Healthcare

8 pages, 184 KiB

Open AccessArticle

Clinical Outcomes and Cost Implications of a Community Psychosocial Rehabilitation Service for Severe and Persistent Mental Illness in Nova Scotia, Canada

by Mahmoud A. Awara and Joshua T. Green

Healthcare 2024, 12(18), 1904; https://doi.org/10.3390/healthcare12181904 - 23 Sep 2024

Abstract

Introduction: Individuals with severe and persistent mental illness (SPMI) present distinct challenges in mental healthcare due to the chronic and complex nature of their conditions. This study was conducted to assess the clinical efficacy and potential cost-effectiveness of a multidisciplinary community-based psychosocial rehabilitation [...] Read more.

Introduction: Individuals with severe and persistent mental illness (SPMI) present distinct challenges in mental healthcare due to the chronic and complex nature of their conditions. This study was conducted to assess the clinical efficacy and potential cost-effectiveness of a multidisciplinary community-based psychosocial rehabilitation team serving individuals with SPMI in Nova Scotia, Canada. Method: This study was conducted to evaluate the effects of a community-based psychosocial rehabilitation program on individuals with severe and persistent mental illness (SPMI) in Nova Scotia, Canada. This research focused on clinical outcomes and potential cost savings following a one-year intervention, offering critical insights into the benefits of community-based care for this population. A cohort of 137 clients accepted into the community rehabilitation service (Connections Dartmouth) between September 2016 and September 2020 was analyzed. Each participant received one year of community rehabilitation intervention. Using data from the Canadian Medical Service Insurance (MSI) billing system, this research compared the use of inpatient services and Emergency Department visits in the year prior to and the year following the intervention. The findings provide valuable evidence on the role of community rehabilitation in reducing healthcare utilization for individuals with SPMI. Results: The results demonstrated a statistically significant reduction in mean admission rates and length of inpatient admissions in the year following rehabilitation compared to the pre-rehabilitation year. A substantial percentage of patients experienced no inpatient admissions (88% vs. 60%) or Emergency Department visits (82% vs. 67%) in the post-rehabilitation year, compared to the pre-rehabilitation year. There was a significant reduction in inpatient days by 90%, translating into substantial cost savings. The findings highlight the potential economic benefits of community rehabilitation for people with SPMI. Conclusions: This uncontrolled study suggests that community rehabilitation is associated with positive clinical outcomes for individuals with SPMI in terms of reduced inpatient service use and associated costs. Further research, including controlled studies and cost-effectiveness studies, into the community psychosocial rehabilitation services in the Canadian setting is needed. Full article

16 pages, 770 KiB

Open AccessArticle

Workplace Violence and Burnout among Health Workers Two Years after the COVID-19 Outbreak in Wuhan, China: The Chain Mediation Effect of Sleep Disturbance and Work Ability

by Fuyuan Wang, Min Zhang, Nian Xiong, Yiming Huang, Yuting Tang, Chuning He, Xinxin Fang, Xi Fang, Lan Chen and Qing Zhang

Healthcare 2024, 12(18), 1903; https://doi.org/10.3390/healthcare12181903 - 23 Sep 2024

Abstract

Background: Health workers (HWs) faced considerable psychosocial hazards during the COVID-19 pandemic, which profoundly affected their occupational health and job performance. The potential indirect relationship between workplace violence (WPV) and burnout among HWs needs to be further explored. The purpose of this study [...] Read more.

Background: Health workers (HWs) faced considerable psychosocial hazards during the COVID-19 pandemic, which profoundly affected their occupational health and job performance. The potential indirect relationship between workplace violence (WPV) and burnout among HWs needs to be further explored. The purpose of this study is to examine the chain mediating effects of sleep disturbance and work ability in the relationship between WPV and burnout among HWs. Methods: A cross-sectional study was conducted in a secondary hospital two years after the COVID-19 outbreak in Wuhan, China. A sample of 571 HWs was recruited using a cluster sampling method, achieving a response rate of 80.06%. Participants completed self-report questionnaires that included demographic information and measures of WPV, burnout, sleep disturbance, and work ability. Results: The prevalence rates of burnout and WPV among HWs two years after the COVID-19 outbreak were 37.30% and 31.52%, respectively. WPV was significantly associated with burnout (β = 0.446, p < 0.001). Sleep disturbance was identified as a mediator in the relationship between WPV and burnout (β = 0.063, 95% CI: 0.027–0.105), accounting for 14.13% of the total effect. Similarly, work ability also played a mediating role in this relationship (β = 0.142, 95% CI: 0.065–0.225), accounting for 31.84%. Additionally, both sleep disturbance and work ability exhibited a chain mediation effect on the association between WPV and burnout (β = 0.020, 95% CI: 0.008–0.036), and the total indirect effect accounted for 50.67%. Conclusions: Among Chinese HWs, WPV exerts significant direct and indirect effects on burnout symptoms, mediated by sleep disturbance and work ability. This finding provides valuable empirical insights for designing interventions to mitigate the adverse effects of psychosocial factors such as WPV and burnout among HWs. After exposure to WPV, measures focused on reducing sleep disturbance and enhancing work ability may prove effective in alleviating burnout in subsequent interventions. Full article

(This article belongs to the Section Coronaviruses (CoV) and COVID-19 Pandemic)

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11 pages, 1974 KiB

Open AccessArticle

Bilateral Total Knee Arthroplasty (TKA) in a One-Stage Procedure Versus Two-Stage Procedure: A Retrospective Study

by Giada Accatino, Alessandra Monzio Compagnoni, Federico Alberto Grassi, Alberto Castelli, Gianluigi Pasta, Francesco Benazzo, Stefano Marco Paolo Rossi and Eugenio Jannelli

Healthcare 2024, 12(18), 1902; https://doi.org/10.3390/healthcare12181902 - 23 Sep 2024

Abstract

Background/Objectives: This retrospective study aims to evaluate the safety and functional outcomes of simultaneous bilateral total knee arthroplasty (TKA) compared to two-stage bilateral TKA procedures. Osteoarthritis is the leading cause of knee joint replacement globally, so we sought to determine whether the one-stage [...] Read more.

Background/Objectives: This retrospective study aims to evaluate the safety and functional outcomes of simultaneous bilateral total knee arthroplasty (TKA) compared to two-stage bilateral TKA procedures. Osteoarthritis is the leading cause of knee joint replacement globally, so we sought to determine whether the one-stage approach could be deemed non-inferior to the two-stage method in terms of perioperative complications and postoperative recovery. Methods: We analyzed two cohorts: 43 patients underwent one-stage bilateral TKA, while 66 patients received two-stage TKA. The data collected included demographic details, comorbidities, postoperative complications, and functional outcomes assessed by the Oxford Knee Score (OKS), European Quality of Life, and Visual Analogue Scale scores at preoperative and five years postoperative follow-ups. Results: The results showed statistically significant improvements in quality-of-life measures for both groups, with the one-stage group exhibiting greater enhancement in OKS (p < 0.05). Complication rates were similar across both procedures, with no significant differences in infection rates or other adverse events. Conclusions: This study suggests that the one-stage approach to treat bilateral knee arthritis could reduce subjective stress and healthcare costs, presenting a safe alternative for appropriately selected patients. However, the findings highlight the necessity of considering patients’ overall health status when planning surgical interventions. Further research involving larger populations is recommended to validate our conclusions. Full article

(This article belongs to the Special Issue New Advances in Joint Osteoarthritis)

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10 pages, 254 KiB

Open AccessArticle

Assessing Patient Satisfaction and the Need for Collaborative Treatment with Korean and Western Medicine

by Soyong Park, Yoonju Lee, Linae Kim, Shiva Raj Acharya and NamKwen Kim

Healthcare 2024, 12(18), 1901; https://doi.org/10.3390/healthcare12181901 - 23 Sep 2024

Abstract

Background: The collaborative treatment of Korean medicine (KM) and Western medicine (WM) in Korea has gained prominence since its initiation. However, comprehensive evaluations of patient satisfaction and care effectiveness remain limited. Thus, this study aimed to evaluate patient satisfaction and the need for [...] Read more.

Background: The collaborative treatment of Korean medicine (KM) and Western medicine (WM) in Korea has gained prominence since its initiation. However, comprehensive evaluations of patient satisfaction and care effectiveness remain limited. Thus, this study aimed to evaluate patient satisfaction and the need for collaborative KM-WM treatment in the fourth phase of the national pilot project. Methods: A multicenter survey was conducted among 321 patients from 15 institutions participating in the fourth phase of the collaborative KM-WM pilot project, spanning from 1 August 2023 to 31 October 2023. Patient satisfaction and needs were assessed using a validated, semi-structured questionnaire with a 5-point Likert scale. Descriptive statistics and hierarchical multiple regression were used in the analysis. Results: The overall satisfaction with collaborative KM-WM treatment was notably high (91.25%). Among the participants, 91.58% indicated the necessity of the collaborative KM-WM pilot project, whereas 90.66% pointed out the need to incorporate inpatient services into collaborative care. Expansion of the pilot project to additional institutions and primary healthcare settings was substantially demanded (85.36% and 80.06%, respectively). Treatment effects (β, 0.344; 95% CI: 0.237–0.451), appropriate treatment time (β, 0.140; 95% CI: 0.051–0.229), medical procedural efficiency (β, 0.227; 95% CI: 0.126–0.328), and promotional activities (β, 0.175; 95% CI: 0.101–0.250) significantly contributed to overall patient satisfaction (each, p < 0.05). Conclusions: The fourth phase of the KM-WM project reflects high patient satisfaction and a substantial need for collaborative treatment. Further research should include longitudinal studies and employ mixed-methods approaches to better understand, evaluate, and improve collaborative KM-WM treatment. Full article

(This article belongs to the Special Issue Patient Experience and the Quality of Health Care)

14 pages, 425 KiB

Open AccessArticle

Prospective Evaluation of Transsphenoidal Pituitary Surgery in Patients with Cushing’s Disease: Delayed Remission and the Role of Postsurgical Cortisol as a Predictive Factor

by Athanasios Saratziotis, Maria Baldovin, Claudia Zanotti, Sara Munari, Diego Cazzador, Enrico Alexandre, Luca Denaro, Jiannis Hajiioannou and Enzo Emanuelli

Healthcare 2024, 12(18), 1900; https://doi.org/10.3390/healthcare12181900 - 22 Sep 2024

Abstract

Background. Transsphenoidal surgery is the treatment of choice for Cushing’s disease. Successful surgery is associated with subnormal postoperative serum cortisol concentrations and cortisoluria levels, which may guide decisions regarding immediate reoperation. Remission is defined as the biochemical reversal of hypercortisolism with the re-emergence [...] Read more.

Background. Transsphenoidal surgery is the treatment of choice for Cushing’s disease. Successful surgery is associated with subnormal postoperative serum cortisol concentrations and cortisoluria levels, which may guide decisions regarding immediate reoperation. Remission is defined as the biochemical reversal of hypercortisolism with the re-emergence of diurnal circadian rhythm. Methods. A single-center prospective cohort study was conducted among thirty-three patients who underwent transsphenoidal pituitary surgery for Cushing’s disease. Postoperative surgical outcomes, daily morning cortisolemia, and 24 h urinary-free cortisol from the first to the fifth morning were evaluated. Results. All patients underwent surgery, with a remission rate of 81.2%. Of the 26 patients who achieved early remission, 92% remained in remission. Two patients (7.7%) showed recurrence of Cushing’s disease during a mean follow-up of 81.7 months. Early postoperative hypocortisolism suggests complete removal of the tumor, correlating with high rates of remission (p < 0.001). Also, in 12.5% of patients with early cortisol values >138 nmol/L, there was a gradual late remission. Conclusions. In our cohort of patients, the endoscopic transsphenoidal approach was safe and effective in the treatment of Cushing’s disease. We demonstrated that serum and urinary cortisol concentrations did not experience significant fluctuations from the first to the fifth day. This constitutes an accurate predictor of durable remission, comprising a distinctive finding in the intermediate term by our team. Full article

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15 pages, 308 KiB

Open AccessArticle

Psychological Wellbeing and Life Satisfaction among Chinese Older Immigrants in Canada across the Early and Late Stages of the COVID-19 Pandemic

by Lixia Yang, Andrea D. Y. Lee and Linying Dong

Healthcare 2024, 12(18), 1899; https://doi.org/10.3390/healthcare12181899 - 22 Sep 2024

Abstract

Objectives: This study compared the psychological wellbeing, life satisfaction, and perceived social support in Chinese older immigrants living in Canada between the early (i.e., Wave 1: September–November 2020) and late (i.e., Wave 2: January–February 2023) stages of the COVID-19 pandemic. Additionally, it assessed [...] Read more.

Objectives: This study compared the psychological wellbeing, life satisfaction, and perceived social support in Chinese older immigrants living in Canada between the early (i.e., Wave 1: September–November 2020) and late (i.e., Wave 2: January–February 2023) stages of the COVID-19 pandemic. Additionally, it assessed perceived social support from family, friends, or others as predictors for psychological wellbeing and life satisfaction in this population. Methods: These questions were addressed with a cross-sectional survey design with two independent samples at Wave 1 (n = 171) and Wave 2 (n = 191), respectively. Results: The results revealed lower levels of psychological wellbeing, life satisfaction, and perceived social support in Wave 2 compared to Wave 1. The hierarchical regression models identified social support from friends (but not from family or others) as a significant predictor for psychological wellbeing and life satisfaction. Additionally, a higher level of income and being a male predicted better psychological wellbeing. A higher level of income and a lower level of education predicted greater life satisfaction. Conclusions: The findings suggest a deterioration in psychological wellbeing and life satisfaction from the early to late stages of the pandemic and highlight the protective effect of social support from friends among Chinese older immigrants. Full article

(This article belongs to the Special Issue Impact of Social Connections on Well-Being of Older Adults)

12 pages, 683 KiB

Open AccessArticle

An Assessment of the Clinical Efficacy of a Topical Application of 5% Thymoquinone Gel for Plaque-Induced Gingivitis Patients: A Randomized Controlled Clinical Trial

by Ahmad H. Almehmadi and Khalid Aljohani

Healthcare 2024, 12(18), 1898; https://doi.org/10.3390/healthcare12181898 - 21 Sep 2024

Abstract

Background: Gingival diseases, encompassing a spectrum of oral health concerns, represent a prevalent issue within the global population. Despite their widespread occurrence, the research landscape concerning effective interventions, particularly those rooted in herbal products, remains somewhat limited. Addressing this knowledge gap, the current [...] Read more.

Background: Gingival diseases, encompassing a spectrum of oral health concerns, represent a prevalent issue within the global population. Despite their widespread occurrence, the research landscape concerning effective interventions, particularly those rooted in herbal products, remains somewhat limited. Addressing this knowledge gap, the current study undertook a comprehensive evaluation aimed at assessing the clinical efficacy of a novel intervention: a 5% thymoquinone (TQ) gel. This investigation specifically focused on the application of TQ gel as an adjunctive measure to the standard protocol of scaling (SC) in individuals afflicted with plaque-induced gingivitis. Through rigorous examination and analysis, this study seeks to provide valuable insights into the potential utility and therapeutic benefits of this herbal-based intervention in managing gingival diseases. Objective: To evaluate the efficacy of 5% TQ gel using a novel liposome drug delivery as a topical application following SC in gingivitis patients. Methods: A double-blinded, parallel, randomized controlled clinical trial. The study was performed at the Faculty of Dentistry, King Abdulaziz University, and Qassim University, Saudi Arabia. This trial enrolled 63 participants in an age group between 18 and 40 years attending the outpatient clinics of the Faculty of Dentistry, Qassim University, Saudi Arabia, and a clinical diagnosis of gingivitis was made. The enrolled subjects were categorized into three groups: Group I—TQ gel with SC, Group II—Placebo with SC, and Group III—SC alone, and clinical outcomes were measured at baseline and two-week follow-up visits. Plaque index (PI), papillary bleeding index (PBI), and any adverse events with TQ gel are categorized as mild, moderate, and severe. 63 patients. Group I (n = 21); Group II (n = 21); Group III (n = 21). Results: The paired t-test compared the mean differences in PI and PBI at two time points and it was observed that there were significant differences in Group I with p-values of 0.04 and 0.05, respectively. A one-way ANOVA test was performed and it showed significant differences in the mean scores between the three groups for PI (p-value—0.01) and PBI (p-value—0.05). The post hoc Tukey’s test compared the mean differences in PI and PBI between the groups and the results were in favor of Group I which used TQ gel with SC. Conclusions: The clinical trial concluded that the plaque and gingival bleeding scores were significantly reduced in the group of patients who intervened with TQ gel following SC when compared to SC-alone and placebo groups. Also, there were significant reductions in the scores from the baseline to the two-week follow-up visit in patients treated with TQ gel and SC. Full article

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13 pages, 646 KiB

Open AccessArticle

Predictors of Coping Strategies in Caregivers of Family Members with a Brain Tumor: A Correlational Study

by Hsiang-Hua Lu and Shu-Yuan Liang

Healthcare 2024, 12(18), 1897; https://doi.org/10.3390/healthcare12181897 - 21 Sep 2024

Abstract

Background/Objectives: Brain tumor patients confront numerous challenges arising from diagnosis and treatment, and these impact the patient’s physical, mental, and social functions at all levels. Primary informal caregivers assume a pivotal role in home-based patient care. Of particular importance are the coping strategies [...] Read more.

Background/Objectives: Brain tumor patients confront numerous challenges arising from diagnosis and treatment, and these impact the patient’s physical, mental, and social functions at all levels. Primary informal caregivers assume a pivotal role in home-based patient care. Of particular importance are the coping strategies employed by family caregivers, as they can influence both their own health and the overall quality of home care. This study aimed to explore the associations among family function, caregiving competence, and coping strategies among primary informal caregivers. Methods: This study adopted a cross-sectional correlational design and convenience sampling to survey the primary informal caregivers of 111 brain tumor patients. The study instruments included the Family Assessment Device General Function, Caregiving Competence Scale, and Revised Ways of Coping Checklist. Results: The findings of this study revealed a significant positive correlation between the family function of primary informal caregivers and their employment of emotion-focused coping (r = 0.209, p < 0.05). Furthermore, caregiving competence exhibited a positive association with problem-focused coping (r = 0.242, p < 0.05) and emerged as a significant predictor of problem-focused coping (β = 0.182, p < 0.05). However, neither family function (r = 0.059, p < 0.05) nor caregiving competence (r = 0.031, p < 0.05) demonstrated significant associations with total coping strategies. Conclusions: The findings of this study affirmed that enhancing the caregiving competence of primary informal caregivers of brain tumor patients can facilitate the adoption of problem-focused coping strategies. Full article

15 pages, 569 KiB

Open AccessArticle

Factors Influence Breastfeeding Duration after High Risk and Low Risk Pregnancies

by Panagiota Brani, Maria Iliadou, Ewa Andersson, Georgios Daskalakis, Peter Drakakis and Maria Dagla

Healthcare 2024, 12(18), 1896; https://doi.org/10.3390/healthcare12181896 - 21 Sep 2024

Abstract

Background: Breastfeeding provides vital nutrients and fosters maternal–infant bonding, benefiting both mother and child. However, breastfeeding duration is influenced by various factors, especially in women of high-risk pregnancy. This study aims to identify predictors of breastfeeding duration among women of high-risk and low-risk [...] Read more.

Background: Breastfeeding provides vital nutrients and fosters maternal–infant bonding, benefiting both mother and child. However, breastfeeding duration is influenced by various factors, especially in women of high-risk pregnancy. This study aims to identify predictors of breastfeeding duration among women of high-risk and low-risk pregnancy, focusing on exclusive and mixed feeding practices. Methods: Conducted at a public hospital in Attica, Greece, this 20-month prospective cohort study (May 2020–January 2022) included 380 pregnant women, divided into high-risk and low-risk groups. The final sample of 157 women, after excluding non-breastfeeding participants, was assessed across five phases from prenatal to six months postpartum using interviews, calls, and surveys. Multiple linear regression identified key predictors, with statistical methods applied. Results: Results revealed birth weight as a consistent significant predictor of breastfeeding duration. For women with high-risk pregnancy, additional factors like infant gender, jaundice, and early introduction of solid foods influenced breastfeeding duration. The mixed breastfeeding model for women with high-risk pregnancy explained 72.9% of the variance. Exclusive and mixed breastfeeding models for women with low-risk pregnancy also highlighted birth weight’s influence. Conclusion: The findings highlight the important role of birth weight and other specific factors in determining breastfeeding duration among women of high-risk and low-risk pregnancy. Further research is needed to validate these findings across diverse populations. Full article

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15 pages, 307 KiB

Open AccessArticle

Effectiveness of Training in Evidence-Based Practice on the Development of Communicative Skills in Nursing Students: A Quasi-Experimental Design

by María Ruzafa-Martínez, Verónica Pérez-Muñoz, María Belén Conesa-Ferrer, Antonio Jesús Ramos-Morcillo and Alonso Molina-Rodríguez

Healthcare 2024, 12(18), 1895; https://doi.org/10.3390/healthcare12181895 - 21 Sep 2024

Abstract

Background: Communication skills (CSs) and evidence-based practice (EBP) are key foundations for offering personalized and quality nursing care. CS that results in open communication is fundamental for applying EBP. Objectives: The objective of the study was to assess the relationship between the acquisition [...] Read more.

Background: Communication skills (CSs) and evidence-based practice (EBP) are key foundations for offering personalized and quality nursing care. CS that results in open communication is fundamental for applying EBP. Objectives: The objective of the study was to assess the relationship between the acquisition of EBP competencies and learning CS after taking an EBP course in the nursing degree. Methods: Pre-test-post-test quasi-experimental study without a control group. The study population comprised fourth-year undergraduate nursing students. Before and after an EBP course, students completed a questionnaire on CS competence (HP-CSS) and EBP competence (EBP-COQ). The EBP course lasts for 15 weeks, with 150 h of work for the student. Out of these 150 h, 60 are conducted in person, while the remaining 90 h are for independent or group work, utilizing the flipped classroom methodology. Bivariate, correlational, pairwise Student’s t-test, and linear regression multivariate analyses were performed. Results: The sample was composed of 153 students. After completing the EBP course, there was a statistically significant improvement in informative communication (p = 0.046) and assertiveness (p = 0.018). However, there were no observed changes in empathy, respect, and the total score of the CS competence. The results from the multivariate analysis showed that the dimensions of attitude towards EBP and EBP knowledge had a positive relation to three of the four dimensions of the CS and overall competence. Regarding the students’ variables and characteristics, admission through special programs for athletes and older students (p < 0.001) and being female (p = 0.004) were positively statistically associated with empathy. Conclusions: EBP training positively affects the development of CS in nursing students, as shown by significant improvements in the total scores of the CS and the dimensions of informative communication and assertiveness after the intervention. This study demonstrates the initial applicability and usefulness of an EBP training program for the development of CS in nursing students. Full article

8 pages, 197 KiB

Open AccessArticle

Prehospital Management of Postpartum Hemorrhage—A National, Cross-Sectional Study in Norway

by Ann-Chatrin Linqvist Leonardsen and Laurits Dydensborg Hansen

Healthcare 2024, 12(18), 1894; https://doi.org/10.3390/healthcare12181894 - 21 Sep 2024

Abstract

Introduction: Postpartum hemorrhage (PPH) is a critical birth complication, and is stated by the World Health Organization (WHO) as among the five most frequent causes of death during pregnancy. External aortic compression (EAC) is recommended by the WHO as an intervention to achieve [...] Read more.

Introduction: Postpartum hemorrhage (PPH) is a critical birth complication, and is stated by the World Health Organization (WHO) as among the five most frequent causes of death during pregnancy. External aortic compression (EAC) is recommended by the WHO as an intervention to achieve temporary bleeding control. An increasing number of births outside hospital underlines the importance of competence in handling potential birth complications, such as PPH. The aim of this study was to assess prehospital personnel’s education, training, knowledge, and experiences regarding PPH and EAC across Norway. Methods: Prehospital personnel were invited to respond to a questionnaire through social media. Questions included those on education, training, knowledge, and experience regarding PPH and EAC. The Statistical Package for the Social Sciences (SPSS) version 28 was used to analyze the data, using descriptive statistics. Results: Over a two-month period, 211 prehospital personnel responded to the questionnaire, of whom 55.5% were male. The respondents had an average of 10.3 years of prehospital experience. About half of the respondents had received education (48.6%) and training (62.4%) in PPH management. Still, 95.7 percent reported a need for more education and training. On knowledge questions, only half of the responses were correct (43.7% to 60.5%). Only 21 percent of the respondents had experienced patients with PPH, and of these only 3.8 percent had used EAC. Bimanual uterine compression was the most frequent intervention used (62.5%) across hospital trusts. Conclusions: Even if prehospital personnel receive education and training in the management of PPH and EAC, almost all report needing more. The results indicate a national variation, which may be discussed as to whether it is appropriate. Full article

(This article belongs to the Section Prehospital Care)

12 pages, 433 KiB

Open AccessReview

by Younhee Kang and Chohee Bang

Healthcare 2024, 12(18), 1893; https://doi.org/10.3390/healthcare12181893 - 21 Sep 2024

Abstract

Background/Objectives: As the elderly population grows, the prevalence of dementia is rising, with 70–95% of patients in hospital settings exhibiting problematic behaviors such as aggression. These behaviors significantly contribute to increased nursing workloads, affecting nurses’ well-being and patient care quality. This study aims [...] Read more.

Background/Objectives: As the elderly population grows, the prevalence of dementia is rising, with 70–95% of patients in hospital settings exhibiting problematic behaviors such as aggression. These behaviors significantly contribute to increased nursing workloads, affecting nurses’ well-being and patient care quality. This study aims to review workload-related issues among nurses caring for dementia patients, highlighting the need for targeted interventions to mitigate stress and improve care quality. Methods: A scoping review was conducted using the five-stage framework of Arksey and O’Malley. The literature search covered studies published between 2013 and 2023, focusing on quantitative research about nurses’ workload-related stress when managing patients with dementia and problematic behaviors. Databases such as PubMed and PsycINFO were searched, and 13 studies were selected based on predefined inclusion and exclusion criteria. Results: The review revealed that problematic behaviors, particularly aggression, significantly increase nurses’ stress and workload. This stress has negative consequences on nurses’ physical and mental health, often leading to burnout, decreased job satisfaction, and a decline in care quality. Inadequate staffing and support systems exacerbate these issues. Conclusions: Targeted education, sufficient staffing, and support are essential to reduce the workload and stress experienced by nurses caring for dementia patients. Implementing these strategies can enhance the quality of care provided and improve the well-being of healthcare professionals. Full article

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15 pages, 647 KiB

Open AccessArticle

Cross-Cultural Adaptation and Pilot Psychometric Validation of the European Organisation for Research and Treatment of Cancer—Quality of Life Questionnaire—Sexual Health (EORTC QLQ-SH22) Scale, Moroccan Arabic Version

by Safiya Mahlaq, Ghizlane Rais, Redouane Abouqal and Jihane Belayachi

Healthcare 2024, 12(18), 1892; https://doi.org/10.3390/healthcare12181892 - 21 Sep 2024

Abstract

Background: The Sexual Health Scale (QLQ-SH22) is the only cancer-specific measure of sexual health. It has never been translated into Arabic. In order to envisage effective healthcare strategies that improve sexual quality of life, the validation of the Moroccan version of this scale [...] Read more.

Background: The Sexual Health Scale (QLQ-SH22) is the only cancer-specific measure of sexual health. It has never been translated into Arabic. In order to envisage effective healthcare strategies that improve sexual quality of life, the validation of the Moroccan version of this scale is a crucial step in exploring the influence of cancer and its treatment on patients in the Moroccan context. In this regard, this study aimed to validate a Moroccan Arabic version among patients with cancer. Method: A total of 280 Moroccan patients with cancer participated in this study from August 2022 to April 2023. The translation and cross-cultural adaptation of the QLQ-SH22 was performed following the EORTC guidelines. Psychometric validation was explored using the reliability of internal consistency, test–retest reliability, and confirmatory factor analyses (CFA). Results: The analysis revealed a greater internal consistency for both sexual satisfaction (α = 0.83) and sexual pain (α = 0.86). The intraclass correlation coefficient indicated an excellent level of test–retest reliability (from 0.925 to 0.993). The CFA demonstrated high-performing model fit indices (χ2/df = 1.17, SRMR = 0.05, RMSEA = 0.035, GFI = 0.94, CFI = 0.99, TLI = 0.99, IFI = 0.99, NFI = 0.94). The concurrent validity between the QLQ-C30 and QLQ-SH22 confirmed a strong correlation between the fatigue scales in both questionnaires (r = 0.69). This version showed good discrimination between known groups. Conclusions: The QLQ-SH22 Moroccan Arabic version has demonstrated a high level of reliability and validity, and therefore it is now ready for use. Full article

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14 pages, 9276 KiB

Open AccessArticle

Survey of Confidence and Knowledge in Managing Patellofemoral Pain among Physical Therapists in Saudi Arabia

by Marwan M. A. Aljohani, Abdulaziz Awali, Raghad Khalid Aljohani, Moiyad Saleh Aljehani and Yasir S. Alshehri

Healthcare 2024, 12(18), 1891; https://doi.org/10.3390/healthcare12181891 - 21 Sep 2024

Abstract

Background: This study assessed the beliefs and knowledge of physical therapists in Saudi Arabia regarding the management of patellofemoral pain (PFP) and their alignment with current Clinical Practice Guidelines (CPGs). Methods: A cross-sectional survey was conducted, involving 111 licensed physical therapists actively treating [...] Read more.

Background: This study assessed the beliefs and knowledge of physical therapists in Saudi Arabia regarding the management of patellofemoral pain (PFP) and their alignment with current Clinical Practice Guidelines (CPGs). Methods: A cross-sectional survey was conducted, involving 111 licensed physical therapists actively treating PFP patients. The survey included questions about PFP risk factors, prognosis, diagnosis, and treatment, using a Likert scale to measure confidence and knowledge. Results: Readers have significantly greater confidence in the knowledge of managing patients with PFP following current CPGs (p < 0.01). No significant differences were observed between groups in the other items (p > 0.01). However, over 70% of respondents, irrespective of guideline familiarity, held beliefs about risk factors, prognosis, diagnosis, and treatment that were inconsistent with CPGs. Conclusions: These discrepancies highlight a significant knowledge gap that may affect patient care quality. Enhancing education and dissemination efforts regarding CPGs is essential to improve adherence to evidence-based practices among physical therapists in Saudi Arabia. To change practitioners’ preferences, attitudes, and beliefs, more targeted programs and interventions for knowledge dissemination and implementation should be provided. Full article

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14 pages, 551 KiB

Open AccessArticle

Regional Variations in Physical Fitness in Children and Adolescents in Shaanxi Province

by Yanbing Li, Longhai Zhang, Shutong Yang, Ling Zhang, Jiaming Yan, Weixin Chen, Haiqi Zeng, Yuliang Sun and Wenfei Zhu

Healthcare 2024, 12(18), 1890; https://doi.org/10.3390/healthcare12181890 - 20 Sep 2024

Abstract

Objectives: This study aims to examine the geographical variation in physical fitness levels among Chinese children and adolescents in Shaanxi province. Methods: A total of 19,175 children from Shaanxi province with physical fitness data in 2019, participated in the study. Physical fitness was [...] Read more.

Objectives: This study aims to examine the geographical variation in physical fitness levels among Chinese children and adolescents in Shaanxi province. Methods: A total of 19,175 children from Shaanxi province with physical fitness data in 2019, participated in the study. Physical fitness was assessed using body mass index, force vital capacity, 50 m sprint, sit and reach, 1 min rope skipping, sit-ups, 50 m × 8 round-trip running, standing long jump, pull-ups, 800 m, and 1000 m running, and their standardized scores were aggregated to form a summary score. The total score is used to classify the physical fitness levels into four grades (excellence to failure). Results: The Guanzhong (GZ) region scored the highest, while Northern Shaanxi (NS) scored the lowest. The excellence rate for physical fitness was highest in GZ and lowest in NS, while the failure rate was highest in NS and lowest in GZ. Notably, children and adolescents in NS demonstrated the best endurance levels despite their overall lower fitness scores. The comprehensive physical fitness among Chinese children and adolescents in Shaanxi province showed significant regional disparities. GZ region exhibited the highest physical fitness levels, while Northern Shaanxi had the lowest. Conclusions: Region-specific interventions and targeted health policies are essential to address these disparities and improve the overall physical health status of children and adolescents in Shaanxi province. Full article

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17 pages, 2696 KiB

Open AccessArticle

The Impact of Starting Positions and Breathing Rhythms on Cardiopulmonary Stress and Post-Exercise Oxygen Consumption after High-Intensity Metabolic Training: A Randomized Crossover Prospective Study

by Yuanyuan Li, Jiarong Wang, Yuanning Li, Dandan Li, Yining Xu and Yi Li

Healthcare 2024, 12(18), 1889; https://doi.org/10.3390/healthcare12181889 - 20 Sep 2024

Abstract

Background: The exploration of optimizing cardiopulmonary function and athletic performance through high-intensity metabolic exercises (HIMEs) is paramount in sports science. Despite the acknowledged efficacy of HIMEs in enhancing cardiopulmonary endurance, the high metabolic stress imposed on the cardiopulmonary system, especially for amateurs, necessitates [...] Read more.

Background: The exploration of optimizing cardiopulmonary function and athletic performance through high-intensity metabolic exercises (HIMEs) is paramount in sports science. Despite the acknowledged efficacy of HIMEs in enhancing cardiopulmonary endurance, the high metabolic stress imposed on the cardiopulmonary system, especially for amateurs, necessitates a scaled approach to training. Objective: The aim of this study is to ascertain whether adjustments in the initiation posture and the adoption of an appropriate breathing strategy can effectively mitigate the cardiopulmonary stress induced by HIMEs without compromising training efficacy. Methods: Twenty-two subjects were recruited into this study. The post-exercise heart rate (PHR) and post-exercise oxygen consumption rate (POCR) were collected within 30 min after exercise. A two-way ANOVA, multi-variable Cox regression, and random survival forest machine learning algorithm were used to conduct the statistical analysis. Results: Under free breathing, only the maximum POCR differed significantly between standing and prone positions, with prone positions showing higher stress (mean difference = 3.15, p < 0.001). In contrast, the regulated breathing rhythm enhanced performance outcomes compared to free breathing regardless of the starting position. Specifically, exercises initiated from prone positions under regulated breathing recorded a significantly higher maximum and average PHR than those from standing positions (maximum PHR: mean difference = 13.40, p < 0.001; average PHR: mean difference = 6.45, p < 0.001). The multi-variable Cox regression highlighted the starting position as a critical factor influencing the PHR and breathing rhythm as a significant factor for the POCR, with respective variable importances confirmed by the random survival forest analysis. These results underscore the importance of controlled breathing and starting positions in optimizing HIME outcomes. Conclusions: Regulated breathing in high-intensity exercises enhances performance and physiological functions, emphasizing the importance of breathing rhythm over starting position. Effective training should balance exercise volume and technique to optimize performance and minimize stress, reducing overtraining and injury risks. Full article

(This article belongs to the Special Issue Physical Fitness—Effects on Muscle Function and Sports Performance)

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13 pages, 536 KiB

Open AccessArticle

Assessing Misophonia in Young Adults: The Prevalence and Psychometric Validation of the MisoQuest Questionnaire

by Lourival de Almeida Silva, Matias Noll, Gabriel Cunha Siqueira and Alana Karolyne N. Barbosa

Healthcare 2024, 12(18), 1888; https://doi.org/10.3390/healthcare12181888 - 20 Sep 2024

Abstract

Background/Objectives: Misophonia, characterized by strong emotional reactions to specific sounds, poses significant challenges, particularly in academic settings. This study aimed to examine the psychometric properties of the Brazilian version of the MisoQuest in a sample of high school and university students. The primary [...] Read more.

Background/Objectives: Misophonia, characterized by strong emotional reactions to specific sounds, poses significant challenges, particularly in academic settings. This study aimed to examine the psychometric properties of the Brazilian version of the MisoQuest in a sample of high school and university students. The primary objective was to assess its reliability and structural validity to enhance understanding of misophonia in young adults. Methods: A total of 549 students (Mean age = 23.2 years, SD = 9.3; 285 females, 260 males, 4 individuals who did not disclose their gender) participated. Both exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were employed to evaluate the MisoQuest. Fit indices for unifactorial and trifactorial models were compared. Internal consistency was assessed using Cronbach’s alpha. Results: The EFA suggested a dominant single-factor structure with high factor loadings (ranging from 0.60 to 0.79). However, the CFA revealed excellent fit for both unifactorial (CFI and TLI = 1.00, RMSEA close to zero) and trifactorial models (CFI and TLI = 1.00, RMSEA = 0.037). The MisoQuest demonstrated high internal consistency (Cronbach’s alpha = 0.93). Additionally, 4.5% of participants were identified as positive for misophonia based on a predefined cutoff score of 61. Conclusions: The Brazilian version of the MisoQuest is a reliable and valid tool for assessing misophonia. These findings suggest that the instrument may capture multiple dimensions of the disorder. Given the observed prevalence of misophonia and its impact on students, early identification and tailored interventions are crucial for providing adequate support. Further research is needed to refine the tool and expand its clinical utility. Full article

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16 pages, 1425 KiB

Open AccessArticle

Effects of 12 Weeks of Combined Exercise Training in Normobaric Hypoxia on Arterial Stiffness, Inflammatory Biomarkers, and Red Blood Cell Hemorheological Function in Obese Older Women

by Wonil Park, Hun-Young Park and Sung-Woo Kim

Healthcare 2024, 12(18), 1887; https://doi.org/10.3390/healthcare12181887 - 20 Sep 2024

Abstract

Background/Objectives: The present study examined the effect of 12-week combined exercise training in normobaric hypoxia on arterial stiffness, inflammatory biomarkers, and red blood cell (RBC) hemorheological function in 24 obese older women (mean age: 67.96 ± 0.96 years). Methods: Subjects were randomly divided [...] Read more.

Background/Objectives: The present study examined the effect of 12-week combined exercise training in normobaric hypoxia on arterial stiffness, inflammatory biomarkers, and red blood cell (RBC) hemorheological function in 24 obese older women (mean age: 67.96 ± 0.96 years). Methods: Subjects were randomly divided into two groups (normoxia (NMX; n = 12) and hypoxia (HPX; n = 12)). Both groups performed aerobic and resistance exercise training programs three times per week for 12 weeks, and the HPX group performed exercise programs in hypoxic environment chambers during the intervention period. Body composition was estimated using bioelectrical impedance analysis equipment. Arterial stiffness was measured using an automatic waveform analyzer. Biomarkers of inflammation and oxygen transport (tumor necrosis factor alpha, interleukin 6 (IL-6), erythropoietin (EPO), and vascular endothelial growth factor (VEGF)), and RBC hemorheological parameters (RBC deformability and aggregation) were analyzed. Results: All variables showed significantly more beneficial changes in the HPX group than in the NMX group during the intervention. The combined exercise training in normobaric hypoxia significantly reduced blood pressure (systolic blood pressure: p < 0.001, diastolic blood pressure: p < 0.001, mean arterial pressure: p < 0.001, pulse pressure: p < 0.05) and brachial–ankle pulse wave velocity (p < 0.001). IL-6 was significantly lower in the HPX group than in the NMX group post-test (p < 0.001). Also, EPO (p < 0.01) and VEGF (p < 0.01) were significantly higher in the HPX group than in the NMX group post-test. Both groups showed significantly improved RBC deformability (RBC EI_3Pa) (p < 0.001) and aggregation (RBC AI_3Pa) (p < 0.001). Conclusions: The present study suggests that combined exercise training in normobaric hypoxia can improve inflammatory biomarkers and RBC hemorheological parameters in obese older women and may help prevent cardiovascular diseases. Full article

(This article belongs to the Special Issue Non-pharmacological Interventions in Older Adults)

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12 pages, 662 KiB

Open AccessArticle

Dentitions of Long-Term Care Residents: Tooth Types, Roles in Occlusion and Association with Dementia

by Jesse Tervonen, Lina Julkunen, Riitta K. T. Saarela, Kaija Hiltunen and Päivi Mäntylä

Healthcare 2024, 12(18), 1886; https://doi.org/10.3390/healthcare12181886 - 20 Sep 2024

Abstract

Background/Objectives: Many older adults living in long-term care (LTC) environments have varying numbers of retained natural teeth. The objective of this study was to assess the disease findings based on tooth type and estimate the role of tooth types in occlusion. Methods: We [...] Read more.

Background/Objectives: Many older adults living in long-term care (LTC) environments have varying numbers of retained natural teeth. The objective of this study was to assess the disease findings based on tooth type and estimate the role of tooth types in occlusion. Methods: We conducted clinical oral examinations of 276 LTC residents. The disease findings were analyzed for each tooth type and to determine their associations with dementia. Results: In total, 67.8% of the participants had molar teeth. Premolars/canines were often present as residual roots and had caries. Deepened periodontal pockets and higher plaque index (PI) values for molars had odds ratios of 2.5 (95% confidence interval [CI] of 1.59–3.91) and 1.61 (95% CI of 1.29–2.02), respectively. Participants with dementia were more likely to have incisors and premolars/canines in the form of root remnants and higher PI scores for all tooth types (p ≤ 0.01), as well as more deepened periodontal pockets in all teeth (p = 0.029), than those without dementia. The median number of remaining molars per participant was 3 out of a maximum of 12 (95% CI 3.4–4.0); thus, they often lacked occlusal contact. Conclusions: The LTC residents’ molars were more prone to periodontal problems, whereas their premolars/canines often had caries or were present in the form of root remnants, especially in the participants with dementia. People’s teeth should be treated in an easy-to-maintain way before they move into LTC to enable daily oral hygiene measures and maintain oral health. Full article

(This article belongs to the Special Issue Oral Health and Quality of Life in Older People)

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14 pages, 272 KiB

Open AccessArticle

Stress among Nursing Students in the Era of the COVID-19 Pandemic

by Grzegorz Kobelski, Katarzyna Naylor, Aleksandra Kobelska and Mariusz Wysokiński

Healthcare 2024, 12(18), 1885; https://doi.org/10.3390/healthcare12181885 - 20 Sep 2024

Abstract

Introduction: The COVID-19 pandemic has significantly impacted stress levels across various professions, particularly in the medical field. This increase in stress has also affected medical students, including nursing students, who faced unprecedented and challenging circumstances. Nursing students, in particular, experienced added pressure due [...] Read more.

Introduction: The COVID-19 pandemic has significantly impacted stress levels across various professions, particularly in the medical field. This increase in stress has also affected medical students, including nursing students, who faced unprecedented and challenging circumstances. Nursing students, in particular, experienced added pressure due to observing the frontline experiences of nurses and the new demands placed upon them. Aim: This study aimed to assess whether the COVID-19 pandemic affected an increase in stress levels among nursing students in Poland during the pandemic. We also attempt to determine whether there is a correlation between the stress level of students and factors such as gender, age, place of residence, marital status, and level of education. Assuming that the stress level will be higher among women of increasing age and bachelor’s students, we also assumed, however, that lower stress levels would occur among people in relationships and living in the countryside. Materials and Methods: The study was conducted from 27 April 2022 to 12 May 2022. We chose that period as it was the final one of the COVID-19 pandemic, and there was an increasing amount of discussion concerning its cessation, with the public accustomed to its presence in our everyday lives. Since we wanted to determine the stress level experienced by students, we decided to use the standardized Perceived Stress Scale (PSS-10). We enriched the study with sociodemographic questions to investigate the potential impact of these characteristics on the degree of stress experienced. Results: The average score obtained by respondents on the PSS-10 was 19.57 ± 6.03. Of the respondents, 49% reported experiencing a high level of stress. No statistically significant differences were found between the mean PSS-10 scores and the gender (Z = 0.169; p = 0.865), age (F = 1.282, p = 0.281), marital status (Z = −0.776, p = 0.437), or place of residence (urban vs. rural) (Z = −0.784, p = 0.433) of the respondents. The mean PSS-10 scores were also analyzed regarding the level of education (bachelor’s vs. master’s). Bachelor’s students had an average PSS-10 score of 18.95 ± 6.42, while master’s students scored 20.05 ± 5.70. Again, no statistically significant differences were found (t = −1.102, p = 0.2720). Conclusions: The study indicated that nursing students experience high stress levels regardless of gender, age, marital status, place of residence, or level of education. High stress levels were reported among both bachelor’s and master’s students. Full article

(This article belongs to the Special Issue Human Health before, during, and after COVID-19)

9 pages, 925 KiB

Open AccessArticle

Correlation of Near-Infrared Spectroscopy (NIRS) with Invasive Arterial Pressure Monitoring during Aortic Coarctation Surgery in Pediatric Patients

by Jelena Pjevalica Dragic, Tatjana Zecevic, Ivan Divac, Andrija Pavlovic, Dejan Bisenic, Luka Stanisic, Jasna Kalanj, Igor Stefanovic, Dejan Nikolic, Ivana Petrov and Vladimir Milovanovic

Healthcare 2024, 12(18), 1884; https://doi.org/10.3390/healthcare12181884 - 20 Sep 2024

Abstract

Aortic coarctation surgery in pediatric patients requires the placement of two arterial cannulas to monitor pressure gradients and surgical correction adequacy. Near-infrared spectroscopy (NIRS) monitoring provides insight into regional blood flow. This study aimed to investigate the correlation between NIRS values and invasive [...] Read more.

Aortic coarctation surgery in pediatric patients requires the placement of two arterial cannulas to monitor pressure gradients and surgical correction adequacy. Near-infrared spectroscopy (NIRS) monitoring provides insight into regional blood flow. This study aimed to investigate the correlation between NIRS values and invasive arterial pressures, exploring NIRS monitoring as a potential substitute for arterial cannulation. In a cohort of 21 consecutive pediatric patients undergoing aortic coarctation surgery, recordings of NIRS and invasive arterial pressure values were evaluated at various time intervals. Pearson correlation evaluated the relationship between NIRS values and invasively measured arterial pressures. Moderate to strong correlations were observed between the mean arterial pressure (MAP) of the upper and lower arteries and cerebral (rSO₂-C) and somatic (rSO₂-S) NIRS values 5 min after cross-clamp placement (r = 0.621, p = 0.003; r = 0.757, p < 0.001). Strong correlations were found 15 min after cross-clamp placement (r = 0.828, p = 0.002; r = 0.783, p = 0.004). Before transfer to the ICU, a strong correlation existed between the upper artery MAP and rSO₂-C (r = 0.730, p < 0.001), but there was no correlation between the lower artery MAP and rSO₂-S. These findings are promising, but further studies are required to validate it as a reliable substitute for invasive pressure monitoring in this patient population. Full article

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12 pages, 1246 KiB

Open AccessProtocol

Factors Influencing the Participation of Shared Decision Making in Stable Coronary Artery Disease Patient: Protocol of a Mixed Methods Study

by Xiangxu Meng, Chengang Hong and Xingwei Zhang

Healthcare 2024, 12(18), 1883; https://doi.org/10.3390/healthcare12181883 - 20 Sep 2024

Abstract

Introduction: The “paternalistic decision-making model” is no longer well suited to the modern clinical environment, and therefore, shared decision making (SDM) has emerged as a key approach. Although the benefits of SDM have been largely reported, several studies have reported low participation in [...] Read more.

Introduction: The “paternalistic decision-making model” is no longer well suited to the modern clinical environment, and therefore, shared decision making (SDM) has emerged as a key approach. Although the benefits of SDM have been largely reported, several studies have reported low participation in SDM in coronary artery disease (CAD) patients. The theory of planned behavior (TPB) model is one of the most frequently employed theoretical frameworks for predicting human behaviors. According to the TPB, intention is influenced by attitude, subjective norm, and perceived behavioral control, while behavior is influenced by both intention and perceived behavioral control. Therefore, we propose a mixed methods study based on TPB to investigate the status of Chinese stable coronary artery disease (SCAD) patients’ participation in SDM, understand their experiences of SDM, and explore the factors that influence their participation in SDM. Materials and Methods: An explanatory sequential mixed methods design will be used to explore the study aims, including a quantitative phase, a subsequent qualitative phase, and the final integration study. The quantitative study will use convenient sampling from the Affiliated Hospital of Hangzhou Normal University to conduct a cross-sectional survey (n ≥ 252). The qualitative study will be sampled using the maximum difference sampling method from the quantitative study results, and then the data will be collected through semi-structured interviews (n = 10–20). This study will use descriptive statistics and test hypotheses while considering a p-value of <0.05, which will be considered statistically significant. Discussions: The study employs a mixed method approach with an explanatory sequential design, incorporating qualitative and quantitative methods to comprehensively understand the factors influencing SCAD patients’ participation in SDM. Furthermore, these findings can inform the design of future intervention studies and provide healthcare providers with targeted information and communication to help SCAD patients make the most appropriate decisions. Study participants will be recruited using convenience sampling from just one single clinical setting, which may limit the findings’ generalizability. Ethics and Dissemination: This study has been approved by the Ethical Committee of the School of Nursing, Hangzhou Normal University (Approval No.: 2024013). All the participants will sign an informed consent form before participating in the survey. The corresponding results and conclusions will be disseminated in journals and conferences after the completion of the study. Full article

(This article belongs to the Special Issue Shared Decision-Making in Healthcare)

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13 pages, 1749 KiB

Open AccessArticle

The Mediating Roles of Lung Function Traits and Inflammatory Factors on the Associations between Measures of Obesity and Risk of Lower Respiratory Tract Infections: A Mendelian Randomization Study

by Xiaofeng Ma, Pan-Pan Zhu, Qian Yang, Yangbo Sun, Chun-Quan Ou and Li Li

Healthcare 2024, 12(18), 1882; https://doi.org/10.3390/healthcare12181882 - 20 Sep 2024

Abstract

Background: Identifying mediators between obesity-related traits and lower respiratory tract infections (LRTIs) would inform preventive and therapeutic strategies to reduce the burden of LRITs. We aimed to recognize whether lung function and inflammatory factors mediate their associations. Methods: We conducted a two-step, two-sample [...] Read more.

Background: Identifying mediators between obesity-related traits and lower respiratory tract infections (LRTIs) would inform preventive and therapeutic strategies to reduce the burden of LRITs. We aimed to recognize whether lung function and inflammatory factors mediate their associations. Methods: We conducted a two-step, two-sample Mendelian randomization (MR) analysis. Two-sample MR was performed on (1) obesity-related traits (i.e., body mass index [BMI], waist circumference [WC], and waist-to-hip ratio [WHR]) and LRTIs (i.e., acute bronchitis, acute bronchiolitis, bronchiectasis, influenza, and pneumonia), (2) obesity-related traits and potential mediators, and (3) potential mediators and LRTIs. Next, two-step MR was applied to infer whether the mediation effects exist. Results: We found that C-reactive protein (CRP), interleukin-6 (IL-6), and forced expiratory volume in the first second (FEV1) mediated 32.59% (95% CI: 17.90%, 47.27%), 7.96% (95% CI: 1.79%, 14.14%), and 4.04% (95% CI: 0.34%, 7.74%) of the effect of BMI on pneumonia, and they mediated 26.90% (95% CI: 13.98%, 39.83%), 10.23% (95% CI: 2.72%, 17.73%), and 4.67% (95% CI: 0.25%, 9.09%) of the effect of WC on pneumonia, respectively. Additionally, CRP, forced vital capacity (FVC), and FEV1 mediated 18.66% (95% CI: 8.70%, 28.62%), 8.72% (95% CI: 1.86%, 15.58%), and 8.41% (95% CI: 2.77%, 14.06%) of the effect of BMI on acute bronchitis, and they mediated 19.96% (95% CI: 7.44%, 32.48%), 12.19% (95% CI: 2.00%, 22.39%), and 12.61% (95% CI: 2.94%, 22.29%) of the effect of WC on acute bronchitis, respectively. Conclusions: Health interventions linked to reducing inflammation and maintaining normal lung function could help mitigate the risk of obesity-related LRTIs. Full article

(This article belongs to the Special Issue The Relationship between Eating Habits, Obesity and Diabetes)

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14 pages, 270 KiB

Open AccessArticle

Translation, Cross-Cultural Adaptation and Validation of the Lymphedema Quality of Life Questionnaire (LYMQOL) in German-Speaking Patients with Upper Limb Lymphedema

by Torsten Schulz, Mary Lee Warg, Simon Heister, Kristin Lidzba, Günce Ciklatekerlio, Yasmin Molter, Stefan Langer and Rima Nuwayhid

Healthcare 2024, 12(18), 1881; https://doi.org/10.3390/healthcare12181881 - 20 Sep 2024

Abstract

Objectives: The LYMQOL is the most frequently translated, validated, objective tool for assessing Health-Related Quality of Life (HRQoL) in individuals with upper limb lymphedema (ULL). There have been adaptations and validations in a number of different countries. While a German version of LYMQOL [...] Read more.

Objectives: The LYMQOL is the most frequently translated, validated, objective tool for assessing Health-Related Quality of Life (HRQoL) in individuals with upper limb lymphedema (ULL). There have been adaptations and validations in a number of different countries. While a German version of LYMQOL Leg for lower limb lymphedema is available, a validated translation of LYMQOL Arm to German is lacking. We aimed to perform a cross-cultural adaption and translation according to ISPOR principles. Methods: Patients suffering from ULL from Germany, Austria, and Switzerland (n = 52) were questioned twice using the translated LYMQOL Arm, SF-36, and an evaluation questionnaire. The assessment of the content validity and face validity proved this version of LYMQOL Arm to be acceptable for interviewing German-speaking patients with ULL in Germany. Results: Comparison of LYMQOL Arm and SF-36 demonstrated good construct validity. Test–retest reliability was moderate to good (intraclass correlation coefficients 0.66–0.73). Cronbach’s alpha values varied between 0.79 and 0.89 in both interviews, indicating good internal consistency. Factor analysis revealed a cumulative variance of 59.5% for the four domains of the questionnaire. Conclusion: There was no significant association between lymphedema stage and LYMQOL Arm score. This trial tested the appropriateness of the German version of the LYMQOL Arm for measuring HRQoL in German-speaking individuals with ULL. Full article

31 pages, 782 KiB

Open AccessSystematic Review

The Effectiveness of Nonpharmacological Interventions in the Management of Chemotherapy Physical Side Effects: A Systematic Review

by Valentina Elisabetta Di Mattei, Gaia Perego, Francesca Milano and Francesca Gatti

Healthcare 2024, 12(18), 1880; https://doi.org/10.3390/healthcare12181880 - 19 Sep 2024

Abstract

Background: Despite advancements in cancer treatment, chemotherapy side effects significantly impact patients both physically and emotionally. While pharmacological treatments can mitigate these side effects, they may trigger additional side effects, exacerbating the overall discomfort experienced by patients; moreover, psychological factors influencing physical symptoms [...] Read more.

Background: Despite advancements in cancer treatment, chemotherapy side effects significantly impact patients both physically and emotionally. While pharmacological treatments can mitigate these side effects, they may trigger additional side effects, exacerbating the overall discomfort experienced by patients; moreover, psychological factors influencing physical symptoms are beyond the reach of pharmacological interventions. Nonpharmacological interventions, however, offer the potential for complementary or alternative solutions. Objectives: This review aims to offer a comprehensive analysis of the literature on the effectiveness of nonpharmacological interventions in managing the physical side effects of chemotherapy. Methods: This review, based on a search of PubMed, PsycINFO, and Web of Science databases, identified 46 relevant studies. It categorizes interventions and evaluates their effectiveness in managing common chemotherapy side effects (fatigue, nausea, pain, diarrhea, and constipation). Results: Guided imagery, tailored exercises, and Qigong show promise in reducing fatigue, while interventions like yoga and cognitive-behavioral approaches address nausea and vomiting. Pain benefits result from guided imagery and educational interventions. Limited evidence exists for diarrhea and constipation interventions, necessitating further research. Conclusions: This review offers provisional conclusions, emphasizing the potential of integrating evidence-based nonpharmacological approaches alongside pharmacological interventions to enhance patient outcomes and reduce chemotherapy-induced side effects, considering factors such as accessibility, safety, customization, and adaptability in clinical settings. Full article

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13 pages, 1336 KiB

Open AccessArticle

Association between Multi-Domain Lifestyle and Objective Cognitive Impairment in Elderly People with SCD and MCI in Chinese Communities

by Yuqin Sun, Ruifen Zhang, Zhiqun Mao, Jiajun Yin, Yuanyuan Zhou and Yue Wu

Healthcare 2024, 12(18), 1879; https://doi.org/10.3390/healthcare12181879 - 19 Sep 2024

Abstract

Objectives: Controlling the lifestyle associated with dementia risk can delay the process of cognitive decline. Subjective cognitive decline (SCD) and mild cognitive impairment (MCI) are early states in the development of dementia and are also the window period for early intervention in dementia. [...] Read more.

Objectives: Controlling the lifestyle associated with dementia risk can delay the process of cognitive decline. Subjective cognitive decline (SCD) and mild cognitive impairment (MCI) are early states in the development of dementia and are also the window period for early intervention in dementia. The purpose of this study was to explore the association between multi-domain lifestyle and objective cognitive impairment in elderly people with SCD and MCI in Chinese communities and to provide reference for effective implementation of precise health management measures to reduce the risk of dementia. Methods: A total of 265 middle-aged and elderly volunteers recruited from the community were divided into SCD group (107 cases), MCI group (80 cases), and healthy control (HC) group (78 cases). All participants received clinical interview, examination, and cognitive assessments. Results: The total Dementia Risk Reduction Lifestyle Scale (DRRLS) scores in the HC, SCD, and MCI groups [110.00 (11.25) vs. 101.00 (10.00) vs. 79.50 (20.75)] exhibited statistically significant differences among them. The total score of the DRRLS showed a significant negative correlation with the Trail-Making Test (TMT), and significant positive correlations with both the Verbal Fluency Test (VFT) and Auditory Verbal Learning Test (AVLT) scores (p < 0.05). After adjusting for confounding factors, such as age and years of education, multiple linear regression analysis revealed several points. In the SCD group, brain-strengthening exercise and interpersonal relationship scores were negatively correlated with TMT scores (β = −11.257, −15.077; all p < 0.05), while health responsibility, smoking control behavior, and interpersonal relationship scores were positively correlated with AVLT scores (β = 0.485, 0.344, and 0.406; all p < 0.05). In the MCI Group, brain-strengthening exercise, brain-healthy diet, and interpersonal relationship were negatively correlated with TMT (β = −22.011, −16.206, −11.696; all p < 0.01), whereas health responsibility, mental activity, smoking control behavior, interpersonal relationship, and stress management were positively correlated with AVLT (β = 0.450, 0.435, 0.308, 0.256, 0.607; all p < 0.05). Conclusions: In Chinese communities, the unhealthy lifestyle of elderly individuals with SCD and MCI is significantly associated with cognitive function impairment. The greater their unhealthy lifestyle habits, the more pronounced the scope and severity of cognitive function impairment becomes. Furthermore, different dimensions of lifestyle have varying impacts on cognitive domains. Full article

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10 pages, 1090 KiB

Open AccessArticle

Association of Tai Chi and Square Dance with Cognitive Function in Chinese Older Adults

by Xiaoguang Zhao, Dongxue Liu and Jin Wang

Healthcare 2024, 12(18), 1878; https://doi.org/10.3390/healthcare12181878 - 19 Sep 2024

Abstract

Objective: This study explores the association of Tai Chi and square dance with cognitive function and compares the effects of the two fitness programs on cognitive function in Chinese older adults. Methods: A total of 1732 older people (aged 60 years and over) [...] Read more.

Objective: This study explores the association of Tai Chi and square dance with cognitive function and compares the effects of the two fitness programs on cognitive function in Chinese older adults. Methods: A total of 1732 older people (aged 60 years and over) met the inclusion criteria from the 2018 Chinese Longitudinal Healthy Longevity Survey. Based on the frequency of participating in Tai Chi and square dance, older adults were divided into three groups: a Tai Chi group (n = 234), a square dance group (n = 345), and a control group (n = 1153). Cognitive function was measured using a modified Mini-Mental State Examination (MMSE). Participation in Tai Chi or square dance was investigated by asking the subjects to report how often they participated in the fitness programs. Results: Older adults in both the Tai Chi group and the square dance group had higher scores in all MMSE items, including orientation, registration, attention and calculation, recall, and language, compared to those in the control group. But there were no significant differences in any MMSE items between the Tai Chi group and the square dance group. Multiple regression analysis showed that participating in Tai Chi or square dance, age, educational level, and sex can predict cognitive function in older people. Conclusion: Our findings suggest that participating in Tai Chi and square dance are associated with better cognitive function, and Tai Chi and square dance have similar effects on cognitive function in the Chinese older population. Full article

(This article belongs to the Topic Effects of Exercise Behavior and Amount of Exercise on Public Health: How to Overcome Barriers to Increase Adherence)

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9 pages, 378 KiB

Open AccessArticle

Assessment of General Population Understanding and Awareness of Drug Addiction before and after a Health Educational Campaign in Taif City, Saudi Arabia

by Mohammad S. Alzahrani, Huriyyah A. Alotaibi, Shahad M. Alhumayani, Hadeel F. Aljuaid, Refah S. Alghamdi and Yusuf S. Althobaiti

Healthcare 2024, 12(18), 1877; https://doi.org/10.3390/healthcare12181877 - 19 Sep 2024

Abstract

Objectives: An awareness campaign was carried out in Taif City to increase awareness about substance abuse and its dangers. This study sought to evaluate the effectiveness of the campaign in enhancing the study participants’ awareness and knowledge about drug addiction. Methods: Using pre- [...] Read more.

Objectives: An awareness campaign was carried out in Taif City to increase awareness about substance abuse and its dangers. This study sought to evaluate the effectiveness of the campaign in enhancing the study participants’ awareness and knowledge about drug addiction. Methods: Using pre- and post-campaign surveys, we assessed the campaign’s impact on participants’ understanding of drug addiction. The survey included demographic items, followed by 12 items for awareness, rated on a 5-point Likert scale, with the total scores ranging up to 60. Results: A total of 146 visitors, with a mean age of 33.4 years (SD = 9.2), completed both the pre- and post-questionnaires. Notably, in the post-campaign, 47.3% of the participants acknowledged the risk of IV drug-related infections, a substantial increase from 28.1% from the pre-campaign. Overall, the mean total awareness score increased significantly, from 47.4 (SD = 6.6) pre-campaign to 50.4 (SD = 6.4) post-campaign (paired t = −4.052, p < 0.001). Conclusion: These findings highlight the potential of such campaigns to significantly improve understanding and awareness of drug addiction. Full article

(This article belongs to the Special Issue Addiction, Substance Use, and Mental Illness: A Public Health Perspective)

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17 pages, 729 KiB

Open AccessSystematic Review

Effectiveness of Mindfulness-Based Interventions with Respect to Psychological and Biomedical Outcomes in Young People with Type 1 Diabetes: A Systematic Review

by Tamara Gutiérrez-Domingo, Naima Z. Farhane-Medina, Joaquín Villaécija, Sebastián Vivas, Carmen Tabernero, Rosario Castillo-Mayén and Bárbara Luque

Healthcare 2024, 12(18), 1876; https://doi.org/10.3390/healthcare12181876 - 19 Sep 2024

Abstract

Background: Type 1 diabetes is a chronic disease especially affecting young people. Mindfulness-based psychological interventions might reduce emotional symptoms post-diagnosis, but the evidence is limited. Objectives: This systematic review aimed to evaluate the effectiveness of mindfulness interventions on psychological well-being and biomedical variables [...] Read more.

Background: Type 1 diabetes is a chronic disease especially affecting young people. Mindfulness-based psychological interventions might reduce emotional symptoms post-diagnosis, but the evidence is limited. Objectives: This systematic review aimed to evaluate the effectiveness of mindfulness interventions on psychological well-being and biomedical variables in young people with type 1 diabetes. Methods: A systematic review of trials was conducted that involved a bibliographic search in electronic databases (Web of Science, MEDLINE, SciELO, Scopus, PsycINFO, and Cochrane Library) considering studies published between 2013 and 2024. Results: A total of 434 records were identified, of which 252 underwent selection according to title and abstract, leaving 32 that were evaluated for eligibility and 7 included in this review. From Google Scholar, six more studies were identified and evaluated, and two were selected. Finally, nine studies were subjected to full reading and a detailed analysis of the inclusion criteria. A total of 66.6% of the studies were evaluated as having a methodological quality of moderate or optimal, but the samples analysed tended to be small, and only two articles carried out short-term follow-up evaluations. Conclusions: Mindfulness-based interventions, upon reviewing the preliminary results, may be posited as a viable strategy to enhance psychological (anxiety, diabetes distress, perceived stress, depression, self-efficacy, psychological well-being, and quality of life) and biomedical outcomes (glycaemic control, blood glucose levels, and diastolic blood pressure) for type 1 diabetes in young people. Although promising, further research is required to improve the quality, methodology, and design of studies. Full article

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11 pages, 2184 KiB

Open AccessArticle

The Prevalence of Chronic Interosseous Membrane Lesions Following Mason II and III Radial Head Fractures in Complex Elbow Instability—A Retrospective Observational Cohort Study

by Giuseppe Giannicola, Luca Di Sante, Giulia Corsi, Carmine Zoccali, Sebastien Prigent, Gianluca Cinotti and Pasquale Sessa

Healthcare 2024, 12(18), 1875; https://doi.org/10.3390/healthcare12181875 - 19 Sep 2024

Abstract

Purpose: The primary aim of the present study was to assess the prevalence of chronic lesions of the central band of the interosseous membrane (cbIOM) in complex elbow instability (CEI) in a consecutive series of patients who had previously undergone surgical treatment for [...] Read more.

Purpose: The primary aim of the present study was to assess the prevalence of chronic lesions of the central band of the interosseous membrane (cbIOM) in complex elbow instability (CEI) in a consecutive series of patients who had previously undergone surgical treatment for Mason II and III radial head (RH) fractures. The secondary aim was to define its clinical significance. Methods: We performed a retrospective study on a prospective database. Our study population comprised 93 patients affected by CEI with type II or III RH fractures according to Mason’s classification who were analyzed in the chronic setting. All patients were treated according to the current therapeutic algorithms. At the last follow-up, the “muscular hernia sign” was investigated by means of a bilateral ultrasonographic examination to assess any chronic cbIOM lesions; the Mayo Elbow Performance Score (MEPS) was used to evaluate the clinical significance of these lesions. Results: All 93 patients were assessed after a mean time of 7.3 years (range: 2–12). No positive “hernia signs” were found, while five patients (5.4%) displayed an increased laxity of the cbIOM when compared with the contralateral side despite a negative “hernia sign”. The clinical outcome in all five patients was excellent with a mean MEPS of 96 (range, 90–100). Conclusions: Chronic cbIOM lesions are very rare in CEI with RH fractures. No patients in this large sample displayed a cbIOM complete lesion; in cases with increased laxity, satisfactory mid-term clinical results were observed. Considering that previous studies reported (1) a high prevalence of cbIOM lesions in patients with Mason II and III RH fractures and (2) the current expert opinion about the scarce healing potential of the cbIOM, this study also suggests that the IOM may heal better than previously believed when RH fractures are treated appropriately in the acute setting. Full article

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Healthcare, Volume 12, Issue 18 (September-2 2024) – 104 articles

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