Healthcare最新文献

Objective: The parallel process latent growth curve model (PP-LGCM) was used to examine the longitudinal relationship between activities of daily living (ADL) and depression and further tested whether chronic diseases (CDs) were associated with depression via mediating variable ADL. Methods: A sample of 2014 Chinese older adults aged 60 and over from the China Health and Retirement Longitudinal Survey (CHARLS) was used. The activities of daily living scale, self-rating depression scale, and chronic diseases scale were used to investigate the ADL, depression, and CD levels of older adults. Following certain statistical analysis steps, we used SPSS 26 and Mplus 8.0 to perform statistical analysis on the data. Results: Firstly, ADL significantly declined in older adults from 2011 to 2018, while depression had a significant rise. Secondly, the intercept of ADL was correlated with the intercept of depression (r = 0.487, p < 0.001), and the slope of ADL was positively correlated with the slope of depression (r = 0.844, p < 0.001). Finally, the intercept of ADL mediated 39% of the association of chronic diseases and the intercept of depression. Conclusions: Our findings showed the trajectories of ADL and depression in older adults and demonstrated that ADL have various associations with depression in longitudinal development. In addition, the effect of chronic diseases on depression is partially mediated by ADL. The ADL play a partial mediating role between chronic diseases and depression in older adults, with an indirect effect of 39%, indicating that ADL are very important. Grasping the mediating mechanism of ADL will help alleviate depression levels in older adults with chronic diseases.

Objective: Upper crossed syndrome (UCS) is an abnormal upper extremity movement pattern characterized by muscle tightness in the neck, shoulders, and upper back, coupled with weakness in opposing muscle groups. This study aimed to investigate the effectiveness of Pilates training combined with fascial massage as an intervention in office workers with UCS. Methods: 34 subjects were recruited and randomly divided into an experimental group (n = 17) and a control group (n = 17). The control group underwent 12 weeks of Pilates training, and the experimental group received 12 weeks of Pilates training combined with fascial massage. Body posture was assessed using the forward head angle (FHA) and forward shoulder angle (FSA), joint mobility was evaluated using cervical spine range of motion (ROM), muscle activity was assessed using surface electromyography (sEMG), and quality of life was evaluated using pain level (VAS) and cervical spine dysfunction index (NDI). Results: After 12 weeks of intervention, the FHA, FSA, VAS, and NDI of the experimental group were significantly lower than those of the pre-intervention group (p < 0.05) and significantly lower than those of the control group (p < 0.05); the extension and left-right rotation cervical spine ROM of the experimental group were significantly higher than those of the pre-intervention group (p < 0.05) and significantly higher than those of the control group (p < 0.05); and sEMG indexes (mean power frequency and median frequency) of the upper trapezius and the pectoralis major in the experimental group were significantly higher than those of the pre-intervention group (p < 0.05) and significantly higher than the control group (p < 0.05). Conclusion: Compared with Pilates training alone, Pilates training combined with fascial massage demonstrated a more significant effect in improving muscle activation, body posture, and pain and enhancing the quality of life for patients with UCS.

Background: Duchenne muscular dystrophy (DMD) is a genetic disorder characterized by progressive muscle weakness, a decline in quality of life, and premature mortality. This study aims to evaluate the perceived quality of healthcare and the experience of DMD patients and their caregivers in Mexico, comparing governmental and non-profit healthcare institutions using a newly designed assessment instrument.

Methods: In a cross-sectional study, data were gathered from 91 participants through an online self-administered questionnaire informed by the Donabedian model and six dimensions of healthcare quality.

Results: Analysis revealed two key mediating factors: perceived quality of healthcare and patient experience. The Mann-Whitney U test showed that non-profit organizations were perceived to provide superior quality care in both aspects (p < 0.05), notably regarding healthcare professionals' preparedness and other domains of quality. However, the patient-centered care domain indicated that the importance of quality domains may vary according to cultural and social contexts. In Mexico, the humanistic approach of healthcare professionals appeared to compensate for shortcomings in timely diagnosis and other quality domains. This emphasizes the necessity for enhanced patient education and healthcare evaluation, and it highlights that patient satisfaction does not always correlate with high-quality healthcare. The developed instrument can further aid in understanding the experiences of DMD patients across different countries and cultures.

Background: This study aimed to evaluate the effect of patient education provided through one-on-one verbal instruction supported by visual media tools for bowel preparation prior to a colonoscopy procedure. Materials and Methods: This prospective study included patients who underwent colonoscopy in our clinic's endoscopy unit between April 2024 and August 2024. The study design included two groups: the control group (CG), wherein patients scheduled for a colonoscopy received standard information about the procedure at the outpatient clinic, and the information group (IG), wherein patients were invited to the clinic 5 days before the procedure and received an interactive education session lasting approximately 10 min in addition to the standard information. The adequacy of bowel preparation was evaluated using the Boston Bowel Preparation Scale (BBPS). Results: This study included 228 patients, with 114 patients in each group. Of the patients, 137 were male (60.08%) and 91 were female (39.92%). The mean age of the patients was 49.41 ± 15.04 years, the mean BMI was 27.48 ± 4.23, and the mean BBPS score was 7.38 ± 1.96. The mean BBPS score of the patients in the IG and CG was 7.76 ± 1.84 and 7.00 ± 2.01, respectively, and there was a statistically significant difference between the two groups (p = 0.003). Conclusions: Additional information provided prior to the colonoscopy procedure was identified as an effective parameter on adequate bowel preparation.

Background/Objectives: The objective of our study was to quantify the annual costs, from a societal perspective, encompassing direct health care costs, direct non-health care costs, and labor productivity losses associated with spinal muscular atrophy (SMA) patients in Bulgaria and their caregivers. Methods: We applied a prevalence-based, bottom-up costing methodology to assess the socio-economic burden of SMA from a societal perspective. We evaluated and summed up all costs for health services (diagnosis, treatment, follow-up, and rehabilitation), educational and social services, and formal and informal care in the community, as well as indirect costs due to the loss of productivity and work capacity of the SMA patients' caregivers. Results: Nine parents of SMA patients provided consent and completed the study's questionnaire. Two children had SMA type III, and seven had SMA type II. The median annual socio-economic burden per SMA patient was EUR 254,968.80. The high direct costs, primarily driven by drug expenses, and the substantial indirect costs resulting from the loss of productivity among informal caregivers were the primary causes. We found no utilization of social care and educational services. Conclusions: We emphasize the need for careful consideration of long-term outcomes, real-world data collection, and performance-based reimbursement. An ideal scenario could achieve these objectives in synergy. A second layer of policy actions and measures must address the unmet needs of SMA patients and their families using a holistic approach. The indirect costs associated with SMA, particularly the productivity loss of informal caregivers, underscore the need for comprehensive support programs.

Background: Dermatology in healthcare is changed by technological advancements, patient awareness, and developing healthcare needs. In Saudi Arabia, choosing a dermatologist is influenced by various factors, including patient satisfaction, digital technology use, and the physician's characteristics and qualities. Purpose: The major aim of this research was to evaluate factors influencing patients' choice of dermatologists in Saudi Arabia, including past experiences, reputation, social media influence, and access to care. Methods: A comprehensive national survey was conducted in Saudi Arabia. The research included 1038 participants using stratified sampling, predominantly from the 18-25 age group (67.1%). The distribution covered all regions of Saudi Arabia, with a larger portion from the Central and Western regions. The survey included quantitative and qualitative questions, assessing factors such as previous experiences with dermatologists, the importance of physician reputation, the role of digital platforms, and access to care. The data were analyzed using the Statistical Package for Social Studies (SPSS 22; IBM Corp., New York, NY, USA), with continuous variables expressed as mean ± standard deviation and categorical variables as percentages. Results: Our study highlighted a strong preference for dermatologists based on previous positive experiences (95.3%) and reputable dermatologists (95.2%). Factors like social media presence were less influential. Demographics matter, with younger and female participants favoring female doctors. The education level affects preference factors like ads, and the convenience of their location holds minimal sway. Recommendations from peers and healthcare professionals carry significant weight in the decision. Conclusions: Positive patient experiences and professional reputation suggest that these are the factors that affect patients' selection of a dermatologist the most. The research findings indicated that while digital platforms are important for information dissemination, they play a minimal role in the actual selection process. The findings can guide dermatologists and healthcare policymakers in enhancing patient-centered care and adapting to evolving patient preferences in the digital age.

Background/objectives: Vulvovaginal candidiasis (VVC) is a common cause of vaginitis. Over-the-counter drugs are usually dispensed by pharmacy professionals to treat this condition without prior medical consultation. This study aimed at assessing the knowledge of Portuguese pharmacy professionals regarding VVC.

Methods: An online questionnaire including questions about the symptoms and treatment of VVC was distributed between March and April of 2024.

Results: A total of 376 professionals participated in this study. There was a significantly lower proportion of men (p = 0.007) and pharmacy technicians (p = 0.005) who correctly identified the main causative agent of VVC when compared to women and pharmacists. Only 30% of women correctly identified the number of VVC episodes in the same year they classified as complicated, but this was significantly higher (p = 0.038) than the proportion of men who identified complicated VVC (20%). Topical clotrimazole preparations were the more frequently identified medicines for the treatment of uncomplicated VVC, and fluconazole-containing medicines were the preferred choice for the treatment of complicated VVC.

Conclusions: This study highlights the need to improve education and training for pharmacy professionals. By addressing these knowledge gaps, pharmacists and pharmacy technicians can provide more accurate and effective advice to patients.

Background/Objectives: This study aimed to investigate the relationship between critical thinking disposition, clinical judgement, nurse-physician collaboration, and triage competency among triage nurses and to identify the factors influencing triage competency. Methods: This descriptive survey study included 152 triage nurses from one tertiary and six general hospitals. Data were collected from 1 September to 1 November 2023 and analysed using SPSS 29.0. Results: Triage competency was positively correlated with critical thinking disposition (r = 0.55, p < 0.001) and clinical judgement (r = 0.61, p < 0.001), while it was negatively correlated with nurse-physician collaboration (r = -0.52, p < 0.001). The hierarchical regression analysis showed that five variables, critical thinking disposition, clinical judgement, nurse-physician collaboration, education level, and years of experience in the emergency department, significantly influenced triage competency. The explanatory power of these variables for triage competency was 63.7% (F = 27.52, p < 0.001). Conclusions: Based on the findings, increasing the level of cooperation and fostering more cooperative relationships between nurses and physicians are necessary measures to improve their triage competency.

Background/Objectives: The prison environment is a unique context of professional practice, characterized by specific challenges requiring conditions that ensure both the delivery of tailored care to inmates and the well-being of healthcare professionals. This study analyzes the characteristics of nursing practice environments in Portuguese prisons. Methods: A descriptive, exploratory, mixed-methods design, combining quantitative and qualitative approaches was conducted in 30 Portuguese prisons. A non-probabilistic convenience sampling method was used to select participants. Data were collected between June and July 2022 using an online self-administered questionnaire. The Statistical Package for the Social Sciences (SPSS), version 28.0, was used to analyze the quantitative data, while Bardin's Thematic Analysis was used to examine the qualitative data. The Ethics Committee granted ethical approval for the study, and the Directorate-General for Reintegration and Prison Services provided authorization. Results: A total of 77 nurses participated in the study, representing 39.4% of the target population. The dimensions with the lowest mean scores included "Nurses' participation and involvement in institutional policies, strategies, and management", "Institutional policy for professional qualification", "Interdependent practices in professional activities", and "Systematic assessment of nurses' performance and supervision". Participants highlighted the need for improved strategies targeting structural, procedural, and outcome-oriented components. Conclusions: Finding fields of weakness can greatly enhance the setting for nursing practices. Priority interventions in Portuguese prisons include the following: enhancing human resources; providing adequate infrastructure and equipment; implementing policies to involve, qualify, and assess nurses' performance; and defining indicators centered on the safety and quality of care as well as the welfare of professionals.

Background: Breast cancer remains the most prevalent malignancy among women worldwide, necessitating effective prevention strategies. The current literature was scrutinized to investigate the impact of dietary factors, such as the consumption of fruits, vegetables, and whole grains, and dietary patterns such as the Mediterranean diet on reducing the risk of breast cancer. Additionally, the potential role of diet in diminishing the risk of disease recurrence and enhancing outcomes among breast cancer survivors was explored. Methods: A systematic literature search was conducted using PubMed, Web of Science, Scopus, and EMBASE to identify relevant studies published between 2000 and 2024. Inclusion criteria were applied to select studies with robust methodologies, including randomized clinical trials, meta-analyses, and prospective cohort studies focusing on adult women. Only studies published in English were considered. Papers on animal studies, editorials, and case series were excluded. Results: Our findings show the critical interplay between diet and breast cancer prevention, crucial for the development of effective strategies to both primary and tertiary prevention. Challenges such as adherence to dietary recommendations, cultural and socioeconomic disparities, and limited high-quality evidence were identified. Conclusions: This review underscores the critical need to integrate nutrition into clinical practice and highlights avenues for future research, including personalized dietary interventions.