Journal of Multidisciplinary Healthcare最新文献

Background: Systematic reviews and meta-analyses play a key role in evidence-based medical decision-making. However, single authorship in these studies may affect the quality and validity of the results. This study aimed to investigate the trends and characteristics of these articles.

Methods: A bibliometric analysis was conducted using the Scopus database to identify systematic reviews and meta-analyses published between 2000 and 2023Article-, author-, and journal-level parameters were assessed. The study followed PRISMA 2020 and PRISMA-S guidelines to ensure transparency in search, screening, and reporting.

Results: Two thousand five hundred four articles were identified, with a trend of increasing publication. The average citations per document was 44. Two-thirds of the journals are hosted in Q1 and Q2. Also, 25% of the authors had more than one systematic review or meta-analysis article. Some authors had published several articles in the same journal. The United States, the United Kingdom, and Saudi Arabia had the highest contributions to these articles. Male authors accounted for 65.33% and female authors for 34.66%.

Conclusion: The persistence of single-authored reviews contradicts international guidelines that emphasize collaborative authorship for methodological rigor. Given that systematic reviews directly inform clinical guidelines and patient care, reinforcing collaborative authorship, along with stricter editorial standards and clearer ethical guidance, is essential to preserve the credibility and reliability of evidence synthesis in evidence-based medicine.

Background: The Coronavirus disease 2019 (COVID-19) pandemic has significantly impacted global health and shares several clinical features with ulcerative colitis (UC). However, the existence of a common pathological mechanism between COVID-19 and UC remains uncertain. Additionally, effective treatment strategies for UC patients infected with COVID-19 are not well established. In this study, we investigate the potential shared pathogenesis of UC and COVID-19 and explore possible therapeutic regimens through bioinformatics and systems biology approaches.

Methods: Common differentially expressed genes (DEGs) were extracted from the COVID-19 and ulcerative colitis (UC) datasets for functional enrichment, pathway analysis. The EnrichR database was used to predict potential transcription factors (TFs), microRNAs (miRNAs), and related drugs and diseases, enabling the construction of a regulatory network for both conditions.

Results: We identified 115 significant common DEGs, with 11 high-confidence hub genes-including IFI16, IL-33, and CD55-implicated in innate immunity and inflammatory regulation. Pathway analysis revealed enrichment in interferon signaling, neutrophil activation, and cytokine-mediated responses. Regulatory network reconstruction highlighted miR-155-5p and transcription factors (eg, STAT1) as key regulators. Drug repurposing efforts prioritized retinoic acid, cyclosporine, and TD-139, which target these shared mechanisms.

Conclusion: This study reveals robust molecular commonalities between COVID-19 and UC, highlighting dysregulated immune pathways and regulatory networks as shared mechanisms. We propose novel drug-repurposing candidates supported by network-based evidence, offering potential therapeutic strategies for patients with comorbid COVID-19 and UC.

Objective: The usability questionnaire of the English version of the virtual reality system was localized to verify its reliability and validity in ICU patients, providing a scientific assessment tool for clinical practice.

Methods: The Brislin translation model was adopted to complete the cross-cultural adaptation of the scale. A total of 331 ICU patients from a tertiary hospital in Zhengzhou City were included through convenience sampling for item analysis, validity and reliability tests.

Results: The Chinese version of the scale consists of 3 dimensions and a total of 9 items. The Cronbach's α coefficient of the total scale was 0.821 and the split-half reliability was 0.782. The content validity index at the item level ranged from 0.833 to 1.000, and the average content validity index at the scale level was 0.978. Exploratory factor analysis extracted three common factors, with a cumulative variance contribution rate of 67.017%. The factor loadings of each item ranged from 0.609 to 0.876, and no items were deleted. Confirmatory factor analysis showed that the standardized path coefficients of all items were within the acceptable range. These results indicate that the adapted questionnaire is a psychometrically sound instrument.

Conclusion: The Chinese version of VRSUQ has good reliability, validity and cultural adaptability. It not only fills the gap of a VR system usability assessment tool that is both culturally and clinically applicable for ICU patients in China, but also overcomes the limitations of existing international tools. Proven tools can be directly applied to clinical practice to guide the optimization of VR intervention measures, thereby enhancing patient experience and intervention effectiveness. In the future, its universality needs to be verified through multi-center research.

Purpose: Exercise-based cardiac rehabilitation (CR) is internationally recognized as an essential component of secondary prevention for coronary heart disease (CHD). However, participation in China remains low. Although barriers to CR have been extensively reported worldwide, China's regional disparities and distinct exercise traditions create context-specific constraints and opportunities. This study conducted a systematic review using the updated Consolidated Framework for Implementation Research (CFIR) 2.0 to identify multi-level factors that facilitate or impede CR implementation within Chinese healthcare systems.

Methods: Seven major databases were searched through October 2024 for studies examining determinants of participation in, or delivery of, exercise-based CR among CHD patients or clinical staff. Study quality was evaluated using the Mixed Methods Appraisal Tool, and extracted findings were organized according to the five CFIR 2.0 domains.

Results: Twenty studies met the inclusion criteria, and several influences distinctive to the Chinese context were identified. For example, hospitals in better-resourced provinces provided more complete and structured CR services, whereas those in less developed regions faced fragmented referral pathways and severely limited rehabilitation infrastructure. Cultural expectations further shaped engagement, with many patients favoring medication-based management over exercise, despite traditional practices such as Tai Chi and Baduanjin being viewed positively and offering a culturally acceptable entry point for rehabilitation. Digital tools, including mobile-health platforms and wearable devices, increasingly supported participation, particularly where in-person services were difficult to access. At the institutional level, CR implementation was more successful in centers with established multidisciplinary teams and stable funding, while hospitals lacking such support struggled to maintain consistent programs.

Conclusion: By clarifying how structural, institutional, and patient-level barriers interact to restrict cardiac rehabilitation in China, the review emphasizes that nationwide advancement will require policy reinforcement, better-trained rehabilitation teams, and implementation approaches tailored to patient needs.

Objective: To explore the construction and application of a bundle management system based on feedforward control in the nursing intervention process for hemoptysis in pulmonary tuberculosis (TB) patients.

Methods: This retrospective study included 112 hospitalized pulmonary TB patients combined with hemoptysis were collected from the Department of Infectious Diseases at Changde First People's Hospital between September, 2023 to April, 2024. Patients were divided into two groups based on the nursing intervention they received: the control group (n=53) received standard nursing interventions, while the intervention group (n=59) received bundle management based on feedforward control. Clinical outcomes included time to stop hemoptysis, hospital stay duration, hemoptysis recurrence rate, incidence of massive hemoptysis, bronchial artery embolization surgery rate, and complication rates. Patient assessment measures included compliance scores, Hamilton Anxiety Rating Scale (HAMA) scores, and Patient Satisfaction Questionnaire-18 (PSQ-18) scores.

Results: The intervention group had a significantly shorter time to stop hemoptysis compared to the control group (P <0.001). Additionally, the intervention group had lower recurrence rates of hemoptysis, incidence of massive hemoptysis, and bronchial artery embolization surgery rate compared to the control group (P <0.05). HAMA scores were significantly lower in the intervention group compared to the control group (P <0.001). Patient compliance and satisfaction were significantly higher in the intervention group compared to the control group (P <0.001). The incidence of asphyxia and mortality in the intervention group were both significantly lower than those in the control group (P <0.05).

Conclusion: The bundle management based on feedforward control can effectively prevent recurrence of hemoptysis and massive hemoptysis in patients with pulmonary TB. This approach can shorten the time of hemoptysis, reduce the incidence and mortality associated with asphyxia, improve patient compliance and satisfaction, and relieve patients' anxiety.

Background and aim: Chronic headache disorders substantially impair quality of life, daily functioning, and social participation. Acceptance and Commitment Therapy (ACT), a third-wave cognitive-behavioral approach, has shown promise in chronic pain management, but little is known about patients' lived experiences with ACT-based group treatment. This study explored how individuals with chronic headache experienced participation in The Headache School, a multidisciplinary ACT-informed program delivered at a specialized Danish headache clinic, with focus on knowledge gains, daily life changes, and the impact of the group setting.

Methods: A qualitative design was applied using focus group interviews. Participants were purposively sampled among patients who had completed at least nine of eleven sessions of The Headache School between 2019 and 2024. Data from nine focus groups with 36 participants were analyzed using reflexive thematic analysis following Braun and Clarke.

Results: Three overarching themes were identified: (1) Knowledge and recognition that it is a real illness, (2) Accepting that the illness will always be part of my life, and (3) Belonging - I did not have to explain, apologize or defend myself. Patients described increased self-understanding, greater acceptance of their condition, and improved ability to communicate needs and limitations. The programme supported value-based life choices and prioritization of well-being despite ongoing symptoms. The group format fostered community, reduced isolation, and offered long-term peer support.

Conclusion: Participation in The Headache School was experienced as meaningful and supportive, facilitating acceptance, psychological flexibility, and empowerment. Patients reported enhanced capacity to live functional, value-driven lives despite persistent headache. The group format played a central role in reducing isolation and fostering lasting connections. These findings highlight the potential of ACT-informed, multidisciplinary group interventions in chronic headache care and emphasize the importance of incorporating patient perspectives into treatment development and evaluation.

Trial registration: Registered with the Region of Southern Denmark (24/32787).

Objective: This study aimed to explore the experiences and needs of parents of children with strabismus through the lens of family systems theory, to guide the development of targeted interventions.

Methods: A total of 12 parents of children, aged 4-11 years, with strabismus were selected through purposive sampling between January and February 2025. There were 2 cases with esotropia and 10 with exotropia. Data were collected through semi-structured interviews, utilizing a descriptive phenomenological approach. The Colaizzi phenomenological seven-step analysis method was employed to systematically summarize, analyze, and refine themes from the data.

Results: Four main themes and twelve sub-themes were identified in the analysis. The primary themes included: (1) emotional distress, which included anxiety, worry, confusion, guilt, embarrassment, and helplessness; (2) adjustment and coping strategies encompassing division of labor, cooperation, and active responses; (3) multiple challenges encountered, such as parent-child conflict, alienation, familial friction, divergence among family members, inconsistent information, and financial burden; and (4) multifaceted needs, including the need for disease-related knowledge, access to medical resources, and emotional support.

Conclusion: Parents of children with strabismus experience significant emotional distress and encounter various challenges, while also developing resilience and adopting coping strategies. Despite these efforts, a lack of adequate knowledge, medical resources, and emotional support persists. It is essential for healthcare professionals to address the emotional well-being of these parents, recognize their positive experiences, and promote proactive coping strategies. Additionally, collaboration among healthcare providers, families and community resources is crucial to delivering comprehensive support and enhancing the overall quality of care.

The Allied Health Assistant (AHA) workforce plays a critical role in enhancing the capacity, efficiency, and accessibility of allied health services across Australia. Considering significant structural reforms in sectors in which AHAs are employed, including the introduction of the National Disability Insurance Scheme (NDIS) and changes to aged care funding, this integrative review synthesizes current evidence on the utilization of AHAs across diverse settings, disciplines, and sectors. A comprehensive search of peer-reviewed and government literature from 2007 to 2025 identified 38 studies and 18 policy documents. A concept analysis identified four key concepts: service efficiency and quality, capacity building through training, contextual and structural determinants of role implementation, and tensions between role innovation and professional boundaries. Findings highlight the positive impact of AHAs on therapy access and service delivery, the importance of context-specific training and supervision, and the need for supportive organizational structures. Despite growing recognition of the AHA role, gaps remain in outcome-focused research, particularly in mental health, disability, and aged care settings. This review underscores the need for targeted workforce strategies and policy development to optimize the integration and sustainability of the AHA workforce in Australia's evolving health landscape.

Background: Life's Crucial 9 (LC9) is a new tool used to evaluate cardiovascular health. At present, no studies have reported the association between LC9 and psoriasis.

Methods: This cross-sectional study utilized data from the National Health and Nutrition Examination Survey (NHANES) conducted between 2009 and 2014. The LC9 score was calculated based on the American Heart Association's recommendations and the Patient Health Questionnaire-9 assessment. Psoriasis status was identified using self-reported questionnaires. Weighted multivariable logistic regression and restricted cubic splines were applied to assess the association between LC9 and psoriasis. Subgroup analyses were conducted for each covariate, and the interaction between LC9 and potential confounders was examined. Additionally, sensitivity analyses were performed to assess the robustness of the results.

Results: A total of 11,762 participants aged 20 years and older were included in this study. After comprehensive adjustments, a negative linear association was observed between psoriasis and LC9: Each 10-point increment in LC9 corresponded to an odds ratio (OR) of 0.87 (95% CI: 0.78-0.96) for psoriasis. Relative to participants in the lowest LC9 quartile (Q1), the ORs for psoriasis were 0.73 (95% CI: 0.55-0.96) for Q3 and 0.55 (95% CI: 0.36-0.85) for Q4. Among participants aged 45 to 64 years, those in the highest LC9 quartile (Q4) had an adjusted OR of 0.42 (95% CI: 0.23-0.78). Heavy drinkers in Q4 exhibited an adjusted OR of 0.37 (95% CI: 0.15-0.92). Sensitivity analyses confirmed these results.

Conclusion: A linear negative relationship between psoriasis and LC9 was identified in this study. This observational result suggesting that enhancing LC9-related cardiovascular health factors may serve as an effective approach for psoriasis prevention and management.

Background: Acute kidney injury (AKI) poses significant challenges to patient outcomes in intensive care units (ICUs). This study aims to examine the knowledge, attitudes, and practices (KAP) of ICU physicians regarding AKI prevention and management, as well as to explore the potential association between burnout levels and KAP performance.

Methods: We conducted a cross-sectional study among physicians working at 18 ICUs in Taizhou, Zhejiang Province, from 26 September 2023 to 18 March 2024. Data were collected using a self-administered KAP questionnaire (knowledge: 18 items [score range: 18-36]; attitude: 8 items [score range: 8-40]; practice: 13 items [score range: 13-65]) and the Maslach Burnout Inventory-General Scale (MBI-GS).

Results: The study enrolled 220 ICU physicians with valid questionnaires. The mean scores were: knowledge 29.92±3.42, attitude 30.94±5.49, practice 46.28±5.65, and burnout 2.13±0.63. Physicians certified by the Chinese Critical Care Certified Course (5C) demonstrated significantly higher KAP levels (K: 30.46±3.20, p=0.008; A: 31.37±5.40, p<0.001; P: 46.76±5.35, p=0.013) despite higher burnout levels (2.18±0.63, p=0.002). Those with resignation intentions had significantly lower KAP scores (K: 27.78±3.81, P=0.001; A: 28.48±4.97, P=0.023; P: 43.83±5.35, p=0.027) and higher burnout (2.51±0.44, p=0.003). Correlation analyses revealed that knowledge was significantly associated with both attitude (r=0.614, p<0.001) and practice (r=0.538, p<0.001). Total Burnout was negatively correlated with attitude (r = -0.223, p < 0.001) and practice (r = -0.238, p < 0.001). Multivariable logistic regression further confirmed that attitude was the strongest modifiable independent predictor of practice behaviors (OR = 1.413, p < 0.001).

Conclusion: ICU physicians demonstrate adequate knowledge, positive attitude and proactive practices toward AKI prevention and management, despite experiencing moderate burnout levels. Attitude is the strongest modifiable predictor of practice, underscoring the importance of fostering positive attitudes to enhance AKI management among ICU physicians. Targeted interventions aimed at enhancing knowledge, fostering positive attitudes, and addressing burnout are needed for effective AKI management in ICU settings.