Search Results (264)

Background: Tinnitus is a common and potentially distressing phenomenon for which no broadly effective curative treatment exists. Self-management skills and empowerment are crucial for coping with chronic conditions, but empirical studies investigating the association of these on individuals burdened by tinnitus are scarce. The primary aim of this cross-sectional study was to investigate the association between the use of an online self-help platform for people with tinnitus and self-perceptions of empowerment, self-management skills, and the cognitive and emotional representations of tinnitus. Methods: One hundred and fifty-two adult participants were recruited from an online self-help platform for people with tinnitus, resulting in a self-selected convenience sample. Self-management skills were assessed using the Patient Assessment of Chronic Illness Care (PACIC) and the Partners in Health Questionnaire. The cognitive and emotional representations of tinnitus were measured with the Illness Perception Questionnaire. Finally, the Empowering Processes and Outcomes Questionnaire was used to evaluate empowerment associated with engagement in the self-help platform. The type and frequency of user activity on the self-help platform were used to explore the relationship between the nature of contributions to the platform and the measured outcomes. Results: The key findings include: (1) The representations of tinnitus were negatively related to their ability to self-manage the condition. (2) The duration of tinnitus did not correlate with improved self-management skills. (3) Comparing those who visited a healthcare provider for their tinnitus with those who did not, we found that treatment adherence was higher among participants with clinical visits. (4) Participants in this study scored lower on all aspects of self-management skills (as measured by the PACIC) compared to patients using primary healthcare services. (5) Participants who actively contributed to the self-help platform by posting scored higher in two empowering processes: helping others and sharing experiences. Conclusions: The present findings suggest that tinnitus self-management skills are independent of tinnitus duration, whereas those skills correlate negatively with illness perception. Further, clinical visits are associated with higher treatment adherence, and active self-help platform use increases feelings related to helping others and shared experiences. Taken together, these results highlight the need for fostering self-management skills and structured peer-to-peer support programs. Because this was a self-selected convenience sample of users of an online tinnitus self-help platform, the findings should be interpreted in light of this recruitment context and not generalized to the broader tinnitus population. Full article

Background: This research explores the intersection between cultural heritage and mental health, analyzing how heritage mediation acts as a strategic asset in the personal recovery of individuals experiencing mental distress. Methods: A systematic review was conducted across PubMed, PsycINFO (via ProQuest Psychology Collection), Scopus, Web of Science, and Google Scholar for the 2015–2026 period, following PRISMA protocols. The methodological quality of 18 selected studies was evaluated using the Mixed Methods Appraisal Tool (MMAT). Results: The findings reveal that the efficacy of these practices stems from a symbiotic interaction between tangible and intangible heritage, functioning as an “identity scaffold” that facilitates the transition from a “patient identity” toward a “citizen identity” with biographical authority. Analysis under the CHIME (Conexión—Hope—Identity—Meaning—Empowerment) framework reveals convergent evidence across the Identity dimension, positioning cultural environments as “third spaces” that mitigate self-stigma. Discussion and Conclusions: Recovery is identified as a circular phenomenon requiring the convergence of clinical and cultural scaffolding. This study advocates for a humanized service architecture where therapeutic practices and affective curating coexist, ensuring the right to identity and social justice within community mental health contexts. Full article

Background: Pediatric obesity (PO) is a chronic disease requiring multidisciplinary management. Recent clinical guidelines emphasize the need for accessible, patient-centered solutions, positioning mHealth interventions as vital “clinical extenders” in modern practice. Objective: This systematic review and meta-analysis evaluate the efficacy and evolution of mHealth interventions for PO management between 2020 and 2026. Methods: A systematic search of electronic databases identified randomized controlled trials (RCTs) investigating mHealth for PO. Quality was assessed using the Cochrane RoB 2 tool, and a meta-analysis was performed on a subset of studies reporting zBMI data. Results: Twenty-three RCTs met the inclusion criteria, of which six were included in the quantitative synthesis. The meta-analysis demonstrated a statistically significant reduction in BMI z-score (MD = −0.20; 95% CI: −0.36 to −0.04; p = 0.02), with moderate heterogeneity (I² = 60%; Q = 13.5, p = 0.019). Beyond anthropometric outcomes, mHealth interventions consistently improved behavioral parameters, including dietary quality and sedentary time. However, engagement declined over time in standalone digital interventions (“mHealth fade-out”), whereas hybrid models integrating human support demonstrated improved retention and sustained effects. Anthropometric and behavioral outcomes showed partially divergent trajectories, with behavioral improvements often preceding measurable changes in BMI, and data on body composition were rarely reported, limiting a more precise understanding of changes in adiposity beyond BMI. Conclusions: mHealth is an effective catalyst for obesity management when integrated into a multidisciplinary framework. Future protocols must prioritize developmental tailoring—targeting parental empowerment in early childhood and encouraging adolescent autonomy—to ensure sustained engagement and a clinical focus that looks beyond BMI. Full article

Background/Objectives: Digital health interventions are increasingly used to support person-centered care (PCC) in chronic disease management, yet it remains unclear which PCC components are most consistently enabled by digital tools and how these relate to outcomes. This study synthesized evidence on digitally supported PCC for adults with chronic conditions, examining how interventions operationalize PCC and which clinical, patient-reported, and implementation outcomes are reported. Methods: A structured literature synthesis was conducted according to PRISMA guidelines across a heterogeneous evidence base, including randomized and pragmatic trials, observational studies, qualitative studies, and systematic reviews. The review protocol was pre-registered in the Open Science Framework (OSF) Registries. Results: Across 16 included studies, digital solutions most consistently supported PCC through enhanced situational awareness via self-monitoring, strengthened partnership through two-way communication and coaching, and reinforced shared documentation through co-created health plans. Benefits were reported most consistently for process and experience outcomes, such as perceived access to support, engagement, and empowerment. Evidence for sustained long-term clinical improvements, such as glycemic control, was mixed and frequently limited by short follow-up periods and variation in intervention integration. Conclusions: Digitalization can strengthen PCC when embedded within relational care models and organizational workflows that translate patient-generated data into meaningful action. Future work should utilize clearer PCC operationalization, longer follow-up, and routine reporting of equity outcomes, alongside targeted training for healthcare professionals delivering PCC in digital encounters. Full article

Background/Objectives: Chronic diseases pose a major challenge for healthcare systems, requiring integrated, patient-centered approaches that combine clinical management, prevention, and self-care. Lifestyle Medicine (LM) and lifestyle in general offers complementary frameworks to address these needs. However, the potential integration of LM within community nursing—particularly through the role of Family and Community Nurse (FCN)—has not been comprehensively synthesized. This narrative review aimed to synthesize international evidence on the role of community nursing—particularly FCN—in integrating chronic care management and LM view. Methods: For quality assessment, a narrative review was conducted in accordance with the SANRA criteria to enable the integration of heterogeneous evidence and a comprehensive synthesis of this complex topic. Literature searches were performed in the PubMed–Medline database, and the final screening of references from included studies was used to identify relevant manuscripts. Primary studies published in English over the past ten years were screened and analyzed using the PICOS framework. Sixteen eligible studies were included in the final synthesis. Results: The included studies indicated that nurse-led community interventions in LM view were associated with improvements in self-management, treatment adherence, and selected clinical outcomes, such as blood pressure, glycated hemoglobin, and physical activity levels. Empowerment-based approaches and the use of digital or telehealth tools supported patient engagement and health literacy. At the organizational level, multidisciplinary collaboration, shared protocols, and professional leadership emerged as key factors in sustaining continuity and quality of care, while organizational fragmentation and limited training in behavioral counseling were commonly reported barriers. Conclusions: Community nursing, particularly through FCNs, plays a relevant role in integrating chronic care management and LM approaches, contributing to improved self-management, treatment adherence, and selected clinical outcomes. The evidence highlights the importance of empowerment-based interventions, digital support tools, and multidisciplinary collaboration in enhancing care continuity and patient engagement. Addressing organizational barriers and strengthening behavioral counseling training remain essential to support effective implementation in community settings. Full article

Aims: To evaluate the effectiveness of preventive educational interventions in individuals with diabetic foot syndrome (DFS) and to summarise current evidence on knowledge, self-care and health-education strategies related to this complication. Materials and methods: A systematic review and meta-analysis was conducted in accordance with PRISMA guidelines. Risk of bias was evaluated using the Cochrane Handbook recommendations. Analyses were performed with Review Manager v5.4.1. Results: Educational interventions produced a significant improvement in patient knowledge and self-care practices compared with usual care. Despite some heterogeneity across studies, the overall effect favoured structured education as a preventive strategy for DFS-related complications. Conclusions: Preventive educational interventions enhance knowledge and self-care among individuals with DFS. Implementing structured education programs may help reduce complications and improve clinical outcomes. Full article

Background: Urticaria, particularly chronic urticaria (CU), is a highly prevalent inflammatory skin disorder characterized by recurrent wheals and/or angioedema with a fluctuating and unpredictable course that significantly impairs quality of life and requires long-term monitoring. Despite established therapeutic guidelines, disease control remains suboptimal in a considerable proportion of patients. Telemedicine has emerged as a promising adjunctive strategy for chronic disease management. This review aims to critically evaluate the role, applications, benefits, and limitations of telemedicine and digital health interventions in urticaria management. Methods: A scoping review of the literature was conducted focusing on studies addressing telemedicine, digital patient-reported outcomes, mobile health applications, and remote monitoring strategies in urticaria. Evidence from pandemic and post-pandemic telemedicine models was also analyzed to identify transferable approaches. Results: Telemedicine demonstrates significant potential in urticaria management by enabling structured symptom monitoring, facilitating remote follow-up during therapeutic escalation (including biologic therapies), improving patient empowerment and adherence, and reducing healthcare utilization and indirect costs. Digital tools such as electronic diaries and validated PRO-based applications support continuous disease assessment. However, telemedicine cannot replace direct clinical examination, and limitations include diagnostic uncertainty, digital inequalities, data privacy concerns, and lack of large disease specific trials. Conclusions: Telemedicine represents a valuable complementary and integrative model for urticaria care, particularly suited for chronic disease monitoring. Hybrid care pathways combining remote and in-person management appear to be the most effective and sustainable strategy. Further high-quality urticaria-specific studies and standardized digital frameworks are required to optimize its clinical implementation. Full article

Background: Chronic kidney disease (CKD) and end-stage renal disease (ESRD) represent a growing global health burden, affecting nearly one in ten adults worldwide. CKD is associated with high morbidity, premature mortality, reduced quality of life and enormous healthcare costs, and is primarily driven by dialysis and kidney transplantation. The silent and progressive nature of CKD means that most patients are diagnosed late, when irreversible damage has already occurred and costly kidney replacement therapies (KRT) become necessary. Dialysis services are resource-intensive, requiring significant infrastructure, specialized staff, and consumables, which makes them especially challenging to sustain in low- and middle-income countries. Traditional models of nephrology, care center-based dialysis and fragmented follow-up are increasingly inadequate in meeting the demands of a rising CKD population. These challenges highlight the urgent need for innovative approaches that enhance efficiency, improve patient outcomes, and expand access. Objective: This review aims to analyze the current landscape of information and communication technology (ICT) applications in nephrology and to evaluate how digital innovations are reconfiguring kidney therapy. Specifically, it seeks to identify the major ICT tools that are currently in use, assess their clinical and operational impact, and discuss their role in creating more sustainable, patient-centered kidney care models. This study reviews and analyzes ICT tools that are reconfiguring nephrology, including remote monitoring, AI, wearables, patient engagement apps and data dashboards. Methods: Narrative and scoping review of recent innovations in nephrology, including remote patient monitoring (RPM), telehealth, artificial intelligence (AI) analytics, wearable sensors, and clinical decision support platforms. Results: ICT tools such as Sharesource, Versia, telenephrology platforms, medical assistant for Chronic Care Service (MACCS), AI-based predictive analytics, wearable devices and patient engagement apps have improved patient outcomes, adherence, and early detection of complications. Key metrics include technique survival, hospitalization rate, patient-reported outcomes, workflow efficiency, and prediction accuracy. The relevant literature describing the potential of digital health technologies, including ICT platforms, artificial intelligence tools, and remote monitoring systems, to transform nephrology care was retrieved and screened for inclusion in this narrative review. Conclusions: ICT has shifted nephrology from reactive to proactive care, enhancing accessibility, patient empowerment and clinical efficiency. Future directions include precision nephrology, fully wearable kidneys, AI integration and large language models for education and triage. Challenges include digital divide, regulatory heterogeneity, cost and the need for long-term evidence. Full article

Introduction: Obesity is a well-established risk factor for numerous chronic diseases, including type 2 diabetes, cardiovascular disease, and certain cancers. Obesity-related complications can be managed through nutritional therapy, pharmacotherapy, and surgical interventions, each capable of achieving weight loss of over 10%. Understanding patient preferences and the factors that influence treatment choices is crucial to enhancing adherence and effectiveness. This sub-study aimed to identify the factors shaping patient preferences for nutritional therapies in the context of available pharmacological and surgical options. Methods: A participatory action study recruited 43 patients aged 18–75 years with a BMI greater than 35 kg/m² and obesity-related complications, including metabolic dysfunction, diabetes, hypertension, and chronic kidney disease. Participants viewed a 60-min informational video outlining treatment options before taking part in one-to-one interviews. Data were analysed using reflective thematic analysis. Results: This sub-study focuses on patients who expressed distinct attitudes toward nutritional therapy. Of the participants, 47% preferred nutritional therapy, 41% chose pharmacotherapy alone, and 6% selected a combination of pharmacotherapy and nutritional therapy. Five themes emerged to explain the preference for nutritional therapy: patient satisfaction, the personalised approach, effectiveness, empowerment, and side effects. Discussion: Nutritional therapies were still the most popular choice of many patients, suggesting there remain unmet needs of patients and that it should not be assumed that large majorities of patients with obesity only want pharmacotherapies or surgical therapies. Conclusion: Ensuring patients receive comprehensive information and regular guidance from nutritional experts is likely to further strengthen engagement. Full article

Background: Aspects of sexuality are often deprioritized or overlooked during the treatment of women with ovarian cancer, despite the profound physical and psychosocial impact of surgical and oncological therapies. This study aimed to explore experiences of sexuality and body image in women with ovarian cancer during the peri- and postoperative period. Methods: This qualitative exploratory study was based on twelve semi-structured, in-depth interviews with women aged ≥18 years diagnosed with ovarian cancer. Interviews were conducted in person or by telephone, transcribed verbatim, and analyzed using qualitative content analysis according to Kuckartz with MAXQDA 24.11. Results: Participants described substantial changes in sexuality and body image throughout their disease trajectory. Participants emphasized a lack of attention to sexual health and well-being in ovarian cancer care and expressed a need for timely and sensitive dialogue with medical professionals, social support systems, and with themselves regarding sexuality and intimacy. Conclusions: Sexuality emerged as a key factor for overall well-being and empowerment in women with ovarian cancer, regardless of age or relationship status. The findings suggest that sexuality-related concerns are oftentimes overlooked in clinical care and may negatively influence recovery. Greater awareness and a holistic, patient-centered perspective may help support sexual health and well-being throughout the disease trajectory. Full article

Background: Pathological scarring (PS) following surgical procedures, burns, or trauma poses significant clinical, psychological, and socio-economic challenges. Despite the high prevalence of PS, reliable information resources are limited, often leading individuals to depend on unvalidated online sources. To address this gap, we developed MyScarSpecialist.com, an evidence-based website providing comprehensive information on scar types, characteristics, and treatment options. This study aimed to optimize the website through co-creation with patients and clinicians. Methods: Semi-structured focus group meetings were conducted with patients and carers; sessions were recorded, transcribed, and analyzed using thematic analysis. Results: From the 3 focus group meetings with 15 patients with scars and 3 carers, four key themes emerged: (1) Information Sources: The Role of Professionals, Peers, and Digital Media in information sharing; (2) Desired information: From scar typing to treatment outcomes to psychosocial impact; (3) Website design: Audience preferences on content layering, information load, and image positioning; (4) Readability: Optimizing content for comprehension. Participants highlighted the need for enhanced peer support and resources addressing the psychological impact of scarring. Conclusions: These findings provide comprehensive insights for optimizing medical educational websites, ensuring inclusivity, accessibility, and empowerment for patients through co-designed strategies. Full article

Background: In today’s dynamic healthcare environment, Changi General Hospital (CGH) has positioned staff wellbeing and engagement as fundamental priorities that underpin workforce sustainability and quality care delivery. Recognizing that allied health professionals (AHPs) face unique emotional demands and potential empathy fatigue, the CGH Allied Health Division (AHD) uses three strategic pillars: individual empowerment, leaders as key stewards and institutional support systems to address staff wellbeing and engagement. This paper will evaluate the outcomes of implementing the programs and identifying the barriers and enablers to achieving staff wellbeing and engagement. Methods: It adopts a mixed-methods approach using both quantitative survey data and qualitative feedback. Results: A total of 314 AHPs participated with a mean employment duration of 8.89 years. While 95% agreed that their work was meaningful and 76.8% reported happiness at work, 40.8% did not experience being recognized by the organization and approximately 30% did not find higher management responsive to their needs or transparent in their communication. Qualitative analysis revealed concerns about psychological safety of sharing one’s opinions and concerns, and a desire for better renumeration and career progression. Conclusions: AHPs reported happiness and meaningfulness in their clinical work. However, issues with organizational recognition, higher management responsiveness and transparency, as well as psychological safety were elicited. Working towards addressing fostering psychological safety and enhancing recognition and communication with management are important in order to develop and sustain a thriving healthcare workforce capable of high-quality patient care. Overall, the findings reinforced AHD direction of putting employee wellbeing and engagement as a strategic priority. Full article

Background/Objectives: Primary health care (PHC) is the cornerstone of any high-quality healthcare system. For PHC to work well, healthcare professionals need to be skilled in critical thinking, self-reflection, and patient-centered care. However, few studies have explored the potential interplays between these factors. Therefore, this cross-sectional study evaluated the critical thinking disposition and training needs of PHC professionals, alongside patient experiences and satisfaction with PHC services. Methods: The study involved 54 PHC professionals and 100 patients from sixteen PHC facilities in Crete, Greece. Professionals completed the Critical Thinking Disposition Scale (CTDS) and Training Needs Assessment (TNA) questionnaires, while patients filled out the Quality-of-Life Instrument of Chronic Conditions in Primary Health Care (QUALICOPC) questionnaire. Results: Our findings indicated that PHC professionals exhibited high critical thinking levels (CTDS, mean score of 46.46 ± 4.24). However, TNA scores suggested moderate training needs, particularly in relationships/investigations [median: 0.50 (0, 1.50)], communication/patient-centered [median: 0.30 (0, 1.1)], and flexibility and application of knowledge [median: 0.40 (0, 1.0)]. Nevertheless, no significant correlation was found between CTDS and TNA (ρ = 0.08, p > 0.05). Patients mostly rated their health as poor (40%), and 26% lacked a family physician. Although patients were highly satisfied with communication and patient-centered care (>95% reporting positive experiences), continuity and empowerment had room for improvement. Only 37% felt their GP knew their living conditions, and 26% lacked a personal physician. Patients with chronic conditions reported significantly different experiences. Specifically, patients with chronic conditions had better continuity of care (84% vs. 59%, p = 0.01) and more comprehensive care (70% vs. 43%, p = 0.01) compared to controls. Conclusions: Our findings suggest that targeted training is needed for PHC professionals to address skill gaps. These initial findings could guide the creation of customized professional development initiatives and point to areas where PHC services could be structurally improved. Additional studies, including longitudinal ones, are required to further validate these associations. Full article

The emergent concept of the epigenetic inheritance of trauma across multiple generations has gained widespread attention in popular media, arguably at the cost of sufficient critical evaluation. This oversight risks distorting the complex and multifaceted nature of trauma transmission, with potential consequences for affected individuals and the broader society. Specifically, the prevalence of this oversimplified narrative in social work and healthcare settings underscores the need for a clearer and critical understanding of the science. To address this need, this work aims to support social workers and other healthcare workers that are interested in better understanding the biological basis of epigenetics as they integrate emerging research on trauma transmission into their daily practice. The paper first introduces fundamental concepts in epigenetics for a non-expert audience, clarifying key mechanisms that regulate gene activity. Building on this foundation, the authors examine sociocultural and biological models for trauma transmission, based on the current evidence, drawing on historic examples to highlight the strengths and limitations of each model. Ultimately, the authors encourage social workers to bridge both of these perspectives in trauma-informed care to enable social workers to challenge misconceptions about inherited trauma and foster patient empowerment through accurate education and advocacy, promoting more holistic and effective care. Full article

Background/Objectives: Urine drug testing (UDT) is a core component of nursing interventions within the treatment of substance use disorder (SUD). Beyond the detection of psychoactive substance use and medication adherence, UDT also provides opportunities for therapeutic dialogue, patient support, and recovery monitoring. Despite its routine use, little is known about how patients experience UDT and its potential as a therapeutic nursing tool within recovery-oriented care. This study aimed to explore patients’ lived experiences with UDT to understand its role in recovery-oriented addiction treatment. Methods: A phenomenological study with in-depth, semi-structured interviews was conducted among 12 residents of a supervised living facility at Addiction Care North Netherlands. Data were analyzed using Colaizzi’s seven-step method. Results: Four main themes were constructed in relation to trust within the therapeutic relationship—empowerment, accountability, and autonomy. Patients stated that their perception of UDTs as either supportive or punitive depended strongly on the level of trust within the therapeutic relationship. When trust was present, UDTs were experienced as supportive nursing tools that fostered empowerment and positive self-image, reinforced accountability for recovery goals, and upheld autonomy in decision-making. Conversely, in the absence of trust, UDTs were often perceived as punitive, coercive measures that undermined self-confidence and diminished accountability, ultimately hindering recovery progress. Nursing practices that emphasized nonjudgmental interpretation of results, collaborative decision-making, and patient-centered support contributed to positive experiences. Conclusions: Patients’ experiences indicate that the therapeutic value of UDT is highly dependent on the quality of the patient–nurse relationship. Nurses play a key role in ensuring that UDT is used as a supportive intervention rather than merely a control measure. Integrating UDT into holistic, recovery-oriented care can foster engagement, empowerment, and a sense of accountability. Future research should investigate nursing-led strategies to optimize UDT implementation tailored to treatment phase and patient needs. Full article