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A special issue of Healthcare (ISSN 2227-9032).

Deadline for manuscript submissions: 31 July 2026 | Viewed by 15915

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Special Issue Editors

Dr. Florence Mei Fung Wong

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Guest Editor

School of Nursing, Tung Wah College, Hong Kong, China
Interests: nursing education; geriatric health; acute care; cardiac care; critical care; health-related quality of life; infection control
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Wai Keung Leung

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Guest Editor

Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
Interests: dentistry; oral health; oral health-related quality of life; periodontics; periodontal microbiology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Healthcare services have become more complex and multidisciplinary, with cost-effective care being provided by specific healthcare disciplines tailored to their clients' health needs. To alleviate the burden of healthcare services in hospital settings, many services have been switched to community-based care, including home-based care. High-quality healthcare services in community settings are crucial for maintaining health and promoting rehabilitative recovery. However, many studies have focused on clinical settings, and their results may not be applicable to healthcare services provided in community settings. To improve the healthcare practice in community settings, we need to conduct more research to disseminate knowledge and enhance the current services. Our journal welcomes all types of reviews or original articles related to the development of new technologies, policies, strategies, and their applications for raising awareness about the health of specific populations in community settings. By promoting and implementing preventive strategies, we can improve the healthcare practice in a specific population in a community. We invite all researchers to submit their papers and contribute to advancing healthcare services in community settings.

Dr. Florence Mei Fung Wong
Prof. Dr. Wai Keung Leung
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

healthcare service
community care
nursing
nursing education
older people
health-related quality of life
cardiac care and critical care
home-based care
multdisciplinary healthcare professionals

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Published Papers (10 papers)

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Research

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18 pages, 270 KB

Open AccessArticle

Understanding the Support Needs of Family Caregivers Living with Severe Developmental Disability: An Interpretive Phenomenological Analysis

by Anna McStravick and Rosanna Cousins

Healthcare 2025, 13(20), 2550; https://doi.org/10.3390/healthcare13202550 - 10 Oct 2025

Viewed by 305

Abstract

Background/Objectives: Living with a disabled family member has extensive implications for the whole family involved in their care, and there is dependency on healthcare support for maintaining quality of life. This qualitative study, conducted in Northern Ireland, investigated the support needs of different family members living with a severely impaired individual across the lifespan. A key objective was to identify support needs for intervention. Methods: In-depth semi-structured interviews were conducted to obtain data from eight mothers, fathers, sisters and brothers of a profoundly disabled child or sibling. Data was analyzed using Interpretive Phenomenological Analysis, allowing for the application of double hermeneutic in which the researchers derived meaning from the lived experiences of participants. Results: The analysis yielded five themes in total. Three themes were related to gaps in healthcare systems: Support Needs in Childhood, Support in Transition into Adult Services, and Worry for the Future; and two themes were linked with support needs: Associative Disability in Family Members; and Stigma. All family members had caregiving roles, and these had similarities and differences according to the relationship with the care-receiver. Participants recognized their families were survivors, however maintained a family tragedy rather than positive change outlook. Conclusions: Recommendations derived from the findings to alleviate the stressors of the situation for family members include increasing community support and age-related respite facilities. Additionally, improving and enhancing education of disabilities in schools, and immersing and further integrating individuals with disability into society, will alleviate the alienation, isolation and loneliness experienced by family members. Full article

(This article belongs to the Special Issue Healthcare Practice in Community)

25 pages, 798 KB

Open AccessArticle

Health Behaviors and Psychological Well-Being Among First-Year Psychology, Medicine, and Nursing Students: A Cross-Sectional Analysis

by Natacha Palenzuela-Luis, Gonzalo Duarte-Clíments, Juan Gómez-Salgado, José Ángel Rodríguez-Gómez and María Begoña Sánchez-Gómez

Healthcare 2025, 13(17), 2162; https://doi.org/10.3390/healthcare13172162 - 30 Aug 2025

Viewed by 924

Abstract

Introduction: Understanding adolescent maturational development and its impact on physical and psychological well-being is essential for supporting the academic and professional growth of undergraduate students in Health Sciences programs (Psychology, Medicine, and Nursing). This study aimed to assess and compare self-concept, self-perception, physical activity, and lifestyle among first-year Health Sciences students. Methods: A descriptive cross-sectional study was conducted with first-year students at the University of La Laguna, Tenerife, Spain. Data were collected using the Rosenberg Self-Esteem Scale (RSES), General Health Questionnaire (GHQ-12), Physical Activity Questionnaire for Adolescents (PAQ-A), and Health Behaviour in School-aged Children (HBSC). Variables included sex, age, study program, and body mass index (BMI). Statistical analyses included descriptive statistics, reliability assessment (Cronbach’s alpha), distribution tests, and chi-squared tests. Results: Among 190 participants, the RSES showed generally positive self-esteem, although 75% of students reported low self-confidence. Male Psychology students all scored in the fair range on self-perception. Physical activity was low, particularly among female students, with 20% classified as sedentary. HBSC results indicated the need for lifestyle improvements. SOC-13 scores showed that 80.5% of students had fair levels of sense of coherence. Conclusions: Health Sciences students exhibited low self-concept, emotional distress, sedentary habits, and inadequate lifestyle behaviors. Male Nursing students and female Psychology students had the poorest self-concept scores. The findings emphasize the need for interventions promoting healthy habits and emotional well-being among students entering health-related academic programs. Full article

(This article belongs to the Special Issue Healthcare Practice in Community)

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26 pages, 472 KB

Open AccessArticle

Knowledge, Attitudes, and Practices of Community Pharmacists Regarding Proton Pump Inhibitor (PPI) Use: A Cross-Sectional Study

by Hebatallah Ahmed Mohamed Moustafa, Ahmad Z. Al Meslamani, Hazem Mohamed Metwaly Elsayed Ahmed, Salma Ahmed Farouk Ahmed, Nada Ehab Shahin Sallam, Ghadah H. Alshehri, Nawal Alsubaie and Amira B. Kassem

Healthcare 2025, 13(13), 1588; https://doi.org/10.3390/healthcare13131588 - 2 Jul 2025

Viewed by 1534

Abstract

Background/Objectives: Up to 25–70% of proton-pump inhibitor (PPI) prescriptions worldwide lack an evidence-based indication, exposing patients to avoidable adverse events and unnecessary costs. Community pharmacists (CPs) are well-equipped to curb the misuse of PPIs. This study aimed to quantify CPs’ knowledge, attitudes, and practices (KAPs) regarding PPIs in two high-use Middle-Eastern markets and determine how demographic and professional factors influence guideline-adherent PPI use. Bridging this gap is crucial to ensure pharmacists can promote rational PPI use, provide accurate patient counseling, and reduce the likelihood of adverse outcomes. Methods: An online cross-sectional survey was undertaken between May 2024 and July 2024 to investigate the KAPs of CPs in Egypt and Iraq toward PPI use. The self-developed thirty-item questionnaire (17 knowledge, 11 attitude, and 6 practice items) was piloted with 30 CPs. A sample size of 385 CPs was required based on an estimated 93,000 community pharmacists in Egypt and 22,120 in Iraq; however, to improve statistical power, we aimed to include >500 CPs. Results: A total of 527 CPs from Egypt and Iraq completed the survey. The total median scores for knowledge, attitude, and practice were 11 out of 17 (IQR: 9–16), 9 out of 11 (IQR: 6–12), and 5 out of 6 (IQR: 3–8), respectively. CPs with >20 years of experience and those who relied on clinical guidelines as a primary information source demonstrated a median knowledge score significantly higher than those with fewer years of experience (p = 0.001 and 0.028, respectively). There was a significant positive association between knowledge and attitude, knowledge and practice, and attitude and practice scores (coefficients: 0.832, 0.701, and 0.445, respectively). Conclusions: Although their attitudes and practices regarding PPI use were satisfactory, the knowledge of CPs about the judicious use of PPIs requires improvement. Thus, a call for action targeting their tailored education and training is necessary to address these knowledge gaps regarding PPIs identified, including PPI adverse-effect profiles, evidence-based indications, and deprescribing criteria, and to foster informed medication attitudes and practices. Such education and training can reinforce guideline adherence, enhance patient counseling skills, and ultimately reduce inappropriate PPI use. Full article

(This article belongs to the Special Issue Healthcare Practice in Community)

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21 pages, 2921 KB

Open AccessArticle

Physician Deserts: Navigating the Texas Terrain of Provider Supply and Demand with GIS Mapping

by Syed Hussain Jafri, Subi Gandhi and Edward Osei

Healthcare 2024, 12(23), 2397; https://doi.org/10.3390/healthcare12232397 - 29 Nov 2024

Cited by 1 | Viewed by 1606

Abstract

Background: Rural health disparities in Texas impact population health due to limited healthcare access, insurance, and transportation challenges, especially in medically underserved areas. A shortage of specialists in rural regions worsens these issues, leading to increased morbidity and mortality rates. Objective: Our research aimed to address a knowledge gap by investigating the availability of three medical specialists—cardiologists, pulmonologists, and endocrinologists—in rural counties of Texas and identifying areas where access to healthcare is limited. Methods: Utilizing data from regional, state, and federal sources, the analysis geocoded specialist locations and created GIS maps to visualize the distribution of specialists across Texas’s 254 counties. Physician demand was calculated by considering disease incidence and population size, resulting in a county-level physician availability index to highlight areas with shortages. Results: Our findings demonstrate a significant deficiency of cardiologists in 196 counties when considering a maximum reasonable travel distance of 50 miles. Comparable deficiencies were observed for pulmonologists and endocrinologists, with western rural counties predominantly comprising the deficiency areas for each specialty. These results emphasize a significant rural–urban disparity concerning access to the three investigated health specialists. Conclusions: Addressing geographic disparities can reduce health inequities, improve rural healthcare access, and promote a more equitable healthcare system across Texas. Solutions may include incentives for specialists to work in underserved areas, expanded telemedicine services, and transportation assistance. Full article

(This article belongs to the Special Issue Healthcare Practice in Community)

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11 pages, 397 KB

Open AccessArticle

Adaptation of the Taiwan Version of the Supportive and Palliative Care Indicators Tool (SPICT-TW) and Its Association with Six-Month Mortality: A Multi-Center Validation Study in Older People

by Jung-Yu Liao, Hsiao-Ting Chang, Jen-Kuei Peng, Scott A. Murray, Chien-Yi Wu, Hsien-Cheng Chang, Chia-Ming Li, Shao-Yi Cheng, Wei-Zhe Tseng, Chao Agnes Hsiung, Hung-Yi Chiou, Sang-Ju Yu, Kirsty Boyd and Ping-Jen Chen

Healthcare 2024, 12(21), 2185; https://doi.org/10.3390/healthcare12212185 - 1 Nov 2024

Cited by 1 | Viewed by 2541

Abstract

Background: The Supportive and Palliative Care Indicators Tool (SPICT) was developed for identifying, in a timely manner, patients who may benefit from supportive and palliative care for better treatment review, care-plan discussion, and end-of-life care. Although the SPICT has been validated in different languages and for patients living in different settings, it has not been validated for patients receiving home-based medical care (HBMC), or in the context of using traditional Chinese characters. Objectives: The present study aimed to validate the Taiwanese version of the SPICT (SPICT-TW) and to measure its ability to predict six-month mortality in patients who received HBMC in Taiwan. Methods: Seven HBMC agents (five clinics and two hospitals) participated in this validation study. We recruited 129 patients aged ≥ 50 years who had been consistently receiving HBMC for >two months. Results: The results revealed that the SPICT-TW demonstrated similar reliability and validity compared to other language versions of the SPICT. It may be an appropriate tool for healthcare professionals to detect, in a timely manner, the needs for palliative care in older people who receive home healthcare. Furthermore, we found that a combination of four general indicators and one clinical indicator in the SPCIT-TW has the best prediction ability at predicting six-month mortality in these HBMC recipients. This multi-center study validated the SPICT-TW among HBMC recipients in Taiwan. Conclusions: The SPICT-TW demonstrated high reliability and validity through the Kuder–Richardson 20, an intraclass correlation coefficient, Cohen’s kappa, and receiver operating characteristic analysis, supporting its potential as a practical tool for identifying older adults at risk of dying within six months who have not yet received palliative care but may benefit from it. Full article

(This article belongs to the Special Issue Healthcare Practice in Community)

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11 pages, 213 KB

Open AccessArticle

Reflexive Views of Virtual Communities of Practice among Informal and Formal Caregivers of People with a Dementia Disease

by Sandra Lukic, Connie Lethin, Jonas Christensen and Agneta Malmgren Fänge

Healthcare 2024, 12(13), 1285; https://doi.org/10.3390/healthcare12131285 - 27 Jun 2024

Cited by 1 | Viewed by 1527

Abstract

Knowledge seems to mitigate the consequences of dementia and new educational strategies are required. This study aimed to qualitatively explore the reflexive views and experiences of virtual Communities of Practice (vCoP) among informal and formal caregivers of people with dementia and explore vCoP as a tool for learning and knowledge development. Data were collected in a sequence of virtual workshops and analyzed and synthesized using thematic analysis. For the informal caregivers, one main theme emerged: Learning and support, comprising three subthemes: Strategies for learning; Creating emotional support; and in need of professional support. Among formal caregivers, one main theme emerged: Professional development, comprising two subthemes: Sharing and gaining knowledge and Knowledge as a professional tool. vCoP and collaborative learning using an educational platform seem to support learning and professional development among informal and formal caregivers, respectively. As a collaborative, virtual activities seem to provide practical and emotional support and promote professional development; vCoP seem to have the potential to promote the resilience and sustainability of care. Further research is necessary to gain an understanding of the effects of Communities of Practice (CoP) and vCoP and their successful implementation in care practices as well as the potential of using CoP in continuing professional development, CPD. Full article

(This article belongs to the Special Issue Healthcare Practice in Community)

14 pages, 414 KB

Open AccessArticle

Validating an Assessment Tool for Oral Health and Oral Care Procedures Performed by Healthcare Workers for Older Residents in Long-Term Care Institutions

by Florence M. F. Wong, Anna Wong and Wai Keung Leung

Healthcare 2024, 12(5), 558; https://doi.org/10.3390/healthcare12050558 - 28 Feb 2024

Cited by 1 | Viewed by 3499

Abstract

Poor oral health is a growing concern among older populations. It is often caused by a failure to maintain proper oral hygiene and inaccessible dental care. Poor oral health in older individuals in long-term care institutions (LTCIs) can be attributed to the fact that healthcare workers might be poorly trained in oral care assessment and practice. To address this issue, an assessment tool has been developed and validated to guide and evaluate healthcare workers’ oral care practices, ensuring the delivery of adequate care and early detection of dental diseases in LTCIs. The tool includes an oral health assessment and an assessment of oral care procedures. It was developed following a robust literature review, two stages of expert reviews, content validity checks, and a pilot study. A total of twenty-three items were developed and validated, with seven items related to oral health assessment and sixteen related to oral care procedures. The items were assessed for content validity and relevance, with high values of 1 obtained for all Item-level Content Validity Index (I-CVI), Scale-level Content Validity Index (S-CVI), and S-CVI/Universal Agreement (UA) scores. This indicates a high level of agreement among the experts (n = 12) regarding the relevance and importance of the items. A pilot study involving 20 nursing students confirmed the tool’s reliability, applicability, and feasibility, demonstrating its high appropriateness and applicability. The newly developed and validated assessment tool can effectively guide and evaluate healthcare workers’ oral care practices, enhancing their competence and improving the oral health of older residents. Full article

(This article belongs to the Special Issue Healthcare Practice in Community)

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Review

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15 pages, 765 KB

Open AccessReview

Knowledge Translation of Healthcare Research in Saudi Arabia—Implications for Community Health and Primary Care Under the New Saudi Model of Care: A Narrative Review

by Ibrahim M. Gosadi

Healthcare 2025, 13(19), 2469; https://doi.org/10.3390/healthcare13192469 - 29 Sep 2025

Viewed by 1029

Abstract

Knowledge translation (KT) is an essential process in bridging the gap between research evidence and healthcare practice, particularly in community health and primary care settings. In Saudi Arabia, KT is gaining increasing importance as the healthcare system undergoes a major transformation under Saudi Vision 2030 and the new Saudi Model of Care. The new model of care emphasizes the importance of healthy communities and primary care as early elements of healthcare service delivery before reaching the secondary and tertiary healthcare levels. Additionally, healthcare transformation under Saudi Vision 2030 encourages the utilization of evidence and KT to improve healthcare services provided to individuals and enhance the standardization of healthcare delivery. Nonetheless, the application of KT principles in community health and primary care contexts has faced some challenges during the period preceding the establishment of the new Saudi Model of Care. While Saudi Arabia has achieved significant advances in health research and institutional capacity building, KT remains underutilized in local community health initiatives. This narrative review aims to provide a conceptual overview of KT and explore its implications within the contexts of community health and primary care in Saudi Arabia. Additionally, the review introduces the key components of KT—evidence synthesis, dissemination, exchange, and application—and examines how these can be implemented in community and primary care contexts. The review emphasizes the necessity of stakeholder engagement, community-based participatory research, and the integration of frameworks such as the knowledge to action and social–ecological models to ensure effective KT in community health settings. Future directions should focus on expanding KT training, promoting its integration across health institutions involved in primary care delivery, and sustaining community health through strong partnerships among academic, governmental, and community stakeholders. Full article

(This article belongs to the Special Issue Healthcare Practice in Community)

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Other

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18 pages, 650 KB

Open AccessSystematic Review

Home-Based Community Elderly Care Quality Indicators in China: A Systematic Literature Review

by Xi Chen, Rahimah Ibrahim, Yok Fee Lee, Tengku Aizan Hamid and Sen Tyng Chai

Healthcare 2025, 13(14), 1637; https://doi.org/10.3390/healthcare13141637 - 8 Jul 2025

Viewed by 1182

Abstract

Background: China’s rapidly aging population has increased the need for effective community-based eldercare services. However, the lack of standardized, culturally relevant evaluation frameworks hinders consistent service quality assessment and improvement. Objective: This systematic review aims to identify, synthesize, and critically evaluate the existing quality indicators (QIs) currently utilized for home-based community elderly care HCEC in China. It also aims to highlight gaps to inform the development of a more comprehensive and context-appropriate quality framework. Methods: Following PRISMA guidelines, systematic searches were conducted across Web of Science, PubMed, Wiley, and CNKI databases for studies published in English and Chinese from 2008 onward. Extracted QIs from eligible studies were categorized using Donabedian’s structure–process–outcome (SPO) model. Results: Fifteen studies met the inclusion criteria, with QI sets ranging from 5 to 64 indicators. Most studies emphasized structural and procedural aspects, while outcome measures were limited. Key gaps include inconsistent terminology, insufficient medical care integration, narrow stakeholder engagement, and limited cultural adaptation of Western theoretical frameworks. Furthermore, subjective weighting methods predominated, impacting indicator reliability. Conclusions: Currently, there is no formal quality framework to guide service providers in HCEC, and therefore, quality indicators can be described as fragmented and lack cultural specificity, medical integration, and methodological robustness. Future research should prioritize developing culturally anchored and medically comprehensive QI frameworks, standardize indicator terminology, actively involve diverse stakeholders through participatory methods, and adopt hybrid methodological approaches combining subjective expert insights and objective, data-driven techniques. Alignment with established international standards, such as the OECD long-term care quality indicators, is essential to enhance eldercare quality and support evidence-based policymaking. Full article

(This article belongs to the Special Issue Healthcare Practice in Community)

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8 pages, 679 KB

Open AccessOpinion

Bridging Barriers: Engaging Ethnic Minorities in Cardiovascular Research

by Nora Bacour, Simran Grewal, M. Corrette Ploem, Jeanine Suurmond, Robert J. M. Klautz and Nimrat Grewal

Healthcare 2025, 13(11), 1217; https://doi.org/10.3390/healthcare13111217 - 22 May 2025

Viewed by 610

Abstract

Background/Objectives: We address the ongoing under-representation of ethnic minority groups in cardiovascular research in this opinion paper—a challenge that limits both scientific validity and equitable healthcare outcomes. We aim to outline the underlying causes of this issue and propose concrete strategies to address it. Methods: To engage ethnic minorities in cardiovascular research, we thoroughly studied the existing literature and gathered expert opinions to identify barriers and formulate practical solutions. Results: Our findings highlight the need for a multifaceted approach, including culturally appropriate educational outreach, interactive multimedia information, community ambassador programs, and improved, but ethically sound, ethnicity registration practices. Conclusions: To promote ethnic minority participation in cardiovascular research, a thorough improvement plan is required. Our proposed solutions, which align with insights from the current literature, suggest that addressing cultural, structural, and informational barriers can help achieve a more representative and inclusive participant population. This is an essential step towards improving cardiovascular outcomes for all. Full article

(This article belongs to the Special Issue Healthcare Practice in Community)

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