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
Medicine Non-Adherence: A New Viewpoint on Adherence Arising from Research Focused on Sub-Saharan Africa
Healthcare 2024, 12(8), 860; https://doi.org/10.3390/healthcare12080860 - 19 Apr 2024
Abstract
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Adherence is vital for medicine to have an effect, yet adherence is considered to be low, with approximately half of the patients not fully adherent. However, research into adherence tends to focus on quantitative analysis of performance, which fails to perceive how people
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Adherence is vital for medicine to have an effect, yet adherence is considered to be low, with approximately half of the patients not fully adherent. However, research into adherence tends to focus on quantitative analysis of performance, which fails to perceive how people are adherent in their many different environments. As a contribution to gaining a deeper understanding, interviews were held with thirty individuals in the UK, Egypt, Kazakhstan, and six countries in sub-Saharan Africa to understand their perceptions on adherence to a range of drugs, and these were compared with an existing well-regarded list. New or undocumented reasons for non-adherence were discovered. Reasons for non-adherence were consistent across both developing and developed worlds. A new viewpoint on adherence is suggested, which considers adherence to be a single act and therefore as an individual opportunity to be adherent, permitting greater focus on the enablers and inhibitors of adherence at any given point in time.
Full article
Open AccessReview
Environmental Risk Assessment in Community Care: A Scoping Review
by
Maryam Rouhi, Tanya Linden, Douglass Doherty and Sarah J. Prior
Healthcare 2024, 12(8), 859; https://doi.org/10.3390/healthcare12080859 - 19 Apr 2024
Abstract
Community care encompasses inherent risks for both clients and healthcare providers. Maintaining a safe environment for the delivery of care services ensures that any risk of unintentional or intentional personal harm is minimised. The aim of this scoping review is to (a) provide
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Community care encompasses inherent risks for both clients and healthcare providers. Maintaining a safe environment for the delivery of care services ensures that any risk of unintentional or intentional personal harm is minimised. The aim of this scoping review is to (a) provide an overview of existing knowledge by summarising the current literature and (b) identify gaps pertaining to understanding and managing environmental risk in community care settings. Guided by the Population/Concept/Context approach and PRISMA guidelines, this paper used two questions to answer how a score-based tool for assessing client suitability in community care is developed and how an environmental screening tool assists with reducing risk to community care workers. Literature searches of CINAHL, PubMed (Medline), Web of Science and PsychINFO databases were conducted between September 2023 and November 2023. We included full text articles published from 2018 to 2023. The following four broad areas were identified as key components in the structure of an environmental screening tool: environmental factors, health factors, socioeconomic factors and cultural factors. The results of this review provide valuable information which can be utilised by care organisations to develop and/or refine tools to ensure the safety and wellbeing of workers within the community care sector.
Full article
(This article belongs to the Section Community Care)
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Open AccessReview
Anesthetic Considerations for Patients with Hereditary Neuropathy with Liability to Pressure Palsies: A Narrative Review
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Krzysztof Laudanski, Omar Elmadhoun, Amal Mathew, Yul Kahn-Pascual, Mitchell J. Kerfeld, James Chen, Daniella C. Sisniega and Francisco Gomez
Healthcare 2024, 12(8), 858; https://doi.org/10.3390/healthcare12080858 - 19 Apr 2024
Abstract
Hereditary neuropathy with liability to pressure palsies (HNPP) is an autosomal dominant demyelinating neuropathy characterized by an increased susceptibility to peripheral nerve injury from trauma, compression, or shear forces. Patients with this condition are unique, necessitating distinct considerations for anesthesia and surgical teams.
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Hereditary neuropathy with liability to pressure palsies (HNPP) is an autosomal dominant demyelinating neuropathy characterized by an increased susceptibility to peripheral nerve injury from trauma, compression, or shear forces. Patients with this condition are unique, necessitating distinct considerations for anesthesia and surgical teams. This review describes the etiology, prevalence, clinical presentation, and management of HNPP and presents contemporary evidence and recommendations for optimal care for HNPP patients in the perioperative period. While the incidence of HNPP is reported at 7–16:100,000, this figure may be an underestimation due to underdiagnosis, further complicating medicolegal issues. With the subtle nature of symptoms associated with HNPP, patients with this condition may remain unrecognized during the perioperative period, posing significant risks. Several aspects of caring for this population, including anesthetic choices, intraoperative positioning, and monitoring strategy, may deviate from standard practices. As such, a tailored approach to caring for this unique population, coupled with meticulous preoperative planning, is crucial and requires a multidisciplinary approach.
Full article
(This article belongs to the Special Issue Anesthesiology and Perioperative Medicine)
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Why Should Diabetic Women Be Active?—The Role of Personality, Self-Esteem, Body-Esteem, and Imagery
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Dagmara Budnik-Przybylska, Malwina Fituch and Aleksandra Kowalewska
Healthcare 2024, 12(8), 857; https://doi.org/10.3390/healthcare12080857 - 18 Apr 2024
Abstract
Diabetes is one of the fastest spreading diseases in the 21st century. The aim of the study is twofold: (1) to find differences in personality traits, self-esteem, body-esteem, and imagery between healthy women and women with diabetes; (2) to verify whether there are
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Diabetes is one of the fastest spreading diseases in the 21st century. The aim of the study is twofold: (1) to find differences in personality traits, self-esteem, body-esteem, and imagery between healthy women and women with diabetes; (2) to verify whether there are differences in the analyzed factors among women with diabetes who engage in sports compared to those who do not. We used 3 questionnaires: Imagination in Sport—short form, Self-Esteem Scale (SES), and BFIS Personality, which were tested online. We found that women with diabetes were characterized by significantly higher neuroticism, lower extraversion, and higher conscientiousness (marginally significant). We also found that women with diabetes who practice sport rated their bodies more highly in terms of sexual attractiveness and made better use of imagined affirmations than women without diabetes who were not active. Our study provides new insights into diabetics in terms of women navigating the disease.
Full article
Open AccessCase Report
The First Use of a Midline Catheter in Outpatient Pain Management
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Kinga Olczyk-Miiller, Maciej Latos, Dariusz Kosson, Marcin Kołacz and Robert Hadzik
Healthcare 2024, 12(8), 856; https://doi.org/10.3390/healthcare12080856 - 18 Apr 2024
Abstract
Midline catheters (MCs) are used to deliver intravenous therapy lasting over 5 days to patients in hospitals. However, the constant development of home and outpatient care is challenging medical teams to provide effective and safe planned therapy to patients under such conditions. We
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Midline catheters (MCs) are used to deliver intravenous therapy lasting over 5 days to patients in hospitals. However, the constant development of home and outpatient care is challenging medical teams to provide effective and safe planned therapy to patients under such conditions. We describe the first time an MC was used in outpatient pain management in Poland. A 60-year-old man presented to the Pain Management Clinic with a history of RCC of the left kidney and lumbar back pain radiating to the left knee joint. The person whose case is described below had poor peripheral veins. He intravenously received lidocaine for 10 days via a midline catheter with a good response.
Full article
(This article belongs to the Section Pain Management)
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Open AccessArticle
Changes in the Average Body Mass Index of Fifth- and Sixth-Grade Korean Elementary School Students: The Role of Physical Education in Student Health
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Byung-Kweon Chang, Se-Won Park, Young-Sik Kim and Seung-Man Lee
Healthcare 2024, 12(8), 855; https://doi.org/10.3390/healthcare12080855 - 18 Apr 2024
Abstract
This study aimed to emphasize the importance of physical education in maintaining sufficient physical activity by examining the average BMI of fifth- and sixth-grade elementary school students in Korea over multiple years. This study investigated changes in the average BMI of fifth- and
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This study aimed to emphasize the importance of physical education in maintaining sufficient physical activity by examining the average BMI of fifth- and sixth-grade elementary school students in Korea over multiple years. This study investigated changes in the average BMI of fifth- and sixth-grade elementary school students in Korea. It provided foundational data to suggest the role of physical education in student health and set future directions. The 2019–2021 Physical Activity Promotion System (PAPS) of the Korean Ministry of Education was used. Data corresponding to fifth- and sixth-grade students (124,693 from 2019, 126,226 from 2020, and 117,809 from 2021) in 1208 elementary schools in Korea were collected. Repeated measures ANOVA was conducted for the data analysis. The study findings are as follows: First, the average BMI of fifth- and sixth-grade elementary school students in Korea increased significantly in 2021 compared with 2019 and 2020. Second, changes in the yearly average BMI showed a significant difference depending on gender and grade. Obesity among fifth- and sixth-grade elementary school students in Korea increased steadily during 2019–2021, which may be due to a decrease in students’ physical activity. Male students showed a steeper increase regardless of grade. During the study period, limited physical activity at school increased obesity rates. Physical education must play a role in students’ health in preparation for future changes.
Full article
(This article belongs to the Section School Health)
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Open AccessArticle
A Mixed-Method Study on the Assessment of Factors Influencing Nurses’ Provision of Spiritual Care
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Evangelos C. Fradelos, Victoria Alikari, Sofia Artemi, Evdokia Missouridou, Polyxeni Mangoulia, Maria Kyranou, Maria Saridi, Aikaterini Toska, Konstantinos Tsaras and Foteini Tzavella
Healthcare 2024, 12(8), 854; https://doi.org/10.3390/healthcare12080854 - 18 Apr 2024
Abstract
The purpose of this study was to explore factors that influence nurses’ beliefs about offering spiritual care. Study Design: A mixed-method study design, incorporating both quantitative (questionnaire) and qualitative research, was used for this study (focus group discussion). Methods: The questionnaires were completed
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The purpose of this study was to explore factors that influence nurses’ beliefs about offering spiritual care. Study Design: A mixed-method study design, incorporating both quantitative (questionnaire) and qualitative research, was used for this study (focus group discussion). Methods: The questionnaires were completed by a convenience sample of nurses and their assistants working in two public hospitals. These questionnaires included the Greek versions of the FACIT-Sp-12, SCIPS, NEO-FFI, and the Spiritual Climate Scale, as well as a specially designed questionnaire to gather demographic, socioeconomic, and professional information about the study population (SCS). Three nurses and two nursing assistants who worked in public hospitals and were chosen through purposive sampling made up the sample for the qualitative study. In utilizing inductive content analysis methodology, a qualitative analysis was carried out. Results: Greek nurses frequently offer spiritual care to their patients, primarily existential spiritual care. It was discovered that the spiritual climate, the nurses’ positive coherence, and their educational level all exert a favorable effect on total spiritual care. Three categories and seven subcategories were used to describe the participants’ prior experiences with spiritual care. Conclusions: Greek nurses frequently offer spiritual care to their patients, and both internal and external factors influence their attitudes in this regard.
Full article
(This article belongs to the Special Issue Emotional Stress of Healthcare Professionals in Work)
Open AccessArticle
Lumbar Paravertebral Muscle Pain Management Using Kinesitherapy and Electrotherapeutic Modalities
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Sînziana Călina Silişteanu, Elisabeta Antonescu, Lavinia Duică, Maria Totan, Andrei Ionuţ Cucu and Andrei Ioan Costea
Healthcare 2024, 12(8), 853; https://doi.org/10.3390/healthcare12080853 - 18 Apr 2024
Abstract
Background: Low back pain is considered a public health problem internationally. Low back pain is a cause of disability that occurs in adolescents and causes negative effects in adults as well. The work environment and physical and psychosocial factors can influence the occurrence
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Background: Low back pain is considered a public health problem internationally. Low back pain is a cause of disability that occurs in adolescents and causes negative effects in adults as well. The work environment and physical and psychosocial factors can influence the occurrence and evolution of low back pain. Methods: The purpose of this paper is to highlight the physiological and functional changes in young adults with painful conditions of the lumbar spine, after using exercise therapy. The study was of the longitudinal type and was carried out over a period 6 months in an outpatient setting. The rehabilitation treatment included electrotherapeutic modalities and kinesitherapy. Results: The results obtained when evaluating each parameter, for all moments, show statistically significant values in both groups. The results obtained regarding the relationship between the therapeutic modalities specific to rehabilitation medicine and low back pain are consistent with those reported in studies. Conclusions: Depending on the clinical-functional status of each patient, kinesitherapy can accelerate the heart rate and increase the blood pressure and oxygen saturation of the arterial blood, values that can later return to their initial levels, especially through training.
Full article
(This article belongs to the Special Issue The 10th Anniversary of Healthcare—Pain Management)
Open AccessArticle
Australian Hospital Experiences of People Living with Deafblindness or Dual Sensory Impairment: The Report Card
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Annmaree Watharow
Healthcare 2024, 12(8), 852; https://doi.org/10.3390/healthcare12080852 - 17 Apr 2024
Abstract
Gaps abound in the literature about what happens when people living with deafblindness or dual sensory impairment (DBDSI) go to the hospital. Anecdotally, from my lived experiences and professional work, as well as from within communities, stories are told about how hazardous it
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Gaps abound in the literature about what happens when people living with deafblindness or dual sensory impairment (DBDSI) go to the hospital. Anecdotally, from my lived experiences and professional work, as well as from within communities, stories are told about how hazardous it is to be a patient in an Australian hospital for those living with DBDSI. This paper outlines a quantitative component of a mixed-methods study examining the intricacies of these experiences. The research objective was to discover what hospital interactions looked like for patients living with DBDSI. A constrained question set was used, namely, the Australian hospital experience question set (AHPEQS 2017). It asked patients about key factors in their hospital interactions. The results form a distressing snapshot of care and communication interactions. Experiences of flouting protective conventions, dehumanisation, neglect, discrimination, disparate care, inaccessible consent forms, and a lack of communication predominate. The participants reported experiences from multiple different hospitals, so these findings suggest a broad culture of failing to provide patient-centred care and accessible-to-the-patient communication. The findings showcase the urgency for more research and remedial actions to be undertaken by both professionals and institutions.
Full article
Open AccessArticle
When the Relationship Is at Stake: Parents’ Perception of the Relationship with a Child with Problematic Gaming and Their Perceived Need for Support
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Marie Werner, Sabina Kapetanovic, Maiken Nielsen, Sevtap Gurdal, Mitchell J. Andersson, Alexandru Panican and Emma Claesdotter-Knutsson
Healthcare 2024, 12(8), 851; https://doi.org/10.3390/healthcare12080851 - 17 Apr 2024
Abstract
Intrapersonal parental factors play a significant role in the development of problematic gaming in children. However, few studies have explored parental perspectives on their relationship with a child engaged in problematic gaming, as well as the need for support parents perceive in relation
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Intrapersonal parental factors play a significant role in the development of problematic gaming in children. However, few studies have explored parental perspectives on their relationship with a child engaged in problematic gaming, as well as the need for support parents perceive in relation to the child’s gaming. We conducted semi-structured interviews with 12 parents (83.3% women) of 11 children (81.8% boys, Mage = 15 ± 2) to examine how parents of children with problematic gaming behavior perceive the parent–child relationship and their need for additional support. We analyzed qualitative accounts using thematic analysis to identify themes and subthemes while drawing on the theoretical frameworks of Aaron Antonovsky’s theory of sense of coherence (SOC) and Jürgen Habermas’ theory of logic. Participants described difficulties regarding all three components of SOC (meaningfulness, comprehensibility, and manageability) in relation to their child’s gaming, with the most significant challenge being manageability. Parents primarily sought assistance from institutions and organizations, such as mental health services, to enhance manageability. The findings emphasize parents’ need for relational and practical support tailored to their unique context, as well as their wish to be more involved in the treatment of their children.
Full article
(This article belongs to the Topic Children’s Diseases, Family Management, and Quality of Life)
Open AccessArticle
Effects of Neuropilates on Functional Outcomes in Chronic Stroke: A Randomized Clinical Trial
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Cristina García-Bravo, Laura Delgado-Lobete, Rebeca Montes-Montes, Mª Pilar Rodríguez-Pérez, Nuria Trugeda-Pedrajo, Gemma Fernández-Gómez and Sara García-Bravo
Healthcare 2024, 12(8), 850; https://doi.org/10.3390/healthcare12080850 - 17 Apr 2024
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Neuropilates is an intervention approach that was developed as a modified version of the Pilates Method to be used for neurological rehabilitation. The main objective of this study was to analyze the effectiveness of regular physiotherapy and occupational therapy rehabilitation in comparison to
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Neuropilates is an intervention approach that was developed as a modified version of the Pilates Method to be used for neurological rehabilitation. The main objective of this study was to analyze the effectiveness of regular physiotherapy and occupational therapy rehabilitation in comparison to a combination of traditional rehabilitation with Neuropilates in adults with post-stroke motor disabilities. This was a rater- and analyst-blinded randomized clinical trial with a three-month intervention and a one-month follow up. Participants were randomly allocated to either the experimental group (EG, receiving a combination of conventional therapy and Neuropilates; n = 15) or the control group (CG, receiving solely conventional therapy; n = 15). Once adjusted for baseline FIM scores, the results showed significant differences favoring the EG in daily functioning (FIM), static balance (FRT), right-hand manual dexterity (NHPT) and right-upper limb coordination (BBT). Satisfaction with the received treatment as measured with the CSQ-8 was significantly higher for the EG. In conclusion, the incorporation of Neuropilates, facilitated by a single experienced therapist, can be a valuable complement to conventional physical and occupational therapy. However, Neuropilates-based interventions should be supervised and tailored to each individual by a professional specifically trained in the method.
Full article
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Open AccessArticle
Factors Influencing Willingness to Undergo Lung Cancer Screening in the Future: A Cross-Sectional Study of Japanese University Students
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Yukihiro Mori, Manato Seguchi, Yoko Iio, Yuka Aoyama, Mamoru Tanaka, Hana Kozai and Morihiro Ito
Healthcare 2024, 12(8), 849; https://doi.org/10.3390/healthcare12080849 - 17 Apr 2024
Abstract
Lung cancer (LC) is currently the leading cause of cancer deaths in Japan. Early detection through lung cancer screening (LCS) is important for reducing mortality. Therefore, exploring the factors affecting willingness to undergo LCS, particularly among young people, is important. This study aimed
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Lung cancer (LC) is currently the leading cause of cancer deaths in Japan. Early detection through lung cancer screening (LCS) is important for reducing mortality. Therefore, exploring the factors affecting willingness to undergo LCS, particularly among young people, is important. This study aimed to elucidate the inclination toward LCS and its determining factors among Japanese university students. This cross-sectional study, involving 10,969 Japanese university students, was conducted in April 2023. A Pearson’s chi-square test and a binomial logistic regression analysis were used to analyze factors related to the dependent variable, willingness to undergo LCS in the future. Out of the 6779 participants (61.8%) involved in this study, 6504 (95.9%) provided valid responses, and 4609 (70.9%) expressed a willingness to undergo LCS in the future. Analysis revealed current smoking as a barrier to future willingness to undergo LCS. Other barriers included postponing the age of screening, anxiety about the screening content, and concerns about the possibility of having cancer after screening. Addressing barriers, such as current smoking and anxiety about screening, that prevent young people from undergoing LCS in the future is crucial. Therefore, universities should provide opportunities to educate students about LCS and explore various educational methods.
Full article
(This article belongs to the Special Issue Preventive Medicine and Community Health)
Open AccessArticle
Impact of a Discontinuous Training Program on Sedentary Behavior in Italian Type 2 Diabetes Older Patients: The Results of the TRIPL-A Randomized Controlled Trial
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Anna Rita Bonfigli, Cristina Gagliardi, Olga Protic, Adrianapia Maria Lamedica, Maria Paola Luconi, Federica Turchi, Elena Tortato, Mirko Di Rosa, Francesco Lucertini and Liana Spazzafumo
Healthcare 2024, 12(8), 848; https://doi.org/10.3390/healthcare12080848 - 17 Apr 2024
Abstract
Background: Physical activity is an important predictor of quality of life in older adults with type 2 diabetes (T2D). Unfortunately, most T2D adults adopt a sedentary lifestyle. The randomized, controlled TRIPL-A trial aims to verify the effect of a personalized, discontinuous exercise
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Background: Physical activity is an important predictor of quality of life in older adults with type 2 diabetes (T2D). Unfortunately, most T2D adults adopt a sedentary lifestyle. The randomized, controlled TRIPL-A trial aims to verify the effect of a personalized, discontinuous exercise program on a sedentary lifestyle of T2D older adults. Methods: A total of 305 T2D patients (mean age ± SD: 68.8 ± 3.3 years) were divided into a control arm receiving only behavioral counseling and an intervention arm of an 18-month supervised discontinuous exercise program (ERS). The primary outcomes were the changes in sitting time (ST) and metabolic equivalent (MET) values, both evaluated by the International Physical Activity Questionnaire short form. A repeated measures ANOVA with Bonferroni correction for multiple comparisons was used to compare study outcomes. Results: The ST and MET differed significantly during the study compared to the control group (p = 0.028 and p = 0.004, respectively). In the intervention group, a decrease from baseline in ST at 6 months (p = 0.01) and an increase in MET values at 6 months (p = 0.01) up to 12 months (p < 0.01) were found. No significant differences were found for the other variables. Conclusions: Beneficial lifestyle changes were found within the first year of intervention. These results align with the theory of change.
Full article
(This article belongs to the Special Issue Effects of Physical Activities on People with Diabetes)
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Open AccessArticle
Compassion Satisfaction, Burnout, and Secondary Traumatic Stress among Saudi Nurses at Medical City: A Cross-Sectional Study
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Ahmad Rayani, Jean Hannan, Salman Alreshidi, Ahmad Aboshaiqah, Abdulaziz Alodhailah and Essa Hakamy
Healthcare 2024, 12(8), 847; https://doi.org/10.3390/healthcare12080847 - 17 Apr 2024
Abstract
Compassion satisfaction, the pleasure gained from assisting others in their recovery from trauma, can help reduce the effects of burnout and secondary traumatic stress. As such, nurses’ job satisfaction can be increased by increasing compassion satisfaction and decreasing compassion fatigue. This study examined
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Compassion satisfaction, the pleasure gained from assisting others in their recovery from trauma, can help reduce the effects of burnout and secondary traumatic stress. As such, nurses’ job satisfaction can be increased by increasing compassion satisfaction and decreasing compassion fatigue. This study examined the incidence of compassion fatigue and other influencing variables, such as compassion satisfaction, burnout, and secondary traumatic stress, among Saudi nurses. This was a cross-sectional study using convenience sampling. Participants comprised 177 registered nurses from various nursing departments. Data collection included the Professional Quality of Life Scale based on lifestyle, demographic details, and occupation-related questions. The averages of scores for the variables, compassion satisfaction, burnout, and secondary traumatic stress, were recorded (37.1 ± 7.4, 25.7 ± 7.5, and 26.7 ± 6.4). Participants aged 36 or older comprised a negative factor for compassion satisfaction, while years of nursing experience and higher job satisfaction were favorable predictors. Together, these three variables accounted for 30.3% of the overall variation. Low job satisfaction and poor sleep negatively affected burnout, accounting for 39.8% of the total variance. The results offer insights into identifying the risks of compassion fatigue in nurses and help design strategies to address burnout and secondary traumatic stress while enhancing their compassion satisfaction levels.
Full article
(This article belongs to the Special Issue The Continuum of Social Isolation and Connectedness: The Impact on Health)
Open AccessArticle
Racial Disparities in Selected Complications and Comorbidities among People with Type 2 Diabetes
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Caitlin M. Hackl, Wei-Chen Lee, Hanaa S. Sallam, Hani Jneid, Kendall M. Campbell and Hani Serag
Healthcare 2024, 12(8), 846; https://doi.org/10.3390/healthcare12080846 - 17 Apr 2024
Abstract
Type 2 diabetes (T2D) is a growing public health concern, disproportionately impacting racial and ethnic minorities. Assessing disparities is the first step towards achieving the translation goal to reduce disparities in diabetes outcomes, according to the Centers for Disease Control and Prevention (CDC)’s
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Type 2 diabetes (T2D) is a growing public health concern, disproportionately impacting racial and ethnic minorities. Assessing disparities is the first step towards achieving the translation goal to reduce disparities in diabetes outcomes, according to the Centers for Disease Control and Prevention (CDC)’s Division of Diabetes. We analyzed the data of patients (18+ years) diagnosed with T2D between 1 January 2012 and 31 March 2017, using the electronic health records of the University of Texas Medical Branch at Galveston. We compared the crude rate and age-standardized rate (using direct method) of selected micro- and macrovascular complication rates, associated obesity, and insulin dependence among racial and ethnic groups. Our sample included 20,680 patients who made 394,106 visits (9922 non-Hispanic White patients, 4698 non-Hispanic Black patients, and 6060 Hispanic patients). Our results suggest a higher risk of acquiring macrovascular (hypertension, ischemic disease, and stroke) and microvascular (renal, ophthalmic, and neurological) complications in Black patients compared to non-Hispanic White and Hispanic patients. The rates of stage I or II obesity were higher in Black patients compared with White and Hispanic patients. The rates of insulin use rather than oral hypoglycemics were also higher in Black patients than White and Hispanic patients. The disparities in terms of the higher susceptibility to complications among Black patients are possibly linked to the socioeconomic disadvantages of this population, leading to poorer management. Prevention strategies are warranted to reduce the incidence of T2D complications in racial minorities.
Full article
Open AccessArticle
Impact of Physician Characteristics on Late-Onset Sepsis (LOS) Evaluation in the NICU
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Harshkumar R. Patel, Blaine Traylor, Mohamed Farooq Ahamed, Ginger Darling, Albert Botchway, Beau J. Batton and Venkata Sasidhar Majjiga
Healthcare 2024, 12(8), 845; https://doi.org/10.3390/healthcare12080845 - 17 Apr 2024
Abstract
The threshold for a late-onset sepsis (LOS) evaluation varies considerably across NICUs. This unexplained variability is probably related in part to physician bias regarding when sepsis should be “ruled out”. The aim of this study is to determine if physician characteristics (race, gender,
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The threshold for a late-onset sepsis (LOS) evaluation varies considerably across NICUs. This unexplained variability is probably related in part to physician bias regarding when sepsis should be “ruled out”. The aim of this study is to determine if physician characteristics (race, gender, immigration status, years of experience and academic rank) effect LOS evaluation in the NICU. This study includes a retrospective chart review of all Level III NICU infants who had a LOS evaluation over 54 months. Physician characteristics were compared between positive and negative blood culture groups and whether CBC and CRP were obtained at LOS evaluations. There were 341 LOS evaluations performed during the study period. Two patients were excluded due to a contaminant. Patients in this study had a birth weight of [median (Q1, Q3)]+ 992 (720, 1820) grams and birth gestation of [median (Q1, Q3)] 276/7 (252/7, 330/7) weeks. There are 10 neonatologists in the group, 5/10 being female and 6/10 being immigrant physicians. Experienced physicians were more likely to obtain a CBC at the time of LOS evaluation. Physician characteristics of race, gender and immigration status impacted whether to include a CRP as part of a LOS evaluation but otherwise did not influence LOS evaluation, including the likelihood of bacteremia.
Full article
(This article belongs to the Section Perinatal and Neonatal Medicine)
Open AccessArticle
Perceived Well-Being among Adults with Diabetes and Hypertension: A National Study
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Leona Yuen-Ling Leung, Hon-Lon Tam, Isaac Sze-Him Leung, Alex Siu-Wing Chan, Yueheng Yin, Xiubin Zhang, Aimei Mao and Pak-Leng Cheong
Healthcare 2024, 12(8), 844; https://doi.org/10.3390/healthcare12080844 - 16 Apr 2024
Abstract
Perceived health and distresses are associated with the practice of lifestyle modifications, which increases the risk of diabetes and hypertension-related complications. This study aimed to define the characteristics and distribution of perceived health and distresses across the states between people with diabetes and
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Perceived health and distresses are associated with the practice of lifestyle modifications, which increases the risk of diabetes and hypertension-related complications. This study aimed to define the characteristics and distribution of perceived health and distresses across the states between people with diabetes and hypertension. Data were derived from a national survey of US adults aged ≥18 years who were interviewed via phone call. Perceived health and distresses were assessed through corresponding questions. An amount of 333,316 respondents (43,911 with diabetes and 130,960 with hypertension) were included in the analysis; 61.8% of people with diabetes and 74.5% of people with hypertension reported having good or better health, while residents in the Southwest region perceived poor health statuses and more distresses. Education level (diabetes: odds ratio [OR] = 0.47–0.79, hypertension: OR = 0.42–0.76), employment status level (diabetes: OR = 1.40–2.22, hypertension: OR = 1.56–2.49), and household income (diabetes: OR = 0.22–0.65, hypertension: OR = 0.15–0.78) were significant factors associated with poorly perceived health among people with diabetes and hypertension, and the use of technology and strategies for policymakers are suggested to improve the perceived health status in this regard.
Full article
(This article belongs to the Special Issue Health, Social Problems and Well-Being of Patients with Chronic Diseases, Quality of Life, and the Need for Emotional and Social Support)
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Open AccessReview
Debridement, Antibiotic Pearls, and Retention of the Implant (DAPRI) in the Treatment of Early Periprosthetic Knee Joint Infections: A Literature Review
by
Giovanni Vicenti, Elisa Pesare, Giulia Colasuonno, Claudio Buono, Federica Albano, Teresa Ladogana, Anna Claudia Passarelli and Giuseppe Solarino
Healthcare 2024, 12(8), 843; https://doi.org/10.3390/healthcare12080843 - 16 Apr 2024
Abstract
(1) Background: Periprosthetic joint infections (PJIs) are severe and frightening complications in orthopaedic surgery, and they are generally divided into three categories: early infections (those occurring within the first 4–6 weeks), delayed infections (those occurring between 3 and 24 months), and late infections
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(1) Background: Periprosthetic joint infections (PJIs) are severe and frightening complications in orthopaedic surgery, and they are generally divided into three categories: early infections (those occurring within the first 4–6 weeks), delayed infections (those occurring between 3 and 24 months), and late infections (those occurring more than 2 years after surgery). PJI treatment comprises “debridement, antibiotics, and implant retention” (DAIR), single-stage revision, and double-stage revision. Nowadays, to improve the chances of retaining an infected implant and to improve the traditional DAIR method, a modified surgical technique has been developed, named DAPRI (debridement, antibiotic pearls, and retention of the implant). Our study aims to present an up-to-date concept evaluation of the DAPRI technique and its success rate. (2) Methods: Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) standards were followed, applying a protocol defined by the authors: a total of 765 articles were identified, and at the end of the screening process only 7 studies were included. (3) Results: Currently, the DAPRI procedure can be performed only on patients who have had PJI symptoms for less than 4 weeks, and in order to achieve the highest success rate, indications are quite strict: it is appropriate in patients with acute, superficial infections without sinus tract presence, and well-fixed implants with known sensitive bacteria. The DAPRI surgical method follows a step-by-step process consisting of a first phase of biofilm identification with intra-articular injection of methylene blue, followed by biofilm removal (thermic, mechanical, and chemical aggression), and a last step consisting of prevention of PJI recurrence by using calcium sulphate antibiotic-added beads. (4) Conclusions: The DAPRI approach improves the traditional DAIR technique. It is a correct treatment for acute and early haematogenous PJI, and improves the DAIR success rate.
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(This article belongs to the Special Issue Orthopedic Implant-Associated Infections: Unlocking the Secrets of Prevention and Treatment)
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Open AccessArticle
Palliative Care and Mental Health among Pancreatic Cancer Patients in the United States: An Examination of Service Utilization and Health Outcomes
by
Divya S. Subramaniam, Zidong Zhang, Zachary Timmer, Elisabeth C. DeMarco, Michael P. Poirier and Leslie J. Hinyard
Healthcare 2024, 12(8), 842; https://doi.org/10.3390/healthcare12080842 - 16 Apr 2024
Abstract
Introduction: Palliative care (PC) utilization remains low among pancreatic cancer patients. This study explores the association of PC with mental health service and pharmacotherapy utilization among pancreatic cancer patients. Methods: Retrospective analysis was conducted on a sample of patients in the United States
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Introduction: Palliative care (PC) utilization remains low among pancreatic cancer patients. This study explores the association of PC with mental health service and pharmacotherapy utilization among pancreatic cancer patients. Methods: Retrospective analysis was conducted on a sample of patients in the United States with newly diagnosed pancreatic cancer using Electronic Health Record data from Optum’s Integrated Claims-Clinical data set. Subsequent diagnoses of anxiety and depression and PC consultation encounters were determined using ICD-9/10 codes. Adjusted associations of mental health treatments with PC and patient characteristics were quantified using multiple logistic regression. Results: Among newly diagnosed pancreatic cancer patients (n = 4029), those with PC consultations exhibited a higher prevalence of anxiety (33.9% vs. 22.8%) and depression (36.2% vs. 23.2%). Mental health service use and pharmacotherapy varied, with the highest utilization among patients having both anxiety and depression. Treatment pattern was also influenced by age (aOR 1.832 for age <55 vs. 65–70 years). Notably, PC consultations showed no significant effect on the likelihood of documented treatment. Discussion: Our study emphasizes underutilization of PC and MH treatment for pancreatic cancer patients. These findings imply a crucial need for further investigation into palliative care’s role in addressing mental health concerns among pancreatic cancer patients.
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(This article belongs to the Section Pain Management)
Open AccessArticle
Development of a Community-Based Communication Intervention among Latin Caregivers of Patients Coping with Cancer
by
Normarie Torres-Blasco, Lianel Rosario-Ramos, Carled Arguelles, Stephanie Torres Marrero, Tiffany Rivera, Zulay Vicente, Maria Elena Navedo, Rosael Burgos, Mayra Garriga, Maria del Carmen Pacheco and Betsy Lopez
Healthcare 2024, 12(8), 841; https://doi.org/10.3390/healthcare12080841 - 16 Apr 2024
Abstract
Background: Cancer affects the emotional well-being of patients and caregivers, highlighting the need for effective communication strategies. This study explores a community-based communication intervention for Latino caregiver–patient dyads coping with cancer. The acceptability of the intervention, along with its associated facilitators and
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Background: Cancer affects the emotional well-being of patients and caregivers, highlighting the need for effective communication strategies. This study explores a community-based communication intervention for Latino caregiver–patient dyads coping with cancer. The acceptability of the intervention, along with its associated facilitators and barriers, are crucial considerations. Methods: Three focus group interviews involved healthcare providers, community partners, patients, and caregivers to discuss the communication needs of this population and the components of a communication intervention while identifying facilitators and barriers to the intervention. Qualitative thematic content analysis was conducted using Nvivo v12, ensuring reliability through independent analysis and consensus building. Results: Participants (89% female, average age of 53) included patients (30%), caregivers (30%), community partners (25%), and healthcare providers (15%), and they discussed the overall acceptability of adapting a communication intervention, where they emphasized benefits for caregivers and patients, primarily through support groups. Communication strategies accepted by participants include psychological support, cancer education, assertive communication skills, and methods for improved interactions with healthcare providers and extended family. Conclusions: Participants’ responses align with the current literature, emphasizing problem-solving, mutual support, and communication strategies and underscoring the role of community partners. The study underlines the necessity for culturally tailored communication interventions for Latino families facing cancer.
Full article
(This article belongs to the Special Issue Mental Health and Nursing Care of Individuals with Cancer and Their Families—2nd Edition)
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