Healthcare最新文献

Background: Interactive conversational agents (chatbots) simulate human conversation using natural language processing and artificial intelligence. They enable dynamic interactions and are used in various fields, including education and healthcare. Objective: This systematic review aims to identify and synthesize studies on chatbots for women and expectant parents in the preconception, pregnancy, and postnatal period through 12 months postpartum. Methods: We searched in six electronic bibliographic databases (MEDLINE (Ovid), CINAHL (EBSCO), Embase, Web of Science, Inspec, and IEEE Xplore) using a pre-defined search strategy. We included sources if they focused on women in the preconception period, pregnant women and their partners, mothers, and fathers/coparents of babies up to 12 months old. Two reviewers independently screened studies and all disagreements were resolved by a third reviewer. Two reviewers independently extracted and validated data from the included studies into a standardized form and conducted quality appraisal. Results: Twelve studies met the inclusion criteria. Seven were from the USA, with others from Brazil, South Korea, Singapore, and Japan. The studies reported high user satisfaction, improved health intentions and behaviors, increased knowledge, and better prevention of preconception risks. Chatbots also facilitated access to health information and interactions with health professionals. Conclusion: We provide an overview of interactive conversational agents used in the perinatal period and their applications. Digital interventions using interactive conversational agents have a positive impact on knowledge, behaviors, attitudes, and the use of health services. Interventions using interactive conversational agents may be more effective than those using methods such as individual or group face-to-face delivery.

Background/objectives: This study explores how narratives can act as therapeutic tools for Latin American immigrant women residing in the Region of Murcia, Spain. The objective is to analyse how the act of narrating their migratory experiences contributes to emotional relief, the re-signification of their trajectories, and the construction of resilience, while strengthening identity and fostering a sense of belonging in contexts marked by exclusion and inequalities in gender and class.

Methods: A qualitative methodology was used with a narrative and gender approach. The field work was carried out between 2022 and 2023, with a sample of 20 women selected through snowball sampling. Data were collected through in-depth interviews and analysed through an inductive approach using MAXQDA 24.5 software. The emerging categories reflected the emotional experience and meanings constructed during the migration process.

Results: The narratives revealed five key categories: emotional relief of social suffering through expression, reconstruction of identity and re-signification of experiences, emotional validation and strengthening of identity, empowerment and symbolic resistance, and sense of belonging and connection. Likewise, it was observed that the interviews created therapeutic spaces that strengthened the bond between researcher and participant.

Conclusions: The narratives contribute to processing emotions and redefining traumatic experiences, while also allowing greater agency in the participating women. This approach highlights the transformative potential of narrative research to generate situated knowledge and promote inclusive practices in contexts of vulnerability.

Background/Objectives: The concept of patient participation is increasingly recognized as an important component in many areas, such as redesigning healthcare processes, improving patient safety, increasing satisfaction, and managing chronic diseases. In this context, measuring the level of patient participation in healthcare services is an important factor. The "Patient Participation Questionnaire" is a tool used to assess patients' evaluations of their participation in their in-hospital care. The absence of a scale in the Turkish literature that measures this concept reveals the importance of this research. Methods: In this study conducted in a tertiary public hospital in Turkey, the final scale translated into Turkish was applied to 355 people using the convenience sampling method. In addition to the "Patient Participation Scale", the "Patient Satisfaction Scale" was used for context validity in the study. Data were analyzed with SPSS 27 and AMOS programs. Results: As a result of the confirmatory factor analysis, the scale, which originally consisted of 16 questions and four dimensions, was adapted to Turkish as 14 questions and four dimensions. As a result of confirmatory factor analysis, the goodness of fit values of the scale were found to be x²/sd = 2.53, GFI = 0.93, AGFI = 0.90, CFI = 0.93, RMSEA = 0.066, RMR = 0.041, and NFI = 0.90. These values are within the acceptable and good fit level ranges. As a result of the correlation analysis performed for context validity, it was determined that there was a positive significant relationship between the adapted patient participation scale and the patient satisfaction scale (r = 0.692, p < 0.001). In addition, the internal consistency coefficient of the scale was examined to determine the reliability of the scale, and it was revealed that the scale was reliable at a good level (α = 0.86). Conclusions: Based on the findings, it was revealed that the "Patient Participation Scale" developed in English is a valid and reliable measurement tool in Turkish culture.

Introduction: The ongoing care of transgender patients in United Kingdom (UK) general practice (GP) is hampered by a lack of UK primary care guidelines regarding the monitoring of treatments, despite the key role that general practice has in holistic lifelong care. This quality improvement project aimed to audit the monitoring of treatments and health screening in a GP practice population, across two large practices in southwest England, in order to drive local improvement and to identify gaps in wider healthcare support for this population. Methods: This project updated a previously published audit instrument, incorporating a novel, pragmatic standard, based on up-to-date UK gender clinic guidelines and the UK population screening programmes. National Health Service (NHS) Health Research Authority and Medical Research Council processes were used to confirm that this quality improvement project did not require formal ethics committee approval. An audit against this standard was performed for 176 transgender and gender-minority patients, to provide data on the consistency of the monitoring of gender hormonal treatments and reminders for appropriate population health screening programmes. Results: A total of 16% of those undergoing hormonal treatments had received optimal monitoring; 20% were missing the most basic hormone level monitoring. Reminders regarding appropriate health screening were rare in patients who had changed the gender markers on their electronic record. Long waiting lists, the use of private clinics, confusion around responsibilities shared between primary and secondary care and growing complex co-morbidity were demonstrated. Conclusions: This project supports previous calls for consistent evidence-based guidelines, improved data systems and adequately resourced primary and secondary care services to support the safe and effective lifelong care of transgender patients.

Background/Objectives: Fatty liver disease (FLD), particularly non-alcoholic fatty liver disease (NAFLD), is a growing global health concern that underscores the need for effective dietary management strategies. With over 25% of patients seeking dietary advice through platforms like YouTube, the quality and reliability of this information remain critical. However, the disparity in educational value and engagement metrics between professional and non-professional content remains underexplored. This study evaluates YouTube's role in disseminating dietary advice for FLD management, focusing on content reliability, engagement metrics, and the educational value of videos. Methods: This cross-sectional study systematically analyzed 183 YouTube videos on FLD and dietary advice. Videos were selected based on relevance, English language, and non-promotional content. Scoring systems, including DISCERN, Global Quality Score (GQS), and the Video Information and Quality Index (VIQI), were employed to assess reliability, quality, and educational value. Engagement metrics such as views, likes, dislikes, and interaction rates were analyzed across uploader categories, including healthcare professionals, patients, and undefined sources. Results: Videos uploaded by healthcare professionals demonstrated significantly higher DISCERN scores (4.2 ± 0.8) and GQS ratings (4.1 ± 0.6) compared to patient-generated content (DISCERN: 2.8 ± 0.9; GQS: 3.0 ± 0.7). However, patient-generated videos achieved higher engagement rates, with median views reaching 340,000 (IQR: 15,000-1,000,000) compared to 450,050 (IQR: 23,000-1,800,000) for professional videos. Nutritional recommendations spanned diverse approaches, including low-carb diets, Mediterranean diets, and guidance to avoid processed foods and sugars. A significant proportion of videos lacked evidence-based content, particularly among non-professional uploads. Conclusions: YouTube represents a widely accessed but inconsistent source of dietary advice for FLD. While healthcare professional videos exhibit higher reliability and educational value, patient-generated content achieves broader engagement, revealing a critical gap in trusted, accessible dietary guidance. These findings highlight the need for clinicians and content creators to collaborate in curating and disseminating evidence-based content, ensuring patients receive accurate, actionable advice for managing FLD.

Background/Objectives: Diagnosis-related group (DRG)-based financing, a subcategory of case-based payment models, has been established as the primary reimbursement scheme in most high-income countries. Almost 40 years thereafter, the impact of the reform on gynecologic oncology funding and recompensation has not been clearly elucidated. This systematic review aims to address the scarce bibliographic data, consolidate the information regarding DRG-based systems in gynecologic oncology, evaluate the advantages and challenges of its implementation worldwide, and examine alternative and complementary recompensation schemes in this context. Methods: A stringent and comprehensive literature review of original articles using online databases (Google Scholar and Pubmed) yielded 173 potential results. Results: These were further assessed for relevance and eligibility and, finally, an in-depth investigation of 15 articles was conducted. We concluded that, despite the fact that DRG-based financing may be beneficial in most healthcare scenarios, the reimbursement scheme is challenged in the context of gynecologic oncology. Conclusions: An innovative approach comprising a combination of the values of case-based and value-based payment models would extend healthcare services beyond acute treatments and propose new perspectives in holistic healthcare provision in a financially sustainable environment.

Background: The intersection of occupational burnout and digital leisure activities has garnered increasing scholarly attention in recent years. However, limited research has examined how Chinese healthcare workers engage with short-form video apps as a stress management tool. Objectives: This study employs a serial multiple mediation model to explore the impact of occupational burnout on the use of short-form video apps and its subsequent effects on a sense of community, intrinsic rewards, and life satisfaction among Chinese healthcare workers aged 18-34. Methods: Data were collected through an online survey, with 362 valid responses, and analyzed using descriptive statistics, hierarchical regression, and mediation analyses, including serial mediation via SPSS 25.0. Results: The results demonstrate a positive direct association between occupational burnout and the use of short-form video apps. Furthermore, the relationship between the use of short-form video apps and life satisfaction was mediated through two distinct pathways, namely, a sense of community and intrinsic rewards. Conclusions: These findings contribute to the expanding body of literature on the role of digital media in stress management and well-being among healthcare workers, as well as highlighting evidence-based digital interventions to support healthcare workers' well-being in high-stress settings.

Background: This research explored how tele-exercise influenced physical fitness and mental well-being in individuals with and without disabilities and with different training habits. Methods: One hundred and ninety-three participants were categorized into two groups: athletes and non-athletes. Participants were involved in either synchronous or asynchronous tele-exercise programs of two or three sessions of workouts per week, lasting eight weeks. Psychological well-being was evaluated pre- vs. post-intervention by the WHO-Five Well-Being Index (WHO-5), Psychological General Well-Being Index (PGWBI), and Perceived Stress Scale (PSS-10). Fitness assessment tools included the 2-minute step test, curl-up test, forward bending test, and squat test. Body weight was also assessed pre- and post-intervention. Results: The analysis showed a significant increment in all fitness scores (p-value ranged from <0.001 to 0.015) with no change in body weight. Psychological tests indicated an overall increment in the participants' well-being measured by the WHO-5 and unexpectedly, also in the stress level assessed through PSS-10. Conclusions: Enabled by technology, tele-exercise provides a flexible and convenient complementary approach to conventional workouts, helping individuals maintain an active lifestyle and improve their well-being. Positive effects on the sedentary population's lifestyles are discussed.

Background/objectives: The current literature reveals a gap in understanding how rehabilitation professionals, such as physical and occupational therapists, perceive and prepare to implement artificial intelligence (AI) in their practices. Therefore, we conducted a cross-sectional observational study to assess the perceptions, knowledge, and willingness of rehabilitation healthcare providers to implement AI in practice.

Methods: This study was conducted in Saudi Arabia, with data collected from 430 physical therapy professionals via an online SurveyMonkey questionnaire between January and March 2024. The survey assessed demographics, AI knowledge and skills, and perceived challenges. Data were analyzed using Statistical Package for the Social Science (SPSS 27) and DATAtab (version 2025), with frequencies, percentages, and nonparametric tests used to examine the relationships between the variables.

Results: The majority of respondents (80.9%) believed that AI would be integrated into physical therapy in future, with 78.6% seeing AI as significantly impacting their work. While 61.4% thought that AI would reduce workload and enhance productivity, only 30% expressed concerns about AI endangering their profession. A lack of formal AI training has commonly been reported, with social media platforms being respondents' primary source of AI knowledge. Despite these challenges, 85.1% expressed an eagerness to learn and use AI. Organizational preparedness was a significant barrier, with 45.6% of respondents reporting that their organizations lacked AI strategies. There were insignificant differences in the mean rank of AI perceptions or knowledge based on the gender, years of experience, and qualification degree of the respondents.

Conclusions: The results demonstrated a strong interest in AI implementation in physical therapy. The majority of respondents expressed confidence in AI's future utility and readiness to incorporate it into their practice. However, challenges, such as a lack of formal training and organizational preparedness, were identified. Overall, the findings highlight AI's potential to revolutionize physical therapy while underscoring the necessity to address training and readiness to fully realize this potential.

Background/Objectives: Falls in nursing homes significantly affect residents' health and quality of life. Although considerable progress has been made in fall prevention strategies in acute care settings and community environments, research on fall risk assessment methods and prevention strategies in nursing homes remains scarce. Nursing homes provide long-term care for residents with high levels of dependency, presenting unique challenges in managing fall risks. Nevertheless, unlike hospitals, nursing homes face operational constraints, such as limited resources and staffing. These factors necessitate a tailored approach to fall risk management. This study aimed to summarize the current knowledge of fall risk assessment and prevention methods in nursing homes, clarify practical insights for implementation, and identify research gaps based on studies published over the past five years. Methods: This narrative review targeted studies published between 2019 and 2024 on fall risk assessment and prevention methods in nursing homes. A literature search was conducted using the PubMed and CINAHL databases, combining keywords such as "Accident Prevention", "Fall Risk Assessment", "Nursing Homes", "Long-Term Care", and "Aged". The inclusion criteria allowed the inclusion of peer-reviewed academic articles on fall risk assessment or prevention interventions in long-term care facilities published in English within the past five years. Studies focusing on community-dwelling older adults, hospitalized older adults, and review articles were excluded. Results: This review analyzed 55 studies; among them, 27 studies focused on fall risk assessment and 28 focused on fall prevention. Regarding fall risk assessment, widely used tools, such as the Morse Fall Scale, which is also utilized in medical settings, have been extensively examined. In addition, new predictive methods utilizing electronic health records (EHR) and wearable devices have been introduced. However, the limited number of reports highlights the potential challenges in developing indicators that consider the unique characteristics and feasibility of LTC facilities. Regarding fall prevention, studies have examined indirect approaches, such as environmental modifications, and direct interventions, such as exercise programs. Furthermore, staff education and organizational initiatives are crucial in implementing preventive measures. However, most studies have been conducted in experimental settings, with limited empirical research available to assess the practical applications of these strategies in real-world nursing home environments. Conclusions: Fall risk assessments in nursing homes lack practical indicators tailored to the specific characteristics of long-term care facilities. Although various digital technologies have been explored for fall prevention, empirical studies that validate their real-world applicability are lacking.