Healthcare

12 pages, 277 KiB

Open AccessArticle

Perceptions of the Sense of Security, Belonging, and Acculturative Stress among International Students in China during COVID-19 Outbreak—An Empirical Analysis

by Aijun Liu, Xiao Sheng, Innocensia Dickson Pato, Gladys Mutinda and Yanping Wu

Healthcare 2023, 11(8), 1202; https://doi.org/10.3390/healthcare11081202 - 21 Apr 2023

Cited by 1 | Viewed by 1552

Abstract

Understanding the cross-cultural adaptation of students studying in foreign countries by exploring acculturative stress factors is crucial to ensure the smooth academic performance of the students and, in turn, to enhance the global reputation of their universities. Therefore, it is an area of [...] Read more.

Understanding the cross-cultural adaptation of students studying in foreign countries by exploring acculturative stress factors is crucial to ensure the smooth academic performance of the students and, in turn, to enhance the global reputation of their universities. Therefore, it is an area of interest for the authorities (Ministry) and the corresponding management of universities. Using a random sample of 138 international students in China, descriptive and logistic regressions were conducted to assess the levels and influence of acculturative stress factors on cross-cultural adaptation, specifically on international students’ sense of security and belonging during the COVID-19 pandemic outbreak. The results revealed that students were most concerned about homesickness, which obtained the highest mean score. The regression results indicated that the perception of fear and discrimination significantly impacted international students’ sense of security. The perception of fear, guilt, and how long the student stayed in China also significantly affected the sense of belonging. We argue that the reflections provided herein are essential for universities to improve how they manage and handle international students to mitigate the effects of acculturative stress, particularly when additional stressful conditions are present, such as the COVID-19 pandemic. Full article

15 pages, 621 KiB

Open AccessArticle

The Effect of Aerobic Exercise on Variation of Oxidative Stress, hs-CRP and Cortisol Induced by Sleep Deficiency

by Jong-Suk Park, Zsolt Murlasits and Sangho Kim

Healthcare 2023, 11(8), 1201; https://doi.org/10.3390/healthcare11081201 - 21 Apr 2023

Cited by 2 | Viewed by 1494

Abstract

The aim of this study was to investigate the impact of sleep deficiency (SD) on oxidative stress, hs-CRP and cortisol levels and to examine the effects of different intensities of aerobic exercise on these parameters under SD conditions. Thirty-two healthy male university students [...] Read more.

The aim of this study was to investigate the impact of sleep deficiency (SD) on oxidative stress, hs-CRP and cortisol levels and to examine the effects of different intensities of aerobic exercise on these parameters under SD conditions. Thirty-two healthy male university students participated in the study and underwent both normal sleep (NS, 8 h of sleep per night for 3 consecutive days) and SD (4 h of sleep per night for 3 consecutive days). After the SD period, the participants performed treatment for 30 min according to their assigned group [sleep supplement after SD (SSD), low-intensity aerobic exercise after SD (LES), moderate-intensity aerobic exercise after SD (MES), high-intensity aerobic exercise after SD (HES)]. Sleep-related factors were measured at NS and SD, while oxidative stress, hs-CRP and cortisol levels were measured at NS, SD and immediately after treatment by group (AT). The results showed that actual total sleep time (ATST) was significantly reduced during SD compared to NS (p < 0.001), while the visual analogue scale (VAS) and Epworth sleepiness scale (ESS) were significantly increased during SD compared to NS (p < 0.001). The difference in reactive oxygen metabolites (d-ROMs) and cortisol levels showed a significant interaction effect (p < 0.01, p < 0.001, respectively), with LES showing a decrease in d-ROMs and cortisol levels compared to SD (p < 0.05). Similarly, SSD showed a decrease in cortisol levels compared to SD (p < 0.05), while HES led to a significant increase in d-ROMs and cortisol levels compared to SD (p < 0.05). Biological antioxidant potential (BAP) and hs-CRP did not show any significant effect (p > 0.05). These results suggest that LES is the most effective exercise intensity for mitigating the negative effects of SD. Full article

(This article belongs to the Special Issue Sports or/and Special Populations: Training Physiology in Health and Sports Performance)

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28 pages, 676 KiB

Open AccessReview

Task Shifting and Task Sharing Implementation in Africa: A Scoping Review on Rationale and Scope

by Sunny C. Okoroafor and Christmal Dela Christmals

Healthcare 2023, 11(8), 1200; https://doi.org/10.3390/healthcare11081200 - 21 Apr 2023

Cited by 5 | Viewed by 4068

Abstract

Numerous studies have reported task shifting and task sharing due to various reasons and with varied scopes of health services, either task-shifted or -shared. However, very few studies have mapped the evidence on task shifting and task sharing. We conducted a scoping review [...] Read more.

Numerous studies have reported task shifting and task sharing due to various reasons and with varied scopes of health services, either task-shifted or -shared. However, very few studies have mapped the evidence on task shifting and task sharing. We conducted a scoping review to synthesize evidence on the rationale and scope of task shifting and task sharing in Africa. We identified peer-reviewed papers from PubMed, Scopus, and CINAHL bibliographic databases. Studies that met the eligibility criteria were charted to document data on the rationale for task shifting and task sharing, and the scope of tasks shifted or shared in Africa. The charted data were thematically analyzed. Sixty-one studies met the eligibility criteria, with fifty-three providing insights on the rationale and scope of task shifting and task sharing, and seven on the scope and one on rationale, respectively. The rationales for task shifting and task sharing were health worker shortages, to optimally utilize existing health workers, and to expand access to health services. The scope of health services shifted or shared in 23 countries were HIV/AIDS, tuberculosis, hypertension, diabetes, mental health, eyecare, maternal and child health, sexual and reproductive health, surgical care, medicines’ management, and emergency care. Task shifting and task sharing are widely implemented in Africa across various health services contexts towards ensuring access to health services. Full article

(This article belongs to the Section Health Policy)

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16 pages, 260 KiB

Open AccessArticle

Qualitative Investigation into the Perception towards Compassionate Parenting among Parents of Autistic Children: Cross-Cultural Comparison between the UK and The Netherlands

by Kenneth Curley and Yasuhiro Kotera

Healthcare 2023, 11(8), 1199; https://doi.org/10.3390/healthcare11081199 - 21 Apr 2023

Cited by 1 | Viewed by 1618

Abstract

Parenting a child with autism spectrum disorder is believed to present challenges that lead to increased levels of stress, as well as a reduction in the quality of the relationship between parent and child. This study aims to investigate parental perceptions toward a [...] Read more.

Parenting a child with autism spectrum disorder is believed to present challenges that lead to increased levels of stress, as well as a reduction in the quality of the relationship between parent and child. This study aims to investigate parental perceptions toward a compassionate parenting style of parenting to better understand how this style may influence relationships and quality of life in parents. Parents from the United Kingdom (six parents) and the Netherlands (five parents) were invited take part in semi-structured interviews, whereby the data collected were subsequently analysed using thematic analysis. Data from both British and Dutch groups were overall similar to each other. Four themes were identified from the aggregated data: (a) “Parents believe compassionate parenting is important” (parents believed that compassion is an essential element of their parenting style and improves situational outcomes); (b) “Compassionate parenting de-escalates stressful situations” (compassionate parenting reduces stress and improves the quality of life); (c) “High pressure situations as a threat to practice compassion” (challenges and limitations to compassionate parenting style); and (d) “Greater public and professional awareness of autistic behaviours” (the general public and professional services often lack awareness to recognise autistic behaviour traits). Results are consistent with research examining the perceptions of parents of neurotypical children, in that a more compassionate approach to parenting is valued, as it is believed to create a greater connection with the child. Our findings inform researchers and educators as to what parents of children with ASD find useful, important, and worthwhile. Future research needs to investigate how compassionate parenting impacts autistic children’s quality of life. Full article

(This article belongs to the Special Issue Mental Health at a Personal, Communal, and Social Level)

14 pages, 752 KiB

Open AccessReview

Economic Evaluation of Oral Cancer Screening Programs: Review of Outcomes and Study Designs

by Sivaraj Raman, Asrul Akmal Shafie, Bee Ying Tan, Mannil Thomas Abraham, Shim Chen Kiong and Sok Ching Cheong

Healthcare 2023, 11(8), 1198; https://doi.org/10.3390/healthcare11081198 - 21 Apr 2023

Cited by 1 | Viewed by 1494

Abstract

A lack of guidance on economic evaluations for oral cancer screening programs forms a challenge for policymakers and researchers to fill the knowledge gap on their cost-effectiveness. This systematic review thus aims to compare the outcomes and design of such evaluations. A search [...] Read more.

A lack of guidance on economic evaluations for oral cancer screening programs forms a challenge for policymakers and researchers to fill the knowledge gap on their cost-effectiveness. This systematic review thus aims to compare the outcomes and design of such evaluations. A search for economic evaluations of oral cancer screening was performed on Medline, CINAHL, Cochrane, PubMed, health technology assessment databases, and EBSCO Open Dissertations. The quality of studies was appraised using QHES and the Philips Checklist. Data abstraction was based on reported outcomes and study design characteristics. Of the 362 studies identified, 28 were evaluated for eligibility. The final six studies reviewed consisted of modeling approaches (n = 4), a randomized controlled trial (n = 1), and a retrospective observational study (n = 1). Screening initiatives were mostly shown to be cost-effective compared to non-screening. However, inter-study comparisons remained ambiguous due to large variations. The observational and randomized controlled trials provided considerably accurate evidence of implementation costs and outcomes. Modeling approaches, conversely, appeared more feasible for the estimation of long-term consequences and the exploration of strategy options. The current evidence of the cost-effectiveness of oral cancer screening remains heterogeneous and inadequate to support its institutionalization. Nevertheless, evaluations incorporating modeling methods may provide a practical and robust solution. Full article

(This article belongs to the Section Preventive Medicine)

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11 pages, 460 KiB

Open AccessArticle

Juvenile Myoclonic Epilepsy: Seizure and Social Outcomes in Taiwan

by Siew-Na Lim, Tony Wu, Wei-En Johnny Tseng, Chun-Wei Chang, Hsiang-Yao Hsieh, Mei-Yun Cheng, Hsing-I Chiang, Chih-Hong Lee, Wey-Ran Lin and Chun-Jing Liu

Healthcare 2023, 11(8), 1197; https://doi.org/10.3390/healthcare11081197 - 21 Apr 2023

Cited by 1 | Viewed by 1451

Abstract

Patients with juvenile myoclonic epilepsy (JME) may not achieve seizure freedom despite optimal treatment with antiseizure medications (ASMs). The aim of this study was to investigate the clinical and social features of patients with JME, and to determine the factors associated with outcomes. [...] Read more.

Patients with juvenile myoclonic epilepsy (JME) may not achieve seizure freedom despite optimal treatment with antiseizure medications (ASMs). The aim of this study was to investigate the clinical and social features of patients with JME, and to determine the factors associated with outcomes. We retrospectively identified 49 patients with JME (25 females, mean age 27.6 ± 8.9 years) who were assessed at the Epilepsy Centre of Linkou Chang Gung Memorial Hospital in Taiwan. The patients were divided into two groups, those who were seizure-free and those with ongoing seizures according to their seizure outcome at the last follow-up for one year. Clinical features and social status were compared between these two groups. Twenty-four (49%) of the JME patients were seizure-free for at least one year, while 51% continued to experience seizures despite being treated with multiple ASMs. The presence of epileptiform discharges in the last electroencephalogram and seizures during sleep were significantly associated with worse seizure outcomes (p < 0.05). The patients who were seizure-free had a higher employment rate compared to those who continued to experience seizures (75% vs. 32%, p = 0.004). Despite receiving ASM treatment, a considerable proportion of the patients with JME continued to have seizures. Moreover, poor seizure control was associated with a lower employment rate, which may lead to negative socioeconomic consequences related to JME. Full article

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20 pages, 1272 KiB

Open AccessArticle

Translation, Cross-Cultural Adaptation and Psychometric Validation of the Arabic Version of the Cardiac Rehabilitation Barriers Scale (CRBS-A) with Strategies to Mitigate Barriers

by Raghdah Aljehani, Sherry L. Grace, Aseel Aburub, Karam Turk-Adawi and Gabriela Lima de Melo Ghisi

Healthcare 2023, 11(8), 1196; https://doi.org/10.3390/healthcare11081196 - 21 Apr 2023

Cited by 1 | Viewed by 1753

Abstract

Cardiac rehabilitation (CR) utilization is low, particularly in Arabic-speaking countries. This study aimed to translate and psychometrically validate the CR Barriers Scale in Arabic (CRBS-A), as well as strategies to mitigate them. The CRBS was translated by two bilingual health professionals independently, followed [...] Read more.

Cardiac rehabilitation (CR) utilization is low, particularly in Arabic-speaking countries. This study aimed to translate and psychometrically validate the CR Barriers Scale in Arabic (CRBS-A), as well as strategies to mitigate them. The CRBS was translated by two bilingual health professionals independently, followed by back-translation. Next, 19 healthcare providers, followed by 19 patients rated the face and content validity (CV) of the pre-final versions, providing input to improve cross-cultural applicability. Then, 207 patients from Saudi Arabia and Jordan completed the CRBS-A, and factor structure, internal consistency, construct, and criterion validity were assessed. Helpfulness of mitigation strategies was also assessed. For experts, item and scale CV indices were 0.8–1.0 and 0.9, respectively. For patients, item clarity and mitigation helpfulness scores were 4.5 ± 0.1 and 4.3 ± 0.1/5, respectively. Minor edits were made. For the test of structural validity, four factors were extracted: time conflicts/lack of perceived need and excuses; preference to self-manage; logistical problems; and health system issues and comorbidities. Total CRBS-A α was 0.90. Construct validity was supported by a trend for an association of total CRBS with financial insecurity regarding healthcare. Total CRBS-A scores were significantly lower in patients who were referred to CR (2.8 ± 0.6) vs. those who were not (3.6 ± 0.8), confirming criterion validity (p = 0.04). Mitigation strategies were considered very helpful (mean = 4.2 ± 0.8/5). The CRBS-A is reliable and valid. It can support identification of top barriers to CR participation at multiple levels, and then strategies for mitigating them can be implemented. Full article

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12 pages, 505 KiB

Open AccessArticle

Justification of Discrimination against People with Mental Illness in Republic of Korea

by Mikyung Seo, Minhwa Lee and Jinhyang Lee

Healthcare 2023, 11(8), 1195; https://doi.org/10.3390/healthcare11081195 - 21 Apr 2023

Viewed by 1098

Abstract

Aims: This study aimed to analyze the process in which individual values and beliefs affected social distance against people with mental illness by mediating cognition, based on applying the justification–suppression model to the stigma of mental illness. Methods: An online survey was conducted [...] Read more.

Aims: This study aimed to analyze the process in which individual values and beliefs affected social distance against people with mental illness by mediating cognition, based on applying the justification–suppression model to the stigma of mental illness. Methods: An online survey was conducted with 491 adults aged 20 to 64 years. Their sociodemographic characteristics, personal values, and beliefs, justification for discrimination, and social distance were measured to assess their perceptions of, and behaviors towards, persons with mental illness. Path analysis was performed to examine the magnitude and significance of the hypothetical relationship between variables. Results: Protestant ethic values and morality significantly affected the justification of inability and dangerousness and attribute responsibility. Excluding attribute responsibility, the justification of inability and dangerousness significantly predicted social distance. In other words, the higher the Protestant ethic values, the higher the morality of binding, and the lower the morality of individualizing, the higher the level of justification based on inability and dangerousness. Such justification has been found to increase social distance from persons with mental illness. In addition, mediating effects were the largest in the path of the morality of binding → justification of dangerousness → social distance. Conclusions: The study proposes various strategies to deal with individual values, beliefs, and justification logic to reduce social distance against those with mental illness. These strategies include a cognitive approach and empathy, both of which inhibit prejudice. Full article

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10 pages, 640 KiB

Open AccessArticle

The Insomnia Severity Index: Factor Structure and Measurement and Structural Invariance across Perinatal Time Points

by Eriko Shinohara, Ayako Hada, Mariko Minatani, Mikiyo Wakamatsu and Toshinori Kitamura

Healthcare 2023, 11(8), 1194; https://doi.org/10.3390/healthcare11081194 - 21 Apr 2023

Cited by 2 | Viewed by 1641

Abstract

Insomnia is associated with adverse outcomes in women in the perinatal period; thus, the assessment of insomnia is important for pregnant women. The Insomnia Severity Index (ISI) is an instrument used globally to assess the severity of insomnia. However, its factor structure and [...] Read more.

Insomnia is associated with adverse outcomes in women in the perinatal period; thus, the assessment of insomnia is important for pregnant women. The Insomnia Severity Index (ISI) is an instrument used globally to assess the severity of insomnia. However, its factor structure and structural invariance for pregnant women have not been studied. Therefore, we aimed to conduct factor analyses to search for the best model to fit its structural invariance. A cross-sectional study with the ISI was conducted at one hospital and five clinics in Japan from January 2017 to May 2019. A set of questionnaires was administered on two occasions with a one-week interval. The study included 382 pregnant women ranging in gestational age from 10 to 13 weeks. One week later, 129 participants answered the retest. After exploratory and confirmatory factor analyses, the measurement and structural invariance between parity and two time points was tested. The two-factor structure model showed an acceptable fit for the ISI in pregnant women (χ² (12) = 28.516, CFI = 0.971, RMSEA = 0.089). The model also showed satisfactory measurement and structure invariance between parity and time points. The findings indicate that the ISI’s use would be appropriate for pregnant women as a two-factor subscale of “severity” and “impact”, regardless of the parity or time point. The ISI’s factor structure may vary by subject; hence, it is necessary to confirm the measurement and structural invariance of the subject for whom the ISI will be used. Furthermore, interventions that focus not only on total scores and cutoff points but also on the phenomenon of subscales should be considered. Full article

(This article belongs to the Special Issue Perinatal Mental Health and Care)

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11 pages, 853 KiB

Open AccessArticle

Effects of Yoga for Coping with Premenstrual Symptoms in Taiwan—A Cluster Randomized Study

by Hsing-Chi Chang, Yi-Chuan Cheng, Chi-Hsuan Yang, Ya-Ling Tzeng and Chung-Hey Chen

Healthcare 2023, 11(8), 1193; https://doi.org/10.3390/healthcare11081193 - 21 Apr 2023

Viewed by 1592

Abstract

Home-based yoga practice has not been approved as a method for alleviating premenstrual symptoms in Taiwan. This study was a cluster randomized trial. A total of 128 women self-reporting at least one premenstrual symptom were enrolled in the study, of which there were [...] Read more.

Home-based yoga practice has not been approved as a method for alleviating premenstrual symptoms in Taiwan. This study was a cluster randomized trial. A total of 128 women self-reporting at least one premenstrual symptom were enrolled in the study, of which there were 65 participants in the experimental group and 63 participants in the control group. Women in the yoga group were provided with a yoga DVD program (30 min) to practice for three menstrual months, at least three times a week. All participants were given the Daily Record of Severity of Problems (DRSP) form to measure premenstrual symptoms. After the yoga exercise intervention, the yoga group had statistically significantly fewer and/or less severe premenstrual depressive symptoms, physical symptoms, and anger/irritability. Other disturbances and the impairment of daily routine, hobbies/social activities, and relationships also occurred significantly less often in the yoga group. The study found that yoga is useful to relieve premenstrual symptoms. Moreover, home-based yoga practice is more pertinent in the pandemic era. The strengths and drawbacks of the study are discussed and further study is recommended. Full article

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16 pages, 319 KiB

Open AccessArticle

Clinical Disease Characteristics and Treatment Trajectories Associated with Mortality among COVID-19 Patients in Punjab, Pakistan

by Muhammad Zeeshan Munir, Amer Hayat Khan and Tahir Mehmood Khan

Healthcare 2023, 11(8), 1192; https://doi.org/10.3390/healthcare11081192 - 21 Apr 2023

Viewed by 2929

Abstract

Background: Data on Pakistani COVID-19 patient mortality predictors is limited. It is essential to comprehend the relationship between disease characteristics, medications used, and mortality for better patient outcomes. Methods: The medical records of confirmed cases in the Lahore and Sargodha districts were examined [...] Read more.

Background: Data on Pakistani COVID-19 patient mortality predictors is limited. It is essential to comprehend the relationship between disease characteristics, medications used, and mortality for better patient outcomes. Methods: The medical records of confirmed cases in the Lahore and Sargodha districts were examined using a two-stage cluster sampling from March 2021 to March 2022. Demographics, signs and symptoms, laboratory findings, and pharmacological medications as mortality indicators were noted and analyzed. Results: A total of 288 deaths occurred out of the 1000 cases. Death rates were higher for males and people over 40. Most of those who were mechanically ventilated perished (OR: 124.2). Dyspnea, fever, and cough were common symptoms, with a significant association amid SpO2 < 95% (OR: 3.2), RR > 20 breaths/min (OR: 2.5), and mortality. Patients with renal (OR: 2.3) or liver failure (OR: 1.5) were at risk. Raised C-reactive protein (OR: 2.9) and D-dimer levels were the indicators of mortality (OR: 1.6). The most prescribed drugs were antibiotics, (77.9%), corticosteroids (54.8%), anticoagulants (34%), tocilizumab (20.3%), and ivermectin (9.2%). Conclusions: Older males having breathing difficulties or signs of organ failure with raised C-reactive protein or D-dimer levels had high mortality. Antivirals, corticosteroids, tocilizumab, and ivermectin had better outcomes; antivirals were associated with lower mortality risk. Full article

(This article belongs to the Special Issue Clinical Decision-Making Processes in COVID-19 Pandemic: Changes and Effects)

14 pages, 2792 KiB

Open AccessArticle

Impact of Lockdown Measures on Health Outcomes of Adults with Type 2 Diabetes Mellitus in Bangladesh

by Farhana Akter, Ahsanul Haq, Brian Godman, Kona Chowdhury, Santosh Kumar and Mainul Haque

Healthcare 2023, 11(8), 1191; https://doi.org/10.3390/healthcare11081191 - 21 Apr 2023

Viewed by 1551

Abstract

COVID-19 lockdown measures appreciably affected patients’ lifestyles, negatively impacting on their health. This includes patients with Type 2 Diabetes Mellitus (T2DM). Care of these patients was also negatively impacted due to a priority to treat patients with COVID-19, certainly initially, within hospitals and [...] Read more.

COVID-19 lockdown measures appreciably affected patients’ lifestyles, negatively impacting on their health. This includes patients with Type 2 Diabetes Mellitus (T2DM). Care of these patients was also negatively impacted due to a priority to treat patients with COVID-19, certainly initially, within hospitals and clinics in Bangladesh, combined with a lack of access to clinics and physicians due to lockdown and other measures. This is a concern in Bangladesh with growing rates of T2DM and subsequent complications. Consequently, we sought to critically analyze the situation among patients with T2DM in Bangladesh during the initial stages of the pandemic to address this information gap and provide future direction. Overall, 731 patients were recruited by a simple random sampling method among patients attending hospitals in Bangladesh, with data collected over 3 timescales: before lockdown, during the pandemic, and after lockdown. Data extracted from patients’ notes included current prescribed medicines and key parameters, including blood sugar levels, blood pressure, and comorbidities. In addition, the extent of record keeping. The glycemic status of patients deteriorated during lockdown, and comorbidities as well as complications related to T2DM increased during this period. Overall, a significant proportion of key datasets were not recorded in patients’ notes by their physician before and during lockdown. This started to change after lockdown measures eased. In conclusion, lockdown measures critically affected the management of patients with T2DM in Bangladesh, building on previous concerns. Extending internet coverage for telemedicine, introduction of structured guidelines, and appreciably increasing data recording during consultations is of the utmost priority to improve the care of T2DM patients in Bangladesh. Full article

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26 pages, 5218 KiB

Open AccessSystematic Review

Prevalence and Risk Factors of Musculoskeletal Disorders in Basketball Players: Systematic Review and Meta-Analysis

by Silvia Cristina de Carvalho Borges, Carolina Rodrigues Mendonça, Regina Márcia Ferreira Silva, Alberto De Vitta and Matias Noll

Healthcare 2023, 11(8), 1190; https://doi.org/10.3390/healthcare11081190 - 21 Apr 2023

Cited by 3 | Viewed by 1860

Abstract

Musculoskeletal disorders characteristically induce pain and limitations in mobility, ability, and overall functioning. In athletes, including basketball players, disorders such as back pain, postural changes, and spinal injuries are common. This systematic review aimed to evaluate the prevalence of back pain and musculoskeletal [...] Read more.

Musculoskeletal disorders characteristically induce pain and limitations in mobility, ability, and overall functioning. In athletes, including basketball players, disorders such as back pain, postural changes, and spinal injuries are common. This systematic review aimed to evaluate the prevalence of back pain and musculoskeletal disorders in basketball players and ascertain the associated factors. Methods: The Embase, PubMed, and Scopus databases were searched for studies published in English without a time limit. Using STATA, meta-analyses were performed to estimate the prevalence of pain and musculoskeletal disorders of the back and spine. Results: Of the 4135 articles identified, 33 studies were included in this review, with 27 studies included in the meta-analysis. Of these, 21 were used for the meta-analysis of back pain, 6 articles were used for the meta-analysis of spinal injury, and 2 studies were used for the meta-analysis of postural changes. The overall prevalence of back pain was 43% [95% CI, −1% to 88%]; of these, the prevalence of neck pain was 36% [95% CI, 22–50%], the prevalence of back pain was 16% [95% CI, 4–28%], the prevalence of low back pain was 26% [95% CI, 16–37%], the prevalence of thoracic spine pain was 6% [95% CI, 3–9%]. The combined prevalence of spinal injury and spondylolysis was 10% [95% CI, 4–15%], with a prevalence of spondylolysis of 14% [95% CI, 0.1–27%]. The combined prevalence of hyperkyphosis and hyperlordosis was 30% [95% CI, 9–51%]. In conclusion, we found a high prevalence of neck pain, followed by low back pain and back pain, in basketball players. Thus, prevention programs are important to improve health and sports performance. Full article

(This article belongs to the Special Issue Sports or/and Special Populations: Training Physiology in Health and Sports Performance)

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11 pages, 294 KiB

Open AccessArticle

by Zafar Ali Khan, Namdeo Prabhu, Rakhi Issrani, Amjad Abdulrahman S. Albulayhid, Shahad Mohammed Mlih Alruwaili, Rola Hliel Gadoe Alruwaili, Basant Mousa Alsiyat, Alzarea K. Bader, Mohammed Ghazi Sghaireen, Krishna Rao and Muhammed Nadeem Baig

Healthcare 2023, 11(8), 1189; https://doi.org/10.3390/healthcare11081189 - 20 Apr 2023

Cited by 1 | Viewed by 1553

Abstract

Background: Breast cancer is one of the most prevalent diseases, and ignoring dental health care before and after treatment can have severe long-term consequences. Additionally, this may have a negative impact on the patient’s general quality of life. Aim: The aim of the [...] Read more.

Background: Breast cancer is one of the most prevalent diseases, and ignoring dental health care before and after treatment can have severe long-term consequences. Additionally, this may have a negative impact on the patient’s general quality of life. Aim: The aim of the present study was to assess oral health-related quality of life (OHRQoL) among breast cancer patients and identify possible factors associated with the outcome. Methodology: In this observational cross-sectional study, 200 women who had received breast cancer therapy and were being followed up at a hospital made up the sample. The study was conducted between January 2021 and July 2022. Information on sociodemographic characteristics, general health, and breast cancer was recorded. The decayed, missing, and filled teeth index was used in clinical examinations to identify caries experience. OHRQoL was evaluated using the Oral Health Impact Profile (OHIP-14) questionnaire. After adjusting for confounding variables, a logistic regression analysis was used to determine the related factors. Results: The mean OHIP-14 score was 11.48 (SD 1.35). There was a 63.0% prevalence of negative impacts. Age and the time frame from cancer diagnosis were found to be significantly linked with the outcome by binary logistic regression analysis. Conclusions: Breast cancer survivors who were ≤55 years old and the time elapsed since diagnosis was less than 36 months had a poor OHRQoL. To lessen the negative impacts of cancer treatment and enhance quality of life, patients with breast cancer need special oral care and should be monitored before, during, and after cancer treatment. Full article

(This article belongs to the Special Issue Breast Cancer in Healthcare)

12 pages, 291 KiB

Open AccessArticle

Complex Posttraumatic Stress Disorder (CPTSD) as an Independent Diagnosis: Differences in Hedonic and Eudaimonic Well-Being between CPTSD and PTSD

by Danfeng Li, Jiaxian Luo, Xingru Yan and Yiming Liang

Healthcare 2023, 11(8), 1188; https://doi.org/10.3390/healthcare11081188 - 20 Apr 2023

Viewed by 2344

Abstract

Although many studies have differentiated complex posttraumatic stress disorder (CPTSD) from posttraumatic stress disorder (PTSD), few studies have explored the differences in positive adaptation between the two. The present study aimed to determine whether there are distinctions between PTSD and CPTSD in hedonic [...] Read more.

Although many studies have differentiated complex posttraumatic stress disorder (CPTSD) from posttraumatic stress disorder (PTSD), few studies have explored the differences in positive adaptation between the two. The present study aimed to determine whether there are distinctions between PTSD and CPTSD in hedonic and eudaimonic well-being. The present study used a Chinese young adult sample with childhood adversity experiences (n = 1451), including 508 males and 943 females, with an average age of 20.07 years (SD = 1.39). PTSD and CPTSD symptoms were measured by the International Trauma Questionnaire. Eudaimonic well-being was measured by the Meaning in Life Questionnaire, and hedonic well-being, including life satisfaction and happiness, was assessed by the Satisfaction with Life Scale and the face scale. Analysis of variance showed that the CPTSD group had lower hedonic and eudaimonic well-being than the PTSD group. Moreover, hierarchical regression analysis showed that disturbances in self-organization (DSO) symptoms in CPTSD were negatively associated with hedonic and eudaimonic well-being, while PTSD was positively associated with eudaimonic well-being. These findings indicate that the core symptoms of CPTSD might hinder individuals from living fulfilling lives. The positive association between eudaimonic well-being and PTSD symptoms may be a manifestation of posttraumatic growth. Based on the perspective of positive adaptation, these results provide new evidence of the importance of considering CPTSD as an independent diagnosis and suggest that future well-being interventions should be implemented in people with DSO symptoms. Full article

18 pages, 1285 KiB

Open AccessArticle

Transforming Health Care Delivery towards Value-Based Health Care in Germany: A Delphi Survey among Stakeholders

by Franziska Krebs, Sabrina Engel, Vera Vennedey, Adrienne Alayli, Dusan Simic, Holger Pfaff, Stephanie Stock and on behalf of the Cologne Research and Development Network (CoRe-Net)

Healthcare 2023, 11(8), 1187; https://doi.org/10.3390/healthcare11081187 - 20 Apr 2023

Cited by 2 | Viewed by 1787

Abstract

Value-based healthcare (VBC) represents one strategy to meet growing challenges in healthcare systems. To date, VBC is not implemented broadly in the German healthcare system. A Delphi survey was conducted to explore stakeholders’ perspectives on the relevance and feasibility of actions and practices [...] Read more.

Value-based healthcare (VBC) represents one strategy to meet growing challenges in healthcare systems. To date, VBC is not implemented broadly in the German healthcare system. A Delphi survey was conducted to explore stakeholders’ perspectives on the relevance and feasibility of actions and practices related to the implementation of VBC in the German healthcare system. Panellists were selected using purposive sampling. Two iterative online survey rounds were conducted which were preceded by a literature search and semi-structured interviews. After two survey rounds, a consensus was reached on 95% of the items in terms of relevance and on 89% of the items regarding feasibility. The expert panels’ responses were in favor of the presented actions and practices of VBC in 98% of items for which consensus was found (n = 101). Opposition was present regarding the relevance of health care being provided preferably in one location for each indication. Additionally, the panel considered inter-sectoral joint budgets contingent on treatment outcomes achieved as not feasible. When planning the next steps in moving towards a value-based healthcare system, policymakers should take into account this study’s results on stakeholders’ perceptions of the relative importance and feasibility of VBC components. This ensures that regulatory changes are aligned with stakeholder values, facilitating greater acceptance and more successful implementation. Full article

(This article belongs to the Section Health Policy)

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12 pages, 1278 KiB

Open AccessArticle

Implementation, Feasibility, and Acceptability of MATCH to Prevent Iatrogenic Disability in Hospitalized Older Adults: A Question of Geriatric Care Program?

by Eva Peyrusqué, Marie-Jeanne Kergoat, Marie-Josée Sirois, Nathalie Veillette, Raquel Fonseca and Mylène Aubertin-Leheudre

Healthcare 2023, 11(8), 1186; https://doi.org/10.3390/healthcare11081186 - 20 Apr 2023

Viewed by 1263

Abstract

Senior adults (>age 65) represent almost 20% of the population but account for 48% of hospital bed occupancy. In older adults, hospitalization often results in functional decline (i.e., iatrogenic disability) and, consequently, the loss of autonomy. Physical activity (PA) has been shown to [...] Read more.

Senior adults (>age 65) represent almost 20% of the population but account for 48% of hospital bed occupancy. In older adults, hospitalization often results in functional decline (i.e., iatrogenic disability) and, consequently, the loss of autonomy. Physical activity (PA) has been shown to counteract these declines effectively. Nevertheless, PA is not implemented in standard clinical practice. We previously showed that MATCH, a pragmatic, specific, adapted, and unsupervised PA program, was feasible and acceptable in a geriatric assessment unit (GAU) and a COVID-19 geriatric unit. This feasibility study aims to confirm that this tool could be implemented in other geriatric care programs, notably a geriatric rehabilitation unit (GRU) and a post-acute care unit (PACU), in order to reach the maximum number of older patients. Eligibility and consent were assessed by the physician for all the patients admitted to the three units (GAU, GRU, and PACU). The rehabilitation therapist taught each participant one of the five PA programs based on their mobility score on the decisional tree. Implementation (eligibility (%): patients eligible/number admitted and delay of implementation: number of days until prescription); feasibility (adherence (%): number sessions completed/number sessions prescribed and walking time (%): total walking time/time prescribed time); and acceptability (healthcare team (%): tool adequacy (yes/no) and patient: System Usability Scale questionnaire (SUS: x/100)) were evaluated and analyzed using a Kruskal–Wallis ANOVA or Fisher’s exact test. Eligibility was different between the units (GRU = 32.5% vs. PACU = 26.6% vs. GAU = 56.0%; p < 0.001), but the time before implementation was similar (days: GRU = 5.91 vs. PACU = 5.88 vs. GAU = 4.78; p > 0.05). PA adherence (GRU = 83.5% vs. PACU = 71.9% vs. GAU = 74.3%) and walking time (100% in all units) were similar (p > 0.05). Patients (SUS: GRU = 74.6 vs. PACU = 77.2 vs. GAU = 77.2; p > 0.05) and clinicians (adequacy (yes; %): GRU = 78.3%; PACU = 76.0%; GAU = 72.2%; p > 0.05) found MATCH acceptable. Overall, MATCH was implementable, feasible, and acceptable in a GAU, GRU, and PACU. Randomized controlled trials are needed to confirm our results and evaluate the health benefits of MATCH compared with usual care. Full article

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11 pages, 472 KiB

Open AccessArticle

Alcohol Consumption in Nursing Students after the COVID-19 Lockdown

by Carmen María Guerrero-Agenjo, Jaime López-Tendero, Ángel López-González, Isabel María Guisado-Requena, Jose Alberto Laredo-Aguilera, Juan Manuel Carmona-Torres, Jesús López-Torres-Hidalgo and Joseba Rabanales-Sotos

Healthcare 2023, 11(8), 1185; https://doi.org/10.3390/healthcare11081185 - 20 Apr 2023

Cited by 1 | Viewed by 1113

Abstract

Excessive alcohol consumption is a major public health issue that can negatively affect behavior among university students. The objective of this study was to estimate the frequency of alcohol consumption in nursing students as well as to describe the pattern of alcohol consumption [...] Read more.

Excessive alcohol consumption is a major public health issue that can negatively affect behavior among university students. The objective of this study was to estimate the frequency of alcohol consumption in nursing students as well as to describe the pattern of alcohol consumption after COVID-19 lockdown. A descriptive, cross-sectional observational study was carried out, in which 1162 degree-level nursing students were evaluated. Sociodemographic characteristics, lifestyles and levels of physical activity were determined using the International Physical Activity Questionnaire: Short Form (IPAQ-SF), and alcohol consumption was determined using the ISCA (Systematized Alcohol Consumption Questionnaire) and AUDIT (Alcohol Use Disorders Inventory Test) questionnaires. According to the AUDIT questionnaire, 36.7% of the students met the criteria for excessive alcohol consumption (26.8% men vs. 39.9% women; p < 0.001). The prevalence of hazardous drinkers was found to be 10.2% (95% CI 5.6–11.7), with the difference between men and women being statistically significant. The IPAQ-SF questionnaire indicated that 26.1% of students were sedentary. No relationship was observed between alcohol consumption and the level of physical activity. The frequency of hazardous drinkers was significantly higher in women (OR: 2.2) and in smokers (OR: 4.2). In conclusion, approximately 10% of nursing students can be considered hazardous drinkers, with significant differences between the sexes. The percentage is higher in women and in smokers. Strategies should be created that encourage healthy lifestyles, emphasizing preventive activities against excessive alcohol consumption. Furthermore, given the differences in excessive alcohol consumption between men and women, it would be advisable to include the gender perspective in these activities. Full article

(This article belongs to the Section Nursing)

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18 pages, 291 KiB

Open AccessArticle

COVID-19: Factors Associated with the Psychological Distress, Fear and Resilient Coping Strategies among Community Members in Saudi Arabia

by Talal Ali F. Alharbi, Alaa Ashraf Bagader Alqurashi, Ilias Mahmud, Rayan Jafnan Alharbi, Sheikh Mohammed Shariful Islam, Sami Almustanyir, Ahmed Essam Maklad, Ahmad AlSarraj, Lujain Nedhal Mughaiss, Jaffar A. Al-Tawfiq, Ahmed Ali Ahmed, Mazin Barry, Sherief Ghozy, Lulwah Ibrahim Alabdan, Sheikh M. Alif, Farhana Sultana, Masudus Salehin, Biswajit Banik, Wendy Cross and Muhammad Aziz Rahman

Healthcare 2023, 11(8), 1184; https://doi.org/10.3390/healthcare11081184 - 20 Apr 2023

Cited by 1 | Viewed by 1806

Abstract

(1) Background: COVID-19 caused the worst international public health crisis, accompanied by major global economic downturns and mass-scale job losses, which impacted the psychosocial wellbeing of the worldwide population, including Saudi Arabia. Evidence of the high-risk groups impacted by the pandemic has been [...] Read more.

(1) Background: COVID-19 caused the worst international public health crisis, accompanied by major global economic downturns and mass-scale job losses, which impacted the psychosocial wellbeing of the worldwide population, including Saudi Arabia. Evidence of the high-risk groups impacted by the pandemic has been non-existent in Saudi Arabia. Therefore, this study examined factors associated with psychosocial distress, fear of COVID-19 and coping strategies among the general population in Saudi Arabia. (2) Methods: A cross-sectional study was conducted in healthcare and community settings in the Saudi Arabia using an anonymous online questionnaire. The Kessler Psychological Distress Scale (K-10), Fear of COVID-19 Scale (FCV-19S) and Brief Resilient Coping Scale (BRCS) were used to assess psychological distress, fear and coping strategies, respectively. Multivariate logistic regressions were used, and an Adjusted Odds Ratio (AOR) with 95% Confidence Intervals (CIs) was reported. (3) Results: Among 803 participants, 70% (n = 556) were females, and the median age was 27 years; 35% (n = 278) were frontline or essential service workers; and 24% (n = 195) reported comorbid conditions including mental health illness. Of the respondents, 175 (21.8%) and 207 (25.8%) reported high and very high psychological distress, respectively. Factors associated with moderate to high levels of psychological distress were: youth, females, non-Saudi nationals, those experiencing a change in employment or a negative financial impact, having comorbidities, and current smoking. A high level of fear was reported by 89 participants (11.1%), and this was associated with being ex-smokers (3.72, 1.14–12.14, 0.029) and changes in employment (3.42, 1.91–6.11, 0.000). A high resilience was reported by 115 participants (14.3%), and 333 participants (41.5%) had medium resilience. Financial impact and contact with known/suspected cases (1.63, 1.12–2.38, 0.011) were associated with low, medium, to high resilient coping. (4) Conclusions: People in Saudi Arabia were at a higher risk of psychosocial distress along with medium-high resilience during the COVID-19 pandemic, warranting urgent attention from healthcare providers and policymakers to provide specific mental health support strategies for their current wellbeing and to avoid a post-pandemic mental health crisis. Full article

(This article belongs to the Special Issue Direct and Indirect Effects of the Ongoing COVID-19 Pandemic on Physical and Mental Health: Second Edition)

15 pages, 1534 KiB

Open AccessArticle

Successive Waves of the COVID-19 Pandemic Had an Increasing Impact on Chronic Cardiovascular Patients in a Western Region of Romania

by Adelina Tudora, Diana Lungeanu, Adina Pop-Moldovan, Maria Puschita and Radu I. Lala

Healthcare 2023, 11(8), 1183; https://doi.org/10.3390/healthcare11081183 - 20 Apr 2023

Cited by 1 | Viewed by 1797

Abstract

Three years since the COVID-19 pandemic started, there is still little information about patients with chronic medical conditions, such as cardiovascular diseases (CVDs), who become infected with SARS-CoV-2. A retrospective analysis was performed to evaluate the impact of the COVID-19 pandemic on patients [...] Read more.

Three years since the COVID-19 pandemic started, there is still little information about patients with chronic medical conditions, such as cardiovascular diseases (CVDs), who become infected with SARS-CoV-2. A retrospective analysis was performed to evaluate the impact of the COVID-19 pandemic on patients with cardiovascular comorbidities hospitalized with positive RT-PCR results for SARS-CoV-2 during the highest peaks of the first three pandemic waves: April 2020, October 2020, and November 2021. The primary outcome was in-hospital mortality; the secondary outcomes were length of hospitalization and required mechanical ventilation to assess the disease severity. Data were extracted from the hospital electronic database system: 680 eligible cases were identified out of 2919 patients. Mortality was the highest in wave 3 (31.9%) compared to the previous waves (13.6% and 25.8%). Hospitalization was also significantly longer in wave 3 (11.58 ± 5.34 vs. 8.94 ± 4.74 and 10.19 ± 5.06; p < 0.001), and so was the need for mechanical ventilation (21.7% vs. 8.2% and 9%; p < 0.001). Older age and male gender were confirmed as highly significant predictors of unfavorable outcomes. Ischemic heart disease worsened the odds of patients’ survival irrespective of the three pandemic waves (Breslow–Day test, p = 0.387), with a marginally significant Mantel–Haenszel common estimate for risk: OR = 1.604, 95% (0.996; 2.586). The significantly worse outcomes in wave 3 could have been influenced by a combination of factors: the low percentage of vaccinations in Romanian population, the more virulent delta strain, and pandemic attrition in the care provided to these patients with chronic CVDs. 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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22 pages, 648 KiB

Open AccessReview

Unemployment and Substance Use: An Updated Review of Studies from North America and Europe

by Carina Nolte-Troha, Patrik Roser, Dieter Henkel, Norbert Scherbaum, Gabriele Koller and Andreas G. Franke

Healthcare 2023, 11(8), 1182; https://doi.org/10.3390/healthcare11081182 - 20 Apr 2023

Cited by 10 | Viewed by 2856

Abstract

Since the industrial revolution, the relationship between unemployment and psychiatric disorders has been a subject of high interest. Currently, regarding the correlation between unemployment and substance-use disorders (SUDs), only older, often isolated and fragmented research results are available in the literature. This review [...] Read more.

Since the industrial revolution, the relationship between unemployment and psychiatric disorders has been a subject of high interest. Currently, regarding the correlation between unemployment and substance-use disorders (SUDs), only older, often isolated and fragmented research results are available in the literature. This review was based on an extensive literature search of the European and North American literature in most relevant databases for “unemployment” and “substance use” related to “drugs”, “alcohol”, “nicotine”, and “tobacco” between November 2022 and January 2023, according to the PRISMA (Preferred Reporting Items for Systematic review and Meta-Analysis) guidelines. A total of 59,117 papers were identified, of which only 33 articles were identified as relevant to the research objective. The literature showed significantly higher prevalence rates of SUDs involving divergent psychotropic substances among unemployed people. Unemployment was found to be a risk factor for SUD, and vice versa. However, the correlation between unemployment and relapses or smoking cessation was inconsistent. In addition, there appeared to be a mild effect of business cycles on SUD. The results showed significant multifaceted correlations between unemployment and SUD, indicating that prevention and early intervention are required to prevent harmful psychosocial consequences, such as social disintegration and severe psychiatric disorders. Full article

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13 pages, 1335 KiB

Open AccessArticle

Predicting Depression in Older Adults after the COVID-19 Pandemic Using ICF Model

by Seonjae Been and Haewon Byeon

Healthcare 2023, 11(8), 1181; https://doi.org/10.3390/healthcare11081181 - 20 Apr 2023

Cited by 3 | Viewed by 1512

Abstract

This study aimed to test a predictive model for depression in older adults in the community after the COVID-19 pandemic and identify influencing factors using the International Classification of Functioning, Disability, and Health (ICF). The subjects of this study were 9920 older adults [...] Read more.

This study aimed to test a predictive model for depression in older adults in the community after the COVID-19 pandemic and identify influencing factors using the International Classification of Functioning, Disability, and Health (ICF). The subjects of this study were 9920 older adults in South Korean local communities. The analysis results of path analysis and bootstrapping analysis revealed that subjective health status, instrumental activities of daily living (IADL), number of chronic diseases, social support satisfaction, household economic level, informal support, and participation in social groups were factors directly influencing depression, while formal support, age, gender, education level, employment status, and participation in social groups were factors indirectly affecting it. It will be needed to prepare measures to prevent depression in older adults during an infectious disease pandemic, such as the COVID-19 pandemic, based on the results of this study. Full article

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26 pages, 27219 KiB

Open AccessArticle

Effective Co-Creation Tool Development for Shared Understanding and Active Communication for Patients with Head and Neck Cancer

by Yoo-Ri Koo, Eun-Jeong Kim and Inn-Chul Nam

Healthcare 2023, 11(8), 1180; https://doi.org/10.3390/healthcare11081180 - 20 Apr 2023

Viewed by 1203

Abstract

To improve the quality of life of cancer patients, patient experience (PE) must be improved along with the overall treatment process. This study aimed to develop an effective and practical co-design tool to improve the healthcare service experience of patients with head and [...] Read more.

To improve the quality of life of cancer patients, patient experience (PE) must be improved along with the overall treatment process. This study aimed to develop an effective and practical co-design tool to improve the healthcare service experience of patients with head and neck cancer (HNC) in various factors. The research consisted of four phases: (1) HNC PE categories for healthcare improvement were identified through systematic review, user interviews, and observation; (2) a focus group meeting was held to materialize the card design; (3) a structured and visual card set was developed for stakeholders to share the content and discuss improvements in PE effectively; (4) to evaluate the feasibility of the developed cards, a co-creation workshop with HNC medical staffs was conducted. From the workshop using insight cards, we identified the differences in the medical staff’s and patients’ perspectives on the factors for improving HNC PE in each stage of the treatment journey. Pat Exp Insight Cards as experience-based co-design (EBCD) tools can be useful for stakeholders to empathize with the specific pain points and needs of patients with HNC and to discuss improvement plans efficiently. Full article

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11 pages, 1255 KiB

Open AccessArticle

Opportunities and Threats of the Legally Facilitated Performance-Based Managed Entry Agreements in Slovakia: The Early-Adoption Perspective

by Petra Hospodková, Klára Gilíková, Miroslav Barták, Elena Marušáková and Aleš Tichopád

Healthcare 2023, 11(8), 1179; https://doi.org/10.3390/healthcare11081179 - 19 Apr 2023

Cited by 2 | Viewed by 1388

Abstract

Slovakia has adopted an amendment to Act No. 363/2011, regulating, among other things, drug reimbursement and is undergoing a significant change in the availability of innovative treatments for patients. High expectations are associated with arrangements related to performance-based managed entry agreements. Opinions and [...] Read more.

Slovakia has adopted an amendment to Act No. 363/2011, regulating, among other things, drug reimbursement and is undergoing a significant change in the availability of innovative treatments for patients. High expectations are associated with arrangements related to performance-based managed entry agreements. Opinions and positions towards this change appear to be inconsistent, and for the further application of the law in practice and when setting up the main implementation processes, it is necessary to understand the positions and opinions of the individual actors who are involved in the PB-MEA process. The interviews were conducted in the period from 20 May to 15 August 2022 around the same time as the finalisation of the amendment to Act No. 363/2011 and its adoption. A roughly one-hour open interview was conducted on a sample of 12 stakeholders in the following groups: representatives of the Ministry of Health, health-care providers, pharmaceutical companies and others, including a health insurance company. The main objective was to qualitatively describe the perception of this topic by key stakeholders in Slovakia. The responses were analysed using MAXQDATA 2022 software to obtain codes associated with key expressions. We identified three main strong top categories of expressions that strongly dominated the pro-management interviews with stakeholders: legislation, opportunities and threats. Ambiguity and insufficient coverage of the new law, improved availability of medicinal products and threats associated with data, IT systems and potentially unfavourable new reimbursement schemes were identified as key topics of each of the said top categories, respectively. Among individual sets of respondents, there is frequent consensus on both opportunities and threats in the area of implementing process changes in PB-MEA. For the successful implementation of the law in practice, some basic threats need to be removed, among which in particular is insufficient data infrastructure. Full article

(This article belongs to the Collection Health Economics & Finance and Global Public Health)

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12 pages, 241 KiB

Open AccessArticle

Distance Learning in Nursing Education during the COVID-19 Pandemic: Psychosocial Impact for the Greek Nursing Students—A Qualitative Approach

by Evangelia Kartsoni, Nikolaos Bakalis, George Markakis, Michail Zografakis-Sfakianakis, Evridiki Patelarou and Athina Patelarou

Healthcare 2023, 11(8), 1178; https://doi.org/10.3390/healthcare11081178 - 19 Apr 2023

Cited by 1 | Viewed by 1465

Abstract

(1) Background: The COVID-19 pandemic posed a major threat to global health and on the educational field. The purpose of this study is to identify and illustrate the psychosocial adaptation of nursing students to the sudden and exclusive application of distance learning during [...] Read more.

(1) Background: The COVID-19 pandemic posed a major threat to global health and on the educational field. The purpose of this study is to identify and illustrate the psychosocial adaptation of nursing students to the sudden and exclusive application of distance learning during the COVID-19 pandemic; (2) Methods: A qualitative interview research has been designed. Two focus groups of seven members each and six individual interviews were conducted in a sample of undergraduate nursing students in Greece from 3 March 2021, to 9 April 2021.; (3) Results: A qualitative thematic analysis of the data identified six themes: 1. Challenges; 2. Concerns; 3. Social changes; 4. Negative Emotions; 5. Evaluation; and 6. Teaching strategies.; (4) Conclusions: During its implementation, it identified gaps and weaknesses in the entire academic community. The study of the psychosocial adaptation of the academic community is considered crucial, as it can highlight the individual difficulties in distance learning and contribute to the improvement of the methods of its the improvement of its methods. Full article

(This article belongs to the Collection Current Nursing Practice and Education)

14 pages, 1381 KiB

Open AccessArticle

Empathy and Occupational Health and Well-Being in Ecuadorian Physicians Working with COVID-19 Patients: A Mixed-Method Study

by Estefan Matiz-Moya, Roberto C. Delgado Bolton, Esperanza García-Gómez and Luis Vivanco

Healthcare 2023, 11(8), 1177; https://doi.org/10.3390/healthcare11081177 - 19 Apr 2023

Cited by 2 | Viewed by 1018

Abstract

Approximately one out of ten COVID-19 cases in Ecuador was a physician. It has been reported that this situation has led to a serious detriment of physicians’ health and well-being. This study aimed to (i) identify predictors of emotional exhaustion, somatization, and work [...] Read more.

Approximately one out of ten COVID-19 cases in Ecuador was a physician. It has been reported that this situation has led to a serious detriment of physicians’ health and well-being. This study aimed to (i) identify predictors of emotional exhaustion, somatization, and work alienation in Ecuadorian physicians working with COVID-19 patients and (ii) explore the pandemic impact on doctor–patient relationships and on empathy. In 79 Ecuadorian physicians (45 women) who worked with COVID-19 patients, two separate multiple regression models explained the following: 73% of the variability of emotional exhaustion was based on somatization, work alienation, working sector, and passing through a symptomatic infection (p < 0.001), and 56% of the variability of somatization was based on gender and emotional exhaustion (p < 0.001), respectively. Furthermore, intention to leave the profession was more frequent among physicians with greater work alienation (p = 0.003). On the contrary, more empathic physicians never considered leaving their profession during the COVID-19 pandemic (p = 0.03). In physicians’ verbatim, cognitive empathy appeared associated to a positive change in doctor–patient relationships. On the contrary, having an overwhelming emotional empathy appeared associated to a negative change in doctor–patient relationships. These findings characterize differences in how physicians cope while working in the frontline of the pandemic. Full article

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8 pages, 1108 KiB

Open AccessCommunication

Positive Impact of Home ERT for Mucopolysaccharidoses and Pompe Disease: The Lesson Learnt from the COVID-19 Pandemic

by Agata Fiumara, Giuseppina Lanzafame, Annamaria Sapuppo, Alessia Arena, Lara Cirnigliaro and Rita Barone

Healthcare 2023, 11(8), 1176; https://doi.org/10.3390/healthcare11081176 - 19 Apr 2023

Viewed by 1221

Abstract

Objective: Patients with Lysosomal disorders (LSDs) are treated with regular infusions of enzyme replacement therapy (ERT). During the COVID-19 pandemic, home treatment was permitted. This study aimed at monitoring the patients’ compliance with home therapy and its effects on physical, psychological, and relational [...] Read more.

Objective: Patients with Lysosomal disorders (LSDs) are treated with regular infusions of enzyme replacement therapy (ERT). During the COVID-19 pandemic, home treatment was permitted. This study aimed at monitoring the patients’ compliance with home therapy and its effects on physical, psychological, and relational issues. Moreover, we also tested the possible impact of home therapy on familial relationships and contacts with the referral hospital. Materials and Methods: Thirteen patients with Pompe disease (N = 8) and MPS (N = 5) were tested through an online questionnaire designed to assess their level of appreciation and satisfaction with home therapy and their feelings about the referral centre and psychological support provided. Results: Most of the patients (84%) stressed the positive impact of home therapy. All patients described a significant reduction in stressful conditions associated with the need to attend the hospital every week or two. Conclusions: Home ERT leads to a clear improvement in “daily life skills”, as represented in our by sample by positive feelings, better emotional self-control, and an increased ability to understand the feelings of relatives. Our data underline the paramount positive effect home ERT has on both patients and their families. Full article

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11 pages, 426 KiB

Open AccessArticle

COPD and Depression Analysis in Regard to Obstructive Pulmonary Levels

by Ivana Jelić, Goran Mihajlović, Filip Mihajlović, Nataša Minić, Miloš Ratinac and Maja Pantović-Stefanović

Healthcare 2023, 11(8), 1175; https://doi.org/10.3390/healthcare11081175 - 19 Apr 2023

Cited by 2 | Viewed by 902

Abstract

Depression symptoms take place recurrently in patients suffering from COPD. This study aims to assess the effects of antidepressant therapy in patients with COPD and a depressive disorder in relation to COPD levels. The study population consisted of N = 87 patients diagnosed [...] Read more.

Depression symptoms take place recurrently in patients suffering from COPD. This study aims to assess the effects of antidepressant therapy in patients with COPD and a depressive disorder in relation to COPD levels. The study population consisted of N = 87 patients diagnosed with COPD, according to the GOLD criteria, and a depressive disorder. All of the patients were subjected to clinical and psychiatric exploration according to psychiatric assessment instruments, which was followed by SSRI therapy for the duration of 8 weeks. The main methods used were descriptive statistics and analysis of variance. The results showed a different distribution of depressive symptoms at a different stage of COPD by FEV1 (χ² = 30.47, df = 6, p < 0.01) and by mMRC (χ² = 34.6, df = 6, p < 0.01). After the application of SSRIs, there was a significant improvement in HDRS scores in all stages of COPD by FEV1 (χ² = 251.62, df = 9, p < 0.01) and by mMRC (χ² = 919.17, df = 9, p < 0.01). This study contributes to the improvement in the quality of life of patients by the targeted application of SSRI therapy and, therefore, more precise and better overall treatment results. Full article

(This article belongs to the Special Issue Continuum of Care: Assessment, Management and Rehabilitative Interventions to Improve Care across Different Settings)

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13 pages, 989 KiB

Open AccessArticle

Effects of a Senior Musical Program on the Physical Function and Cognitive Abilities of Older Women in the Community

by Byeong-Soo Kim, Ji-Youn Kim, Sam-Ho Park and Myung-Mo Lee

Healthcare 2023, 11(8), 1174; https://doi.org/10.3390/healthcare11081174 - 19 Apr 2023

Viewed by 1017

Abstract

Background: We aimed to investigate the effects of a community-based senior musical program on the cognitive and physical functions in older women. Method: Older women aged ≥65 years participating in a program at a community welfare center were randomized to experimental (n = [...] Read more.

Background: We aimed to investigate the effects of a community-based senior musical program on the cognitive and physical functions in older women. Method: Older women aged ≥65 years participating in a program at a community welfare center were randomized to experimental (n = 17) or control (n = 17) groups. The control group participated in singing and yoga classes offered at the welfare center, while the experimental group participated in a senior musical program consisting of vocal training, dancing, and breathing training. The effects of the 12-week program (120 min/session, two sessions/week) and the intergroup differences in outcomes were compared using the cognitive impairment screening test (CIST), pulmonary function test (PFT), respiratory muscle pressure test (RPT), and static and dynamic balance tests. Result: The experimental group showed significant post-intervention changes in CIST scores, cardiorespiratory parameters, and static and dynamic balance (p < 0.05), but the control group only showed significant changes in some respiratory and balance parameters (p < 0.05). In comparison with the control group, the experimental group showed significantly greater post-intervention changes in the CIST score, PFT and RPT parameters, static balance, and Y-balance anterior (p < 0.05). Conclusions: The senior musical program enhanced older women’s cognitive, respiratory, and physical functions and promoted a sense of accomplishment and self-satisfaction. Full article

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13 pages, 667 KiB

Open AccessArticle

Factors Determining the Quality of Life of Polish Women during Menopause Based on the Menopause-Specific Quality of Life Questionnaire

by Agnieszka Bień, Magdalena Korżyńska-Piętas, Marta Zarajczyk, Mariusz Wysokiński, Iwona Niewiadomska, Krzysztof Jurek and Ewa Rzońca

Healthcare 2023, 11(8), 1173; https://doi.org/10.3390/healthcare11081173 - 19 Apr 2023

Cited by 1 | Viewed by 1489

Abstract

Background: The aim of the study was to present the process of cultural adaptation to Polish conditions and the validation of a scale assessing the quality of life of Polish women during the menopause and to identify the factors determining this quality of [...] Read more.

Background: The aim of the study was to present the process of cultural adaptation to Polish conditions and the validation of a scale assessing the quality of life of Polish women during the menopause and to identify the factors determining this quality of life. Methods: The research tools were the menopause-specific quality of life (MENQOL) questionnaire and a standardized interview questionnaire comprising questions on the participants’ characteristics. The study involved 516 women using health care services who had symptoms caused by the menopause. Results: The value of the Cronbach’s alpha coefficient was 0.923. The discriminative power coefficients of all the questionnaire items were higher than 0.3. The study confirmed the validity and internal consistency of the Polish version of the MENQOL questionnaire for measuring the quality of life of postmenopausal women, suggesting that the tool can be used for screening menopausal symptoms in women. There was a relationship between general quality of life and age (p = 0.002), marital status (p < 0.001), education (p = 0.021), the impact of professional work (p < 0.001), the impact of physical activity (p < 0.001) and the impact of social life (p < 0.001). Conclusion: In the group of women who took part in the study, the authors observed a lower quality of life during menopause reported by older women who were married/in a stable relationship, with no formal education (no formal education) and who, according to their subjective assessment, negatively evaluated the impact of the accompanying menopause-related symptoms on their work, physical activity and social life. Full article

(This article belongs to the Special Issue New Waves of Sexual and Reproductive Health)

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Healthcare, Volume 11, Issue 8 (April-2 2023) – 144 articles

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