Healthcare

19 pages, 1827 KiB

Open AccessArticle

Understanding Non-Pharmacological Treatments for Fibromyalgia Functional and Well-Being Status: The Role of Literacy

by Anca Maria Amzolini, Carmen Daniela Neagoe, Taina Elena Avramescu, Adina Mitrea, Rodica Traistaru, Elena Simona Micu, Simona Laura Ianoşi and Daniela Matei

Healthcare 2024, 12(19), 1956; https://doi.org/10.3390/healthcare12191956 - 30 Sep 2024

Abstract

Background/Objectives: Fibromyalgia (FM) affects up to 5% of the global population and is a leading cause of significant social and economic consequences. Higher health literacy leads to better understanding of treatment plans, improved self-care, and adherence to recommendations, enhancing overall quality of life. [...] Read more.

Background/Objectives: Fibromyalgia (FM) affects up to 5% of the global population and is a leading cause of significant social and economic consequences. Higher health literacy leads to better understanding of treatment plans, improved self-care, and adherence to recommendations, enhancing overall quality of life. This study aims to determine whether different aspects of the disease are influenced by patients’ education level and literacy when applying the same therapy and to assess how patients’ perceptions of therapy outcomes vary over time based on their educational level. Methods: This study involved 140 fibromyalgia (FM) patients diagnosed using the 2016 ACR criteria, with 128 completing the study. Participants attended three visits over 28 weeks and were stratified into four groups based on educational level: Group 1—secondary school or less; Group 2—high school graduates; Group 3—college graduates; Group 4—university graduates. Patients were assigned to groups (n = 32, 32, 30, and 34, respectively) after the initial evaluation (T0). The treatment was assessed (T1) and followed up three months later (T2) to evaluate changes in functional status and quality of life. All patients underwent the same rehabilitation program, cognitive therapy, and kinesiotherapy. Results: Significant differences in disease impact on the patient’s life (FIQ total score) were observed between groups from the initial evaluation (p = 0.000). The overall FIQ score was notably affected by non-pharmacological therapy in patients with higher education. These differences continued to be significant even three months after the treatment ended (p = 0.000). Functional limitations were evident from the start (p = 0.000) and improved significantly post-treatment in patients with higher education (p = 0.000). However, subjective evaluations of disease impact (assessed by the first item of FIQ) did not consistently align with objective findings (hand grip strength). Functional limitations did not significantly differ in subjective evaluations (F1Q1) across educational levels (p = 0.045), and inverse correlations were noted between functional status and SF-12 well-being components. Conclusions: This study underscores that higher education enhances fibromyalgia management and functional outcomes, particularly when combined with non-pharmacological therapies. However, subjective perceptions may not always align with objective improvements, indicating that factors beyond education, such as personal and external influences, also impact disease management. Thus, improving health literacy through educational interventions could further benefit FM patients’ quality of life. Full article

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17 pages, 1339 KiB

Open AccessArticle

Oral Health Behaviour, Care Utilisation, and Barriers among Students with Disabilities: A Parental Perspective

by Faris Yahya I. Asiri, Marc Tennant and Estie Kruger

Healthcare 2024, 12(19), 1955; https://doi.org/10.3390/healthcare12191955 - 30 Sep 2024

Abstract

Background: Oral health is a critical component of overall well-being. However, students with disabilities (SWDs) face unique challenges in maintaining oral hygiene and accessing dental care. This study aims to explore oral health behaviours, dental care utilisation, and barriers to accessing dental care [...] Read more.

Background: Oral health is a critical component of overall well-being. However, students with disabilities (SWDs) face unique challenges in maintaining oral hygiene and accessing dental care. This study aims to explore oral health behaviours, dental care utilisation, and barriers to accessing dental care among SWDs in Al-Ahsa, Saudi Arabia, from the perspectives of their parents. Methods: A descriptive cross-sectional study was conducted among parents of SWDs in Al-Ahsa, Saudi Arabia. Data were collected using a validated questionnaire covering oral health behaviours, dental care utilisation, and barriers to care. The sample size was determined based on the SWDs population in the region. Data were analysed using descriptive and analytical statistics, with significant associations identified at p < 0.05. Results: Findings revealed that 45.7% of SWDs brushed irregularly, with only 16.8% brushing twice a day or more. Dental flossing was reported by just 4.3% of SWDs. Emergency-based dental visits were common (51.9%), and 29.5% of SWDs had never visited a dentist. Significant associations were found between maternal education and tooth brushing frequency (p = 0.004) and between parental education and the frequency of dental visits (p = 0.035). The most reported barriers included fear of treatment (47.1%), difficulty finding willing dentists (45.5%), and long wait times for appointments (44.7%). Conclusions: The study emphasises the pressing need for targeted interventions to improve oral hygiene practices and enhance accessibility to dental services for SWDs. Full article

(This article belongs to the Special Issue Oral Health Status of Children and Adolescents)

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12 pages, 1033 KiB

Open AccessArticle

Translation, Cultural Adaptation of the Portuguese Provider Attitudes toward Cardiac Rehabilitation and Referral (PACRR-P) Scale and Assessment of Its’ Measurement Properties

by Mayara Moura Alves da Cruz, Luiz Carlos Marques Vanderlei, Carolina Takarashi, Maria Julia Lopez Laurino, Murilo Reis Alves da Cruz, Sherry L. Grace and Gabriela L. M. Ghisi

Healthcare 2024, 12(19), 1954; https://doi.org/10.3390/healthcare12191954 - 30 Sep 2024

Abstract

Background/Objectives: Access to cardiac rehabilitation (CR) is contingent upon physician referrals, yet these are often inadequate, particularly in low-resource settings. This multi-method study aimed to translate, culturally adapt, and validate the Portuguese version of the Provider Attitudes toward CR and Referral (PACRR-P) scale, [...] Read more.

Background/Objectives: Access to cardiac rehabilitation (CR) is contingent upon physician referrals, yet these are often inadequate, particularly in low-resource settings. This multi-method study aimed to translate, culturally adapt, and validate the Portuguese version of the Provider Attitudes toward CR and Referral (PACRR-P) scale, as well as to identify key factors influencing CR referral in a Latin American context for the first time. Methods: The PACRR was translated into Brazilian Portuguese through a rigorous process involving independent translation, back-translation, and expert panel review to ensure face, content, and cross-cultural validity. A total of 44 Brazilian physicians completed the questionnaire, allowing for an assessment of internal consistency, criterion validity, and convergent validity. Results: The findings confirmed the face, content, and cultural validity of the 20 translated items, with a mean item clarity rating of 4.8/5. The final version included 17 of the original 19 PACRR-P items, with a Cronbach’s alpha of 0.73. Referral rates were significantly associated with over one-third of the PACRR-P items, preliminarily supporting the scale’s criterion validity, while correlations with the ReCaRe scores further supported its convergent validity. The most prominent barriers to referral were a lack of familiarity with CR site locations, absence of a standard referral form, and lack of automatic referral processes. Conclusions: The PACRR’s validity and reliability among Portuguese-speaking providers are preliminarily supported. Full article

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10 pages, 232 KiB

Open AccessStudy Protocol

Modified Oral Health Assessment Tool (M-OHAT) for Residential Aged Care: A Co-Design Protocol

by Laura J. Ferris, Kristiana Ludlow, Nicole Walker, Andrew Georgiou, Julie D. Henry, Claudia Lopez Silva, Diep H. Ha, Nicole Stormon, Laurence J. Walsh, Saso Ivanovski, Christopher Sexton, Helena Silveira Schuch, Haitham Tuffaha, Angelique Zamora, Lyndal Pritchard and Loc G. Do

Healthcare 2024, 12(19), 1953; https://doi.org/10.3390/healthcare12191953 - 30 Sep 2024

Abstract

Background: Older adults in residential aged care facilities (RACFs) experience disproportionate levels of poor oral health relative to other groups in the general population, affecting their physical and mental wellbeing. The Oral Health Assessment Tool (OHAT) is a validated and widely used [...] Read more.

Background: Older adults in residential aged care facilities (RACFs) experience disproportionate levels of poor oral health relative to other groups in the general population, affecting their physical and mental wellbeing. The Oral Health Assessment Tool (OHAT) is a validated and widely used dental assessment tool; however, recent systematic reviews have identified shortcomings with respect to its measurement properties. Objective: The objective of this protocol is to provide a detailed overview of a multidisciplinary qualitative study that aims to (a) co-design and develop a modified OHAT for RACFs and (b) inform the development of an OHAT training package and implementation strategies. Methods: This study will utilize a co-design methodology with aged care residents, caregivers, staff members, and health professionals. The co-design workshops will: (1) investigate the barriers to and enablers of optimal oral healthcare in RACFs; and (2) co-design a modified version of the Oral Health Assessment Tool and a referral to treatment pathway that is appropriate for use in RACFs. The co-design workshops will facilitate group discussion and involve interactive activities using, for example, mind mapping and Sticky Notes. Qualitative data (transcripts and artefacts from co-design activities) will be analyzed in NVivo using an inductive codebook thematic analysis, specifically a template analysis. Conclusion: The findings of this study will inform a modified OHAT (M-OHAT), as well as future study phases regarding training and implementation strategies. It is expected that the M-OHAT will have enhanced usability and relevance to RACFs, facilitating the identification of poor oral health and timely referral to dental treatment. Full article

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

10 pages, 262 KiB

Open AccessArticle

Perceptions and Interest in Lung Cancer Screening by Smoking Status: A Cross-Sectional Study of HINTS 6 (2022)

by Wenxue Lin, Ibrahim Alasqah, Saad A. Alotaibi, Nada Alqarawi, Sulaiman Sulmi Almutairi, Ariana Saraiva and António Raposo

Healthcare 2024, 12(19), 1952; https://doi.org/10.3390/healthcare12191952 - 30 Sep 2024

Abstract

Background: Lung cancer screening guidelines prioritize individuals with a history of smoking due to their higher risk of the disease. Methods: Our study examines the awareness and interest in low-dose computed tomography (LDCT) lung cancer screening among different smoking statuses using data from [...] Read more.

Background: Lung cancer screening guidelines prioritize individuals with a history of smoking due to their higher risk of the disease. Methods: Our study examines the awareness and interest in low-dose computed tomography (LDCT) lung cancer screening among different smoking statuses using data from the National Cancer Institute’s Health Information National Trends Survey (HINTS) 6 (2022). We analyzed data from HINTS 6, including 3915 participants on smoking status, LDCT screening, and telehealth use. Participants were categorized as current smokers, former smokers, and non-smokers. Results: Current smokers had the highest likelihood of being recommended for LDCT screening (OR: 7.1, aOR: 10.4) compared with non-smokers. Former smokers also had increased odds of screening recommendations (OR: 3.1, aOR: 3.4) than non-smokers. Despite higher screening recommendations, current smokers exhibited significantly lower interest in cancer screening (interest rating score: 2.1) compared with non-smokers (interest rating score: 2.4) and former smokers (interest rating score: 2.5). Current smokers rated their telehealth care experiences more positively in terms of care quality compared with non-smokers. Conclusions: Our findings underscore a gap in cancer screening interest among current smokers despite their higher likelihood of being recommended for LDCT screening. The favorable perception of telehealth among current smokers provides an opportunity to enhance engagement and promote LDCT scan through telehealth care. Full article

13 pages, 2805 KiB

Open AccessSystematic Review

Diagnostic Performance of Host and Viral DNA Methylation Analysis in the Identification of Anal Intraepithelial Neoplasia and Cancer: Systematic Review and Meta-Analysis

by Narcisa Muresu, Mariangela Valentina Puci, Giovanni Sotgiu, Illari Sechi, Andrea Cossu, Manuela Usai and Andrea Fausto Piana

Healthcare 2024, 12(19), 1951; https://doi.org/10.3390/healthcare12191951 - 30 Sep 2024

Abstract

Introduction: DNA methylation-based biomarkers have been investigated as useful tools in the carcinogenesis process, including the triage of HPV-associated cancers. In this context, we conducted a systematic review and meta-analysis focused on evaluating the changes in the level of DNA methylation in cases [...] Read more.

Introduction: DNA methylation-based biomarkers have been investigated as useful tools in the carcinogenesis process, including the triage of HPV-associated cancers. In this context, we conducted a systematic review and meta-analysis focused on evaluating the changes in the level of DNA methylation in cases of pre-cancerous (i.e., anal intraepithelial neoplasia, AIN-1, -2., -3) and cancerous (i.e., squamous cell carcinoma, SCC) anal lesions. Methods: A research in the PubMed, Scopus, and Web of Science databases was carried out, following the PRISMA 2020 protocol, using the following keywords: “anal cancer”, “anal intraepithelial neoplasia”, “methylation”, and “epigenetic”. All observational studies that reported the level of DNA methylation by grade of anal lesions and for different target genes were included. The QUADAS-2 tool was used to assess the studies’ quality, whereas pooled prevalence, sensitivity, specificity, and diagnostic odds ratio (DOR) were employed to verify the accuracy of the test in the detection of high-grade lesions. Results: Eight studies met the inclusion criteria, involving a total of 1555 clinical samples. The prevalence of methylation-positive samples by histological grading was 27%, 45%, 54%, and 98% for AIN1, AIN2, AIN3, and SCC, respectively. Similar results were observed for the DOR, with higher ORs in more severe lesions. The pooled AUC (95%CI) for the diagnosis of ≥AIN2 was 0.68 (0.63–0.73). Conclusions: The present review and meta-analysis support the introduction of DNA methylation-based biomarkers in the triage of subjects with low-grade anal lesions and in the monitoring of treatment outcomes. Standardized protocols and a prospective study design are needed to implement methylation tests in clinical practice. Full article

(This article belongs to the Special Issue Current and Future Directions in the Prevention and Treatment of HPV-Related Diseases)

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25 pages, 558 KiB

Open AccessSystematic Review

Cost-Effectiveness Analysis of Pneumococcal Vaccines in the Pediatric Population: A Systematic Review

by Nam Xuan Vo, Huong Lai Pham, Uyen My Bui, Han Tue Ho and Tien Thuy Bui

Healthcare 2024, 12(19), 1950; https://doi.org/10.3390/healthcare12191950 - 29 Sep 2024

Abstract

Objectives: Pneumococcal disease, caused by Streptococcus pneumoniae, is the leading cause of mortality in children worldwide. The tremendous direct cost of hospital admissions and significant indirect costs from productivity loss contribute considerably to its economic burden, with vaccination being the only efficient [...] Read more.

Objectives: Pneumococcal disease, caused by Streptococcus pneumoniae, is the leading cause of mortality in children worldwide. The tremendous direct cost of hospital admissions and significant indirect costs from productivity loss contribute considerably to its economic burden, with vaccination being the only efficient protection against the illness. Our study aims to summarize the cost-effectiveness of the pneumococcal conjugate vaccine (PCV) implemented in the pediatric population. Methods: Employing the online databases PubMed, Embase, and Medline, we looked for economic evaluations from 2018 until March 2024. The Incremental Cost-Effectiveness Ratios (ICER) and Quality-Adjusted Life Years (QALY) were the primary outcomes for measuring the cost-effectiveness of PCVs. A 28-item CHEERS 2022 checklist was applied to assess the quality of the collected studies. Results: Of the 16 papers found, 9/16 discussed the lower-valent vaccines (PCV13, PCV10) and 7/16 examined the higher-valent vaccines (PCV20, PCV15). PCV13 and PCV10 involved greater costs and generated more QALY compared to no vaccination. Both PCV15 and PCV20 averted substantial healthcare costs and yielded greater quality of life than PCV13. Additionally, PCV20 was a dominant strategy compared to PCV15. Conclusions: Utilizing PCV13 is a very cost-effective option compared to not getting vaccinated. Transitioning from PCV13 to PCV20 would result in higher QALY gain and more cost-saving than switching to PCV15. Full article

(This article belongs to the Special Issue Cost, Economics and Databases of Pharmaceutical Drugs in Public Health: Second Edition)

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15 pages, 288 KiB

Open AccessArticle

The Effects of the Expansion of Dental Care Coverage for the Elderly

by Yang Zhao and Beomsoo Kim

Healthcare 2024, 12(19), 1949; https://doi.org/10.3390/healthcare12191949 - 29 Sep 2024

Abstract

Background: Expanding dental care coverage for the elderly is globally recommended but not widely implemented due to its high costs and intangible benefits. Methods: This study examined the impact of such an expansion in Korea using the imputation-based method proposed by Borusyak et [...] Read more.

Background: Expanding dental care coverage for the elderly is globally recommended but not widely implemented due to its high costs and intangible benefits. Methods: This study examined the impact of such an expansion in Korea using the imputation-based method proposed by Borusyak et al. We analyzed data from the Korea National Health and Nutrition Examination Survey (2007–2019) on dental service utilization and chewing ability among older adults. Results: The policy resulted in a 13.5% increase in partial denture use and a 60.5% increase in dental implants among those aged 65 and above. These changes corresponded with reductions in severe chewing difficulty by 23.3% and 13.0%, respectively. No significant changes were observed in full denture use. The price elasticity of demand for partial dentures and dental implants was estimated to be −0.19 and −0.86, respectively. Conclusions: These findings underscore the critical role of affordability in enhancing the utilization of dental implants among the elderly and highlight the importance of appropriately expanding dental insurance coverage to improve oral health outcomes in this population. Full article

12 pages, 1939 KiB

Open AccessArticle

Patient-Reported Outcomes of Depression and Fibromyalgia Symptoms Do Not Predict Non-Inflammatory versus Inflammatory Diagnoses at Initial Rheumatology Consultation

by Arne Schäfer, Magdolna Szilvia Kovacs, Axel Nigg and Martin Feuchtenberger

Healthcare 2024, 12(19), 1948; https://doi.org/10.3390/healthcare12191948 - 29 Sep 2024

Abstract

Objective: The objective of this study was to assess the potential value of patient-reported outcomes (PROs) of depression, fibromyalgia symptoms, and pain in predicting non-inflammatory vs. inflammatory diagnoses in rheumatology patients. Methods: This retrospective, single-center study evaluated electronic health record (EHR) data from [...] Read more.

Objective: The objective of this study was to assess the potential value of patient-reported outcomes (PROs) of depression, fibromyalgia symptoms, and pain in predicting non-inflammatory vs. inflammatory diagnoses in rheumatology patients. Methods: This retrospective, single-center study evaluated electronic health record (EHR) data from adults who were seen for their first rheumatology consultation and subsequently received a diagnosis of an inflammatory (e.g., rheumatoid arthritis or spondyloarthritis) or non-inflammatory (e.g., osteoarthritis or fibromyalgia) condition. The PROs evaluated included depressive symptoms (Patient Health Questionnaire-2 [PHQ-2]), fibromyalgia symptom severity (FM SS), and pain. Results: A total of 3669 patients were evaluated, including patients with (n = 984; 26.82%) and without (n = 2685; 73.18%) inflammatory rheumatologic disease, of whom 141 (3.8%) had fibromyalgia. The non-inflammatory subgroup reported higher FM SS scores, and the inflammatory subgroup had higher pain and inflammatory markers. Bivariate models based on PHQ-2 and FM SS had a very low specificity (0.3%) for predicting non-inflammatory conditions, resulting in the misclassification of >99% of inflammatory cases. Adding pain, inflammatory markers, and other relevant EHR variables increased specificity but still resulted in a high level of misclassification. Conclusions: The PROs evaluated in this study are not suitable for predicting non-inflammatory vs. inflammatory rheumatologic disease, even when combined with other EHR variables. Full article

(This article belongs to the Special Issue New Challenges in Health Care Services among Patients with Musculoskeletal Pain)

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14 pages, 1401 KiB

Open AccessArticle

Development and Usability Assessment of Virtual Reality- and Haptic Technology-Based Educational Content for Perioperative Nursing Education

by Hyeon-Young Kim

Healthcare 2024, 12(19), 1947; https://doi.org/10.3390/healthcare12191947 - 29 Sep 2024

Abstract

Background/Objectives: In perioperative nursing practice, nursing students can engage in direct, in-person clinical experiences in perioperative environments; however, they face limitations due to infection and contamination risks. This study aimed to develop and evaluate educational content for perioperative clinical practice for nursing students [...] Read more.

Background/Objectives: In perioperative nursing practice, nursing students can engage in direct, in-person clinical experiences in perioperative environments; however, they face limitations due to infection and contamination risks. This study aimed to develop and evaluate educational content for perioperative clinical practice for nursing students using virtual reality (VR) and haptic technology. Methods: The program, based on the Unity Engine, was created through programming and followed the system development lifecycle (SDLC) phases of analysis, design, implementation, and evaluation. This program allows nursing students to engage in perioperative practice using VR and haptic technology, overcoming previous environmental limitations and enhancing practical and immersive experiences through multi-sensory stimuli. Results: Expert evaluations indicated that the developed content was deemed suitable for educational use. Additionally, a usability assessment with 29 nursing students revealed high levels of presence, usability, and satisfaction among the participants. Conclusions: This program can serve as a foundation for future research on VR-based perioperative nursing education. Full article

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21 pages, 274 KiB

Open AccessArticle

Depression, Anxiety, and Psychological Resilience in Healthcare Workers during the Pandemic (COVID-19)

by Elif Yöyen, Tülay Güneri Barış and Fatih Bal

Healthcare 2024, 12(19), 1946; https://doi.org/10.3390/healthcare12191946 - 28 Sep 2024

Abstract

Background/Objectives: The aim of this study is to examine the relationship between depression, anxiety, and psychological resilience variables with working conditions and various demographic variables in healthcare professionals who are actively involved in the pandemic process. Methods: This study included 1440 healthcare workers [...] Read more.

Background/Objectives: The aim of this study is to examine the relationship between depression, anxiety, and psychological resilience variables with working conditions and various demographic variables in healthcare professionals who are actively involved in the pandemic process. Methods: This study included 1440 healthcare workers in different professions in two state hospitals accepted as pandemic hospitals. The research data were collected with the Sociodemographic Data Form, Hospital Anxiety and Depression Scale (HAD), and Psychological Resilience Scale (PRS). Independent samples t-test, one-way analysis of variance (ANOVA), and descriptive analyses were used to analyze the data. Results: As a result of the analyses, female participants had higher anxiety scores than male participants; healthcare professionals working as nurses, midwives, and health officers had higher anxiety scores than other healthcare professionals; those with less professional experience had higher anxiety scores than those with more professional experience; and those who had long hours of contact with COVID-19-positive patients (8 h or more per day) had higher anxiety scores than those with less contact. Single female healthcare workers reported higher depression symptoms than married female healthcare workers, those with children reported higher depression symptoms than those without children, and those with average professional experience (6–10 years) reported higher depression symptoms than those with more experience. Being single, having children, and having an average number of shifts (working at night) caused an increase in psychological resilience. Conclusions: The results of the study may contribute to the structuring of health policies to protect and support the mental health of healthcare workers in ongoing and future pandemic processes. Full article

(This article belongs to the Special Issue Mental Health of Health Care Workers in the COVID-19 Era)

21 pages, 1954 KiB

Open AccessArticle

Transcutaneous Electrical Acupoint Stimulation for Elders with Amnestic Mild Cognitive Impairment: A Randomized Controlled Pilot and Feasibility Trial

by Wenjing Xu, Zichun Ding, Heng Weng, Junyu Chen, Wenjing Tu, Yulei Song, Yamei Bai, Shuxia Yan and Guihua Xu

Healthcare 2024, 12(19), 1945; https://doi.org/10.3390/healthcare12191945 - 28 Sep 2024

Abstract

Background: Amnestic mild cognitive impairment (aMCI) is an important window of opportunity for early intervention and rehabilitation in dementia. The aim of this study was to investigate the feasibility and effect of delivering transcutaneous electrical acupuncture stimulation (TEAS) intervention to elders with aMCI. [...] Read more.

Background: Amnestic mild cognitive impairment (aMCI) is an important window of opportunity for early intervention and rehabilitation in dementia. The aim of this study was to investigate the feasibility and effect of delivering transcutaneous electrical acupuncture stimulation (TEAS) intervention to elders with aMCI. Methods: A total of 61 aMCI patients were randomly allocated into the intervention group (receiving a 12-week TEAS) and control group (receiving health education). The feasibility outcomes included recruitment rate, retention rate, adherence rate, and an exploration of patients’ views and suggestions on the research. The effective outcomes included cognitive function, sleep quality, and life quality, which were measured by the Montreal cognitive assessment scale (MoCA), auditory verbal learning test—Huashan version (AVLT-H), Pittsburgh sleep quality index (PSQI), and quality of life short-term-12 (QoL SF-12). Results: The recruitment rate, retention rate, and adherence rate were 67.35%, 92.42%, and 85.29%, respectively. Most aspects of the research design and administration of the TEAS intervention were acceptable. The quantitative analysis suggests that compared with the control group, the scores of MoCA, AVLT-H, and SF-12 (mental component summary) were significantly better (p < 0.05); however, the differences were not statistically significant in PSQI and SF-12 (physical component summary) (p > 0.05). Conclusions: The findings demonstrated that the study was feasible. TEAS awas possible for enhancing cognitive function and mental health in people with aMCI. Full article

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16 pages, 2344 KiB

Open AccessArticle

The Associations between Depression and Sugar Consumption Are Mediated by Emotional Eating and Craving Control in Multi-Ethnic Young Adults

by Austin J. Graybeal, Jon Stavres, Sydney H. Swafford, Abby T. Compton, Stephanie McCoy, Holly Huye, Tanner Thorsen and Megan E. Renna

Healthcare 2024, 12(19), 1944; https://doi.org/10.3390/healthcare12191944 - 28 Sep 2024

Abstract

Background/Objectives: Individuals with mental health conditions such as depression are vulnerable to poor dietary habits, potentially due to the maladaptive eating behaviors often used to regulate negative emotion. However, the specific dietary components most associated with depression, as well as the mediating roles [...] Read more.

Background/Objectives: Individuals with mental health conditions such as depression are vulnerable to poor dietary habits, potentially due to the maladaptive eating behaviors often used to regulate negative emotion. However, the specific dietary components most associated with depression, as well as the mediating roles of emotion regulation and other eating behaviors, remains ambiguous in young adults. Methods: For this cross-sectional evaluation, a total of 151 (86 F, 65 M; BMI: 22.0 ± 5.1 kg/m²; age: 21.4 ± 2.5 y) multi-ethnic participants (50 White, 36 Black, 60 Asian, and 5 White Hispanic) completed a digital 24-h dietary recall and self-reported measures of depressive symptoms, emotional regulation, and eating behaviors. LASSO regression was used to identify the dietary variables most associated with each subscale and to remove extraneous dietary variables, and multiple regression and mediation analyses were conducted for the remaining variables. Results: Out of >100 dietary factors included, only added sugar in the combined sample (p = 0.043), and relative sugar in females (p = 0.045), were retained and positively associated with depressive symptoms. However, the relationships between depression and added and relative sugar intake were mediated by craving control and emotional eating, respectively. Individuals with higher added sugar intake (p = 0.012–0.037), and females with higher relative sugar intake (p = 0.029–0.033), had significantly higher odds of risk for major depression disorder and the use of mental health medications. Conclusions: Added and relative sugar intake are significantly associated with depressive symptoms in young adults, but these relationships may be mediated by facets of emotional dysregulation, such as emotional eating and craving control. Full article

(This article belongs to the Special Issue The Impact and Relationship of Lifestyle Behaviors and Mental Health)

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12 pages, 380 KiB

Open AccessArticle

Insights into Pharmacists’ Participation in Professional Certification Programs in Saudi Arabia

by Ammar Y. Alhuzli, Mohammed B. Alzahrani, Ahmed J. Althobaiti, Abdullah S. Alshammari, Adnan Alharbi, Mahmoud Elrggal, Nasser M. Alorfi, Foud O. Bahamdain, Walaa Alnemari, Mohammed Alrashed, Abdulmalik S. Alotaibi and Mohammed A. Alnuhait

Healthcare 2024, 12(19), 1943; https://doi.org/10.3390/healthcare12191943 - 28 Sep 2024

Abstract

Introduction: Professional certification programs play a crucial role in helping pharmacists develop specialized skills and establish their expertise in the field. This study explores how pharmacists in Saudi Arabia engage with these programs by examining their levels of awareness, attitudes, and participation. It [...] Read more.

Introduction: Professional certification programs play a crucial role in helping pharmacists develop specialized skills and establish their expertise in the field. This study explores how pharmacists in Saudi Arabia engage with these programs by examining their levels of awareness, attitudes, and participation. It also identifies the key barriers and motivators that influence their decision to pursue certification. Methods: An online survey was conducted among pharmacists in Saudi Arabia to assess participants’ knowledge of certification programs, their perceived benefits, the actual participation rates, and their preferences regarding certification areas and assessment methods. Results: Out of 394 participating pharmacists, around 47% had never participated in a professional certification program, and about 27% of our sample were unaware of such programs in Saudi Arabia. Financial constraints and a lack of awareness were noted as the primary barriers to participation. Almost 55% showed an interest in Clinical Pharmacy Specialties certification, while 54% were inclined toward Pharmacy Management and Leadership certifications. A preference for practical assessments in certification programs was suggested by 55% of participants. Conclusions: This study highlights a significant need for increased awareness and accessibility to professional certification programs among pharmacists in Saudi Arabia. Addressing participation barriers is vital to foster professional development and meet the healthcare sector’s evolving demands in Saudi Arabia. Full article

(This article belongs to the Special Issue Advancing Healthcare Excellence: On-the-Job Training, Professional Competence, and Skills Development)

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14 pages, 1153 KiB

Open AccessArticle

Clinical Health Psychology Perspectives in Diabetes Care: A Retrospective Cohort Study Examining the Role of Depression in Adherence to Visits and Examinations in Type 2 Diabetes Management

by Rossella Messina, Jacopo Lenzi, Simona Rosa, Maria Pia Fantini and Paolo Di Bartolo

Healthcare 2024, 12(19), 1942; https://doi.org/10.3390/healthcare12191942 - 27 Sep 2024

Abstract

Background: Depression in type 2 diabetes mellitus (T2DM) impacts glycemic control and complications. This study examines the influence of depression on compliance with recommended annual diabetes assessments in patients within the Local Healthcare Authority of Romagna. From a clinical health psychology perspective, understanding [...] Read more.

Background: Depression in type 2 diabetes mellitus (T2DM) impacts glycemic control and complications. This study examines the influence of depression on compliance with recommended annual diabetes assessments in patients within the Local Healthcare Authority of Romagna. From a clinical health psychology perspective, understanding how depression influences patients’ engagement in managing their conditions is crucial. This insight can help improve healthcare services by ensuring they address mental health needs and thereby enhance treatment effectiveness and overall patient outcomes. Methods: This retrospective cohort study included residents of Romagna with incident T2DM from 2015 to 2017, followed from 1 January 2018 to 31 December 2022. Depression was identified via hospital discharge records or antidepressant prescriptions. Adherence to diabetes care guidelines was measured using the Guideline Composite Indicator (GCI). Results: The study included 13,285 patients, with a mean age of 61.1 years. Prevalence of post-diabetes depression increased from 3.0% in 2018 to 8.9% in 2022. Initial analyses showed higher GCI rates among patients with depression. However, propensity-score adjustment revealed that by 2021–2022, patients with pre-diabetes depression had 5% lower compliance rates (p-value ≤ 0.05). Older adults with depression had reduced adherence, while younger adults with post-diabetes depression had higher adherence rates. Conclusions: Depression significantly affects adherence to diabetes care guidelines in T2DM patients, particularly among older adults. Integrated care models addressing both diabetes and depression are crucial for improving health outcomes. Full article

(This article belongs to the Special Issue Psychosocial Aspects in Chronic Conditions: Implications for Clinical Practice and Healthcare Delivery)

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20 pages, 556 KiB

Open AccessArticle

Assessing the Relationships between Physical Activity, a Healthy Life, and Personal Happiness in European Union Countries

by Gabriel Ioan Mangra, Mădălina Giorgiana Mangra, Claudiu George Bocean and Anca Antoaneta Vărzaru

Healthcare 2024, 12(19), 1941; https://doi.org/10.3390/healthcare12191941 - 27 Sep 2024

Abstract

Background: Maintaining a physically active lifestyle is a determinant factor of a healthy life and personal happiness. Meanwhile, physical inactivity remains a significant issue, resulting in negative consequences for public health. Objectives: This paper investigates the relationships between physical activity, physical inactivity, a [...] Read more.

Background: Maintaining a physically active lifestyle is a determinant factor of a healthy life and personal happiness. Meanwhile, physical inactivity remains a significant issue, resulting in negative consequences for public health. Objectives: This paper investigates the relationships between physical activity, physical inactivity, a healthy life, life expectancy, and personal happiness in European Union (EU) countries. Methods: This empirical study uses an artificial neural network and cluster analysis to analyze and interpret data from 27 EU countries. Artificial neural network analysis enables the assessment of the relationships between physical activity and inactivity, a healthy life, and personal happiness, while cluster analysis identifies groups of EU countries based on physical activity, healthy life, and personal happiness indicators. Results: The results show significant positive links between physical activity and improvements in healthy living and personal happiness. Conclusions: This study highlights considerable variations among EU countries regarding the levels of physical activity, healthy living, and personal happiness, emphasizing the importance of promoting physical activity to enhance public health and overall well-being. The findings suggest the need to develop customized policies that address country-specific factors and promote an active lifestyle. Full article

(This article belongs to the Special Issue Effects of Physical Activity on Physical and Psychological Health)

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11 pages, 240 KiB

Open AccessReview

Recent Developments in the Non-Pharmacological Management of Children’s Behavior Based on Distraction Techniques: A Concise Review

by Jieyi Chen, Ke Deng, Dikuan Yu, Cancan Fan, Limin Liu, Haijing Gu, Fang Huang and Yongbiao Huo

Healthcare 2024, 12(19), 1940; https://doi.org/10.3390/healthcare12191940 - 27 Sep 2024

Abstract

Oral diseases and conditions affect children’s oral health and negatively influence their overall health. Early detection and intervention are important in mitigating these negative consequences. However, dental fear and anxiety (DFA) regarding dental procedures often hinder children from seeking necessary dental care. Non-pharmacological [...] Read more.

Oral diseases and conditions affect children’s oral health and negatively influence their overall health. Early detection and intervention are important in mitigating these negative consequences. However, dental fear and anxiety (DFA) regarding dental procedures often hinder children from seeking necessary dental care. Non-pharmacological behavior management strategies, such as distraction techniques, are commonly adopted to manage children’s behaviors. Distraction techniques have been developed rapidly in recent years and are widely accepted by both health professionals and parents due to their noninvasive and low-cost nature. This concise review aims to summarize current distraction techniques applied during dental treatments, especially for children. The most commonly reported techniques for children are audio distraction, audio-visual distraction, tactile distraction, olfactory distraction, and gustatory distraction. Audio distraction techniques involving music and storytelling help children relax. Audio-visual distraction techniques help to divert children’s attention from the dental treatment. Tactile stimuli can reduce the transmission of pain signals. Olfactory stimuli can help children feel comfortable and relaxed. Gustatory distraction involving sweet substances can create a positive environment. These distraction techniques effectively reduce DFA in children and improve their satisfaction with dental procedures. As technology continues to develop, further research is needed to provide more robust, evidence-based guidance for dentists using distraction techniques. Full article

(This article belongs to the Special Issue Prevention and Management of Oral Diseases among Children)

14 pages, 1269 KiB

Open AccessArticle

Trends and Patterns of ICU E-Referrals in Saudi Arabia during 2020–2021: Results from the National Saudi Medical Appointments and Referrals Centre

by Abdullah A. Alharbi, Nawfal A. Aljerian, Hani A. Alghamdi, Meshary S. Binhotan, Ali K. Alsultan, Mohammed S. Arafat, Abdulrahman Aldhabib, Ahmed I. Aloqayli, Eid B. Alwahbi, Mohammed A. Muaddi and Mohammed K. Alabdulaali

Healthcare 2024, 12(19), 1939; https://doi.org/10.3390/healthcare12191939 - 27 Sep 2024

Abstract

Background/Objectives: Intensive care unit (ICU) e-referrals are an important indicator for exploring potential deficiencies in critical care resources. This study aimed to examine the epidemiology and patterns of ICU e-referrals across all regions of Saudi Arabia during the COVID-19 pandemic using routinely collected [...] Read more.

Background/Objectives: Intensive care unit (ICU) e-referrals are an important indicator for exploring potential deficiencies in critical care resources. This study aimed to examine the epidemiology and patterns of ICU e-referrals across all regions of Saudi Arabia during the COVID-19 pandemic using routinely collected data from April 2020 to December 2021. Methods: This descriptive epidemiological study analyzed data from the Saudi Medical Appointments and Referrals Centre (SMARC). This study reveals novel regional ICU e-referral patterns for critical cases using national unique digital health data, adding insights beyond the existing literature. Variables included age, sex, referral timing, reason, specialty, and region of origin. Descriptive statistics and mapping of administrative areas were performed based on e-referral request rates per 10,000 population. Results: During the study period, 36,619 patients had ICU e-referral requests. The mean age was 54.28 years, with males constituting 64.81% of requests. Out-of-scope e-referrals comprised 71.44% of requests. Referrals related to medical specialties, such as cardiology and pulmonology, were the most common (62.48%). Referral patterns showed peaks in July–August 2020 and May 2021. The Northern Border and Albaha areas had the highest request rates per population, potentially reflecting a higher proportion of severe cases requiring ICU-level care compared to other regions. Conclusions: The temporal pattern and geographic distribution of ICU e-referrals mirrored previously reported critical COVID-19 cases in Saudi Arabia. Preventive measures and vaccination programs contributed to a significant decline in ICU e-referral requests, suggesting a positive impact on controlling severe COVID-19 cases. Population-adjusted analysis revealed regional disparities, highlighting the importance of considering population size in healthcare resource management and policy. Full article

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13 pages, 604 KiB

Open AccessArticle

Complementary Musical Intervention for Patients in Palliative Care in Spain: A Randomized Controlled Trial

by Inmaculada Valero-Cantero, María Ángeles Vázquez-Sánchez, José Luis Casals-Sánchez, Milagrosa Espinar-Toledo, Juan Corral-Pérez and Cristina Casals

Healthcare 2024, 12(19), 1938; https://doi.org/10.3390/healthcare12191938 - 27 Sep 2024

Abstract

Background: Patients with advanced cancer often endure a heavy burden of symptoms, both in quantity and intensity. Complementary therapies offer potential relief in this challenging scenario. Increasing the number of randomized controlled trials provides a unique opportunity to generate rigorous data, which can [...] Read more.

Background: Patients with advanced cancer often endure a heavy burden of symptoms, both in quantity and intensity. Complementary therapies offer potential relief in this challenging scenario. Increasing the number of randomized controlled trials provides a unique opportunity to generate rigorous data, which can be used to establish causal relationships and evaluate interventions; hence, nurses can strengthen evidence-based practices, leading to better patient outcomes and quality of care. Our study aimed to evaluate the impact of a 7-day pre-recorded music intervention on cancer symptoms and satisfaction in advanced-stage cancer patients receiving palliative care at home. Methods: This multicenter, double-blind, randomized, controlled clinical trial involved 80 Spanish cancer patients receiving palliative care at home, and was conducted from July 2020 to November 2021. The intervention group (n = 40) received self-selected pre-recorded music for 30 min daily over 7 days. The control group (n = 40) received pre-recorded basic health education sessions of equal duration and frequency. Symptoms and patient satisfaction were assessed before and after the intervention using the Edmonton Symptom Assessment System and the Client Satisfaction Questionnaire, respectively. Results: Comparing the intervention with the control group, significant improvements were observed in various symptoms: total symptom burden (p < 0.001), pain (p = 0.001), fatigue (p = 0.007), depression (p = 0.001), anxiety (p = 0.005), drowsiness (p = 0.006), appetite (p = 0.047), well-being (p ≤ 0.001), and sleep (p < 0.001); additionally, patient satisfaction was higher in the intervention group (p < 0.001). Conclusions: The 7-day pre-recorded music intervention reduced both physical and psychological symptoms in advanced-stage cancer patients receiving home-based palliative care, demonstrating significant alleviation of overall symptom burden and increased satisfaction with healthcare. Full article

(This article belongs to the Special Issue Improving the Quality of Nursing: Focus on Palliative Care and End-of-Life Care)

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15 pages, 1438 KiB

Open AccessArticle

Switching from Cigarettes to Heated Tobacco Products in Japan—Potential Impact on Health Outcomes and Associated Health Care Costs

by Joerg Mahlich and Isao Kamae

Healthcare 2024, 12(19), 1937; https://doi.org/10.3390/healthcare12191937 - 27 Sep 2024

Abstract

Background: Japan’s rising health expenditure, driven by an aging population, coincides with growing demands for increased spending. Reducing smoking-related costs could alleviate the burden on the health care system. Despite efforts to promote smoking cessation, success has been limited, indicating a need for [...] Read more.

Background: Japan’s rising health expenditure, driven by an aging population, coincides with growing demands for increased spending. Reducing smoking-related costs could alleviate the burden on the health care system. Despite efforts to promote smoking cessation, success has been limited, indicating a need for strategies beyond cessation. Methods: Using a status quo simulation based on hospital resource data from the Japanese Ministry of Health, Labor, and Welfare, we examine the impact of heated tobacco products (HTPs) on the prevalence of four smoking-attributable diseases (chronic obstructive pulmonary disease, ischemic heart disease, stroke, and lung cancer) and the related direct health care costs. The baseline scenario assumes a 50% switch from combustible cigarettes to HTPs, with a 70% risk reduction. A sensitivity analysis was conducted to assess the effects of parameter variations. Results: If 50% of smokers replaced combustible tobacco products with HTPs, 12 million patients could be averted equivalent to JPY 454 billion in health care savings. Prefectures located in the north and south of Japan would benefit the most. Conclusions: Considering the heterogeneous prevalence rates, a one-size-fits-all tobacco control approach is ineffective. Japan should prioritize cost-efficient measures that promote public health and economic benefits. Encouraging smokers to switch to reduced-risk products, raising awareness of health risks, and adopting a harm-based taxation model can drive positive change. Public–private partnerships can further enhance harm reduction efforts. With a combination of tax reforms, revised regulations, collaborations, and ongoing research, Japan can create a more effective and comprehensive approach to tobacco control. Full article

(This article belongs to the Section Health Policy)

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12 pages, 264 KiB

Open AccessArticle

Emotional Intelligence as Critical Competence in Nurses’ Work Performance: A Cross-Sectional Study

by Petros Galanis, Aglaia Katsiroumpa, Ioannis Moisoglou, Konstantina Derizioti, Parisis Gallos, Maria Kalogeropoulou and Vasiliki Papanikolaou

Healthcare 2024, 12(19), 1936; https://doi.org/10.3390/healthcare12191936 - 27 Sep 2024

Abstract

Background/Objectives: Emotional intelligence may help nurses to cope with demanding work environments where the need to improve the quality and safety of the care provided, as well as the care of the chronically ill, prevails. Although it is well known that emotional intelligence [...] Read more.

Background/Objectives: Emotional intelligence may help nurses to cope with demanding work environments where the need to improve the quality and safety of the care provided, as well as the care of the chronically ill, prevails. Although it is well known that emotional intelligence is positively related to work performance, the literature on nurses is limited. The aim of our study was to examine the impact of emotional intelligence on work performance in a sample of nurses in Greece. Methods: We conducted a cross-sectional study with 318 nurses. We collected data from a convenience sample of nurses during January 2024. Since we conducted an online survey through social media, our sample could not be representative of all nurses in Greece. For instance, older nurses may be underrepresented in our study due to limited access on social media. We measured emotional intelligence with the Trait Emotional Intelligence Questionnaire-Short Form (TEIQue-SF) and work performance with the Individual Work Performance Questionnaire (IWPQ). We created multivariable linear regression models adjusted for sex, age, educational level, and work experience. We followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Results: We found that the four streams of emotional intelligence (i.e., well-being, self-control, emotionality, sociability) increased nurses’ work performance. In particular, we found a positive relationship between well-being and task performance (adjusted beta = 0.210, 95% CI = 0.140 to 0.281, p-value < 0.001) and contextual performance (adjusted beta = 0.135, 95% CI = 0.050 to 0.221, p-value = 0.002). Similarly, there was a positive relationship between self-control and task performance (adjusted beta = 0.136, 95% CI = 0.030 to 0.241, p-value = 0.012). Additionally, sociability increased task performance (adjusted beta = 0.223, 95% CI = 0.151 to 0.295, p-value < 0.001) and contextual performance (adjusted beta = 0.198, 95% CI = 0.111 to 0.286, p-value < 0.001). Moreover, emotionality (adjusted beta = −0.198, 95% CI = −0.319 to −0.076, p-value = 0.002) and sociability (adjusted beta = −0.133, 95% CI = −0.221 to −0.044, p-value = 0.003) reduced counterproductive work behavior. Conclusions: Our multivariable models identified a positive impact of emotional intelligence on nurses’ work performance. Nurse managers and healthcare organizations should adopt appropriate interventions to improve nurses’ emotional intelligence. Enhancing emotional intelligence among nurses can improve work performance and, thus, healthcare outcomes. Moreover, higher levels of emotional intelligence may empower nurses’ compassion and resilience, fostering a supportive work environment. In this context, the well-being of both nurses and patients may improve. Full article

(This article belongs to the Special Issue Towards Holistic Healthcare: Advancing Nursing and Medical Education)

7 pages, 175 KiB

Open AccessPerspective

Emerging Evidence Supports Broader Definition of Chairside Behavior Guidance and Familial Compliance

by Paul S. Casamassimo

Healthcare 2024, 12(19), 1935; https://doi.org/10.3390/healthcare12191935 - 27 Sep 2024

Abstract

Background and Objectives: Behavior management as a set of clinical techniques to induce desirable clinical treatment and subsequent compliance behaviors in children and families varies internationally based on professional training, access to care, health literacy, and societal norms. This report proposes non-typical diagnostic [...] Read more.

Background and Objectives: Behavior management as a set of clinical techniques to induce desirable clinical treatment and subsequent compliance behaviors in children and families varies internationally based on professional training, access to care, health literacy, and societal norms. This report proposes non-typical diagnostic considerations of additional inherent behavioral conditions and familial and social qualifiers that may help predict success both at the chairside and in compliance with home self-care behaviors to reduce caries susceptibility. Methods: A review of the medical and dental literature provides ample support for the consideration of changing characteristics of both the patient and the environment. Results: The current recommendations for choice of behavior guidance in direct clinical care, as used in the USA, often fall short of efficacy for a variety of reasons including the provider limitations, the extent and difficulty of treatment, and most recently appreciated, the complexity of negative childhood experiences, subclinical behavioral disorders, and immutable negative determinants of health outside the dental setting affecting interaction with health professionals. These same factors, such as family dysfunction and societal stresses, also impact compliance with out-of-clinic preventive efforts that many oral health care providers rely upon to help mitigate treatment limitations in reaching children. There are also behavioral elements of compliance and attitudes toward health that dentists need to recognize. Conclusions: A broader, more inclusive concept of behavior guidance to include factors beyond those typically associated with a dental patient affecting treatment and compliance with preventive behaviors may be beneficial. Every population and patient will have differing characteristics and require individualized care. Full article

(This article belongs to the Special Issue Oral Health Status of Children and Adolescents)

22 pages, 747 KiB

Open AccessArticle

Exploration of Food Attitudes and Management of Eating Behavior from a Psycho-Nutritional Perspective

by Anca Mihaela Dicu, Lavinia Denisia Cuc, Dana Rad, Andreea Ioana Rusu, Andrea Feher, Florin Lucian Isac, Daniel Manate, Annamaria Pallag and Florentina Simona Barbu

Healthcare 2024, 12(19), 1934; https://doi.org/10.3390/healthcare12191934 - 27 Sep 2024

Abstract

Background/Objectives: This study investigates the relationship between food attitudes and the management of eating behavior from a psycho-nutritional perspective, with a focus on the Health Belief Model (HBM). The objective was to explore how emotional food cravings influence different aspects of eating behavior [...] Read more.

Background/Objectives: This study investigates the relationship between food attitudes and the management of eating behavior from a psycho-nutritional perspective, with a focus on the Health Belief Model (HBM). The objective was to explore how emotional food cravings influence different aspects of eating behavior and dietary attitudes, and to identify indirect pathways through which these cravings affect attitudes toward dieting behaviors. Methods: Data were collected from 659 participants using validated scales that assessed dieting tendencies, bulimia and food preoccupation, culinary behaviors, food preoccupation, expectations of positive outcomes, and emotional food cravings. Descriptive statistics, Pearson’s correlations, and network analysis were employed to uncover significant associations among these variables. A sequential mediation analysis was conducted using SPSS PROCESS Macro Model 6 to identify indirect pathways. Results: The analysis revealed significant associations among the variables. Emotional food craving had a negative indirect effect on dieting attitudes through bulimia tendencies (effect size: −0.523) and a positive indirect effect through food preoccupation (effect size: 0.1006). These results highlight the complex interplay between emotional food cravings, bulimia tendencies, and food preoccupation in shaping dieting attitudes. Conclusions: The findings emphasize the complex dynamic between emotional food cravings, bulimia tendencies, and food preoccupation, and their collective impact on dieting attitudes. This study provides insights into potential intervention strategies aimed at improving eating habits by addressing emotional food cravings and their indirect effects on dietary behavior. Full article

(This article belongs to the Special Issue Food, Health and Society: Determinants of Eating Behavior)

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15 pages, 491 KiB

Open AccessArticle

In the Shadow of the Pandemic: Examining Therapists’ Perceptions of Work-Related Stress in the Late Stages of the COVID-19 Pandemic in Germany

by Smilla Johann, Megan Evans, Rike Böttcher, Nadine Muller, Barbara Buchberger, Charbel El Bcheraoui and Heide Weishaar

Healthcare 2024, 12(19), 1933; https://doi.org/10.3390/healthcare12191933 - 26 Sep 2024

Abstract

Background/Objectives: The previous literature has identified increased work-related stress among healthcare workers (HCWs) during the COVID-19 pandemic. This study analyzes work-related perceived stress experienced by therapists during the COVID-19 pandemic in Germany to identify potential for supporting this crucial group of HCWs in [...] Read more.

Background/Objectives: The previous literature has identified increased work-related stress among healthcare workers (HCWs) during the COVID-19 pandemic. This study analyzes work-related perceived stress experienced by therapists during the COVID-19 pandemic in Germany to identify potential for supporting this crucial group of HCWs in future health crises. Methods: Survey data on stress, measured through the Perceived Stress Scale 4, among HCWs (therapists n = 612, nurses n = 501, and doctors n = 461) were analyzed using descriptive statistics, and data from four semi-structured interviews and seven focus group discussions with therapists were analyzed using thematic content analysis. Data were collected from March to September 2022. Results: Therapists reported similar stress levels to other HCWs, with the reporting of perceived stress differing between work contexts. Eight stressors were identified through the thematic analysis: (1) concerns about maintaining the quality of care, (2) uncertainty about the future, (3) workload, (4) interactions with colleagues and patients, (5) PPE, (6) the risk of infection, (7) insufficient information flow, and (8) the lack of public and political recognition. Conclusions: This study emphasizes the distinct challenges that therapists experienced during the COVID-19 pandemic. By identifying the factors that contributed to the stress experienced, the study can inform targeted support strategies which can enhance therapists’ work, ultimately contributing to sustaining essential healthcare services during public health crises. Full article

(This article belongs to the Special Issue Emotional Stress of Healthcare Professionals in Work)

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11 pages, 385 KiB

Open AccessArticle

Eating Habits Related to Pregnancy, Body Perception, Attractiveness and Self-Confidence

by Wioleta Faruga-Lewicka, Wiktoria Staśkiewicz-Bartecka, Patrycja Janiszewska, Martina Grot and Marek Kardas

Healthcare 2024, 12(19), 1932; https://doi.org/10.3390/healthcare12191932 - 26 Sep 2024

Abstract

Background: Pregnancy is a period of many changes in a woman’s life, including those related to eating habits, taking care of health and fitness, as well as esthetic and psychological considerations. Methods: The study was conducted between January 2021 and December 2022. A [...] Read more.

Background: Pregnancy is a period of many changes in a woman’s life, including those related to eating habits, taking care of health and fitness, as well as esthetic and psychological considerations. Methods: The study was conducted between January 2021 and December 2022. A questionnaire was used to conduct the study, the questions of which concerned eating habits, as well as perceptions of one’s body and changes in appearance during pregnancy. Respondents filled out the questionnaire twice. The first survey was in the first two weeks after the doctor’s confirmation of pregnancy and after the end of pregnancy, up to a maximum of 2 months after delivery. The purpose of the study was to evaluate changes in women’s eating habits during pregnancy compared to before pregnancy to analyze the impact of pregnancy on women’s body perception and attractiveness and self-confidence; furthermore, the study aimed to analyze the body mass index (BMI) of women before pregnancy and to compare weight gain during pregnancy depending on the initial BMI, taking into account different age groups. The values of measurable parameters were presented using the arithmetic mean, median, dominant and standard deviation. Non-measurable parameters were presented using percentages. The Chi2 test of homogeneity was used to examine differences between groups. Results: During pregnancy, respondents mostly ate five meals a day, increased the amount of vegetables and fruits in their diets, and ate their meals without rushing (defined as slowly, calmly and without measuring the time left until the end of the meal break). Respondents reduced their coffee intake during pregnancy, while they increased their water intake to about 2 L a day. In the survey, about 2% of respondents followed a weight-loss diet during pregnancy. Respondents who were more likely to take body circumference measurements equally often monitored their daily energy intake. Conclusion: Women changed their eating habits during pregnancy to healthier ones compared to before pregnancy. The women’s eating habits and well-being were also not affected by their age. Also, there was no significant relationship between eating habits and well-being in pregnant women, regardless of their age. The study may assist medical staff in promoting healthier eating habits and tailoring psychological support, which is crucial for the well-being of pregnant women. Full article

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12 pages, 270 KiB

Open AccessArticle

Dietary Habits, Awareness, and Knowledge among Polish Healthcare Providers and Healthcare Students

by Magdalena Kurnik-Łucka, Dominika Grońska, Iga Salwa, Julia Niedbałowska, Kamil Paweł Skowron, Katarzyna Anna Dyląg, Elżbieta Rząsa-Duran, Marcin Wojnarski, Agnieszka Pac and Krzysztof Gil

Healthcare 2024, 12(19), 1931; https://doi.org/10.3390/healthcare12191931 - 26 Sep 2024

Abstract

Background/Objectives: Nutrition plays a significant role in preventive medicine, as up to 80% of chronic diseases could be avoided by adhering to healthy dietary principles. The aim of our study was to identify dietary habits, awareness, and nutrition knowledge in a random [...] Read more.

Background/Objectives: Nutrition plays a significant role in preventive medicine, as up to 80% of chronic diseases could be avoided by adhering to healthy dietary principles. The aim of our study was to identify dietary habits, awareness, and nutrition knowledge in a random sample of Polish healthcare students and professionals. Methods: Initially, a total screened sample consisted of 1287 respondents, yet the actual response/participation rate was 634/1287. A validated questionnaire for the Polish population, the Dietary Habits and Nutrition Beliefs Questionnaire (KomPAN), was used for the assessment. Results: The majority of respondents were females (84.2% of medical students and 87.2% of healthcare professionals), current non-smokers (79.6% of medical students and 85.2% of healthcare professionals), and had a normal waist circumference (76.3% of medical students and 63.1% of healthcare professionals). Both clinical dieticians and students studying clinical dietetics received significantly different scores of dietary indexes (pro-healthy pHDI-10 and non-healthy nHDI-14) vs. respective groups of respondents. Both healthcare students and professionals who self-reported better nutritional knowledge indeed yielded significantly better results in the dietary indexes as well as nutritional knowledge scores. The nutrition knowledge score was positively correlated with pHDI-10 and negatively correlated with nHDI-14, BMI, age, and waist circumference. Conclusions: Our results illustrate lifestyle trends among Polish healthcare students and professionals, and such results should encourage the development of evidence-based dietary policies targeting healthcare providers. High-quality continuing nutrition education should be obligatorily provided to all healthcare providers to enhance their dietary awareness as well as ensure high quality of care and outcomes achieved by the Polish healthcare system. Full article

10 pages, 618 KiB

Open AccessArticle

Comparative Study of Physical Activity, Leisure Preferences, and Sedentary Behavior among Portuguese, Italian, and Spanish University Students

by Rui Paulo, André Ramalho, Isabella Scursatone, Maria Caire, Nicolás Bores Calle, Daniel Bores-García, María Espada, Miguel Rebelo and Pedro Duarte-Mendes

Healthcare 2024, 12(19), 1930; https://doi.org/10.3390/healthcare12191930 - 26 Sep 2024

Abstract

Objective: The objective of this study is to describe and compare the levels of physical activity, preferences for leisure-time physical activity, and the frequency of non-sedentary behaviors of Portuguese, Italian, and Spanish students attending higher education. Methods: A total of 1354 students (21.2 [...] Read more.

Objective: The objective of this study is to describe and compare the levels of physical activity, preferences for leisure-time physical activity, and the frequency of non-sedentary behaviors of Portuguese, Italian, and Spanish students attending higher education. Methods: A total of 1354 students (21.2 ± 2.9 years) participated in the study, with data collected through an online questionnaire for 6 months. Results: The highest levels of sedentary behavior are found among Spanish students, followed by the Portuguese, and lastly the Italians. In relation to physical activity levels, Spanish students perform more low and moderate physical activity, while Italian students perform more vigorous activities and naturally have a lower level of sedentary behavior. Conclusions: However, it is worth highlighting that students from all three countries reach the minimum levels of physical activity recommended by the WHO. Full article

(This article belongs to the Special Issue Physical Activity, Healthy Lifestyle and Well-Being across the Lifespan)

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14 pages, 809 KiB

Open AccessArticle

Assessing Patient Use of and Attitudes toward eHealth Services for Communication with Primary Care Centers in Saudi Arabia and Factors Affecting Usage

by Tourkiah Alessa, Khalid Alhussaini and Luc de Witte

Healthcare 2024, 12(19), 1929; https://doi.org/10.3390/healthcare12191929 - 26 Sep 2024

Abstract

Background: This study investigates patients’ use of eHealth services, their awareness of the availability of these services, and their intention to use them in primary care. It also examines patient characteristics and factors that influence the use of these services. Methods: A cross-sectional [...] Read more.

Background: This study investigates patients’ use of eHealth services, their awareness of the availability of these services, and their intention to use them in primary care. It also examines patient characteristics and factors that influence the use of these services. Methods: A cross-sectional design using questionnaires was conducted. Based on the unified theory of acceptance and use of technology (UTAUT), the participants rated the two most common services. Descriptive analyses and linear correlation analyses were performed. A simple linear regression was conducted to identify factors influencing the participants’ intention to use eHealth services. Results: In total, 1203 participants with an average age of 43.7 years were surveyed. The participants’ usage rates varied, with the lowest at 2.4%, for measuring vital signs, and the highest at 47.4%, for booking appointments. The intentions to use the services ranged from 22.5%, for video consultations, to 46.6%, for prescription refill requests. Approximately 20% of the respondents were unaware of each service’s availability. Positive associations were found between all the constructs and the intention to use online services, with a younger age being the most significant factor. Conclusions: The use of and intention to use eHealth services varied greatly. The participants were often unaware of the availability of these services. Promoting the availability and benefits of eHealth services could enhance patient engagement in primary care settings. Full article

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17 pages, 624 KiB

Open AccessArticle

Associations between the Number of Children, Depressive Symptoms, and Cognition in Middle-Aged and Older Adults: Evidence from the China Health and Retirement Longitudinal Study

by Yongze Zhao, Huaxin Mai and Ying Bian

Healthcare 2024, 12(19), 1928; https://doi.org/10.3390/healthcare12191928 - 26 Sep 2024

Abstract

Background: China’s rapidly aging population presents challenges for cognitive health and mental well-being among the older adults. This study examines how the number of children affects cognitive function in middle-aged and older adults and whether depressive symptoms mediate this relationship. Methods: [...] Read more.

Background: China’s rapidly aging population presents challenges for cognitive health and mental well-being among the older adults. This study examines how the number of children affects cognitive function in middle-aged and older adults and whether depressive symptoms mediate this relationship. Methods: This study analyzed data from waves 1 to 5 (2011–2020) of the China Health and Retirement Longitudinal Study (CHARLS), involving 5932 participants aged 45 and older. Participants were grouped by the number of children: childless, only child and multiple children. We used Logarithmic Generalized Linear Models (LGLMs) to explore the relationships among the number of children, depressive symptoms, and cognitive function. Indirect effect coefficients and 95% bias-corrected and accelerated confidence intervals (BCaCI) were estimated using Simultaneous Equation Models (SEM) with three-stage least squares (3SLS) and the bootstrap method to assess the mediating effect of depressive symptoms. Results: In middle-aged and older adults, a negative association was observed between the number of children and overall cognitive functioning (all p < 0.01). This association remained significant even after adjusting for covariates in groups with three (β = −0.023, p < 0.05) and four or more children (β = −0.043, p < 0.001). Conversely, the positive association between the number of children and depression also persisted after adjusting for covariates, although it weakened as the number of children increased (all p < 0.01). Depressive symptoms consistently correlated negatively with overall cognitive function (p < 0.001) and partially mediated the relationship between the number of children and cognitive function (pMe = 20.36%, p < 0.05). The proportion of the mediating effect attributed to depression was more pronounced in middle-aged and older adults who had experienced the loss of children (pMe = 24.31%) or had two children (pMe = 25.39%), with stronger mediating effects observed in males (pMe = 48.84%) and urban residents (pMe = 64.58%). Conclusions: The findings indicate that depressive symptoms partially mediate the relationship between the number of children and cognitive function in middle-aged and older adults in China. These results highlight the significance of considering mental health factors when studying cognitive function in this demographic. Notably, in families without children and those with two children, depressive symptoms play a crucial role in explaining the decline in cognitive function. Full article

(This article belongs to the Special Issue Depression: Recognizing and Addressing Mental Health Challenges)

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11 pages, 226 KiB

Open AccessArticle

Exploring the Relationship between Health Literacy and Depression among Individuals with Chronic Conditions: Insights from the KCHS

by Eungyeong Kim

Healthcare 2024, 12(19), 1927; https://doi.org/10.3390/healthcare12191927 - 26 Sep 2024

Abstract

Objectives: This study, utilizing data from the 2021 Korean Community Health Survey (KCHS), aimed to investigate the role of health literacy in mitigating depression among individuals with chronic diseases, particularly focusing on how sociodemographic and subjective factors influence this relationship. Methods: With a [...] Read more.

Objectives: This study, utilizing data from the 2021 Korean Community Health Survey (KCHS), aimed to investigate the role of health literacy in mitigating depression among individuals with chronic diseases, particularly focusing on how sociodemographic and subjective factors influence this relationship. Methods: With a sample of 77,133 subjects primarily dealing with hypertension and diabetes, the study employed various analytical tools to identify factors associated with an increased risk of depression. Results: These factors included marital status (OR 1.47, 95% CI 1.40–1.54), residential district (OR 1.43, 95% CI 1.39–1.50), unemployment (OR 1.47, 95% CI 1.41–1.54), enrollment in the national basic living security program (OR 1.50, 95% CI 1.40–1.62), unmet healthcare needs (OR 2.32, 95% CI 2.14–2.51), fair subjective health status (OR 1.74, 95% CI 1.63–1.90), poor subjective health status (OR 4.33, 95% CI 4.05–4.63), and stress (OR 4.56, 95% CI 4.36–4.77). Notably, individuals with higher health literacy showed a significantly lower susceptibility to depression (OR 0.74, 95% CI 0.68–0.75), underscoring the importance of health literacy as a critical factor in mental health outcomes. Conclusions: Such initiatives could serve as effective preventive measures against depression in this vulnerable population. Full article

(This article belongs to the Special Issue Mental Health at a Personal, Communal, and Social Level)

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Healthcare, Volume 12, Issue 19 (October-1 2024) – 52 articles

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