Healthcare最新文献

Background: Anxiety is highly prevalent among individuals living with disability, chronic illness, or hospitalisation, yet it often remains insufficiently addressed in healthcare settings. Animal-assisted therapy (AAT) has been proposed as a complementary intervention to reduce anxiety; however, existing evidence is fragmented across populations and methodologies. Methods: A systematic review was conducted following PRISMA 2020 guidelines. The review protocol was registered in PROSPERO (CRD42024494109); no amendments were made to the protocol after registration. Four databases (Scopus, APA PsycInfo, Web of Science, and PubMed) were searched for empirical studies (2013-2023) evaluating AAT delivered by trained professionals using domesticated species and reporting anxiety outcomes in individuals with disability, illness, or hospitalisation. Results: Thirty-one studies met eligibility criteria and were included in the review. Across heterogeneous designs, most interventions-primarily using dogs or horses-reported significant post-intervention reductions in anxiety. Randomised clinical trials consistently showed superior results compared with control conditions. AAT demonstrated beneficial effects across populations including PTSD, paediatric hospitalisation, chronic illness, disability, acute care, and trauma exposure. Long-term outcomes were mixed, and methodological variability limited comparability across studies. Conclusions: AAT appears to be a promising complementary intervention for anxiety management within clinical, psychosocial, and healthcare settings. Evidence supports short-term anxiolytic effects across diverse populations, although standardisation and long-term evaluations remain insufficient. Future research should establish optimal intervention parameters, mechanisms of action, and strategies for integrating AAT into multidisciplinary mental healthcare.

Objectives: This study aims to explore the facilitators and barriers in the process of using AI agents for disease management in older COPD patients.

Methods: Based on the normalization process theory, a descriptive qualitative study was used to conduct semi-structured interviews with 28 older patients with COPD recruited from June to August 2025 in a Class A tertiary hospital in Wuxi, Jiangsu Province.

Results: A total of 28 interviews were conducted. Four themes (Coherence, Cognitive Participation, Collective Action, Reflexive Monitoring), nine subthemes (recognition of intelligent technology;supported by policy discourse and the background of national-level projects; the creation of a family atmosphere; recommendations from HCPs; relief and social connection; new "doctor"-patient relationship and communication; eliminate the burden and return to life; benefit and value perception; right self-decision by AI) in facilitators and nine subthemes (privacy conflicts and trust deficiency; blurred boundaries of human-machine responsibility and authority; non-high-quality services are chosen reluctantly; technical anxiety; lack of motivation for continued engagement; extra burden; limitations of the physical environment; human-machine dialogue frustration; a sense of uncertainty about the future of AI) in barriers were extracted.

Conclusions: This study identified key factors influencing the use of AI agents in chronic disease management in older patients with COPD. The results provide directions for improving the implementation and sustainable use of AI health technologies.

Background/Objectives: Cancer is a disabling, challenging, and growing global disease. Although early diagnosis and adequate treatment of cancer are developing rapidly, a large part of the population remains without access to specialized services and routinely progresses to uncontrolled pain, poorer quality of life, and suffering. Complementary therapies for pain management and the well-being of patients under palliative care are fundamental tools of integrative oncological medicine. This first version of the protocol was created in August 2023 to structure the aim of this study to investigate the effectiveness of the experimental protocol which uses immersive virtual reality as a meditation tool in patients followed at the Pain Therapy and Palliative Care Service of the CECON Foundation. Methods: This randomized clinical trial, conducted at the Pain Therapy and Palliative Care Service (STDCP) of the FCECON, explores the use of immersive virtual reality to promote regular meditation practice among cancer patients as an effective means of managing pain and improving quality of life. Discussion: The present study has the potential to evaluate the effectiveness of immersive virtual reality as a meditation tool for patients undergoing palliative care, in addition to contributing scientific evidence that supports better decisions in healthcare for the management of cancer pain. Trial registration: Brazilian Registry of Clinical Trials (ReBEC) and ClinicalTrials.gov/NCT06328751/Universal Trial Number (UTN) U1111-1304-3752.

Background/Objectives: Von Hippel-Lindau (VHL) disease is a rare autosomal dominant hereditary disorder. Central nervous system hemangioblastomas are one of the most common tumor types associated with VHL disease. Although these tumors are histologically benign, delayed diagnosis and treatment may result in severe neurological dysfunction, permanent disability, and even death. However, little is known about the experiences of patients with VHL disease. The aim of this study was to gain a better understanding of the illness experiences and psychological responses of patients with VHL disease accompanied by central nervous system hemangioblastomas. Methods: A qualitative study based on a semi-structured guide was conducted. Twelve participants were recruited. Data were collected through face-to-face interviews and analyzed using the constant comparative method. Results: Four themes and their subthemes were identified: 1. powerlessness-unpredictable disease progression and uncontrollable continuity; 2. negative emotional experiences-guilt and self-blame, depression, and low self-esteem; 3. compromise-acceptance of fate, positive outlook, and sense of hope; and 4. persistent worry-worries about family members, anxiety regarding finances and employment, and uncertainty regarding the future. Conclusions: This study identified four major themes in the illness experiences of patients with VHL disease accompanied by central nervous system hemangioblastomas, which provided deep insights into the care needs of individuals with VHL disease. Healthcare providers should develop effective measures to enhance patients' ability to maintain a good quality of life and confront the future with resilience.

(1) Background: The purpose of this study was to investigate the associations between perceived stress and anxiety in high school senior students, taking into account the possible influence from lifestyle (physical activity, nicotine dependence, and alcohol use) and social support. (2) Methods: A representative sample of high school senior students (N = 405; mean age: 18.2 ± 0.4), reflecting the overall geographic distribution of Lithuania's student population, was investigated using anonymous questionnaires on perceived stress (Perceived Stress Scale, PSS-10), anxiety (Generalized Anxiety Disorder Scale, GAD-7), perceived social support (Multidimensional Scale of Perceived Social Support, MSPSS), lifestyle (Fagerström Test for Nicotine Dependence), alcohol use (Alcohol Use Disorders Identification Test, AUDIT), and physical activity (International Physical Activity Questionnaire, IPAQ). Hierarchical multiple regression analysis was employed, investigating mediating and moderating effects. (3) Results: The direct effect of perceived stress on anxiety was significant (B = 0.364; SE = 0.0486; 95% CI [0.268, 0.459]; p < 0.001). Furthermore, the analysis revealed a significant indirect effect via social support (B = 0.387; SE = 0.0525; 95% CI [0.284, 0.490]), indicating that a portion of the relationship between perceived stress and anxiety was mediated by social support. Physical inactivity, alcohol use, and nicotine dependence served as moderators. Our findings confirmed that all three moderators showed significant interaction effects, with standardized β = -0.124, p = 0.002, for physical inactivity, β = 0.073, p = 0.016, for alcohol dependence, and β = 0.119, p = 0.001, for nicotine dependence, in the relationship between perceived stress and anxiety among high school senior students. (4) Conclusions: These findings have practical insights for educators who implement physical activity and alcohol and nicotine usage programs for high school senior students to help reduce their stress and anxiety.

Background: Care homes are complex care environments where supporting residents' identity, wellbeing, and sense of personhood is central to person-centred care. Reminiscence is widely recognised as a psychosocial approach that can support these outcomes. However, existing evidence has largely focused on group-based interventions, with comparatively limited attention given to how individual reminiscence is implemented and sustained within care home practice. Methods: This study was an implementation-focused qualitative exploration of staff experiences of introducing and embedding individualised reminiscence in care home practice. Care home staff participated in four monthly workshops that introduced principles of individualised reminiscence and supported them to plan and implement reminiscence with at least one resident. Participants used either the InspireD digital reminiscence app (n = 19) or non-digital approaches such as life story books (n = 2), depending on local preferences and perceived suitability. Three focus groups were conducted with 21 care home staff to explore experiences of implementing individualised reminiscence and perceptions of its impact on residents, staff, and families. Data were analysed using reflexive thematic analysis. Results: Four interrelated themes were identified: (1) reminiscence within pressured systems; (2) resident experience and identity; (3) adapting and sustaining practice; and (4) families as partners in reminiscence. Participants described challenges associated with workload pressures, role expectations, and variability in family involvement, which influenced how reminiscence was adopted in practice. Despite these constraints, participants described perceived benefits for residents, including perceived improvements in mood, engagement, and expressions of identity. Participants also discussed perceived increased staff confidence, strengthened staff-resident relationships, and enhanced awareness of person-centred care practices. Conclusions: Findings highlight the perceived potential of individualised reminiscence to support person-centred and relational care in care homes, while identifying key contextual influences on implementation. Further research is needed to examine sustainability and effectiveness using comparative and mixed-method designs.

Background: Pre-exposure prophylaxis (PrEP) offers over 99% protection against HIV when used consistently, but stigma continues to undermine persistence in care. While much research has described the external manifestations of PrEP-related stigma, less is known about how individuals cope with these stigmas and how such coping processes influence persistence. Guided by Social Cognitive Theory, this study examined the psychosocial strategies men who have sex with men (MSM) in Tanzania use to cope with PrEP-related stigma and sustain persistence in care. Methods: Thirty-two in-depth interviews were conducted with purposefully selected MSM aged 18-38 years at Ngamiani Health Centre in Tanga region. The sampling included both persistent and non-persistent PrEP users with variation in age and sexual position preferences. Participants were sampled for variation in persistence status (persistent and non-persistent), age, and sexual position preference to capture heterogeneity in stigma experiences and coping processes. Interviews were conducted in Kiswahili, audio-recorded, transcribed, translated, and analyzed using reflexive thematic analysis. Results: Participants described PrEP-related stigma as socially constructed through narratives that equated PrEP with HIV treatment, labeled it a "gay pill," associated it with promiscuity, or linked it to bodily harm or increased HIV risk. These stigmas impact persistence in care through discouraging clinic visits and daily pill taking. However, some participants remained persistent in care despite stigma by using protective mental strategies such as personal agency, mental time travel, and affirmation from supportive social connections, which buffered emotional impacts and sustained persistence. Conclusions: Persistence in PrEP care is shaped not only by stigma in the social environment but also by how individuals interpret and respond to it. Interventions should therefore combine structural stigma-reduction efforts with mental health-informed strategies that strengthen agency and supportive social relationships to sustain PrEP engagement among MSM.

Background/Objectives: Adolescence is a developmental period characterised by intensive use of social media and an increased prevalence of emotional problems such as depression and anxiety. Scientific evidence indicates that the modality of social media use (active or passive) can significantly predict these problems, with active use being linked to a higher likelihood of cyberbullying victimisation. As victimisation is associated with more severe emotional problems, social media represents an important context for understanding adolescent mental health. Following this, the main aim of this study was to examine how the modality of social media use (SMU) is related to emotional problems, and whether cyberbullying victimisation mediates this relationship. Methods: This study was conducted on a convenient sample of N = 1822 students (49.0% boys, 51.0% girls; M_age = 13.22 years, SD_age = 0.629) from a total of 64 elementary schools throughout Croatia. A modified Croatian version of the Active and Passive Use of Social Networks Scale, the Anxiety and Depression subscales of the Depression, Anxiety, Stress Scale-Youth Version, and the Cyber-Victimisation subscale of the European Cyberbullying Intervention Project Questionnaire were used. Results: The results indicate that passive SMU among boys is directly related only to anxiety, while that among girls contributes only to the explanation of depression. Regarding cyberbullying victimisation as a mediator, full mediation in the association between active SMU and emotional problems was found for both girls and boys. Conclusions: This represents a significant theoretical contribution, as well as a contribution to the development of psychosocial interventions.

Objectives: The purpose of the current research is to examine and analyze the attitudes of healthcare service users towards the integration of remote medical services into ophthalmology in Bulgaria, including teleglaucoma. Methods: A cross-sectional survey study was conducted among 902 healthcare users during the period from May 2023 until December 2024. Descriptive statistics, parametric, and non-parametric tests for hypothesis testing were used. Results: The present study outlined predominantly positive attitudes towards the use of telemedicine services in ophthalmology, with 69.6% of respondents reporting a positive overall opinion in the final assessment. The greatest support was observed during remote consultations with a familiar doctor (77.4%) and during continuous follow-up of eye conditions (55.2%). Willingness to use such services was lower in emergencies or when contacting an unfamiliar specialist. A significant correlation was established between socio-demographic characteristics and attitudes-respondents with greater education levels (p = 0.006), men, and younger participants were more positive towards telemedicine (p < 0.05). The high level of awareness about glaucoma, particularly among those with university-level education, served as a positive prerequisite for the implementation of teleophthalmology services related to its monitoring. Mobile applications and digital solutions were evaluated as beneficial means of facilitating communication and increasing adherence to treatment. Regarding the use of artificial intelligence, certain skepticism and insufficient awareness levels were observed, which required additional efforts to increase trust and digital literacy among users. Conclusions: The implementation of telemedicine services into ophthalmology has potential but outlines the necessity of considering the individual attitudes of applying coherent quality and safety standards and of directed awareness campaigns, especially towards the groups of lower technological and healthcare literacy.

Background/Objectives: Primary Progressive Aphasia (PPA) is a neurodegenerative disorder characterized by gradual and progressive deterioration of speech and language abilities. Speech and language therapy is considered an important intervention to slow decline and support the recovery of linguistic functions in individuals with PPA. This study aims to examine the effectiveness of an elaborated Semantic Feature Analysis (SFA) approach in enhancing naming abilities and semantic networks in individuals with the logopenic and semantic variants of PPA. Methods: Fourteen participants were recruited, including seven individuals with logopenic PPA and seven with semantic PPA. All participants received an elaborated SFA intervention twice weekly for four weeks. The Aphasia Language Assessment Test (ADD), the Turkish Picture Naming Test (T-RAT), and the SAQOL-39 were conducted at the following three time points: prior to treatment (pre-test), immediately after treatment (post-test), and one month post-treatment (follow-up). Results: Significant improvements were observed in ADD, T-RAT, and SAQOL-39 scores in both logopenic and semantic PPA groups following treatment (p < 0.05). Although follow-up scores declined compared to posttest performance (p < 0.05), several follow-up scores remained higher than pretest levels. Between-group comparisons indicated no significant difference in ADD scores; however, logopenic PPA participants demonstrated higher T-RAT scores (p < 0.05), while semantic PPA participants showed higher SAQOL-39 scores, except at follow-up (p < 0.05). Conclusions: Preliminary results suggest that the elaborated SFA intervention is effective in improving naming skills, language functioning, and quality of life in both logopenic and semantic variants of PPA. Although treatment gains partially decreased after one month, many improvements were maintained above baseline, supporting the clinical value of SFA in managing language decline in PPA.