Journal Description
Healthcare
Healthcare
is an international, scientific, peer-reviewed, open access journal on health care systems, industry, technology, policy, and regulation, and is published semimonthly online by MDPI. Ocular Wellness & Nutrition Society (OWNS) is affiliated with Healthcare and its members receive discounts on article processing charges.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within Scopus, SCIE and SSCI (Web of Science), PubMed, PMC, and other databases.
- Journal Rank: JCR - Q2 (Health Policy & Services ) / CiteScore - Q2 (Leadership and Management)
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 19.5 days after submission; acceptance to publication is undertaken in 2.4 days (median values for papers published in this journal in the second half of 2023).
- Recognition of Reviewers: reviewers who provide timely, thorough peer-review reports receive vouchers entitling them to a discount on the APC of their next publication in any MDPI journal, in appreciation of the work done.
- Companion journals for Healthcare include: Trauma Care and European Burn Journal.
Impact Factor:
2.8 (2022);
5-Year Impact Factor:
3.0 (2022)
Latest Articles
One World, One Health: Zoonotic Diseases, Parasitic Diseases, and Infectious Diseases
Healthcare 2024, 12(9), 922; https://doi.org/10.3390/healthcare12090922 (registering DOI) - 29 Apr 2024
Abstract
When we take into account how the boundaries between human, animal, and environmental health are inextricably linked and increasingly intertwined, it comes as no surprise that the One Health approach has assumed an unprecedented level of importance over the past decade [1]. [...]
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When we take into account how the boundaries between human, animal, and environmental health are inextricably linked and increasingly intertwined, it comes as no surprise that the One Health approach has assumed an unprecedented level of importance over the past decade [1]. [...]
Full article
(This article belongs to the Special Issue One World, One Health: Zoonotic Diseases, Parasitic Diseases and Infectious Diseases)
Open AccessArticle
Patient-Orientated Evaluation of Treatment of Non-Melanoma Skin Cancer with Rhenium-188 Compared to Surgery
by
Maila I. C. Krönert, Sarah M. Schwarzenböck, Jens Kurth, Martin Heuschkel, Bernd J. Krause, Steffen Emmert and Julia K. Tietze
Healthcare 2024, 12(9), 921; https://doi.org/10.3390/healthcare12090921 (registering DOI) - 29 Apr 2024
Abstract
Background: Non-melanoma skin cancers (NMSCs) are responsible for up to one-third of all human malignancies. Surgery is usually the treatment of choice, but patients often experience pain during the procedure. Topical rhenium-188 resin skin cancer treatment (RSCT) may be a valid therapeutic alternative.
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Background: Non-melanoma skin cancers (NMSCs) are responsible for up to one-third of all human malignancies. Surgery is usually the treatment of choice, but patients often experience pain during the procedure. Topical rhenium-188 resin skin cancer treatment (RSCT) may be a valid therapeutic alternative. Methods: In this monocentric pilot study, 19 patients suffering from NMSC were treated with RSCT. Most of these patients had also experienced surgery, either because they developed a new NMSC in aftercare, or they had suffered previously from NMSC. Three RSCT-treated patients, who had no exposure to surgery so far, were paired with three matched patients, who had received surgery. We sought to evaluate and compare the patients’ experience with both treatments. A questionnaire assessed patients’ perceptions regarding side effects, aesthetic outcomes, wound care, fear of complications, and personal treatment preferences. Patients evaluated the different parameters of their either RSCT- or surgery-treated lesions on a scale from 0–10. Results: Patients were more afraid of complications before surgery than before RSCT (p = 0.04). Treatment with RSCT caused significantly less pain on treatment day (mean 0.56) than surgery (mean 2.32) (0 no pain, 10 maximum pain) (p = 0.02) and 14 days after the procedure (mean 0.89 versus mean 2.47) (p = 0.02). On day 14, RSCT-treated lesions were also significantly less itchy (mean 0.34) than after surgery (mean 1.50). Most patients were very satisfied with the aesthetic outcome after both RSCT (mean 8.42) and surgery (mean 8.31) (p = 0.89). In the case of a new NMSC, the majority of patients who experienced both treatments would rather be treated primarily with RSCT (44%) or would consider both options (31%); only 19% preferred surgery. Conclusion: Patients evaluated RSCT as less painful than surgery. The aesthetic outcomes of both treatments were comparable. For pain-sensitive patients, RSCT might be a preferable treatment option.
Full article
(This article belongs to the Section Pain Management)
Open AccessArticle
Oral Health Status of Healthcare Workers in Ilembula/Tanzania during the COVID-19 Condition
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Tobias Bensel, Simon Megiroo, Werner Kronenberg, Wolfgang Bömicke, Timo Ulrichs and Sebastian Hinz
Healthcare 2024, 12(9), 920; https://doi.org/10.3390/healthcare12090920 (registering DOI) - 29 Apr 2024
Abstract
The challenge of reduced dental treatment and education infrastructure in the Tanzanian highlands affects the oral health situation of both the general population and local healthcare workers. The aim of this study was to investigate the oral health status of healthcare workers at
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The challenge of reduced dental treatment and education infrastructure in the Tanzanian highlands affects the oral health situation of both the general population and local healthcare workers. The aim of this study was to investigate the oral health status of healthcare workers at Ilembula Lutheran Hospital (ILH), Tanzania, during the COVID-19 pandemic. In total, 134 healthcare workers (62 women, 72 men; mean age 36.48 ± 9.56 years, range 19–59 years; median age 35.00 years) participated in this cross-sectional study, conducted from 12 February to 27 February. A dental examiner trained in oral health screening performed the oral health data collection. Data collection was performed by probability sampling using the Ilembula Data Collection Form—Oral Health (IDCF-Oral Health) questionnaire distributed in paper form. Ethical approval was obtained from the National Institute for Medical Research/Tanzania. The decayed, missing, and filled teeth (DMF/T) index proposed by the World Health Organization (WHO) was used with the associated caries measurement method and the simplified oral hygiene index (OHI-S). Details regarding edentulism, nutritional habits, and socio-economic factors were collected. Statistical analysis was performed using linear regression (α = 0.05). The average DMF-T index was 3.33 ± 0.82, with age, gender, meal frequency, and soft drink consumption significantly influencing the index. No evidence of dental plaque was detected in 43.3% of the participants. Of the participants, 32.8% required prosthetic treatment (Kennedy Class III), while 16.4% needed it for acute malocclusions. Oral hygiene products were used in 97% of cases. A total of 35.8% of the participants had an OHI-S score of up to 1.0, with (p < 0.001) age and (p < 0.001) sex having a significant influence on the index. The current oral health situation of healthcare workers at ILH shows a moderate need for restorative and prosthetic treatment in rural Tanzania. Despite the COVID-19 pandemic, there was no change in the need for dental treatment, which may be explained by the generally restricted access to dental healthcare in the investigated region. The development of an interdisciplinary oral health prophylaxis system could help to reduce the need for future treatments.
Full article
Open AccessArticle
Effect of Therapeutic Gardening Program in Urban Gardens on the Mental Health of Children and Their Caregivers with Atopic Dermatitis
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Hyunjin Baik, Sueran Choi, Miae An, Hyeyoung Jin, Insoon Kang, Wonsuck Yoon and Young Yoo
Healthcare 2024, 12(9), 919; https://doi.org/10.3390/healthcare12090919 (registering DOI) - 29 Apr 2024
Abstract
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This study was conducted to identify the physical and psychological difficulties of children with atopic dermatitis and their caregivers, and to investigate the effects of participation in a novel therapeutic gardening program based on psychological intervention on their physical and mental health. The
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This study was conducted to identify the physical and psychological difficulties of children with atopic dermatitis and their caregivers, and to investigate the effects of participation in a novel therapeutic gardening program based on psychological intervention on their physical and mental health. The program, consisting of 15 sessions, was conducted for approximately 4 months in urban gardens in Seoul and involved 30 children with atopic dermatitis and their caregivers. Additionally, a control group of 30 non-participating caregivers was recruited for comparative analysis. The psychological and emotional changes in caregivers were assessed using six self-report scales (depression, anxiety, stress, vitality, life satisfaction, parenting efficacy) before and after participation in the program. Additionally, the depression index (CDI) and atopic dermatitis index (SCORAD, TEWL) were measured for the children with atopic dermatitis. The research results indicate that the therapeutic gardening program utilizing psychological intervention had a positive impact on the physiological and psychological health of participants. These results are significant as they demonstrate the clinical application of the professionally developed therapeutic gardening program through active intervention and operation. This study suggests that this program can serve as an effective intervention in improving the mental health of both children with atopic dermatitis and their caregivers.
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Open AccessArticle
Establishment of a Dataset for the Traditional Korean Medicine Examination in Healthy Adults
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Soyoung Kim, Ancho Lim, Young-Eun Kim, Youngseop Lee, Hyeong Joon Jun, Mi Hong Yim, Daehyeok Kim, Purumea Jun, Jeong Hwan Park and Sanghun Lee
Healthcare 2024, 12(9), 918; https://doi.org/10.3390/healthcare12090918 (registering DOI) - 29 Apr 2024
Abstract
We established a protocol for the traditional Korean medicine examination (KME) and methodically gathered data following this protocol. Potential indicators for KME were extracted through a literature review; the first KME protocol was developed based on three rounds of expert opinions. The first
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We established a protocol for the traditional Korean medicine examination (KME) and methodically gathered data following this protocol. Potential indicators for KME were extracted through a literature review; the first KME protocol was developed based on three rounds of expert opinions. The first KME protocol’s feasibility was confirmed, and data were collected over four years from traditional Korean medicine (KM) hospitals, focusing on healthy adults, using the final KME protocol. A literature review identified 175 potential core indicators, condensed into 73 indicators after three rounds of expert consultation. The first KME protocol, which was categorized under questionnaires and medical examinations, was developed after the third round of expert opinions. A pilot study using the first KME protocol was conducted to ensure its validity, leading to modifications resulting in the development of the final KME protocol. Over four years, data were collected from six KM hospitals, focusing on healthy adults; we obtained a dataset comprising 11,036 healthy adults. This is the first protocol incorporating core indicators of KME in a quantitative form and systematically collecting data. Our protocol holds potential merit in evaluating predisposition to diseases or predicting diseases.
Full article
(This article belongs to the Special Issue Emerging Developments in Integrative and Complementary Medicine: Advancements in Research and Clinical Applications)
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Open AccessReview
The Role of Tele-Exercise for People with Type 2 Diabetes: A Scoping Review
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Hani Fahad A. Albalawi
Healthcare 2024, 12(9), 917; https://doi.org/10.3390/healthcare12090917 (registering DOI) - 29 Apr 2024
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Background: Supervised exercise interventions tend to be more effective than unsupervised exercises or physical activity advice alone. However, people with type 2 diabetes may find it difficult to attend supervised exercise interventions due to several obstacles. Tele-exercise, or utilizing technology to deliver home-based
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Background: Supervised exercise interventions tend to be more effective than unsupervised exercises or physical activity advice alone. However, people with type 2 diabetes may find it difficult to attend supervised exercise interventions due to several obstacles. Tele-exercise, or utilizing technology to deliver home-based exercise, might be a solution. Objective: This scoping review aimed to explore clinical trials investigating the impact of tele-exercise interventions in individuals with type 2 diabetes Methods: Four electronic databases were searched for the period up to January 2024 for clinical trials investigating the impact of tele-exercise on health-related outcomes in adults with type 2 diabetes. Results: Seven trials involving 460 individuals with type 2 diabetes met the inclusion criteria. In these trials, combined aerobic and resistance exercise programs were the main types delivered remotely. To deliver such programs, both synchronous (n = 4) and asynchronous (n = 3) delivery modes were adopted. Regardless of the delivery mode, all tele-exercise interventions led to improvements in various factors related to type 2 diabetes and its complications, including glycemic control, blood lipids, body composition, functional capacity, muscle strength, and quality of life. The improvements were also found to be as effective as those of supervised exercise. Conclusions: Tele-exercise interventions seem to be feasible and as effective as supervised exercise interventions in terms of improving glycemic control, blood lipids, functional capacity, muscle strength, body composition, and quality of life for people with type 2 diabetes.
Full article
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Open AccessArticle
Patient Knowledge, Medication Adherence, and Influencing Factors: A Cross-Sectional Study among Hypertensive Patients in Greece
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Konstantinos Giakoumidakis, Evridiki Patelarou, Hero Brokalaki, Maria Bastaki, Nikolaos V. Fotos, Parthena Ifantopoulou, Antonios Christodoulakis, Anastasia A. Chatziefstratiou and Athina Patelarou
Healthcare 2024, 12(9), 916; https://doi.org/10.3390/healthcare12090916 (registering DOI) - 29 Apr 2024
Abstract
This study aimed to investigate the knowledge of patients with hypertension about their condition, adherence to antihypertensive medication, and the factors influencing it. A cross-sectional study was conducted in two cardiology outpatient clinics of two tertiary hospitals, in Greece. The study included 188
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This study aimed to investigate the knowledge of patients with hypertension about their condition, adherence to antihypertensive medication, and the factors influencing it. A cross-sectional study was conducted in two cardiology outpatient clinics of two tertiary hospitals, in Greece. The study included 188 patients diagnosed with hypertension. The patients’ knowledge about their disease and adherence to medication were assessed by using the HK-LS and A-14 scales, respectively. Patients had sufficient knowledge levels about their disease, but significantly low levels of adherence to medication. Patients with higher knowledge levels were more adherent to medications [r(188) = 0.885, p < 0.001]. By using multivariate analysis, higher age (p = 0.018), residence in a more populous area (p = 0.041), more years with the disease (p = 0.012), and a lower number of medications (p = 0.03) were associated with higher levels of knowledge. Conversely, younger age (p = 0.036), lower educational levels (p = 0.048), fewer years with the disease (p = 0.001), and a higher number of medications (p = 0.003) were associated with lower adherence to medication. The Greek patients’ hypertension knowledge was sufficient; however, adherence to medication was significantly low. Healthcare managers could utilize our findings to design targeted interventions for improving adherence to medication for these patients.
Full article
Open AccessArticle
A Comprehensive Workplace Exercise Intervention to Reduce Musculoskeletal Pain and Improve Functional Capacity in Office Workers: A Randomized Controlled Study
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Konstantina Karatrantou and Vassilis Gerodimos
Healthcare 2024, 12(9), 915; https://doi.org/10.3390/healthcare12090915 (registering DOI) - 28 Apr 2024
Abstract
The high levels of musculoskeletal pain, in conjunction with the low levels of functional capacity, may negatively affect workers’ health, efficiency, and productivity. This randomized controlled study investigated the efficacy of a 6-month comprehensive workplace exercise program on musculoskeletal pain and functional capacity
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The high levels of musculoskeletal pain, in conjunction with the low levels of functional capacity, may negatively affect workers’ health, efficiency, and productivity. This randomized controlled study investigated the efficacy of a 6-month comprehensive workplace exercise program on musculoskeletal pain and functional capacity in office workers. Seventy male and female office workers with musculoskeletal pain in any body area were randomly assigned to either an intervention (IG; n = 35) or a control group (CG; n = 35). The IG participated every working day (during working hours) in a 6-month supervised combined (flexibility, strength, and balance) exercise program (120 training sessions; five times/week) for the total body. The CG did not participate in any intervention. Musculoskeletal pains in nine body areas and functional capacity (flexibility, balance, and strength) of the lower and upper body were measured before and following the intervention. The IG significantly reduced duration and intensity of pain (43.1–70%; p = 0.000) as well as days of work absenteeism (84.6%; p = 0.000), while improving work capacity (87.1%; p = 0.000). Furthermore, the IG significantly increased cervical, handgrip, back, and leg maximal strength (10.3–27.1%; p = 0.000) and flexibility and balance (12.3–73.7%; p = 0.000). In CG, all musculoskeletal pain and functional capacity indices remained unchanged. In conclusion, this program may be effectively used to reduce musculoskeletal pain and improve functional capacity.
Full article
(This article belongs to the Special Issue Health Risks in the Work Environment: Assessment and Improvement)
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Open AccessArticle
How Professional and Market Logics and the Conflict between Institutional Demands Affect Hospital Accreditation Compliance: A Multiple-Case Study in Brazil
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Tiago Martins Ramos da Silva and Luciano Rossoni
Healthcare 2024, 12(9), 914; https://doi.org/10.3390/healthcare12090914 (registering DOI) - 27 Apr 2024
Abstract
Hospital accreditation has become ubiquitous in developing countries. While research acknowledges that accreditation can enhance healthcare quality, efficiency, and safety, concerns persist regarding hospitals’ management of conflicts stemming from the diverse institutional logic inherent in this process. Therefore, this study aimed to investigate
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Hospital accreditation has become ubiquitous in developing countries. While research acknowledges that accreditation can enhance healthcare quality, efficiency, and safety, concerns persist regarding hospitals’ management of conflicts stemming from the diverse institutional logic inherent in this process. Therefore, this study aimed to investigate how professional and market logic, alongside conflicts arising from institutional demands, affect compliance with hospital accreditation. To this end, we conducted a multiple-case study in four Brazilian hospitals employing in-depth interviews and on-site observations. The triangulation of narrative analysis and the outcomes of multiple correspondence analysis revealed that when professional logic predominates, there is a greater propensity to tailor accredited activities by segmenting the tasks between physicians and nurses with the intention of mitigating existing conflicts. Conversely, when conflicts occur over established goals between professionals and orientated marked logic executives, the accreditation process is impeded, resulting in non-compliance. Ultimately, the findings underscore the alignment between the pursuit of legitimacy and efficiency within the accreditation process. We conclude by delineating the theoretical and practical implications of scrutinizing the internal dynamics of institutional logic.
Full article
(This article belongs to the Section Healthcare Quality and Patient Safety)
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Open AccessArticle
Differentiating Pressure Ulcer Risk Levels through Interpretable Classification Models Based on Readily Measurable Indicators
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Eugenio Vera-Salmerón, Carmen Domínguez-Nogueira, José A. Sáez, José L. Romero-Béjar and Emilio Mota-Romero
Healthcare 2024, 12(9), 913; https://doi.org/10.3390/healthcare12090913 (registering DOI) - 27 Apr 2024
Abstract
Pressure ulcers carry a significant risk in clinical practice. This paper proposes a practical and interpretable approach to estimate the risk levels of pressure ulcers using decision tree models. In order to address the common problem of imbalanced learning in nursing classification datasets,
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Pressure ulcers carry a significant risk in clinical practice. This paper proposes a practical and interpretable approach to estimate the risk levels of pressure ulcers using decision tree models. In order to address the common problem of imbalanced learning in nursing classification datasets, various oversampling configurations are analyzed to improve the data quality prior to modeling. The decision trees built are based on three easily identifiable and clinically relevant pressure ulcer risk indicators: mobility, activity, and skin moisture. Additionally, this research introduces a novel tabular visualization method to enhance the usability of the decision trees in clinical practice. Thus, the primary aim of this approach is to provide nursing professionals with valuable insights for assessing the potential risk levels of pressure ulcers, which could support their decision-making and allow, for example, the application of suitable preventive measures tailored to each patient’s requirements. The interpretability of the models proposed and their performance, evaluated through stratified cross-validation, make them a helpful tool for nursing care in estimating the pressure ulcer risk level.
Full article
(This article belongs to the Section Artificial Intelligence in Medicine)
Open AccessArticle
Risk Factors for Overweight and Obesity in Later School-Aged Children: Focus on Lifestyle Behaviours and Psychosocial Characteristics
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Yong-Sook Eo and Myo-Sung Kim
Healthcare 2024, 12(9), 912; https://doi.org/10.3390/healthcare12090912 (registering DOI) - 27 Apr 2024
Abstract
The study analysed the 12th wave (2019) of data from the Panel Study on Korean Children conducted by the Korea Institute of Child Care and Education. A total of 1174 children were selected as the subjects of the study. The results concerning the
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The study analysed the 12th wave (2019) of data from the Panel Study on Korean Children conducted by the Korea Institute of Child Care and Education. A total of 1174 children were selected as the subjects of the study. The results concerning the identifying factors influencing overweight and obesity in later school-aged children revealed that when compared to boys, girls were 1.66 times more likely to be overweight or obese. Moreover, for every one-hour increase in media usage time, the likelihood of being overweight or obese increased by 1.23 times, and for every one-point increase in body dissatisfaction, the probability of being overweight or obese increased by 2.07 times. However, among personality traits, neuroticism was associated with a 0.96 times lower likelihood of being overweight or obese. These findings underscore the significance of considering not only lifestyle factors but also psychosocial characteristics such as body dissatisfaction and neuroticism as predictive factors for overweight and obesity in later school-aged children, providing a basis for intervention.
Full article
(This article belongs to the Special Issue Interventions for Preventing Obesity in Children and Adolescents)
Open AccessArticle
Benefit or Problem: Exploration of How Response Options Affect Self-Reported Behaviors and Interests in Autistic Adults
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Hyein Lee, Nikita Jadav, Ellen Wilkinson and Vanessa H. Bal
Healthcare 2024, 12(9), 911; https://doi.org/10.3390/healthcare12090911 (registering DOI) - 27 Apr 2024
Abstract
Assessment of restricted, repetitive behaviors (RRB) in autism evaluations often assumes that these behaviors negatively impact the individual. Qualitative studies of first-person accounts indicate the negative impact of the stigma associated with RRBs but also provide insights into the positive aspects. The current
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Assessment of restricted, repetitive behaviors (RRB) in autism evaluations often assumes that these behaviors negatively impact the individual. Qualitative studies of first-person accounts indicate the negative impact of the stigma associated with RRBs but also provide insights into the positive aspects. The current study explores how framing response options as negative (i.e., level of problem associated with occurrence) or positive (i.e., level of benefit associated with occurrence) affects RRB self-reports in autistic adults. Sixty-six autistic adults aged 18–59 filled out the Repetitive Behavior Scale-Revised (RBS-R) and a modified RBS-R+, assessing problems and benefits of reported behaviors, respectively. There was a moderate to strong correlation between the forms, each assessing problems and benefits in terms of the number of behaviors endorsed (r = 0.746) and the levels of benefits and problems (r = 0.637). Autistic adults reported a higher number of RRBs in the form that assessed problems, but the number of behaviors was comparable between the forms when counting in the response option of the occurrence of behavior without having a benefit. Despite some variability in the level of problems and the benefits across the subdomains of RRB, autistic adults largely rated comparable levels of associated benefits and problems, highlighting the complexity of RRBs as having both positive and negative impacts. Future screening and diagnostic tools for adults should aim to assess both positive and negative aspects of autistic features to afford a more nuanced understanding of individual experiences while still yielding diagnostically relevant information. Qualitative studies are needed to better understand the complex experiences associated with these behaviors; however, it may be important to ensure that options for endorsement of behaviors without a specific benefit are also needed to ensure some behaviors (e.g., self-injurious behaviors) are not missed.
Full article
(This article belongs to the Special Issue Autism beyond School-Age: Characterization, Intervention, and Community Support)
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Open AccessOpinion
Measurement-Based Care in Youth: An Opportunity for Better Clinical Outcomes?
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Roberta Frontini, Catarina Costa, Sílvia Baptista, Constança do Carmo Garcia and António Vian-Lains
Healthcare 2024, 12(9), 910; https://doi.org/10.3390/healthcare12090910 (registering DOI) - 27 Apr 2024
Abstract
Measurement-based care (MBC) is a procedure in which systematic and routine assessments are performed. Through this practice, clinicians can verify the progress of the symptomatology of the patient and adapt the appointments and the intervention to the current symptoms. Studies have reflected on
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Measurement-based care (MBC) is a procedure in which systematic and routine assessments are performed. Through this practice, clinicians can verify the progress of the symptomatology of the patient and adapt the appointments and the intervention to the current symptoms. Studies have reflected on the importance and the benefits of this type of procedure in the adult population, and have shown positive results. However, there is a lack of evidence concerning the remaining populations. Regarding youth, for instance, few articles have evaluated the benefits of using this procedure in clinical practice. However, research focused on this topic has revealed positive results, especially when clinicians were loyal to the MBC procedures. Still, further research is needed. This letter aims to share the methodology used by our multidisciplinary team, composed of psychologists and psychiatrists, in a clinical context at the Hospital Cruz Vermelha, Lisboa, applied to the adult population; the objective is to share and discuss some alterations that could be made to our evaluation protocol to enable the same to be used with the youth population. We believe that implementing MBC for youth is crucial for several reasons, including enhanced treatment efficacy, more personalized treatment, a reduced reliance on subjectivity, and empowerment not only of patients but also families.
Full article
Open AccessArticle
Hazard Flagging as a Risk Mitigation Strategy for Violence against Emergency Medical Services
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Justin Mausz, Dan Piquette, Robert Bradford, Mandy Johnston, Alan M. Batt and Elizabeth A. Donnelly
Healthcare 2024, 12(9), 909; https://doi.org/10.3390/healthcare12090909 (registering DOI) - 27 Apr 2024
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Paramedics are increasingly being subjected to violence, creating the potential for significant physical and psychological harm. Where a patient has a history of violent behavior, hazard flags—applied either to the individual, their residential address, or phone number—can alert paramedics to the possibility of
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Paramedics are increasingly being subjected to violence, creating the potential for significant physical and psychological harm. Where a patient has a history of violent behavior, hazard flags—applied either to the individual, their residential address, or phone number—can alert paramedics to the possibility of violence, potentially reducing the risk of injury. Leveraging a novel violence reporting process embedded in the electronic patient care record, we reviewed violence reports filed over a thirteen-month period since its inception in February 2021 to assess the effectiveness of hazard flagging as a potential risk mitigation strategy. Upon reviewing a report, paramedic supervisors can generate a hazard flag if recurrent violent behavior from the patient is anticipated. In all, 502 violence reports were filed, for which paramedic supervisors generated hazard flags in 20% of cases (n = 99). In general, cases were not flagged either because the incident occurred at a location not amenable to flagging or because the supervisors felt that a hazard flag was not warranted based on the details in the report. Hazard flagging was associated with an increased risk of violence during subsequent paramedic attendance (Odds Ratio [OR] 6.21, p < 0.001). Nevertheless, the process appears to reliably identify persons who may be violent towards paramedics.
Full article
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Open AccessReview
Implementing Trauma-Informed Care—Settings, Definitions, Interventions, Measures, and Implementation across Settings: A Scoping Review
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Lene Lauge Berring, Tine Holm, Jens Peter Hansen, Christian Lie Delcomyn, Rikke Søndergaard and Jacob Hvidhjelm
Healthcare 2024, 12(9), 908; https://doi.org/10.3390/healthcare12090908 (registering DOI) - 27 Apr 2024
Abstract
Traumatic experiences can have long-lasting negative effects on individuals, organizations, and societies. If trauma is not addressed, it can create unsafe cultures with constant arousal, untrusting relationships, and the use of coercive measures. Trauma-informed care (TIC) can play a central role in mitigating
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Traumatic experiences can have long-lasting negative effects on individuals, organizations, and societies. If trauma is not addressed, it can create unsafe cultures with constant arousal, untrusting relationships, and the use of coercive measures. Trauma-informed care (TIC) can play a central role in mitigating these negative consequences, but it is unknown how and in which way(s) TIC should be implemented. Our objective was to conduct a scoping review that systematically explored and mapped research conducted in this area and to identify existing knowledge about the implementation of TIC. The search was conducted on the CINAHL, Cochrane, Embase, ERIC, Medline, PsycINFO, and Web of Science databases, and more than 3000 empirical papers, published between 2000 and 2022, were identified. Following further screening, we included 157 papers in our review, which were mainly from the USA, Australia, New Zealand, and Canada, focusing on study settings, methodologies, and definitions of TIC, as well as the types of interventions and measures used. This review shows that TIC is a complex and multifaceted framework, with no overarching structure or clear theoretical underpinnings that can guide practical implementations. TIC has been defined and adapted in varied ways across different settings and populations, making it difficult to synthesize knowledge. A higher level of agreement on how to operationalize and implement TIC in international research could be important in order to better examine its impact and broaden the approach.
Full article
(This article belongs to the Topic Global Mental Health Trends)
Open AccessArticle
General, Vaccination, Navigational and Digital Health Literacy of Students Enrolled in Different Medical and Health Educational Programs
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Gaukhar Kayupova, Aliya Takuadina, Zhanerke Bolatova, Zhaniya Dauletkaliyeva, Nurbek Yerdessov, Karina Nukeshtayeva and Olzhas Zhamantayev
Healthcare 2024, 12(9), 907; https://doi.org/10.3390/healthcare12090907 (registering DOI) - 26 Apr 2024
Abstract
Evaluating prospective graduates’ health literacy profiles before they enter the job market is crucial. Our research aimed to explore the health literacy levels of medical and health students by assessing their ability to obtain health-related information, understand healthcare systems, use e-health, and be
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Evaluating prospective graduates’ health literacy profiles before they enter the job market is crucial. Our research aimed to explore the health literacy levels of medical and health students by assessing their ability to obtain health-related information, understand healthcare systems, use e-health, and be informed about vaccination as well as to explore the factors associated with health literacy. Short versions of the HLS19-Q12 were used for a cross-sectional survey that was carried out among 1042 students enrolled in various medical and health educational programs at three medical universities in Kazakhstan between September and November of 2023. Additionally, instruments such as Digital Health Literacy (HLS19-DIGI), Navigational Health Literacy (HLS19-NAV), and Vaccination Health Literacy (HLS19-VAC) were employed. The score of General Health Literacy was 88.26 ± 17.5. One in eight students encountered difficulties in Vaccination Health Literacy. Despite overall high health literacy, Navigational Health Literacy posed challenges for all students. The Public Health students exhibited the highest General Health Literacy (91.53 ± 13.22), followed by students in Nursing, General Medicine, other educational programs (Dentistry and Biomedicine) and Pharmacy. Financial constraints for medication and medical examinations significantly influenced health literacy across all types of individuals. Since comprehensive health literacy instruction or interventions are still uncommon in the curricula, it seems reasonable to develop and incorporate appropriate courses for medical and health educational programs.
Full article
Open AccessArticle
Factors Associated with Evidence-Based Practice Competencies among Taiwanese Nurses: A Cross-Sectional Study
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Li-Chuan Cheng, Chia-Jung Chen, Shih-Chun Lin and Malcolm Koo
Healthcare 2024, 12(9), 906; https://doi.org/10.3390/healthcare12090906 (registering DOI) - 26 Apr 2024
Abstract
Evidence-based practice (EBP) is an essential component of healthcare practice that ensures the delivery of high-quality care by integrating the best available evidence. This study aimed to explore factors influencing EBP among nursing professionals in Taiwan. A cross-sectional survey study was conducted with
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Evidence-based practice (EBP) is an essential component of healthcare practice that ensures the delivery of high-quality care by integrating the best available evidence. This study aimed to explore factors influencing EBP among nursing professionals in Taiwan. A cross-sectional survey study was conducted with 752 registered nurses and nurse practitioners recruited from a regional teaching hospital in southern Taiwan. EBP competency was evaluated using the Taipei Evidence-Based Practice Questionnaire (TEBPQ). The results showed that participation in evidence-based courses or training within the past year had the strongest association with EBP competencies (Std. B = 0.157, p < 0.001). Holding a graduate degree (Std. B = 0.151, p < 0.001), working in gynecology or pediatrics (Std. B = 0.126, p < 0.001), searching the literature in electronic databases (Std. B = 0.072, p = 0.039), and able to read academic articles in English (Std. B = 0.088, p = 0.005) were significantly associated with higher TEBPQ scores. Younger age (Std. B = −0.105, p = 0.005) and male gender (Std. B = 0.089, p = 0.010) were also identified as factors contributing to higher EBP competencies. The study highlights the importance of ongoing professional development, including EBP training and language proficiency, in enhancing EBP competencies among nursing professionals in Taiwan.
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(This article belongs to the Special Issue Research, Education, Workforce, and Regulation to Transforming Nursing Practice and Leadership: The Future of Nursing)
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Open AccessArticle
Assessing the Knowledge of HPV-Associated Oropharyngeal Squamous Cell Carcinoma, HPV Vaccination, and Practice Scope among Saudi Dental Students in the Western Region
by
Maha T. Alsharif and Elham Alsahafi
Healthcare 2024, 12(9), 905; https://doi.org/10.3390/healthcare12090905 (registering DOI) - 26 Apr 2024
Abstract
(1) Background: Human papillomavirus (HPV) infection is significantly associated with oropharyngeal squamous cell carcinoma (HPV-OPSCC), which is one of the fastest-growing cancer incidences globally. Dental practitioners play a crucial role in the primary and secondary prevention of HPV-OPSCC. There is little known about
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(1) Background: Human papillomavirus (HPV) infection is significantly associated with oropharyngeal squamous cell carcinoma (HPV-OPSCC), which is one of the fastest-growing cancer incidences globally. Dental practitioners play a crucial role in the primary and secondary prevention of HPV-OPSCC. There is little known about dental students’ awareness regarding HPV-OPSCC and HPV vaccination, as well as their intention to promote ‘primordial prevention’ among their patients. HPV vaccine, and the extent of their professional responsibilities. (2) Methods: This cross-sectional study was conducted in the western region of Saudi Arabia and involved undergraduate dental students (n = 688) from six public and private dental schools. Participants were requested to complete a sequential-section anonymous online survey, with 257 successfully completing all sections of the questionnaire. The association between participant characteristics and HPV-OPSCC, HPV vaccination awareness ratings, and perceived engagement in prevention were analyzed using ANOVA and chi-squared testing. A binary logistic regression analysis was conducted to examine the variables linked to these outcomes. (3) Results: Generally, the overall level of awareness of HPV-OPSCC and HPV vaccination was acceptable, with an average score of 53.44 ± 29.3 out of 100. However, a significant knowledge gap was observed, with 53% of respondents being unaware of the common sites for HPV-OPSCC and 63.8% being uninformed of the appropriate age for HPV vaccination. Females and those with a prior history of sexually transmitted diseases (STDs) had considerably higher levels of HPV vaccination knowledge (p < 0.05). The participants showed a favorable attitude towards their responsibility of informing patients about HPV-OPSCC and advocating HPV immunization. (4) Conclusions: This study underscores the need to enhance dental students’ understanding of HPV-OPSCC and HPV immunization, enabling them to effectively engage in primary and secondary preventative efforts against HPV-OPSCC.
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(This article belongs to the Section Preventive Medicine)
Open AccessArticle
Institutional Surgical Setting and Volume Effects of Certified Arthroplasty Centers in Germany: Evaluation of the Quality of Care in a 5-Year Comparison
by
Katrin Osmanski-Zenk, Annett Klinder, Andreas Pingsmann, Christoph H. Lohmann, Hermann Josef Bail, Bernd Kladny and Wolfram Mittelmeier
Healthcare 2024, 12(9), 904; https://doi.org/10.3390/healthcare12090904 (registering DOI) - 26 Apr 2024
Abstract
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To improve arthroplasty care quality, the EndoCert initiative focuses on structural, processual, and surgeon-related quality assurance. The aim of this study was to assess the impact of a surgeon’s case load in certified centers on quality of care, distinguished by different types of
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To improve arthroplasty care quality, the EndoCert initiative focuses on structural, processual, and surgeon-related quality assurance. The aim of this study was to assess the impact of a surgeon’s case load in certified centers on quality of care, distinguished by different types of surgeons. Data from the annual reports of EndoCert certified centers for the years 2017 to 2021 were analyzed. The study revealed reduced numbers of cases, while the number of surgeons remained constant. Since 2020, the decrease in the average case load per surgeons has become more pronounced. There were also differences between senior (sECrs) and EndoCert-registered surgeons (ECrs). Before the 2020 pandemic, over half of surgeons exceeded minimum annual case requirements, while, afterwards, this number declined, especially for the ECrs. Affiliated surgeons, who are also sECrs or ECrs, performed predominantly lower numbers of arthroplasties. However, a higher percentage of affiliated surgeons in a center correlated with faster surgeries and lower mortality rates. High numbers of arthroplasties per center or surgeon were not necessarily associated with better quality indicators, especially in the knee. While the comprehensive quality standards may offset volume effects, EndoCert should reconsider minimum volume regulations based on surgeon, but also on each joint.
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Open AccessSystematic Review
Korean Hospital Nurses’ Experiences with COVID-19: A Meta-Synthesis of Qualitative Findings
by
Suk-Jung Han, Hee-Jung Hong and Bok-Soon Shin
Healthcare 2024, 12(9), 903; https://doi.org/10.3390/healthcare12090903 (registering DOI) - 26 Apr 2024
Abstract
During the COVID-19 pandemic, hospital nurses in South Korea cared for patients amid their own anxiety and fear of infection, armed with a sense of professional duty and overcoming all odds to end the country’s infectious disease pandemic. This study aims to provide
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During the COVID-19 pandemic, hospital nurses in South Korea cared for patients amid their own anxiety and fear of infection, armed with a sense of professional duty and overcoming all odds to end the country’s infectious disease pandemic. This study aims to provide a meta-synthesis of qualitative studies examining the perceptions and experiences of nurses who cared for patients in dedicated COVID-19 hospitals in South Korea. Electronic databases, including RISS, KISS, KMbase, NDSL, KoreaMed, DBpia, PubMed, CINAHL, and Cochrane, were searched for research published until 2023. The study included research using qualitative approaches. These were reviewed and analyzed using a thematic synthesis approach. The quality of the studies was ascertained using the Critical Appraisal Skills Program checklist for qualitative research. Ultimately, 13 studies involving 219 nurses were included in the final review. Six major themes and thirteen subthemes emerged. The six topics are: “The crisis of a pandemic that suddenly appeared”, “Challenges in nursing patients with infectious diseases”, “A struggle in an unknown time due to a prolonged infectious disease”, “Ethical dilemmas in the face of infectious diseases”, “Duality of the social support system”, and “Professional growth for nurses regarding infectious diseases”. During the unexpected COVID-19 pandemic, nurses were able to overcome difficult situations through their interactions with patients, sense of professional mission, and commitment to nursing. Most importantly, they persevered through their collaboration and closeness with fellow nurses, despite confusion about their professional identity, the ethical dilemmas they faced in patient care, and dual attitudes regarding their social support system. To prepare for future infectious disease outbreaks, a multifaceted support system should be established to enable nurses to have positive interactions with their families, colleagues, and patients, which are central to their resilience.
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(This article belongs to the Collection COVID-19: Impact on Public Health and Healthcare)
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