Healthcare最新文献

Background/objectives: Adoption of user-centred design methods is essential in healthcare applications because it ensures that complex workflows are shaped around real users' needs and behaviours, improving usability, accessibility, and sustainability. The use of user-centred design in healthcare applications still presents open challenges for identifying user requirements, including diverse stakeholder needs, limited user availability, complex interaction workflows, and organizational constraints. To address these challenges, this paper proposes a user-centred interaction design framework that systematically supports the identification and translation of user needs into actionable design requirements.

Methods: The framework integrates user-centred design principles with generative tools, employing the Persona-and-Scenario method to transform user insights into actionable design requirements. By actively involving healthcare stakeholders, the framework ensures that both explicit and latent needs are captured.

Results: The framework was implemented through two co-design events, which provided valuable feedback on data collection, visualization, interaction modalities, and privacy considerations. These insights were translated into functional, usability, and interface requirements for the Change Management Platform (CMP) for the KEEPCARING project.

Conclusions: This framework introduces a structured, scenario-driven process that actively engages stakeholders in envisioning future states rather than merely refining existing systems. Its application demonstrates promising indications that it enhances requirement elicitation, promotes cross-stakeholder alignment, and yields higher-quality, contextually relevant design requirements.

Background/Objectives: Empirical evidence on intergenerational commensality in institutional care settings remains scarce. This pilot and feasibility study evaluated the preliminary impact of an innovative intergenerational mealtime model on older adults' subjective well-being, self-esteem, perceived health, and food consumption in an adult day care setting. Methods: A 16-week wait-list randomised controlled pilot trial with a sequential explanatory mixed-methods design was conducted in an intergenerational centre in southern Spain. Twenty-two older adults who reside in a community living setting and attend a day care service were randomly assigned to two intergenerational dining intervention/waiting-list groups or a control group. Participants in the intervention/waiting-list groups had lunch four times per week with children 2-3 years of age, following a structured protocol. The quantitative outcomes examined included subjective well-being (WHO-5 Well-Being Index), self-esteem (Rosenberg scale), perceived health (EuroQol EQ-5D), and objective assessment of plate leftovers using photographic records and the Comstock visual estimation method. Qualitative data were collected through semi-structured interviews and ethnographic observation. The trial was registered at ClinicalTrials.gov (NCT06996418). Results: Across the study period, intervention, waiting-list, and control groups showed preliminary improvements in subjective well-being and self-esteem, but with no significant group-by-time interaction. In contrast, mixed-effects models revealed an encouraging significant reduction in plate leftovers among older adults during intergenerational meals, particularly in second courses. The reduction was consolidated during the post-intervention follow-up. Qualitative findings showed perceived improvements in emotional well-being, motivation, and appetite, thus highlighting potential relational and affective mechanisms underlying changes in eating behaviour. Conclusions: This pilot study shows promise for intergenerational commensality in adult day care settings and provides preliminary evidence of its potential to promote well-being and self-esteem and reduce food waste among older adults. Larger, multi-centre, appropriately powered trials are warranted to validate these findings.

Introduction: Fever is one of the most common reasons for Paediatric Emergency Department (PED) visits, often driven by parental anxiety and misconceptions about fever management. This study aimed to evaluate the knowledge, attitudes, and practices of parents regarding childhood fever to identify gaps and guide targeted educational interventions. Understanding parental behaviors is crucial for improving care outcomes and reducing unnecessary PED utilization.

Methods: This study is a descriptive cross-sectional study. The sample of this study consists of a total of 440 parents of children admitted to the Paediatric Emergency Department (PED) with complaints of fever. Convenience sampling was used to select the participants. Data were collected using a questionnaire covering sociodemographics, a form surveying the parents' fever knowledge and attitude, and the validated parents' fever management scale (Turkish version). The data were analyzed using the SPSS 22.0 statistical program.

Results: Most parents (95.5%) reported prior experience with childhood fever, yet 54.1% lacked a regular physician. Common fever detection methods included tactile assessment (56.4%) and thermometers (27.3%). Parental concern arose at 39 °C (48.6%). Cold applications (41.6%) and antipyretics (21.1%) were frequent interventions. The mean PFMS-TR score was high (34.97 ± 4.27), indicating elevated caregiver burden. Scores varied significantly by the child's age (higher for infants, p = 0.044) and maternal education (higher for educated mothers, p = 0.008). Satisfaction with healthcare staff correlated with higher scores (p = 0.024). Negative correlations emerged between parental age, number of children, and fever management scores (p < 0.05).

Conclusions: Parents exhibited high interventionist behaviors and persistent knowledge gaps, underscoring the need for targeted education programs. Educational programs targeting fever management, tailored to parental demographics and misconceptions, are essential. Healthcare providers, particularly pediatric nurses, should prioritize clear communication and evidence-based guidance to empower parents and reduce unnecessary healthcare burdens. Future research should expand to diverse geographic and cultural settings to enhance generalizability.

Background and Objectives: Gastroesophageal reflux disease (GERD) is a prevalent gastrointestinal disorder that significantly affects quality of life. Night eating syndrome (NES), characterized by evening hyperphagia and nocturnal eating, may worsen reflux through delayed gastric emptying and increased nocturnal acid exposure, yet evidence in young adults remains limited. This study aimed to estimate the prevalence of GERD and NES, examine their association, and identify clinically relevant predictors among adults in southern Saudi Arabia. Methods: A cross-sectional study was conducted among 831 adults (≥18 years) in the Jazan region between November 2024 and April 2025. Data were collected using a validated 54-item online questionnaire assessing sociodemographic characteristics, lifestyle behaviors, dietary habits, and medical history. GERD was defined using the GerdQ (score ≥ 8), and NES using the night eating questionnaire (NEQ ≥ 25). Multivariable logistic and linear regression analyses were performed to identify independent predictors. Results: The prevalence of GERD was 25.6%, and 9.7% of participants met the criteria for NES. Higher NEQ scores were independently associated with increased odds of GERD (OR = 1.05, 95% CI: 1.02-1.07; p = 0.001). GERD was predicted by tea consumption, middle income (10,000-14,999 SAR), asthma, hiatal hernia, and a family history of GERD. NES was independently associated with GERD, smoking, and frequent intake of fatty foods, chocolate, salty foods, and soft drinks, while male sex, employment or student status, higher income, and fiber-rich food intake were protective. Conclusions: NES is significantly associated with GERD among young adults. Integrating screening for disordered eating behaviors and dietary counseling into routine GERD care may improve clinical outcomes.

Background: Diabetes in youth, specifically type 1 diabetes (T1D), is an increasing global health concern. As prevalence rises, a growing number of adolescents are required to transition from pediatric to adult healthcare services. This phase is recognized as a particularly critical and high-risk period, during which emerging adults with T1D must exhibit advanced self-management skills to maintain optimal outcomes. When transition support is inadequate, the process is frequently associated with deterioration in glycemic control, higher rates of hospitalization, and significant psychological distress. Methods: A systematic review was conducted in accordance with PRISMA guidelines to identify and evaluate instruments that assess transition readiness in adolescents with diabetes, focusing on their psychometric properties. Five electronic databases (PubMed, CINAHL, Embase, APA PsycInfo, and Web of Science) were searched. Methodological quality and measurement properties were appraised using the updated 2024 COSMIN Guidelines. Results: Eleven studies were included, examining 10 distinct instruments. Overall, psychometric evidence was promising but limited. Only the "On TRAck" instrument demonstrated moderate-quality evidence with acceptable feasibility and reliability. Other tools showed partial support for validity, reliability, and responsiveness, but presented methodological limitations. Conclusions: Interest in diabetes-specific tools to assess transition readiness is growing, yet their psychometric robustness remains limited. Further research is needed to develop and validate instruments with stronger methodological rigor. Future efforts should focus on longitudinal performance and predictive validity to enhance their applicability in clinical practice and ultimately improve outcomes during transition.

Background: Mothers caring for children with physical disabilities experience sustained physical and psychological demands; however, evidence simultaneously examining physical activity, functional limitation, pain, caregiver burden, and mental health within local caregiving contexts remains limited. Objective: This pilot study aimed to explore the multidimensional associations between physical and psychological health outcomes and health-related quality of life in mothers caring for children with physical disabilities in Türkiye. Methods: Forty volunteer mothers residing in Yalova, Türkiye, were assessed using the IPAQ-SF, BDI, SF-36, ZBI, ODI, DASH, and SF-MPQ. Data were analyzed in SPSS 26.0 using correlation analyses and exploratory multiple linear regression models, with p < 0.05 considered statistically significant. Descriptive statistics, Pearson or Spearman correlation analyses, and exploratory multiple linear regression models were applied. Results: The mean age was 38.52 ± 9.10 years. Depression (BDI) and functional limitation showed pronounced negative associations with quality-of-life domains (e.g., General Health: r = -0.749, p < 0.001). Moderate physical activity was associated with higher vitality, social functioning, and mental health (p < 0.05). Conclusions: The findings suggest co-occurring links between psychological distress and physical functioning in caregiving mothers. Within the exploratory scope of this pilot study, multidisciplinary approaches that integrate physiotherapy and psychosocial support may be relevant for supporting caregiver health needs.

Background/Objectives: The potential of outdoor physical activity as an intervention strategy to promote height growth velocity via stimulating growth hormone secretion and vitamin D synthesis has been scarcely investigated. The present study aimed to investigate the associations between outdoor physical activity duration and height growth velocity, and differences in gender, age, exposure time period (daily, school days vs. weekends), and body mass index (BMI) category. Methods: We performed a secondary analysis of longitudinal data from the 2019-2020 Chinese National Survey on Students' Constitution and Health. The analytic sample included 5029 adolescents aged 9-18 years. High or low height growth velocity was defined as sex- and age-specific percentiles. Associations of high height growth velocity with outdoor activity duration (≥1 h, ≥2 h) on school days and weekends were investigated using multivariable logistic regression models. Analyses were stratified by sex, age group (9-12, 13-15, 16-18 years), and BMI category (normal weight, overweight, and obese). Results: Results from this cross-sectional analysis indicate that ≥1 h of daily outdoor physical activity is significantly associated with higher height growth velocity among normal-weight boys aged 9-15 years (OR range: 1.71-2.01) and girls aged 9-12 years (OR = 1.68). The positive association increased with ≥2 h (ORs up to 7.96). Consistently positive associations were found for activity during the school day compared to weekends. No significant associations were found in overweight and obese children. Conclusions: Ensuring adequate daily outdoor physical activity-especially on weekends-for at least two hours may be an important potential strategy to promote height growth in normal-weight children and adolescents. Interventions should consider differences in weight status and timing of activity.

Background: Women in polygamous marriages are known to experience higher levels of psychological distress. However, less is known about how physicians perceive and interpret their complaints and how these perceptions shape the patient-physician relationship. Aim: This study aimed to examine physicians' perceptions of somatic complaints among Bedouin Arab women in polygamous versus monogamous marriages and to explore differences in the patient-physician relationship. Methods: This quantitative study included 126 participants-75 women in monogamous marriages and 51 in polygamous marriages-along with their treating physicians. Women completed self-report measures assessing psychological distress, self-esteem, marital satisfaction, and family functioning. Physicians provided information regarding clinic utilization patterns, symptom characteristics, and their interpretations of patients' complaints. Results: Women in polygamous marriages reported significantly higher psychological distress, greater somatization, poorer family functioning, and reduced marital satisfaction compared to women in monogamous marriages, consistent with previous research. Physicians reported more frequent unscheduled clinic visits among women in polygamous marriages and were more likely to interpret their complaints as having psychological rather than purely physical origins. These patterns reflected differences in clinical perceptions and patient-physician interactions between the groups. Conclusions: The findings highlight differences in how physicians perceive and respond to complaints presented by women in polygamous versus monogamous marriages. These results underscore the importance of culturally informed clinical approaches and increased awareness of potential biases in primary healthcare settings.

Falls among older people remain one of the most pressing and persistent public health challenges worldwide [...].

Background/Objectives: Stroke frequently leads to balance deficits. Vestibular physical therapy (VPT) may enhance postural control through neuroplastic mechanisms. Virtual reality (VR) can provide ecologically valid environments for rehabilitation, increasing patient engagement. Methods: In this randomized feasibility study, nine individuals with chronic stroke were randomized to either a Real visuo-vestibular rehabilitation group (n = 6) or a Sham VR group (n = 3) to explore the feasibility of the protocol and randomization procedures rather than to compare clinical efficacy. Both groups were trained in immersive VR environments for 12 sessions. The Real group experienced visuo-vestibular stimuli requiring sensorimotor integration; the Sham group trained in the same environments without such stimuli. Feasibility was assessed through attendance, participation (Pittsburgh Rehabilitation Participation Scale, PRPS), and user satisfaction (USEQ). Safety and acceptability were monitored through adverse event reporting. Secondary exploratory outcomes included measures of balance-the Mini Balance Evaluation Systems Test (MiniBESTest), the Berg Balance Scale (BBS), and the Performance-Oriented Mobility Assessment (POMA)-as well as functional independence (Barthel Index), health-related quality of life (Stroke-Specific Quality of Life Scale, SSQoL), and a set of spatiotemporal and gait quality parameters derived from inertial measurement unit (IMU) data collected during the 10-Meter Walk Test and the Figure of 8 Walk Test. Results: All participants completed the protocol without adverse events. Participation, as measured by the PRPS, remained consistently high across sessions (mean ≥5.7/6), while USEQ scores indicated excellent user satisfaction (mean ≥28/30). Exploratory analyses revealed improvements in MiniBESTest and BBS scores for the Real group. Instrumental measures derived from IMUs demonstrated improvements across groups. Conclusions: Exploratory outcomes suggested positive trends in balance improvements, and the integration of clinical scales with wearable sensors proved feasible and informative.