Search Results (1,099)

Background: Artificial intelligence (AI) is increasingly integrated into healthcare systems, with important implications for nursing practice and clinical workflows. However, evidence regarding nurses’ digital skills, perceptions, and readiness to adopt AI-enabled technologies remains limited, particularly in national healthcare contexts such as Greece. Objectives: This study examined nurses’ digital skills, perceptions of AI, and readiness for AI adoption in clinical practice, and explored demographic and professional factors associated with these outcomes. Methods: A cross-sectional survey was conducted among 166 nurses working in two public hospitals in Greece. Results: Nurses reported moderate digital skills, with 59.1% indicating competence in email/video communication and 27.2% reporting adequate use of digital security tools, while exposure to AI remained limited (18.0% reported using AI products/services in daily life). Perceived professional impact of AI was moderate, whereas readiness for AI adoption was comparatively lower, with only 7.8% considering health professionals adequately prepared and 7.2% reporting adequate AI training. Statistical analyses indicated that educational level and computer literacy certification were positively associated with digital skills, whereas longer professional experience was negatively associated with readiness for AI adoption. Conclusions: These findings highlight a gap between general digital competence and preparedness for AI-driven healthcare applications and underline the need for targeted education and implementation strategies to support effective and ethical integration of AI in nursing practice. From a nursing workforce perspective, the results underscore the importance of integrating AI literacy into continuing professional education and aligning digital health implementation strategies with clinical nursing practice. Full article

Background: Intensive care units (ICUs) are high-acuity environments that require respiratory therapists (RTs) to maintain vigilance, manage emotions, and make rapid clinical decisions. In such settings, performance stability is critical for patient safety. Although emotional intelligence (EI) and work–life balance (WLB) have been linked to professional outcomes in health care, their independent and direction-specific associations with job performance among ICU respiratory therapists remain underexamined. Methods: A national cross-sectional survey was conducted among respiratory therapists working in ICUs across Saudi Arabia (June 2025–January 2026). EI was measured using the Wong and Law Emotional Intelligence Scale. WLB was assessed using the work interference with personal life (WIPL), personal life interference with work (PLIW), and work–personal life enhancement (WPLE) scales. Job performance was evaluated using the Individual Work Performance Questionnaire. Correlation and multivariable linear regression analyses were performed to estimate independent associations. Results: A total of 392 RTs were included in the final analysis. Higher EI was independently associated with greater task performance (B = 0.21, p < 0.01) and contextual performance (B = 0.30, p < 0.001), and with lower counterproductive work behaviours (B = −0.24, p < 0.001). Among WLB dimensions, PLIW showed the strongest adverse association, predicting lower task performance (B = −0.20, p < 0.05) and higher counterproductive behaviours (B = 0.39, p < 0.001), but was not significantly associated with contextual performance in the fully adjusted model. WPLE demonstrated modest positive associations with performance, whereas WIPL was not significant in adjusted models. Conclusions: Job performance among ICU respiratory therapists is shaped by both emotional regulatory capacity and cross-domain strain. Personal life interference with work emerged as the most influential adverse predictor, whereas EI was associated with constructive performance patterns. Findings should be interpreted in light of the cross-sectional design and self-reported data. Sustaining performance in high-acuity settings requires attention to emotional competencies and structural sources of role conflict alongside clinical expertise. These findings inform workforce strategies to support performance and sustainability in critical care settings. Full article

Background: Healthcare policy in the United Kingdom recognizes that teenagers and young adults (TYAs: 16–24 years at diagnosis) require specialist care. In England, Principal Treatment Centers (PTCs) exist, delivering enhanced care exclusively within the PTC or as ‘joint care’ with designated hospitals (DHs). Central to this is the TYA multidisciplinary team (MDT) and an outreach model coordinating care between hospitals. We previously reported similar outcomes regardless of care location. Aims: To compare TYA experiences of care with healthcare professionals’ perspectives of the service they deliver. Methods: Mixed methods across England and Wales were used. The TYA-MDT identified TYAs who then received a postal invite to a cross-sectional survey capturing experiences of places of care, treatment, healthcare professional support (HCP), mental health, sexuality/fertility, clinical trials and care coordination. Comparisons were made based on exposure to care in a specialist TYA environment within 6 months of diagnosis: all-TYA-PTC (all care in the TYA-PTC, n = 70, 28%), no-TYA-PTC (no care in the TYA-PTC (n = 87, 35%): care delivered in a children/adult unit only), and joint care (care in a TYA-PTC and in a children’s/adult unit, n = 91, 36%). HCP perspectives were captured by rapid ethnography. Results: A total of 250/1056 (24%) TYAs participated. Overall, 200 (80%) rated their teams as excellent/good for helping them prepare for treatment. No evidence of significant differences existed between categories of care for proportions receiving support from key TYA-related professionals: TYA cancer nurse specialists (all-TYA-PTC n = 58, 91%; joint care n = 71, 88%; no-TYA-PTC n = 64, 82%) and social workers (all-TYA-PTC n = 30, 55%; joint care n = 36, 48%; no-TYA-PTC n = 28, 38%). A trend of diminishing support from youth support co-coordinators existed (all-TYA-PTC 63%; joint care 49%; no-TYA-PTC 40%, p = 0.069). This may explain why few differences in patient experiences existed across categories of care. Forty-nine HCPs participated. They were more critical in their interpretation of care, highlighting inequity in resources and challenges in some pathways and coordination. Conclusions: Similar access to age-appropriate support across care settings is likely to reflect recruitment methods. When TYAs are known to the MDT, age-appropriate care can be mobilized beyond TYA units, which could explain the equitable outcomes observed across different care locations in young people who responded to the survey. Nevertheless, gaps persist in communication and coordination, particularly within joint care models, and in the involvement of allied health professionals such as dieticians and physiotherapists, whose input is essential for rehabilitation and return to normal life. Strengthening these areas will require continued investment in workforce capacity and digital infrastructure to support genuinely coordinated, developmentally appropriate TYA cancer care. Full article

The evolving digital landscape, including artificial intelligence (AI) and its generative forms, is changing how younger generations learn. As students utilize generative AI systems, they cultivate trust in such technology to support their current and long-term learning. The objective of this study was to investigate the relationship between generative AI use among students in health professions and their trust in this technology to support their lifelong learning as future health professionals. This study employed a survey methodology using a cross-sectional study design. The survey included sociodemographic variables and questions regarding students’ generative AI use and their trust in this technology to support their lifelong learning. Descriptive and inferential statistical procedures were used to analyze the data. A total of 558 students representing various health professions responded to the survey. In the regression analysis, after controlling for student’s sex and location variables, greater generative AI use was associated with students’ increased trust in this technology to support their lifelong learning (beta = 0.58, p < 0.001), explaining close to 40% of the total variance. Given the rapidly evolving digital landscape, this finding warrants further study, with implications for training of the future health workforce. Full article

Background: Examining the relationship between burnout and absenteeism is important for understanding how chronic occupational stress translates into economic costs, reduced productivity, and deterioration in the health of nursing staff. The aim of this study was to evaluate absenteeism among nursing staff and its association with burnout from a gender perspective. Methods: A total of 154 nursing professionals with permanent contracts were included. An interview was conducted, which included the collection of sociodemographic data, characteristics related to their employment status, and the Maslach Burnout Inventory questionnaire in its Spanish-validated healthcare personnel version. The absenteeism rate was calculated using information from the hospital’s human resources department. The Mantel–Haenszel test was used to identify the association between burnout and absenteeism from a gender perspective. A p-value < 0.05 was considered statistically significant. Results: The prevalence of burnout was 70.1%; 52.6% reported absenteeism in 2024. The general nursing category was significantly associated with burnout (p = 0.039). Although no association was found between burnout and overall absenteeism, holding multiple jobs was identified as a determinant of partial absenteeism (p < 0.05). The hospital absenteeism rate was 4.8%. No statistically significant difference was found between burnout, gender, and absenteeism, with an adjusted odds ratio of 1.386 (95% CI: 0.75–2.65) after controlling for the effect of gender (χ²_MH = 0.672, df = 1, p = 0.412). Conclusions: Nursing staff present a critical level of burnout. No statistically significant difference was found between burnout, gender, and absenteeism, which could indicate that gender roles in the workforce may be changing in our population. Full article

Background/Objectives: Shoulder disorders are among the most prevalent musculoskeletal conditions, with lifetime prevalence reaching 67% and substantial associated disability and economic burden. Geographic barriers and workforce shortages impede access to optimal rehabilitation. This narrative review aims to synthesize current evidence on tele-diagnostics and tele-rehabilitation in shoulder disorders, evaluate clinical outcomes and implementation factors, and explore models for integrating these complementary approaches. Methods: A structured but non-systematic literature search was conducted across PubMed, Scopus, and Web of Science covering publications from January 2010 through December 2025, using terms related to telehealth, tele-rehabilitation, tele-diagnostics, and shoulder disorders. Priority was given to randomized controlled trials, systematic reviews, feasibility studies, and clinical practice guidelines in adult populations. A total of 97 articles were included in the final narrative synthesis. Results: Tele-diagnostic approaches demonstrate acceptable reliability for range-of-motion assessment and general diagnostic classification, though glenohumeral instability evaluation remains challenging remotely. Multiple randomized controlled trials suggest non-inferior outcomes for tele-rehabilitation compared to conventional physiotherapy across rotator cuff repair, shoulder arthroplasty, and conservative management, with generally high patient satisfaction. Certainty of evidence is currently low to moderate due to short follow-up durations, modest sample sizes, and heterogeneous protocols. Key implementation barriers include the digital divide, inability to deliver manual therapy, and insufficient long-term outcome data. Conclusions: Current evidence supports telehealth as a viable complement to conventional shoulder care, with the strongest evidence base for postoperative tele-rehabilitation. Hybrid care models appear clinically feasible, though widespread adoption requires standardized outcomes, longer-term trials, and strategies addressing health equity barriers. Full article

Background: Oral healthcare workers play a pivotal role in exploring the significant potential of integrating oral healthcare with overall health within a healthcare system. This review aims to identify the main barriers and facilitators to integrating oral health into primary and general healthcare from the perspectives of oral healthcare professionals. Methods: The study adhered to the Arksey and O’Malley methodological framework for scoping reviews. Five main databases were systematically searched, namely Web of Science, PubMed, Scopus, ProQuest, and Embase, spanning from 1 January 2000 to 31 December 2024. The Rainbow Model served as the framework for content analysis, organizing the advantages, disadvantages, barriers, and facilitators into micro, meso, and macro levels. Results: Five integration domains were identified across macro, meso, and micro levels, illustrating how oral health can be systematically embedded within general health through the utilization of oral healthcare professionals. These domains encompassed chronic disease management (screening, counseling, and referral), emergency management, electronic health records, interprofessional education, and tele-dentistry, highlighting policy, organizational, and workforce levers for strengthening care integration, enhancing system efficiency, and improving access and equity. Conclusions: This scoping review synthesizes five integration domains and four cross-cutting strategic directions for embedding oral health within broader healthcare systems. By conceptualizing integration across macro, meso, and micro levels, the study provides a structured framework that may serve as a reference for policymakers, educators, and health service leaders. The findings highlight potential enablers, such as coordinated governance, workforce development, digital infrastructure, and community engagement, which could support integration. Full article

International policy frameworks, including the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) and the WHO Quality Rights initiative, have established dignity as a foundational right in mental health care. However, a significant gap remains between these policy aspirations and the lived experience of service users, often due to risk-averse cultures that prioritize control over autonomy. This commentary employs an interpretive synthesis of international literature (2006–2025) and illustrative case examples, such as the Trieste model and Quality Rights implementation in low-resource settings, to examine the operationalization of dignity-centered care. I argue for a paradigm shift from control-based safety models to relational safety grounded in biographical literacy and positive risk-taking. Key findings highlight that dignity-centered approaches not only improve patient experiences of respect and agency but also mitigate moral injury and burnout among the nursing workforce. Furthermore, as digital mental health tools and AI-driven risk assessments emerge, systems must ensure these technologies enhance rather than automate paternalism. I conclude that realizing dignity-centered care requires a structural and cultural transformation, embedding dignity into clinical protocols, leadership practices, and environmental design to move beyond rhetorical commitments toward measurable, humane standards. Full article

Equity in precision cancer health, defined here as equitable access to inclusive cancer risk assessment, cancer risk reduction/management, and risk-appropriate cancer healthcare from prevention through survivorship, is critical for addressing broader population cancer disparities. Specifically, we describe the impact of the Illinois Cancer Health Equity Research (I-CHER) Center on precision cancer health equity, including how the Center cumulatively served >10,000 residents from under-resourced communities; disseminated findings to >300 members of the local cancer health disparities workforce; and translated scientific solutions into sustained clinical practice and two state laws. The objective of this case report is to describe the I-CHER Center’s multisectoral structure; participatory administrative processes for research; early implementation challenges and tensions across sectors; and solutions that contributed to early center-wide successes. This case report offers one example of the administrative infrastructure needed for advancing scientific solutions in precision cancer health equity within a Minority Serving Institution (MSI) and its internal federally qualified health center (FQHC). Full article

Background/Objectives: Municipal hospitals in transitional health systems operate under structural resource constraints that complicate managerial decision-making and shape patient perceptions. This study examines how patients interpret resource allocation and evaluate the ethical and legitimacy consequences of alternative strategic priorities. Methods: A qualitative research design was employed using semi-structured patient interviews. Participants were recruited using purposive sampling based on predefined inclusion criteria: age over 18, hospitalization for digestive symptoms, undergoing diagnostic investigations, and provision of informed consent. Thematic analysis identified key expectation domains related to technological modernization, workforce capacity, infrastructure, and relational communication. These themes were translated into core governance variables and integrated into a conceptual simulation model comparing three allocation scenarios: technological investment, human resource expansion, and status quo preservation. Results: Findings show that patient evaluations extend beyond satisfaction to include distributive fairness, symbolic modernization, and institutional legitimacy. Simulation findings suggest that technological investment strengthens symbolic legitimacy and perceived equity but may increase workload and fiscal exposure; workforce expansion enhances relational justice and operational stability yet leaves modernization gaps; and status quo preservation maintains short-term fiscal balance while risking gradual legitimacy erosion. Conclusions: The study demonstrates that satisfaction metrics alone are insufficient for governance evaluation. Integrating ethical analysis, organizational legitimacy theory, participatory input, and systems thinking provides a structured framework for assessing resource allocation trade-offs in resource-constrained municipal hospitals. Full article

Care home staff are routinely exposed to stressful and traumatic events, increasing risks of psychological distress, burnout, and reduced workforce resilience. Psychological First Aid (PFA), recommended by the World Health Organization, provides an evidence-based framework for delivering immediate emotional and practical support; however, its adaptation for care home contexts is limited. This study aimed to co-produce and adapt an existing PFA training resource for care home staff using a person-based approach (PBA) to enhance contextual relevance, acceptability, and feasibility. A two-phase qualitative design guided by PBA principles was used. Phase 1 integrated stakeholder workshops, semi-structured interviews, and literature review to generate guiding principles, a logic model, and preliminary training content. We adapted the WHO PFA “Look–Listen–Link” framework alongside existing open-access materials. Phase 2 used think aloud interviews to optimize usability and contextual fit. Thematic and sentiment analysis identified key needs: high exposure to traumatic events, inconsistent organisational support, desire for measurable skill development, the importance of transferable competencies, and motivational factors. Participants emphasized the need for flexibility, inclusivity, and realistic care-home-specific examples. Adaptations included bite-sized interactive modules, blended delivery options, and reflective exercises. The final co-produced intervention aligns with trauma-informed principles and organisational realities. Further work is needed to access feasibility, acceptability, and fidelity in real-world settings, offering a transferable model for adapting psychological interventions in other high-stress care environments internationally. Full article

Hospitals play a central role in promoting health and well-being, yet they are also among the most resource-intensive institutions, contributing significantly to environmental degradation through high energy and water consumption, extensive waste generation, and reliance on single-use materials. This conceptual paper explores how principles of the circular economy and green economy can be integrated into hospital operations through a strategic Corporate Social Responsibility (CSR) framework, reframing sustainability as a strategic management issue rather than a compliance-driven activity. Drawing on environmental economics, sustainability studies, and institutional theory, the paper develops an integrated conceptual model structured around the environmental, social, and economic pillars of sustainability. Within this framework, four interconnected operational domains are identified: waste management and circular practices, energy consumption and renewable integration, sustainable procurement and circular supply chains, and economic and policy incentives. The social dimension explicitly encompasses healthcare staff and patients, addressing issues of workforce well-being, health education, safety, quality of life, and equitable care delivery. This advances theory by positioning strategic CSR as a function of circular and green economy, yielding a new model for hospitals, S-CSR = f(CE, GE). The paper also examines institutional and cultural barriers that constrain sustainability implementation and highlights the role of strategic leadership, governance, and system-wide innovation in overcoming these challenges. While not empirical, the study provides a theoretical foundation to inform future research, policy development, and strategic decision-making aimed at advancing sustainable, low-carbon, and resilient healthcare systems. Full article

Background: Mental health needs are rising globally, while workforce shortages constrain access to timely care. Israel launched formal training for Psychiatric–Mental Health Nurse Practitioners (PMHNPs) in 2023 as part of broader efforts to strengthen the public mental health system. This narrative review provides a focused synthesis of international and Israeli literature on PMHNP roles, models of practice, outcomes, and implementation considerations relevant to the Israeli context. Methods: We conducted a narrative, non-systematic literature review of international and Israeli literature on Psychiatric–Mental Health Nurse Practitioners (PMHNPs). Searches were conducted in PubMed/MEDLINE, CINAHL, PsycINFO, and Scopus (January 2000–December 2024), alongside targeted policy and regulatory documents. Eligible sources addressed NP/PMHNP roles, scope of practice, clinical and service outcomes, implementation processes, workforce implications, or policy considerations in high-income health systems. Findings were synthesized thematically. Results: Across the reviewed literature, particularly in primary care and community-based settings, PMHNP/NP-delivered care was generally associated with comparable outcomes on selected quality and safety indicators, alongside improved accessibility, continuity, and high patient satisfaction. Successful implementation depended on regulatory clarity, organizational readiness, interprofessional collaboration, and the development of a clear professional identity. In Israel, the role is emerging within a cautious regulatory framework and may face early barriers related to role ambiguity, variable organizational support, and limited stakeholder awareness. Conclusions: PMHNP implementation may offer an important strategy for strengthening mental health service capacity in Israel. However, the extent of its contribution will depend on regulatory clarity, organizational support, implementation quality, and future empirical evaluation in the Israeli context. Full article

Background/Objectives: Midwifery workforce sustainability faces critical challenges including high burnout and turnover rates threating the service quality and the maternal health outcomes. While self-leadership and self-compassion represent promising psychological resources, their roles relative to organizational factors remain underexplored. This study examined associations between self-leadership, self-compassion, and workforce outcomes (job satisfaction, turnover intention, performance) among Turkish midwives. Methods: A cross-sectional survey was conducted with 346 midwives working in diverse healthcare settings across Turkey from May 2021 to April 2022. Data were collected through an online self-report questionnaire using validated scales for self-leadership and self-compassion as well as measures of job satisfaction, turnover intention, and job performance, and including demographic and organizational items. Descriptive statistics, one-way ANOVA (with Eta-squared [η²] calculated to determine effect size), and correlation analyses were conducted, followed by hierarchical multiple regression and binary logistic regression to examine predictive relationships, with organizational factors entered before psychological resources. Results: Self-leadership and self-compassion demonstrated a moderate positive correlation (r = 0.342, p < 0.01). Self-leadership strongly predicted job performance (OR = 2.497, p = 0.001), particularly through natural reward strategies emphasizing intrinsic motivation (OR = 1.970, p < 0.001). However, neither psychological resource significantly predicted job satisfaction or turnover intention when organizational factors were included. Work schedule, healthcare setting, professional position, and income emerged as primary predictors of satisfaction and retention. Work experience predicted increased psychological distress (OR = 1.073, p = 0.003). Conclusions: Psychological resources demonstrate domain-specific effects on workforce outcomes in midwifery: self-leadership strategies strongly enhance job performance, whereas job satisfaction and turnover intention are influenced primarily by organizational conditions. These findings highlight the need for multi-level strategies to support the sustainability of the midwifery workforce. Full article

Purpose: This study examines (1) the change in partnership between local health departments (LHDs) and schools of public health or public health programs (SPHs/PHPs) from 2016 to 2019, and (2) the LHD characteristics associated with this partnership. Background: The Council on Education for Public Health updated accreditation criteria in 2016, shifting from core curricula to competencies to better prepare public health graduates for the workforce. Strong partnerships between LHDs and SPHs/PHPs can enhance practical training and employment opportunities for students, ultimately bolstering the public health workforce. Methods: We analyzed the 2016 and 2019 National Profiles of Local Health Departments, using descriptive statistics to evaluate partnership levels and multivariable logistic regression to identify LHD characteristics associated with collaboration. Results: The partnership between LHDs and SPHs/PHPs was suboptimal and unevenly distributed. Engagement in activities like formal training agreements and advisory roles declined. Notably, the presence of formal written agreements for staff training and active recruitment of SPH/PHP graduates by LHDs showed significant improvements (χ² = 3.84; p = 0.049; χ² = 8.19; p = 0.004). Factors such as top executive characteristics, workforce capacity, and governance context influenced these partnerships. Conclusions: The study identifies gaps in LHD engagement with SPHs/PHPs and highlights opportunities for advocacy. Addressing these gaps can lead to a more competent workforce, thereby benefiting both LHDs and SPHs/PHPs in their service to communities. Full article