Search Results (87)

Background and objectives: Duloxetine is widely used for the treatment of major depressive disorder (MDD), generalized anxiety disorder (GAD), and various types of neuropathic pain. While its efficacy is well documented in clinical trials, less is known about how it is perceived and utilized in routine psychiatric practice. To address this knowledge gap, we conducted a cross-sectional observational study involving 80 psychiatrists from Spain to assess real-world clinical attitudes toward duloxetine. Methods: Participants completed a 20-item multiple-choice questionnaire that examined familiarity, perceived efficacy in multiple conditions (MDD, GAD, neuropathic pain, somatization, and quality of life), and perspectives on tolerability, safety, adherence, and overall satisfaction. Results: Survey results indicated that a large majority of psychiatrists frequently prescribe duloxetine, particularly for patients with MDD and comorbid chronic pain. Notably, 94% rated it as either “more effective” or “much more effective” for diabetic peripheral neuropathic pain. Psychiatrists reported a high perceived efficacy of duloxetine: 94% rated it as “more effective” or “much more effective” for diabetic peripheral neuropathy, and 93% gave similarly positive ratings for general neuropathic pain. For somatization, 70% found it “effective” or “very effective”, and 83% observed improvements in quality of life for many of their patients. Psychiatrists generally reported favorable perceptions of duloxetine’s tolerability profile: 97.5% rated it as the antidepressant associated with the least weight gain, and 82.5% perceived fewer sexual side effects compared to other options. Sedation and gastrointestinal side effects were generally considered mild or less severe. In terms of treatment adherence, 69% rated it as “better” or “much better” than other antidepressants, and 80% found its combination with other antidepressants to be “favorable” or “very favorable”. Overall satisfaction was high, with 99% of psychiatrists reporting being either “satisfied” or “very satisfied” with its use. The side effect profile was generally viewed as manageable, with low perceived rates of weight gain, sedation, and sexual dysfunction. Furthermore, 96% of respondents expressed a willingness to recommend duloxetine to their colleagues. Conclusions: Psychiatrists reported highly favorable attitudes toward duloxetine, viewing it as a flexible treatment option in routine care. However, these findings reflect clinicians’ subjective perceptions rather than objective clinical outcomes and should be interpreted accordingly. Full article

Background/Objectives: Increasing evidence has shown that terminal cancer patients experience a poor quality of life (QoL), but the complex internal structure of the QoL among terminal cancer patients is not well documented. This study aimed to explore the core attributes of QoL and their interrelationships in low-income terminal cancer patients stratified by survival time (<3 months vs. 3–6 months). Methods: This study retrospectively analyzed the records of 5649 low-income terminal cancer patients from a hospital hospice center. The Cancer Pain and Quality of Life Questionnaire for Chinese Cancer Patients (CPQLQ) was employed to assess the QoL. A network analysis was conducted to examine centrality indices and density measures. Results: For patients with a survival time of 3 to 6 months, the highest centrality score was associated with “attitudes towards treatment” of the CPQLQ (rs = 1.84). In contrast, for those with a survival time of less than 3 months, “illness perception” of the CPQLQ had the highest centrality score (rs = 1.70). In both the less than 3 months and 3–6 months survival time groups, the network analysis indicated that the strongest correlations were between “illness perception” and “attitudes towards treatment” of the CPQLQ. Conclusions: Attitudes towards treatment and illness perception emerge as core attributes of the QoL network and are strongly interrelated among low-income terminally ill cancer patients. The findings highlight that a shift in hospice care priorities, linked to survival time, is crucial for enhancing the QoL of terminal cancer patients. Full article

Background: Unlike other chronic diseases, cancer patients undergo different types of treatments that affect their well-being, and as a result, they tend to have different experiences from those of other chronic disease sufferers. The purpose of this study was to assess the effects of cancer diagnosis and coping strategies on patients in Vhembe District hospitals in Limpopo Province. Methodology: The study design used was a quantitative descriptive cross-sectional survey. The target population included patients in the Vhembe District of Limpopo who had started treatment within the last year. Probability-stratified sampling was used to sample 207 patients from seven selected hospitals in Vhembe District. A self-administered questionnaire was used to collect data, and the data were analyzed using a software package for descriptive statistics (SPSS version 23). Tables were used to display the results visually, and chi-square tests were used to compare the variables. Ethical principles were considered for the participants’ privacy, anonymity, and informed consent. Findings: The findings revealed that the majority of patients 185 (89.4%) experienced a sense of psychosocial distress such as emotional pain; 142 (68.6%) participants experienced hopelessness and despair, 127 (61.3%) resorted to substance use, 160 (77.3%) did not have a positive attitude towards seeking the medical and other support resources available, only a minority resorted to spirituality, and 121 (63.2%) indicated seeking further clarity about the disease. The study recommends supporting cancer patients and their families through the cancer journey. Contributions: Clinicians should provide psychosocial support interventions to enhance mental health and quality of life in cancer patients, and decentralize oncology services by including primary care professionals in delivering chronic illness disease management strategies. Full article

Background/Objectives: Public perception of clinical trials (CT) in Poland remains underexplored. This study aims to assess attitudes towards clinical trials, to identify key sociodemographic and health-related predictors of participation willingness, and to evaluate the perceived health impact (CT-PHI) associated with participants’ involvement in trials. Methods: A cross-sectional online survey was conducted (2–20 March 2022) among 2050 Polish adults who had benefited from medical care in the past 24 months. This study examined sociodemographic factors, health-related factors (self-perceived health, EQ-5D-5L, the level of awareness of patient rights, use of public vs. private healthcare, adherence), and motivations for participation in trials (health-related, financial, and altruistic). Multivariate logistic and generalized linear models identified predictors of participation willingness and CT-PHI variability. Results: Overall, 56.3% of the respondents expressed a willingness to participate in clinical trials. The main motivation was health improvement (45.8%), followed by financial incentives (23.2%) and altruism (22.7%). Those driven by health reasons showed the highest sensitivity to demographic and health-related factors. In this group, higher CT-PHI scores were associated with older age (66+: B = 1.24, p < 0.001), female gender (B = 0.41, p = 0.034), rural residence (B = 0.41, p = 0.033), dual use of public/private healthcare (B = 0.64, p = 0.001), adherence (B = 2.50, p < 0.001), and greater pain severity (moderate: B = 1.36, p < 0.001; severe: B = 0.91, p = 0.023). Socioeconomic factors played a greater role for financially motivated individuals, while altruistic participants showed the least variability in influencing factors. Conclusions: Willingness to participate in clinical trials in Poland is influenced by the motivation type. A patient-centered approach to recruitment strategies, considering diverse motivations and sociodemographic factors, is essential for optimizing participation in clinical trials. Full article

Background: The attitudes and beliefs of patients with chronic pain significantly affect their response to treatment. The Survey of Pain Attitudes (SOPA) scale was developed to identify pain-related beliefs. The aim of the present study was to adapt and validate the short version (30 items) of the Survey of Pain Attitudes in 200 Greek patients living with chronic pain, mainly due to rheumatic and musculoskeletal diseases (RMDs). Method: In addition to the SOPA-Brief scale (30 items), the participants completed the Pain Beliefs, Perceptions and Attitudes Inventory (PBAPI) and also the Chronic Pain Coping Inventory (CPCI). Results: Data analysis revealed that the internal reliability coefficient of the scale in the Greek language was Cronbach’s a = 0.773 for the individual items, and for the subscales, it ranged from Cronbach’s a = 0.56 (for the SOPAMedication scale) to Cronbach’s a = 0.78 (for the SOPASolicitude scale). Similarly, the SOPA-Brief subscales in Greek showed positive correlations with subscales of both the PBAPI and the CPCI. Finally, an exploratory factor analysis was performed on the dataset and confirmed the structure of the original scale (Eigenvalues > 1), with 71.54% of variance explained. Conclusions: Overall, the psychometric properties of the short version of the Attitudes Towards Pain Scale (30 items) in Greek show acceptable internal reliability and validity for the scale to be used in daily clinical and research practice. Full article

Background: Crohn’s disease (CD) and ulcerative colitis (UC) are chronic inflammatory bowel diseases (IBDs) characterized by various clinical symptoms including abdominal pain, diarrhea, fatigue, and extraintestinal manifestations, which negatively affect a patient’s quality of life. Both mainly occur in adolescence and young adulthood and therefore affect women in their sexually active period. The aim of this study was to assess the effect of IBD on female sexuality and attitudes towards contraception. Methods: A prospective cross-sectional survey study was conducted at the Medical University of Vienna, Austria. Data were collected using a self-designed questionnaire, which included questions on demographics, gynecological patient history, contraceptive choices, and fertility, as well as the Female Sexual Functionality Index (FSFI). Results: A total of 83 female patients with IBD (CD: n = 47, UC: n = 36) and 340 healthy control participants between the ages of 18 and 50 years were investigated. Demographic parameters did not differ between the groups; however, mean FSFI scores were significantly lower in the patient group (p < 0.001). Significantly fewer patients in the IBD group used contraception (p = 0.008). No significant differences regarding conception rates and infertility rates were noted between patients with IBD and control participants (p = 0.533 and p = 0.506, respectively). Conclusions: Female sexuality is significantly impaired in patients with IBD. Women with IBD do not receive sufficient information regarding contraception and should be screened for sexual dysfunction to optimize their quality of life. Full article

Introduction: Chronic neck pain is a prevalent condition that challenges physical therapists (PTs) due to its multifactorial etiology. Differential diagnosis is crucial for identifying the underlying causes and providing appropriate interventions. However, the extent to which PTs apply and understand differential diagnostic criteria remains unclear. This study aimed to evaluate the knowledge, attitudes, and behaviors of PTs in France regarding the differential diagnosis of chronic neck pain. Materials and Methods: An online questionnaire was designed to assess PTs’ beliefs, attitudes, knowledge, and clinical application of differential diagnostic criteria in chronic neck pain. The survey was distributed nationwide and included questions regarding demographic data, theoretical knowledge, practical application, and perceived barriers. A total of 80 responses were collected and analyzed using descriptive and inferential statistics. Results: The results revealed moderate levels of theoretical knowledge among participants, with 62% correctly identifying key criteria for differential diagnosis. However, only 45% reported consistently applying these criteria in clinical practice. Common barriers included time constraints (70%), lack of access to advanced diagnostic tools (55%), and insufficient training (40%). Attitudes towards the importance of differential diagnosis were predominantly positive, with 85% recognizing its relevance for improving patient outcomes. Conclusions: This study highlights a gap between PTs’ knowledge and the practical application of differential diagnosis criteria in chronic neck pain. Addressing barriers such as training and resource availability could enhance clinical practices. Future efforts should focus on integrating these competencies into professional development programs to improve diagnostic accuracy and patient care. Full article

Background/Objectives: Fibromyalgia syndrome (FMS) is a chronic, debilitating condition characterized by widespread pain, fatigue, and psychological distress. There is a lack of qualitative studies on the unique experiences of patients with FMS in Arab countries, particularly through social media. Despite the availability of diagnostic criteria, diagnosing and managing patients remains challenging. This study aimed to describe the experiences of patients with FMS in Arab countries, their understanding of the illness, and perceptions of treatment. Methods: A qualitative study was conducted using a content analysis of patients’ narratives published in a supportive group, describing their experiences with fibromyalgia. The dataset included 2305 quotes from 192 main posts and 2113 comments collected between 2019 and 2024. Results: The analysis of the posts and associated comments revealed six main themes: patients’ experiences with the syndrome, symptoms, searching for a doctor, pharmacological management, self-management, and the impact of fibromyalgia and peer support. Most posts and comments focused on patients’ experiences with self-management approaches and coping strategies, highlighting significant noncompliance with therapeutic modalities. Factors influencing patients’ experiences and decisions included their relationship with physicians, medication side effects, personal fears, and physical and mental health. Conclusions: Patients with FMS in Arab countries face similar challenges to those in other regions, including physical, psychological, social, and economic impacts. Many patients reject conventional therapeutic management strategies and adopt coping mechanisms to mitigate adverse effects and healthcare costs. The findings suggest that the physician–patient relationship, as well as the physician’s knowledge and attitude toward fibromyalgia syndrome, are the cornerstones of gaining patients’ trust. Full article

Background: In light of the opioid epidemic, opioid-prescribing modalities for postoperative pain management have been discussed controversially and show a wide variation across geographic regions. The aim of this study was to compare postoperative pain treatment regimes. Methods: We performed a matched cohort study of women undergoing hysterectomy in Austria (n = 200) and Canada (n = 200). We aimed to compare perioperative opioid medications, converted to morphine equivalent dose (MED) and doses of non-opioid analgesic (NOA) within the first 24 h after hysterectomy, and opioid prescriptions at discharge between the two cohorts. Results: The total MED received intraoperatively, in the post-anaesthesia care unit (PACU) and during the first 24 h after surgery, was similar in both cohorts (145.59 vs. 137.87; p = 0.17). Women in the Austrian cohort received a higher MED intraoperatively compared to the Canadian cohort (117.24 vs. 79.62; p < 0.001) but a lower MED in the PACU (25.96 vs. 30.42; p = 0.04). The primary outcome, MED within 24 h in the postoperative ward, was markedly lower in the Austrian compared to the Canadian cohort (2.36 vs. 27.98; p < 0.001). In a regression analysis, only the variables “Country” and “mode of hysterectomy” affected this outcome. A total of 98.5% in the Canadian cohort were given an opioid prescription at discharge vs. 0% in the Austrian cohort. Conclusions: Our analysis reveals marked differences between Austria and Canada regarding pain management practices following elective hysterectomy; the significantly higher intraoperative and significantly lower postoperative MED administration in the Austrian cohort compared to the Canadian cohort seems to be significantly affected by each country’s cultural attitudes towards pain management; this may have significant public health consequences and warrants further research. Full article

Background: Identity formation, a primary developmental task of adolescence, may be particularly relevant to another commonly occurring event for young athletes—sport injury. Relationships between a subdimension of self-identity—athletic identity—and sport injury processes and outcomes have been documented in the general athlete population. The purpose of this supplemental narrative review is to explore the potential role of athletic identity in the risk of injury occurrence and responses to and consequences of injury among young athletes. Methods: Studies on athletic identity in relation to sport injury, with a focus on young athletes, were extracted from a recent scoping review and identified through an updated literature search from April 2020 through June 2024. A total of 23 studies were examined. Results: Across the studies reviewed, high levels of athletic identity were associated with a reluctance to report injury-related symptoms, a tendency to endorse attitudes and behaviors reflecting a willingness to play through pain and injury, intensified physical and psychological symptoms after injury, a disposition toward over-adhering to rehabilitation, high levels of postinjury coping skills, and better functional and return-to-sport outcomes after injury among young athletes. Conclusions: Athletic identity may, therefore, be a source of both strength and vulnerability in young athletes in terms of sport injury processes and outcomes. Full article

Introduction: Caring for the dying can generate anxiety and emotional distress, particularly in nursing students, and perceived competence could play a crucial role in enabling nurses to perform their duties with greater confidence. Unfortunately, few studies describe the relationship between students’ nursing attitudes and perceived self-efficacy in palliative care (PC). To overcome this gap, this survey aimed to assess the attitudes towards dying patients and the perceived competence of nursing students in palliative care at different universities in the south of Italy. Methods: A cross-sectional study was conducted from September 2022 to March 2023 involving nursing students from the three major Sicilian universities (Italy). The study included a survey investigating socio-demographic characteristics, palliative care training, knowledge about pain management, and previous experience with dying. Moreover, the Professional Competence of the Core Curriculum in Palliative Care Nursing (CCPCN) questionnaire and the Frommelt Attitudes Toward Care of the Dying—B Italian version (FATCOD-B-I) assessed competencies and emotional attitudes. Results: A total of 1913 nursing students were recruited, of which 71.3% were females, and 53.9% were in the age range of 18 to 21 years. In the multivariable analysis, practical PC training was a substantial factor in enhancing competencies (Adj-OR 2.78 [95% CI = 2.12–3.65]). Male students had higher competence odds (Adj-OR 1.38 [95% CI = 1.14–1.66]), and perceived knowledge strongly correlated with self-assessed competence. Advancement in academic years also positively influenced competence self-assessment (Adj-OR 1.98 [95% CI = 1.75–2.24]). Regarding emotional attitudes, a per-quartile increase in competence score was found to improve the attitude score (Adj-OR 1.24 [95% CI = 1.13–1.35]). Conclusions: Nursing students gain valuable experience during clinical experience. PC training and perceived knowledge of PC significantly increase nurses’ competencies, and the latter seem to be strongly associated with attitudes. Thus, introducing palliative care education into nurses’ core curricula could be a way to reduce anxiety and emotional distress in young students. Full article

Background/Objectives: Early childhood caries (ECC) is a significant global health issue, particularly affecting deciduous teeth in young children. ECC is prevalent in Romania, where nearly half of children experience dental caries. This study aimed to assess the influence of gender, age, and living environment on parents’ knowledge, attitudes, and practices (KAP) regarding ECC in Bihor County, Romania, using a KAP-type questionnaire. Methods: A cross-sectional study was conducted between March and September 2024, utilizing an online KAP questionnaire distributed via social networks. The sample comprised 419 parents of children under six years old. Respondents provided socio-demographic data and answered questions regarding their knowledge, attitudes, and practices concerning ECC prevention, treatment, and oral health. Statistical analysis was conducted using Chi-square tests to assess associations between demographic factors and parental KAP. A p-value of less than 0.05 was considered statistically significant. Results: Of the 419 respondents, 83.1% were female, and 62.5% were between the ages of 31 and 40. Significant gender-based differences were found in knowledge about pain from caries (93.7% of female participants vs. 81.7% of male participants, p = 0.004) and the importance of brushing twice daily (93.7% of female respondents vs. 80.3% of male respondents, p = 0.010). Younger parents (aged 18–30) were more likely to affirm the effectiveness of fluoride (65.4%) compared to those aged 31–40 (53.1%, p = 0.02). Urban parents were more likely to correctly identify the timing of tooth eruption (59.1% vs. 52.6% of rural parents, p = 0.021). Conclusions: The study highlights gender, age, and urban–rural disparities in parental knowledge and attitudes towards ECC. These findings underscore the need for targeted educational interventions to improve oral health outcomes and reduce ECC prevalence in the Bihor region. Tailored public health strategies addressing demographic factors could enhance preventive oral health behaviors and reduce the healthcare burden associated with untreated dental caries. Full article

This study evaluated Spanish physiotherapists’ orientations toward biopsychosocial and biomedical approaches in chronic pain management through a cross-sectional survey of 447 registered professionals. Validated questionnaires assessed knowledge, attitudes, and beliefs. Multivariate analysis of covariance (MANCOVA) identified influential factors and ordinal regression determined the frequency of biopsychosocial application. Content analysis of open-ended responses explored barriers to biopsychosocial implementation. Over 50% of physiotherapists favored the biopsychosocial model, influenced by interdisciplinary work settings, advanced pain knowledge, and specific training. Comprehensive pain knowledge significantly impacted both biomedical and biopsychosocial orientations inversely. The biomedical approach was more prevalent among those with lower education levels and less pain knowledge, particularly at the beginning or over 20 years into their careers. Despite the theoretical preference for biopsychosocial among Spanish physiotherapists, practical application was infrequent, with only 9.8% always using it and 40.7% frequently. Self-reported confidence and skills were crucial determinants of biopsychosocial implementation frequency. Significant barriers included inadequate psychological skills (63.6%), coordination challenges (47.6%), time constraints (43.6%), patient misconceptions (34.2%), and systemic issues. These findings align with international research, highlighting the need to bridge the gap between theoretical knowledge and clinical practice. Addressing these challenges through targeted training and systemic reforms is crucial for improving chronic pain management globally. Full article

Non-steroidal anti-inflammatory drugs (NSAIDs) are largely used for controlling various pain conditions and are widely available in community pharmacies, with and without prescription. Despite their effectiveness, NSAIDs can pose significant risks due to potential side effects and drug interactions, particularly in polypharmacy and comorbidity contexts and for vulnerable users. This study investigated whether and how NSAIDs deprescribing can be conducted at the community pharmacy level by assessing pharmacists’ confidence, attitudes, and potential barriers and facilitators. Additionally, we aimed to identify any deprescribing guidelines that pharmacists could use. A literature search and a cross-sectional digital questionnaire targeting community pharmacists in Norway were conducted. Results showed that study participants (N = 73) feel confident in identifying needs for deprescribing NSAIDs but barriers such as time constraints, lack of financial compensation, and communication challenges were noted. Participants reported positive attitudes toward deprescribing but highlighted a need for better guidelines and training. This study highlights a gap in specific guidelines for deprescribing NSAIDs and a potential for enhancing pharmacists’ roles in the deprescribing process, for example, through training and improved financial incentives. Further research is encouraged to develop concrete strategies for an effective implementation where community pharmacists can be involved in the deprescribing of NSAIDs. Full article

Background: Sickle Cell Disease (SCD) presents significant health challenges globally. Despite its prevalence in diverse geographical regions, there is a paucity of literature synthesizing evidence on healthcare professionals’ knowledge, attitudes, and practices (KAP) toward SCD assessment and management. This meta-aggregative review systematically examined and synthesized existing qualitative research to elucidate healthcare professionals’ KAP regarding SCD assessment and management. Methods: This meta-aggregative review followed Aromataris and Pearson’s guidelines and the PRISMA framework for systematic review reporting. The search was conducted in Scopus, PubMed, Embase, CINAHL Web of Science, Google Scholar, Dimensions AI, and HINARI. Quality appraisal was performed using the Joanna Briggs Institute tool. Results: Healthcare professionals (HCPs) demonstrate varying levels of KAP toward SCD assessment and management. Studies reveal low-to-moderate levels of general knowledge among HCPs, with nurses often exhibiting poorer understanding than physicians. Deficiencies in awareness of specific interventions, such as chemoprophylaxis and prenatal diagnosis, are noted, along with gaps in SCD assessment and diagnosis, particularly in pain management and premarital screening. Attitudes toward SCD patients vary, and practices reveal inconsistencies and deficiencies, including inadequate nutritional counseling and barriers in emergency departments. However, interventions aimed at improving HCPs’ KAP show promise in enhancing understanding and attitudes toward SCD, suggesting potential avenues for improvement. Conclusions: Educational initiatives targeted at both student nurses and practicing healthcare providers, coupled with the implementation of standardized protocols and guidelines, can enhance knowledge acquisition and promote consistent, high-quality care delivery. Future studies should improve the quality of their methods in this area of study. Full article