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
The Role of Place Attachment in the Relationship between Attitudes toward Aging and Subjective Well-Being among Community-Dwelling Older Adults in Taiwan
Healthcare 2024, 12(10), 981; https://doi.org/10.3390/healthcare12100981 (registering DOI) - 9 May 2024
Abstract
Subjective well-being presents a societal challenge for vulnerable older adults. This study aims to investigate the mediating role of place attachment in the relationship between attitudes toward aging and subjective well-being among community-dwelling older adults in Taiwan. Two waves of investigations were conducted
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Subjective well-being presents a societal challenge for vulnerable older adults. This study aims to investigate the mediating role of place attachment in the relationship between attitudes toward aging and subjective well-being among community-dwelling older adults in Taiwan. Two waves of investigations were conducted to examine the interplay between attitudes toward aging, subjective well-being, and place attachment among older adults. In Wave I, 1190 participants were enrolled, revealing predominantly younger cohorts with substantial educational levels. The subsequent Wave II involved 483 participants, maintaining continuity in characteristics. Subjective well-being remained moderate across waves, with prevalent positive attitudes toward aging. Place attachment scores indicated moderate to high associations. After controlling for demographics, structural equation modeling (SEM) in both waves revealed significant positive associations: attitudes toward aging influenced well-being, attitudes toward aging were positively associated with place attachment, and place attachment was positively related to well-being. Mediation testing confirmed the mediating role of place attachment in the relationship between attitudes toward aging and well-being. These findings underscore the important role of place attachment. It is evident that improving attitudes toward aging is an effective intervention which can lead to a better sense of well-being by enhancing place attachment to empower civil society.
Full article
(This article belongs to the Special Issue Healthy Aging and Care in the Global Communities: Models & Challenges)
Open AccessArticle
Effect of Antimicrobial Photodynamic Therapy on the Tongue Dorsum on Reducing Halitosis and the Duration of the Effect: A Randomized Clinical Trial
by
Takayuki Maruyama, Daisuke Ekuni, Aya Yokoi, Junichiro Nagasaki, Nanami Sawada and Manabu Morita
Healthcare 2024, 12(10), 980; https://doi.org/10.3390/healthcare12100980 (registering DOI) - 9 May 2024
Abstract
Antimicrobial photodynamic therapy (PDT) is a treatment that is gaining popularity in modern clinical medicine. However, little is known about the effect of PDT alone on reducing oral halitosis and the duration of the effect. This trial examined the effect of PDT on
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Antimicrobial photodynamic therapy (PDT) is a treatment that is gaining popularity in modern clinical medicine. However, little is known about the effect of PDT alone on reducing oral halitosis and the duration of the effect. This trial examined the effect of PDT on the tongue dorsum on reducing oral halitosis and the duration of the effect. This study was approved by the Ethics Committee of Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, and Okayama University Hospital (CRB20-015), and it was registered in the Japan Registry of Clinical Trials (jRCTs061200060). Twenty-two participants were randomly assigned to two groups: an intervention group and control group. PDT was performed in the intervention group using red laser emission and methylene blue gel on the middle and posterior area of the tongue dorsum. The concentration of volatile sulfur compounds, bacterial count on the tongue dorsum, probing pocket depth, bleeding on probing, and simplified oral debris index score were determined before and 1 week after PDT. The Mann–Whitney U test was used to assess the significance of the differences in each parameter between the two groups. We found that the hydrogen sulfide concentration and bacterial count on the tongue dorsum were decreased in the intervention group, but there was no statistically significant difference between the two groups. These results indicated that performing only PDT on the tongue dorsum may not contribute to reducing halitosis.
Full article
(This article belongs to the Special Issue Preventive Care in Healthcare—2nd Edition)
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Open AccessEssay
The Scabbard of Excalibur: An Allegory on the Role of an Efficient and Effective Healthcare System under Universal Health Coverage during the Pandemic Response
by
Hiroyuki Noda
Healthcare 2024, 12(10), 979; https://doi.org/10.3390/healthcare12100979 (registering DOI) - 9 May 2024
Abstract
During the COVID-19 pandemic, while some countries succeeded in reducing their rate of death after SARS-CoV-2 infection via vaccination by the end of 2021, some of them also faced hospital capacity strain, leading to social anxiety about delays in the diagnosis and treatment
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During the COVID-19 pandemic, while some countries succeeded in reducing their rate of death after SARS-CoV-2 infection via vaccination by the end of 2021, some of them also faced hospital capacity strain, leading to social anxiety about delays in the diagnosis and treatment of patients with other diseases. This essay presents an allegory to explain the situation during the COVID-19 pandemic. Through an allegory and Le Morte d’Arthur (Arthur’s Death), this essay indicates that “the scabbard of Excalibur” that we are looking for is an efficient and effective healthcare system that can diagnose patients who might become severely ill due to COVID-19 and to treat them without hospital capacity strain. In Le Morte d’Arthur, the scabbard of Excalibur was lost, and we have not been able to find any alternatives to end the COVID-19 pandemic. We can choose a future in which “the scabbard of Excalibur” exists, providing a different ending for the next pandemic.
Full article
(This article belongs to the Topic Post COVID-19: Latest Advances, Challenges and Methodologies)
Open AccessArticle
Changes in MRI Workflow of Multiple Sclerosis after Introduction of an AI-Software: A Qualitative Study
by
Eiko Rathmann, Pia Hemkemeier, Susan Raths, Matthias Grothe, Fiona Mankertz, Norbert Hosten and Steffen Flessa
Healthcare 2024, 12(10), 978; https://doi.org/10.3390/healthcare12100978 (registering DOI) - 9 May 2024
Abstract
The purpose of this study was to explore the effects of the integration of machine learning into daily radiological diagnostics, using the example of the machine learning software mdbrain® (Mediaire GmbH, Germany) in the diagnostic MRI workflow of patients with multiple sclerosis
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The purpose of this study was to explore the effects of the integration of machine learning into daily radiological diagnostics, using the example of the machine learning software mdbrain® (Mediaire GmbH, Germany) in the diagnostic MRI workflow of patients with multiple sclerosis at the University Medicine Greifswald. The data were assessed through expert interviews, a comparison of analysis times with and without the machine learning software, as well as a process analysis of MRI workflows. Our results indicate a reduction in the screen-reading workload, improved decision-making regarding contrast administration, an optimized workflow, reduced examination times, and facilitated report communication with colleagues and patients. Our results call for a broader and quantitative analysis.
Full article
(This article belongs to the Special Issue Artificial Intelligence Applications in Medicine: Second Edition)
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Open AccessArticle
Post-Pandemic Evolution of Suicide Risk in Children and Adolescents Attending a General Hospital Accident and Emergency Department
by
Ana Maciá-Casas, Javier de la Iglesia-Larrad, Llanyra García-Ullán, Belén Refoyo-Matellán, Clara Munaiz-Cossío, Sara Díaz-Trejo, Vanesa Berdión-Marcos, Julia Calama-Martín, Carlos Roncero and Jesús Pérez
Healthcare 2024, 12(10), 977; https://doi.org/10.3390/healthcare12100977 - 9 May 2024
Abstract
Background: Lockdowns and other health protective measures, such as social distancing, imposed during the COVID-19 pandemic nurtured unprecedented levels of stress and social isolation around the world. This scenario triggered an increase in suicide thoughts and self-harm behaviours among children and young people.
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Background: Lockdowns and other health protective measures, such as social distancing, imposed during the COVID-19 pandemic nurtured unprecedented levels of stress and social isolation around the world. This scenario triggered an increase in suicide thoughts and self-harm behaviours among children and young people. However, the longer-term impact of the pandemic on children’s and adolescents’ mental health, especially with regard to self-harm, is still to be fully discovered. Methods: We carried out a retrospective study where we collected data related to suicide ideation and self-harm behaviours in all patients aged under 18 that required on-call psychiatric services at the General Hospital Accident and Emergency (A&E) department in Salamanca, Spain, during 2019 (pre-pandemic) and in both 2021 and 2022 to capture possible variation at different time points during the post-pandemic period. Results: A total of 316 patients aged under 18 were seen by on-call psychiatric services at the A&E department during the three time periods: 78 in 2019, 98 in 2021 and 140 in 2022. The mean age was 15.12 (SD 2.25) and females represented more than twice the number of males each year. More than half of all patients assessed during 2022 disclosed suicide thoughts, whilst in 2019, it was near 25%. This increase in suicide ideation rates was more marked among females (X2 = 15.127; p = 0.001), those aged over 15 (X2 = 16.437; p < 0.001) and/or those with a previous history of mental health problems (X2 = 17.823; p < 0.001). We identified an increase in the proportion of males with suicide ideas, especially between 2021 and 2022 (X2 = 8.396; p = 0.015). Conclusions: Our study suggests that children’s and adolescents’ demand for urgent mental healthcare and their clinical presentations in A&E departments with suicide thoughts and/or self-injuries do not seem to be declining after the pandemic but increasing over time. More research is warranted to understand possible factors involved in this sustained upward trend.
Full article
(This article belongs to the Topic One Health Approach in Global Health and Clinical Medicine)
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Open AccessArticle
Comparing Conventional Physician-Led Education with VR Education for Pacemaker Implantation: A Randomized Study
by
Adela Drozdova, Karin Polokova, Otakar Jiravsky, Bogna Jiravska Godula, Jan Chovancik, Ivan Ranic, Filip Jiravsky, Jan Hecko and Libor Sknouril
Healthcare 2024, 12(10), 976; https://doi.org/10.3390/healthcare12100976 - 9 May 2024
Abstract
Introduction: Education of patients prior to an invasive procedure is pivotal for good cooperation and knowledge retention. Virtual reality (VR) is a fast-developing technology that helps educate both medical professionals and patients. Objective: To prove non-inferiority of VR education compared to conventional education
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Introduction: Education of patients prior to an invasive procedure is pivotal for good cooperation and knowledge retention. Virtual reality (VR) is a fast-developing technology that helps educate both medical professionals and patients. Objective: To prove non-inferiority of VR education compared to conventional education in patients prior to the implantation of a permanent pacemaker (PPM). Methods: 150 participants scheduled for an elective implantation of a PPM were enrolled in this prospective study and randomized into two groups: the VR group (n = 75) watched a 360° video about the procedure using the VR headset Oculus Meta Quest 2, while the conventional group (n = 75) was educated by a physician. Both groups filled out a questionnaire to assess the quality of education pre- and in-hospital, their knowledge of the procedure, and their subjective satisfaction. Results: There was no significant difference in the quality of education. There was a non-significant trend towards higher educational scores in the VR group. The subgroup with worse scores was older than the groups with higher scores (82 vs. 76 years, p = 0.025). Anxiety was reduced in 92% of participants. Conclusion: VR proved to be non-inferior to conventional education. It helped to reduce anxiety and showed no adverse effects.
Full article
(This article belongs to the Special Issue Healthcare in Digital Environments: An Interdisciplinary Perspective)
Open AccessArticle
Role of a National Health Service Electronic Prescriptions Database in the Detection of Prescribing and Dispensing Issues and Adherence Evaluation of Direct Oral Anticoagulants
by
Anna Gavrilova, Maksims Zolovs, Dins Šmits, Anastasija Ņikitina, Gustavs Latkovskis and Inga Urtāne
Healthcare 2024, 12(10), 975; https://doi.org/10.3390/healthcare12100975 - 9 May 2024
Abstract
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Background: Anticoagulation therapy plays a crucial role in the management of atrial fibrillation (AF) by significantly reducing the risk of stroke. Direct oral anticoagulants (DOAC) became preferred over warfarin due to their superior safety and efficacy profile. Assessing adherence to anticoagulation therapy is
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Background: Anticoagulation therapy plays a crucial role in the management of atrial fibrillation (AF) by significantly reducing the risk of stroke. Direct oral anticoagulants (DOAC) became preferred over warfarin due to their superior safety and efficacy profile. Assessing adherence to anticoagulation therapy is necessary in clinical practice for optimising patient outcomes and treatment efficacy, thus emphasising its significance. Methods: A retrospective study utilised the Latvian National Health Service reimbursement prescriptions database, covering prescriptions for AF and flutter from January 2012 to December 2022. The proportion of days covered method was selected for adherence assessment, categorising it into three groups: (1) below 80%, (2) between 80% and 90%, and (3) above 90%. Results: A total of 1,646,648 prescriptions were analysed. Dabigatran prescriptions started declining after 2020, coinciding with a decrease in warfarin prescriptions since 2018. The total adherence levels to DOAC therapy were 69.4%. Only 44.2% of users achieved an adherence level exceeding 80%. The rate of paper prescriptions decreased from 98.5% in 2017 to 1.3% in 2022. Additionally, the utilisation of international non-proprietary names reached 79.7% in 2022. Specifically, 16.7% of patients selected a single pharmacy, whereas 27.7% visited one or two pharmacies. Meanwhile, other patients obtained medicines from multiple pharmacies. Conclusions: The total adherence level to DOAC therapy is evaluated as low and there was no significant difference in age, gender, or “switcher” status among adherence groups. Physicians’ prescribing habits have changed over a decade.
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Open AccessArticle
The Role of Healthcare Professionals in the Transition Process: A Qualitative Study of Families of Trans Children and Adolescents
by
Lucía González-Mendiondo, Aingeru Mayor and Nieves Moyano
Healthcare 2024, 12(10), 974; https://doi.org/10.3390/healthcare12100974 - 9 May 2024
Abstract
The aim of this study was to explore the role that healthcare professionals, such as pediatricians, psychologists, psychiatrists and sexologists, play in supporting trans children and adolescents in their transition processes. To this end, 22 life stories written by parents of trans children
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The aim of this study was to explore the role that healthcare professionals, such as pediatricians, psychologists, psychiatrists and sexologists, play in supporting trans children and adolescents in their transition processes. To this end, 22 life stories written by parents of trans children and adolescents who had undergone social transition were collected, and a qualitative analysis was carried out using MAXQDA software. For this purpose, three key periods were considered in the stories: before, during and after the transition. Among other aspects, the stories highlight a major lack of understanding on the part of the professionals who should support trans children and adolescents, and their families, in their transition processes. Parents described the attitude of those professionals who actively listened to their children’s needs and were cooperative as positive, even if they do not have the necessary training. The need for specific training in diversity is one of the main conclusions of this study.
Full article
(This article belongs to the Special Issue Sexual Functioning, Sexual Satisfaction and Health)
Open AccessCorrection
Correction: Bogusz, A.; Górnicka, M. Low Diet Quality and Nutritional Knowledge in Women with Endometriosis: A Pilot Study. Healthcare 2024, 12, 673
by
Angelika Bogusz and Magdalena Górnicka
Healthcare 2024, 12(10), 973; https://doi.org/10.3390/healthcare12100973 - 9 May 2024
Abstract
The authors would like to make the following corrections to the publication, dealing with references #25 and #42 [...]
Full article
Open AccessStudy Protocol
Women Acute Myocardial Infarction—Identifying and Understanding the Gender Gap (WAMy-GAP): A Study Protocol
by
Vincenza Giordano, Assunta Guillari, Vincenza Sansone, Maria Catone and Teresa Rea
Healthcare 2024, 12(10), 972; https://doi.org/10.3390/healthcare12100972 - 9 May 2024
Abstract
Barriers to accessing care and misinterpretations of ischemic heart disease symptoms due to lack of awareness contribute to women’s delay in seeking care. Women may delay seeking treatment for up to 3 h or even up to 5 days. They often perceive themselves
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Barriers to accessing care and misinterpretations of ischemic heart disease symptoms due to lack of awareness contribute to women’s delay in seeking care. Women may delay seeking treatment for up to 3 h or even up to 5 days. They often perceive themselves to be at low risk of cardiovascular disease (CVD) and prioritize family responsibilities or household chores. The causes of this delay are multifactorial and influence the decision-making process, particularly in the pre-hospital phase. The objective of this study protocol is to evaluate prodromal symptoms and identify risk behaviors in women with acute myocardial infarction (AMI). This is a protocol for a multicenter study that will be conducted using the mixed-method methodology using the McSweeney Acute and Prodromal Myocardial Infarction Symptom Survey (MAPMISS) to evaluate symptoms and semi-structured interviews to investigate behaviors. This study protocol is intended to fill an important knowledge gap on premonitory and acute symptoms of AMI in women in Italy, as well as to understand the causes and mechanisms underlying delays in accessing healthcare services during an acute event such as AMI. The investigation of this issue will facilitate the removal of gender-related inequalities in the diagnosis and treatment of acute myocardial infarction while also fostering dialogue on the barriers to behavior change.
Full article
(This article belongs to the Section Women's Health Care)
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Open AccessReview
Telerehabilitation in Children and Adolescents with Cystic Fibrosis: A Scoping Review
by
Ezequiel Pessoa, Mara Ferreira and Cristina Lavareda Baixinho
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
by
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
by
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.
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(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
Abstract
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Show Figures
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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Figure 1
Open AccessArticle
Associations between Fluid Intelligence and Physical Fitness in School Children
by
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.
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(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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