Search Results (359)

Background/Objective: The sequelae of COVID-19 on geriatric health is profound, yet its consequences on mental well-being remain insufficiently elucidated, particularly in older adults with musculoskeletal conditions. This study aimed to explore the interrelationships and magnitude of the effects of fear of COVID-19, fear of falls, physical activity, and social frailty on depressive symptoms in this population. Methods: Purposive sampling was applied to recruit 292 older adults with musculoskeletal conditions. Data were collected through structured interviews (face-to-face and telephone) using standard questionnaires. Path analysis with Satorra–Bentler correction examined the relationships in the proposed model of depressive symptoms. The model fit indices were evaluated using the chi-square (χ²); the goodness-of-fit test was assessed with standard criteria of the comparative fit index (CFI ≥ 0.95), the Tucker–Lewis index (TLI ≥ 0.95), the root mean squared error of approximation (RMSEA < 0.08), and the standardized root mean square residual (SRMR < 0.05). Results: Mean participant age was 70.30 ± 6.56 years, with 74.3% female. The path analysis model demonstrated an excellent fit indicating χ² = 0.007 (p = 0.933), CFI and TLI = 1.000, RMSEA = 0.000, SRMR = 0.001. Fear of COVID-19 negatively indirectly impacted depressive symptoms (β = −0.07, p = 0.017), while physical activity had a positive direct effect (β = 0.16, p = 0.004). Fear of COVID-19 directly influenced social frailty (β = 0.18, p = 0.003) but had a negative direct impact on physical activity (β = −0.37, p = 0.000). However, fear of falling did not show a significant relationship with the other study variables. Conclusions: Depressive symptoms entail physical and psychosocial consequences. Physical activity has a positive effect on depressive symptoms. Fear of COVID-19 increases social frailty, while increasing physical activity reduces this fear. Future research should evaluate longitudinal effects and investigate evidence-based public health interventions or tailored cognitive–behavioral interventions to reduce pandemic-related fear and prevent mental health sequelae. Full article

Background: Physical activity provides substantial survival and quality-of-life benefits for cancer survivors, yet participation remains suboptimal globally, particularly in the Middle East and North Africa (MENA) regions. This study represents the first comprehensive examination of physical activity barriers and facilitators among Tunisian cancer survivors. Methods: This cross-sectional study recruited 120 cancer survivors ≥3 months post-chemotherapy completion from University Hospital Farhat Hached, Sousse, Tunisia (October–December 2024). Participants completed validated questionnaires via structured telephone interviews: the International Physical Activity Questionnaire Short Form (IPAQ-SF), the Physical Activity Barriers After Cancer scale (PABAC), the Fatigue Assessment Scale (FAS), and the Patient Activation Measure (PAM-13). Statistical analyses included descriptive statistics, receiver operating characteristic (ROC) analysis, correlation analyses, and multivariable regression modeling with Bonferroni correction for multiple comparisons. Results: Participants (mean age 51.89 ± 10.2 years, 73.9% female) demonstrated significant physical activity declines post-chemotherapy: moderate activity decreased from 31.1% to 1.7% (p < 0.001), median intensity declined from 297 to 44 MET-min/week (p < 0.001). Mean PABAC score was 29.72 ± 5.13, with cognitive barriers predominating (2.85 ± 0.58). Fatigue was universal (100%), with 21% reporting severe fatigue (FAS ≥ 35). Only 26.1% received exercise guidance from healthcare professionals. PABAC demonstrated excellent predictive performance for physical inactivity (AUC = 0.805, 95%CI: 0.724–0.887). Independent predictors of higher barriers included fatigue severity (β = 0.466, p < 0.001), low patient activation (β = −0.091, p = 0.010), and advanced cancer stage (β = 1.932, p = 0.008). Conclusions: Tunisian cancer survivors experience substantial, multidimensional barriers to physical activity, with inadequate healthcare guidance representing a critical system-level gap. Findings support the development of culturally adapted, multidisciplinary interventions that target modifiable cognitive and symptom-related barriers, while enhancing patient activation and healthcare provider engagement. Full article

Objectives: Hearing aids (HAs) are the most common intervention recommended for hearing loss (HL). Many adults with HL do not seek HA rehabilitation. Several studies have attempted to identify barriers and facilitators to using HAs. Different bureaucratic processes for acquiring HAs may lead to different barriers and facilitators. In addition, studies have not yet explored the factors influencing compliance with a recommendation for an HA consultation. This study focuses on the stage prior to consultation in a context where HAs are heavily subsidized. Methods: 148 patients who had undergone a hearing test during 2022 at Hadassah University Medical Center and received a recommendation to undergo a hearing aid consultation were contacted for a telephone survey. Seventy-two adults, 48 male and 24 female, aged 25–85 years, with HL ranging from slight to profound, responded to a telephone questionnaire. The questionnaire, based on two previously published English questionnaires and translated and adapted into Hebrew, was used to assess the main reasons a person did or did not comply with the recommendation to pursue an HA consultation. Results: HL was more severe in those who sought hearing rehabilitation. The main reasons for seeking hearing rehabilitation are the need and desire to hear better and pressure from others. The foremost reasons for not pursuing hearing rehabilitation are feeling that there is currently no need, esthetics, lack of time, and self-consciousness. No significant gender- or age-based differences were found. Conclusions: There are additional barriers to seeking HAs aside from cost and accessibility. Understanding the reasons for avoidance of hearing rehabilitation may help in developing strategies that encourage people to seek hearing rehabilitation and use HAs when the need exists. Full article

Background/Objectives: Early detection of undiagnosed prediabetes (PD) and type 2 diabetes (T2D) could prevent or delay the onset of diabetes and its complications. The dental setting has been suggested as a location for expanding diabetes screening in primary care. This study aimed to investigate behavioural factors that influence an oral healthcare professional’s (OHP) participation in diabetes screening and their decision to refer individuals at a high risk of diabetes for medical follow-up and confirmatory diagnosis. These factors provide targets for future interventions to encourage screening implementation and increase referral guideline compliance. Methods: This qualitative study utilised OHPs who had participated in a diabetes screening trial in Victoria, Australia. Qualitative, semi-structured interviews were conducted by telephone or videoconferencing and transcribed and analysed thematically. The themes identified were deductively mapped onto the Capability, Opportunity, Motivation, and Behaviour (COM-B) model and the Theoretical Domains Framework (TDF). Results: In total, eight interviews were conducted (seven dentists and one oral health therapist). Five COM-B domains were identified: reflective motivation, automatic motivation, social opportunity, physical opportunity, and psychological capability. Nine TDF domains were associated with issues related to knowledge, the environmental context and resources, memory, attention and decision processes, skills, social influences, beliefs about consequences, emotion, beliefs about capability, and social influence. Conclusions: This is the first study to investigate the factors influencing an OHP’s participation and decision making in diabetes screening and referral processes in the dental setting. The results demonstrate that OHPs need more education and training to screen for diabetes in dental clinics. This study represents the first step in developing interventions to target these factors and improve the effectiveness of diabetes screening in the dental setting. Full article

Introduction. Cervical artery dissection (CAD) is a rare condition, being one of the leading causes of stroke in patients under the age of 45, with a reported prevalence of up to 20%. The management of CAD remains controversial due to its rarity and the lack of large-scale randomized controlled trials. The aim of this study was to report the long-term outcomes of CAD in a real-world setting. Methods. This retrospective, observational, single-center study included patients diagnosed with CAD between 2010 and 2019 (approval number: 153/2015/U/Oss/AOUBo). Clinical presentation, risk factors, and medical therapies were prospectively analyzed. Management strategies included both medical and interventional approaches. Follow-up consisted of annual clinical visits and carotid duplex ultrasound (DUS), with telephone interviews every six months. The primary endpoint was defined by the overall long-term stroke/death rate and in relation to the type of medical treatment, localization of the dissection and clinical manifestations. Results. A total of 62 patients were included, predominantly male (65%) with a mean age of 58 (±2) years. Thirteen dissections (21%) were trauma-related. CAD locations included the common carotid artery in 6 cases (10%), extracranial internal carotid artery in 29 (46%), intracranial internal carotid artery in 9 (14%), and vertebral artery in 16 (25%). One patient (2%) had dissections in both the extracranial internal carotid and vertebral arteries, and another (2%) in both the vertebral and basilar arteries. Bilateral dissections were observed in 5 patients (8%). Ischemic manifestations occurred in 43 patients (68%): 10 transient ischemic attacks (16%), 17 minor strokes (27%), and 16 major strokes (25%), with ischemic lesions on cerebral CT in 31 cases (72%). Fifty-eight (93%) patients were treated medically (anticoagulants and/or antiplatelets), while 4 patients (7%) underwent surgical or endovascular intervention. The mean follow-up was 81 ± 35 months. During this period, 2 patients (4%) experienced stroke and 15 (24%) died. The estimated 10-year survival rate was 71%, and the 10-year stroke/death-free survival rate was 70%. Among medically treated patients, the 10-year stroke/death-free survival was 86% for those on anticoagulation and 67% for those on antiplatelet therapy (p = 0.1). Patients presenting with ischemic symptoms had a lower estimated 10-year stroke/death-free survival rate compared to those with non-ischemic presentations (61% vs. 69%, p = 0.7). Patients with dissection of the common carotid artery had a significantly lower estimated 10-year stroke/death-free survival rate (25%), compared to dissections in other cervical arteries (p = 0.001). Conclusions. In this real-world, single-center experience, cervical artery dissection was associated with a favorable long-term prognosis in most cases, especially among patients managed conservatively with medical therapy. Stroke and mortality rates were relatively low during extended follow-up. Although no statistically significant difference was observed between anticoagulation and antiplatelet therapy, the trend favored anticoagulation for stroke/death-free survival. Patients with CCA dissections had significantly worse 10-year stroke/death-free survival compared to those with dissections in other cervical arteries. Full article

Aim: To assess the impact of the environment on the attitude and mood of pediatric patients undergoing computed tomography (CT) scans at our pediatric clinic within the colorful setting of a dedicated CT scan room. Background: In pediatric healthcare, interventions must address the specific needs of both children and their parents. While medical imaging is essential for diagnosis and management, it can cause stress and anxiety in children, potentially affecting cooperation and diagnostic quality. Creating a supportive, child-friendly environment can alleviate these challenges and improve the likelihood of successful imaging outcomes. Method: This retrospective quantitative study investigated the phenomenological experience of pediatric patients (aged 0–18) who underwent CT imaging at the “De Marchi” pediatric clinic between November 2021 and June 2024. Patients were manually selected from the clinic’s CT database. A standardized telephone survey assessed perceived environmental impact before, during, and after the procedure. Data were anonymized and recorded in Excel (Microsoft, Redmond, WA, USA). Crosstab analyses and Pearson’s chi-square tests were performed using SPSS version 25.0 (IBM, Armonk, NY, USA). Results: Between November 2021 and June 2024, 838 pediatric patients underwent 1144 CT scans at the “De Marchi” clinic. Patients were grouped as previous-CT elsewhere (12.3%), first-time CT (68.9%), and returning patients (18.8%). Most reported positive experiences: 63.3% of the first group rated the experience better than prior exams, 73.9% of first-time patients found the environment comfortable, and 85.6% of returning patients felt at ease. Overall, 94.2% would recommend the clinic for pediatric CT scans. Conclusions: Our research demonstrates that a child-friendly environment is not just a concept, but a tangible solution that effectively alleviates the stress experienced by young patients and their families during diagnostic exams. This finding should inspire optimism about the potential for creating more reassuring and comfortable hospital settings in pediatric healthcare. Full article

(1) Introduction: Arab American (ArA) men have higher smoking rates than the general population, driven by cultural norms. Culturally tailored interventions that incorporate ArA cultural, linguistic, and social contexts are essential for addressing tobacco use and promoting health equity. This study aimed to evaluate a culturally tailored smoking cessation intervention for ArA men living in North Carolina. (2) Methods: This pilot study employed a one-group pre- and post-test design to evaluate program effectiveness within financial and time constraints. The participants completed questionnaires and Carbon monoxide measurements and were provided with Nicotine Replacement therapy. (3) Results: The study found that participants experienced anxiety and stress when delaying their first morning cigarette, which hindered cessation. Although smoking was reduced, relapse was common, highlighting the need for personalized support, especially for those with higher nicotine dependence. While telephone Motivational Interviewing helped reduce anxiety, it was insufficient for complete cessation, underscoring the need for tailored approaches addressing both psychological and physical factors. (4) Conclusions: The study suggests that culturally tailored telephone counseling did not show promise as a smoking cessation strategy for Arab Americans in North Carolina due to low participation. The sample size is really too small to test the efficacy of the intervention itself. It seems to have been more successful in another state. Future efforts should address cultural factors, emerging nicotine products, and expanded research. The project is significant for addressing health disparities among Arab Americans by integrating culturally relevant smoking cessation strategies with evidence-based methods like Nicotine Replacement Therapy. Full article

Background/Objectives: Family is a key protective factor for firefighters’ mental health, yet the home-related challenges of firefighting’s occupational demands remain underexplored in South Korea. This study aimed to establish an initial understanding of these challenges by conducting in-depth interviews with male firefighters and analyzing their lived experiences using a phenomenological approach. Methods: Twenty-nine married male firefighters (mean age = 43.4 years, range = 31–55) affiliated with the Busan Fire Department participated in individual telephone interviews between April and July 2022 during the COVID-19 pandemic. Data were analyzed using Giorgi’s descriptive phenomenological method, with NVivo Pro 12.0 employed for coding and organization. Results: Six themes were identified: (1) acting as an emergency commander at home, (2) reinterpreting traumatic experiences after marriage, (3) physical and emotional exhaustion from irregular schedules, (4) being national heroes misunderstood by families, (5) guilt-ridden and indebted Superman, and (6) striving to be Superman at home as well. These themes reflected the overarching meaning of a “lonely breadwinner struggling to be Superman both at work and home.” Participants described hyperarousal, emotional withdrawal, strained relationships, guilt over missed family events, and compensatory overextension. Distress was often concealed to protect families, but this limited emotional support. Conclusions: Korean male firefighters face significant work–family conflict shaped by cultural and occupational factors. These findings highlight the need for family-centered counseling, psychoeducation, and organizational interventions. Policy measures such as guaranteed rest after shifts, couple-based communication programs, and resilience-building initiatives are recommended to strengthen families as vital sources of psychological resilience. Full article

Background: Telepharmacy, the provision of patient care services by pharmacists through the use of telecommunications technology, is associated with improved diabetes-related outcomes and access to healthcare. The primary aim of this study was to characterize pharmacists’ interventions at a virtual pharmacist-led diabetes clinic (PLDC). The secondary aim was to assess the feasibility of conducting a future cost-effectiveness study of the PLDCs. Methods: This prospective observational feasibility study was conducted within a pharmacist-led clinic at Seha Virtual Hospital, Riyadh, Saudi Arabia. Two intern pharmacists collected data between 31 July 2024 and 31 January 2025. Results: Seventy-five patients (mean [SD] age 50.47 years [14.95]) attended the clinic. The majority were female (58.7%), had type 2 diabetes (86.6%), and were from outside Riyadh (97.3%). The communication with patients was carried out mainly via telephone (73, 97.3%). The mean consultation duration was 7.64 min (SD = 5.68). A total of 179 interventions were conducted, with a mean number of interventions per patient of 2.5 (median 3, min 0, max 5). The most common intervention was patient education and counseling about their disease and medications. While it was feasible to capture the details of pharmacist interventions and resource use data, incomplete data on patient outcomes presented a challenge. Conclusions: Our detailed documentation of pharmacist–patient encounters revealed the ability of pharmacists to identify and manage the problems of diabetes patients at virtual PLDCs. Our feasibility study identified a few challenges that need to be addressed when designing future cost-effectiveness studies. Full article

Background: The World Health Organization defined specific recommendations about digital tobacco cessation modalities as a self-management tool or as an adjunct to other support for adults. Objectives: The present umbrella review primarily aimed to assess the long-term (≥6 months) effectiveness and adherence of the different standalone digital tobacco cessation modalities (mobile text messaging, smartphone apps, Internet-based websites and programs, AI-based), administered individually or in combination; secondarily, the study aimed to assess the effect on smokers’ health. Methods: The present study (PROSPERO number: CRD42024601824) followed the PRISMA guidelines. The included studies were qualitatively synthesized and evaluated through the AMSTAR-2 tool. Results: Forty-five systematic reviews were included, encompassing 164,010 adult daily smokers of combustible tobacco. At 6 months, highly interactive or human-centered digital tools showed higher effectiveness (biochemically verified continuous abstinence rates (CARs) were 11.48% for smartphone apps and 11.76% for video/telephone counseling). In contrast, at 12 months, simpler, less interactive tools demonstrated higher effectiveness (self-reported CARs was 24.38% for mobile text messaging and 18.98% for Internet-based). Adherence rates were generally high, particularly with human-centered digital tools, amounting to 94.12% at 6 months and 64.08% at 12 months. Compared with individually administered digital tobacco cessation modalities, at 12 months, combined ones registered slightly higher effectiveness (self-reported CARs were 13.12% vs. 13.94%) and adherence (62.36% vs. 63.70%), potentially attributed to the multi-component nature and longer durations. Conclusions: Clinicians should prioritize combined digital tobacco cessation interventions that incorporate human-centered engagement initially, alongside simpler, sustained digital support to enhance long-term effectiveness and adherence. Future research should explore long-term medical and oral health benefits to assess the impact on overall health and well-being. Full article

Background/Objectives: Family caregivers in palliative care often face complex physical, emotional, and logistical challenges, which can result in a significant caregiving burden. Dyadic interventions—designed to support both the patient and the caregiver simultaneously—have emerged as a promising holistic approach to enhancing well-being and quality of life. This systematic review aimed to evaluate the effects of dyadic support interventions in reducing caregiver burden among middle-aged and older adults receiving palliative care. Methods: A systematic literature search was conducted following PRISMA guidelines across five databases (CINAHL, MEDLINE, Web of Science, Scopus, and Google Scholar for grey literature) covering the period from 2019 to January 2025. Results: Of 653 records identified, 8 studies met the inclusion criteria. Interventions were typically delivered by multidisciplinary teams and included weekly in-person consultations, telephone follow-up, telemedicine, physical exercise sessions, laughter therapy, and music therapy over durations ranging from 16 weeks to 6 months. These programs resulted in reduced anxiety and depressive symptoms (PHQ-4, HADS, SDS, BAI, SAS), improved functional and social performance (SF-36), and/or enhanced quality of life (MQLQ, QOL-AD, KCCQ-12, EORTC QLQ-C30). In patients, they contributed to better symptom control (ESAS, CFS), while in caregivers, they effectively reduced burden (ZBI-12, FCBSI, CBI) and/or supported the anticipatory grief process (PGQ, AGS). However, not all studies reported consistently positive outcomes. Conclusions: Structured dyadic interventions that involve both patients and caregivers significantly improve outcomes in palliative care for middle-aged and older adults. Future research should examine their long-term impact and explore the integration of artificial intelligence to optimize intervention delivery. Full article

Background/Objectives: Quality of life (QOL) is a multifaceted concept involving a variety of factors which define the overall well-being of individuals. Food security, which implies a resilient food system, is one factor that is central to the calculus of the QOL status of a community considering that food is a staple of life. Advancing food security as a strategy for attaining sustained improvement in community QOL hinges on recognizing that food security is embedded in a matrix of other factors that work with it to generate the QOL the community experiences. The lived experience of the community defines the community’s QOL value matrix and the relative position of food security in that value matrix. Our thesis is that the role of food security in the lived experience of low-income communities depends on the position food security is accorded relative to other factors in the QOL value matrix of the community. Methods: This study employed a multimethod approach to define the QOL value matrix of low-income Guilford County residents, identifying the relative position of the value components and demographic segments based on priority ranking. First, an in-depth interview was conducted and then a telephone survey (280 sample) was used for collecting data. The ISAC Analysis Procedure and Best–Worst Scaling methods were used to identify and rank components of the QOL value matrix in terms of their relative impact on QOL. Results: The analysis revealed that spiritual well-being is the most important contributor to QOL, with a weight of 0.23, followed by access to health services (0.21) and economic opportunities (0.16), while food security has a moderate impact with 0.07. Conclusions: These findings emphasize the need for targeted policy interventions that consider the specific needs of different demographic segments to effectively improve QOL and inform the design of resilient food systems that reflect the lived experiences of low-income communities. Food security policies must be integrated with broader quality of life interventions, particularly for unemployed, low-educated, and single individuals, to ensure that a resilient food system effectively reduces inequities and address community-specific vulnerabilities. Full article

Background/Objectives: This study aimed to evaluate myocardial scar burden and distribution, as well as other nuclear imaging parameters, in predicting cardiac resynchronization therapy (CRT) responses and long-term outcomes in patients selected for CRT with ischemic HF etiology. Methods: Seventy-one patients were prospectively included. They all had NYHA class II/III despite optimal medical therapy, LVEF ≤ 35%, wide QRS complexes, and ischemic HF etiology. All were indicated for de novo CRT implantation and underwent a SPECT MPI viability test prior to CRT implantation. Two-dimensional echocardiography was performed one day before CRT implantation and 6 months after the intervention. The follow-up examination was conducted six months after the CRT implantation and, after 5 years, patients underwent a telephone follow-up to assess survival. Results: Most patients (85%) were male, with an average age of 66.26 ± 9.25 yrs. SPECT MPI revealed large myocardial scars (44.53 ± 20.94%) with high summed rest scores (SRSs) of 25.02 ± 11.29 and low EFs of 26.67 ± 7.71%. At the 6-month follow-up, after the CRT implantation, the NYHA class significantly changed and 35% of the patients were classified as CRT responders. The only difference between responders and non-responders was in the SRS and myocardial scar size (p < 0.001). A scar size of 19.5% was an optimal cutoff for the prediction of CRT response (AUC 0.853, Sn 85% and 1-sp 94%). Conclusions: SPECT MPI parameters are valuable in predicting responses and long-term survival in patients with CRT. Patients with myocardial scars of less than 19.5% may be suited to CRT and experience better cardiovascular survival. Full article

Background/Objectives: Obstructive sleep apnea (OSA) is a highly prevalent disorder that significantly impacts quality of life and daily functioning. While continuous positive airway pressure (CPAP) therapy is effective, long-term adherence remains a challenge. This single-arm observational study aimed to evaluate clinical outcomes and adherence patterns during telemedicine-supported CPAP therapy and identify distinct phenotypic response clusters in Romanian patients with OSA. Methods: This prospective observational study included 86 adults diagnosed with OSA, treated with ResMed Auto CPAP devices at “Victor Babeș” University Hospital in Timișoara, Romania. All patients were remotely monitored via the AirView™ platform and received monthly telephone interventions to promote adherence when necessary. Clinical outcomes were assessed through objective telemonitoring data. K-means clustering and t-distributed stochastic neighbor embedding (t-SNE) were employed to explore phenotypic response patterns. Results: During telemedicine-supported CPAP therapy, significant clinical improvements were observed. The apnea–hypopnea index (AHI) decreased from 42.0 ± 21.1 to 1.9 ± 1.3 events/hour. CPAP adherence improved from 75.5% to 90.5% over six months. Average daily usage increased from 348.4 ± 85.8 to 384.2 ± 65.2 min. However, post hoc analysis revealed significant concerns about the validity of self-reported psychological improvements. Self-esteem changes showed negligible correlation with objective clinical measures (r < 0.2, all p > 0.1), with only 3.3% of variance being explained by measurable therapeutic factors (R² = 0.033). Clustering analysis identified four distinct adherence and outcome profiles, yet paradoxically, patients with lower adherence showed greater self-esteem improvements, contradicting therapeutic causation. Conclusions: Telemedicine-supported CPAP therapy with structured monthly interventions was associated with substantial clinical improvements, including excellent AHI reduction (22-fold) and high adherence rates (+15% after 6 months). Data-driven phenotyping successfully identified distinct patient response profiles, supporting personalized management approaches. However, the single-arm design prevents definitive attribution of improvements to telemonitoring versus natural adaptation or placebo effects. Self-reported psychological outcomes showed concerning patterns suggesting predominant placebo responses rather than therapeutic benefits. While the overall findings demonstrate the potential value of structured telemonitoring for objective CPAP outcomes, controlled trials are essential to establishing true therapeutic efficacy and distinguishing intervention effects from measurement bias. Full article

Aim: To explore the experiences, beliefs, and values of patients who participated in a two-arm randomized clinical trial assessing a nurse-led intervention program for chronic pain self-management, which demonstrated positive effects on pain reduction, depression, and anxiety, and on health-related quality of life 24 months after completion of the program. Design: Descriptive phenomenological qualitative study. Methods: Patients were recruited via telephone, informed about the study, and invited to participate in an individual interview at a place of their choice (hospital or home). All interviews were audiotaped, and an inductive thematic analysis was performed. Results: Seven interviews were carried out between both groups. Six emerging categories were found: effective relationship with the healthcare system, learning to live with pain, family and social support, behaviors regarding pain, resources for self-management, and concomitant determinants. Conclusions: Patients report key aspects that help us to understand the impact of this type of nurse-led group intervention: the intrinsic therapeutic effect of participating in the program itself, the ability to learn to live with pain, the importance of family and social support, the modification of pain-related behaviors, and the identification of resources for self-care. The findings highlight the need for gender-sensitive, individualized care approaches to chronic pain, addressing stigma and social context. Expanding community-based programs and supporting caregivers is essential, as is further research into gender roles, family dynamics, and work-related factors. Full article