Journal Description
Healthcare
Healthcare
is an international, scientific, peer-reviewed, open access journal on health care systems, industry, technology, policy, and regulation, and is published semimonthly online by MDPI. Ocular Wellness & Nutrition Society (OWNS) is affiliated with Healthcare and its members receive discounts on article processing charges.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within Scopus, SCIE and SSCI (Web of Science), PubMed, PMC, and other databases.
- Journal Rank: JCR - Q2 (Health Policy & Services ) / CiteScore - Q2 (Leadership and Management)
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 19.5 days after submission; acceptance to publication is undertaken in 2.4 days (median values for papers published in this journal in the second half of 2023).
- Recognition of Reviewers: reviewers who provide timely, thorough peer-review reports receive vouchers entitling them to a discount on the APC of their next publication in any MDPI journal, in appreciation of the work done.
- Companion journals for Healthcare include: Trauma Care and European Burn Journal.
Impact Factor:
2.8 (2022);
5-Year Impact Factor:
3.0 (2022)
Latest Articles
Nursing Students’ Attitudes toward Working in Mental Health Facilities in Saudi Arabia: A Cross-Sectional Study
Healthcare 2024, 12(12), 1168; https://doi.org/10.3390/healthcare12121168 (registering DOI) - 8 Jun 2024
Abstract
(1) Background: There is a global demand for more psychiatric nurses, with nursing students’ attitudes toward mental illness and working in mental health facilities playing a pivotal role in their career choices. This study aims to evaluate attitudes toward working in mental health
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(1) Background: There is a global demand for more psychiatric nurses, with nursing students’ attitudes toward mental illness and working in mental health facilities playing a pivotal role in their career choices. This study aims to evaluate attitudes toward working in mental health facilities among undergraduate nursing students in Saudi Arabia, both before and after exposure to psychiatry courses, and examine their relationship with perceptions of mental illness. (2) Methods: A quantitative descriptive and correlational cross-sectional design was employed. Nursing students’ attitudes toward working in mental health facilities were assessed using the Attitude Toward Psychiatry 18 (ATP-18) questionnaire and the Beliefs Toward Mental Illness (BMI) scale. (3) Results: No significant relationship has been found between the frequency of negative views of both ATP-18 and BMI, and exposure to the psychiatry course. However, nurses who completed the psychiatry course held more positive views towards psychiatrists and found psychiatric patients less demanding, were less likely to view psychological disorders as dangerous, more confident in trusting mentally ill colleagues, and felt less embarrassed by the term “psychological disorder” compared to those who had not taken the course. (4) Conclusion: Based on our findings, it is evident that exposure to psychiatric courses and training enhances the potential of nursing students to contribute effectively to the psychiatric field. Therefore, integrating mental health and illness community services training into nursing education programs can play a pivotal role in raising awareness and attracting students who may hold negative attitudes towards individuals with mental illness.
Full article
(This article belongs to the Section Nursing)
Open AccessSystematic Review
Nordic Walking as a Non-Pharmacological Intervention for Chronic Pain and Fatigue: Systematic Review
by
Daniel González-Devesa, Silvia Varela, Miguel Adriano Sanchez-Lastra and Carlos Ayán
Healthcare 2024, 12(12), 1167; https://doi.org/10.3390/healthcare12121167 (registering DOI) - 8 Jun 2024
Abstract
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Objective: We aimed to analyze and summarize the available scientific evidence on the benefits of Nordic walking for people with chronic pain and fatigue. Literature Survey: This systematic review adhered to PRISMA guidelines and conducted a comprehensive search across five databases using the
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Objective: We aimed to analyze and summarize the available scientific evidence on the benefits of Nordic walking for people with chronic pain and fatigue. Literature Survey: This systematic review adhered to PRISMA guidelines and conducted a comprehensive search across five databases using the PICO strategy. Methodology: Inclusion criteria encompassed randomized trials evaluating Nordic walking for pain and fatigue. Two authors independently screened studies, extracted data, and assessed methodological quality using the PEDro scale. Synthesis: A total of 14 studies were included, with sample sizes ranging from 20 to 136 participants. The methodological quality of the included studies varied from fair (five studies) to good (nine studies). The interventions consisted of supervised Nordic walking sessions lasting 6 to 24 weeks, with a frequency of 2 to 4 days per week and duration of 25 to 75 min. The results of this review suggest that Nordic walking had beneficial effects in six of the eight studies that analyzed participant fatigue. However, Nordic walking did not show greater beneficial effects on fatigue than walking (two studies) or than not performing physical activity (one study). Additionally, six of the nine studies that examined the effects of Nordic walking on participants’ perceptions of pain showed beneficial results. However, five studies that compared Nordic walking with control groups did not find any significant inter-group differences on pain. Conclusions: Based on our findings, Nordic walking exercise programs provide a potentially efficient method for alleviating pain and fatigue in people with chronic conditions. Its straightforwardness and ease of learning make it accessible to a broad spectrum of participants, which can result in higher adherence rates and lasting positive effects.
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Open AccessArticle
Geriatric Syndromes and Their Relationship with Mortality in a Population of Mexican Older Adults Aged 65 and Over, Admitted to the Emergency Department of a Second-Level Care Hospital
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José Juan Gómez-Ramos, Melissa González-Guerra, Ingrid Patricia Dávalos-Rodríguez, María Eloísa Pérez-Ruíz, Emiliano Peña-Durán and Alejandro Marín-Medina
Healthcare 2024, 12(12), 1166; https://doi.org/10.3390/healthcare12121166 (registering DOI) - 8 Jun 2024
Abstract
The main objective of this study was to analyze the relationship between Geriatric Syndromes (GSs) and in-hospital mortality in adults aged 65 and older admitted to the Emergency Department (ED). The study included 202 Older Adults (OAs) who met the inclusion criteria. We
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The main objective of this study was to analyze the relationship between Geriatric Syndromes (GSs) and in-hospital mortality in adults aged 65 and older admitted to the Emergency Department (ED). The study included 202 Older Adults (OAs) who met the inclusion criteria. We conducted a Comprehensive Geriatric Assessment and collected clinical and demographic data. A univariate analysis was carried out for each of the GSs analyzed. Those variables with p < 0.05 were entered into a multiple logistic regression using the backward stepwise entry method to analyze the independent predictor variables. The average number of GSs per individual was 4.65 (±2.76). Frailty syndrome was the most prevalent (70.2% of patients). Our study found an association between mortality and some GSs, such as frailty (p = 0.042), risk of falls (p = 0.010), delirium, cognitive impairment, dependence, and risk of ulcers (p < 0.001). We found that cognitive impairment (adjusted OR, 6.88; 95% CI, 1.41–33.5; p = 0.017) and dependence (adjusted OR, 7.52; 95% CI, 1.95–29.98; p = 0.003) were independent predictors associated with mortality in our population. It is necessary to develop new care strategies in the ED that respond to the needs of aging societies, including the use of new technologies and personnel with experience in gerontology.
Full article
(This article belongs to the Special Issue Emergency Medicine and Public Health: Intersecting Strategies for Population Well-Being)
Open AccessArticle
Machine Learning Approach for Cardiovascular Death Prediction among Nonalcoholic Steatohepatitis (NASH) Liver Transplant Recipients
by
Yasin Fatemi, Mohsen Nikfar, Amir Oladazimi, Jingyi Zheng, Haley Hoy and Haneen Ali
Healthcare 2024, 12(12), 1165; https://doi.org/10.3390/healthcare12121165 (registering DOI) - 8 Jun 2024
Abstract
Cardiovascular disease is the leading cause of mortality among nonalcoholic steatohepatitis (NASH) patients who undergo liver transplants. In the present study, machine learning algorithms were used to identify important risk factors for cardiovascular death and to develop a prediction model. The Standard Transplant
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Cardiovascular disease is the leading cause of mortality among nonalcoholic steatohepatitis (NASH) patients who undergo liver transplants. In the present study, machine learning algorithms were used to identify important risk factors for cardiovascular death and to develop a prediction model. The Standard Transplant Analysis and Research data were gathered from the Organ Procurement and Transplantation Network. After cleaning and preprocessing, the dataset comprised 10,871 patients and 92 features. Recursive feature elimination (RFE) and select from model (SFM) were applied to select relevant features from the dataset and avoid overfitting. Multiple machine learning algorithms, including logistic regression, random forest, decision tree, and XGBoost, were used with RFE and SFM. Additionally, prediction models were developed using a support vector machine, Gaussian naïve Bayes, K-nearest neighbors, random forest, and XGBoost algorithms. Finally, SHapley Additive exPlanations (SHAP) were used to increase interpretability. The findings showed that the best feature selection method was RFE with a random forest estimator, and the most critical features were recipient and donor blood type, body mass index, recipient and donor state of residence, serum creatinine, and year of transplantation. Furthermore, among all the outcomes, the XGBoost model had the highest performance, with an accuracy value of 0.6909 and an area under the curve value of 0.86. The findings also revealed a predictive relationship between features and cardiovascular death after liver transplant among NASH patients. These insights may assist clinical decision-makers in devising strategies to prevent cardiovascular complications in post-liver transplant NASH patients.
Full article
(This article belongs to the Section Artificial Intelligence in Medicine)
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Open AccessArticle
Towards the Improvement of Patient Experience Evaluation Items for Patient-Centered Care in Head and Neck Cancer: A Qualitative Comparative Study
by
Eun-Jeong Kim, Yoo-Ri Koo and Inn-Chul Nam
Healthcare 2024, 12(12), 1164; https://doi.org/10.3390/healthcare12121164 (registering DOI) - 8 Jun 2024
Abstract
Owing to long-term treatment, frequent consultations, and complications, the evaluation of patients with head and neck cancer (HNC) must be improved. This study explored an opportunity for improving patient experience (PE) evaluation of patients with HNC to achieve a patient-centered, integrative evaluation model
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Owing to long-term treatment, frequent consultations, and complications, the evaluation of patients with head and neck cancer (HNC) must be improved. This study explored an opportunity for improving patient experience (PE) evaluation of patients with HNC to achieve a patient-centered, integrative evaluation model based on patient needs. The study comprised four phases: (1) a systematic literature review of PE factors for patient quality of life (QoL) and establishment of PE factor categories as a framework, (2) a review of current cancer or HNC PE evaluation tools, (3) identification of potential PE evaluation items based on patient needs by conducting user research, and (4) suggestion of integrative HNC PE evaluation items through expert validation. As a result, the 39 potential items were initially identified from the literature review and user research. After conducting two survey rounds with experts, 25 items were suggested as HNC PE evaluation items. These underscore the importance of highlighting the patient’s participation, the medical staff’s comprehensive information delivery, empathy, and collaborative communication, the hospital’s support of communication channels, the medical environment for patient emotional support, the education program, and systematic patient satisfaction data management. PE evaluation items that consider the diverse perspectives of stakeholders involved in HNC treatment and factors of comprehensive PE will contribute to improving HNC patient-centered care (PCC).
Full article
(This article belongs to the Special Issue Quality of Life and Health Promotion in Chronic Illness or Critical Medical Conditions: Implications for Integrated Health Care Delivery)
Open AccessArticle
Self-Assessment of Lower Urinary Tract Condition in Female Competitive Cyclists
by
Mariola Saulicz, Aleksandra Saulicz and Edward Saulicz
Healthcare 2024, 12(12), 1163; https://doi.org/10.3390/healthcare12121163 - 7 Jun 2024
Abstract
During cycling, prolonged compression by the bicycle saddle on the anatomical structures located in the perineum area occurs. An additional factor that may have a negative impact on organs located in the pelvic area may be a prolonged sitting position resulting in increased
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During cycling, prolonged compression by the bicycle saddle on the anatomical structures located in the perineum area occurs. An additional factor that may have a negative impact on organs located in the pelvic area may be a prolonged sitting position resulting in increased intraabdominal pressure. This situation has the potential to adversely affect pelvic floor function. Therefore, the aim of this study was to assess the incidence of lower urinary tract symptoms (LUTSs) in female competitive road cyclists and cross-country cyclists. The study included 76 female competitive road cyclists and cross-country cyclists and 76 women not practising competitive sport. The Core Lower Urinary Tract Symptom Score (CLSS) questionnaire was used to assess the lower urinary tract condition. Female competitive cyclists had a statistically significantly higher LUTSs score (95% CI: 3.12–4.2 vs. 2.31–3.16; p < 0.05) compared to women not practising competitive sports. Female cyclists had a statistically significantly higher overall CLSS score (95% CI: 3.99–5.61 vs. 2.79–3.97; p < 0.05). Female cyclists had a statistically significantly higher incidence and severity of urinary frequency (p < 0.05 and p < 0.02), urge (p < 0.001 and p < 0.02) and stress incontinence (p < 0.001 and p < 0.001), and pain in the bladder (p < 0.01 and p < 0.01), while physically inactive women recorded a statistically higher incidence of slow urinary stream (p < 0.01 and p < 0.04). A statistically significant association was recorded between the years of cycling and the number of hours per week spent on training and the number of symptoms and their severity. The number of natural births experienced by women involved in competitive cycling significantly affects the severity of LUT symptoms. Compared to women not practising competitive sports, competitive female cyclists are found to have a higher prevalence of LUTSs and a greater degree of severity. LUTSs in competitive female cyclists are negatively influenced by years of competitive career and weekly number of training hours and the number of natural births experienced.
Full article
Open AccessArticle
Effect of Forward Head Posture on Resting State Brain Function
by
Ju-Yeon Jung, Yeong-Bae Lee and Chang-Ki Kang
Healthcare 2024, 12(12), 1162; https://doi.org/10.3390/healthcare12121162 - 7 Jun 2024
Abstract
Forward head posture (FHP) is a common postural problem experienced by most people. However, its effect on brain activity is still unknown. Accordingly, we aimed to observe changes in brain waves at rest to determine the effect of FHP on the nervous systems.
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Forward head posture (FHP) is a common postural problem experienced by most people. However, its effect on brain activity is still unknown. Accordingly, we aimed to observe changes in brain waves at rest to determine the effect of FHP on the nervous systems. A total of 33 computer users (Male = 17; Female = 16; age = 22.18 ± 1.88) were examined in both FHP and neutral posture. For each session, brain waves were measured for 5 min, and then muscle mechanical properties and cranio-vertebral angle (CVA) were measured. Changes in brain waves between the neutral posture and FHP were prominent in gamma waves. A notable increase was confirmed in the frontal and parietal lobes. That is, eight channels in the frontal lobe and all channels in the parietal lobe showed a significant increase in FHP compared to neutral posture. Additionally, FHP changes were associated with a decrease in CVA (p < 0.001), an increase in levator scapulae tone (Right, p = 0.014; Left, p = 0.001), and an increase in right sternocleidomastoid stiffness (p = 0.002), and a decrease in platysma elasticity (Right, p = 0.039; Left, p = 0.017). The change in CVA was found to have a negative correlation with the gamma activity (P7, p = 0.044; P8, p = 0.004). Therefore, increased gamma wave activity in FHP appears to be related to CVA decrease due to external force that was applied to the nervous system and cervical spine.
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(This article belongs to the Section Environmental Factors and Global Health)
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Open AccessReview
Interventions for School-Aged Children with Auditory Processing Disorder: A Scoping Review
by
Jacynthe Bigras, Josée Lagacé, Ahmed El Mawazini and Héloïse Lessard-Dostie
Healthcare 2024, 12(12), 1161; https://doi.org/10.3390/healthcare12121161 - 7 Jun 2024
Abstract
(1) Background: Auditory processing (AP) disorder is associated with learning difficulties and poses challenges to school-aged children in their daily activities. This scoping review identifies interventions and provides audiologists with protocol insights and outcome measures. (2) Methods: A systematic search of both peer-reviewed
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(1) Background: Auditory processing (AP) disorder is associated with learning difficulties and poses challenges to school-aged children in their daily activities. This scoping review identifies interventions and provides audiologists with protocol insights and outcome measures. (2) Methods: A systematic search of both peer-reviewed and grey literature (January 2006 to August 2023) covered ten databases. Studies included had the following characteristics: (i) published in French or English; (ii) participants were school-aged, and had a normal audiogram, AP difficulties or disorder, and no cognitive, developmental, congenital or neurological disorder (with the exception of learning, attention, and language disabilities); (iii) were intervention studies or systematic reviews. (3) Results: Forty-two studies were included, and they predominantly featured auditory training (AT), addressing spatial processing, dichotic listening, temporal processing and listening to speech in noise. Some interventions included cognitive or language training, assistive devices or hearing aids. Outcome measures listed included electrophysiological, AP, cognitive and language measures and questionnaires addressed to parents, teachers or the participants. (4) Conclusions: Most interventions focused on bottom-up approaches, particularly AT. A limited number of top-down approaches were observed. The compiled tools underscore the need for research on metric responsiveness and point to the inadequate consideration given to understanding how children perceive change.
Full article
(This article belongs to the Special Issue Auditory Processing Disorder: A Forgotten Hearing Impairment)
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Open AccessArticle
Optimising Combat Readiness: Practical Strategies for Integrating Physiological and Psychological Resilience in Soldier Training
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José Francisco Tornero-Aguilera, Maria Stergiou, Alejandro Rubio-Zarapuz, Alexandra Martín-Rodríguez, Luís Miguel Massuça and Vicente Javier Clemente-Suárez
Healthcare 2024, 12(12), 1160; https://doi.org/10.3390/healthcare12121160 - 7 Jun 2024
Abstract
This narrative review examines the intricate psychophysiological interplay between cognitive functions and physical responses within military personnel engaged in combat. It elucidates the spectrum of responses elicited by symmetric and asymmetric warfare alongside specialised combat scenarios, including close-quarters and subterranean warfare. Central to
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This narrative review examines the intricate psychophysiological interplay between cognitive functions and physical responses within military personnel engaged in combat. It elucidates the spectrum of responses elicited by symmetric and asymmetric warfare alongside specialised combat scenarios, including close-quarters and subterranean warfare. Central to this discourse is the emphasis on integrating training programs beyond physical conditioning to encompass psychological resilience and decision-making efficacy under duress. The exploration further ventures into applying advanced technologies such as virtual reality and wearable devices, highlighting their pivotal role in augmenting training outcomes and supporting soldier health. Through a detailed analysis of psychophysiological variations across different military branches of service, the narrative review advocates for bespoke training regimens and support frameworks tailored to address the unique exigencies of each service branch. Concluding observations stress the importance of evolving military training paradigms, advocating for adopting realistic, immersive training simulations that mirror the complexities of the contemporary battlefield. This synthesis aims to contribute to the ongoing discourse on optimising military training protocols and enhancing the operational readiness and well-being of armed forces personnel. This narrative review is essential for military psychologists, trainers, and policymakers, aiming to bridge the gap between theoretical knowledge and practical implementation in military training programs.
Full article
(This article belongs to the Special Issue Health and Readiness of Tactical Populations)
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Open AccessArticle
Our New Normal: Pediatric Nurse Residents’ Experiences with Transition to Practice during the COVID-19 Pandemic
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Katherine A. Hinderer, Dennis W. Klima, Marni B. Kellogg, Cecelia Morello, Karen Myers and Beth A. Wentland
Healthcare 2024, 12(12), 1159; https://doi.org/10.3390/healthcare12121159 - 7 Jun 2024
Abstract
This phenomenological qualitative study examined the lived experience of pediatric nurse residents’ transition to practice during the COVID-19 pandemic. The purposive sample included nine pediatric nurses, participating in a nurse residency program, who entered the nursing profession during the first year of the
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This phenomenological qualitative study examined the lived experience of pediatric nurse residents’ transition to practice during the COVID-19 pandemic. The purposive sample included nine pediatric nurses, participating in a nurse residency program, who entered the nursing profession during the first year of the pandemic. The setting was a free-standing, Magnet-recognized, pediatric academic medical center in the Northeastern U.S. Individual interviews were audio recorded and transcribed. Narratives were analyzed using a hermeneutic phenomenological approach. Five themes emerged from the data: Our New Normal; The Rules Keep Changing; I’m Not Ready for This (transition to practice); The Toll of COVID; and Shattered Family-Centered Care. Sub-themes emerged in The Toll of COVID theme: COVID and the Nursing Care Environment, Emotional Toll of COVID, Burnout: A Universal Truth, and The Pandemic within the Pandemic. The nurse residents’ narratives uncovered the essence of their uncertainty, sorrow, growth, and resilience. Through the eyes of pediatric nurse residents, this study illuminated the experiences of these novices as they entered the nursing profession amid a pandemic.
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(This article belongs to the Section Nursing)
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Open AccessCase Report
Congenital Complete Heart Block—To Stimulate (When?) or Not to Stimulate?
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Piotr Kukla, Beata Podlejska and Jerzy Wiliński
Healthcare 2024, 12(12), 1158; https://doi.org/10.3390/healthcare12121158 - 7 Jun 2024
Abstract
This article presents the case of a 27-year-old female patient with idiopathic congenital complete heart block who does not consent to the implantation of a cardiac pacemaker but was referred by her primary care physician for cardiological evaluation. The conduction disturbance was recognized
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This article presents the case of a 27-year-old female patient with idiopathic congenital complete heart block who does not consent to the implantation of a cardiac pacemaker but was referred by her primary care physician for cardiological evaluation. The conduction disturbance was recognized at the age of 6 and was asymptomatic. The professional disqualification from pacemaker implantation included a detailed history of a patient’s symptoms, an echocardiographic assessment of the heart, exercise testing and ECG Holter monitoring. The aid of salbutamol administered orally was also useful.
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(This article belongs to the Section Chronic Care)
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Open AccessArticle
Secondary Prevention via Case Managers in Stroke Patients: A Cost-Effectiveness Analysis of Claims Data from German Statutory Health Insurance Providers
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Juliane A. Duevel, Sebastian Gruhn, John Grosser, Svenja Elkenkamp and Wolfgang Greiner
Healthcare 2024, 12(11), 1157; https://doi.org/10.3390/healthcare12111157 - 6 Jun 2024
Abstract
Strokes remain a leading cause of death and disability worldwide. The STROKE OWL study evaluated a novel case management approach for patients with stroke (modified Rankin Scale 0–4) or transient ischemic attack (TIA) who received support across healthcare settings and secondary prevention training
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Strokes remain a leading cause of death and disability worldwide. The STROKE OWL study evaluated a novel case management approach for patients with stroke (modified Rankin Scale 0–4) or transient ischemic attack (TIA) who received support across healthcare settings and secondary prevention training from case managers for one year. The primary aim of this quasi-experimental study was a reduction in stroke recurrence. Here, we report the results of a health economic analysis of the STROKE OWL study, conducted in accordance with CHEERS guidelines. The calculations were based on claims data of cooperating statutory health insurance companies. In addition to a regression analysis for cost comparison, the incremental cost-effectiveness ratio was determined, and a probabilistic sensitivity analysis was carried out. In total, 1167 patients per group were included in the analysis. The intervention group incurred 32.3% higher direct costs (p < 0.001) than the control group. With a difference of EUR 1384.78 (95% CI: [1.2384–1.4143], p < 0.0001) and a 5.32% increase in hazards for the intervention group (HR = 1.0532, 95% CI: [0.7869–1.4096], p = 0.7274) resulting in an ICER of EUR 260.30, we found that the case management intervention dominated in the total stroke population, even for an arbitrarily high willingness to pay. In the TIA subgroup, however, the intervention was cost-effective even for a low willingness to pay. Our results are limited by small samples for both TIA and severe stroke patients and by claims data heterogeneity for some cost components, which had to be excluded from the analysis. Future research should investigate the cost-effectiveness of case management interventions for both severe stroke and TIA populations using appropriate data.
Full article
(This article belongs to the Special Issue Healthcare Management and Health Economics)
Open AccessSystematic Review
Effects of Visual Art Therapy on Positive Symptoms, Negative Symptoms, and Emotions in Individuals with Schizophrenia: A Systematic Review and Meta-Analysis
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Shih-Cing Du, Chih-Yen Li, Ya-Yun Lo, Yu-Hsuan Hu, Chi-Wei Hsu, Chung-Yin Cheng, Tzu-Ting Chen, Pei-Hsuan Hung, Pao-Yen Lin and Chyi-Rong Chen
Healthcare 2024, 12(11), 1156; https://doi.org/10.3390/healthcare12111156 - 6 Jun 2024
Abstract
Schizophrenia is characterized by psychiatric symptoms and emotional issues. While pharmacological treatments have limitations, non-pharmacological interventions are essential. Art therapy has the potential to enhance emotional expression, communication, and health; however, the effectiveness of visual art therapy remains uncertain. This systematic review and
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Schizophrenia is characterized by psychiatric symptoms and emotional issues. While pharmacological treatments have limitations, non-pharmacological interventions are essential. Art therapy has the potential to enhance emotional expression, communication, and health; however, the effectiveness of visual art therapy remains uncertain. This systematic review and meta-analysis synthesizes the findings of randomized controlled trials (RCTs) of visual art therapy on positive symptoms, negative symptoms, and emotions in patients with schizophrenia. This study reviews RCTs published prior to February, 2024. The PubMed, Embase, Cochrane Library, CEPS, CNKI, Wanfang, and Yiigle databases were searched, and three independent researchers screened the studies. In this meta-analysis, standardized mean difference (SMD) was employed as a measure to calculate effect sizes for continuous variables using a random effects model, while the meta-regression and subgroup analyses were performed with patient and intervention characteristics. A total of 31 studies revealed visual art therapy had a significant small-to-moderate effect on positive symptoms (SMD = 0.407, 95% CI 0.233 to 0.581), a moderate effect on negative symptoms (SMD = 0.697, 95% CI 0.514 to 0.880), a moderate effect on depression (SMD = 0.610, 95% CI 0.398 to 0.821), and a large effect on anxiety (SMD = 0.909, 95% CI 0.386 to 1.433). The subgroup analysis revealed painting and handcrafts had significant effects on positive symptoms, negative symptoms, and emotions. Combined Chinese calligraphy and painting had significant effects on positive symptoms, depression, and anxiety. Better improvement was noted among the Asian population, and a longer weekly treatment duration was associated with better improvement in positive symptoms. Female participants tended to have more improvements in negative symptoms and anxiety through visual art therapy. The results indicate that visual art therapy has positive effects on the psychiatric symptoms and emotions of individuals with schizophrenia. We recommend future research further investigate art therapy modalities and durations.
Full article
(This article belongs to the Special Issue Biological and Clinical Aspects of the Treatment of Schizophrenia and Related Disorders: Second Edition)
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Open AccessStudy Protocol
Factors Influencing Dementia Care Competence among Care Staff: A Mixed-Methods Systematic Review Protocol
by
Jinfeng Zhu, Jing Wang, Bo Zhang, Xi Zhang and Hui Wu
Healthcare 2024, 12(11), 1155; https://doi.org/10.3390/healthcare12111155 - 6 Jun 2024
Abstract
Background: Dementia care competence is defined as the ability, acquired through practical experience, to deliver high-quality care services to persons with dementia (PWD). However, many studies only focus on one aspect of competence using qualitative or quantitative research design and have small sample
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Background: Dementia care competence is defined as the ability, acquired through practical experience, to deliver high-quality care services to persons with dementia (PWD). However, many studies only focus on one aspect of competence using qualitative or quantitative research design and have small sample sizes of care staff with dementia. This study aims to conduct a mixed-methods systematic review of the factors influencing the competence of dementia care staff, and explore the relationship between these factors and competence. Methods: This review was designed following the PRISMA-P 2015 statement and methodological guidance for the conduct of mixed-methods systematic reviews from the Joanna Briggs Institute (JBI). Seven English and four Chinese databases will be searched to systematically review the existing eligible studies. JBI Critical Appraisal Checklist for Qualitative Research and Analytical Cross-Sectional Studies will be used to assess the methodological quality of each study. A JBI Mixed-Methods Data Extraction Form will be applied for data extraction. The JBI convergent integrated approach will be used for data synthesis and integration. The synthesized findings will be graded according to the JBI ConQual approach as high, moderate, low, or very low. The protocol was registered with PROSPERO in October 2023 (CRD42023474093).
Full article
(This article belongs to the Topic Establishing Professional Competency and Talent Cultivation Strategies in the Post-Pandemic Generation Based on the Sustainability Education Development)
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Open AccessArticle
Impact of Social Capital on Health Behaviors of Middle-Aged and Older Adults in China—An Analysis Based on CHARLS2020 Data
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Zheyu Wang, Yong Fang and Xingwei Zhang
Healthcare 2024, 12(11), 1154; https://doi.org/10.3390/healthcare12111154 - 6 Jun 2024
Abstract
To actively respond to the challenges posed by population aging, people are paying more and more attention to healthy behavioral lifestyles, and the impact of social capital as an informal system on health behaviors cannot be ignored. This paper explores the impact of
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To actively respond to the challenges posed by population aging, people are paying more and more attention to healthy behavioral lifestyles, and the impact of social capital as an informal system on health behaviors cannot be ignored. This paper explores the impact of social capital on health behaviors of middle-aged and older adults based on 2020 CHARLS data. Using binary logistic regression models, we discussed the association between social capital and five health behaviors. The results suggest that structural social capital significantly increases physical activity and physical examination behaviors among middle-aged and older adults but also decreases the probability of abstinence behaviors. Cognitive social capital increases the probability that middle-aged and older adults will have a reasonable amount of sleep and physical activity. However, it also decreases the probability that smoking cessation behaviors will occur. Further attention needs to be paid to the role of social capital, the creation of a harmonious social environment and the enhancement of social trust, the strengthening of communities and grass-roots social organizations, and the provision of more platforms for the participation of middle-aged and older adults in social activities, to improve the quality of the healthy lives of middle-aged and older adults and, in turn, to promote the establishment of healthy behaviors.
Full article
(This article belongs to the Special Issue Aging and Quality of Life)
Open AccessArticle
Understanding the Impact of the COVID-19 Pandemic on Mental Health among a Sample of University Workers in the United Arab Emirates
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Anamika V. Misra, Heba M. Mamdouh, Anita Dani, Vivienne Mitchell, Hamid Y. Hussain, Gamal M. Ibrahim, Reham Kotb and Wafa K. Alnakhi
Healthcare 2024, 12(11), 1153; https://doi.org/10.3390/healthcare12111153 - 6 Jun 2024
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Research on the mental health of university staff during the COVID-19 pandemic has uncovered a high prevalence of probable anxiety, depression, and post-traumatic stress disorder among academic and non-academic staff in many parts of the world. This study aimed to assess the prevalence
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Research on the mental health of university staff during the COVID-19 pandemic has uncovered a high prevalence of probable anxiety, depression, and post-traumatic stress disorder among academic and non-academic staff in many parts of the world. This study aimed to assess the prevalence of anxiety, depressive symptoms, and resilience among a sample of faculty and staff members working in the Higher College of Technology campuses in the UAE. From September to November 2021, a cross-sectional study was carried out using an online survey. The Generalized Anxiety Disorder 7-item scale, The Patient Health Questionnaire (9-items), and the Connor–Davidson Resilience Scale were used to assess anxiety, depression, and resilience. The impact of COVID-19 was assessed using a designated list of questions. The results demonstrated that the COVID-19 pandemic had impacted the mental health of the studied sample of university workers, with almost 16% of the participants having moderate-to-severe depression and anxiety symptoms. This study highlighted significant differences in the participants’ depressive and anxiety symptoms due to sociodemographic differences. Depression and anxiety symptoms were most prevalent among females, those of UAE nationality, and never-married workers, with females scoring 5.81 on the PHQ-9 compared to only 4.10 in males, p = 0.004 *. UAE-national participants had significantly higher mean PHQ-9 scores than their non-national counterparts (6.37 ± 5.49 SD versus 4.77 ± 5.1 SD, respectively, p = 0.040 *). Overall, the total mean scores of all participants were below the assumed cut-off threshold of having a high resilience level (29.51 ± 7.53 SD). The results showed a significant difference in severe depression symptoms as a result of the impact of COVID-19. These results could imply that the COVID-19 pandemic might have augmented negative mental health impacts on this sample of university workers. This study highlighted some areas where the responsible authorities can intervene to further protect and enhance the mental health of university workers, particularly after the COVID-19 pandemic.
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Open AccessArticle
Psychometric Properties of the Knowledge of Hydration among Foreign Students of Óbuda University, Hungary
by
Melvin Omone Ogbolu, Olanrewaju D. Eniade, Miklós Vincze and Miklós Kozlovszky
Healthcare 2024, 12(11), 1152; https://doi.org/10.3390/healthcare12111152 - 6 Jun 2024
Abstract
It is known that the quantity, makeup, and distribution of bodily fluids have a significant impact on the cognitive health, physiological health, and cell activity of human beings. This narrative could be influenced by the level of knowledge about hydration, dehydration, and the
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It is known that the quantity, makeup, and distribution of bodily fluids have a significant impact on the cognitive health, physiological health, and cell activity of human beings. This narrative could be influenced by the level of knowledge about hydration, dehydration, and the practice of Adequate Water Intake (AWI) of an individual based on the recommended daily Total Water Intake (TWI) by either the World Health Organization (WHO) or the European Food Safety Authority (EFSA). In this study, we have developed and validated a scale to adequately measure knowledge of the recommended daily Total Water Intake (TWI) practices among foreign students at Óbuda University, Hungary. Hence, we implemented an 11-item scale to measure the Knowledge of Hydration (KH-11) and evaluate its psychometric properties among students. This study is an online cross-sectional study assessing water intake knowledge with the use of the KH-11 tool among 323 students with ages ranging from 18 to 35 years, who have enrolled for at least two semesters at the University. The statistical analysis performed was reliability (using Cronbach alpha ≥ 70%) and factor analysis. Knowledge levels were categorized as poor (<50%), intermediate (50–70%), or adequate (71–100%). The intraclass correlation, chi-square, and rotated component matrix were also estimated and reported. Data were analyzed using SPSS version 25. Cronbach’s alpha analysis revealed that the KH-11 had an overall good reliability with a value of 0.80, where the survey items had an acceptable level of consistency ranging from 0.75 to 0.81 and demonstrated sufficient independence from each other as Pearson’s R within factors was positive and ranged from 0.02 to 0.74. In evaluating the participants’ knowledge of hydration, the total possible score for the scale is 72, while the mean score for the KH-11 was 55.2 ± 11.61 SD, and the factor analysis model yielded an acceptable fit (χ2 = 3259.4, p = 0.000). We recorded a high-level positive concordance of 0.770 with an average intraclass correlation of 0.80 at a 95% CI, where p-value = 0.000. Our findings show that the majority (66.3%) of the students have a good knowledge of hydration. However, the skewed distribution of the knowledge scores suggests that some may have lower levels of knowledge, which may warrant further study to improve knowledge in those students.
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(This article belongs to the Section Nutrition and Public Health)
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Open AccessArticle
Lifestyle Medicine in Focus: A Cross-Sectional Study Comparing Domestic and International Students
by
Eszter Kovács, Viktor Rekenyi, Anna Nánási, Csongor István Szepesi, Putu Ayu Indrayathi, Nóra Horváth, Angéla Csirmaz, Gréta Marjai and Kolozsvári László Róbert
Healthcare 2024, 12(11), 1151; https://doi.org/10.3390/healthcare12111151 - 6 Jun 2024
Abstract
This study investigated lifestyle factors among Hungarian and international students, utilizing lifestyle medicine principles to enhance overall well-being. Conducted at the University of Debrecen through a cross-sectional survey, we examined selected lifestyle factors, more specifically sleep patterns, weight management, nutrition, physical activity, mental
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This study investigated lifestyle factors among Hungarian and international students, utilizing lifestyle medicine principles to enhance overall well-being. Conducted at the University of Debrecen through a cross-sectional survey, we examined selected lifestyle factors, more specifically sleep patterns, weight management, nutrition, physical activity, mental well-being, and alcohol use. Hungarian (N = 122) and international (N = 139) students were compared, revealing significant differences. Hungarian students slept less (p = 0.041), desired weight loss (p = 0.040), ate more fruits and vegetables (p = 0.014), exercised longer (p = 0.002), and reported higher purpose and social support (p = 0.009), with higher alcohol use (p < 0.001). These findings highlight distinct experiences and challenges faced by these student groups including variations in sleep, weight management, diet, exercise, and social support. Targeted interventions and tailored support are essential to address their specific needs. To promote the well-being of both Hungarian and international students, educational programs addressing various facets of a healthy lifestyle are crucial. This study offers valuable insights into lifestyle factors and health outcomes among Hungarian and international students and underscores the importance of addressing the unique needs of each group through tailored interventions.
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Open AccessArticle
The Prevalence of Duplicate Prescription of Oral Antibiotic Drugs in Outpatient Care among People Insured by Corporate Health Insurance Societies in Japan
by
Kenichi Fujimoto and Shinichi Tanihara
Healthcare 2024, 12(11), 1150; https://doi.org/10.3390/healthcare12111150 - 5 Jun 2024
Abstract
Inappropriate antimicrobial use is a global problem, especially because the use of antimicrobials in excess of appropriate doses is associated with increased antimicrobial resistance. Duplicate prescriptions are an issue contributing to inappropriate antimicrobial use. This study aimed to analyse antibiotic prescriptions during a
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Inappropriate antimicrobial use is a global problem, especially because the use of antimicrobials in excess of appropriate doses is associated with increased antimicrobial resistance. Duplicate prescriptions are an issue contributing to inappropriate antimicrobial use. This study aimed to analyse antibiotic prescriptions during a specific month to examine the frequency of outpatients receiving duplicate antibiotic prescriptions and the associated determinants. Utilizing the Japan Medical Data Centre health insurance claim database, we retrospectively identified 527,110 insured individuals with at least one medicine prescription in October 2014. Data regarding age, gender, antibiotic drug usage, and health insurance status were extracted. Duplicate prescriptions entailed a patient receiving two or more prescriptions of systemic antibiotics from multiple facilities within one month. The risk factors for duplicate antibiotic prescriptions were evaluated using logistic regression analysis. Of the total sample, 131,709 individuals (25.0%) received antibiotics, and 24,529 of these individuals (18.6%) had duplicate prescriptions. Third-generation cephalosporins accounted for the largest proportion of prescriptions (37.4%). Duplicate prescriptions were significantly associated with sex, age, medical facilities, and health insurance status. These findings could help to identify patients at risk of duplicate antibiotic prescriptions, highlighting the need to promote proper antimicrobial use in both patients and medical professionals.
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(This article belongs to the Section Health Policy)
Open AccessPerspective
Epistemological Flexibility in Person-Centered Care: The Cynefin Framework for (Re)Integrating Indigenous Body Representations in Manual Therapy
by
Rafael Zegarra-Parodi, Giandomenico D’Alessandro, Francesca Baroni, Jaris Swidrovich, Lewis Mehl-Madrona, Travis Gordon, Luigi Ciullo, Emiliano Castel and Christian Lunghi
Healthcare 2024, 12(11), 1149; https://doi.org/10.3390/healthcare12111149 - 5 Jun 2024
Abstract
Background: Chiropractic, osteopathy, and physiotherapy (COP) professionals regulated outside the United States traditionally incorporate hands-on procedures aligned with their historical principles to guide patient care. However, some authors in COP research advocate a pan-professional, evidence-informed, patient-centered approach to musculoskeletal care, emphasizing hands-off management
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Background: Chiropractic, osteopathy, and physiotherapy (COP) professionals regulated outside the United States traditionally incorporate hands-on procedures aligned with their historical principles to guide patient care. However, some authors in COP research advocate a pan-professional, evidence-informed, patient-centered approach to musculoskeletal care, emphasizing hands-off management of patients through education and exercise therapy. The extent to which non-Western sociocultural beliefs about body representations in health and disease, including Indigenous beliefs, could influence the patient–practitioner dyad and affect the interpretation of pillars of evidence-informed practice, such as patient-centered care and patient expectations, remains unknown. Methods: our perspective paper combines the best available evidence with expert insights and unique viewpoints to address gaps in the scientific literature and inform an interdisciplinary readership. Results: A COP pan-professional approach tends to marginalize approaches, such as prevention-oriented clinical scenarios traditionally advocated by osteopathic practitioners for patients with non-Western sociocultural health assumptions. The Cynefin framework was introduced as a decision-making tool to aid clinicians in managing complex clinical scenarios and promoting evidence-informed, patient-centered, and culturally sensitive care. Conclusion: Epistemological flexibility is historically rooted in osteopathic care, due to his Indigenous roots. It is imperative to reintroduce conceptual and operative clinical frameworks that better address contemporary health needs, promote inclusion and equality in healthcare, and enhance the quality of manual therapy services beyond COP’s Western-centered perspective.
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(This article belongs to the Section Chronic Care)
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