Search Results (1,646)

Background/Objectives: Survey administration mode may significantly influence responses on polarizing health topics, yet this methodological factor remains understudied in vaccine hesitancy research. Understanding how data collection methods affect parental attitudes toward childhood vaccination is crucial for accurate public health surveillance and intervention design. Methods: This comparative cross-sectional study examined parental attitudes toward childhood vaccination using both paper-based (n = 487) and online (n = 386) survey administration among 873 parents. This study employed multivariate logistic regression analysis to assess differences between survey modes while controlling for demographic variables. Results: Key outcomes included general vaccination support, belief in vaccine–autism links, preference for natural immunity, and communication comfort with healthcare providers. Substantial differences emerged between survey modes. Online respondents showed significantly lower vaccination support (61.92% vs. 88.48%, p < 0.001), higher belief in the vaccine–autism link (37.31% vs. 16.77%, p < 0.001), and greater endorsement of natural immunity over vaccination (38.08% vs. 12.50%, p < 0.001). After adjusting for demographics, online respondents had 5 times lower odds of supporting childhood vaccination (OR = 0.20, 95% CI: 0.13–0.30) and nearly 5 times higher odds of preferring natural immunity (OR = 4.67, 95% CI: 3.19–6.95). Online respondents were also less likely to feel comfortable discussing vaccines with healthcare providers (51.0% vs. 72.7%, p < 0.001). Conclusions: Survey administration mode substantially influences measured parental vaccine attitudes, with online platforms capturing more vaccine-skeptical responses. These findings have critical implications for public health research methodology and suggest that mixed-mode survey designs or statistical adjustments may be necessary to obtain representative population estimates of vaccine hesitancy. Full article

Background/Objectives: Parkinson’s disease (PD) is a progressive neurodegenerative disorder frequently associated with cognitive impairment. In the context of increasing interest in remote healthcare solutions, particularly after the COVID-19 pandemic, this preliminary study aimed to evaluate the feasibility of an online version of the Parkinson’s Disease—Cognitive Rating Scale (PD-CRS), a first-level neuropsychological screening tool for mild cognitive impairment (MCI) in individuals with PD. Methods: Seventy-nine patients with idiopathic PD were recruited between October 2020 and February 2024. A telematic version of the PD-CRS was administered via video call using adapted materials (e.g., slide-based instructions and webcam-mediated tasks). Both patients and examiners completed a Visual Analogue Scale (VAS) to rate perceived difficulty. Descriptive statistics and non-parametric tests were used to analyze data. Results: Difficulty ratings were low for both patients (mean VAS = 1.60, SD = 0.88) and the examiner (mean VAS = 1.43, SD = 0.61), with no significant difference (p = 0.176). No demographic or clinical variable predicted difficulty. Conclusions: These findings support the feasibility and usability of an online version of PD-CRS. This approach may facilitate wider access to cognitive screening for PD patients, particularly those with mobility limitations or living in underserved areas. Full article

Background: With the advancement of AI-powered online tools, patients are increasingly turning to AI for guidance on healthcare-related issues. Methods: Acting as patients, we posed eight direct questions concerning a common clinical condition—liver cysts—to four AI chatbots: ChatGPT, Perplexity, Copilot, and Gemini. The responses were collected and compared both among the chatbots and with the current literature, including the most recent guidelines. Results: Overall, the responses from the four chatbots were generally consistent with the literature, with only a few inaccuracies noted. For questions addressing “grey areas” in clinical research, all chatbots provided generalized answers. ChatGPT, Copilot, and Gemini highlighted the lack of conclusive evidence in the literature, while Perplexity offered speculative correlations not supported by data. Importantly, all chatbots recommended consulting a healthcare professional. While Perplexity, Copilot, and Gemini included references in their responses, not all cited sources were academic or of medium/high evidence quality. An analysis of Flesch Readability Ease Scores and Estimated Reading Grade Levels indicated that ChatGPT and Gemini provided the most readable and comprehensible responses. Conclusions: The integration of chatbots into real-world healthcare scenarios requires thorough testing to prevent potentially serious consequences from misuse. While undeniably innovative, this technology presents significant risks if implemented improperly. Full article

Background: Pharmacy professionals have an important role in delivering patient-centred care, with effective communication skills forming the foundation of interactions with patients. This study aimed to explore how pharmacy students perceived their own communication skills; along with the communication skills education and training experiences in their undergraduate pharmacy degree in the UK. Methods: A 22-item questionnaire was designed and piloted before being distributed online. Snowball sampling was employed to recruit participants undertaking an undergraduate pharmacy degree. Quantitative statistical and qualitative thematic analysis was conducted. Results: A range of pharmacy schools were represented in the data set (n = 10) with 217 responses collected. Participants rated their communication skills highly (53.03%, n = 114), but stated they still required improvement (79.72%, n = 173). A proportion of participants stated that they could appropriately make professional decisions (52.08%, n = 100) and that their communication skills had facilitated their professional decision-making skills (57.89%, n = 110). Effective teaching methods reported included role play with peers (80%, n = 156) and small-group teaching sessions (64.10%, n = 125). Participants felt that interprofessional education and simulated patients could help improve their communication skills further. Conclusions: Communication education is a crucial element in developing future healthcare professionals. Thus, investment in resources is required to facilitate communication skills in the earlier stages of the undergraduate pharmacy degree. Full article

This study assessed satisfaction with physiotherapy care for individuals with cystic fibrosis across face-to-face, online, and blended formats at the National Association for Cystic Fibrosis. Forty participants, including patients and legal representatives, reported high satisfaction overall. Key strengths included respectful communication, involvement in decision-making, scheduling flexibility, and therapist support. Face-to-face care received the highest ratings, though privacy, understanding, and engagement were consistently strong across all modalities. The results highlight the importance of patient-centred approaches and suggest that high-quality care can be delivered effectively across different treatment formats, reinforcing satisfaction as a key indicator of healthcare quality and effectiveness. Full article

Background/Objectives: Ethical challenges in healthcare require awareness and adherence to professional codes of ethics, particularly in interdisciplinary settings such as tertiary hospitals. This study aimed to assess the attitudes and awareness of healthcare professionals regarding codes of ethics at the University Hospital of Split in Croatia, which did not have an institutional code at the time of the study. Methods: A cross-sectional survey using a structured, anonymous questionnaire was distributed both physically across hospital departments and online via email. Welch’s t-test, ANOVA, Kruskal–Wallis, and correlation tests were used to assess associations between favourability scores and participant characteristics. Linear and logistic regression analyses further examined predictors of favourable attitudes. Results: Of 442 returned questionnaires, 377 were complete and included in the analysis, mainly from nurses (56.5%) and physicians (42.7%). The median favourability score was 83.8% (88/105; IQR 78.1–88.6), with 87.0% scoring above the favourable threshold (≥75%). Female gender and higher education were significantly associated with more favourable attitudes. Participants strongly endorsed core principles such as patient confidentiality and autonomy, yet 57.6% considered ethics education during training inadequate, and only 36.3% viewed dual practices as a conflict of interest. Most respondents reported adherence to ethical standards (85.4%), while only over half were familiar with their professional ethics code (64.5%) and the hospital Ethics Committee (56.2%); a total of 66.3% supported introducing a hospital-specific code. Awareness and support for ethical structures were higher among women and those with more education. Conclusions: This study reveals a gap between personal ethical commitment and institutional ethical infrastructure. Strengthening ethics education and implementing a hospital-specific ethics code may enhance organisational ethical culture. Full article

Background. Living with a stoma entails profound changes in a person’s life, affecting physical, psychological, and social well-being. Patients often face challenges related to body image, interpersonal relationships, and self-esteem. A stoma can impair quality of life, trigger feelings of shame and limit freedom of movement. Objectives. To assess the subjective perception of quality of life and related psychophysical consequences in individuals with an intestinal stoma. To evaluate the level of perceived support from healthcare professionals involved in the care pathway. Methods. This is a descriptive observational study conducted through the administration of an online questionnaire. The sample includes 189 adult patients with an intestinal stoma. Results. Data analysis revealed that participants aged ≥65 years and those with a permanent stoma reported higher quality of life scores compared to younger individuals or those with a temporary stoma. An inverse correlation emerged between quality of life and perceived stress (p < 0.001); in particular, pain and social embarrassment were strongly associated with higher levels of stress. The enterostomal therapy nurse was identified as a key figure in the care pathway (70.4%). Conclusions. The findings highlight the need for person-centered care that addresses not only clinical aspects but also emotional and relational dimensions. Enhancing the role of trained professionals, such as enterostomal therapy nurses, and promoting targeted educational interventions may contribute to improving the quality of life in patients living with a stoma. Full article

The increasing adoption of artificial intelligence (AI) in intelligent healthcare systems has elevated the demand for robust medical imaging and vision-based inventory solutions. For an intelligent healthcare inventory system, accurate recognition and classification of medical items, including medicines and emergency supplies, are crucial for ensuring inventory integrity and timely access to life-saving resources. This study presents a hybrid deep learning framework, EfficientDet-BiFormer-ResNet, that integrates three specialized components: EfficientDet’s Bidirectional Feature Pyramid Network (BiFPN) for scalable multi-scale object detection, BiFormer’s bi-level routing attention for context-aware spatial refinement, and ResNet-18 enhanced with triplet loss and Online Hard Negative Mining (OHNM) for fine-grained classification. The model was trained and validated on a custom healthcare inventory dataset comprising over 5000 images collected under diverse lighting, occlusion, and arrangement conditions. Quantitative evaluations demonstrated that the proposed system achieved a mean average precision (mAP@0.5:0.95) of 83.2% and a top-1 classification accuracy of 94.7%, outperforming conventional models such as YOLO, SSD, and Mask R-CNN. The framework excelled in recognizing visually similar, occluded, and small-scale medical items. This work advances real-time medical item detection in healthcare by providing an AI-enabled, clinically relevant vision system for medical inventory management. Full article

Background: Pain detection and management in older people with impaired cognition is an unmet need, leading to healthcare inequalities. This study aimed to enhance pain detection by translating and culturally adapting the PAIC-15 questionnaire into Brazilian Portuguese, establishing its content validity and comparing findings with a similar Dutch study. Methods: Following the same international standards used in the English-to-Dutch validation, we translated and culturally adapted PAIC-15 for Brazil. Content validity was assessed using two questions: (A) whether the item indicated pain and (B) whether it was specific to pain. An online form was distributed to ‘target users’ (nurses and geriatricians in LTCFs or other settings) and other healthcare professionals (HCPs) experienced in pain assessment in people with cognitive decline. Results were compared with the English-to-Dutch validation. Results: A total of 103 HCPs responded (mean age 45.2 ± 11.4 years)—76 (74%) were female and 54 (52%) had previously used pain assessment tools. Among the 63 target users, 13 items (87%) were validated as indicative and/or specific to pain. Comparing Brazilian and Dutch users, 10 items (67%) showed agreement on pain specificity. Conclusions: The Brazilian Portuguese PAIC-15 is now available, showing acceptable content validity. Linguistic challenges highlight the need for training and further validation in larger samples. Full article

Background/Objectives: The emergence of artificial intelligence (AI) has revolutionized the healthcare industry. However, its integration into clinical practices raises ethical and practical concerns. This study aims to explore ethical and practical considerations perceived by physicians and nurses in Saudi Arabia. Methods: It employed a cross-sectional design with 400 physicians and nurses, using a pre-established online questionnaire. Descriptive data were analyzed through means and standard deviations, while inferential statistics were performed using the independent samples t-test. Results: Most participants were male (57%) and physicians (73.8%), with most employed in governmental organizations (87%). The participants’ use and awareness of AI was low, as 34.0% said they had never used it, but 74.5% of respondents were willing to use AI in clinical practices. Also, 80.5% of participants were aware of the AI benefits, and 71.0% had background knowledge about the ethical concerns related to AI’s implementation in their clinical practices. Moreover, (62.0%) of respondents recognized the applicability of AI in their specialty. Key findings revealed significant concerns: participants perceived a lack of skills to effectively utilize AI in clinical practice (mean = 4.04) and security risks such as AI manipulation or hacking (mean = 3.83). The most pressing ethical challenges included AI’s potential incompatibility with all populations and cultural norms (mean = 3.90) and uncertainty regarding responsibility for AI-related errors (mean = 3.84). Conclusions: These findings highlight substantial barriers that hinder the effective integration of AI in clinical practices in Saudi Arabia. Addressing these challenges requires leadership support, specific training initiatives, and developing practical strategies tailored to the local context. Future research should include other healthcare professionals and qualitatively explore further underlying factors influencing AI adoption. Full article

Background: Although the expansion of medical resources has largely alleviated challenges of “more diseases but fewer medicines”, the growing urbanization and rapid aging in China have led to increasing demands of healthcare services in metropolitan cities. The uneven distribution of medical facilities makes services unequal for residents in the city. To achieve fair and rapid access to medical services, healthcare accessibility and equity have become key concerns. The introduction of tele-health, i.e., online visits or digital health, can help balance the distribution of medical resources to improve accessibility and equity, particularly for elderly patients with chronic diseases. Methods: To quantitatively assess the spatial accessibility of healthcare facilities, an improved two-step floating catchment area method with tele-health (i2SFCA-TH) is proposed to study the demand–supply ratio by considering traveling time, chronic diseases, and online visits based on services provided by community and tertiary hospitals. An optimization model using mixed-integer programming to maximize average accessibility under resource constraints could help improve overall accessibility and reduce differences in access among all residential divisions to achieve better equity in the region. Results: By applying the method in a metropolitan city in China, it is observed that the overall spatial accessibility of residential divisions in the city is 0.72, but the gap between the highest and the lowest reaches 2.36; i.e., significant differences exhibit due to uneven allocation of medical resources. By introducing tele-health, the gaps of access among different divisions can be decreased, with the largest gap reduced to 1.49, and the accessibility in divisions with poor medical resource allocation can be increased. Finally, the mean healthcare accessibility and equity in the study region can be improved to 0.75. In addition, it is shown that proper management of medical resources and patients’ willingness to accept online visits could help improve accessibility and equity, which can provide insights for hospital management and urban planning. Conclusions: An integrated framework to quantitatively assess and optimally improve healthcare accessibility and equity of medical resource allocation through tele-health is presented in this paper. An i2SFCA-TH method and an optimization model are used in the framework, which provides hospital management and urban planners a quantitative tool to improve accessibility and equity in metropolitan cities in China and other countries. Full article

This study aimed to develop a website providing physiotherapy, exercise, and disease knowledge information as a digital tool for use with children with chronic suppurative lung diseases (CSLDs). Data were analyzed using a mixed qualitative and quantitative approach. Initially, a comprehensive list of the website’s content and functions was developed through a Focus Group study with healthcare professionals (HCPs) and parents. Afterward, two rounds of an online Delphi survey were conducted with a group of expert HCPs (pediatricians and physiotherapists) who were recruited based on their expertise in the field of pediatric physiotherapy. The Focus Groups established 10 main themes. Two rounds of Delphi questionnaires established the important items of a website, based on expert consensus from HCPs. A Delphi survey containing 36 outcomes was completed by participants from Greece. The findings support the integration of multidisciplinary and user-centered approaches in the design of a pediatric website. This website is expected to enhance disease self-management, improve treatment adherence, and support families in daily care. Full article

Introduction: Recent guidelines developed by the European Association for the Study of Obesity (EASO) and the European Federation of the Associations of Dietitians (EFAD) focused on the dietetic management of obesity in adults. The present study aimed to explore the perspectives of healthcare professionals regarding these guidelines. Methods: In total, 85 registered dietitians/nutritionists from Greece, the Netherlands, the Republic of Ireland, and the United Kingdom completed an online survey, and 10 were interviewed, in February–March 2023. Demographic data were also collected. Results: Awareness of the EASO-EFAD guidelines among registered dietitians/nutritionists was moderate (57.6%), but only 20% had read them in full. Dietitians with higher education and relevant experience were more likely to have read the guidelines. Less than half reported that key evidence-based recommendations, such as individualized medical nutrition therapy and intensive behavioral interventions, are already included in national guidance. Recommendations like portfolio or DASH diets, partial meal replacements, and calorie restriction were less commonly part of national guidance/usual practice. A small percentage of participants described their adoption of several nutritional approaches novel to them. These included the portfolio dietary pattern, partial meal replacements, and intermittent fasting or continuous calorie restriction. For some Irish dietitians, prioritizing weight as the main outcome conflicted with their emphasis on overall health and individualized nutrition therapy. Other barriers of recommendation implementation included exclusive availability in English, rapid changes in obesity management, staffing shortages, limited multidisciplinary collaboration, and inconsistent knowledge among healthcare providers. Conclusions: The present study identified gaps in the adoption of the EASO-EFAD guidelines into dietetic/clinical practice. EFAD will develop strategies to disseminate these guidelines at different levels of stakeholders (national/local authorities, dietitians/nutritionists, and patients). Full article

Background: Children with inflammatory bowel disease (IBD) are at heightened risk for vaccine-preventable infections because of underlying immune dysregulation and long-term immunosuppressive therapy. Despite published guidelines affirming vaccine safety, real-world coverage remains suboptimal. It is a pilot, single-country survey designed to explore baseline knowledge and practices regarding vaccination in paediatric IBD within a specific local healthcare context. Objective: The objective of this study is to evaluate the knowledge, attitudes, and practices of paediatric gastroenterologists (PGs) regarding the immunisation of children with IBD. Methods: We conducted an exploratory pilot, cross-sectional survey of paediatric gastroenterologists in Russia, focusing on immunisation knowledge and practical barriers in routine care. A cross-sectional, anonymous online survey was distributed to PGs nationwide between January 2022 and April 2022. The online questionnaire explored demographic characteristics, awareness of international recommendations, perceptions of vaccine safety at various disease and treatment stages, and routine vaccination practices. Responses were analysed with non-parametric statistics (α = 0.05). In a parallel prospective cohort, the vaccination certificates of 98 paediatric IBD patients (January 2022–April 2023) were audited to quantify real-world coverage. Results: Fifty-one PGs completed the survey. Forty-one per cent agreed that vaccines do not provoke IBD flares, while 17.6% considered live vaccines acceptable during immunosuppressive remission. Nearly one-third (32%) did not personally oversee immunisation, and 18% occasionally discouraged vaccination during therapy. Only 35.3% deemed baseline serology essential before starting immunosuppression; 46.5% supported antibody checks immediately prior to vaccination. The certificate audit revealed a full schedule completion rate of 66.3% for measles–mumps–rubella and 74.2% for hepatitis B, contrasting with parental reports of 82.3% complete coverage. Conclusions: Knowledge gaps, limited guideline awareness, and parental concerns contribute to suboptimal vaccination of paediatric IBD patients. Targeted educational initiatives, clearer shared-care pathways, and routine certificate audits are needed to close the coverage gap and reduce infection-related morbidity. Findings are hypothesis-generating and reflect local practice; as a pilot study, results should be interpreted with caution and may not generalise beyond similar settings. Full article

Humor plays a vital role in human well-being and communication and is increasingly recognized as a beneficial resource in healthcare contexts. While prior studies have explored humor in general university populations, limited research has focused on nursing students, who face distinct interpersonal and emotional demands during their training. This pilot study aimed to describe multidimensional sense of humor among first-year nursing students in Spain using the validated Spanish version of the Multidimensional Sense of Humor Scale (MSHS), which includes a three-dimension model: humor competence, humor as a coping mechanism, and social attitudes toward humor. A total of 78 students completed the MSHS questionnaire via an online survey. The overall mean score was 66.8 (SD = 13.1) out of 96, with the highest mean observed in the dimension of humor as a coping mechanism (mean = 22.2, SD = 4.0). Individual item analysis revealed strong agreement with positively worded statements such as “I like a good joke” (mean = 3.36, SD = 0.82) and “Humor is a lousy coping mechanism” (reverse scored; mean = 3.69, SD = 0.67). These findings suggest that humor is a relevant personal and interpersonal resource among future healthcare professionals. Incorporating humor-related competencies in nursing education may support student resilience and enhance patient-centered care. Further research is needed to examine humor’s longitudinal development and its role in clinical practice. Full article