Healthcare最新文献

Background: Developing and implementing diverse interventions is imperative for addressing schizophrenia in the context of deinstitutionalization policies. This study evaluates the effectiveness of an agro-healing horticultural therapy as a psychosocial rehabilitation program for inpatients with schizophrenia. Methods: This quasi-experimental study utilizes a non-equivalent control group pre-post design to assess the efficacy of a therapeutic horticulture program for patients diagnosed with schizophrenia. Results: This study's findings supported the initial hypothesis, as the experimental group exhibited a statistically significant reduction in perceived stress, with post-test scores differing significantly between groups (Z = -2.11, p = 0.035). Hypothesis 2, which examined self-esteem, was rejected because no statistically significant differences were found between groups (Z = -0.57, p = 0.566). Hypothesis 3 was supported, as the experimental group's Positive and Negative Symptom Scale (PANSS) scores decreased following treatment, with significant post-treatment differences between groups (Z = -3.43, p < 0. 001). Conclusions: The agro-healing horticultural therapy program in this study effectively reduced stress and PANSS scores among inpatients with schizophrenia. Combining this intervention with medication may enhance rehabilitation outcomes and quality of life for patients afflicted with schizophrenia.

Background/objectives: Home care plays a crucial role in contemporary healthcare systems, particularly in the long-term care of people with chronic and progressive illnesses. Family caregivers often experience substantial physical, emotional, and organizational burden. Telemedicine and digital health applications have the potential to support home care by improving health monitoring, communication, and care coordination. However, their use among family caregivers remains inconsistent, and little is known about how organizational support structures such as telemedicine centers influence acceptance and everyday use. This study aims to examine the benefits of telemedicine in home care and to evaluate the role of telemedicine centers as supportive infrastructures for family caregivers.

Methods: A mixed-methods design was applied. Quantitative data were collected through an online survey of 58 family caregivers to assess the use of telemedicine and digital health applications, perceived benefits, barriers, and support needs. This was complemented by an in-depth qualitative case study exploring everyday caregiving experiences with telemedicine technologies and telemedicine center support. A systematic literature review informed the theoretical framework and the development of the empirical instruments.

Results: Most respondents reported not using telemedicine or digital health applications in home care. Among users, telemedicine was associated with perceived improvements in quality of care, particularly through enhanced health monitoring, improved communication with healthcare professionals, and increased feelings of safety and control. Key barriers to adoption included technical complexity, data protection concerns, and limited digital literacy. Both quantitative findings and the qualitative case study highlighted the importance of structured support. Telemedicine centers were perceived as highly beneficial, providing technical assistance, training, coordination, and ongoing guidance that facilitated technology acceptance and sustained use.

Conclusions: Telemedicine and digital health applications can meaningfully support home care and reduce caregiver burden when they are embedded in supportive socio-technical structures. Telemedicine centers can function as central points of contact that enhance usability, trust, and continuity of care. The findings suggest that successful implementation of telemedicine in home care requires not only technological solutions but also accessible organizational support and targeted training for family caregivers.

Objectives: Intensive care units (ICUs) are characterised by high care complexity and nursing workload, which directly affects patient safety and staff sustainability. Latvia faces a chronic shortage of nurses, particularly in intensive care, yet systematic national data on nursing workload have been lacking. This study aimed to quantitatively assess nursing workload in Latvian ICUs using the Nursing Activities Score (NAS) and to evaluate its relationship with staffing adequacy. Methods: A prospective, multicentre observational study was conducted over six months (May-November 2025) in 14 Latvian ICUs representing all three levels of intensive care. Nursing workload was measured using the NAS during each 12 h shift. A total of 28,079 complete NAS observations were analysed using descriptive statistics, inferential tests (t-tests, ANOVA), mixed-effects modelling, regression analysis, and time-series forecasting. Results: The mean NAS was 65.45 (SD = 25.76), equivalent to an average of 15.71 nursing care hours per patient per day. Workload remained similarly high during day and night shifts. Significant differences were observed between ICUs and care levels, with level 2 units showing the highest workload. The average nursing shortage rate was 42.6% and was strongly predicted by NAS values (R² = 0.115), whereas shift type and unit level had minimal explanatory power. Conclusions: ICU nursing workload in Latvia is persistently high and unevenly distributed across units. Staffing levels are not adequately adjusted to actual care demands. Integrating NAS-based workload monitoring into staffing models is essential for evidence-based workforce planning, improving patient safety, and reducing nurse overburdening.

Background/Objectives: To investigate whether healthcare workers present different characteristics of musculoskeletal symptoms depending on the level of complexity in which these professionals work in the Brazilian Unified Health System. Methods: Health professionals were recruited from 24 health institutions, using probabilistic stratified sampling. Data were collected using the Nordic Musculoskeletal Questionnaire. We obtained the questionnaire scores through exploratory factor analysis. Based on the scores, individuals could be grouped into symptom configurations using a non-hierarchical clustering algorithm (K-means). Results: The created groups differed in symptom intensity and location but did not differ by level of work complexity, as defined by Brazil's healthcare sector division. Therefore, regardless of the level of complexity at which professionals perform their activities in the Brazilian Unified Health System, the burden of musculoskeletal symptoms related to the factor under analysis is similar. We developed distinct symptom profiles for each group, accompanied by targeted occupational intervention recommendations. Conclusions: This study challenges conventional assumptions by demonstrating that musculoskeletal symptom burden remains consistent across varying levels of work complexity, while providing a practical framework for developing targeted interventions based on symptom profiles.

Background: The rising prevalence and enduring impact of mental health problems in youth have intensified the call for population-level prevention. Low positive and high negative affect in childhood are vulnerability factors for mental health problems in adolescence. Supporting youth in managing affect during early adolescence may foster mental health preventively. Self-regulation training has shown promise in this regard. Moreover, its parallels with Behavioral Activation (BA) align with the recommendation to adapt evidence-based clinical interventions into scalable, accessible formats for prevention. Methods: This study examined whether a 12-day mobile-based self-regulation training, consistent with BA principles and delivered in an innovative digital format, could increase positive and decrease negative affect in a sample of 156 youths (M_age = 10.0). Results: No significant group differences emerged in affect change over time, and neither baseline levels of self-control nor emotion regulation strategies moderated the effects. Conclusions: The findings suggest that low-intensity mobile-based interventions may be insufficient to produce meaningful affect change in youth. The potential need to shift from universal prevention strategies to more selective approaches targeting at-risk youth is discussed.

Background/Objectives: Wearable fitness trackers (WFTs) are growing in popularity as tools to motivate physical activity and support healthier lifestyles. Evidence suggests that they can have both positive and negative effects on user behaviour and well-being. However, little is known about their impact in Saudi settings, considering its unique cultural context. This study aims to investigate the perceived positive and negative impacts of WFTs on adults' health behaviours and well-being in Saudi Arabia. Methods: A cross-sectional survey was conducted among Saudi adults aged 18 years or older who currently use or have previously used WFTs, using an online questionnaire distributed via social media platforms in May 2025. The survey was developed based on evidence from the literature. It included demographic items, five-point Likert-scale questions assessing positive (9 items) and negative (10 items) effects of WFTs, and an open-ended question. Responses were analysed using descriptive statistics, independent samples t-tests, and one-way ANOVA. Results: A total of 154 adults participated. The mean composite score for positive effects was 3.26 (SD = 0.73), indicating general agreement on the benefits of WFTs, while the negative effects score was 2.15 (SD = 0.66), showing low endorsement of adverse outcomes. No significant differences appeared between gender (positive: p = 0.34; negative: p = 0.24) or age groups (positive: p = 0.56; negative: p = 0.19). However, users of over two months had higher positive scores (M = 3.43, SD = 0.66) than newer or former users (p = 0.01). Open responses showed 62% positive experiences; 27% reported stress, guilt, or obsessive monitoring. Conclusions: This study provides initial insights into WFT use and perceptions in Saudi Arabia. However, its cross-sectional nature limits the ability to draw causal conclusions. While most users experienced beneficial health outcomes, a significant proportion reported negative psychological experiences. These findings highlight WFT users' dual experiences and the need for further longitudinal research and diverse recruitment strategies to better understand sustained engagement and psychological effects.

Background/Objectives: Irregular maritime migration is a global health challenge as it combines exposure to extreme physical risks with profound psychosocial vulnerability. Understanding the role of maritime rescue professionals is essential for designing effective public health strategies that respond to these realities. The objective of this study was to explore and describe the experiences of SASEMAR professionals involved in the emergency care and rescue of irregular migrants arriving by small boat to the Spanish coast. Methods: Using a qualitative descriptive design, we conducted in-depth interviews and focus groups with 12 SASEMAR professionals. Thematic analysis was performed using Braun and Clarke's approach with ATLAS.ti software. Results: The findings were grouped into three overarching themes: (1) Innovative Emergency Response Systems for Vulnerable Populations; (2) Holistic Health Approaches in Maritime Emergency Care; and (3) Integrated Approaches to Resource Use and Migrant Care Policies. Conclusions: Rescuing irregular migrants at sea requires coordinated, flexible, and multidisciplinary strategies to address diverse profiles and challenging conditions. Strengthening rescue capacity and policies is essential to ensure effective, human care during maritime emergencies.

Background: The World Health Organization (WHO) has recently focused much attention on physical activity recommendations. Regular physical activity offers broad health benefits, reducing the risk of some chronic diseases and improving bone structure and muscle strength. Although the scientific literature provides numerous recommendations for physical activity during pregnancy and the postpartum period, there are no official recommendations for lifestyle-related physical activity.

Objectives: This narrative review aimed to review the current knowledge on physical activity during pregnancy and the postpartum period, specifically focusing on lifestyle-related physical activity. The review was based on the definition of lifestyle-related physical activity proposed by Dunn et al. in 1998, which is at least 30 min of self-selected activity per day, encompassing all recreational, occupational, or household activities, as well as planned and unplanned activities that are part of daily life.

Methods: A number of databases were analyzed, including PubMed, the Cochrane Library, Embase, and Web of Science.

Results: The most valuable reports and recommendations regarding physical activity during the perinatal period were identified.

Conclusions: Moderate physical activity during pregnancy is safe and offers benefits, such as reducing the risk of gestational diabetes, preeclampsia, and excessive weight gain, as well as improving mental health. The most common benefits of continuing physical activity after delivery include weight control, reduced risk of depression, and improved quality of life. Lifestyle-based physical activity is easier to implement and more achievable than structured exercise. Further research is needed to establish recommendations regarding lifestyle-based physical activity during the perinatal period.

Background/Objective: This study aims to examine changes in hedonic hunger and problematic eating behaviors over a 24-week follow-up period after sleeve gastrectomy and Roux-en-Y gastric bypass and to compare differences between the two surgical procedures. Methods: This prospective observational study included 144 adults who underwent sleeve gastrectomy (n = 74) or Roux-en-Y gastric bypass (n = 70). Hedonic hunger was assessed using the Power of Food Scale, and problematic eating behaviors were evaluated with the Eating Disorder Examination Questionnaire. Data was collected one week before surgery and 24 weeks postoperatively through face-to-face interviews. Results: At the 24-week follow-up, participants who underwent gastric bypass had higher total Power of Food Scale scores than those who underwent sleeve gastrectomy (2.42 vs. 2.15), although reductions from baseline were not significantly different (-1.31 vs. -1.16, p = 0.136). Both procedures resulted in significant decreases in total Eating Disorder Examination Questionnaire scores (sleeve gastrectomy: 2.37 to 1.00, p < 0.01; gastric bypass: 2.41 to 1.36, p < 0.01), as well as in Eating Concern, Shape Concern, and Weight Concern subgroups. Reductions in Eating Disorder Examination Questionnaire total score and in Shape Concern and Weight Concern subgroups score were greater after sleeve gastrectomy (-1.37 vs. -1.05, p = 0.030). Total weight loss percentage was positively correlated with decreases in Eating Disorder Examination Questionnaire scores in both groups (p = 0.010) and was significantly associated with Power of Food Scale reductions only in sleeve gastrectomy (r = 0.163, p = 0.014). Conclusions: Both procedures reduce hedonic hunger and problematic eating behaviors, but the magnitude of change and its effect on weight loss may vary by surgical method.

A large and growing empirical literature documents that privatization, deregulation, financialization, and under-regulation of harmful industries are associated with adverse health outcomes in the United States. However, this evidence remains fragmented across sectors and rarely articulates a unifying causal framework. This paper advances the literature by integrating findings across health care, harmful-product industries, and economic and social policy to demonstrate that corporate profit maximization functions as a cross-cutting driver of health disparities and premature mortality in the United States. We synthesize evidence showing that profit-driven incentives shape insurance markets, hospital and physician practice ownership, pharmaceutical marketing, and the aggressive promotion of tobacco, alcohol, ultra-processed foods, opioids, firearms, and fossil fuels-together contributing to more than one million deaths annually. We further document how corporate influence over public policy has increased poverty, economic inequality, and discrimination, all of which are powerful social determinants of health. In contrast to sector-specific analyses, this paper presents a unified, systems-level account of how profit-first governance undermines population health. We conclude by describing how a social movement to achieve a single payer system that provides Medicare for All would not only vastly improve public health, it would be a catalyst for numerous other reforms that enhance the general wellbeing.