Healthcare

17 pages, 1883 KiB

Open AccessEditor’s ChoiceArticle

Development and Validation of a Risk Scoring Tool for Bronchopulmonary Dysplasia in Preterm Infants Based on a Systematic Review and Meta-Analysis

by Zhumei Yu, Lili Wang, Yang Wang, Min Zhang, Yanqin Xu and Annuo Liu

Healthcare 2023, 11(5), 778; https://doi.org/10.3390/healthcare11050778 - 06 Mar 2023

Cited by 3 | Viewed by 1745

Abstract

Background: Bronchopulmonary dysplasia (BPD) is the most common serious pulmonary morbidity in preterm infants with high disability and mortality rates. Early identification and treatment of BPD is critical. Objective: This study aimed to develop and validate a risk scoring tool for early identification [...] Read more.

Background: Bronchopulmonary dysplasia (BPD) is the most common serious pulmonary morbidity in preterm infants with high disability and mortality rates. Early identification and treatment of BPD is critical. Objective: This study aimed to develop and validate a risk scoring tool for early identification of preterm infants that are at high-risk for developing BPD. Methods: The derivation cohort was derived from a systematic review and meta-analysis of risk factors for BPD. The statistically significant risk factors with their corresponding odds ratios were utilized to construct a logistic regression risk prediction model. By scoring the weights of each risk factor, a risk scoring tool was established and the risk stratification was divided. External verification was carried out by a validation cohort from China. Results: Approximately 83,034 preterm infants with gestational age < 32 weeks and/or birth weight < 1500 g were screened in this meta-analysis, and the cumulative incidence of BPD was about 30.37%. The nine predictors of this model were Chorioamnionitis, Gestational age, Birth weight, Sex, Small for gestational age, 5 min Apgar score, Delivery room intubation, and Surfactant and Respiratory distress syndrome. Based on the weight of each risk factor, we translated it into a simple clinical scoring tool with a total score ranging from 0 to 64. External validation showed that the tool had good discrimination, the area under the curve was 0.907, and that the Hosmer–Lemeshow test showed a good fit (p = 0.3572). In addition, the results of the calibration curve and decision curve analysis suggested that the tool showed significant conformity and net benefit. When the optimal cut-off value was 25.5, the sensitivity and specificity were 0.897 and 0.873, respectively. The resulting risk scoring tool classified the population of preterm infants into low-risk, low-intermediate, high-intermediate, and high-risk groups. This BPD risk scoring tool is suitable for preterm infants with gestational age < 32 weeks and/or birth weight < 1500 g. Conclusions: An effective risk prediction scoring tool based on a systematic review and meta-analysis was developed and validated. This simple tool may play an important role in establishing a screening strategy for BPD in preterm infants and potentially guide early intervention. Full article

(This article belongs to the Special Issue Maternal, Fetal and Neonatal Health)

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12 pages, 1138 KiB

Open AccessArticle

Prevalence of Work-Related Musculoskeletal Disorders and Its Effects amongst Nurses in the Selected Intellectual Disability Unit of the Limpopo Province

by Livhuwani Muthelo, Nakisani Faith Sinyegwe, Thabo Arthur Phukubye, Masenyani Oupa Mbombi, Tshepo Albert Ntho and Tebogo Maria Mothiba

Healthcare 2023, 11(5), 777; https://doi.org/10.3390/healthcare11050777 - 06 Mar 2023

Cited by 4 | Viewed by 2527

Abstract

The COVID-19 pandemic continuously highlights the need for occupational health and safety among healthcare professionals. Physical and mental health safety resulting from needle prick injuries, stress, infections, and chemical hazards are priority work-related musculoskeletal disorders for nurses, including those working in the intellectual [...] Read more.

The COVID-19 pandemic continuously highlights the need for occupational health and safety among healthcare professionals. Physical and mental health safety resulting from needle prick injuries, stress, infections, and chemical hazards are priority work-related musculoskeletal disorders for nurses, including those working in the intellectual disability unit. The intellectual disability unit provides basic nursing care to patients with known mental disabilities, such as learning, problem-solving, and judgment problems, which demand diverse physical activities. Nevertheless, the safety of nurses within the unit receives little attention. Thus, we adopted a quantitative cross-sectional epidemiological survey design to determine the prevalence of work-related musculoskeletal disorders amongst nurses working in the intellectual disability unit at the selected hospital in Limpopo Province, South Africa. A self-administered questionnaire collected data from 69 randomly selected nurses from the intellectual disability unit. Data were extracted, coded, and captured in MS Excel format (2016) and imported into the IBM Statistical Package for the Social Sciences (SPSS), software version 25.0, for analysis. The study reported a low (38%) prevalence of musculoskeletal disorders in the intellectual disability unit, with significant effects on nursing care and staffing. The effects of these WMSDs included missing work, interference with the daily routine, disturbance with sleeping patterns after work, and absenteeism from work. Since intellectually disabled patients depend entirely on nurses for the basic activities of daily living, this paper recommends the incorporation of physiotherapy among nurses in the intellectual disability unit to treat the incidence of lower back pain while mitigating nurses missing work or absenteeism. Full article

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13 pages, 609 KiB

Open AccessArticle

Cultural Adaptation of a Health Literacy Toolkit for Healthcare Professionals Working in the Primary Care Setting with Older Adults

by Areti Efthymiou, Argyroula Kalaitzaki and Michael Rovithis

Healthcare 2023, 11(5), 776; https://doi.org/10.3390/healthcare11050776 - 06 Mar 2023

Cited by 1 | Viewed by 1640

Abstract

Healthcare professionals’ health literacy (HL) knowledge and skills influence their interaction with older adults. Healthcare professionals, when effectively communicating with older adults, can empower and enhance patients’ skills to make informed decisions about their health. The study aimed to adapt and pilot test [...] Read more.

Healthcare professionals’ health literacy (HL) knowledge and skills influence their interaction with older adults. Healthcare professionals, when effectively communicating with older adults, can empower and enhance patients’ skills to make informed decisions about their health. The study aimed to adapt and pilot test a HL toolkit to enhance the HL skills of health professionals working with older adults. A mixed methodology of three phases was used. Initially, the healthcare professionals’ and older adults’ needs were identified. Following a literature review of existing tools, a HL toolkit was selected, translated, and adapted into Greek. The HL toolkit was introduced to 128 healthcare professionals as part of 4 h webinars; 82 healthcare professionals completed baseline and post assessments, and 24 healthcare professionals implemented it in their clinical practice. The questionnaires used included an interview on HL knowledge, communication strategies, and self-efficacy using a communication scale. HL and communication strategies knowledge (13 items) and self-efficacy in communication (t = −11.127, df = 81, p < 0.001) improved after the end of the HL webinars, and improvement was retained during the follow-up after 2 months (H = 8.99, df = 2, p < 0.05). A culturally adapted HL toolkit was developed to support the needs of healthcare professionals working with older adults, taking into consideration their feedback in all phases of the development. Full article

(This article belongs to the Special Issue Health and Social Care Policy)

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9 pages, 735 KiB

Open AccessArticle

Patients Satisfied with Care Report Better Quality of Life and Self-Rated Health—Cross-Sectional Findings Based on Hospital Quality Data

by Linda Baumbach, Marc Frese, Martin Härter, Hans-Helmut König and André Hajek

Healthcare 2023, 11(5), 775; https://doi.org/10.3390/healthcare11050775 - 06 Mar 2023

Cited by 2 | Viewed by 1527

Abstract

Background: Satisfaction with care is an important indicator of health care quality. However, if this process measure is associated with patients’ outcomes in real-world data is largely unknown. We, therefore, aimed to evaluate if satisfaction with physician- and nurse-related care is associated with [...] Read more.

Background: Satisfaction with care is an important indicator of health care quality. However, if this process measure is associated with patients’ outcomes in real-world data is largely unknown. We, therefore, aimed to evaluate if satisfaction with physician- and nurse-related care is associated with quality of life and self-rated health among inpatients at the University Hospital Hamburg-Eppendorf in Germany. Method: We used standard hospital quality survey data of 4925 patients treated at various departments. We used multiple linear regressions to examine an association between satisfaction with staff-related care and quality of life as well as self-rated health, adjusted for age, gender, mother tongue, and treating ward. Patients rated their satisfaction with physician- and nurse-related care from 0 “not at all” to 9 “very much”. The outcomes regarding quality of life and self-rated health were evaluated on five-point Likert scales ranking from 1 “bad” to 5 “excellent”. Results: We found that satisfaction with physician-related care was positively associated with quality of life (ß = 0.16; p < 0.001) as well as with self-rated health (ß = 0.16; p < 0.001). Similar findings were observed for satisfaction with nurse-related care and the two outcomes (ß = 0.13; p < 0.001 and ß = 0.14; p < 0.001, respectively). Conclusion: We show that patients who are more satisfied with staff-related care report better quality of life and self-rated health than patients less satisfied with care. Thus, patient satisfaction with care, is not only a process measure indicating the quality of care but is also positively associated with patient-reported outcomes. Full article

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14 pages, 589 KiB

Open AccessArticle

Effects of Physical Education Playfulness on Academic Grit and Attitude toward Physical Education in Middle School Students in The Republic of Korea

by Heonsu Gwon and Jongseob Shin

Healthcare 2023, 11(5), 774; https://doi.org/10.3390/healthcare11050774 - 06 Mar 2023

Cited by 3 | Viewed by 1543

Abstract

The purpose of this study was to explore the effect of playability in secondary physical education classes in Korea on academic grit and attitudes toward physical education. A total of 296 middle school students located in Seoul and Gyeonggi-do, Korea were surveyed via [...] Read more.

The purpose of this study was to explore the effect of playability in secondary physical education classes in Korea on academic grit and attitudes toward physical education. A total of 296 middle school students located in Seoul and Gyeonggi-do, Korea were surveyed via simple random sampling. Data were analyzed via descriptive statistical analysis, confirmatory factor analysis, reliability analysis, correlation analysis, and standard multiple regression analysis. Three primary results were obtained. First, playfulness was found to have a significant positive effect on academic grit. Specifically, mental spontaneity positively and significantly affected academic passion (β = 0.400), academic perseverance (β = 0.298), and consistency of academic interest (β = 0.297). Additionally, among the sub-variables of playfulness, humorous perspective was found to have a positive significant effect on maintaining consistency of academic interest (β = 0.255). The second primary finding was that playfulness had a significant positive effect on classroom attitudes to physical education. Specifically, physical animation and emotional fluidity were found to positively and significantly affect basic attitudes (β = 0.290 and 0.330, respectively) and social attitudes (β = 0.398 and 0.297, respectively). Third, academic grit was found to have a significant positive effect on PE classroom attitudes. Specifically, academic passion was found to have a positive and significant effect on basic attitudes (β = 0.427) and social attitude (β = 0.358). The results imply that attitude toward school life can be improved through physical activity in secondary physical education classes. Full article

(This article belongs to the Special Issue Social Psychology in Youth Sport)

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14 pages, 1446 KiB

Open AccessArticle

A Single-Center, Randomized Controlled Trial to Test the Efficacy of Nurse-Led Motivational Interviewing for Enhancing Self-Care in Adults with Heart Failure

by Federica Dellafiore, Greta Ghizzardi, Ercole Vellone, Arianna Magon, Gianluca Conte, Irene Baroni, Giada De Angeli, Ida Vangone, Sara Russo, Alessandro Stievano, Cristina Arrigoni and Rosario Caruso

Healthcare 2023, 11(5), 773; https://doi.org/10.3390/healthcare11050773 - 06 Mar 2023

Cited by 1 | Viewed by 2606

Abstract

Background: The role of nurse-led motivational interviewing (MI) in improving self-care among patients with heart failure (HF) is promising, even if it still requires further empirical evidence to determine its efficacy. For this reason, this study tested its efficacy in enhancing self-care maintenance [...] Read more.

Background: The role of nurse-led motivational interviewing (MI) in improving self-care among patients with heart failure (HF) is promising, even if it still requires further empirical evidence to determine its efficacy. For this reason, this study tested its efficacy in enhancing self-care maintenance (primary endpoint), self-care management, and self-care confidence after three months from enrollment in adults with HF compared to usual care, and assessed changes in self-care over follow-up times (3, 6, 9, and 12 months). Methods: A single-center, randomized, controlled, parallel-group, superiority study with two experimental arms and a control group was performed. Allocation was in a 1:1:1 ratio between intervention groups and control. Results: MI was effective in improving self-care maintenance after three months when it was performed only for patients (arm 1) and for the patients–caregivers dyad (arm 2) (respectively, Cohen’s d = 0.92, p-value < 0.001; Cohen’s d = 0.68, p-value < 0.001). These effects were stable over the one-year follow-up. No effects were observed concerning self-care management, while MI moderately influenced self-care confidence. Conclusions: This study supported the adoption of nurse-led MI in the clinical management of adults with HF. Full article

(This article belongs to the Special Issue Research, Education, Workforce, and Regulation to Transforming Nursing Practice and Leadership: The Future of Nursing)

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14 pages, 6183 KiB

Open AccessArticle

COVID-19 Vaccination Program Data Analysis Based on Regional Status and Day Type: A Study from West Java Province, Indonesia

by Putri Adilla Ilhami, Mulya Nurmansyah Adisasmita, Dwi Agustian and Budi Sujatmiko

Healthcare 2023, 11(5), 772; https://doi.org/10.3390/healthcare11050772 - 06 Mar 2023

Cited by 1 | Viewed by 1714

Abstract

Vaccination is a strategy to control the COVID-19 pandemic and holds a crucial impact on global health. A better understanding of factors associated with vaccination is needed to establish a good vaccination program in a population. The purpose of this study is to [...] Read more.

Vaccination is a strategy to control the COVID-19 pandemic and holds a crucial impact on global health. A better understanding of factors associated with vaccination is needed to establish a good vaccination program in a population. The purpose of this study is to analyze COVID-19 vaccination program data based on regional status and day type in the West Java Province of Indonesia and contribute to discovering other characteristics of the COVID-19 vaccination program. This study is a cross-sectional study using secondary data (N = 7922) from West Java’s COVID-19 Information and Coordination Center (PIKOBAR) from January to November 2021. Independent t-test with an alternative non-parametric Mann–Whitney U test (p-value < 0.05) is used as a statistical test in this study. The result reported significant differences in vaccination coverage between the city area and the regency area (p < 0.001). Significant differences in vaccination on working day and holiday were also found in both settings (p < 0.001). Vaccination was confirmed to be higher in the city compared to the regency and decreased on holiday compared to the working day. In conclusion, factors linked to regional status and day type must be considered as important factors for developing and accelerating vaccination programs. Full article

(This article belongs to the Section Coronaviruses (CoV) and COVID-19 Pandemic)

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13 pages, 273 KiB

Open AccessArticle

Prevalence of Use and Knowledge about Tobacco Products and Their Harmful Effects among University Students in Southern Croatia

by Dora Istenic, Lidia Gavic and Antonija Tadin

Healthcare 2023, 11(5), 771; https://doi.org/10.3390/healthcare11050771 - 06 Mar 2023

Cited by 1 | Viewed by 1751

Abstract

Understanding students’ attitudes toward smoking and tobacco products is essential for effective smoking prevention interventions. This questionnaire-based cross-sectional survey aims to determine the prevalence of use and knowledge about cigarettes, heated tobacco products, and electronic cigarettes and their harmful effects among university students. [...] Read more.

Understanding students’ attitudes toward smoking and tobacco products is essential for effective smoking prevention interventions. This questionnaire-based cross-sectional survey aims to determine the prevalence of use and knowledge about cigarettes, heated tobacco products, and electronic cigarettes and their harmful effects among university students. The survey was conducted using a self-administered online questionnaire among 1184 students. Questions were related to the respondents’ demographic characteristics, tobacco use patterns, and opinions about exposure to health warnings and tobacco product advertising messages. Data were analyzed using descriptive statistics and generalized linear regression analysis. The results showed that 30.2% of the students use tobacco products (74.5% smoked conventional cigarettes; 7.9% used electronic cigarettes; and 17.6% used heated tobacco products). The median (interquartile range) score of the students’ knowledge (maximum = 27) was 16 (12–22). The results showed that students from technical, social, humanities, natural, and biotechnology scientific programs had lower levels of knowledge about tobacco products and their harmful effects than biomedical students (p ≤ 0.001). In addition, past and current use of tobacco products was significantly associated with higher overall knowledge of tobacco products and their harmful effects (adjusted odds ratio (OR) 1.90, % confidence interval (CI) 1.09–3.31, p = 0.023; OR 1.41, CI 1.08–1.84, p = 0.011). The research findings confirm the lack of knowledge and misconceptions about the harmful effects associated with tobacco product use. They also emphasize the need for better prevention and awareness of the harmful effects of smoking on human health. Full article

11 pages, 653 KiB

Open AccessArticle

Functional Disability and Symptomatic Slow-Acting Drugs for Osteoarthritis in Adults with Periodontitis

by Nik-Madihah Nik-Azis, Nurulhuda Mohd, Badiah Baharin, Fazalina Mohd Fadzilah, Nor Hazla Mohamed Haflah and Mohd Shahrir Mohamed Said

Healthcare 2023, 11(5), 770; https://doi.org/10.3390/healthcare11050770 - 06 Mar 2023

Viewed by 1144

Abstract

Osteoarthritis (OA) patients have decreased functional ability and restricted access to healthcare facilities and are on a spectrum of medications. These can impact their oral health. This study aims to investigate the association between periodontal disease and OA disease parameters, specifically the functional [...] Read more.

Osteoarthritis (OA) patients have decreased functional ability and restricted access to healthcare facilities and are on a spectrum of medications. These can impact their oral health. This study aims to investigate the association between periodontal disease and OA disease parameters, specifically the functional disability and the medications taken. This was a cross-sectional study on OA participants recruited from the Hospital Canselor Tuanku Mukhriz. Periodontal health parameters were obtained from an oral examination of the participants. A Health Assessment Questionnaire (HAQ) was administered to ascertain the functional status of the participants. Out of the 130 participants recruited, 71 (54.6%) had periodontitis. There was a correlation between the teeth count with OA severity, where participants with a greater Kellgren–Lawrence score had less teeth (rs = 0.204, p = 0.025). Participants with a greater degree of functional limitation also had less teeth (rs = −0.181, p = 0.039) and a higher clinical attachment loss (rs = 0.239, p = 0.006). There were no associations found between the symptomatic slow-acting drugs in OA and periodontal health parameters. In conclusion, there was a high proportion of periodontitis in patients with OA. Functional disability was associated with measures of periodontal health. It is suggested that clinicians treating OA patients consider the need for a referral for dental care when managing this group of patients. Full article

(This article belongs to the Special Issue Preventive Oral Health Strategies and Oral Health Status)

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8 pages, 232 KiB

Open AccessArticle

Common Traditions, Practices, and Beliefs Related to Safe Motherhood and Newborn Health in Morocco

by Chaimae Moujahid, Jack E. Turman, Jr. and Loubna Amahdar

Healthcare 2023, 11(5), 769; https://doi.org/10.3390/healthcare11050769 - 06 Mar 2023

Viewed by 2152

Abstract

The cultural context influences women’s antenatal care and postpartum knowledge. This study aims to determine the traditional practices related to maternal health in Morocco. We conducted in-depth qualitative interviews with 37 women from three different Moroccan regions on the first postpartum day. We [...] Read more.

The cultural context influences women’s antenatal care and postpartum knowledge. This study aims to determine the traditional practices related to maternal health in Morocco. We conducted in-depth qualitative interviews with 37 women from three different Moroccan regions on the first postpartum day. We used thematic content to analyze data, and an a priori coding framework was created utilizing the pertinent literature. Beliefs regarding pregnancy and postpartum positively affect maternal health, such as family support, prolonged rest for health recovery, and specific dietary precautions according to the mode of delivery of the new mother. However, some practices may negatively affect maternal health, such as cold postpartum treatment through traditional medicine and not seeking prenatal care after the first pregnancy experience. Such practices include painting newborns with henna, using kohl and oil to hasten the umbilical cord’s descent, and producing solutions based on chicken throat to cure respiratory ailments in newborns that might harm their health. Full article

(This article belongs to the Special Issue Maternal and Child Health and Healthcare)

11 pages, 624 KiB

Open AccessReview

Operations Research to Solve Kidney Allocation Problems: A Systematic Review

by Nigar Sekercioglu and Rui Fu

Healthcare 2023, 11(5), 768; https://doi.org/10.3390/healthcare11050768 - 06 Mar 2023

Cited by 1 | Viewed by 1364

Abstract

Background: Operations research techniques enable health care administrators to optimize resource allocation and to find solutions to staff and patient scheduling problems. We aimed to conduct the first systematic review of the international literature on the use of operations research for allocating deceased-donor [...] Read more.

Background: Operations research techniques enable health care administrators to optimize resource allocation and to find solutions to staff and patient scheduling problems. We aimed to conduct the first systematic review of the international literature on the use of operations research for allocating deceased-donor kidneys. Methods: We searched the MEDLINE, EMBASE, and PubMed databases from inception to February 2023. Two reviewers independently screened the title/abstract and subsequently the full text of potentially eligible articles and abstracted the data. Quality assessment of the final set of studies was conducted using Subben’s checklist. Results: Of the 302 citations identified, 5 studies were included. These studies covered three themes, including (1) provider-facing decision aids to determine the timing of transplant for single or multiple patients; (2) system-level planning on kidney allocation based on blood type matching rules; and (3) patient-facilitated wait times estimation using incomplete information. Markov models, sequential stochastic assignment models, and queuing models were amongst the most used techniques. Although we found all included studies to meet Subben’s criteria, we believe the checklist in its current form lacks items to assess the validity of model inferences. As such, we ended this review with a set of practical recommendations. Conclusions: Our review demonstrated the utility of operations research techniques in assisting the system, healthcare providers, and patients in the transplantation process. More research is needed to reach a consensus on a model that can be used to support the decision-making of different stakeholders for efficient kidney allocation, with the ultimate goal of reducing the gap between kidney supply and demand and enhancing the population’s well-being. Full article

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10 pages, 1491 KiB

Open AccessArticle

Comparison of the Clinical Results of Platelet-Rich Plasma, Steroid and Autologous Blood Injections in the Treatment of Chronic Lateral Epicondylitis

by Aybars Kıvrak and Ibrahim Ulusoy

Healthcare 2023, 11(5), 767; https://doi.org/10.3390/healthcare11050767 - 06 Mar 2023

Cited by 3 | Viewed by 1771

Abstract

Background: The aim of our study is to compare the efficacy of PRP, steroids, and autologous blood injection in patients with chronic lateral epicondylitis. Method: A total of 120 patients comprised our study. Three groups of 40 patients each received only one of [...] Read more.

Background: The aim of our study is to compare the efficacy of PRP, steroids, and autologous blood injection in patients with chronic lateral epicondylitis. Method: A total of 120 patients comprised our study. Three groups of 40 patients each received only one of the following: PRP, steroids, or autologous blood injections. Thereafter, VAS (visual analog scale), DASH (Disabilities of the Arm, Shoulder, and Hand), and Nirschl scores of those treated were evaluated in the second week, the fourth week, the third month, and the sixth month. Results: The baseline evaluation revealed no significant change in VAS, DASH, and Nirschl scores among the three groups (p > 0.050). At the second week evaluation, patients treated with steroids showed significant improvement compared to patients treated with PRP and autologous blood (p < 0.001). The fourth-week evaluation revealed the VAS, DASH, and Nirschl scores of the patients treated with steroids to have improved more significantly than those of patients treated with PRP and autologous blood (p < 0.001). The third month, when the results of all three groups were compared, revealed similar results (p > 0.050). The sixth-month evaluation, when the results of all three groups were compared, revealed the autologous blood and PRP applications provided significantly better results than the group treated with steroids (p < 0.001). Conclusion: We concluded that steroid administration is effective in the short term, while PRP and autologous blood applications are more effective than steroid administration in the long term. Full article

(This article belongs to the Topic New Insights on Chronic Illness: Pathogenesis, Prevalence, Prevention, and Systemic Therapies)

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12 pages, 648 KiB

Open AccessReview

The Intestinal and Skin Microbiome in Patients with Atopic Dermatitis and Their Influence on the Course of the Disease: A Literature Review

by Małgorzata Mazur, Hanna Tomczak, Martha Łodyga, Katarzyna Plagens-Rotman, Piotr Merks and Magdalena Czarnecka-Operacz

Healthcare 2023, 11(5), 766; https://doi.org/10.3390/healthcare11050766 - 06 Mar 2023

Cited by 4 | Viewed by 3569

Abstract

Bacteria inhabiting the digestive tract are responsible for our health. The microbiome is essential for the development of the immune system and homeostasis of the body. Maintaining homeostasis is very important, but also extremely complicated. The gut microbiome is related to the skin [...] Read more.

Bacteria inhabiting the digestive tract are responsible for our health. The microbiome is essential for the development of the immune system and homeostasis of the body. Maintaining homeostasis is very important, but also extremely complicated. The gut microbiome is related to the skin microbiome. It can therefore be assumed that changes in the microbes inhabiting the skin are greatly influenced by the bacteria living in the intestines. Changes in the composition and function of microbes (dysbiosis in the skin and intestines) have recently been linked to changes in the immune response and the development of skin diseases, including atopic dermatitis (AD). This review was compiled by collaborating Dermatologists specializing in atopic dermatitis and psoriasis. A comprehensive review of the current literature was performed using PubMed and limited to relevant case reports and original papers on the skin microbiome in atopic dermatitis. The inclusion criterion was that the paper was published in a peer-reviewed journal in the last 10 years (2012–2022). No limitations on the language of the publication or the type of study were made. It has been shown that any rapid changes in the composition of the microflora may be associated with the appearance of clinical signs and symptoms of the disease. Various studies have proven that the microbiome of many systems (including the intestines) may have a significant impact on the development of the inflammatory process within the skin in the course of AD. It has been shown that an early interaction between the microbiome and immune system may result in a noticeable delay in the onset of atopic diseases. It seems to be of high importance for physicians to understand the role of the microbiome in AD, not only from the pathophysiological standpoint but also in terms of the complex treatment that is required. Perhaps young children diagnosed with AD present specific characteristics of the intestinal microflora. This might be related to the early introduction of antibiotics and dietary manipulations in breastfeeding mothers in the early childhood of AD patients. It is most likely related to the abuse of antibiotics from the first days of life. Full article

(This article belongs to the Special Issue Skin and Nail Care)

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10 pages, 2137 KiB

Open AccessArticle

Child and Adolescent Mental Health during the COVID-19 Pandemic: Challenges of Psychiatric Outpatient Clinics

by Mariela Mosheva, Yael Barzilai, Nimrod Hertz-Palmor, Ehud Mekori-Domachevsky, Asia Avinir, Galit Erez, Noa Vardi, Gila Schoen, Tal Lahav, Hadar Sadeh, Michal Rapaport, Chen Dror, Alex Gizunterman, Shlomit Tsafrir, Doron Gothelf and Yuval Bloch

Healthcare 2023, 11(5), 765; https://doi.org/10.3390/healthcare11050765 - 06 Mar 2023

Cited by 2 | Viewed by 1796

Abstract

Background: Worldwide national surveys show a rising mental health burden among children and adolescents (C&A) during COVID-19. The objective of the current study is to verify the expected rise in visits to psychiatric outpatient clinics of C&A, especially of new patients. Methods: a [...] Read more.

Background: Worldwide national surveys show a rising mental health burden among children and adolescents (C&A) during COVID-19. The objective of the current study is to verify the expected rise in visits to psychiatric outpatient clinics of C&A, especially of new patients. Methods: a cross-sectional study focusing on visits as recorded in electronic medical records of eight heterogeneous C&A psychiatric outpatient clinics. The assessment was based on visits held from March to December of 2019 (before the pandemic) in comparison to visits held in 2020 (during the pandemic). Results: The number of visits was similar for both periods. However, in 2020, 17% of the visits used telepsychiatry (N = 9885). Excluding telepsychiatry reveals a monthly decrease in traditional in-person activities between 2020 and 2019 (691.6 ± 370.8 in 2020 vs. 809.1 ± 422.8 in 2019, mean difference = −117.5, t (69) = −4.07, p = 0.0002, Cohen’s d = −0.30). Acceptation of new patients declined during 2020, compared to 2019 (50.0 ± 38.2 in 2020 vs. 62.8 ± 42.9 in 2019; Z = −3.12, p = 0.002, r = 0.44). Telepsychiatry was not used for new patients. Conclusions: The activity of C&A psychiatric outpatient clinics did not rise but was guarded due to the use of telepsychiatry. The decline in visits of new patients was explained by the lack of use of telepsychiatry for these patients. This calls for expanding the use of telepsychiatry, especially for new patients. Full article

(This article belongs to the Special Issue The Impact of the COVID-19 Pandemic on Health: Time to Take a Longer-Term Perspective)

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10 pages, 666 KiB

Open AccessArticle

Patterns and Trends in Pharmacological Treatment for Outpatients with Postherpetic Neuralgia in Six Major Areas of China, 2015–2019

by Gang Han, Yun Han, Lingyan Yu, Yuhua Zhao and Zhenwei Yu

Healthcare 2023, 11(5), 764; https://doi.org/10.3390/healthcare11050764 - 06 Mar 2023

Cited by 2 | Viewed by 1569

Abstract

The aim of this study was to assess the patterns and trends of pharmacological treatment for outpatients with postherpetic neuralgia (PHN) in China in the period 2015–2019. Prescription data for outpatients with PHN were extracted from the database of the Hospital Prescription Analysis [...] Read more.

The aim of this study was to assess the patterns and trends of pharmacological treatment for outpatients with postherpetic neuralgia (PHN) in China in the period 2015–2019. Prescription data for outpatients with PHN were extracted from the database of the Hospital Prescription Analysis Program of China according to the inclusion criteria. The trends in yearly prescriptions and corresponding costs were analyzed and stratified by drug class and specific drugs. A total of 19,196 prescriptions from 49 hospitals in 6 major regions of China were included for analysis. The yearly prescriptions increased from 2534 in 2015 to 5676 in 2019 (p = 0.027), and the corresponding expenditures increased from CNY 898,618 in 2015 to CNY 2,466,238 in 2019 (p = 0.027). Gabapentin and pregabalin are the most commonly used drugs for PHN, and more than 30% of these two drugs were combined with mecobalamin. Opioids were the second most frequently prescribed drug class, and oxycodone accounted for the largest share of the cost. Topical drugs and TCAs are rarely used. The frequent use of pregabalin and gabapentin was in accordance with current guidelines; however, the use of oxycodone raised concerns about rationality and economic burden. The results of this study may benefit the allocation of medical resources and management for PHN in China and other countries. Full article

(This article belongs to the Special Issue Pharmacovigilance and Appropriate Drug Use)

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10 pages, 561 KiB

Open AccessArticle

Predicting Maximum Oxygen Uptake from Non-Exercise and Submaximal Exercise Tests in Paraplegic Men with Spinal Cord Injury

by Bum-Suk Lee, Jae-Hyuk Bae, Yu-Jin Choi and Jung-Ah Lee

Healthcare 2023, 11(5), 763; https://doi.org/10.3390/healthcare11050763 - 05 Mar 2023

Cited by 1 | Viewed by 1513

Abstract

This study aimed to develop prediction equations for maximum oxygen uptake (VO₂max) based on non-exercise (anthropometric) and submaximal exercise (anthropometric and physiological) variables in paraplegic men with a spinal cord injury. All participants were tested on an arm ergometer using a [...] Read more.

This study aimed to develop prediction equations for maximum oxygen uptake (VO₂max) based on non-exercise (anthropometric) and submaximal exercise (anthropometric and physiological) variables in paraplegic men with a spinal cord injury. All participants were tested on an arm ergometer using a maximal graded exercise test. Anthropometric variables such as age, height, weight, body fat, body mass index, body fat percentage, and arm muscle mass and physiological variables such as VO₂, VCO₂, and heart rate at 3 and 6 min of graded exercise tests were included in the multiple linear regression analysis. The prediction equations revealed the following. Regarding non-exercise variables, VO₂max was correlated with age and weight (equation R = 0.771, R² = 0.595, SEE= 3.187). Regarding submaximal variables, VO₂max was correlated with weight and VO₂ and VCO₂ at 6 min (equation R = 0.892, R² = 0.796, SEE = 2.309). In conclusion, our prediction equations can be used as a cardiopulmonary function evaluation tool to estimate VO₂max simply and conveniently using the anthropometric and physiological characteristics of paraplegic men with spinal cord injuries. Full article

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9 pages, 253 KiB

Open AccessArticle

Caregiving Self-Efficacy of the Caregivers of Family Members with Oral Cancer—A Descriptive Study

by Ching-Hui Cheng, Shu-Yuan Liang, Ling Lin, Tzu-Ting Chang, Tsae-Jyy Wang and Ying Lin

Healthcare 2023, 11(5), 762; https://doi.org/10.3390/healthcare11050762 - 05 Mar 2023

Cited by 1 | Viewed by 1329

Abstract

In Taiwan, oral cancer is the fourth most common cause of cancer death in men. The complications and side effects of oral cancer treatment pose a considerable challenge to family caregivers. The purpose of this study was to analyze the self-efficacy of the [...] Read more.

In Taiwan, oral cancer is the fourth most common cause of cancer death in men. The complications and side effects of oral cancer treatment pose a considerable challenge to family caregivers. The purpose of this study was to analyze the self-efficacy of the primary family caregivers of patients with oral cancer at home. A cross-sectional descriptive research design and convenience recruiting were adopted to facilitate sampling, and 107 patients with oral cancer and their primary family caregivers were recruited. The Caregiver Caregiving Self-Efficacy Scale-Oral Cancer was selected as the main instrument to be used. The primary family caregivers’ mean overall self-efficacy score was 6.87 (SD = 1.65). Among all the dimensions, managing patient-related nutritional issues demonstrated the highest mean score (mean = 7.56, SD = 1.83), followed by exploring and making decisions about patient care (mean = 7.05, SD = 1.92), acquiring resources (mean = 6.89, SD = 1.80), and managing sudden and uncertain patient conditions (mean = 6.17, SD = 2.09). Our results may assist professional medical personnel to focus their educational strategies and caregiver self-efficacy enhancement strategies on the dimensions that scored relatively low. Full article

(This article belongs to the Special Issue Mental Health and Nursing Care of Individuals with Cancer and Their Families)

28 pages, 1721 KiB

Open AccessReview

Rapid Review of “No Surprise” Medical Billing in the United States: Stakeholder Perceptions and Challenges

by Cristian Lieneck, Mario Gallegos, Madison Ebner, Hannah Drake, Emma Mole and Kaitlin Lucio

Healthcare 2023, 11(5), 761; https://doi.org/10.3390/healthcare11050761 - 05 Mar 2023

Viewed by 3240

Abstract

Surprise medical bills received after care delivery in both emergency and non-emergency situations for out-of-network (OON) or other contractual health plan regulations adds additional stress upon the care guarantor, most often the patient. The passing and continued implementation of the federal No Surprises [...] Read more.

Surprise medical bills received after care delivery in both emergency and non-emergency situations for out-of-network (OON) or other contractual health plan regulations adds additional stress upon the care guarantor, most often the patient. The passing and continued implementation of the federal No Surprises Act (NSA) and related state-level legislation continues to influence the processes of care delivery in the United States. This rapid review evaluated the literature specific to surprise medical billing in the United States since the passing of the No Surprise Act, guided by the preferred reporting items for systematic reviews and meta-analyses (PRISMA) protocol. A total of 33 articles were reviewed by the research team and the results demonstrate industry stakeholder perceptions related to two primary industry themes (constructs) surrounding surprise billing: healthcare stakeholder perspectives and medical claim dispute (arbitration) processes. Further investigation identified sub-constructs for each: the practice of balance-billing patients for OON care and healthcare provider, and facility equitable reimbursement challenges (primary theme 1), and arbitration observations and challenges surrounding (a) the NSA medical dispute process, (b) state-level arbitration processes and perceptions, and (c) use of the Medicare fee schedule as a benchmark for arbitration decisions (primary theme 2). The results indicate the need for formative policy improvement initiatives to address the generation of surprise billing. Full article

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11 pages, 584 KiB

Open AccessArticle

Determining the Role of Employee Engagement in Nurse Retention along with the Mediation of Organizational Culture

by Ridhya Goyal and Gurvinder Kaur

Healthcare 2023, 11(5), 760; https://doi.org/10.3390/healthcare11050760 - 05 Mar 2023

Cited by 1 | Viewed by 3026

Abstract

In today’s unpredictable environment, the rapid emergence of the COVID-19 pandemic has shaken the world and its healthcare infrastructure immensely. As nurses are the building blocks of the healthcare personnel labor market, organizations should develop tactics that aid in their retention. With a [...] Read more.

In today’s unpredictable environment, the rapid emergence of the COVID-19 pandemic has shaken the world and its healthcare infrastructure immensely. As nurses are the building blocks of the healthcare personnel labor market, organizations should develop tactics that aid in their retention. With a solid theoretical foundation in self-determination theory, this study aims to understand the role of employee engagement in keeping nurses in 51 hospitals in the Northern Indian region, along with the mediation of organizational culture through smart PLS. In a complementary mediation relationship with organizational culture, nurse retention is positively correlated with employee engagement. Full article

(This article belongs to the Special Issue Advances and Challenges in the Labour Markets for Healthcare Professionals)

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10 pages, 273 KiB

Open AccessArticle

Prevalence of Obstructed Defecation among Patients Who Underwent Hemorrhoidectomy and Correlation between Preoperative Constipation Score and Postoperative Patients’ Satisfaction: A Prospective Study in Two Centers

by Walid M. Abd El Maksoud, Khaled S. Abbas, Mohammed A. Bawahab, Fares Rayzah, Sultan M. Alkorbi, Abdulelah G. Alfaifi, Abdulrahman N. Alqahtani, Abdullah F. Alahmari and Turki B. Alotaibi

Healthcare 2023, 11(5), 759; https://doi.org/10.3390/healthcare11050759 - 05 Mar 2023

Cited by 1 | Viewed by 1241

Abstract

Background and Objectives: obstructed defecation syndrome (ODS) is a common but underestimated condition that may affect the outcomes after hemorrhoidectomy. Therefore, the aim of this study was to determine the prevalence of obstructed defecation syndrome (ODS) among patients who underwent hemorrhoidectomy and to [...] Read more.

Background and Objectives: obstructed defecation syndrome (ODS) is a common but underestimated condition that may affect the outcomes after hemorrhoidectomy. Therefore, the aim of this study was to determine the prevalence of obstructed defecation syndrome (ODS) among patients who underwent hemorrhoidectomy and to assess the correlation between preoperative constipation score and postoperative patients’ satisfaction. Materials and Methods: This prospective study included adult patients who underwent hemorrhoidectomy for 3rd and 4th-grade hemorrhoidal diseases. All participant patients underwent an assessment of functional OD severity by the Agachan–Wexner Constipation Scoring System. All patients were subjected to conventional hemorrhoidectomy. At 6 months postoperatively, patients were assessed again for their constipation score and postoperative patients’ satisfaction. Results: The study included 120 patients (62 males and 58 females) with a mean age of 38.7 ± 12.1 years. About one-quarter of patients (24.2%) had obstructed defecation (constipation score ≥12). ODS (constipation score ≥12) was found to be significantly more among older patients, female patients, especially those with multiple pregnancies and multiple labors, and those with perineal descent. The postoperative constipation score (5.6 ± 3.3 mean ± SD) showed significant improvement (p = 0.001) compared to (9.3 ± 3.9 mean ± SD) preoperatively. Postoperative patients’ satisfaction (mean 12.3 ± 3.0) at 6 months had a negative correlation with preoperative total constipation score (r = −0.035, p = 0.702). Conclusions: The prevalence of obstructed defecation among patients with hemorrhoids was higher than reported among the general population. High preoperative constipation scores had a negative correlation with postoperative patients’ satisfaction. Routine preoperative measurement of ODS can allow the detection of this particular group of patients who require a more physical and psychological evaluation, in addition to special preoperative counseling. Full article

12 pages, 2241 KiB

Open AccessSystematic Review

Worldwide Prevalence of Alcohol Use in Non-Fatally Injured Motor Vehicle Drivers: A Systematic Review and Meta-Analysis

by Laura Kassym, Assiya Kussainova, Yuliya Semenova, Almas Kussainov, Damir Marapov, Marat Zhanaspayev, Zhanar Urazalina, Almira Akhmetova, Madi Tokanov, Yerbol Smail and Geir Bjørklund

Healthcare 2023, 11(5), 758; https://doi.org/10.3390/healthcare11050758 - 05 Mar 2023

Cited by 2 | Viewed by 1655

Abstract

Drunk driving is an important risk factor significantly contributing to traffic accidents and their associated lethality. This meta-analysis of observational studies aims to provide the estimates of drunk driving prevalence in non-lethally injured motor vehicle drivers in relation to the world region, blood [...] Read more.

Drunk driving is an important risk factor significantly contributing to traffic accidents and their associated lethality. This meta-analysis of observational studies aims to provide the estimates of drunk driving prevalence in non-lethally injured motor vehicle drivers in relation to the world region, blood alcohol concentration (BAC), and quality of the primary study. A systematic search for observational studies that examined the prevalence of drunk driving in injured drivers was performed, and 17 studies comprising 232,198 drivers were included in the pooled analysis. The pooled prevalence of drunk driving in injured drivers was found to be 16.6% (95% CI: 12.8–20.3%; I² = 99.87%, p < 0.001). In addition, the prevalence of alcohol use ranged from 5.5% (95% CI: 0.8–10.1%) in the Middle East, North Africa, and Greater Arabia region to 30.6% (95% CI: 24.6–36.5%) in the Asia region. As for the subgroups with different thresholds of BAC, the maximum value of 34.4% (95% CI: 28.5–40.3%) was found for a dose of 0.3 g/L. The prevalence of alcohol use reported by high-quality studies was 15.7% (95% CI: 11.1–20.3%), compared to 17.7% (95% CI: 11.3–24.2%) reported by studies of moderate quality. These findings could inform law enforcement efforts to promote road safety. Full article

(This article belongs to the Special Issue Innovations in Forensic Medicine)

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14 pages, 589 KiB

Open AccessReview

Ethnic Minorities’ Experiences of Cardiac Rehabilitation: A Scoping Review

by Aiesha Carew Tofani, Elaina Taylor, Ingrid Pritchard, Jessica Jackson, Alison Xu and Yasuhiro Kotera

Healthcare 2023, 11(5), 757; https://doi.org/10.3390/healthcare11050757 - 04 Mar 2023

Cited by 1 | Viewed by 3325

Abstract

Cardiac rehabilitation (CR) can improve cardiovascular risk factors, decrease cardiac mortality, and promote healthy lifestyle behaviours. However, services remain underutilized by groups of ethnic minorities. The purpose of the study was to identify patients’ personal CR experiences to identify the differences CR makes [...] Read more.

Cardiac rehabilitation (CR) can improve cardiovascular risk factors, decrease cardiac mortality, and promote healthy lifestyle behaviours. However, services remain underutilized by groups of ethnic minorities. The purpose of the study was to identify patients’ personal CR experiences to identify the differences CR makes towards minorities’ lifestyle. An initial electronic search was performed in 2021 for papers ranging from 2008–2020 across specific databases, including PubMed, EMBASE, APA PsycINFO, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and Medline. Google Scholar was also used to supplement the search process and to identify studies performed within grey literature. A total of 1230 records were screened, of which 40 were assessed for eligibility. The final sample consisted of seven qualitative design studies that were identified for inclusion in this review. Based on patient personal experiences, this review identified that ethnic minorities continue to remain disadvantaged when accessing healthcare interventions, primarily as a result of cultural behaviours, linguistic barriers, socioeconomic status, religious and fatalistic beliefs, and low physician referral rates. More research is needed to elucidate this phenomenon and address these factors faced by ethnic minorities. Full article

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11 pages, 616 KiB

Open AccessArticle

The Association of Socioeconomic and Lifestyle Factors with the Oral Health Status in School-Age Children from Pakistan: A Cross-Sectional Study

by Maria Moin, Afsheen Maqsood, Muhammad Mohsin Haider, Hajra Asghar, Kulsoom Fatima Rizvi, Abedalrahman Shqaidef, Rania A. Sharif, Ghazala Suleman, Gotam Das, Mohammad Khursheed Alam and Naseer Ahmed

Healthcare 2023, 11(5), 756; https://doi.org/10.3390/healthcare11050756 - 04 Mar 2023

Cited by 3 | Viewed by 1814

Abstract

The data on how lifestyle factors of school-going children affect their oral health are not sufficient; therefore, there is a need to analyze the adverse effects of poor lifestyle habits and the role of mothers’ education on oral health. The aim of this [...] Read more.

The data on how lifestyle factors of school-going children affect their oral health are not sufficient; therefore, there is a need to analyze the adverse effects of poor lifestyle habits and the role of mothers’ education on oral health. The aim of this study was to analyze the association of socioeconomic and lifestyle factors with the oral health status of school-going children through a structured questionnaire and oral examination. Ninety-five (26.5%) children were from class 1. One hundred eighty-seven (52.1%) mothers were educated while 172 (47.9%) were uneducated. Two hundred seventy-six (76.9%) children had never visited the dentist. The results indicate that dental health behavior is associated with lifestyle factors as well as socio-demographic variables. Parent education and awareness regarding oral health plays a major role in determining the oral health of children. Full article

(This article belongs to the Special Issue Oral Health and Dental Care in Pediatric Dentistry: Second Edition)

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16 pages, 312 KiB

Open AccessProtocol

Romani Girls Matter: Developing a Participatory Action Research Protocol for Reproductive Justice

by Belen Soto-Ponce, Manuel Garcia-Ramirez and Lucía Jiménez

Healthcare 2023, 11(5), 755; https://doi.org/10.3390/healthcare11050755 - 04 Mar 2023

Viewed by 1183

Abstract

Despite the last few decades’ advances towards social and gender justice, reproductive decisions are still a source of oppression for many European Romani women and girls. This protocol aims to propose a model to empower Romani women and girls’ reproductive decisions, inspired by [...] Read more.

Despite the last few decades’ advances towards social and gender justice, reproductive decisions are still a source of oppression for many European Romani women and girls. This protocol aims to propose a model to empower Romani women and girls’ reproductive decisions, inspired by Reproductive Justice—the recognition of women and girls’ ability to make safe and free decisions about their bodies and reproduction. Through Participatory Action Research, 15–20 Romani girls and their families, two Romani platforms, and key agents from a rural and an urban context in Spain will participate. They will (1) contextualize Romani women and girls’ inequities, (2) build partnerships, (3) implement Photovoice and advocate for their gender rights, and (4) assess the initiative’s related changes, using self-evaluation techniques. Qualitative and quantitative indicators will be collected to assess impacts among participants, while tailoring and assuring the quality of the actions. Expected outcomes include the creation and consolidation of new social networks, and the promotion of Romani women and girls’ leadership. For this, Romani organizations must be transformed into empowering settings for their communities, spaces where Romani women and girls assume responsibility of the initiatives, being these tailored to their real needs and interests, and guaranteeing transformative social changes. Full article

(This article belongs to the Section Women's Health Care)

13 pages, 601 KiB

Open AccessArticle

Nursing Profession Self-Efficacy Scale—Version 2: A Stepwise Validation with Three Cross-Sectional Data Collections

by Arianna Magon, Gianluca Conte, Federica Dellafiore, Cristina Arrigoni, Irene Baroni, Alice Silvia Brera, Jennifer Avenido, Maddalena De Maria, Alessandro Stievano, Giulia Villa and Rosario Caruso

Healthcare 2023, 11(5), 754; https://doi.org/10.3390/healthcare11050754 - 03 Mar 2023

Cited by 3 | Viewed by 2269

Abstract

Background: The nursing professional self-efficacy scale (NPSES) is one of the most used self-reporting tools for assessing nursing self-efficacy. Its psychometric structure was described differently in several national contexts. This study aimed to develop and validate version 2 of the NPSES (NPSES2), which [...] Read more.

Background: The nursing professional self-efficacy scale (NPSES) is one of the most used self-reporting tools for assessing nursing self-efficacy. Its psychometric structure was described differently in several national contexts. This study aimed to develop and validate version 2 of the NPSES (NPSES2), which is a brief version of the original scale selecting items that contribute to stably detecting attributes of care delivery and professionalism as descriptors of salient aspects of the nursing profession. Methods: Three different and subsequent cross-sectional data collections were employed to reduce the number of items to generate the NPSES2 and validate its new emerging dimensionality. The first (June 2019–January 2020) involved 550 nurses and was used to reduce the number of the original scale items by using a Mokken scale analysis (MSA) to ensure the selection of items consistently with the invariant item ordering properties. The subsequent data collection was performed to conduct an exploratory factor analysis (EFA) involving 309 nurses (September 2020–January 2021), and the last data collection (n = 249) was performed to cross-validate with a confirmatory factor analysis (CFA), the most plausible dimensionality derived from the EFA (June 2021–February 2022). Results: The MSA led to the removal of twelve items and retention of seven items (Hs = 0.407, standard error = 0.023), which showed adequate reliability (rho reliability = 0.817). The EFA showed a two-factor solution as the most plausible structure (factors loading ranged from 0.673 to 0.903; explained variance = 38.2%), which was cross-validated by the CFA that showed adequate fit indices: χ² (13, N = 249) = 44.521, p < 0.001; CFI = 0.946; TLI = 0.912; RMSEA = 0.069 (90% CI = 0.048–0.084); SRMR = 0.041. The factors were labeled as care delivery (four items) and professionalism (three items). Conclusions: NPSES2 is recommended to allow researchers and educators to assess nursing self-efficacy and inform interventions and policies. Full article

(This article belongs to the Special Issue Research, Education, Workforce, and Regulation to Transforming Nursing Practice and Leadership: The Future of Nursing)

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18 pages, 632 KiB

Open AccessArticle

Humane and Comprehensive Management of Challenging Behaviour in Health and Social Care: Cross-Sectional Study Testing Newly Developed Instrument

by Sirpa Tölli, Raija Kontio, Pirjo Partanen, Anja Terkamo-Moisio and Arja Häggman-Laitila

Healthcare 2023, 11(5), 753; https://doi.org/10.3390/healthcare11050753 - 03 Mar 2023

Cited by 1 | Viewed by 2068

Abstract

Background: Management of challenging behaviour causes victimization and violates the human rights of service users in psychiatric and long-term settings for people having mental health issues and learning disabilities. The purpose of the research was to develop and test an instrument for measuring [...] Read more.

Background: Management of challenging behaviour causes victimization and violates the human rights of service users in psychiatric and long-term settings for people having mental health issues and learning disabilities. The purpose of the research was to develop and test an instrument for measuring humane behaviour management (HCMCB). The research was guided by the following questions: (1) What is the structure and content of the Human and Comprehensive management of Challenging Behaviour (HCMCB) instrument, (2) What are the psychometric properties of the HCMCB instrument, and (3) How do Finnish health and social care professionals evaluate their humane and comprehensive management of challenging behaviour? Methods: A cross-sectional study design and STROBE checklist were applied. A convenience sample of health and social care professionals (n = 233) studying at the University of Applied Sciences (n = 13) was recruited. Results: The EFA revealed a 14-factor structure and included a total of 63 items. The Cronbach’s alpha values for factors varied from 0.535 to 0.939. The participants rated their individual competence higher than leadership and organizational culture. Conclusions: HCMCB is a useful tool for evaluating competencies, leadership, and organizational practices in the context of challenging behaviour. HCMCB should be further tested in various international contexts involving challenging behaviour with large samples and longitudinal design. Full article

(This article belongs to the Special Issue Moving Away from Coercion in Mental Health Care)

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16 pages, 2329 KiB

Open AccessArticle

Is It Possible to Predict COVID-19? Stochastic System Dynamic Model of Infection Spread in Kazakhstan

by Berik Koichubekov, Aliya Takuadina, Ilya Korshukov, Anar Turmukhambetova and Marina Sorokina

Healthcare 2023, 11(5), 752; https://doi.org/10.3390/healthcare11050752 - 03 Mar 2023

Cited by 1 | Viewed by 1198

Abstract

Background: Since the start of the COVID-19 pandemic, scientists have begun to actively use models to determine the epidemiological characteristics of the pathogen. The transmission rate, recovery rate and loss of immunity to the COVID-19 virus change over time and depend on many [...] Read more.

Background: Since the start of the COVID-19 pandemic, scientists have begun to actively use models to determine the epidemiological characteristics of the pathogen. The transmission rate, recovery rate and loss of immunity to the COVID-19 virus change over time and depend on many factors, such as the seasonality of pneumonia, mobility, testing frequency, the use of masks, the weather, social behavior, stress, public health measures, etc. Therefore, the aim of our study was to predict COVID-19 using a stochastic model based on the system dynamics approach. Method: We developed a modified SIR model in AnyLogic software. The key stochastic component of the model is the transmission rate, which we consider as an implementation of Gaussian random walks with unknown variance, which was learned from real data. Results: The real data of total cases turned out to be outside the predicted minimum–maximum interval. The minimum predicted values of total cases were closest to the real data. Thus, the stochastic model we propose gives satisfactory results for predicting COVID-19 from 25 to 100 days. The information we currently have about this infection does not allow us to make predictions with high accuracy in the medium and long term. Conclusions: In our opinion, the problem of the long-term forecasting of COVID-19 is associated with the absence of any educated guess regarding the dynamics of β(t) in the future. The proposed model requires improvement with the elimination of limitations and the inclusion of more stochastic parameters. Full article

(This article belongs to the Special Issue Computer-Based Medical Systems)

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23 pages, 2142 KiB

Open AccessArticle

Exploration of Sex and Age-Based Associations in Clinical Characteristics, Predictors of Severity, and Duration of Stay among COVID-19 Patients at the University Hospital of Saudi Arabia

by Rasha Assad Assiri, Asmatanzeem Bepari, Waseemoddin Patel, Syed Arif Hussain, Shaik Kalimulla Niazi, Asma Alshangiti, Safia Ali Alshangiti, Mary Anne Wong Cordero and Shazima Sheereen

Healthcare 2023, 11(5), 751; https://doi.org/10.3390/healthcare11050751 - 03 Mar 2023

Cited by 3 | Viewed by 9828

Abstract

COVID-19 infection has a spectrum of variable clinical severity between populations because of their characteristic demographic features, co-morbidities, and immune system reactions. This pandemic tested the healthcare system’s preparedness, which depends on predictors of severity and factors related to the duration of hospital [...] Read more.

COVID-19 infection has a spectrum of variable clinical severity between populations because of their characteristic demographic features, co-morbidities, and immune system reactions. This pandemic tested the healthcare system’s preparedness, which depends on predictors of severity and factors related to the duration of hospital stays. Therefore, we carried out a single-center, retrospective cohort study in a tertiary academic hospital to investigate these clinical features and predictors of severe disease and study the different factors that affect hospital stay. We utilized medical records from March 2020 to July 2021, which included 443 confirmed (positive RT-PCR) cases. The data were explained using descriptive statistics and analyzed via multivariate models. Among the patients, 65.4% were female and 34.5% were male, with a mean age of 45.7 years (SD ± 17.2). We presented seven age groups with ranges of 10 years and noticed that patients aged 30–39 years old comprised 23.02% of the records, while patients aged 70 and above comprised 10%. Nearly 47% were diagnosed as having mild, 25% as moderate, 18% as asymptomatic, and 11% as having a severe case of COVID-19 disease. Diabetes was the most common co-morbidity factor in 27.6% of patients, followed by hypertension (26.4%). Our population’s predictors of severity included pneumonia, identified on a chest X-ray, and co-morbid conditions such as cardiovascular disease, stroke, ICU stay, and mechanical ventilation. The median length of hospital stay was six days. It was significantly longer in patients with a severe disease and who were administered systemic intravenous steroids. An empirical assessment of various clinical parameters could assist in effectively measuring the disease progression and follow-up with patients. Full article

(This article belongs to the Collection COVID-19: Impact on Public Health and Healthcare)

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24 pages, 1542 KiB

Open AccessArticle

Key Factors for Enhancing Home Care Workers’ Intention to Stay by Multiple-Criteria Decision Analysis

by Wei Hsu and Fang-Ping Shih

Healthcare 2023, 11(5), 750; https://doi.org/10.3390/healthcare11050750 - 03 Mar 2023

Cited by 3 | Viewed by 1901

Abstract

The ageing population is increasing rapidly in Taiwan, where the ageing rate exceeds even that of Japan, the United States and France. The increase in the disabled population and the impact of the COVID-19 pandemic have resulted in an increase in the demand [...] Read more.

The ageing population is increasing rapidly in Taiwan, where the ageing rate exceeds even that of Japan, the United States and France. The increase in the disabled population and the impact of the COVID-19 pandemic have resulted in an increase in the demand for long-term professional care, and the shortage of home care workers is one of the most important issues in the development of such care. This study explores the key factors that promote the retention of home care workers through multiple-criteria decision making (MCDM) to help managers of long-term care institutions retain home care talent. A hybrid model of multiple-criteria decision analysis (MCDA) combining Decision-Making Trial and Evaluation Laboratory (DEMATEL) and the analytic network process (ANP) was employed for relative analysis. Through literature discussion and interviews with experts, all factors that promote the retention and desire of home care workers were collected, and a hierarchical MCDM structure was constructed. Then, the hybrid MCDM model of DEMATEL and the ANP was used to analyze the questionnaire data of seven experts to evaluate the factor weights. According to the study results, the key direct factors are improving job satisfaction, supervisor leadership ability and respect, while salary and benefits are the indirect factor. This study uses the MCDA research method and establishes a framework by analyzing the facets and criteria of different factors to promote the retention of home care workers. The results will enable institutions to formulate relevant approaches to the key factors that promote the retention of domestic service personnel and to strengthen the intention of Taiwan’s home care workers to stay in the long-term care industry. Full article

(This article belongs to the Collection Health Care and Services for Elderly Population)

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12 pages, 971 KiB

Open AccessArticle

Socioeconomic Status and Quality of Life: An Assessment of the Mediating Effect of Social Capital

by Jonathan Aseye Nutakor, Lulin Zhou, Ebenezer Larnyo, Stephen Addai-Danso and Debashree Tripura

Healthcare 2023, 11(5), 749; https://doi.org/10.3390/healthcare11050749 - 03 Mar 2023

Cited by 11 | Viewed by 3802

Abstract

Socioeconomic status has been found to be a significant predictor of quality of life, with individuals of higher socioeconomic status reporting better quality of life. However, social capital may play a mediating role in this relationship. This study highlights the need for further [...] Read more.

Socioeconomic status has been found to be a significant predictor of quality of life, with individuals of higher socioeconomic status reporting better quality of life. However, social capital may play a mediating role in this relationship. This study highlights the need for further research on the role of social capital in the relationship between socioeconomic status and quality of life, and the potential implications for policies aimed at reducing health and social inequalities. The study used a cross-sectional design with 1792 adults 18 and older from Wave 2 of the Study of Global AGEing and Adult Health. We employed a mediation analysis to investigate the relationship between socioeconomic status, social capital, and quality of life. The results showed that socioeconomic status was a strong predictor of social capital and quality of life. In addition to this, there was a positive correlation between social capital and quality of life. We found social capital to be a significant mechanism by which adults’ socioeconomic status influences their quality of life. It is crucial to invest in social infrastructure, encourage social cohesiveness, and decrease social inequities due to the significance of social capital in the connection between socioeconomic status and quality of life. To improve quality of life, policymakers and practitioners might concentrate on creating and fostering social networks and connections in communities, encouraging social capital among people, and ensuring fair access to resources and opportunities. Full article

(This article belongs to the Special Issue Socioeconomic Inequalities in Access to Care, Outcomes, and Healthcare Utilization)

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Healthcare, Volume 11, Issue 5 (March-1 2023) – 148 articles

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