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
How Professional and Market Logics and the Conflict between Institutional Demands Affect Hospital Accreditation Compliance: A Multiple-Case Study in Brazil
Healthcare 2024, 12(9), 914; https://doi.org/10.3390/healthcare12090914 (registering DOI) - 27 Apr 2024
Abstract
Hospital accreditation has become ubiquitous in developing countries. While research acknowledges that accreditation can enhance healthcare quality, efficiency, and safety, concerns persist regarding hospitals’ management of conflicts stemming from the diverse institutional logic inherent in this process. Therefore, this study aimed to investigate
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Hospital accreditation has become ubiquitous in developing countries. While research acknowledges that accreditation can enhance healthcare quality, efficiency, and safety, concerns persist regarding hospitals’ management of conflicts stemming from the diverse institutional logic inherent in this process. Therefore, this study aimed to investigate how professional and market logic, alongside conflicts arising from institutional demands, affect compliance with hospital accreditation. To this end, we conducted a multiple-case study in four Brazilian hospitals employing in-depth interviews and on-site observations. The triangulation of narrative analysis and the outcomes of multiple correspondence analysis revealed that when professional logic predominates, there is a greater propensity to tailor accredited activities by segmenting the tasks between physicians and nurses with the intention of mitigating existing conflicts. Conversely, when conflicts occur over established goals between professionals and orientated marked logic executives, the accreditation process is impeded, resulting in non-compliance. Ultimately, the findings underscore the alignment between the pursuit of legitimacy and efficiency within the accreditation process. We conclude by delineating the theoretical and practical implications of scrutinizing the internal dynamics of institutional logic.
Full article
(This article belongs to the Section Healthcare Quality and Patient Safety)
Open AccessArticle
Differentiating Pressure Ulcer Risk Levels through Interpretable Classification Models Based on Readily Measurable Indicators
by
Eugenio Vera-Salmerón, Carmen Domínguez-Nogueira, José A. Sáez, José L. Romero-Béjar and Emilio Mota-Romero
Healthcare 2024, 12(9), 913; https://doi.org/10.3390/healthcare12090913 (registering DOI) - 27 Apr 2024
Abstract
Pressure ulcers carry a significant risk in clinical practice. This paper proposes a practical and interpretable approach to estimate the risk levels of pressure ulcers using decision tree models. In order to address the common problem of imbalanced learning in nursing classification datasets,
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Pressure ulcers carry a significant risk in clinical practice. This paper proposes a practical and interpretable approach to estimate the risk levels of pressure ulcers using decision tree models. In order to address the common problem of imbalanced learning in nursing classification datasets, various oversampling configurations are analyzed to improve the data quality prior to modeling. The decision trees built are based on three easily identifiable and clinically relevant pressure ulcer risk indicators: mobility, activity, and skin moisture. Additionally, this research introduces a novel tabular visualization method to enhance the usability of the decision trees in clinical practice. Thus, the primary aim of this approach is to provide nursing professionals with valuable insights for assessing the potential risk levels of pressure ulcers, which could support their decision-making and allow, for example, the application of suitable preventive measures tailored to each patient’s requirements. The interpretability of the models proposed and their performance, evaluated through stratified cross-validation, make them a helpful tool for nursing care in estimating the pressure ulcer risk level.
Full article
(This article belongs to the Section Artificial Intelligence in Medicine)
Open AccessArticle
Risk Factors for Overweight and Obesity in Later School-Aged Children: Focus on Lifestyle Behaviours and Psychosocial Characteristics
by
Yong-Sook Eo and Myo-Sung Kim
Healthcare 2024, 12(9), 912; https://doi.org/10.3390/healthcare12090912 (registering DOI) - 27 Apr 2024
Abstract
The study analysed the 12th wave (2019) of data from the Panel Study on Korean Children conducted by the Korea Institute of Child Care and Education. A total of 1174 children were selected as the subjects of the study. The results concerning the
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The study analysed the 12th wave (2019) of data from the Panel Study on Korean Children conducted by the Korea Institute of Child Care and Education. A total of 1174 children were selected as the subjects of the study. The results concerning the identifying factors influencing overweight and obesity in later school-aged children revealed that when compared to boys, girls were 1.66 times more likely to be overweight or obese. Moreover, for every one-hour increase in media usage time, the likelihood of being overweight or obese increased by 1.23 times, and for every one-point increase in body dissatisfaction, the probability of being overweight or obese increased by 2.07 times. However, among personality traits, neuroticism was associated with a 0.96 times lower likelihood of being overweight or obese. These findings underscore the significance of considering not only lifestyle factors but also psychosocial characteristics such as body dissatisfaction and neuroticism as predictive factors for overweight and obesity in later school-aged children, providing a basis for intervention.
Full article
(This article belongs to the Special Issue Interventions for Preventing Obesity in Children and Adolescents)
Open AccessArticle
Benefit or Problem: Exploration of How Response Options Affect Self-Reported Behaviors and Interests in Autistic Adults
by
Hyein Lee, Nikita Jadav, Ellen Wilkinson and Vanessa H. Bal
Healthcare 2024, 12(9), 911; https://doi.org/10.3390/healthcare12090911 (registering DOI) - 27 Apr 2024
Abstract
Assessment of restricted, repetitive behaviors (RRB) in autism evaluations often assumes that these behaviors negatively impact the individual. Qualitative studies of first-person accounts indicate the negative impact of the stigma associated with RRBs but also provide insights into the positive aspects. The current
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Assessment of restricted, repetitive behaviors (RRB) in autism evaluations often assumes that these behaviors negatively impact the individual. Qualitative studies of first-person accounts indicate the negative impact of the stigma associated with RRBs but also provide insights into the positive aspects. The current study explores how framing response options as negative (i.e., level of problem associated with occurrence) or positive (i.e., level of benefit associated with occurrence) affects RRB self-reports in autistic adults. Sixty-six autistic adults aged 18–59 filled out the Repetitive Behavior Scale-Revised (RBS-R) and a modified RBS-R+, assessing problems and benefits of reported behaviors, respectively. There was a moderate to strong correlation between the forms, each assessing problems and benefits in terms of the number of behaviors endorsed (r = 0.746) and the levels of benefits and problems (r = 0.637). Autistic adults reported a higher number of RRBs in the form that assessed problems, but the number of behaviors was comparable between the forms when counting in the response option of the occurrence of behavior without having a benefit. Despite some variability in the level of problems and the benefits across the subdomains of RRB, autistic adults largely rated comparable levels of associated benefits and problems, highlighting the complexity of RRBs as having both positive and negative impacts. Future screening and diagnostic tools for adults should aim to assess both positive and negative aspects of autistic features to afford a more nuanced understanding of individual experiences while still yielding diagnostically relevant information. Qualitative studies are needed to better understand the complex experiences associated with these behaviors; however, it may be important to ensure that options for endorsement of behaviors without a specific benefit are also needed to ensure some behaviors (e.g., self-injurious behaviors) are not missed.
Full article
(This article belongs to the Special Issue Autism beyond School-Age: Characterization, Intervention, and Community Support)
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Open AccessOpinion
Measurement-Based Care in Youth: An Opportunity for Better Clinical Outcomes?
by
Roberta Frontini, Catarina Costa, Sílvia Baptista, Constança do Carmo Garcia and António Vian-Lains
Healthcare 2024, 12(9), 910; https://doi.org/10.3390/healthcare12090910 (registering DOI) - 27 Apr 2024
Abstract
Measurement-based care (MBC) is a procedure in which systematic and routine assessments are performed. Through this practice, clinicians can verify the progress of the symptomatology of the patient and adapt the appointments and the intervention to the current symptoms. Studies have reflected on
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Measurement-based care (MBC) is a procedure in which systematic and routine assessments are performed. Through this practice, clinicians can verify the progress of the symptomatology of the patient and adapt the appointments and the intervention to the current symptoms. Studies have reflected on the importance and the benefits of this type of procedure in the adult population, and have shown positive results. However, there is a lack of evidence concerning the remaining populations. Regarding youth, for instance, few articles have evaluated the benefits of using this procedure in clinical practice. However, research focused on this topic has revealed positive results, especially when clinicians were loyal to the MBC procedures. Still, further research is needed. This letter aims to share the methodology used by our multidisciplinary team, composed of psychologists and psychiatrists, in a clinical context at the Hospital Cruz Vermelha, Lisboa, applied to the adult population; the objective is to share and discuss some alterations that could be made to our evaluation protocol to enable the same to be used with the youth population. We believe that implementing MBC for youth is crucial for several reasons, including enhanced treatment efficacy, more personalized treatment, a reduced reliance on subjectivity, and empowerment not only of patients but also families.
Full article
Open AccessArticle
Hazard Flagging as a Risk Mitigation Strategy for Violence against Emergency Medical Services
by
Justin Mausz, Dan Piquette, Robert Bradford, Mandy Johnston, Alan M. Batt and Elizabeth A. Donnelly
Healthcare 2024, 12(9), 909; https://doi.org/10.3390/healthcare12090909 (registering DOI) - 27 Apr 2024
Abstract
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Paramedics are increasingly being subjected to violence, creating the potential for significant physical and psychological harm. Where a patient has a history of violent behavior, hazard flags—applied either to the individual, their residential address, or phone number—can alert paramedics to the possibility of
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Paramedics are increasingly being subjected to violence, creating the potential for significant physical and psychological harm. Where a patient has a history of violent behavior, hazard flags—applied either to the individual, their residential address, or phone number—can alert paramedics to the possibility of violence, potentially reducing the risk of injury. Leveraging a novel violence reporting process embedded in the electronic patient care record, we reviewed violence reports filed over a thirteen-month period since its inception in February 2021 to assess the effectiveness of hazard flagging as a potential risk mitigation strategy. Upon reviewing a report, paramedic supervisors can generate a hazard flag if recurrent violent behavior from the patient is anticipated. In all, 502 violence reports were filed, for which paramedic supervisors generated hazard flags in 20% of cases (n = 99). In general, cases were not flagged either because the incident occurred at a location not amenable to flagging or because the supervisors felt that a hazard flag was not warranted based on the details in the report. Hazard flagging was associated with an increased risk of violence during subsequent paramedic attendance (Odds Ratio [OR] 6.21, p < 0.001). Nevertheless, the process appears to reliably identify persons who may be violent towards paramedics.
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Open AccessReview
Implementing Trauma-Informed Care—Settings, Definitions, Interventions, Measures, and Implementation across Settings: A Scoping Review
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Lene Lauge Berring, Tine Holm, Jens Peter Hansen, Christian Lie Delcomyn, Rikke Søndergaard and Jacob Hvidhjelm
Healthcare 2024, 12(9), 908; https://doi.org/10.3390/healthcare12090908 (registering DOI) - 27 Apr 2024
Abstract
Traumatic experiences can have long-lasting negative effects on individuals, organizations, and societies. If trauma is not addressed, it can create unsafe cultures with constant arousal, untrusting relationships, and the use of coercive measures. Trauma-informed care (TIC) can play a central role in mitigating
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Traumatic experiences can have long-lasting negative effects on individuals, organizations, and societies. If trauma is not addressed, it can create unsafe cultures with constant arousal, untrusting relationships, and the use of coercive measures. Trauma-informed care (TIC) can play a central role in mitigating these negative consequences, but it is unknown how and in which way(s) TIC should be implemented. Our objective was to conduct a scoping review that systematically explored and mapped research conducted in this area and to identify existing knowledge about the implementation of TIC. The search was conducted on the CINAHL, Cochrane, Embase, ERIC, Medline, PsycINFO, and Web of Science databases, and more than 3000 empirical papers, published between 2000 and 2022, were identified. Following further screening, we included 157 papers in our review, which were mainly from the USA, Australia, New Zealand, and Canada, focusing on study settings, methodologies, and definitions of TIC, as well as the types of interventions and measures used. This review shows that TIC is a complex and multifaceted framework, with no overarching structure or clear theoretical underpinnings that can guide practical implementations. TIC has been defined and adapted in varied ways across different settings and populations, making it difficult to synthesize knowledge. A higher level of agreement on how to operationalize and implement TIC in international research could be important in order to better examine its impact and broaden the approach.
Full article
(This article belongs to the Topic Global Mental Health Trends)
Open AccessArticle
General, Vaccination, Navigational and Digital Health Literacy of Students Enrolled in Different Medical and Health Educational Programs
by
Gaukhar Kayupova, Aliya Takuadina, Zhanerke Bolatova, Zhaniya Dauletkaliyeva, Nurbek Yerdessov, Karina Nukeshtayeva and Olzhas Zhamantayev
Healthcare 2024, 12(9), 907; https://doi.org/10.3390/healthcare12090907 (registering DOI) - 26 Apr 2024
Abstract
Evaluating prospective graduates’ health literacy profiles before they enter the job market is crucial. Our research aimed to explore the health literacy levels of medical and health students by assessing their ability to obtain health-related information, understand healthcare systems, use e-health, and be
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Evaluating prospective graduates’ health literacy profiles before they enter the job market is crucial. Our research aimed to explore the health literacy levels of medical and health students by assessing their ability to obtain health-related information, understand healthcare systems, use e-health, and be informed about vaccination as well as to explore the factors associated with health literacy. Short versions of the HLS19-Q12 were used for a cross-sectional survey that was carried out among 1042 students enrolled in various medical and health educational programs at three medical universities in Kazakhstan between September and November of 2023. Additionally, instruments such as Digital Health Literacy (HLS19-DIGI), Navigational Health Literacy (HLS19-NAV), and Vaccination Health Literacy (HLS19-VAC) were employed. The score of General Health Literacy was 88.26 ± 17.5. One in eight students encountered difficulties in Vaccination Health Literacy. Despite overall high health literacy, Navigational Health Literacy posed challenges for all students. The Public Health students exhibited the highest General Health Literacy (91.53 ± 13.22), followed by students in Nursing, General Medicine, other educational programs (Dentistry and Biomedicine) and Pharmacy. Financial constraints for medication and medical examinations significantly influenced health literacy across all types of individuals. Since comprehensive health literacy instruction or interventions are still uncommon in the curricula, it seems reasonable to develop and incorporate appropriate courses for medical and health educational programs.
Full article
Open AccessArticle
Factors Associated with Evidence-Based Practice Competencies among Taiwanese Nurses: A Cross-Sectional Study
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Li-Chuan Cheng, Chia-Jung Chen, Shih-Chun Lin and Malcolm Koo
Healthcare 2024, 12(9), 906; https://doi.org/10.3390/healthcare12090906 (registering DOI) - 26 Apr 2024
Abstract
Evidence-based practice (EBP) is an essential component of healthcare practice that ensures the delivery of high-quality care by integrating the best available evidence. This study aimed to explore factors influencing EBP among nursing professionals in Taiwan. A cross-sectional survey study was conducted with
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Evidence-based practice (EBP) is an essential component of healthcare practice that ensures the delivery of high-quality care by integrating the best available evidence. This study aimed to explore factors influencing EBP among nursing professionals in Taiwan. A cross-sectional survey study was conducted with 752 registered nurses and nurse practitioners recruited from a regional teaching hospital in southern Taiwan. EBP competency was evaluated using the Taipei Evidence-Based Practice Questionnaire (TEBPQ). The results showed that participation in evidence-based courses or training within the past year had the strongest association with EBP competencies (Std. B = 0.157, p < 0.001). Holding a graduate degree (Std. B = 0.151, p < 0.001), working in gynecology or pediatrics (Std. B = 0.126, p < 0.001), searching the literature in electronic databases (Std. B = 0.072, p = 0.039), and able to read academic articles in English (Std. B = 0.088, p = 0.005) were significantly associated with higher TEBPQ scores. Younger age (Std. B = −0.105, p = 0.005) and male gender (Std. B = 0.089, p = 0.010) were also identified as factors contributing to higher EBP competencies. The study highlights the importance of ongoing professional development, including EBP training and language proficiency, in enhancing EBP competencies among nursing professionals in Taiwan.
Full article
(This article belongs to the Special Issue Research, Education, Workforce, and Regulation to Transforming Nursing Practice and Leadership: The Future of Nursing)
Open AccessArticle
Assessing the Knowledge of HPV-Associated Oropharyngeal Squamous Cell Carcinoma, HPV Vaccination, and Practice Scope among Saudi Dental Students in the Western Region
by
Maha T. Alsharif and Elham Alsahafi
Healthcare 2024, 12(9), 905; https://doi.org/10.3390/healthcare12090905 (registering DOI) - 26 Apr 2024
Abstract
(1) Background: Human papillomavirus (HPV) infection is significantly associated with oropharyngeal squamous cell carcinoma (HPV-OPSCC), which is one of the fastest-growing cancer incidences globally. Dental practitioners play a crucial role in the primary and secondary prevention of HPV-OPSCC. There is little known about
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(1) Background: Human papillomavirus (HPV) infection is significantly associated with oropharyngeal squamous cell carcinoma (HPV-OPSCC), which is one of the fastest-growing cancer incidences globally. Dental practitioners play a crucial role in the primary and secondary prevention of HPV-OPSCC. There is little known about dental students’ awareness regarding HPV-OPSCC and HPV vaccination, as well as their intention to promote ‘primordial prevention’ among their patients. HPV vaccine, and the extent of their professional responsibilities. (2) Methods: This cross-sectional study was conducted in the western region of Saudi Arabia and involved undergraduate dental students (n = 688) from six public and private dental schools. Participants were requested to complete a sequential-section anonymous online survey, with 257 successfully completing all sections of the questionnaire. The association between participant characteristics and HPV-OPSCC, HPV vaccination awareness ratings, and perceived engagement in prevention were analyzed using ANOVA and chi-squared testing. A binary logistic regression analysis was conducted to examine the variables linked to these outcomes. (3) Results: Generally, the overall level of awareness of HPV-OPSCC and HPV vaccination was acceptable, with an average score of 53.44 ± 29.3 out of 100. However, a significant knowledge gap was observed, with 53% of respondents being unaware of the common sites for HPV-OPSCC and 63.8% being uninformed of the appropriate age for HPV vaccination. Females and those with a prior history of sexually transmitted diseases (STDs) had considerably higher levels of HPV vaccination knowledge (p < 0.05). The participants showed a favorable attitude towards their responsibility of informing patients about HPV-OPSCC and advocating HPV immunization. (4) Conclusions: This study underscores the need to enhance dental students’ understanding of HPV-OPSCC and HPV immunization, enabling them to effectively engage in primary and secondary preventative efforts against HPV-OPSCC.
Full article
(This article belongs to the Section Preventive Medicine)
Open AccessArticle
Institutional Surgical Setting and Volume Effects of Certified Arthroplasty Centers in Germany: Evaluation of the Quality of Care in a 5-Year Comparison
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Katrin Osmanski-Zenk, Annett Klinder, Andreas Pingsmann, Christoph H. Lohmann, Hermann Josef Bail, Bernd Kladny and Wolfram Mittelmeier
Healthcare 2024, 12(9), 904; https://doi.org/10.3390/healthcare12090904 (registering DOI) - 26 Apr 2024
Abstract
To improve arthroplasty care quality, the EndoCert initiative focuses on structural, processual, and surgeon-related quality assurance. The aim of this study was to assess the impact of a surgeon’s case load in certified centers on quality of care, distinguished by different types of
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To improve arthroplasty care quality, the EndoCert initiative focuses on structural, processual, and surgeon-related quality assurance. The aim of this study was to assess the impact of a surgeon’s case load in certified centers on quality of care, distinguished by different types of surgeons. Data from the annual reports of EndoCert certified centers for the years 2017 to 2021 were analyzed. The study revealed reduced numbers of cases, while the number of surgeons remained constant. Since 2020, the decrease in the average case load per surgeons has become more pronounced. There were also differences between senior (sECrs) and EndoCert-registered surgeons (ECrs). Before the 2020 pandemic, over half of surgeons exceeded minimum annual case requirements, while, afterwards, this number declined, especially for the ECrs. Affiliated surgeons, who are also sECrs or ECrs, performed predominantly lower numbers of arthroplasties. However, a higher percentage of affiliated surgeons in a center correlated with faster surgeries and lower mortality rates. High numbers of arthroplasties per center or surgeon were not necessarily associated with better quality indicators, especially in the knee. While the comprehensive quality standards may offset volume effects, EndoCert should reconsider minimum volume regulations based on surgeon, but also on each joint.
Full article
Open AccessSystematic Review
Korean Hospital Nurses’ Experiences with COVID-19: A Meta-Synthesis of Qualitative Findings
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Suk-Jung Han, Hee-Jung Hong and Bok-Soon Shin
Healthcare 2024, 12(9), 903; https://doi.org/10.3390/healthcare12090903 (registering DOI) - 26 Apr 2024
Abstract
During the COVID-19 pandemic, hospital nurses in South Korea cared for patients amid their own anxiety and fear of infection, armed with a sense of professional duty and overcoming all odds to end the country’s infectious disease pandemic. This study aims to provide
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During the COVID-19 pandemic, hospital nurses in South Korea cared for patients amid their own anxiety and fear of infection, armed with a sense of professional duty and overcoming all odds to end the country’s infectious disease pandemic. This study aims to provide a meta-synthesis of qualitative studies examining the perceptions and experiences of nurses who cared for patients in dedicated COVID-19 hospitals in South Korea. Electronic databases, including RISS, KISS, KMbase, NDSL, KoreaMed, DBpia, PubMed, CINAHL, and Cochrane, were searched for research published until 2023. The study included research using qualitative approaches. These were reviewed and analyzed using a thematic synthesis approach. The quality of the studies was ascertained using the Critical Appraisal Skills Program checklist for qualitative research. Ultimately, 13 studies involving 219 nurses were included in the final review. Six major themes and thirteen subthemes emerged. The six topics are: “The crisis of a pandemic that suddenly appeared”, “Challenges in nursing patients with infectious diseases”, “A struggle in an unknown time due to a prolonged infectious disease”, “Ethical dilemmas in the face of infectious diseases”, “Duality of the social support system”, and “Professional growth for nurses regarding infectious diseases”. During the unexpected COVID-19 pandemic, nurses were able to overcome difficult situations through their interactions with patients, sense of professional mission, and commitment to nursing. Most importantly, they persevered through their collaboration and closeness with fellow nurses, despite confusion about their professional identity, the ethical dilemmas they faced in patient care, and dual attitudes regarding their social support system. To prepare for future infectious disease outbreaks, a multifaceted support system should be established to enable nurses to have positive interactions with their families, colleagues, and patients, which are central to their resilience.
Full article
(This article belongs to the Collection COVID-19: Impact on Public Health and Healthcare)
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Open AccessArticle
Changes in Mental Health among Japanese University Students during the COVID-19 Era: Differences by College Department, Graduate Level, Sex, and Academic Year
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Emma Underwood, Ryo Horita, Nanako Imamura, Taku Fukao, Miho Adachi, Satoko Tajirika, Ricardo Izurieta and Mayumi Yamamoto
Healthcare 2024, 12(9), 902; https://doi.org/10.3390/healthcare12090902 (registering DOI) - 26 Apr 2024
Abstract
This study compared the effects of academic year, college department, and undergraduate or graduate status on Japanese students’ mental health during the COVID-19 pandemic. From 2021–2023, an online survey was conducted using the Counseling Center Assessment of Psychological Systems-Japanese (CCAPS-Japanese) to evaluate students’
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This study compared the effects of academic year, college department, and undergraduate or graduate status on Japanese students’ mental health during the COVID-19 pandemic. From 2021–2023, an online survey was conducted using the Counseling Center Assessment of Psychological Systems-Japanese (CCAPS-Japanese) to evaluate students’ mental health; 9395 undergraduate students (4623 female, 4772 male) and 1169 graduate students (380 female, 789 male) responded. Undergraduate students in medicine had lower levels of depression, generalized anxiety, and social anxiety than those in other departments. Engineering students exhibited the highest level of academic distress. First-year students had the highest levels of generalized and social anxiety but the lowest level of academic distress. Second-year students had the lowest level of depression, and third-year students had the highest level of academic distress. Among graduate students, first-year students had higher levels of depression, generalized anxiety, social anxiety, academic distress, and hostility than second-year students. Undergraduates had poorer mental health than graduate students. Females had higher levels of eating concerns than males among undergraduate students. This study revealed that the mental health of university students was affected by various factors. These findings demonstrate the characteristics of university students requiring early support.
Full article
Open AccessEditorial
Updating Exercise Testing Strategies and Exercise Prescription Protocols
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Rafael Oliveira and João Paulo Brito
Healthcare 2024, 12(9), 901; https://doi.org/10.3390/healthcare12090901 (registering DOI) - 26 Apr 2024
Abstract
Exercise testing and prescription is still a hot topic [...]
Full article
(This article belongs to the Special Issue Exercise Testing and Prescription Strategies to Improve Quality of Life)
Open AccessArticle
Group Intervention Program to Facilitate Post-Traumatic Growth and Reduce Stigma in HIV
by
Nuno Tomaz Santos, Catarina Ramos, Margarida Ferreira de Almeida and Isabel Leal
Healthcare 2024, 12(9), 900; https://doi.org/10.3390/healthcare12090900 (registering DOI) - 26 Apr 2024
Abstract
Background: Research on post-traumatic growth (PTG) and HIV is scarce and the relationship between PTG and stigma is controversial. Group psychotherapeutic interventions to facilitate PTG in clinical samples are effective but none exist to simultaneously decrease stigma in the HIV population. The main
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Background: Research on post-traumatic growth (PTG) and HIV is scarce and the relationship between PTG and stigma is controversial. Group psychotherapeutic interventions to facilitate PTG in clinical samples are effective but none exist to simultaneously decrease stigma in the HIV population. The main objective was to evaluate the effectiveness of an intervention in increasing PTG and decreasing stigma in HIV, as well as to explore relationships between the variables. Methods: Quasi-experimental design with a sample of 42 HIV-positive adults (M = 46.26, SD = 11.90). The experimental group (EG) was subjected to a 9-week group intervention. Instruments: CBI, PTGI-X, PSS-10, HIV stigma, emotional expression, HIV stress indicators, HIV literacy, and skills. Multiple linear regression analysis was performed to assess the relationship between the variables. Results: There was an increase in PTG and a significant decrease in stigma in all domains and subscales in the EG. Compared to the control group, stigma (t(42) = −3.040, p = 0.004) and negative self-image (W = −2.937, p = 0.003) were significant, showing the efficacy of the intervention. Discussion: The intervention demonstrated success in facilitating PTG, attesting that in order to increase PTG, personal strength, and spiritual change, it is necessary to reduce stigma and negative self-image. The research provides more information on group interventions for PTG in HIV, relationships between variables, and population-specific knowledge for professionals.
Full article
(This article belongs to the Special Issue The Effects of Loneliness, Stigma, and Social Support on the Health and Mental Health of Older Populations)
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Open AccessArticle
Person-Centred Diabetes Care: Examining Patient Empowerment and Diabetes-Specific Quality of Life in Slovenian Adults with Type 2 Diabetes
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Tina Virtič Potočnik, Nina Ružić Gorenjec, Matic Mihevc, Črt Zavrnik, Majda Mori Lukančič, Antonija Poplas Susič and Zalika Klemenc-Ketiš
Healthcare 2024, 12(9), 899; https://doi.org/10.3390/healthcare12090899 - 26 Apr 2024
Abstract
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Patient empowerment is crucial for promoting and strengthening health. We aimed to assess patient empowerment and diabetes-specific health-related quality of life (HRQoL) in adults with type 2 diabetes (T2D). A multi-centre, cross-sectional survey was conducted among adults with T2D in urban and rural
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Patient empowerment is crucial for promoting and strengthening health. We aimed to assess patient empowerment and diabetes-specific health-related quality of life (HRQoL) in adults with type 2 diabetes (T2D). A multi-centre, cross-sectional survey was conducted among adults with T2D in urban and rural primary care settings in Slovenia between April and September 2023. The survey utilised convenience sampling and included sociodemographic and clinical data, the Diabetes Empowerment Scale (DES), and the Audit of Diabetes-Dependent QoL (ADDQoL). The study included 289 people with T2D and a mean age of 67.2 years (SD 9.2). The mean overall DES score was 3.9/5 (SD 0.4). In a multivariable linear regression model, higher empowerment was significantly associated with residing in a rural region (p = 0.034), higher education (p = 0.028), and a lack of comorbid AH (p = 0.016). The median overall ADDQoL score was −1.2 (IQR [−2.5, −0.6]). The greatest negative influence of diabetes on HRQoL was observed in the domain ‘Freedom to eat’, followed by ‘Freedom to drink’, ‘Leisure activities’, and ‘Holidays’. Despite high empowerment among adults with T2D, the condition still imposes a personal burden. Integrated primary care models should prioritise the importance of implementing targeted interventions to enhance diabetes empowerment, address comorbidities, and improve specific aspects of QoL among individuals with T2D.
Full article
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Open AccessSystematic Review
Oral Health Education in Patients with Diabetes: A Systematic Review
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Pinelopi Petropoulou, Ioannis Kalemikerakis, Eleni Dokoutsidou, Eleni Evangelou, Theocharis Konstantinidis and Ourania Govina
Healthcare 2024, 12(9), 898; https://doi.org/10.3390/healthcare12090898 - 26 Apr 2024
Abstract
Diabetes is known as a “silent epidemic” and is a public health problem that accounts for 9% of all deaths worldwide. The prevention of diabetes is a significant challenge, as its prevalence and incidence are both increasing rapidly. According to the World Health
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Diabetes is known as a “silent epidemic” and is a public health problem that accounts for 9% of all deaths worldwide. The prevention of diabetes is a significant challenge, as its prevalence and incidence are both increasing rapidly. According to the World Health Organization (WHO), education is the cornerstone of diabetes treatment. Since the severity of oral diseases is significantly higher in diabetic patients, this systematic review aims to highlight the oral care of diabetic patients as a priority for glycemic control and the importance of education for diabetic patients’ oral health. We evaluated 20 clinical studies and 15 meta-analyses from PubMed and Google Scholar over the last five years. Their main themes are the direct relationship between diabetes and oral health, especially periodontitis, and the necessity of education and behaviors that can lead to a better quality of life. Our analysis indicated that good oral health is a critical factor of glycemic control in diabetic patients and can be enhanced by targeted educational programs, backed by long-term medical and dental follow-up. Healthcare personnel should be encouraged to develop their knowledge of oral health in relation to the disease so that behaviors can be adopted to improve patients’ quality of life. Telemedicine could also contribute to patient education and self-management of the disease.
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(This article belongs to the Special Issue Nursing Care for Patients with Diabetes)
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Open AccessArticle
Online Health Information-Seeking Behaviour among People of African Descent in the United Kingdom: A Qualitative Study
by
Jesse Enebi Usman, Charmaine Childs, David Rogerson and Markos Klonizakis
Healthcare 2024, 12(9), 897; https://doi.org/10.3390/healthcare12090897 - 26 Apr 2024
Abstract
Effective public health interventions rely on understanding how individuals access, interpret, and utilise health information. Studying the health information-seeking behaviour (HISB) of a community can provide valuable insights to inform strategies that address community health needs and challenges. This study explored the online
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Effective public health interventions rely on understanding how individuals access, interpret, and utilise health information. Studying the health information-seeking behaviour (HISB) of a community can provide valuable insights to inform strategies that address community health needs and challenges. This study explored the online HISBs of People of African Descent (PoAD) in the United Kingdom (UK), a demographic that comprises four percent of the UK population and has a 92.8% active Internet usage rate. Data on the HISB were collected from 21 PoAD across various UK regions through online semi-structured interviews before being analysed using reflexive Thematic Analysis (TA). The participants ranged in age from 20 to 70 years and had a mean age of 42.8 (SD ± 11.4). Our analysis of the interview transcripts revealed five key themes: Internet usage and preferences, attitudes toward social media, barriers to seeking health information online, trust in online health information, and cultural influences on online HISB. Our findings indicate a proactive engagement among PoAD in seeking health information online that is underscored by a preference for professional sources over ethnic congruence. However, concerns about misinformation exist, and there are barriers to accessing health information online, including data privacy, unreliable information, and information relevance and overload. We also found that cultural factors and traditional beliefs impact the adoption of Internet-based interventions among PoAD, highlighting the need for culturally sensitive approaches. Preferences regarding the frequency and delivery of online health information varied among participants, with a majority preferring a weekly update. This study emphasises the critical need for accessible, culturally appropriate, secure, and reliable online health resources tailored to the needs and preferences of the PoAD.
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(This article belongs to the Special Issue Digital Health for Equity)
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Open AccessSystematic Review
Occupational Therapy Interventions to Improve the Quality of Life of Older Adults with Dementia Living in Nursing Homes: A Systematic Review
by
Cristian Uceda-Portillo, Sandra Aranda-Valero and Pedro Moruno-Miralles
Healthcare 2024, 12(9), 896; https://doi.org/10.3390/healthcare12090896 - 25 Apr 2024
Abstract
The increase in older adults with dementia presents challenges in promoting research to improve the quality of life of this population. The objective of this study was to assess the scientific evidence on the effectiveness of occupational therapy interventions in improving the quality
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The increase in older adults with dementia presents challenges in promoting research to improve the quality of life of this population. The objective of this study was to assess the scientific evidence on the effectiveness of occupational therapy interventions in improving the quality of life of older adults over 65 years old with dementia living in nursing homes. The databases used were PubMed, Web of Science, OTSeeker, clinicaltrials.gov, Dialnet, Scopus, Cochrane, and SciELO between 2013 and 2023. The studies were selected and evaluated according to the Cochrane guidelines. The review was carried out following the PRISMA 2020 Statement. Sixteen articles met the inclusion criteria and were categorized into four groups according to the focus of the intervention: “meaningful activities/occupations”, “physical, cognitive and sensory functioning”, “performance areas”, and “physical and social environment and staff training”. The strength of evidence was moderate, and the risk of bias was low. The findings revealed that occupational therapy interventions based on participation in recreational activities, reminiscence, performance-based activities and the physical and social environment, and specialized staff training, could improve the perceived quality of life of older adults with dementia living in nursing homes.
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(This article belongs to the Special Issue Aging and Quality of Life)
Open AccessSystematic Review
Gait Compensation among Children with Non-Operative Legg–Calvé–Perthes Disease: A Systematic Review
by
Abdulrhman Mashabi, Rula Abdallat, Mohammed S. Alghamdi and Mohammad Al-Amri
Healthcare 2024, 12(9), 895; https://doi.org/10.3390/healthcare12090895 - 25 Apr 2024
Abstract
Perthes disease is a condition that affects walking patterns in young children due to poor blood circulation in the hip joint. Understanding the gait strategies of affected children is of great importance for an objective assessment and better management of this condition. The
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Perthes disease is a condition that affects walking patterns in young children due to poor blood circulation in the hip joint. Understanding the gait strategies of affected children is of great importance for an objective assessment and better management of this condition. The aim of this systematic review was to evaluate the current literature to identify gait compensation patterns in non-operative children with Perthes disease. Methods: A systematic electronic search was performed using MEDLINE, CINAHL, Embase, BIOSIS, and the Cochrane Library to identify studies published from inception up until December 2023. An adapted Downs and Black checklist was utilised to assess methodological quality and project risk of bias. Percentage agreement and nominal kappa statistics with bootstrapped bias-corrected 95% confidence intervals (CIs) were used. Result: A comprehensive literature search revealed 277 citations for review, of which 210 studies entered full-text screening. In total, eight studies met the inclusion criteria for quality assessment by two independent reviewers. The results revealed variations in data quality, with scores ranging from 12 to 17 due to missing information related to subject characteristics, biomechanical model, and power calculation. Conclusions: This review reveals common compensation strategies associated with walking among non-operative children with Perthes disease such as Trendelenburg gait due to weakness of the hip abductor muscle.
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(This article belongs to the Section Chronic Care)
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