Search Results (600)

Background: Vaccine hesitancy is a major threat to public health. As part of efforts to increase vaccine uptake, the focus is on optimizing the quality of communication among healthcare workers. Physician shortages and workloads create time constraints, making communication interventions in primary care challenging. This study aimed to propose strategies to improve communication between general practitioners and vaccine-hesitant individuals. This narrative review addresses the specific needs of general practitioners for effective communication and proposes strategies to combat vaccine hesitancy in culturally and linguistically diverse regions. Methods: Systematic searches of EMBASE and PubMed were performed using terms related to vaccine hesitancy, communication strategies, primary care, and cultural diversity. Additionally, the websites of major health organizations were searched for relevant reports and guidelines. Selection criteria were based on the relevance and quality of the selected studies. Results: The findings highlight the importance of empathy, transparency, and personalized information in communication strategies. The need for communication training and addressing policy and workload barriers for healthcare providers is significant. The proposed strategy includes regular communication skills and cultural competency workshops, language training, the development of multilingual resources, implementation of telemedicine services, and active community engagement. Conclusions: Policy recommendations advocate for increased primary care resources, support from general practitioner unions, and the integration of digital tools. These strategies are essential to improve vaccine uptake and public health outcomes by enhancing the capacity of general practitioners to effectively engage with vaccine-hesitant patients. Full article

With the steady global progress in integrating technology into healthcare delivery, doctors’ behavioral patterns on online healthcare platforms have increasingly become a focal point in the fields of digital health and healthcare service management. Grounded in Job Crafting Theory, this study constructs a proactive crafting index, which captures doctors’ proactive behaviors on the platform across three dimensions: consultation rate, number of consultations, and response speed. We systematically examine the multidimensional impacts of such behaviors on performance outcomes, including online consultation volume, offline service volume, and user evaluation performance. This study collects publicly available records from a major online healthcare platform in China and conducts empirical analysis using the entropy weight method and econometric techniques. The results reveal that there is an optimal level of proactive engagement: moderate proactivity maximizes online consultation volume, while both insufficient and excessive proactivity reduce it. Offline service volume, in contrast, follows a U-shaped relationship, where moderate proactive engagement minimizes offline visits, while too little or too much engagement leads to more offline service needs. These nonlinear patterns highlight the importance of framing doctors’ proactive behavior to optimize both online engagement and offline service. The findings enrich Job Crafting Theory by identifying boundaries in platform-based service environments and provide actionable insights for platform operators to design behavior management and incentive systems tailored to doctors’ professional rank, patient condition, and regional context. Full article

Objective: The objective of this retrospective cross-sectional study is to explore how caregiver social determinants of health, appraisal of healthcare provider effectiveness, and insurance coverage influence caregiver ability to have their adolescent child access vision care, including completion of annual vision screening, visiting an ophthalmologist or optometrist, and completion of recommended additional screenings. Study Design: We used National Survey of Children’s Health (NSCH) data for 12–17-year-old adolescents for the years 2022 and 2023 (n = 37,425). Summary statistics for the selected sample were generated and binary logistic regressions were conducted. Outcome variables were the type of vision screening that occurred or not. Covariates were socioeconomic and demographic data of the adolescent’s primary caregiver. Independent variables were insurance coverage and healthcare provider’s skill and effectiveness. Results: Significant associations were reported between visiting an ophthalmologist or optometrist and each of spending enough time with patients; listening carefully to patients; and making patients feel like care is a partnership. Additionally, significant associations were reported between insurance coverage and both successful completion of vision screening and visiting an eye doctor. Conclusions: This study underscores the substantial impact of effectiveness of eye doctors in delivering annual vision exams and insurance adequacy on adolescent vision care engagement. Our results will inform the development of future evidence-based educational interventions to raise awareness on the importance of annual vision screenings in US adolescents and emphasize the need for screening mandates to advocate for this important public health issue. Full article

Amid globalization, tourism has increasingly emphasized health and well-being through sustainable, wellness-oriented services. Thailand has been recognized as having strong potential to become a regional hub for wellness tourism, supported by its efficient healthcare system and diverse attractions. This study aims to identify key indicators of wellness tourism based on holistic health principles and to examine their relationships with tourists’ intentions to use wellness services. Data were collected from 1200 wellness tourists in Thailand through stratified random sampling and analyzed using Exploratory Factor Analysis (EFA) and Structural Equation Modeling (SEM). The results revealed six significant wellness factors, with Environmental Wellness being the most influential. In addition, gender, income, and occupation were found to positively affect wellness tourism behavior. Attitude and subjective norms also significantly influenced tourists’ intentions to engage in wellness services. This study provides policy recommendations to assist tourism and public health agencies in promoting wellness tourism and enhancing health-focused travel experiences. Full article

Introduction: Newborn mortality is unacceptably high, especially in low- and middle-income countries. The Safer Births Bundle of Care (SBBC) was implemented in Tanzania, including training of healthcare workers on neonatal resuscitation by means of frequent in situ simulation training using improved training tools. We aimed to assess the acceptability of this training model among healthcare providers in selected health facilities under SBBC intervention. Methods: A cross-sectional study was conducted among healthcare workers in labor wards and obstetric theaters in selected facilities one year after the introduction of the SBBC model. The theoretical framework for assessment of the acceptability of healthcare interventions was used to assess the acceptability of the training model and accompanying tools. The chi-square test was used to assess the association between acceptability in specific constructs and average individual practice per month, while a modified Poisson regression analysis was used to assess factors associated with acceptability in specific framework constructs. Results: A total of 227 healthcare workers were enrolled in the study. Overall, 223 (98.2%) accepted the intervention. However, 207 (91.2%) reported that the intervention increased their work burden, while 39 (17.2%) reported that it interfered with other equally important activities. The level of health facility was independently associated with the reporting that engaging in simulation practice interfered with other equally important activities. Conclusions: In situ, low-dose, high-frequency facility-based simulation training for neonatal resuscitation was highly acceptable among healthcare providers. However, the perceived increased work burden of this intervention and interference with other equally important activities were identified as potential threats to successful implementation. Full article

Background/Objectives: Pain, anxiety, and distress are common yet frequently insufficiently managed issues for patients undergoing radiology and radiotherapy procedures. Immersive technologies, including virtual reality (VR), augmented reality (AR), and mixed reality (MR), are emerging as innovative non-pharmacological approaches to alleviate such burdens through engaging interventions. This review, combining scoping and narrative methodologies, seeks to examine the current application, efficacy, and integration of these technologies to enhance patient care and wellbeing within diagnostic and oncological environments. Methods: Employing a mixed scoping and narrative review approach, this study conducted a systematic search of PubMed, EMBASE, Scopus, and Web of Science databases (no date restrictions—search included studies up to May 2025) to identify relevant studies utilizing VR, AR, MR, or XR for mitigating pain, anxiety, or distress in patients undergoing radiology or radiotherapy. Two independent reviewers selected eligible papers, with data extracted systematically. The narrative analysis supplemented the scoping review by providing contextual insights into clinical relevance and technological challenges. Results: The screening process identified 76 articles, of which 27 were assessed for eligibility and 14 met the inclusion criteria. Most studies focused on oncology and primarily employed VR as the immersive technology. VR has shown promising effects in reducing anxiety and pain—particularly during radiotherapy sessions and invasive procedures—and in supporting patient education through engaging, immersive experiences, making it a valuable approach meriting further investigation. Patient acceptance was notably high, especially among those with elevated distress levels. However, findings in radiology were less consistent, likely due to shorter procedure durations limiting the effectiveness of VR. The variability in outcomes highlights the importance of tailoring immersive interventions to specific procedures and patient needs. The narrative component identified key barriers, such as regulatory hurdles, standardization issues, and implementation challenges, that need addressing for broader clinical adoption. Conclusions: Immersive digital therapeutics are evolving from preliminary research tools toward more structured incorporation into clinical practice. Their future success relies on harmonizing technological advancements with patient-focused design and robust clinical evidence. Achieving this will require collaborative efforts among researchers, industry stakeholders, and healthcare providers. The integration of scoping and narrative review methods in this study offers a comprehensive perspective on the current landscape and informs strategic directions for advancing immersive technologies in radiology and radiotherapy. Full article

Background/Objectives: In today’s rapidly evolving healthcare landscape, fostering a culture of innovation and continuous improvement is essential—especially within a nursing association that leads individual and organizational credentialing. Methods: Colleagues from the American Nurses Enterprise (ANE) Innovation Department and the Institute for Nursing Research and Quality Management collaborated to develop the Culture of Innovation and Quality Model^TM. This process involved conducting a literature review, developing a survey instrument, and administering a pilot pre-survey to ANE employees to collect baseline data. Future research will include a comparison with a post-survey after interventions aimed at strengthening the culture of innovation and quality. Results: The results of the pilot pre-survey were high overall and guided the team in identifying areas with the greatest opportunities for improvement. Based on these findings, interventions are being developed that will be implemented at ANE to enhance the practice of and promote the synergy between innovation and quality. Conclusions: Achieving and sustaining high-quality standards of care and advancing the professional development of nurses requires a culture where staff feel safe and have opportunities to create, innovate, improve, and learn. This will help promote an environment where people thrive while ensuring that the nursing profession and practice remain cutting-edge and aligned with emerging technologies and evolving healthcare complexities. The Culture of Innovation and Quality Model^TM may provide a blueprint for organizations who seek to advance innovation and quality knowledge, engagement, and practices and assist their employees in providing better service to colleagues, partners, and customers while adapting to the evolving healthcare environment. Full article

Adherence to medications is a significant challenge in chronic disease management. Poor adherence can lead to adverse patient outcomes including disease progression, increased morbidity, reduced quality of life, higher hospitalization rates, increased medical costs, and mortality. Medical adherence is a complex issue, influenced by multiple factors, including patient-related, medication-related, and healthcare system-related barriers. This review explores reasons for both intentional non-adherence, such as patients underestimating the consequences of the disease, inadequate education or poor healthcare provider–patient communication, and unintentional non-adherence, including forgetfulness, pathophysiological barriers, socioeconomic barriers (including lifestyle and patient factors), or healthcare resource limitations. Multifaceted, patient-tailored interventions that could improve adherence are discussed, including promoting health education, enhancing healthcare provider–patient engagement, and exploring alternative medical solutions and emerging technological advances. No single approach fits all; this review aims to deepen the understanding of intentional and unintentional non-adherence and to inform targeted interventions to empower patients, foster trust, and improve adherence for those with chronic conditions. Full article

Objectives: The adoption of telemedicine, which is the delivery of healthcare services through digital platforms, exploded during the COVID-19 pandemic as a means to ensure the continuity of care while minimizing infection risks. While this modality improved access and convenience for many, disparities in adoption have emerged, particularly in rural and underserved populations. This study aims to evaluate the impact of telemedicine on patient satisfaction before and during the pandemic, with a focus on chronic disease management—notably hypertension—and to identify factors influencing the equitable adoption of telehealth. Methods and Procedures: This study used a mixed method approach, combining quantitative survey data and causal loop modeling to analyze patient satisfaction levels and the interplay between telehealth adoption, healthcare access, and demographic disparities. Patient-reported satisfaction data were collected in two time periods—before and during the pandemic. Causal modeling was used to explore systemic relationships between provider support, technology access, patient engagement, and health equity. Results: The findings revealed that telemedicine significantly enhanced healthcare access during the pandemic, with a notable increase in patient satisfaction scores. Patients with chronic conditions, especially those diagnosed with hypertension, reported the improved continuity of care and reduced geographic barriers. However, disparities in telehealth access were more pronounced in non-metropolitan areas and among older adults and minority populations. Causal analysis highlighted key enablers of telehealth success, i.e., provider support, digital literacy, and access to reliable internet and devices. Conclusions: Telemedicine presents a transformative solution for equitable healthcare delivery, especially in chronic disease management. Strategic efforts are needed to address adoption disparities and ensure the sustained and inclusive integration of telehealth after the pandemic. Full article

The challenge for healthcare policy makers, managers and practitioners is finding ways to effectively collaborate with patients and community to plan, deliver and evaluate services. The study examined how managers engage the community with the strategic redesign of health services. The study focused on four large scale redevelopment projects, valued at A$2.8B, occurring within a health district in New South Wales, Australia. The study employed a multiple qualitative methods design comprising semi-structured interviews and focus groups. Participants were professionals (n = 24) involved in the strategic planning of health facility redevelopment. Thematic analysis was used to identify, analyse and report findings. Three issues emerged as significant factors influencing engagement, including the following: establishing a new mindset to service planning and delivery; future proofing service delivery; and management of stakeholder expectations. The unique contribution of the research is the identification of three interwoven strategies with 30 actions proposed to assess, understand and respond to external factors: 1. Foster an environment that allows for flexible and adaptable thinking and discussion; 2. Develop systems, structures and processes that facilitate engagement; 3. Encourage systems thinking for effective continuous service provision and redevelopment. Large scale redevelopment projects provide a platform for the strategic redesign of health services. When doing so, engaging the community with strategic planning, implementation and evaluation of healthcare services can lead to improved care outcomes. Full article

Background: Hepatitis presents a major health and economic challenge in Saudi Arabia, necessitating insight into its epidemiology, risk factors, and control measures. This review aims to synthesize current evidence on the epidemiology, risk factors, and prevention strategies for viral hepatitis in Saudi Arabia. It evaluates the effectiveness of existing interventions and proposes data-driven approaches to advance national hepatitis elimination goals. Methods: This study reviewed data from 2016 to 2024, sourced from PubMed, Google Scholar, ResearchGate, and ScienceDirect, focusing on hepatitis epidemiology and prevention in Saudi Arabia. Studies relevant to Saudi-specific trends and prevention strategies were included. Results: Saudi Arabia has achieved significant reductions in viral hepatitis prevalence, notably HBV (1.3%) due to universal infant vaccination (98% coverage), and HCV (0.124%) through the Saudi National Hepatitis Program (SNHP), which provides free DAAs (95% cure rate) and has screened 5 million people. However, challenges persist: HAV susceptibility is rising in adults (seroprevalence 33.1%), HDV affects 7.7% of HBV patients, and key risk factors include socioeconomic disparities (higher HAV/HEV in rural/low-income areas), intravenous drug use (30–50% of HCV cases), unsafe medical/cultural practices (e.g., Hijama), and limited healthcare access for migrants/rural populations. While interventions like water sanitation initiatives (58% HAV decline) and prenatal screening are effective, advancing elimination goals requires addressing gaps in HDV/HEV surveillance, outdated seroprevalence data, equitable treatment access (35% lower in rural areas), stigma reduction, and targeted strategies for high-risk groups to meet WHO 2030 targets. Conclusions: Saudi Arabia has made significant progress in hepatitis control through vaccination and public health efforts, but challenges persist. Strengthening healthcare systems, improving community engagement, and ensuring equitable access are key to sustaining elimination efforts. Full article

Background/Objectives: Maintaining proper oral hygiene is particularly challenging for individuals with autism spectrum disorder (ASD) due to sensory sensitivities, communication difficulties, and anxiety. Traditional oral hygiene education methods may be ineffective for this population, thereby necessitating innovative solutions. This study evaluates the effectiveness of a virtual reality (VR)-based educational program in improving home oral hygiene practices among children and adolescents with ASD. Methods: Sixty-four children with ASD (Level 1) were recruited and divided into two groups. Group 1 received traditional oral hygiene education, while Group 2 used a VR-based intervention featuring a virtual domestic bathroom with an avatar demonstrating proper brushing and flossing techniques. The intervention lasted eight weeks, with two one-hour sessions per week. The oral health assessment tool (OHAT) was used to evaluate oral hygiene status before and after the intervention. An unpaired t-test compared outcomes between groups. Results: Both groups showed improvements in oral hygiene, but the VR intervention group exhibited a significantly greater reduction in OHAT scores compared to the traditional education group (p < 0.001) due to a greater improvement in oral health. The VR-based approach enhanced engagement and adherence to oral hygiene routines, particularly benefiting children with ASD who struggle with conventional methods. Conclusions: VR-based education appears to be a promising tool for improving oral hygiene habits in children with ASD by providing an interactive and immersive learning experience. Future research should explore long-term adherence and the broader application of VR in healthcare education. Full article

Background and Clinical Significance: Pituitary adenomas, also termed pituitary neuroendocrine tumors, pose a significant risk of hypogonadotropic hypogonadism (HH) after surgical resection, with profound consequences for fertility and sexual function in young patients. Case Presentation: We present the case of a 29-year-old man from rural Japan who developed severe HH and azoospermia following two transsphenoidal resections for a large pituitary adenoma. Despite early engagement with neurosurgery teams, fertility management was delayed by the absence of on-site endocrinology expertise and limited local oncofertility resources. After comprehensive endocrine evaluation and counseling, the patient began combined human chorionic gonadotropin and recombinant follicle-stimulating hormone therapy, resulting in full recovery of sexual function and normalization of semen parameters, ultimately leading to spontaneous conception and the birth of a healthy child. Building on this real-world case, we provide a narrative review of current practical management strategies for HH after pituitary surgery, including the utility of hormone-stimulation tests, Japanese guideline-based subsidy systems, and best-practice approaches to hormonal replacement. Conclusions: This case underscores not only the necessity for early, interdisciplinary collaboration and preoperative counseling but also highlights a rare instance in which a patient with a benign tumor received care that did not address his fertility-related needs, emphasizing that such considerations should be integrated into preoperative counseling even for non-malignant conditions. Strengthening regional oncofertility networks and improving healthcare providers’ awareness of fertility-preservation options remain essential for improving outcomes. Full article

Disabled children often experience limited access to Family-Centred Care and social participation, while their families face significant caregiving responsibilities. Healthcare providers have a vital role in providing paediatric rehabilitation and support, yet access to and quality of services remain a key concern. To improve quality healthcare delivery, it is essential to understand stakeholder experiences of Family-Centred Care. Using an interpretive paradigm, semi-structured qualitative interviews and focus groups were conducted with paediatric healthcare service providers and service users, followed by reflexive thematic analysis. A key theme of ‘relationships enhance knowingness’ was identified. This theme highlights relationships as critical in meaningful service delivery and emphasises that mutual understanding, or knowingness, between service providers and service users is essential for success. Both service providers and service users identified subthemes related to ‘individual characteristics’ and ‘perceptions of families’, shaped by their differing positions within the care relationship. A distinct subtheme concerning ‘experiences of therapy’ was described by service users but was absent from service provider accounts. Fluctuating family capacity was identified as an influential factor affecting service engagement. A new service delivery model is presented to guide providers in delivering tailored, Family-Centred responsive Care. Full article

Climate change is the biggest global health threat of the 21st century. However, this challenge presents an opportunity to do things differently. This paper sets out how, using a design-led and collaborative approach, one can re-imagine the delivery of healthcare itself in a way that will deliver environmental sustainability. The paper presents a series of eight projects at the intersections of design, health and wellbeing, and complex net zero challenges, with an emphasis on inclusive, equitable, and sustainable design-led interventions. This encompasses diverse interventions across and beyond conventional design boundaries such as architecture, product design, and textile design providing insights that demonstrate the impact of design thinking, making, and acting on real-world net zero issues. Addressing such a broad and complex topic requires engagement across a wide range of stakeholders. The work undertaken has been conducted as part of a UK Government-funded Green Transition Ecosystem (GTE) Hub that has allowed multiple academic disciplines, research organisations, regional and local industry, and other public sector stakeholders, to connect with policy makers. Across seven themes, the paper describes how Design HOPES (Healthy Organisations in a Place-based Ecosystem, Scotland), as a design-led GTE Hub, brings in multiple and marginalised perspectives and how its design-led projects as one part of a wider movement for transformational change can re-use, nurture and develop these interventions sustainably. The overarching ambition being, through our collaborative design-led thinking, making, and acting, to build a more equitable and sustainable health and social care system across Scotland. Full article