for guiding resident support initiatives. This study aims to identify [...] Read more.

Background and Aims: Resident satisfaction is a critical indicator of the quality of care in long-term care facilities (LTCFs). Yet, the relative importance quality of care factors in predicting resident satisfaction remains unclear for guiding resident support initiatives. This study aims to identify the relative contribution of personal and facility care service factors as predictors of satisfaction LTCF residents. Methods: This cross-sectional study enrolled a convenience sample of 399 older adult residents from LTCFs in Shanghai, Nanjing, and Changsha, China, from June to December 2023. The inclusion criteria were age 65 or older, fluency in speaking and reading simplified Chinese Mandarin, having resided in long-term care facilities for at least one month, and cognitive competence to comprehend the questionnaires. Hierarchical multiple regressions were utilized to examine self-report survey data on ten resident personal variables, and seven care facility service domains were examined for their relative contribution to resident care satisfaction. Moreover, the analysis included the interaction between personal factors and care service attributes. Results: The combined personal and care service factors explained 26.1% of the variance in overall resident satisfaction. Personal factors that predicted resident satisfaction included age, level of independence, and length of stay (ΔR² = 0.11). Of the care facility factors, the significant predictors of higher resident satisfaction were spending time (β = 0.60, p < 0.01, ΔR² = 0.09) and environment domains (β = 0.62, p < 0.01, ΔR² = 0.03). Age moderated the relationship between the spending time domain and overall satisfaction, with a positive effect for residents aged 70–79 compared to those aged 60–69 (β = −1.26, p < 0.05). Conclusions: This study provides evidence to suggest the importance of personal and care facility characteristics to LTFC resident satisfaction. Based on these findings, improved resident satisfaction is likely with LTCF care services that provide tailored care plans using resident characteristics. Full article

(This article belongs to the Section Health Informatics and Big Data)

23 pages, 3514 KiB

Open AccessReview

A Bibliometric Analysis of Healthcare Intervention-Related Studies Reporting Patient and Public Involvement and Engagement

by Wenze Lu, Yan Li, Jed Montayre, Mengqi Li, Ka Yan Ho, Jiaying Li and Janelle Yorke

Healthcare 2025, 13(3), 305; https://doi.org/10.3390/healthcare13030305 (registering DOI) - 2 Feb 2025

Background/Objectives: Patient and public involvement and engagement (PPIE) has gained global recognition as an innovative healthcare research practice. PPIE engages end-users throughout the research process, improving intervention effectiveness, resource efficiency, and user satisfaction. Despite its increasing inclusion in studies, comprehensive bibliometric reviews of [...] Read more.

Background/Objectives: Patient and public involvement and engagement (PPIE) has gained global recognition as an innovative healthcare research practice. PPIE engages end-users throughout the research process, improving intervention effectiveness, resource efficiency, and user satisfaction. Despite its increasing inclusion in studies, comprehensive bibliometric reviews of healthcare intervention-related studies reporting PPIE are scarce. This study aims to conduct a bibliometric analysis of healthcare intervention-related studies reporting PPIE in recent decades to identify key worldwide bibliometric features, themes, and trends. Methods: The analysis includes 10,624 relevant English articles published in the Web of Science (WoS) Core Collection up to 26 November 2024. Search terms were selected based on PPIE conceptualization, interventional types, and related healthcare terms. Using WoS descriptive analysis and CiteSpace, we examined bibliometric features and identified major international themes and trends. Results: There has been a significant increase in the number of healthcare intervention-related studies reporting PPIE over the past five years, especially from the United States and the United Kingdom, with a recent rise in Asia. However, cross-national collaboration remains limited. Key research themes identified include “community participation”, “health equity”, “coronary heart disease”, “web-based patient empowerment”, “mental illness”, and “obesity prevention”, with growing interest in “mobile health” and “digital health”. Conclusions: This study provides a comprehensive and up-to-date overview of the bibliometric characteristics and evolving trends in healthcare intervention-related studies reporting PPIE. It highlights global regions with limited PPIE implementation, suggests pathways for further development, and identifies key research themes. The study offers researchers and practitioners valuable insights into tracking PPIE trends in healthcare interventions and fostering collaborations on evidence-based PPIE studies with leading scholars and institutions worldwide. Additionally, the findings drive innovations aimed at improving patient and public healthcare outcomes. Full article

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18 pages, 1139 KiB

Open AccessArticle

Somatization and Body Composition: Findings from a Cross-Sectional Study on Non-Clinical Young Adults

by Marius Baranauskas, Ingrida Kupčiūnaitė, Jurgita Lieponienė and Rimantas Stukas

Healthcare 2025, 13(3), 304; https://doi.org/10.3390/healthcare13030304 (registering DOI) - 2 Feb 2025

Background/Objectives: Lifestyle is a significant, common, and easily modifiable factor capable of increasing or reducing the risk of acquiring many diseases. Currently, there is a research gap as too little scientific attention has been focused on exploring the relationship between mental health and [...] Read more.

Background/Objectives: Lifestyle is a significant, common, and easily modifiable factor capable of increasing or reducing the risk of acquiring many diseases. Currently, there is a research gap as too little scientific attention has been focused on exploring the relationship between mental health and nutritional status in various populations. Moreover, the association between body composition and somatization has not been fully disclosed. Therefore, this study aimed to assess the associations of body composition with the symptomatology of somatization in an environmentally vulnerable sample of young adults. Methods: A single cross-sectional study included young non-clinical Lithuanian students (n = 1223) aged 21.7 ± 3.9. The body adiposity status of the study participants was estimated using both the body mass index (BMI) and the Body Adiposity Estimator (CUN-BAE) method. Fat-free mass was evaluated via the adjusted fat-free mass index equation (FFMI_adj). The Patient Health Questionnaire (PHQ-15) was applied to assess the severity of the perceived symptoms of a somatic symptom disorder (SSD). Results: The CUN-BAE was considered to be a better predictor of adiposity than the BMI because 14.7% of females and 6.2% of males were interpreted as obese using the CUN-BAE, while the BMI equation identified participants as having a normal body weight. The highest rates of somatization were found in 18.6% of the cohort. Young adults with higher amounts of body fat mass (β: 0.050, 95% confidence interval (95% CI): 0.013; 0.084, p = 0.007) and lower FFMI are prone to a higher risk for developing somatization (β: −0.429, 95% CI: −0.597; −0.260, p < 0.001). Conclusions: Our study revealed that body composition is significantly related to multiple somatic complaints throughout a range of measurements. However, in contrast to the CUN-BAE tool, the BMI equation underestimated the relationship between body fat and mental health outcomes in young adults. Even though nutritional status along with targeted physical load, as the mediators, are likely to play a significant role in the maintenance of optimal body composition and mental health outcomes, healthcare providers are recommended to advise individuals to lower their body fat percentage and increase fat-free mass in order to reduce the risk of somatization. Full article

(This article belongs to the Special Issue Caring for the Mental Health of Higher Education Students: Coping Strategies and Well-Being Support)

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21 pages, 1013 KiB

Open AccessArticle

Environment Disaster: A Cross-Sectional Study of the Determinants for the Preparation of Azorean Nurses

by Eunice Gatinho Pires, Paulo Nogueira, Maria Adriana Henriques, Miguel Arriaga and Andreia Silva Costa

Healthcare 2025, 13(3), 303; https://doi.org/10.3390/healthcare13030303 (registering DOI) - 2 Feb 2025

Background/Objectives: Climate change increases the vulnerability of regions, communities, and individuals, stressing the urgent requirement to prepare health professionals in alignment with the Sustainable Development Goals. To foster sustainable and resilient communities, it is essential to integrate disaster preparedness into health education and [...] Read more.

Background/Objectives: Climate change increases the vulnerability of regions, communities, and individuals, stressing the urgent requirement to prepare health professionals in alignment with the Sustainable Development Goals. To foster sustainable and resilient communities, it is essential to integrate disaster preparedness into health education and practice. By equipping nurses with essential knowledge and skills, healthcare systems can be better prepared to respond to the challenges of climate change and disasters, contributing to safer and more resilient urban environments. This study aims to identify the factors that determine nurses’ preparedness for disaster situations. Methods: A cross-sectional online survey was conducted through digital platforms among 230 nurses across the Azores to assess their preparedness for disaster management. A structured questionnaire, adapted from the validated Disaster Preparedness Evaluation Tool (DPET©), was administered to registered nurses affiliated with the Nursing Council. The sample was chosen for convenience, and data were analyzed using IBM^® SPSS Statistics, employing descriptive statistics, Cronbach’s alpha for measuring internal consistency, independent samples t-tests, and one-way ANOVA for comparative analysis. Ethical oversight was obtained from the Ethics Committee of the Azores, ensuring confidentiality and the voluntary nature of participation. Results: The findings revealed concerns about nurses’ disaster response, with 70% of participants indicating low ability. While knowledge was relatively strong (M = 5.50, SD = 1.07), practical competence showed a moderate score (3.51, SD = 1.797). Additional education is necessary in areas such as family preparation (M = 2.58, SD = 1.569), patient management during responses (M = 3.43, SD = 1.312), disaster-specific knowledge (M = 2.95, SD = 1.45), and recovery management (M = 2.53, SD = 1.363). Conclusions: Despite increased knowledge and awareness of climate change and its global impact, there is a need for more meaningful nursing interventions to minimize the impact of climate change on the community. This study highlights that nurses have an in-depth knowledge of communities’ needs, which puts them in a unique position to influence disaster preparation and response. By developing these strategies, nurses contribute significantly to communities’ resilience in climate change, improving society’s ability to respond and adapt to these challenges. Full article

(This article belongs to the Special Issue Health Education and Prevention: New Healthcare Perspectives for Emerging Challenges)

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12 pages, 196 KiB

Open AccessArticle

Tetanus Vaccine Knowledge, Beliefs, and Attitudes Among Syrian Pregnant Women in Türkiye: A Qualitative Study

by Zeynep Meva Altaş, Bayan Abdulhaq, Mehmet Akif Sezerol and Selma Karabey

Healthcare 2025, 13(3), 302; https://doi.org/10.3390/healthcare13030302 (registering DOI) - 2 Feb 2025

Background: In this qualitative study, we aimed to evaluate the knowledge, beliefs, and attitudes of Syrian pregnant women living in Türkiye toward tetanus vaccination, vaccine hesitations, and the perceived benefits and harms of the tetanus vaccine. Methods: In face-to-face, in-depth interviews, an open-ended, [...] Read more.

Background: In this qualitative study, we aimed to evaluate the knowledge, beliefs, and attitudes of Syrian pregnant women living in Türkiye toward tetanus vaccination, vaccine hesitations, and the perceived benefits and harms of the tetanus vaccine. Methods: In face-to-face, in-depth interviews, an open-ended, semi-structured interview guide was used by an interviewer and translator who spoke Arabic, which is the mother tongue of the participants. Codes, themes, and subthemes were created. Results: In the study, face-to-face in-depth interviews were conducted with a total of 16 pregnant women. The median age of the pregnant women was 26.5 years (18.0–41.0). The median time since they arrived in Türkiye as migrants was 8.5 years (3.0–10.0). The themes were “Beliefs about vaccines”, “Information about vaccines”, “Knowledge, beliefs and attitudes about tetanus vaccine”, “Reasons for vaccination desire”, “Reasons for not being vaccinated”, and “Problems experienced while receiving health services”. Pregnant women mostly mentioned that vaccines have benefits. Most of the women stated that tetanus vaccine is needed to protect from diseases. There were no women thinking that vaccines are harmful. Some of them only mentioned the minor side effects observed after vaccination. Participants mentioned that they get information about vaccines from relatives such as family and friends, health professionals, television, and social media. However, some women talked about the fact that they had no knowledge about vaccines. A lack of knowledge and not visiting the health institution were the reasons for not being vaccinated. Conclusions: Although participants mostly believed that vaccination is necessary and has benefits, some women had no idea about the exact purpose of vaccines. This lack of knowledge may cause vaccine hesitancy and refusal. Full article

(This article belongs to the Special Issue Healthcare for Immigrants and Refugees)

19 pages, 697 KiB

Open AccessArticle

The Relationship of the Psychological Resilience and Stress Coping Level of Health Personnel Working in Hospitals After Kahramanmaraş-Based Earthquakes with Traumatic Stress

by Mehmet Koca, Serdar Deniz and Feyza İnceoğlu

Healthcare 2025, 13(3), 301; https://doi.org/10.3390/healthcare13030301 (registering DOI) - 2 Feb 2025

Objectives: In this study, we aimed to examine the indirect and direct effects of the stress experienced by health workers after an earthquake on their psychological resilience. Methods: This study was conducted using the Structural Equation Model on 315 employees serving in hospitals [...] Read more.

Objectives: In this study, we aimed to examine the indirect and direct effects of the stress experienced by health workers after an earthquake on their psychological resilience. Methods: This study was conducted using the Structural Equation Model on 315 employees serving in hospitals in Kahramanmaraş, Gaziantep, Şanlıurfa, Diyarbakır, Adana, Adıyaman, Osmaniye, Hatay, Kilis, Malatya, and Elazığ (11 provinces) that were most affected by the earthquake. Results: The study group consisted of 58.4% (n = 184) women and 41.6% (n = 131) men. The mean score on the Psychological Resilience Scale was 71.74, the mean score on the Coping with Stress Scale was 87.17, the mean score on the Traumatic Stress Symptom Scale was 44.04, and the mean score on the Disability Scale was 3.75. Psychological resilience had a statistically significant negative effect on traumatic stress symptoms (β₁ = −0.26; p = 0.001 < 0.05). There was a statistically significant positive relationship between coping with stress and psychological resilience (β₁ = 0.52; p = 0.001 < 0.05). Conclusions: It was concluded that an increase in an individual’s psychological resilience will increase the level of coping with stress, and the traumatic stress symptoms of individuals with an increased level of coping with stress will decrease. Full article

(This article belongs to the Special Issue Innovative Treatments for Post-traumatic Stress Disorder (PTSD))

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8 pages, 1800 KiB

Open AccessCase Report

Prurigo Pigmentosa Associated with a Ketogenic Diet in a Romanian Patient: A Case Report

by Carmen Andrada Iliescu, Cristina Beiu, Tiberiu Tebeică and Liliana Gabriela Popa

Healthcare 2025, 13(3), 300; https://doi.org/10.3390/healthcare13030300 (registering DOI) - 2 Feb 2025

Background/Objectives: Prurigo pigmentosa (PP) is a rare inflammatory dermatosis characterized by recurrent pruritic eruptions resolving with reticulated hyperpigmentation. Initially described in young Asian women, PP is increasingly reported worldwide, often linked to ketosis-inducing factors such as low-carbohydrate diets. This report documents the first [...] Read more.

Background/Objectives: Prurigo pigmentosa (PP) is a rare inflammatory dermatosis characterized by recurrent pruritic eruptions resolving with reticulated hyperpigmentation. Initially described in young Asian women, PP is increasingly reported worldwide, often linked to ketosis-inducing factors such as low-carbohydrate diets. This report documents the first case of PP in a Romanian patient and highlights the importance of recognizing the condition in diverse populations. Methods: We describe a 16-year-old girl with a six-month history of pruritic eruptions on the neck, trunk, shoulders, and thighs. A detailed clinical assessment was conducted, including dietary history, physical examination, laboratory evaluation of urinary ketones, and skin biopsy for histopathological analysis. Results: Clinical examination revealed erythematous papules and plaques with peripheral pustules and post-inflammatory hyperpigmentation. Substantial weight loss and elevated urinary ketone levels suggested dietary-induced ketosis from a strict low-carbohydrate diet. Histopathological findings confirmed the diagnosis of PP. The patient’s skin lesions resolved following carbohydrate reintroduction and doxycycline therapy. Conclusions: This case highlights the association between ketosis and PP, emphasizing the importance of thorough dietary history-taking and histopathological confirmation for accurate diagnosis. As ketogenic diets become more popular globally, heightened awareness of PP is essential to ensure timely diagnosis and effective management. Full article

(This article belongs to the Special Issue Dermatological Health and Skin Integrity: Multidisciplinary Rehabilitation Strategies for Optimal Care)

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22 pages, 1472 KiB

Open AccessSystematic Review

A Systematic Review of Community-Based Exercise Interventions for Adults with Intellectual Disabilities

by Teresa Greene, Laurence Taggart and Gavin Breslin

Healthcare 2025, 13(3), 299; https://doi.org/10.3390/healthcare13030299 (registering DOI) - 1 Feb 2025

Background: Adults with intellectual disabilities are a particularly inactive sub-population who experience disproportionally poorer health and social exclusion when compared with the wider general population. This systematic review aimed to identify whether community-based exercise interventions were theoretically underpinned, whether they had an [...] Read more.

Background: Adults with intellectual disabilities are a particularly inactive sub-population who experience disproportionally poorer health and social exclusion when compared with the wider general population. This systematic review aimed to identify whether community-based exercise interventions were theoretically underpinned, whether they had an active single- or multi-exercise component, and how the interventions were objectively and/or subjectively measured, as well as deducing if they improved the health of this population. Method: A systematic search of five databases was conducted up to May 2024. The study was registered in PROSPERO and followed PRISMA reporting guidelines. Study methodological quality was appraised using the Critical Appraisal Skills Programme. Risk of bias was determined using the Cochrane collaboration tools ROB 2 and ROB 2 CRT. Articles were eligible for inclusion if they recruited adults with intellectual disability, were community-based, had an active exercise component and measured physical activity (PA) levels as an outcome measure. Results: In total, 9034 records were identified, with five studies meeting the eligibility criteria. All studies used a feasibility RCT or RCT methodology and all focused on weight loss or PA levels as the primary outcome measure. Two studies focused on walking as a single exercise, two combined walking with nutrition/weight loss, and one combined walking with aerobics. One multi-component walking and aerobics intervention led to statistically significant improvements in PA. Multi-component community-based exercise interventions led to statistically significant improvements in body composition measures. No studies showed statistically significant improvements in quality of life. Risk of bias was rated moderate to high across all included studies. Conclusions: Caution should be taken in drawing firm conclusions due to the small number of included studies, small sample sizes and high risk of bias. Multi-component community-based interventions are more effective at improving PA levels in adults with intellectual disabilities than walking-only studies. Future studies should be theoretically underpinned and explore the use of peer and student models of social support. The use of fitness facilities such as leisure centres and gyms requires further exploration in this population. Full article

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11 pages, 1674 KiB

Open AccessReview

Long COVID Research, 2020–2024: A PubMed-Based Bibliometric Analysis

by Cristina Honorato-Cia, Elena Cacho-Asenjo, Antonio Martinez-Simon, Irene Aquerreta and Jorge M. Núñez-Córdoba

Healthcare 2025, 13(3), 298; https://doi.org/10.3390/healthcare13030298 (registering DOI) - 1 Feb 2025

Long COVID is a SARS-CoV-2 infection-associated chronic condition with great potential to impact health and socioeconomic outcomes. The research efforts to face the challenges related to long COVID have resulted in a substantial amount of publications, which warrants the need for bibliometric profiling. [...] Read more.

Long COVID is a SARS-CoV-2 infection-associated chronic condition with great potential to impact health and socioeconomic outcomes. The research efforts to face the challenges related to long COVID have resulted in a substantial amount of publications, which warrants the need for bibliometric profiling. This is a large-scale PubMed-based bibliometric analysis of more than 390,000 COVID-19 publications. The overall aim was to update the profile of long COVID publications in comparison with the rest of the COVID-19 scientific literature through December 2024. The estimated proportion of long COVID publications was relatively low (2.3% of all COVID-19 publications), although the cumulative frequency (n = 8928) continues to pose a challenge for proper information management. Currently, “treatment” and “mechanism” appear to be the most predominant research topics in the long COVID literature. Interestingly, this evaluation revealed a distinctive profile of the long COVID literature, with a clear preponderance of “case report” and “mechanism” research topics when compared with other COVID-19 publications. This evaluation also identified and ranked the most prolific scientific journals in the production of long COVID-related publications. This study may improve the visibility of long COVID research and contribute to the management of the growing scientific knowledge on long COVID. Full article

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11 pages, 766 KiB

Open AccessArticle

Satisfaction with Social Support and Quality of Life Among Portuguese Patients with Breast Cancer: Mediating Effects of Coping Styles—Cross-Sectional Study

by Joana Carreiro, Susana Cardoso, Pedro Teques, Andreia P. Teques and José Luís Pais-Ribeiro

Healthcare 2025, 13(3), 297; https://doi.org/10.3390/healthcare13030297 (registering DOI) - 1 Feb 2025

Background/Objectives: The purpose of this study was to analyze the mediating effects of coping styles on the relationship between satisfaction with social support (SSS) and quality of life (QoL) in breast cancer patients. Methods: A cross-sectional structural equation modeling (SEM) approach [...] Read more.

Background/Objectives: The purpose of this study was to analyze the mediating effects of coping styles on the relationship between satisfaction with social support (SSS) and quality of life (QoL) in breast cancer patients. Methods: A cross-sectional structural equation modeling (SEM) approach was used to examine the mediating effects. The participants were 311 women who were breast cancer patients, aged between 27 and 86 years (M = 46.61, SD = 9.53). Results: SEM analyses showed that SSS was positively associated with fighting spirit (β = 0.31, p < 0.05), cognitive avoidance (β = 0.19, p > 0.05), and QoL (β = 0.21, p < 0.05), and negatively associated with helplessness–hopelessness (β = −0.28, p < 0.05). Furthermore, fighting spirit and helplessness–hopelessness showed significant relationships with QoL. Anxious preoccupation was negatively related to QoL. Furthermore, fighting spirit and helplessness–hopelessness showed significant relationships with quality of life (β = 0.18, p < 0.05; β = −0.15, p < 0.05, respectively). In addition, the mediation analysis revealed that coping styles (i.e., fighting spirit and helplessness–hopelessness) mediated the relationship between SSS and QoL. Conclusions: The findings suggest that perceptions of SSS from family and friends may promote perceived QoL via adaptive coping, such as fighting spirit and helplessness–hopelessness strategies to deal with the cancer experience. Full article

(This article belongs to the Special Issue Multidisciplinary Approaches in Cancer Healthcare)

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18 pages, 735 KiB

Open AccessReview

Mindfulness Meditation for Sleep Disturbances Among Individuals with Cognitive Impairment: A Scoping Review

by Sunny H. W. Chan, Richard Cheston, Charlotte Steward-Anderson, Chong-Ho Yu, Emily Dodd and Elizabeth Coulthard

Healthcare 2025, 13(3), 296; https://doi.org/10.3390/healthcare13030296 (registering DOI) - 31 Jan 2025

Background: This scoping review investigates the effectiveness of mindfulness meditation in alleviating sleep disturbances among individuals with mild cognitive impairment (MCI) and Alzheimer’s disease (AD). With the rising prevalence of dementia and its profound impact on cognitive function and quality of life, [...] Read more.

Background: This scoping review investigates the effectiveness of mindfulness meditation in alleviating sleep disturbances among individuals with mild cognitive impairment (MCI) and Alzheimer’s disease (AD). With the rising prevalence of dementia and its profound impact on cognitive function and quality of life, this review aims to synthesize existing research and identify gaps in the literature. Methods: We systematically searched six electronic databases (CINAHL, Embase, Medline, PsycINFO, PubMed, and Scopus) from 2004 to 2024, yielding 462 potentially relevant articles. Screening was conducted using ASReview, an AI ranking tool, which facilitated the selection of studies. Ultimately, seven studies that met our stringent eligibility criteria were included in the review. We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines for reporting. Results: Our findings indicate that mindfulness meditation significantly improves sleep quality, reduces insomnia severity, and enhances overall well-being in this at-risk population. Notably, interventions that combine structured, face-to-face sessions with at-home practice emerged as the most effective. Conclusions: Despite these positive outcomes, methodological limitations, including small sample sizes and reliance on self-reported measures, underscore the need for more rigorous long-term studies. This review highlights the potential of mindfulness meditation as a low-cost, scalable intervention to improve sleep and cognitive health in older adults, paving the way for future research and clinical applications. Full article

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15 pages, 932 KiB

Open AccessArticle

Evaluation of Social Media Addiction and Its Relationship with Anxiety and Academic Performance Among Medical and Non-Medical Students: A Cross-Sectional Study from Saudi Arabia

by Suhaj Abdulsalim, Mohammed Saif Anaam, Maryam Farooqui, Mohammed S. Alshammari, Saeed Alfadly, Jehad Alolayan, Anas Ahmad Aljarallah and Saud Alsahali

Healthcare 2025, 13(3), 295; https://doi.org/10.3390/healthcare13030295 (registering DOI) - 31 Jan 2025

Background: Social media (SM) use has become an integral aspect of daily life. Overutilization of SM can adversely impact an individual’s physical and emotional well-being, especially that of students. This study evaluated the potential impact of SM addiction on anxiety and academic performance [...] Read more.

Background: Social media (SM) use has become an integral aspect of daily life. Overutilization of SM can adversely impact an individual’s physical and emotional well-being, especially that of students. This study evaluated the potential impact of SM addiction on anxiety and academic performance among university students. Methods: A cross-sectional study was conducted among medical ad non-medical students at Qassim University during September 2022–April 2023 after obtaining the Ethics Committee’s permission. Raosoft was used for calculating the sample size, and participants were selected through convenience sampling. Both descriptive and inferential statistics were used to analyze and interpret the results, using SPSS version 25. Results: A total of 269 students participated in the study. The majority of them were male (52%), with a mean age of 22.28. The main purpose of SM usage was entertainment, followed by communication. More than 30% of them were using SM for 4–6 h per day, accessing SM 1–10 times in a day, with more than half of them feeling that they had SM addiction and that it was affecting their daily activities and sleep. The majority of them agreed that SM can be used for group discussion (78.1% vs. 71.6%) and knowledge sharing (93.7% vs. 90%). However, a statistically significant difference was observed about anxiety level between the two groups. A negative correlation was found between cumulative grade point average (CGPA) and anxiety level. Conclusion: The findings suggest that SM has both positive and negative effects on academic performance and social anxiety. Continuous education and motivation about wise use of SM is warranted among students by parents, university authorities, and policymakers. Full article

(This article belongs to the Topic Diversity, Educational Inclusion, Emotional Intelligence, Coping, and Other Factors That Influence Psychological Health and Well-Being)

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16 pages, 488 KiB

Open AccessArticle

Investigating the Interplay Between Sleep, Anxiety, and Depression in Chronic Kidney Disease Patients: Implications for Mental Health

by Reynita Saguban, Asmaa Mohamed Ali AlAbd, Evalyn Rondilla, Joyce Buta, Salwa Ali Marzouk, Richard Maestrado, Chandrakala Sankarapandian, Sameer A. Alkubati, Romeo Mostoles Jr., Salman Amish Alshammari, Maha Sanat Alrashidi, Analita Gonzales, Grace Ann Lagura and Ferdinand Gonzales

Healthcare 2025, 13(3), 294; https://doi.org/10.3390/healthcare13030294 (registering DOI) - 31 Jan 2025

Background/Objectives: This study aims to determine the level of anxiety, depression, and sleep disturbances in patients with chronic kidney disease, as well as the interactions between the three comorbidities, and the implications it has for health practitioners. Methods: A descriptive cross-sectional study, following [...] Read more.

Background/Objectives: This study aims to determine the level of anxiety, depression, and sleep disturbances in patients with chronic kidney disease, as well as the interactions between the three comorbidities, and the implications it has for health practitioners. Methods: A descriptive cross-sectional study, following the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines, was implemented whereby 179 patients with chronic kidney disease attending a government hospital were recruited to this study. Results: Our results showed that 65.9% of the participants had the metrics of severe anxiety while 34.1 percent had moderate anxiety. Further, it was reported that more than half 51.4% of participants had poor sleep quality. The levels of depression reported by the patients were roughly 40.2% minimal depression, 29.6% mild, 21.2% moderate, and 8.9% depression that was severe. There was a significant correlation between mental health disease together with sociodemographic variables such as gender, marital status, educational status, and nationality (p < 0.05). Cut points of those aged 26–35 found younger patients experiencing higher anxiety levels (cut point (AOR = 2.792; p = 0.021)), and they also had poorer sleep quality (AOR = 0.403; p = 0.020). Conclusion: Our findings illustrate the importance of more frequent early mental health measures and strategies that help patients with chronic kidney diseases. The main study limitation was the cross-sectional design, which allows for correlational but not causal statements to be made. We address a gap in the literature with our results by noting specific demographic characteristics that are associated with poor mental health in chronic kidney disease populations and discuss practical and policy recommendations aimed at enhancing the mental well-being of chronic kidney disease patients. Full article

15 pages, 371 KiB

Open AccessArticle

Examining Risk and Protective Factors for Suicidal Behaviors: A Cross-Sectional Study Among Portuguese Male Inmates

by Catarina Oliveira and Miguel Basto-Pereira

Healthcare 2025, 13(3), 293; https://doi.org/10.3390/healthcare13030293 (registering DOI) - 31 Jan 2025

Background/Objectives: Prison inmates face a significantly higher risk of acting on suicidal thoughts than the general population. However, Portuguese studies distinguishing inmates who think about suicide from those who attempt it remain scarce. Given this ideation-to-action distinction, the current cross-sectional study aimed to [...] Read more.

Background/Objectives: Prison inmates face a significantly higher risk of acting on suicidal thoughts than the general population. However, Portuguese studies distinguishing inmates who think about suicide from those who attempt it remain scarce. Given this ideation-to-action distinction, the current cross-sectional study aimed to examine risk and protective factors for suicidal ideation, suicide attempts, and the transition from one outcome to another. Methods: A total of 411 male inmates (M = 37.94 years, SD = 10.91) from 16 Portuguese prisons participated in the study. Data were collected between 2020 and2024 using four instruments: (1) Sociodemographic Questionnaire; (2) Social and Emotional Competencies Questionnaire (SEC-Q); (3) Predictive Antisocial Spectrum Questionnaire; and (4) Health Risk Behavior Checklist. Results: Among the total sample, 29.1% reported a lifetime history of suicidal ideation, and 19.4% had attempted suicide. Impulsivity/irresponsibility emerged as a key risk factor for suicidal ideation, whereas social and emotional competencies of self-management and motivation were protective factors against suicide attempts. Previous self-harm behavior was the only risk factor for both suicidal ideation and suicide attempts. Conclusions: Our findings provide important insights into risk and protective factors for suicidal behaviors among male inmates, offering key information for policy and practice efforts aimed at reducing mortality in this high-risk population. Full article

14 pages, 224 KiB

Open AccessArticle

Moments of Care: Perceptions of Young Carers and Day-to-Day Well-Being

by Melinda S. Kavanaugh, Matthew J. Zawadzki, Kayla T. Johnson and Miranda R. Boville

Healthcare 2025, 13(3), 292; https://doi.org/10.3390/healthcare13030292 - 31 Jan 2025

Background/Objectives: Over 5 million youth under the age of 19 provide daily, hands-on care to an ill or injured family member across the United States. Yet how these young carers perceive the care they deliver in the moment, and how these perceptions relate [...] Read more.

Background/Objectives: Over 5 million youth under the age of 19 provide daily, hands-on care to an ill or injured family member across the United States. Yet how these young carers perceive the care they deliver in the moment, and how these perceptions relate to well-being, is unexplored, particularly in complex neurological conditions. This paper presents initial data on young carers for a family member with amyotrophic lateral sclerosis (ALS). Methods: Ecological momentary assessment (EMA) was used to measure perceptions of care in the moments of care and the cognitive and emotional states of the young carers during those moments. Young carers (n = 15) aged 10–19 were followed for seven days, completing assessments three times per day, which provided 260 total measurements. Young carers reported frequently engaging in caregiving (~39% of assessments). Results: The results indicated that it was not simply performing a caregiving task that related to outcomes, but rather how caregiving moments were perceived that mattered. Caregiving moments perceived as more fulfilling resulted in young carers feeling less discontent and more focused, whereas caregiving moments perceived as lacking resources predicted more discontent and distress. Exploratory analyses highlighted the potential for burden for young carers. They reported high levels of worry when they were not around the care recipient, with this worry predicting feeling more discontent and distressed. Conclusions: Young carers are deeply involved in care and perceive care differently across moments, both positive and negative. These initial data can be used to develop targeting support programs in the moment of care, potentially lessening the negative impacts of care. Full article

(This article belongs to the Special Issue Young Carers: Prevention, Intervention, Services and Outcomes—What Works?)

11 pages, 214 KiB

Open AccessArticle

The Determinants of Men’s Health Behaviors: A Cross-Sectional Study Among Public Safety Personnel in Kelantan, Malaysia

by Muhammad Iqbal Haji Mukhti and Mohd Ismail Ibrahim

Healthcare 2025, 13(3), 291; https://doi.org/10.3390/healthcare13030291 - 31 Jan 2025

Background: Men’s health behaviors influence health outcomes but remain understudied in high-risk occupational groups. This study examines determinants of health behaviors among public safety personnel using Andersen’s Behavioral Model. Methods: A cross-sectional study was conducted among 257 male public safety personnel in Kelantan, [...] Read more.

Background: Men’s health behaviors influence health outcomes but remain understudied in high-risk occupational groups. This study examines determinants of health behaviors among public safety personnel using Andersen’s Behavioral Model. Methods: A cross-sectional study was conducted among 257 male public safety personnel in Kelantan, Malaysia. Participants were selected through simple random sampling. Data were collected using proforma and the validated Malay Health Behavior Inventory-Short Form (MHBI-SF). Multiple logistic regression identified factors associated with poor health behaviors. Results: Key risk factors for poor health behaviors included reliance on parental influence (AOR: 5.54; 95% CI: 1.74–17.64) and restricted healthcare access during leisure time (AOR: 4.70; 95% CI: 1.43–15.49). Protective factors included peer influence (AOR: 0.19; 95% CI: 0.05–0.71) and transportation support (AOR: 0.22; 95% CI: 0.06–0.79). Conclusions: Addressing barriers to healthcare access and enhancing social support are critical to promoting healthy behaviors among men in high-risk occupations. Targeted interventions can reduce health disparities and improve outcomes. Full article

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