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Background: Twenty-four-hour movement behaviours (physical activity, sedentary time, and sleep) may be associated with adolescent cognitive performance, but evidence from Central/Eastern Europe is limited.

Methods: A total of 82 Slovak adolescents (15-19 years) completed tests of IQ, attention, and visual memory. Participants wore a wrist accelerometer 24/7 for seven consecutive days (processed in GGIR v3.0-3). Moderate-to-vigorous physical activity (MVPA), total sedentary time, and sleep duration were derived from accelerometry; physical activity was also self-reported using the Physical Activity Questionnaire for Adolescents (PAQ-A). Non-parametric tests and Spearman correlations were applied; sleep × MVPA interaction models (robust HC3 standard errors) were adjusted for age and sex.

Results: MVPA was low (median 32.9 min/day; 11% met ≥60 min/day), while sedentary time was high (median 652.6 min/day). Associations between movement behaviours and cognition were generally small, and no sleep × MVPA interaction effects were observed. The PAQ-A overestimated device-based MVPA (mean bias +1.68 units; 95% limits of agreement +1.10 to +2.25), with greater overestimation in girls and older adolescents.

Conclusions: In this convenience sample, 24 h movement patterns were suboptimal, and their associations with cognition were modest and exploratory. Larger longitudinal studies are needed to confirm these findings.

Background: Cancer patients admitted to the bone marrow transplant (BMT) unit face life-threatening medical conditions. Consequently, their family members experience uncertainty, resulting in high levels of anxiety and depression (AD). Limited updates and communication from medical staff exacerbate these emotional burdens. To address these challenges, we developed a mobile health (mHealth) intervention, FamCarePlus, and evaluated its feasibility, usability, and efficacy. We hypothesized that the FamCarePlus application would demonstrate a high degree of feasibility and usability and would reduce AD compared to a control group relying solely on traditional communication through the nurses' station. Methods: We employed a quasi-experimental pretest/posttest non-randomized, non-blinded self-report design over 3 weeks, with an experimental group (n = 10) using FamCarePlus and a control group (n = 9). We selected participants via convenience sampling using the electronic medical record to identify eligible patients and families, guided by inclusion and exclusion criteria. We used descriptive statistics and the Hospital Anxiety and Depression Scale (HADS) guidelines to analyze the data. Feasibility was defined by a retention rate > 80%, with usability testing using the System Usability Scale (SUS) and NASA Task Load Index (NASA-TLX) surveys. The HADS measured AD, comparing baseline to Week 3. Results: We met our feasibility criteria of >80%. All SUS and NASA scores were in the higher index, suggesting a significant degree of usability and low workload demand on participants. For efficacy, we compared baseline mean scores, with the experimental group reporting lower AD levels at Week 1 (41.9% and 27.8%, respectively) than the control group (55.2% and 34.2%, respectively). From Week 1 to Week 3, the percentage change showed an 8.6% decrease in anxiety in the experimental group, compared to a 12.8% decrease in anxiety in the control group. These results were consistent when analyzed according to HADS guidelines. Conclusions: The findings of this study provide preliminary evidence that the FamCarePlus intervention is feasible and usable, while also demonstrating that its use may be associated with a sustained reduction in AD levels among family members of patients admitted to the BMT unit. These outcomes underscore the potential of digital interventions to address disparities in patient health information access and psychosocial support.

Background: Allograft failure after kidney transplantation remains common despite improving long-term outcomes and persistent organ scarcity. We aimed to develop and internally validate a perioperative risk model for kidney allograft failure within 2 years of transplantation.

Methods: We conducted a single-center retrospective cohort study using the Medical Informatics Operating Room Vitals and Events Repository. Adult patients (≥18 years) undergoing kidney transplantation between January 2018 and July 2023 with at least 2 years of follow-up were included. The primary outcome was allograft failure within 2 years, defined as return to dialysis, pre-emptive re-transplantation, or death. Candidate predictors included demographic characteristics, comorbidities, preoperative laboratory values, and intraoperative variables. After univariate screening and variable selection with LASSO-penalized regression, we estimated relative risks using modified Poisson regression and assessed internal validity with 200 bootstrap resamples.

Results: Among 319 recipients, 53 (16.6%) experienced early allograft failure. In the final multivariable model, obesity (relative risk [RR] 4.76; bootstrap 95% CI 2.88-9.31) and thrombocytopenia (RR 1.96; bootstrap 95% CI 1.18-3.38) were independently associated with increased risk. Anemia (RR 0.22; bootstrap 95% CI 0.13-0.37), preoperative clonidine use (RR 0.33; bootstrap 95% CI 0.00-0.85), and female sex (RR 0.55; bootstrap 95% CI 0.26-0.83) were associated with reduced risk. Model performance was modest (pseudo-R² 0.21) but identified clinically distinct risk strata.

Conclusions: A five-variable perioperative model based on obesity, thrombocytopenia, anemia, preoperative clonidine use, and female sex identified kidney transplant recipients at differing risk of allograft failure within 2 years. These associations highlight potentially modifiable targets that warrant further study and external validation before clinical use.

Background/Objectives: Data on the perpetrators of workplace violence (WPV) in healthcare settings are lacking. We sought to identify characteristics of perpetrators of WPV in a United States emergency department (ED) and explore associations between patient demographics and acute visit features. Methods: This is a retrospective descriptive study of the perpetrators of WPV against ED healthcare workers (HCWs) identified in a previous prospective study. Perpetrator demographics and visit features are described. Regression analyses were performed to assess for associations between perpetrator demographics and visit features with physical violence (PV) and restraint use. Results: 91 WPV encounters were included. The average age was 44.8 years. Most patients (n = 48; 53%) did not have an active psychiatric complaint and were not intoxicated, but 71 (78%) had a history of psychiatric illness. Twenty-four events (26%) involved PV, which was more common among patients on an emergency detention (RR 2.18; 95% CI 1.12-4.23) but was not associated with any patient demographics after adjustment. Restraints were ordered in 33 (36%) patients. Age, sex, PV, and intoxication or active psychiatric complaints were associated with restraint use, but in adjusted analysis, only PV (RR 1.89; 95% CI 1.13-3.16) and active psychiatric complaint or intoxication (RR 2.26; 95% CI 1.21-4.22) remained associated with restraint use. Conclusions: Half of perpetrators in this study were neither intoxicated nor had an active psychiatric complaint. PV was more common among patients on emergency detention. Restraint use was more likely in PV events and patients who were intoxicated or had psychiatric complaints.

Background/Objectives: Colorectal cancer (CRC) is a major health concern in South Korea, where incidence and mortality rates remain high despite the National Cancer Screening Program. Understanding the factors associated with CRC screening behaviors is essential for developing effective interventions. The purpose of this study was to examine the associations of sociodemographic characteristics, access to health care, knowledge, health beliefs, and cultural beliefs with CRC screening behaviors among Koreans. Methods: A cross-sectional survey was conducted with 648 Koreans aged 50 years and older at average risk for CRC. Participants completed questionnaires assessing sociodemographic characteristics, access to health care, knowledge, health beliefs, cultural beliefs, and CRC screening behaviors. Data were analyzed using descriptive statistics, bivariate logistic regression, and multivariate logistic regression with stepwise procedures. Results: Physician recommendation and perceived barriers were the strongest predictors of fecal occult blood test (FOBT) adherence, while physician recommendation, a usual source of health care, perceived benefits, and perceived barriers significantly predicted colonoscopy use. Perceived barriers reduced the likelihood of adhering to both, FOBT or colonoscopy (OR = 0.431, 95% CI = 0.316-0.588) or colonoscopy (OR = 0.432, 95% CI = 0.313-0.596), respectively, by 57%, whereas higher perceived benefits doubled the odds of colonoscopy participation (OR = 1.871, 95% CI = 1.331-2.631). Knowledge gaps were evident regarding CRC seriousness and the need for screening beginning at age 50 without symptoms. Conclusions: CRC screening participation among Koreans is associated primarily with access to care and health belief components. Encouraging physician recommendation and reducing perceived barriers are essential for improving screening rates. Culturally informed education and consideration of expanding colonoscopy services within the national cancer screening program is needed to further enhance CRC screening adherence.

Background/Objectives: The transition to higher education is often accompanied by lifestyle changes that may influence sleep habits, physical activity, and social media use, with potential consequences for physical and mental health. Methods: A quantitative, cross-sectional, descriptive, and correlational study was conducted using an online questionnaire administered between April and May 2024. The sample included 201 participants (123 students and 78 teaching/non-teaching staff). Data were collected using the Mental Health Inventory-5 (MHI-5), Social Media Addiction Scale (SMAS), Global Physical Activity Questionnaire (GPAQ), and Pittsburgh Sleep Quality Index (PSQI). Descriptive statistics and Spearman correlation analyses were performed. Results: Students presented lower mental health scores compared to staff members. Sleep quality indicators, particularly reduced sleep efficiency and increased use of sleep medication, were significantly associated with poorer mental health. Correlations between physical activity, social media use, sleep quality, and mental health were generally weak, suggesting that these domains contribute independently to perceived well-being. Staff members showed slightly higher levels of social media addictive behaviors, while students reported shorter sleep duration and greater emotional variability. Conclusions: The findings indicate that students presented lower mental health scores and poorer sleep indicators compared to staff members. Sleep quality-particularly sleep duration, efficiency, and use of sleep medication-showed the most consistent associations with mental health, while physical activity and social media use demonstrated weaker relationships. These results highlight the relevance of targeted sleep-focused interventions within higher education settings, especially for students in low-density regions.

Background: Truck drivers constitute a high-risk occupational group due to irregular schedules, prolonged sedentary work, fatigue, and limited access to healthcare, contributing to adverse physical and mental health outcomes. Although mobile health (mHealth) tools offer potential to support driver health, sustained engagement remains a persistent challenge. Objectives: This systematic review aimed to identify behavioural, technological, and contextual determinants influencing truck drivers' compliance, retention, and long-term engagement with digital health interventions. Methods: Following the PRISMA 2020 guidelines, six eligible studies were identified and thematically synthesised across technology acceptance, behaviour change, and persuasive system design perspectives. Results: Across studies, sustained engagement was facilitated by self-monitoring, real-time feedback, goal-setting, coaching support, and simple, flexible system design. In contrast, technological complexity, high interaction demands, limited digital literacy, privacy concerns, misalignment with irregular schedules, and fatigue consistently undermined engagement and retention. Autonomy, trust, and voluntary participation emerged as cross-cutting determinants supporting continued use. Based on the synthesis, an integrative framework was developed to explain how behavioural, technological, and contextual factors interact to shape truck drivers' compliance, engagement, and retention with mHealth. Despite generally moderate to high study quality, the evidence base remains fragmented and dominated by short-term evaluations. Conclusions: The findings highlight the importance of context-sensitive, user-centred design to support effective digital health interventions in the trucking sector.

Background/Objectives: Rural older adults are exposed to multiple chronic stressors that may heighten depressive symptoms, and these effects can be intensified by social disconnection, particularly in resource-constrained settings. This study examined whether global and dimension-specific perceived social support-an indicator of perceived social connection-mediates and/or buffers the association between perceived stress and depressive symptoms in rural older adults from northern Peru. Methods: A cross-sectional survey was conducted with 166 community-dwelling adults aged ≥60 years in a rural coastal district. Perceived stress (PSS-4), depressive symptoms (GDS-15), and perceived social support (MOS-SSS) were assessed. Regression-based mediation and moderation models with bootstrapped confidence intervals were estimated, adjusting for age, sex, marital status, education, income category, and chronic medical conditions. Results: Higher perceived stress was associated with greater depressive symptoms. Greater overall social support was associated with lower perceived stress and fewer depressive symptoms. Indirect effects supported a stress-process pathway for overall support, particularly socioemotional dimensions (positive social interaction and affectionate support). No buffering effect was observed for overall support; however, tangible (instrumental) support attenuated the association between stress and depressive symptoms. Conclusions: Mediation analyses supported an indirect pathway linking perceived stress to depressive symptoms via socioemotional support, whereas tangible (instrumental) support moderated the stress-depression association. Interventions that strengthen social connectedness and practical assistance may help protect mental health in rural older adults.

Introduction: Myasthenia gravis (MG) is a chronic autoimmune disorder in which fatigue represents one of the most burdensome symptoms. This multidimensional manifestation extends beyond neuromuscular fatigability and has a substantial impact on daily functioning, mental health, and quality of life. The present study aimed to evaluate the perception of fatigue in patients with MG, with particular emphasis on its interference with everyday activities and the extent to which it is understood by others. Methods: The study included 67 MG patients (61.2% women, mean age 53 years) treated at the Neurology Outpatient Department of the University Clinical Center in Gdańsk. Data were collected using an author-developed survey and standardized instruments: Chalder Fatigue Scale (CFQ), MG-ADL, MG-QoL15, HADS-M, Mini-COPE, and ACDS. Results: More than 70% of patients reported constant or frequent fatigue. Higher fatigue severity was positively associated with functional impairment (MG-ADL) and lower quality of life (MG-QoL15). More than 70% of patients reported constant or frequent fatigue. Higher fatigue severity was moderately associated with greater functional impairment and poorer quality of life. The extent to which fatigue interfered with daily life was associated with higher levels of depressive symptoms, poorer self-rated health, and less favorable disease-related perceptions (acceptance and influence). In contrast, perceiving fatigue as being better understood by others was associated with lower anxiety and depression and more favorable disease-related perceptions (acceptance, control, understanding), while it was not significantly related to fatigue severity, functional status, or quality of life. Conclusions: Fatigue in myasthenia gravis is a prevalent symptom, closely related to functional impairment and reduced quality of life. Different aspects of fatigue perception show distinct psychosocial correlates, highlighting the importance of considering subjective and social dimensions of fatigue alongside its severity. These findings support the relevance of psychosocial factors in the comprehensive care of patients with MG.

Background/objectives: The incorporation of peer support within mental health services has shown benefits for service users' recovery and engagement, yet implementation is often hindered by role ambiguity and limited institutional recognition. The aim of this study is to explore the experiences of workers in a programme that provides peer support within a personal assistance model. The focus is on how they perceive the shaping of their professional role and their integration within care teams, rather than on evaluating service outcomes or effectiveness.

Methods: An interpretive qualitative methodology with an exploratory approach was used. The study was conducted in a single organisational setting and focused on the self-reported experiences of personal assistants. Fieldwork was conducted in 2025 with ten personal assistants. Data were obtained through individual semi-structured interviews and one focus group with the same participants. A thematic content analysis combining inductive and deductive coding strategies was conducted using MAXQDA (version 24.11).

Results: Findings indicate that the Personal Assistant role was perceived as reducing some of the ambiguity commonly associated with peer support, due to a clearer contractual framework and a more explicit delineation of functions. However, tensions persisted in relation to its hybrid professional identity, experiences of task overload, and ongoing gaps in coordination with traditional professional roles. Key facilitators included institutional support, accessible coordination, a supportive culture of care, and informal peer networks. Perceived benefits were reported for service users, including increased trust, hope, and autonomy, as well as for assistants, who described enhanced professional purpose and progress in their own recovery, alongside risks of emotional strain.

Conclusions: Analysing the perspective of participants, the personal assistance model may represent a promising framework for the professionalisation of peer support through functional clarity, continuous supervision, and recognition of experiential knowledge. Further progress requires strengthening internal communication, expanding training opportunities, and enhancing the structural participation of personal assistants in decision-making. The study contributes an exploratory qualitative perspective to the growing literature on integrating lived-experience professionals into mental health services.