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Sustainability: Challenges for Healthcare

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Care Sciences & Services".

Deadline for manuscript submissions: closed (30 September 2023) | Viewed by 13007

Special Issue Editors


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Guest Editor
Department of Diagnostics and Public Health, University of Verona, Strada Le Grazie 8, 37134 Verona, Italy
Interests: nursing; caring; elderly; physical restraints; pressure injuries; nursing sensitive outcomes
Special Issues, Collections and Topics in MDPI journals

E-Mail Website
Guest Editor
Department of Diagnostics and Public Health, University of Verona, Strada Le Grazie 8, 37134 Verona, Italy
Interests: nursing education; qualitative research; nurse caring; nursing sensitive outcomes

Special Issue Information

Dear Colleagues,

Over recent decades, the impact of climate change on human health has become increasingly evident, highlighting the need for a change toward a more sustainable approach. The creation of the Sustainable Development Goals global agenda is a clear indication of this culture shift.  

Sustainability has been defined as the process of “meeting the needs of the present without compromising the ability of future generations to meet their own needs”; it comprehends three dimensions—economic resilience, environmental integrity, and social equity—which all need to be supported to ensure sustainable development. 

Healthcare systems have an important role in the fight against climate change; this is because they are responsible for a considerable portion of carbon emissions worldwide, and because healthcare professionals witness first-hand, every day, the health consequences of climate change.

For this reason, this Special Issue will focus on experiences regarding sustainability in healthcare. Sustainable practices include, for example, more efficient service delivery, implementation of low-carbon alternatives for healthcare services, and education initiatives on sustainable healthcare, health promotion, and patient empowerment. We welcome original research papers using different study designs, both quantitative and qualitative, as well as systematic reviews and meta-analyses.

Dr. Elisa Ambrosi
Dr. Federica Canzan
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • sustainability
  • healthcare
  • SustHealth
  • environment
  • tools
  • frameworks
  • models
  • healthcare improvement
  • sustainability outcomes

Published Papers (6 papers)

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Research

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16 pages, 1210 KiB  
Article
Usability and Feasibility Testing of an Atrial Fibrillation Educational Website with Patients Referred to an Atrial Fibrillation Specialty Clinic
by Kathy L. Rush, Lindsay Burton, Cherisse L. Seaton, Peter Loewen, Brian P. O’Connor, Kendra Corman, Robyn Phillips, Lana Moroz and Jason G. Andrade
Int. J. Environ. Res. Public Health 2023, 20(18), 6792; https://doi.org/10.3390/ijerph20186792 - 21 Sep 2023
Viewed by 958
Abstract
Background: The purpose of this study was to design, usability test, and explore the feasibility of a web-based educational platform/intervention for patients with atrial fibrillation (AF) as part of their virtual AF care. Methods: Participants were patients attending a specialized AF clinic. The [...] Read more.
Background: The purpose of this study was to design, usability test, and explore the feasibility of a web-based educational platform/intervention for patients with atrial fibrillation (AF) as part of their virtual AF care. Methods: Participants were patients attending a specialized AF clinic. The multiple mixed-methods design included website design, think-aloud usability test, 1-month unstructured pre-testing analysis using Google Analytics, follow-up interviews, and a non-randomized one-group feasibility test using pre/post online surveys and Google Analytics. Results: Usability testing participants (n = 2) guided adjustments for improving navigation. Pre-testing participants’ (n = 9) website activity averaged four sessions (SD = 2.6) at 10 (SD 8) minutes per session during a 1-month study period. In the feasibility test, 30 patients referred to AF specialty clinic care completed the baseline survey, and 20 of these completed the 6-month follow-up survey. A total of 19 patients accessed the website over the 6 months, and all 30 participants were sent email prompts containing information from the website. Health-related quality of life, treatment satisfaction, household activity, and AF knowledge scores were higher at follow-up than baseline. There was an overall downward trend in self-reported healthcare utilization at follow-up. Conclusions: Access to a credible education website for patients with AF has great potential to complement virtual and hybrid models of care. Full article
(This article belongs to the Special Issue Sustainability: Challenges for Healthcare)
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12 pages, 782 KiB  
Article
To Get Vaccinated or Not? The Vaccination Decision-Making by Healthcare Professionals Working in Haematology: A Qualitative Study
by Gian Luca Tunisi, Elisa Ambrosi, Giorgia Zulianello, Elisabetta Allegrini, Domenico Provenzano, Tiziana Rizzello and Federica Canzan
Int. J. Environ. Res. Public Health 2023, 20(10), 5901; https://doi.org/10.3390/ijerph20105901 - 21 May 2023
Viewed by 1482
Abstract
Haematological patients are more susceptible to infections. Vaccination has always been the most effective primary prevention strategy, even during the COVID-19 pandemic. However, the efficacy of vaccines for some haematological patients is low. Although vaccination of Healthcare Workers (HCWs) could protect patients from [...] Read more.
Haematological patients are more susceptible to infections. Vaccination has always been the most effective primary prevention strategy, even during the COVID-19 pandemic. However, the efficacy of vaccines for some haematological patients is low. Although vaccination of Healthcare Workers (HCWs) could protect patients from vaccine-preventable diseases, there is evidence of a high level of hesitation among healthcare workers in Italy. The aim of this study was to explore the attitudes towards vaccination of HCWs caring for haematology patients. Qualitative descriptive design was conducted. Twenty-one HCWs were interviewed. Content analysis was applied to the qualitative data. The following themes were generated from the analysis: “Trust”, “Decision-making process focusing on individual health”, “Decision-making process focusing on community health”, “Changing opinion”, and “Two sides of vaccination commitment”. The most hesitant HCWs were oriented towards individual health. They perceived a lack of benefit from vaccines, feared side effects, or were influenced by negative experiences of others. In contrast, community-health-oriented HCWs showed more positive attitudes towards vaccination. Some hesitant HCWs changed their opinion on vaccination because they began to reflect on the importance of vaccination for the community. The change in opinion of some HCWs interviewed provided insight into the importance of focusing organisational efforts on collective responsibility. Full article
(This article belongs to the Special Issue Sustainability: Challenges for Healthcare)
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9 pages, 303 KiB  
Article
Information Gathering about Pregnancy, Birth, and Puerperium—Good and Fake Information
by Oezden Oyman, Joy Fest, Roland Zimmermann, Nicole Ochsenbein-Kölble and Ladina Vonzun
Int. J. Environ. Res. Public Health 2023, 20(6), 4848; https://doi.org/10.3390/ijerph20064848 - 09 Mar 2023
Cited by 1 | Viewed by 1184
Abstract
Recent research on the subject of information-gathering processes among pregnant women has revealed a shift towards online sources. Health professionals’ knowledge about sources of information has been shown to improve the understanding and counseling of patients. The objective of this study was to [...] Read more.
Recent research on the subject of information-gathering processes among pregnant women has revealed a shift towards online sources. Health professionals’ knowledge about sources of information has been shown to improve the understanding and counseling of patients. The objective of this study was to create an overview of all types of sources relevant to information gathering and to put their role and perception into perspective. Methods: A total of 249 women were included in this study and recruited over a period of one month at the University Hospital of Zurich (USZ). Exclusion criteria included cases of fetal demise and late abortions. The survey on information-gathering processes was divided into three stages: pregnancy, birth, and puerperium. The different sources of information were compared based on women’s characteristics. Results: The response rate was 78% (n = 197). The main findings include a significant difference in information gathering based on varying levels of education, with women at the lowest educational level using the Internet the least during pregnancy (p = 0.029). During puerperium, significant differences could be observed in the involvement of the gynecologist. Primipara women as well as women of lower educational levels contacted their gynecologist less in contrast to multipara women (p = 0.006) and women of higher educational levels (p = 0.011). Overall, health professionals were considered to be the most important source of information. Conclusions: This study demonstrates that parity and educational level influence the information-gathering process. As the most important source for information gathering, health professionals must use this advantage to better assist their patients in accessing reliable information. Full article
(This article belongs to the Special Issue Sustainability: Challenges for Healthcare)

Review

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25 pages, 1075 KiB  
Review
Effectiveness of Nonpharmacological Interventions in the Field of Ventilation: An Umbrella Review
by Neuza Reis, Luis Gaspar, Abel Paiva, Paula Sousa and Natália Machado
Int. J. Environ. Res. Public Health 2023, 20(7), 5239; https://doi.org/10.3390/ijerph20075239 - 23 Mar 2023
Viewed by 2008
Abstract
This umbrella review aimed to determine the effectiveness of nonpharmacological interventions in pulmonary ventilation and their impact on respiratory function. An individual with impaired ventilation displays visible variations manifested in their respiratory frequency, breathing rhythm ratio (I:E), thoracic symmetry, use of accessory muscles, [...] Read more.
This umbrella review aimed to determine the effectiveness of nonpharmacological interventions in pulmonary ventilation and their impact on respiratory function. An individual with impaired ventilation displays visible variations manifested in their respiratory frequency, breathing rhythm ratio (I:E), thoracic symmetry, use of accessory muscles, dyspnea (feeling short of breath), oxygen saturation, diaphragm mobility, minute ventilation, peak flow, walking test, spirometry, Pimax/Pemax, diffusion, and respiratory muscle strength. Any variation in these markers demands the need for interventions in order to duly manage the signs and symptoms and to improve ventilation. Method: Systematic reviews of the literature published in English, Spanish, French, and Portuguese were used, which included studies in which nonpharmacological interventions were used as a response to impaired ventilation in adults in any given context of the clinical practice. The recommendations given by the Joanna Briggs Institute (JBI) for umbrella reviews were followed. This research took place in several databases such as MEDLINE, CINAHL Complete, CINHAL, MedicLatina, ERIC, Cochrane Reviews (Embase), and PubMed. The Joanna Briggs critical analysis verification list was used for the systematic review. The data extraction was performed independently by two investigators based on the data extraction tools of the Joanna Briggs Institute, and the data were presented in a summary table alongside the support text. Results: Forty-four systematic reviews, thirty randomized clinical essays, and fourteen observational studies were included in this review. The number of participants varied between n = 103 and n = 13,370. Fifteen systematic revisions evaluated the effect of isolated respiratory muscular training; six systematic revisions evaluated, in isolation, breathing control (relaxed breathing, pursed-lip breathing, and diaphragmatic breathing exercises) and thoracic expansion exercises; and one systematic review evaluated, in isolation, the positions that optimize ventilation. Nineteen systematic reviews with combined interventions that reinforced the role of education and capacitation while also aiming for their success were considered. The articles analyzed isolated interventions and presented their efficacy. The interventions based on respiratory exercises and respiratory muscular training were the most common, and one article mentioned the efficacy of positioning in the compromisation of ventilation. Combined interventions in which the educational component was included were found to be effective in improving pulmonary function, diffusion, oxygenation, and functional capacity. The outcomes used in each study were variable, leading to a more difficult analysis of the data. Conclusions: The interventions that were the focus of the review were duly mapped. The results suggest that nonpharmacological interventions used to optimize ventilation are effective, with a moderate to high level of evidence. There is a strong foundation for the use of the chosen interventions. The lack of studies on the intervention of “positioning to optimize ventilation” points out the need for a deeper analysis of its effects and for studies with a clear focus. This study supports the decisions and recommendations for the prescription of these interventions to patients with impaired ventilation. Full article
(This article belongs to the Special Issue Sustainability: Challenges for Healthcare)
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24 pages, 781 KiB  
Review
Professional Interpreter Services and the Impact on Hospital Care Outcomes: An Integrative Review of Literature
by Michelle Kwan, Zakia Jeemi, Richard Norman and Jaya A. R. Dantas
Int. J. Environ. Res. Public Health 2023, 20(6), 5165; https://doi.org/10.3390/ijerph20065165 - 15 Mar 2023
Cited by 9 | Viewed by 4786
Abstract
Migration patterns have rapidly changed in Australia and elsewhere, which have contributed to increasingly culturally and linguistically diverse societies. This requires healthcare sectors to provide professional interpreter services for patients with a language barrier to eliminate healthcare disparities. This integrative review aimed to [...] Read more.
Migration patterns have rapidly changed in Australia and elsewhere, which have contributed to increasingly culturally and linguistically diverse societies. This requires healthcare sectors to provide professional interpreter services for patients with a language barrier to eliminate healthcare disparities. This integrative review aimed to investigate the impact of professional interpreter services on hospital care outcomes and the associated cost of service provision. A systematic search of five databases was conducted for peer-reviewed articles from January 1996 to December 2020. Data were extracted for the hospital setting, intervention, population, study design, outcomes and key findings. Following the PRISMA guidelines, full-text screening identified 37 articles that were analysed and included. Communication quality, hospital care outcomes and hospital costs were the three main themes identified. Closing the language gap should be a primary consideration to prevent adverse events that affect patient safety and the standard of care in hospitals. The findings of this review indicate the provision of professional interpreter services can enhance hospital care for linguistically diverse patients by improving patient–provider communication. To gain insight into the changing patterns on the outcomes of medical care, further research requires efforts by the hospital administrative system to document complete records of service usage. Full article
(This article belongs to the Special Issue Sustainability: Challenges for Healthcare)
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12 pages, 474 KiB  
Review
Isoniazid Preventive Therapy for Prevention of Tuberculosis among People Living with HIV in Ethiopia: A Systematic Review of Implementation and Impacts
by Dawit Getachew Assefa, Eden Dagnachew Zeleke, Delayehu Bekele, Dawit A. Ejigu, Wondwosen Molla, Tigist Tekle Woldesenbet, Amdehiwot Aynalem, Mesfin Abebe, Andualem Mebratu and Tsegahun Manyazewal
Int. J. Environ. Res. Public Health 2023, 20(1), 621; https://doi.org/10.3390/ijerph20010621 - 29 Dec 2022
Cited by 4 | Viewed by 1931
Abstract
Background: Tuberculosis (TB) is a major cause of morbidity and mortality in people living with HIV (PLWHIV). Isoniazid preventive therapy (IPT) prevents TB in PLWHIV, but estimates of its effects and actual implementation vary across countries. We reviewed studies that examined the impact [...] Read more.
Background: Tuberculosis (TB) is a major cause of morbidity and mortality in people living with HIV (PLWHIV). Isoniazid preventive therapy (IPT) prevents TB in PLWHIV, but estimates of its effects and actual implementation vary across countries. We reviewed studies that examined the impact of IPT on PLHIV and the factors influencing its implementation in Ethiopia. Methods: We searched PubMed/MEDLINE, Embase, and the Cochrane Central Register of Clinical Controlled Trials from their inception to 1 April 2021 for studies of any design that examined the impact of IPT on PLHIV and the factors influencing its implementation. The protocol was registered in PROSPERO, ID: CRD42021256579. Result: Of the initial 546 studies identified, 13 of which enrolled 12,426 participants, 15,640 PLHIV and 62 HIV clinical care providers were included. PLHIV who were on IPT, independently or simultaneously with ART, were less likely to develop TB than those without IPT. IPT interventions had a significant association with improved CD4 count and reduced all-cause mortality. IPT was less effective in people with advanced HIV infection. The major factors influencing IPT implementation and uptake were stock-outs, fear of developing isoniazid-resistant TB, patient’s refusal and non-adherence, and improper counseling and low commitment of HIV clinical care providers. Conclusion: IPT alone or in combination with ART significantly reduces the incidence of TB and mortality in PLHIV in Ethiopia than those without IPT. More research on safety is needed, especially on women with HIV who receive a combination of IPT and ART. Additionally, studies need to be conducted to investigate the efficacy and safety of the new TPT (3 months combination of isoniazid and rifapentine) in children and people living with HIV. Full article
(This article belongs to the Special Issue Sustainability: Challenges for Healthcare)
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