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
Telerehabilitation in Children and Adolescents with Cystic Fibrosis: A Scoping Review
Healthcare 2024, 12(10), 971; https://doi.org/10.3390/healthcare12100971 - 8 May 2024
Abstract
Cystic fibrosis requires regular monitoring and intervention by healthcare teams; despite that, adherence to therapeutic measures is less than desired. The evolution of technology has allowed much of the care provided in person to be replaced by a telehealth delivery model, but studies
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Cystic fibrosis requires regular monitoring and intervention by healthcare teams; despite that, adherence to therapeutic measures is less than desired. The evolution of technology has allowed much of the care provided in person to be replaced by a telehealth delivery model, but studies on telerehabilitation are scarce and dispersed. This scoping review aimed to identify which domains of rehabilitation intervention are mediated by information and communication technologies and how they are developed in the provision of care to children and adolescents with cystic fibrosis. The data collection was conducted in February and June 2023, following the three steps recommended by the JBI for this type of review: (1) the search was conducted in MEDLINE, CINAHL, Scopus, JBI, and Web of Science; (2) the bibliographic references obtained from the included articles were analysed; and (3) the grey literature was checked. The eligibility criteria were children and adolescents and rehabilitation interventions mediated by information and communication technologies. The five studies included in this review were subjected to analysis, and a narrative synthesis of the results was carried out. The interventions identified included physical exercise programs (60%), management of the therapeutic regimen (40%), and symptom control (40%). The information and communication technologies were web-based platforms, video games, and telephones. The use of telerehabilitation included face-to-face meetings to ensure participants performed the exercises correctly, monitor their response to exercise, and teach them how to avoid risky situations during home workouts. In all studies, exercise sessions were supervised by the participants’ parents or caregivers.
Full article
(This article belongs to the Special Issue Family Care and Mental Health Delivery to Improve Welfare of Children and Parents)
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Open AccessArticle
Family Caregivers’ Experiences during the COVID-19 Pandemic: Qualitative Study
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Milagros Rico-Blázquez, Raquel Sánchez-Ruano, Cristina Oter-Quintana, Elena Polentinos-Castro, Ángel Martín-García, Pedro Otones-Reyes, Damián González-Beltrán and Mercedes Martínez-Marcos
Healthcare 2024, 12(10), 970; https://doi.org/10.3390/healthcare12100970 - 8 May 2024
Abstract
Background: The COVID-19 pandemic imposed lockdown measures that affected caregiving. Understanding caregivers’ context provides reveals their adaptive strategies to continue caring in this situation of uncertainty and isolation. Objective: To better understand the caregiving experiences of caregivers looking after dependent individuals living in
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Background: The COVID-19 pandemic imposed lockdown measures that affected caregiving. Understanding caregivers’ context provides reveals their adaptive strategies to continue caring in this situation of uncertainty and isolation. Objective: To better understand the caregiving experiences of caregivers looking after dependent individuals living in the community during the pandemic. Design: Qualitative research, phenomenological approach. Setting: Primary healthcare centers in Madrid region (Spain). Participants: 21 family caregivers. Methods: Purposive and theoretical sampling was used to recruit caregivers across nurses from primary healthcare centers. Participants were interviewed using a semi-structured interview guide to explore the caring experience. Interview transcripts were evaluated using thematic analysis. Results: The findings were categorized into two themes: “Caregivers during lockdown—providing care in a time of adversity” and “Caregiving toward normality”. The sub-themes identified were the re-structuring of before-care services and the introduction of new care approaches, managing the dependent person’s health problems, looking after oneself, and dealing with adversity. To adapt to the new normal, strategies were put in place designed to recover confidence and trust, reincorporate assistance, and reconnect with others. Conclusions: Care intensified during the pandemic. Caregivers took on the task without assistance, focusing on preventing contagion and protecting themselves to be able to continue giving care.
Full article
(This article belongs to the Special Issue Patient Centred Care: Current Situation and Development)
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Open AccessArticle
Adapting and Evaluating a Theory-Driven, Non-Pharmacological Intervention to Self-Manage Pain
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Jennifer Kawi, Chao Hsing Yeh, Lauren Grant, Johannes Thrul, Hulin Wu, Paul J. Christo and Lorraine S. Evangelista
Healthcare 2024, 12(10), 969; https://doi.org/10.3390/healthcare12100969 - 8 May 2024
Abstract
Background: The existing literature has limited detail on theory-driven interventions, particularly in pain studies. We adapted Bandura’s self-efficacy framework toward a theory-driven, non-pharmacological intervention using auricular point acupressure (APA) and evaluated participants’ perceptions of this intervention on their pain self-management. APA is a
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Background: The existing literature has limited detail on theory-driven interventions, particularly in pain studies. We adapted Bandura’s self-efficacy framework toward a theory-driven, non-pharmacological intervention using auricular point acupressure (APA) and evaluated participants’ perceptions of this intervention on their pain self-management. APA is a non-invasive modality based on auricular acupuncture principles. Methods: We mapped our study intervention components according to Bandura’s key sources of self-efficacy (performance accomplishments, vicarious experience, verbal persuasion, and emotional arousal) to facilitate the self-management of pain. Through a qualitative study design, we conducted virtual interviews at one and three months after a 4-week APA intervention among 23 participants using purposive sampling to describe their experiences in managing their pain based on our theory-driven APA intervention. Results: Using thematic analyses, we found four themes: the enhanced self-management of pain, improved pain outcomes, the feasibility of technology, and the sustainability of APA. Conclusions: Describing how interventions are mapped according to the elements of theoretical frameworks can help to guide intervention development, advance science and knowledge development, and promote the implementation of interventions. As such, using Bandura’s self-efficacy theory as a foundation for the APA intervention, APA was found to be feasible and sustainable, improving self-management, pain intensity, and pain-related outcomes. Participants provided recommendations for the further improvement of this theory-driven intervention.
Full article
(This article belongs to the Special Issue New Challenges in Health Care Services among Patients with Musculoskeletal Pain)
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Open AccessArticle
The Effect of Hot Application Applied to the Breast with the Help of the Thera Pearl in the Postpartum Period on Mothers’ Milk Perception and Postpartum Breastfeeding Self-Efficacy: A Randomized Controlled Study
by
Hava Ozkan, Betül Uzun Ozer and Ozlem Arı
Healthcare 2024, 12(10), 968; https://doi.org/10.3390/healthcare12100968 - 8 May 2024
Abstract
Breastfeeding difficulties are often present in the first weeks of the postpartum period, and various factors can cause a mother’s early cessation of breastfeeding. Such factors include mothers’ self-efficacy and perception of insufficient milk. This study aimed to examine the effect of a
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Breastfeeding difficulties are often present in the first weeks of the postpartum period, and various factors can cause a mother’s early cessation of breastfeeding. Such factors include mothers’ self-efficacy and perception of insufficient milk. This study aimed to examine the effect of a hot application on the breast with the help of the Thera Pearl in the postpartum period on milk perception and breastfeeding self-efficacy. This was a randomized controlled trial. This study was completed with 64 puerperal mothers, 31 of whom were control and 33 were experimental. A Personal Information Form, Breastfeeding Observation Form, Breastfeeding Self-Efficacy Scale, and Insufficient Milk Perception Scale were used to collect data. The average breastfeeding self-efficacy scale scores of the experimental group were 42.46 and 62, respectively, at the first and last follow-up, while the control group’s mean scores were 57.42 and 47. The average scores of the experimental group on the insufficient milk perception scale were 19, 28, and 48, respectively, from the first to the last follow-up, while those of the control group were 28, 24, and 34, respectively. As a result, self-efficacy and milk perception are important factors affecting breastfeeding. In this study, we found that Thera Pearl application increased breastfeeding self-efficacy but did not affect milk perception.
Full article
(This article belongs to the Section Women's Health Care)
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Open AccessArticle
A Nursing Process for Shared Decision-Making for Patients with Severe Mental Illness Receiving Treatment Involving Long-Term Coercive Measures: A Modified Grounded Theory Approach
by
Yutaka Nagayama
Healthcare 2024, 12(10), 967; https://doi.org/10.3390/healthcare12100967 - 8 May 2024
Abstract
The use of shared decision-making (SDM) has recently attracted attention for building recovery-oriented therapeutic relationships with patients with severe mental illness (SMI). The purpose of this study was to describe a nursing process for SDM for psychiatric patients with SMI being treated via
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The use of shared decision-making (SDM) has recently attracted attention for building recovery-oriented therapeutic relationships with patients with severe mental illness (SMI). The purpose of this study was to describe a nursing process for SDM for psychiatric patients with SMI being treated via long-term coercive measures, such as seclusion and physical restraint, in the “seclusion room” of a psychiatric ward. The study used a modified grounded theory approach. The participants were 17 psychiatric nurses. Data were collected via semi-structured interviews. Concepts and categories were generated from verbatim transcripts, and their relationships were illustrated using a diagram and by generating a storyline. The nursing process for SDM was based on sensing the response to triggering stimuli, and the nurse-led preventive measures compensated for the patients’ lack of coping skills. Because of the patients’ persistent instability in response to certain stimuli, in our process, nurses are involved in creating opportunities for self-understanding and self-selection while also taking proactive preventative measures. Patients’ reactions to surrounding stimuli were evaluated by nurses, who then determined whether they (or the patient) should take the lead in terms of decision-making.
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(This article belongs to the Section Nursing)
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Open AccessArticle
A Multi-Parametric Approach for Characterising Cerebral Haemodynamics in Acute Ischaemic and Haemorrhagic Stroke
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Abdulaziz Alshehri, Ronney B. Panerai, Angela Salinet, Man Yee Lam, Osian Llwyd, Thompson G. Robinson and Jatinder S. Minhas
Healthcare 2024, 12(10), 966; https://doi.org/10.3390/healthcare12100966 - 8 May 2024
Abstract
Background and Purpose: Early differentiation between acute ischaemic (AIS) and haemorrhagic stroke (ICH), based on cerebral and peripheral hemodynamic parameters, would be advantageous to allow for pre-hospital interventions. In this preliminary study, we explored the potential of multiple parameters, including dynamic cerebral autoregulation,
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Background and Purpose: Early differentiation between acute ischaemic (AIS) and haemorrhagic stroke (ICH), based on cerebral and peripheral hemodynamic parameters, would be advantageous to allow for pre-hospital interventions. In this preliminary study, we explored the potential of multiple parameters, including dynamic cerebral autoregulation, for phenotyping and differentiating each stroke sub-type. Methods: Eighty patients were included with clinical stroke syndromes confirmed by computed tomography within 48 h of symptom onset. Continuous recordings of bilateral cerebral blood velocity (transcranial Doppler ultrasound), end-tidal CO2 (capnography), electrocardiogram (ECG), and arterial blood pressure (ABP, Finometer) were used to derive 67 cerebral and peripheral parameters. Results: A total of 68 patients with AIS (mean age 66.8 ± SD 12.4 years) and 12 patients with ICH (67.8 ± 16.2 years) were included. The median ± SD NIHSS of the cohort was 5 ± 4.6. Statistically significant differences between AIS and ICH were observed for (i) an autoregulation index (ARI) that was higher in the unaffected hemisphere (UH) for ICH compared to AIS (5.9 ± 1.7 vs. 4.9 ± 1.8 p = 0.07); (ii) coherence function for both hemispheres in different frequency bands (AH, p < 0.01; UH p < 0.02); (iii) a baroreceptor sensitivity (BRS) for the low-frequency (LF) bands that was higher for AIS (6.7 ± 4.2 vs. 4.10 ± 2.13 ms/mmHg, p = 0.04) compared to ICH, and that the mean gain of the BRS in the LF range was higher in the AIS than in the ICH (5.8 ± 5.3 vs. 2.7 ± 1.8 ms/mmHg, p = 0.0005); (iv) Systolic and diastolic velocities of the affected hemisphere (AH) that were significantly higher in ICH than in AIS (82.5 ± 28.09 vs. 61.9 ± 18.9 cm/s), systolic velocity (p = 0.002), and diastolic velocity (p = 0.05). Conclusion: Further multivariate modelling might improve the ability of multiple parameters to discriminate between AIS and ICH and warrants future prospective studies of ultra-early classification (<4 h post symptom onset) of stroke sub-types.
Full article
(This article belongs to the Special Issue Prehospital and Hospital Care for Stroke Patients)
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Open AccessArticle
Service Quality and Related Factors in Primary Health Care Services: A Cross-Sectional Study
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Mehmet Sait Değer and Halim İşsever
Healthcare 2024, 12(10), 965; https://doi.org/10.3390/healthcare12100965 - 8 May 2024
Abstract
Primary health care services aim to prevent diseases and improve health efficiently and effectively. This study measures perceived service quality in a primary healthcare organization and examines the effect of personality traits on service quality. The cross-sectional study population comprised individuals over the
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Primary health care services aim to prevent diseases and improve health efficiently and effectively. This study measures perceived service quality in a primary healthcare organization and examines the effect of personality traits on service quality. The cross-sectional study population comprised individuals over the age of 18 who applied to the Bingöl Central Community Health Centre. A total of 460 participants were included in the study between November 2018 and March 2019. The participants completed a face-to-face questionnaire that included socio-demographic characteristics, the SERVQUAL Scale, and an abbreviated form of the revised Eysenck Personality Questionnaire. This study is based on doctoral research in public health. The study found median values for personality trait sub-dimensions as follows: neuroticism: 2, psychoticism: 2.65, extraversion: 4, and lying: 5. The SERVQUAL Score was −0.02. The study revealed that the quality of primary health care services did not meet the participants’ expectations. The study findings also indicated that age, educational attainment, and extraverted and psychotic personality traits were significantly associated with the satisfaction of service quality expectations (p < 0.05). It is recommended to provide primary health care services in facilities with good physical characteristics, with sufficient and competent health personnel, and in a timely and accurate manner to improve service quality.
Full article
(This article belongs to the Special Issue Review Research on Healthcare Quality and Patient Safety)
Open AccessCase Report
Inflatable Penile Prosthesis Complication in the Emergency Department
by
Farzad Sedaghat and Aws Kamona
Healthcare 2024, 12(10), 964; https://doi.org/10.3390/healthcare12100964 - 8 May 2024
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Inflatable penile prostheses are a widely utilized treatment for erectile dysfunction. While MRI is the optimal imaging modality for patients with suspected implant complications, it is often unavailable in the acute setting. In light of these limitations, we present a case of urethral
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Inflatable penile prostheses are a widely utilized treatment for erectile dysfunction. While MRI is the optimal imaging modality for patients with suspected implant complications, it is often unavailable in the acute setting. In light of these limitations, we present a case of urethral perforation by an implanted penile cylinder and its evaluation with contrast-enhanced computed tomography (CT) in an emergent setting.
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Open AccessArticle
Associations between Fluid Intelligence and Physical Fitness in School Children
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Borja Bazalo, Verónica Morales-Sánchez, Nuria Pérez-Romero, Falonn Contreras-Osorio, Christian Campos-Jara, Antonio Hernández-Mendo and Rafael E. Reigal
Healthcare 2024, 12(10), 963; https://doi.org/10.3390/healthcare12100963 - 8 May 2024
Abstract
Previous research has highlighted that active lifestyles that contribute to improved physical fitness are positively related to cognitive functioning in children and adolescents. Specifically, the increase in physical condition at school age is considered relevant because it is related to better cognitive ability
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Previous research has highlighted that active lifestyles that contribute to improved physical fitness are positively related to cognitive functioning in children and adolescents. Specifically, the increase in physical condition at school age is considered relevant because it is related to better cognitive ability and greater academic performance. Thus, the aim of this study was to analyze the relationships between explosive strength, speed–agility, and fluid reasoning in schoolchildren. To achieve this objective, an associative, comparative, and predictive design was used in this research. A total of 129 children participated in this study (age: M = 9.48; SD = 0.99). To assess fluid reasoning, the Raven test’s Standard Progressive Matrices Subtest and the Wechsler Intelligence Scale for Children (WISC-V) were used. To assess physical fitness, the speed–agility test and the horizontal jump test (ALPHA-fitness battery tests), as well as the ball throw test (2 kg), were used. The results showed that the speed–agility test significantly predicted WISC-V Fluid Reasoning Index scores, and the medicine ball toss test significantly predicted Raven test scores. The results obtained highlight the associations between physical condition at these ages and fluid intelligence. This suggests that promoting active lifestyles that improve physical fitness could have a positive impact on children’s cognitive health.
Full article
(This article belongs to the Special Issue Physical Activity, Healthy Lifestyle and Well-Being across the Lifespan)
Open AccessArticle
Virtual Golf, “Exergaming”, Using Virtual Reality for Healthcare in Older Adults: Focusing on Leisure Constraints, Participation Benefits, and Continuous Participation Intention
by
Chulhwan Choi, Dong-Kyu Kim and Inyup Lee
Healthcare 2024, 12(10), 962; https://doi.org/10.3390/healthcare12100962 - 8 May 2024
Abstract
Exergaming, a new type of sport, combined with virtual reality, has provided new opportunities for the aging population. This study analyzed the differences in leisure constraints, participation benefits, and continuous participation intention in virtual golf (represented as an exergame) depending on the participants’
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Exergaming, a new type of sport, combined with virtual reality, has provided new opportunities for the aging population. This study analyzed the differences in leisure constraints, participation benefits, and continuous participation intention in virtual golf (represented as an exergame) depending on the participants’ ages. Data collection was conducted from August 2023 to November 2023. A quantitative research design and a convenience sampling method were employed, targeting 310 regular virtual golf participants aged 20 years or older in the Republic of Korea. For comparative analysis, the survey participants were segmented into three groups: Group 1, young adults (18–35 years); Group 2, middle-aged adults (36–55 years); and Group 3, older adults (56–69 years). To compare and analyze participation behaviors in virtual golf, the dependent variables were identified: (a) leisure constraints (four factors) to limit formation and participation in leisure; (b) participation benefits (four factors) to encourage participation in leisure; and (c) continuous participation intention (single factor) to show likelihood to participate in leisure in the future. The results revealed that the young adult group showed statistically high results for costs under leisure constraints (F = 14.949, p < 0.001, ηp2 = 0.089), and the older adult group reported statistically high results in physical (F = 9.346, p < 0.001, ηp2 = 0.057) and mental (F = 7.249, p < 0.001, ηp2 = 0.045) participation benefits and continuous participation intention (F = 6.486, p < 0.01, ηp2 = 0.041). This study confirmed that virtual golf using advanced technology brings physical and mental benefits to older people based on reasonable cost and enables continuous participation in physical activity.
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Open AccessArticle
The Efficacy of Early Osteopathic Therapy in Restoring Proper Sucking in Breastfed Infants: Preliminary Findings from a Pilot Study
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Arianna Parodi, Rosalba Ruffa, Viola De Felice, Marina Sartini, Maria Luisa Cristina, Beatrice Martino, Francesca Bianco, Roberta Di Stefano and Massimo Mazzella
Healthcare 2024, 12(10), 961; https://doi.org/10.3390/healthcare12100961 - 8 May 2024
Abstract
Despite the care provided, some newborns, who are perfectly healthy, show functional alterations that impair a good breast attack in the first few days. This situation often leads to the early failure of lactation. We conducted a randomized single-blind controlled trial to evaluate
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Despite the care provided, some newborns, who are perfectly healthy, show functional alterations that impair a good breast attack in the first few days. This situation often leads to the early failure of lactation. We conducted a randomized single-blind controlled trial to evaluate whether four weeks of osteopathic treatment can normalize the sucking score in a group of neonates with impaired lactation ability. Forty-two healthy full-term neonates were enrolled in this study. On the basis of the sucking score and the assessment of the infant’s breastfeeding skills, infants who had intrinsic breastfeeding difficulties were selected. The inclusion criteria were healthy infants born > 37 weeks, a suction score ≤ 6, and any breast milk at enrolment. At the end of the study, the sucking score was significantly greater in the osteopathic group than in the untreated group; the median sucking score in the treated group was in the normal range, while it remained lower in the untreated group. At the end of the follow-up, the percentage of exclusively breastfeeding infants in the treatment group increased by +25%. This pilot study demonstrates the efficacy of early osteopathic intervention to relieve breastfeeding difficulties in newborns in the first few weeks of life.
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(This article belongs to the Section Nutrition and Public Health)
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Open AccessReview
Spiritual Distress, Hopelessness, and Depression in Palliative Care: Simultaneous Concept Analysis
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Helga Martins, Rita S. Silva, Joana Bragança, Joana Romeiro and Sílvia Caldeira
Healthcare 2024, 12(10), 960; https://doi.org/10.3390/healthcare12100960 - 7 May 2024
Abstract
Spiritual distress, hopelessness, and depression are concepts that are often used in palliative care. A simultaneous concept analysis (SCA) of these concepts is needed to clarify the terminology used in palliative care. Therefore, the aim of this study is to conduct a SCA
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Spiritual distress, hopelessness, and depression are concepts that are often used in palliative care. A simultaneous concept analysis (SCA) of these concepts is needed to clarify the terminology used in palliative care. Therefore, the aim of this study is to conduct a SCA of spiritual distress, hopelessness, and depression in palliative care. A SCA was performed using the methodology of Haase’s model. A literature search was conducted in March 2020 and updated in April 2022 and April 2024. The search was performed on the following online databases: CINAHL with Full-Text, MEDLINE with Full-Text, MedicLatina, LILACS, SciELO, and PubMed. The search was achieved without restrictions on the date of publication. A total of 84 articles were included in this study. The results highlight that the three concepts are different but also share some overlapping points. Spiritual distress is embedded in the rupture of their spiritual/religious belief systems, a lack of meaning in life, and existential issues. Hopelessness is a sense of giving up and an inability to control and fix the patient’s situation. Finally, depression is a state of sadness with a multi-impaired situation. In conclusion, refining the three concepts in palliative care is essential since it promotes clarification and enhances knowledge development towards intervention.
Full article
(This article belongs to the Section Nursing)
Open AccessArticle
Incidence and Factors Associated with Falls in Older People in a Long-Term Care Facility: A Prospective Study in Taiwan
by
Hung-Chun Lee, Chia-Jung Hsieh and Jih-Shuin Jerng
Healthcare 2024, 12(10), 959; https://doi.org/10.3390/healthcare12100959 - 7 May 2024
Abstract
Background: The effectiveness of applying a fall-risk assessment to prevent falls in residents of long-term care facilities has not been investigated. Methods: This prospective study enrolled elderly residents in a long-term care facility in Taiwan. Caregivers were provided with a health-status assessment and
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Background: The effectiveness of applying a fall-risk assessment to prevent falls in residents of long-term care facilities has not been investigated. Methods: This prospective study enrolled elderly residents in a long-term care facility in Taiwan. Caregivers were provided with a health-status assessment and fall-risk data to enhance their fall-prevention practices. A multivariate analysis was performed to identify the factors associated with falls. Results: A total of 123 subjects, including 68 and 55 for general and nursing-care models, respectively, were assessed. Their health status and risk of falls were provided to the care units to enhance their fall-prevention practices. Subjects in the nursing-care model had more dementia and more prescribed medications, worse physiologic conditions, and higher fall risk. Of them, 28 (23%) had subsequent falls. A univariate analysis showed that those with and without falls were similar in demographic characteristics, prescribed medications, physiologic function, and fall risk. There was a tendency for more falls in the nursing-care model residents (accounting for 61% of those who fell; p = 0.053). A regression analysis showed that gender (beta = 1.359; 95% confidence interval = 0.345–2.374; p = 0.010) and NPI score (beta = 0.101; 95% CI = 0.001–0.200; p = 0.047) were associated with the risk of falls. Conclusion: Residents at the long-term care facility had a significant risk of falls despite knowledge of their fall risk and the implementation of preventive measures. In this context of being aware of the risk, gender, and psychiatric symptoms were significantly associated with falls. Caregivers at long-term care facilities should implement further measures to prevent falls based on behavioral and psychological symptoms.
Full article
(This article belongs to the Special Issue Review Research on Healthcare Quality and Patient Safety)
Open AccessArticle
The First Two Years of COVID-19 Hospitalization Characteristics and Costs: Results from the National Discharge Registry
by
Pierpaolo Ferrante
Healthcare 2024, 12(10), 958; https://doi.org/10.3390/healthcare12100958 - 7 May 2024
Abstract
Background: The COVID-19 pandemic has emerged as the primary global health challenge of the new millennium. Understanding its impact on health systems and learning from these experiences are crucial for improving system resilience against future health crises. This paper examines hospitalizations related to
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Background: The COVID-19 pandemic has emerged as the primary global health challenge of the new millennium. Understanding its impact on health systems and learning from these experiences are crucial for improving system resilience against future health crises. This paper examines hospitalizations related to COVID-19 in Italy from 2020 to 2021, with a specific focus on the costs associated with these admissions. Design and methods: This is a retrospective, population-based study of Italian hospitalizations of patients diagnosed with COVID-19 during the 2020–2021 period, using data extracted from the National Hospital Discharge Registry. The outcome variables considered include hospital admissions, costs, and length of stay. Results: In Italy, hospitalizations for COVID-19 totaled 357,354 in 2020 and 399,043 in 2021, with the transfer rate being three times higher than that of other patients. Hospitalizations were predominantly concentrated in the northern regions, especially during the first year. Mortality rates increased with age, while hospitalization rates peaked in the youngest and oldest age groups. The financial impact of COVID-19 hospitalizations was approximately €3.1 billion in 2020 and €3.6 billion in 2021. The cost per admission was around €8000 for standard care and €24,000 for intensive therapy in both years. Conclusion: Conducting a cost-benefit analysis of implementing a protective pad around the entire health system, which leverages networks of family doctors and nurses connected in real-time, could be an important step in strengthening health system resilience.
Full article
(This article belongs to the Special Issue Primary Health Care: Challenges and Recommendations during a Pandemic)
Open AccessSystematic Review
The General Public and Young Adults’ Knowledge and Perception of Palliative Care: A Systematic Review
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Yann-Nicolas Batzler, Manuela Schallenburger, Jacqueline Schwartz, Chantal Marazia and Martin Neukirchen
Healthcare 2024, 12(10), 957; https://doi.org/10.3390/healthcare12100957 - 7 May 2024
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Background: As a result of demographic change, chronic and oncological diseases are gaining importance in the context of public health. Palliative care plays a crucial role in maintaining the quality of life of those affected. International guidelines demand access to palliative care not
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Background: As a result of demographic change, chronic and oncological diseases are gaining importance in the context of public health. Palliative care plays a crucial role in maintaining the quality of life of those affected. International guidelines demand access to palliative care not only for the elderly but also for younger people who face severe illnesses. It can be assumed that palliative care will become increasingly important for them. In order to develop public health strategies which are able to promote palliative care, it is important to assess the knowledge of, and attitude towards, palliative care as found among members of the general public and its specific target groups. In particular, little is known about young adults’ knowledge and perceptions of palliative care. Objectives and design: This work aimed to assess the understanding and viewpoints regarding palliative care among the general population and among young adults aged 18 to 24. We therefore conducted a systematic review, which, for this target population, could be seen as a novel approach. Methods: Exclusion and inclusion criteria were developed using the PICOS process. Literature was researched within MEDLINE (via PubMed), Google Scholar and Web of Science. A search string was developed and refined for all three databases. Grey literature was included. Duplicates were excluded using Mendeley. The literature was independently screened by two researchers. Narrative synthesis was used to answer the main research question. Results: For the general public, palliative care is still associated with death and dying and comforting sick people towards the end of their lives. Multiple social determinants are linked to better knowledge of palliative care: higher education, higher income, female gender, having relatives that received palliative care, and permanent employment. The population’s knowledge of palliative care structures increases, the longer such structures have been established within a country. Young adults are familiar with the term palliative care, yet their understanding lacks nuance. They associate palliative care with death and dying and perceive palliative care to be a medical discipline primarily for the elderly. Nevertheless, young adults demand participation within the planning of interventions to destigmatize palliative care. Conclusions: The general public still lacks a detailed understanding of palliative care. Palliative care faces stigma at multiple levels, which creates barriers for those who set out to implement it. However, addressing young adults as a crucial peer group can help break down barriers and promote access to palliative care.
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Open AccessArticle
Attention-Deficit/Hyperactivity Disorder and Unhealthy Lifestyle in Adolescence: Unforeseen Role of Allostatic Overload and Psychological Well-Being
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Sara Gostoli, Giulia Raimondi, Chiara Rafanelli and Paola Gremigni
Healthcare 2024, 12(10), 956; https://doi.org/10.3390/healthcare12100956 - 7 May 2024
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Unhealthy lifestyle behaviors (ULBs) are common in early adolescence and could be worsened by Attention-Deficit/Hyperactivity Disorder (ADHD), as well as by specific psychosocial factors, such as stress and unbalanced (i.e., too high or low scores of) psychological well-being (PWB) dimensions. This multi-center study
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Unhealthy lifestyle behaviors (ULBs) are common in early adolescence and could be worsened by Attention-Deficit/Hyperactivity Disorder (ADHD), as well as by specific psychosocial factors, such as stress and unbalanced (i.e., too high or low scores of) psychological well-being (PWB) dimensions. This multi-center study aimed to evaluate how interactions between ADHD symptoms and psychosocial factors associated with ULBs (i.e., Allostatic Overload and multidimensional Psychological Well-Being), considered as moderators, could affect the adoption of ULBs during adolescence. A total of 440 fourteen-year-old adolescents were recruited from six upper secondary schools in Bologna and Rome (Italy) and completed self-report questionnaires on ULBs, ADHD, and psychosocial factors. Relations between ADHD symptomatology and specific ULBs (i.e., impaired sleep, problematic Internet use) were moderated by variables deemed as “negative” (i.e., Allostatic Overload) or “positive” (i.e., PWB dimensions of Self-Acceptance, Personal Growth, Positive Relations, Purpose in Life, Environmental Mastery): when the “negative” moderator is absent and the levels of the “positive” moderators are higher, ULBs decrease among students with lower ADHD symptomatology but increase among students with more severe ADHD. Based on ADHD severity, interventions should aim at promoting a state of euthymia, which consists in balanced PWB dimensions and reflects the optimal level of well-being to fulfill one’s own potential and self-realization.
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Open AccessArticle
Emotion in Motion: Weight Bias Internalization, Exercise Avoidance, and Fitness-Related Self-Conscious Emotions
by
Sophie S. Smith, Gill A. Ten Hoor, Niharika Lakhote and Karlijn Massar
Healthcare 2024, 12(10), 955; https://doi.org/10.3390/healthcare12100955 - 7 May 2024
Abstract
Weight bias internalization (WBI), the process of internalizing negative attitudes and stereotypes towards overweight individuals, significantly impacts self-worth and health behaviors, such as exercise avoidance. In the current study, we focused on the mediating role of fitness-related self-conscious emotions, particularly shame and guilt.
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Weight bias internalization (WBI), the process of internalizing negative attitudes and stereotypes towards overweight individuals, significantly impacts self-worth and health behaviors, such as exercise avoidance. In the current study, we focused on the mediating role of fitness-related self-conscious emotions, particularly shame and guilt. A cross-sectional study involving 150 self-described overweight Dutch women (age M = 49.63 ± 10.72) was conducted online. Participants completed measures assessing weight bias internalization, exercise avoidance, and body/fitness-related self-conscious emotions. Data were analyzed using linear regression and mediation analysis, controlling for age, BMI, and exercise frequency. The results show that weight bias internalization, guilt-free shame, and shame-free guilt uniquely predict exercise avoidance. Guilt-free shame partially mediated the relationship between weight bias internalization and exercise avoidance, indicating that increased internalized weight bias led to higher levels of guilt-free shame, which in turn contributed to exercise avoidance. Shame-free guilt did not act as a unique mediator. These findings underscore the importance of addressing weight bias internalization and fitness-related self-conscious emotions, particularly guilt-free shame, in interventions targeting exercise avoidance among overweight individuals. Strategies promoting self-compassion and reducing shame may prove beneficial in improving exercise behaviors and overall well-being.
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Open AccessSystematic Review
The Impact of Exercise on Interleukin-6 to Counteract Immunosenescence: Methodological Quality and Overview of Systematic Reviews
by
Anne Sulivan Lopes da Silva Reis, Guilherme Eustáquio Furtado, Marcos Rodrigo Trindade Pinheiro Menuchi and Grasiely Faccin Borges
Healthcare 2024, 12(10), 954; https://doi.org/10.3390/healthcare12100954 - 7 May 2024
Abstract
Objective: This study evaluated the methodological quality of published systematic reviews on randomized and non-randomized clinical trials to synthesize evidence on the association between IL-6, immunosenescence, and aerobic and/or resistance exercise. Method: The Preferred Reporting Items for Overviews of Systematic Reviews (PRIO-harms) guideline
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Objective: This study evaluated the methodological quality of published systematic reviews on randomized and non-randomized clinical trials to synthesize evidence on the association between IL-6, immunosenescence, and aerobic and/or resistance exercise. Method: The Preferred Reporting Items for Overviews of Systematic Reviews (PRIO-harms) guideline was used, with registration number CRD42022346142-PROSPERO. Relevant databases such as Cochrane Library, PubMed, Web of Science, Scopus, and Google Scholar were searched using English Medical Subject Headings terms. Inclusion criteria were systematic reviews analyzing aerobic exercise, resistance exercise, or a combination of both and assessing IL-6 as a biomarker of cellular immunosenescence in humans. The Measurement Tool to Assess Systematic Reviews 2 (AMSTAR-2) was employed. Results: Out of 742 identified articles, 18 were eligible, and 13 were selected for analysis. Sample sizes ranged from 249 to 1421 participants, mostly female, with ages ranging from 17 to 95 years. Aerobic exercise was the most studied type (46.15%), followed by combined exercise (38.46%) and resistance exercise (15.38%). Aerobic exercise showed a statistically significant reduction in IL-6, C-reactive protein (CRP), and tumor necrosis factor-alpha (TNF-α) levels. Among the 13 reviews analyzed using AMSTAR-2, 8 were rated as critically low quality, and 5 were classified as low quality. Conclusion: Aerobic exercise has anti-inflammatory properties and the potential to modulate IL-6, CRP, and TNF-α levels in immunosenescence. However, the limited methodological quality of the analyzed systematic reviews highlights the urgent need for robust, high-quality studies to improve access to information and facilitate evidence-based decision-making in healthcare.
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(This article belongs to the Section Chronic Care)
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Open AccessArticle
Empirical Study on Hospitalist System: A Value Creation Perspective
by
Liang-Hsi Kung and Yu-Hua Yan
Healthcare 2024, 12(10), 953; https://doi.org/10.3390/healthcare12100953 - 7 May 2024
Abstract
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This study investigates the impact of hospitalist system awareness, motivation, and behavior on value creation within the healthcare context of Taiwan. As population aging and the prevalence of chronic diseases continue to rise, accompanied by increased medical resource consumption, the Taiwan Ministry of
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This study investigates the impact of hospitalist system awareness, motivation, and behavior on value creation within the healthcare context of Taiwan. As population aging and the prevalence of chronic diseases continue to rise, accompanied by increased medical resource consumption, the Taiwan Ministry of Health and Welfare introduced the hospitalist system. Despite its implementation, the number of participating hospitals remains low. Using a questionnaire survey conducted from October 2021 to March 2022, data were collected from medical teams involved in the hospitalist system. A total of 324 valid questionnaires were analyzed. The results reveal that hospitalist awareness positively influences participation motivation (β = 0.846, p < 0.001), which subsequently impacts participation behavior positively (β = 0.888, p < 0.001). Moreover, participation behavior significantly contributes to value creation (β = 0.869, p < 0.001), along with the direct effect of awareness (β = 0.782, p < 0.001) on value creation. In conclusion, the successful promotion and implementation of the hospitalist system rely heavily on the support and active participation of medical staff. Effective interactions and comprehensive information dissemination are essential for maximizing healthcare value creation.
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Open AccessBrief Report
Implementation of the Recovery Model and Its Outcomes in Patients with Severe Mental Disorder
by
Antonio José Sánchez-Guarnido, María Isabel Ruiz-Granados, José Antonio Garrido-Cervera, Javier Herruzo and Carlos Herruzo
Healthcare 2024, 12(9), 952; https://doi.org/10.3390/healthcare12090952 - 6 May 2024
Abstract
Background: The recovery model assumes that the patient can experience personal growth even while maintaining symptoms of a mental disorder. In order to achieve this recovery, the practices of professionals must also change. However, in our setting, there are limited data on the
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Background: The recovery model assumes that the patient can experience personal growth even while maintaining symptoms of a mental disorder. In order to achieve this recovery, the practices of professionals must also change. However, in our setting, there are limited data on the implementation of practices based on the recovery model and their effect on personal recovery. Objective: To describe the association between professionals’ practices and patients’ personal recovery. Methods: An observational and cross-sectional study in which the Recovery Self-Assessment (RSA) was used to assess the degree of implementation of the different practices and the Recovery Assessment Scale (RAS) was used to assess the personal recovery of 307 patients with severe mental disorders. Results: Patients attended by professionals who followed the recovery model obtained a greater personal recovery (p < 0.001, d = 1.10). The dimension associated with greater recovery was that of working toward life goals. The least implemented dimensions had to do with offering treatment options and patient participation in decision-making. This study was conducted in accordance with STROBE (STrengthening the Reporting of OBservational studies in Epidemiology). Conclusions: Although this is a cross-sectional study that does not allow us to establish causal relationships, it shows that the model with which mental health professionals work is associated with patients’ chances of recovery. We therefore consider that it is important to foster the implementation of practices based on the recovery model within mental health care.
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