Journal Description
Healthcare
Healthcare
is an international, scientific, peer-reviewed, open access journal on health care systems, industry, technology, policy, and regulation, and is published semimonthly online by MDPI. Ocular Wellness & Nutrition Society (OWNS) is affiliated with Healthcare and its members receive discounts on article processing charges.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within Scopus, SCIE and SSCI (Web of Science), PubMed, PMC, and other databases.
- Journal Rank: JCR - Q2 (Health Policy & Services ) / CiteScore - Q2 (Leadership and Management)
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 19.5 days after submission; acceptance to publication is undertaken in 2.4 days (median values for papers published in this journal in the second half of 2023).
- Recognition of Reviewers: reviewers who provide timely, thorough peer-review reports receive vouchers entitling them to a discount on the APC of their next publication in any MDPI journal, in appreciation of the work done.
- Companion journals for Healthcare include: Trauma Care and European Burn Journal.
Impact Factor:
2.8 (2022);
5-Year Impact Factor:
3.0 (2022)
Latest Articles
Bayesian Spatio-Temporal Multilevel Modelling of Patient-Reported Quality of Life following Prostate Cancer Surgery
Healthcare 2024, 12(11), 1093; https://doi.org/10.3390/healthcare12111093 (registering DOI) - 26 May 2024
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Background: Globally, prostate cancer is the second leading cause of cancer deaths among males. It is the most commonly diagnosed cancer in Australia. The quality of life of prostate cancer patients is poorer when compared to the general population due to the disease
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Background: Globally, prostate cancer is the second leading cause of cancer deaths among males. It is the most commonly diagnosed cancer in Australia. The quality of life of prostate cancer patients is poorer when compared to the general population due to the disease itself and its related complications. However, there is limited research on the geographic pattern of quality of life and its risk factors in Victoria. Therefore, an examination of the spatio-temporal pattern and risk factors of poor quality of life, along with the impact of spatial weight matrices on estimates and model performance, was conducted. Method: A retrospective study was undertaken based on the Prostate Cancer Outcome Registry—Victoria data. Patient data (n = 5238) were extracted from the Prostate Cancer Outcome Registry, a population-based clinical quality outcome assessment from 2015 to 2021. A Bayesian spatio-temporal multilevel model was fitted to identify risk factors for poor quality of life. This study also evaluated the impact of distance- and adjacency-based spatial weight matrices. Model convergence was assessed using Gelman–Rubin statistical plots, and model comparison was based on the Watanabe–Akaike Information Criterion. Results: A total of 1906 (36.38%) prostate cancer patients who had undergone surgery experienced poor quality of life in our study. Belonging to the age group between 76 and 85 years (adjusted odds ratio (AOR) = 2.90, 95% credible interval (CrI): 1.39, 2.08), having a prostate-specific antigen level between 10.1 and 20.0 (AOR = 1.33, 95% CrI: 1.12, 1.58), and being treated in a public hospital (AOR = 1.35, 95% CrI: 1.17, 1.53) were significantly associated with higher odds of poor quality of life. Conversely, residing in highly accessible areas (AOR = 0.60, 95% CrI: 0.38, 0.94) was significantly associated with lower odds of poor prostate-specific antigen levels. Variations in estimates and model performance were observed depending on the choice of spatial weight matrices. Conclusion: Belonging to an older age group, having a high prostate-specific antigen level, receiving treatment in public hospitals, and remoteness were statistically significant factors linked to poor quality of life. Substantial spatio-temporal variations in poor quality of life were observed in Victoria across local government areas. The distance-based weight matrix performed better than the adjacency-based matrix. This research finding highlights the need to reduce geographical disparities in quality of life. The statistical methods developed in this study may also be useful to apply to other population-based clinical registry settings.
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Open AccessArticle
Association of Electronic Cigarette Usage with the Subsequent Initiation of Combustible Cigarette Smoking among Dental Students in Riyadh, Saudi Arabia: A Longitudinal Study
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Sanjeev B. Khanagar, Ibrahim Aldawas, Salman Khalid Alrusaini, Farraj Albalawi, Aram Alshehri, Mohammed Awawdeh, Kiran Iyer and Darshan Devang Divakar
Healthcare 2024, 12(11), 1092; https://doi.org/10.3390/healthcare12111092 (registering DOI) - 26 May 2024
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The use of electronic cigarettes, or “e-cigarettes”, among youths has sparked worries about the possibility of nicotine dependence as a serious public health issue. Dental practitioners play a critical role in helping their patients quit smoking. Dental schools across the globe have policies
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The use of electronic cigarettes, or “e-cigarettes”, among youths has sparked worries about the possibility of nicotine dependence as a serious public health issue. Dental practitioners play a critical role in helping their patients quit smoking. Dental schools across the globe have policies encouraging their students to help patients quit smoking. Current research, however, indicates that a significant portion of dental students smoke combustible cigarettes and use e-cigarettes. According to studies, using e-cigarettes has resulted in the subsequent initiation of combustible cigarette smoking among its users. The aim of this study was to determine the association between the use of electronic cigarettes and the subsequent initiation of combustible cigarette smoking among dental students who were not attitudinally susceptible to smoking combustible cigarettes. A longitudinal cohort study was conducted among 121 study participants who were never combustible cigarette users and were attitudinally non-susceptible to smoking at baseline. At baseline, 66 (54.6%) study participants were categorized as e-cigarette users who were attitudinally non-susceptible to combustible cigarette smoking, and 55 (45.4%) study participants were categorized as non-users who were attitudinally non-susceptible to combustible cigarette smoking. The initiation of combustible cigarette smoking was assessed at 6- and 12-month intervals. Binomial regression analysis of the outcome at the end of one-year follow-up, when analyzed with independent variables, revealed a significant influence of e-cigarette use on taking up combustible cigarette smoking [Relative Risk: 9.395; 95% CI: 3.03–29.04]. Chi-squared analysis of independent variables revealed e-cigarette use to be significantly associated with fathers’ education level (p = 0.00), parental cigarette smoking status (p = 0.00), cigarette smoking among friends (p = 0.00), and family income (p = 0.00). E-cigarette users are more likely to believe it to be healthier (p = 0.00) than combustible smoking. In the present study, e-cigarette usage demonstrated a significant influence on taking up combustible cigarette smoking among its users. Educational institutions should implement stringent policies and regulations to prevent health professionals from using these products.
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Open AccessArticle
Trends in Coronary Artery Anomalies Detection by Coronary Computed Tomography Angiography (CCTA): A Real-Life Comparative Study before and during the COVID-19 Pandemic
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Alexandra-Simona Zamfir, Tudor-Andrei Cernomaz, Bogdan Mihnea Ciuntu, Doina Azoicăi, Carmen Lăcrămioara Zamfir, Raluca Ozana Chistol and Anca Sava
Healthcare 2024, 12(11), 1091; https://doi.org/10.3390/healthcare12111091 (registering DOI) - 26 May 2024
Abstract
Background: In the wake of the coronavirus disease 19 (COVID-19) pandemic, affecting healthcare systems globally, urgent research is needed to understand its potential repercussions on the diagnosis and management of cardiovascular disorders. This emphasises the importance of detecting coronary artery anomalies (CAAs), rare
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Background: In the wake of the coronavirus disease 19 (COVID-19) pandemic, affecting healthcare systems globally, urgent research is needed to understand its potential repercussions on the diagnosis and management of cardiovascular disorders. This emphasises the importance of detecting coronary artery anomalies (CAAs), rare conditions that can range from benign to potentially life-threatening manifestations. We aimed to retrospectively assess the impact of the COVID-19 pandemic on the detection of various coronary anomalies using Coronary Computed Tomography Angiography (CCTA) within a regional tertiary cardiology unit in north-eastern Romania, focusing on perceived occurrence in the population under study, types, and related demographic and clinical factors. Methods: We analysed CCTA scans and investigated the trends in CAA detection among cardiology patients over a decade. We compared pre-COVID-19 and pandemic-era data to assess the impact of healthcare utilisation, patient behaviour, and diagnostic approaches on anomaly detection. Results: Our analysis revealed a higher detection rate of CAAs during the pandemic (3.9% versus 2.2%), possibly highlighting differences in patient clinical profile and addressability changes presentation compared to the previous period. Origination and course anomalies, often linked to severe symptoms, were significantly higher pre-COVID-19 (64.1% versus 51.3%). Conversely, intrinsic CAAs, typically asymptomatic or manifesting later in life, notably increased during the pandemic (49.0% versus 61.4%; p = 0.020). Conclusions: Our study underscores a significant rise in CAA detection during the COVID-19 era, potentially linked to changes in cardiovascular and respiratory clinical patterns, with advanced imaging modalities like CCTA offering accuracy in identification.
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(This article belongs to the Special Issue Management in Different Health Conditions)
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Open AccessSystematic Review
Patients and Healthcare Providers’ Perspectives on Patient Experience Factors and a Model of Patient-Centered Care Communication: A Systematic Review
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Eun-Jeong Kim, Yoo-Ri Koo and Inn-Chul Nam
Healthcare 2024, 12(11), 1090; https://doi.org/10.3390/healthcare12111090 (registering DOI) - 26 May 2024
Abstract
Effective communication between patients and healthcare providers is essential for a positive patient experience (PE), and improving patient-centered care (PCC) involves many factors. This study aimed to (1) identify the factors that affect PE improvement, (2) reflect patients and healthcare providers’ perspectives on
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Effective communication between patients and healthcare providers is essential for a positive patient experience (PE), and improving patient-centered care (PCC) involves many factors. This study aimed to (1) identify the factors that affect PE improvement, (2) reflect patients and healthcare providers’ perspectives on the factors’ importance, and (3) present a structural model for improving PCC. A systematic review of empirical studies that specified PE factors was conducted. Studies that did not reflect users’ perspectives and non-empirical studies were excluded. The literature was searched using Google Scholar, PubMed, Web of Science, and the Taylor and Francis online journal. The MMAT 2018 checklist was used to assess bias in the included studies, and frequency, content, and thematic analyses were employed to synthesize the results, yielding 25 articles. The 80 PE factors identified from the analyses were categorized into six categories: Practice, Physical Needs, Psychological Needs, Social Needs, Practical Needs, and Information Needs. From a user perspective, patients emphasized professional, continuous, and comprehensive service delivery, whereas healthcare providers stressed efficient system improvements and positive provider–patient relationships. We propose a structured model for PCC improvement using a service blueprint and system map. The PCC model provides an overview of the interactions and the roles of all stakeholders regarding quality of care to improve healthcare.
Full article
(This article belongs to the Special Issue Review Research on Healthcare Quality and Patient Safety)
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Open AccessArticle
Healthcare Professionals’ Beliefs and Views towards Exercise during Pregnancy: A Cross-Sectional Study in Greece
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Vasileios Daglas, Nikolaos Kostopoulos, Irina Mrvoljak-Theodoropoulou, Aikaterini Lykeridou and Evangelia Antoniou
Healthcare 2024, 12(11), 1089; https://doi.org/10.3390/healthcare12111089 (registering DOI) - 25 May 2024
Abstract
Background: Healthcare professionals appear to play a key role in shaping pregnant women’s views and attitudes towards lifestyle issues, such as exercise. The aim of this study is to investigate the views and beliefs of Greek midwives and obstetricians regarding exercise during pregnancy.
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Background: Healthcare professionals appear to play a key role in shaping pregnant women’s views and attitudes towards lifestyle issues, such as exercise. The aim of this study is to investigate the views and beliefs of Greek midwives and obstetricians regarding exercise during pregnancy. Methods: This is a cross-sectional study conducted during the period of January 2022–March 2023. For this study, 237 Greek midwives and obstetricians employed in healthcare settings in Attica, Greece completed an anonymous and self-report questionnaire. Four different/independent models of multivariate analyses of variance were conducted. Results: The vast majority of these healthcare professionals (88.6%) believed that exercise during pregnancy is generally beneficial. According to the multivariate analyses, healthcare professionals with postgraduate/doctoral studies were more likely to believe that (a) exercise is generally beneficial (p = 0.03), (b) pregnant women should be informed about it (p = 0.028), (c) informing pregnant women is necessary/useful (p = 0.023), and (d) pregnant women showed interest in it (p = 0.034). Also, freelance midwives were more likely to believe that pregnant women should be informed about exercise (p = 0.006), and that they showed interest in it (p = 0.034). In addition, (a) freelance midwives (p = 0.050), and those who had experience in antenatal counselling (p = 0.037), as well as (b) obstetricians who were largely experienced in monitoring normal pregnancies (p = 0.001), were less likely to associate exercise during pregnancy with the occurrence of placental abruption. Conclusion: Alongside healthcare professionals’ educational level, their professional setting and professional experience emerge as key factors and need to be considered when designing innovative interventions to support exercise during pregnancy.
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(This article belongs to the Special Issue Midwifery Care: Improvement of Maternal and Newborn Health)
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Open AccessArticle
Contraceptive Counseling: Construction and Validation of Instrument—“5C Contraceptive Counseling”
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Sara Palma, Diogo Ayres-de-Campos, Mónica Antunes, Ricardo São-João and Maria Helena Presado
Healthcare 2024, 12(11), 1088; https://doi.org/10.3390/healthcare12111088 (registering DOI) - 25 May 2024
Abstract
Introduction: Contraceptive illiteracy leads to non-adherence, discontinuation, and dissatisfaction with the method. Person-centered contraceptive counseling is based on quality care on a communicative basis that promotes shared decision-making, leading to a choice adapted to the woman’s needs, lifestyle, and health condition. We intend
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Introduction: Contraceptive illiteracy leads to non-adherence, discontinuation, and dissatisfaction with the method. Person-centered contraceptive counseling is based on quality care on a communicative basis that promotes shared decision-making, leading to a choice adapted to the woman’s needs, lifestyle, and health condition. We intend to build and validate an instrument that serves as a guide for quality contraceptive counseling, facilitating decision-making about contraceptive methods. Methods: We used the Delphi method in a total of two rounds. The content was validated through a panel of eighteen experts with experience in teaching, research in contraceptive counseling, and obstetric nursing. To assess the consensus and stability of the responses, two questionnaires were administered and the Content Validity Index and Content Validity Ratio were calculated. Results: The initial version of the guide, consisting of six indicators and thirty-five items, was submitted to the panel of experts to obtain consensus and stability from respondents (first round). The results showed a response rate of 66.0%; thirty-four indicators reached consensus and one did not reach consensus. Suggestions for modifying the indicator were received by the experts and incorporated in the next round. In the second round, the response rate increased to 78.0%. Two indicators were resubmitted, of which one was accepted. This resulted in the final version of the instrument, with six points and thirty-five items. Discussion: The guide proved to be a valid tool for nurse–midwives to provide quality contraceptive advice to women, allowing them to make autonomous and informed choices regarding their sexual and reproductive health.
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Open AccessArticle
Personality and Pain Outcomes in Rheumatic Disease: The Mediating Role of Psychological Flexibility
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Cristiana-Manuela Cojocaru, Cosmin Octavian Popa, Alina Schenk, Ștefan Marian, Horia Marchean, Bogdan Andrei Suciu, Simona Szasz, Horațiu Popoviciu and Simona Mureșan
Healthcare 2024, 12(11), 1087; https://doi.org/10.3390/healthcare12111087 (registering DOI) - 25 May 2024
Abstract
Background: Chronic pain is associated with increased disability and vulnerability to emotional disorders. Personality and psychological flexibility (PF) describe interindividual differences that shape the adjustment to chronic pain. Specifically, PF was found to be associated with pain, fatigue, anxiety, and depression intensity. Although
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Background: Chronic pain is associated with increased disability and vulnerability to emotional disorders. Personality and psychological flexibility (PF) describe interindividual differences that shape the adjustment to chronic pain. Specifically, PF was found to be associated with pain, fatigue, anxiety, and depression intensity. Although previous studies established strong correlations between personality and pain outcomes, evidence on the nature of this relationship is scarce. Therefore, the objective of this study is to explore the mediating effect of PF on the relationship between personality and distress. Methods: This transversal study included 108 participants (age M = 56.7, SD = 11.3) diagnosed with musculoskeletal chronic pain. Self-reported measures were administered by the medical care team. Multiple mediation models were performed for estimating the indirect effects on each outcome variable. Results: After controlling for age and gender covariates, we found that PF completely mediated the relationship between personality traits and all pain outcomes and partially mediated the impact of extraversion on anxiety. In addition, emotional stability also had an indirect effect on anxiety through PF. Conclusions: Personality traits and PF are significant predictors of pain outcomes. PF represents a core process mediating the impact of personality traits on the perceived intensity of pain, fatigue, anxiety, and depression in patients with rheumatic disease. These results could facilitate the application of individualized psychological interventions in clinical contexts targeting the reduction of emotional avoidance and in chronic pain patients.
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(This article belongs to the Special Issue Clinical Psychology: The State of the Art)
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Patient Safety Incidents in Primary Care: Comparing APEAS–2007 (Spanish Patient Safety Adverse Events Study in Primary Care) with Data from a Health Area in Catalonia (Spain) in 2019
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Montserrat Gens-Barberà, Maria-Pilar Astier-Peña, Núria Hernández-Vidal, Immaculada Hospital-Guardiola, Ferran Bejarano-Romero, Eva Mª Oya-Girona, Yolanda Mengíbar-Garcia, Nuria Mansergas-Collado, Angel Vila-Rovira, Sara Martínez-Torres, Cristina Rey-Reñones, Francisco Martín-Luján and QiSP-Tar Research Group
Healthcare 2024, 12(11), 1086; https://doi.org/10.3390/healthcare12111086 (registering DOI) - 25 May 2024
Abstract
The initial APEAS study, conducted in June 2007, examined adverse events (AEs) in Spanish Primary Healthcare (PHC). Since then, significant changes have occurred in healthcare systems. To evaluate these changes, a study was conducted in the Camp de Tarragona PHC region (CTPHC) in
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The initial APEAS study, conducted in June 2007, examined adverse events (AEs) in Spanish Primary Healthcare (PHC). Since then, significant changes have occurred in healthcare systems. To evaluate these changes, a study was conducted in the Camp de Tarragona PHC region (CTPHC) in June 2019. This cross-sectional study aimed to identify AEs in 20 PHC centres in Camp de Tarragona. Data collection used an online questionnaire adapted from APEAS–2007, and a comparative statistical analysis between APEAS–2007 and CTPHC–2019 was performed. The results revealed an increase in nursing notifications and a decrease in notifications from family doctors. Furthermore, fewer AEs were reported overall, particularly in medication-related incidents and healthcare-associated infections, with an increase noted in no-harm incidents. However, AEs related to worsened clinical outcomes, communication issues, care management, and administrative errors increased. Concerning severity, there was a decrease in severe AEs, coupled with an increase in moderate AEs. Despite family doctors perceiving a reduction in medication-related incidents, the overall preventability of AEs remained unchanged. In conclusion, the reporting patterns, nature, and causal factors of AEs in Spanish PHC have evolved over time. While there has been a decrease in medication-related incidents and severe AEs, challenges persist in communication, care management, and clinical outcomes. Although professionals reported reduced severity, the perception of preventability remains an area that requires attention.
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(This article belongs to the Special Issue Primary and Community Care: Opportunities and Challenges)
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Open AccessArticle
Positive and Negative Correlates of Psychological Well-Being and Distress in College Students’ Mental Health: A Correlational Study
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Maria José Carvalho Nogueira and Carlos Alberto Sequeira
Healthcare 2024, 12(11), 1085; https://doi.org/10.3390/healthcare12111085 (registering DOI) - 25 May 2024
Abstract
Background: Recognizing the positive or negative effects of students’ mental health promotes personal development, well-being, and academic success. Academic life exposes college students to multiple adjustments, demands, and vulnerabilities that can cause stress and mental health problems. This study aims to identify psychological
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Background: Recognizing the positive or negative effects of students’ mental health promotes personal development, well-being, and academic success. Academic life exposes college students to multiple adjustments, demands, and vulnerabilities that can cause stress and mental health problems. This study aims to identify psychological well-being and psychological distress effects on college students’ mental health. Methods: A correlational study was designed involving a non-probabilistic 560 sample of students (446 women) aged 18 to 41 years (M = 19.6; SD = 1.68). An online self-report questionnaire was used including demographic, relational, academic, and health behaviors variables, and the measures: Mental Health Inventory; Satisfaction with Social Support Scale; Academic Life Satisfaction Scale; and Psychological Vulnerability Scale. Results: Regression analyses indicate that male students, dating, good academic performance, exercise, sleeping seven hours, satisfaction with social support, and academic life satisfaction were significant correlates (p < 0.05) of psychological well-being, with the last two having great weight in the model. Females, low income, aged 21–24 years, sleeping less than 6 h, moderate psychological vulnerability, and perception of vulnerability were significant (p < 0.05) negative effects of psychological distress. Conclusions: This study addresses the positive and negative effects of psychological well-being and distress in college students. Specific mental health promotion and morbidity prevention programs can improve students’ mental health literacy and resilience.
Full article
(This article belongs to the Special Issue Patient Safety, Environment, and Mental Health)
Open AccessArticle
The Changing Prevalence of Pressure Injury among Ontarians with SCI/D at Rehabilitation Admission: Opportunities for Improvement
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Beverley Catharine Craven, Emma A. Bateman, Heather Flett, Farnoosh Farahani, Dalton L. Wolfe, Sussan Askari, Maryam Omidvar and Mohammad Alavinia
Healthcare 2024, 12(11), 1084; https://doi.org/10.3390/healthcare12111084 (registering DOI) - 25 May 2024
Abstract
Background: Despite preventability, 20–50% of patients with acute spinal cord injury/disease (SCI/D) develop hospital-acquired pressure injuries (PIs). The Spinal Cord Injury Implementation and Evaluation Quality Care Consortium (SCI IEQCC) aimed to mitigate PI risk through patient-reported daily skin checks alongside usual care. Methods:
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Background: Despite preventability, 20–50% of patients with acute spinal cord injury/disease (SCI/D) develop hospital-acquired pressure injuries (PIs). The Spinal Cord Injury Implementation and Evaluation Quality Care Consortium (SCI IEQCC) aimed to mitigate PI risk through patient-reported daily skin checks alongside usual care. Methods: This quality improvement initiative utilized an interrupted time series design, encompassing adults ≥ 18 years admitted for inpatient rehabilitation across five Ontario sites from 2020 to 2023. Patient demographics, etiology, and impairment data were obtained from a national registry, while participating sites gathered data on PI onset, location, and severity. Run charts depicted temporal trends, and statistical analyses, including chi-square and logistic regression, compared patients with and without PIs. Results: Data from 1767 discharged SCI/D patients revealed that 26% had ≥1 PI, with 59% being prevalent and 41% incident. Most severe PIs (stages III and IV and unstageable) were acquired prior to admission. Process indicator fidelity was reasonable at 68%. Patients with PIs experienced longer hospital stays, lower Functional Independence Measure (FIM) changes, and FIM efficiency during rehabilitation. Conclusions: PI prevalence is increasing, particularly sacral injuries at admission, while incident cases have decreased since 2021 due to regular skin checks. This trend calls for proactive health system interventions to reduce costs and improve patient outcomes.
Full article
(This article belongs to the Special Issue New Challenges in Health Care Services among Patients with Spinal Cord Injury)
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Open AccessArticle
Artificial Intelligence in Postoperative Care: Assessing Large Language Models for Patient Recommendations in Plastic Surgery
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Cesar A. Gomez-Cabello, Sahar Borna, Sophia M. Pressman, Syed Ali Haider, Ajai Sehgal, Bradley C. Leibovich and Antonio J. Forte
Healthcare 2024, 12(11), 1083; https://doi.org/10.3390/healthcare12111083 (registering DOI) - 24 May 2024
Abstract
Since their release, the medical community has been actively exploring large language models’ (LLMs) capabilities, which show promise in providing accurate medical knowledge. One potential application is as a patient resource. This study analyzes and compares the ability of the currently available LLMs,
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Since their release, the medical community has been actively exploring large language models’ (LLMs) capabilities, which show promise in providing accurate medical knowledge. One potential application is as a patient resource. This study analyzes and compares the ability of the currently available LLMs, ChatGPT-3.5, GPT-4, and Gemini, to provide postoperative care recommendations to plastic surgery patients. We presented each model with 32 questions addressing common patient concerns after surgical cosmetic procedures and evaluated the medical accuracy, readability, understandability, and actionability of the models’ responses. The three LLMs provided equally accurate information, with GPT-3.5 averaging the highest on the Likert scale (LS) (4.18 ± 0.93) (p = 0.849), while Gemini provided significantly more readable (p = 0.001) and understandable responses (p = 0.014; p = 0.001). There was no difference in the actionability of the models’ responses (p = 0.830). Although LLMs have shown their potential as adjunctive tools in postoperative patient care, further refinement and research are imperative to enable their evolution into comprehensive standalone resources.
Full article
(This article belongs to the Special Issue Healthcare Goes Digital: Mobile Health and Electronic Health Technology in the 21st Century)
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Open AccessReview
The Impact of Artificial Intelligence (AI) on Midwifery Education: A Scoping Review
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Angela Kranz and Harald Abele
Healthcare 2024, 12(11), 1082; https://doi.org/10.3390/healthcare12111082 (registering DOI) - 24 May 2024
Abstract
As in other healthcare professions, artificial intelligence will influence midwifery education. To prepare midwifes for a future where AI plays a significant role in healthcare, educational requirements need to be adapted. This scoping review aims to outline the current state of research regarding
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As in other healthcare professions, artificial intelligence will influence midwifery education. To prepare midwifes for a future where AI plays a significant role in healthcare, educational requirements need to be adapted. This scoping review aims to outline the current state of research regarding the impact of AI on midwifery education. The review follows the framework of Arksey and O’Malley and the PRISMA-ScR. Two databases (Academic Search Premier and PubMed) were searched for different search strings, following defined inclusion criteria, and six articles were included. The results indicate that midwifery practice and education is faced with several challenges as well as opportunities when integrating AI. All articles see the urgent need to implement AI technologies into midwifery education for midwives to actively participate in AI initiatives and research. Midwifery educators need to be trained and supported to use and teach AI technologies in midwifery. In conclusion, the integration of AI in midwifery education is still at an early stage. There is a need for multidisciplinary research. The analysed literature indicates that midwifery curricula should integrate AI at different levels for graduates to be prepared for their future in healthcare.
Full article
(This article belongs to the Special Issue Midwifery-Led Care and Practice: Promoting Maternal and Child Health)
Open AccessReview
The Effect of Menopausal Status, Insulin Resistance and Body Mass Index on the Prevalence of Non-Alcoholic Fatty Liver Disease
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Anastasia Ntikoudi, Alketa Spyrou, Eleni Evangelou, Eleni Dokoutsidou and George Mastorakos
Healthcare 2024, 12(11), 1081; https://doi.org/10.3390/healthcare12111081 - 24 May 2024
Abstract
Non-alcoholic fatty liver disease (NAFLD) is common and presents in a large proportion—up to 30%—of the global adult female population. Several factors have been linked with NAFLD in women, such as age, obesity, and metabolic syndrome. To extract appropriate details about the topic,
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Non-alcoholic fatty liver disease (NAFLD) is common and presents in a large proportion—up to 30%—of the global adult female population. Several factors have been linked with NAFLD in women, such as age, obesity, and metabolic syndrome. To extract appropriate details about the topic, we conducted an extensive search using various medical subject headings and entry terms including ‘Menopause’, ‘Non-alcoholic fatty liver disease’, ‘Insulin resistance’, and ‘BMI’. This exhaustive search resulted in a total of 180 studies, among which only 19 were able to meet the inclusion criteria. While most of these studies indicated a significant rise in NAFLD prevalence among postmenopausal women, two did not find strong evidence linking menopause with NAFLD. Moreover, it was observed that women with NAFLD had higher insulin resistance levels and BMIs compared to those without the condition. In summary, it is important to consider specific factors like risk profile, hormonal status, and age along with metabolic components when treating women presenting with NAFLD. There is need for data-driven research on how gender affects the sensitivity of biomarkers towards NAFLD as well as the development of sex-specific prediction models—this would help personalize management approaches for women, who stand to benefit greatly from such tailored interventions.
Full article
(This article belongs to the Special Issue Nursing Care for Patients with Diabetes)
Open AccessArticle
An Orthopedic Healthcare Facility Governance Assessed with a New Indicator System
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Flaviu Moldovan and Liviu Moldovan
Healthcare 2024, 12(11), 1080; https://doi.org/10.3390/healthcare12111080 - 24 May 2024
Abstract
Background and Objectives: A sustainability-oriented hospital governance has the potential to increase the efficiency of healthcare services and reduce the volume of expenses. The objective of this research is to develop a new complex tool for evaluating healthcare facility governance as a component
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Background and Objectives: A sustainability-oriented hospital governance has the potential to increase the efficiency of healthcare services and reduce the volume of expenses. The objective of this research is to develop a new complex tool for evaluating healthcare facility governance as a component of social responsibility, integrated into sustainability. Materials and Methods: We designed the research to develop the domains of a new reference framework for evaluating healthcare facility governance. The methodology for designing the indicators that make up the new reference framework consists of collecting and processing the most recent and relevant practices regarding the governance of healthcare facilities that have been reported by representative hospitals around the world. Results: We designed eight indicators that are brought together in the healthcare facility governance indicators matrix. They have descriptions and qualitative and quantitative rating scales with values from 0 to 5 that allow the degree of fulfillment to be quantified. The importance of the indicators is evaluated on a specific scale described qualitatively and quantitatively by values from 0 to 5. The values of the degree of achievement–importance couples of the indicators allow the development of improvement measures with priority according to the results revealed by the Eisenhower-type assessment diagram. Conclusions: Validation in practice of the system of indicators at an emergency hospital in an orthopedic profile highlighted the fact that they can be integrated into other national and international reference frameworks implemented in the hospital. The added value of the implementation consists of the facilitation of sustainable development and the orientation of health personnel, patients, and interested parties toward sustainability.
Full article
(This article belongs to the Special Issue Innovation in Hospital Management: Strategies and Efforts for Patient and Healthcare Workers Safety and Prevention of Claims: 2nd Edition)
Open AccessSystematic Review
A Systematic Review of the Reliability and Validity of the Patient Activation Measure Tool
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Qin Xiang Ng, Matthias Yi Quan Liau, Yong Yi Tan, Ansel Shao Pin Tang, Clarence Ong, Julian Thumboo and Chien Earn Lee
Healthcare 2024, 12(11), 1079; https://doi.org/10.3390/healthcare12111079 - 24 May 2024
Abstract
Patient activation, broadly defined as the ability of individuals to manage their health and navigate the healthcare system effectively, is crucial for achieving positive health outcomes. The Patient Activation Measure (PAM), a popularly used tool, was developed to assess this vital component of
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Patient activation, broadly defined as the ability of individuals to manage their health and navigate the healthcare system effectively, is crucial for achieving positive health outcomes. The Patient Activation Measure (PAM), a popularly used tool, was developed to assess this vital component of health care. This review is the first to systematically examine the validity of the PAM, as well as study its reliability, factor structure, and validity across various populations. Following the PRISMA and COSMIN guidelines, a search was conducted in MEDLINE, EMBASE, and Cochrane Library, from inception to 1 October 2023, using combinations of keywords related to patient activation and the PAM. The inclusion criteria were original quantitative or mixed methods studies focusing on PAM-13 or its translated versions and containing data on psychometric properties. Out of 3007 abstracts retrieved, 39 studies were included in the final review. The PAM has been extensively studied across diverse populations and geographical regions, including the United States, Europe, Asia, and Australia. Most studies looked at populations with chronic conditions. Only two studies applied the PAM to community-dwelling individuals and found support for its use. Studies predominantly showed a high internal consistency (Cronbach’s alpha > 0.80) for the PAM. Most studies supported a unidimensional construct of patient activation, although cultural differences influenced the factor structure in some cases. Construct validity was established through correlations with health behaviors and outcomes. Despite its strengths, there is a need for further research, particularly in exploring content validity and differential item functioning. Expanding the PAM’s application to more diverse demographic groups and community-dwelling individuals could enhance our understanding of patient activation and its impact on health outcomes.
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Multidimensional Study of the Attitude towards Euthanasia of Older Adults with Mixed Anxiety-Depressive Disorder
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Luís Fonseca, Luísa Castro, Guilhermina Rêgo and Rui Nunes
Healthcare 2024, 12(11), 1078; https://doi.org/10.3390/healthcare12111078 - 24 May 2024
Abstract
Introduction: This study aims to verify if older adults with mixed anxiety-depressive disorder are more prone to euthanasia and identify factors that interfere with their satisfaction with health and capacity for well-informed decisions. Material and Methods: The study applied a paper questionnaire composed
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Introduction: This study aims to verify if older adults with mixed anxiety-depressive disorder are more prone to euthanasia and identify factors that interfere with their satisfaction with health and capacity for well-informed decisions. Material and Methods: The study applied a paper questionnaire composed of a sociodemographic section and a battery of scales (to assess depression, anxiety, cognitive performance, suicide risk, therapeutic adhesion, functionality, loneliness, attitude towards euthanasia, decision pattern, personality, empathy, and health status) in the Psychogeriatric Unity of Senhora da Oliveira Hospital in Portugal. The sample was collected by convenience to include patients and controls of the same age. Six months later, a reassessment was performed. Patients and controls were compared using descriptive statistics and a multiple-regression model. Results: A total of 114 patients and 25 controls were included. Eighty-one point six percent of patients had four or fewer years of schooling. Contrary to controls, they presented mild depressive and anxiety symptoms, loneliness feelings, worse cognitive performance, a more fragile personality, higher personal distress, and a poorer health state. No statistically significant differences were found between controls and patients regarding their attitudes towards euthanasia. Patients more favourable to euthanasia had higher empathic concern, conscientiousness, and fantasy, and lower personal distress. Discussion and Conclusion: When addressing euthanasia in these patients, it is crucial to ensure they are fully self-determinate and that all the necessary treatment and support are available. It may not be the case when the educational level is low and a mild disease persists, significantly affecting their well-being and cognitive performance.
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Assessment of Social Connection among Autistic and Non-Autistic Adults: A Proof of Concept Study for the Connections with Others Scales
by
Annabelle M. Mournet, Vanessa H. Bal, Edward A. Selby and Evan M. Kleiman
Healthcare 2024, 12(11), 1077; https://doi.org/10.3390/healthcare12111077 - 24 May 2024
Abstract
Background: A gap exists in measures available to assess levels of motivation, desire, and value associated with connecting with others. Moreover, few social connection scales have been developed with a goal of including autistic individuals in the sample to create a measure that
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Background: A gap exists in measures available to assess levels of motivation, desire, and value associated with connecting with others. Moreover, few social connection scales have been developed with a goal of including autistic individuals in the sample to create a measure that has utility across neurodiverse populations. This study aims to develop a measure to assess different facets of social connection that is valid among both autistic and non-autistic adults. Methods: The sample consisted of 200 participants recruited online. Participants completed an initial set of 35 items. Exploratory factor analyses and confirmatory factor analyses were performed. Four-factor models were produced by the EFAs. Results: Item reduction resulted in the development of two 8-item scales: the Connections with Others Scale (CWOS) intended for the general population and the CWOS–Autistic Version (CWOS-AV) intended for autistic populations (CWOS-AV). Autistic participants had significantly greater motivation/desire to connect with others compared to non-autistic participants (t(195) = 3.39; p < 0.001). Conclusions: These measures will allow for greater ability to assess the motivation to connect with others, resulting in improved ability to produce research that clarifies theories and describes psychological phenomena.
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(This article belongs to the Special Issue Autism beyond School-Age: Characterization, Intervention, and Community Support)
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An Evaluation of the Health Economics of Postnatal Depression Prevention and Treatment Strategies in China: A Cost-Effectiveness Analysis
by
Zhou Zheng, Tianyu Feng, Jiaying Xu, Xiaolin Zhang and Xihe Yu
Healthcare 2024, 12(11), 1076; https://doi.org/10.3390/healthcare12111076 - 24 May 2024
Abstract
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Objective: The primary objectives of this study are to assess the cost-effectiveness of early postnatal screening and prenatal psychological interventions for the prevention and treatment of postpartum depression (PPD) among Chinese pregnant women. Additionally, we aim to explore the most cost-effective prevention and
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Objective: The primary objectives of this study are to assess the cost-effectiveness of early postnatal screening and prenatal psychological interventions for the prevention and treatment of postpartum depression (PPD) among Chinese pregnant women. Additionally, we aim to explore the most cost-effective prevention and treatment strategies for PPD in China. Methods: We used TreeAge 2019 to construct a decision tree model, with the model assuming a simulated queue size of 10,000 people. The model employed Monte Carlo simulation to assess the cost-effectiveness of PPD prevention and treatment strategies. Transfer probabilities were derived from published studies and meta-analyses. Cost and effectiveness data were obtained from published sources and relevant studies. Incremental cost-effectiveness ratios (ICERs) were used to describe the results, with willingness-to-pay (WTP) thresholds set at China’s gross domestic product (GDP) per capita. Results: Compared to the usual care group, the cost per additional quality-adjusted life year (QALY) for the early postnatal screening group and the prenatal psychological interventions is USD 6840.28 and USD 3720.74, respectively. The cure rate of mixed treatments for PPD has the greatest impact on the model, while patient participation in treatment has a minor impact on the cost-effectiveness of prevention and treatment strategies. Conclusion: Both early postnatal screening and prenatal psychological interventions are found to be highly cost-effective strategies for preventing and treating PPD in China. Prenatal psychological interventions for pregnant women are the most cost-effective prevention and treatment strategy. As such, from the perspective of national payers, we recommend that maternal screening for PPD be implemented in China to identify high-risk groups early on and to facilitate effective intervention.
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Exploring the Health-Related Quality of Life and the Lived Experience of Adolescents following Invasive Meningococcal Disease
by
Mark McMillan, Joshua McDonough, Margaret Angliss, Jim Buttery, Lynda Saunders, Suja M. Mathew, David Shaw, David Gordon, Morgyn S. Warner, Renjy Nelson, Rory Hannah and Helen S. Marshall
Healthcare 2024, 12(11), 1075; https://doi.org/10.3390/healthcare12111075 - 24 May 2024
Abstract
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Background: Data on the health-related quality of life (HRQoL) for invasive meningococcal disease (IMD) survivors, particularly among adolescents and young adults (AYAs), are limited. This study aimed to investigate the in-depth experiences and impacts of IMD on AYAs. Methods: Participants were recruited from
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Background: Data on the health-related quality of life (HRQoL) for invasive meningococcal disease (IMD) survivors, particularly among adolescents and young adults (AYAs), are limited. This study aimed to investigate the in-depth experiences and impacts of IMD on AYAs. Methods: Participants were recruited from two Australian states, Victoria and South Australia. We conducted qualitative, semi-structured interviews with 30 patients diagnosed with IMD between 2016 and 2021. The interview transcripts were analyzed thematically. Results: Of the participants, 53% were aged 15–19 years old, and 47% were aged 20–24. The majority (70%) were female. Seven themes relating to the participants’ experience of IMD were identified: (1) underestimation of the initial symptoms and then rapid escalation of symptoms; (2) reliance on social support for emergency care access; (3) the symptoms prompting seeking medical care varied, with some key symptoms missed; (4) challenges in early medical diagnosis; (5) traumatic and life-changing experience; (6) a lingering impact on HRQoL; and (7) gaps in the continuity of care post-discharge. Conclusion: The themes raised by AYA IMD survivors identify multiple areas that can be addressed during their acute illness and recovery. Increasing awareness of meningococcal symptoms for AYAs may help reduce the time between the first symptoms and the first antibiotic dose, although this remains a challenging area for improvement. After the acute illness, conducting HRQoL assessments and providing multidisciplinary support will assist those who require more intensive and ongoing assistance during their recovery.
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Open AccessArticle
Comparing the Efficacy of Manual Therapy and Exercise to Synchronized Telerehabilitation with Self-Manual Therapy and Exercise in Treating Subacromial Pain Syndrome: A Randomized Controlled Trial
by
Erman Berk Çelik and Aysenur Tuncer
Healthcare 2024, 12(11), 1074; https://doi.org/10.3390/healthcare12111074 - 24 May 2024
Abstract
This study aimed to investigate the efficacy of manual therapy and exercise versus synchronized telerehabilitation with self-manual therapy and exercise in treating Subacromial Pain Syndrome (SAPS). Sixty individuals diagnosed with SPS, aged 18–50 years, were randomly assigned to home exercise (HE), manual therapy
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This study aimed to investigate the efficacy of manual therapy and exercise versus synchronized telerehabilitation with self-manual therapy and exercise in treating Subacromial Pain Syndrome (SAPS). Sixty individuals diagnosed with SPS, aged 18–50 years, were randomly assigned to home exercise (HE), manual therapy (MT), and telerehabilitation (TR) groups. Treatment protocols were administered over 8 weeks and included specific exercises and therapy interventions. Outcome measures included the Visual Pain Scale (VAS), shoulder range of motion (ROM) via goniometric measurements, Quick Disability Arm-Shoulder-Hand Problems Survey (Q-DASH), and patient satisfaction. Results revealed that both MT and TR groups exhibited reduced pain, increased ROM, lower Q-DASH scores, and higher patient satisfaction than the HE group. However, no significant differences were found between the MT and TR groups regarding pain levels, ROM, Q-DASH scores, or patient satisfaction. The study concludes that both telerehabilitation and manual therapy effectively alleviate pain and are well-received by patients with SPS. Additionally, manual therapy demonstrates superiority in enhancing functional levels compared to exercise-based interventions (Registration: NCT05200130).
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(This article belongs to the Special Issue Telehealth and Remote Patient Monitoring)
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