Journal of Multidisciplinary Healthcare最新文献

Objective: This study aimed to explore the barriers and facilitators of the linkage to care in Bandung, Indonesia.

Methods: This study used a descriptive qualitative design with in-depth interviews with 17 purposively selected participants, including people living with HIV (PLHIV), healthcare providers, case managers, and community health volunteers. Data were collected from September 2024 to December 2024 in three key service settings in Bandung. A socio-ecological framework guided data collection and deductive content analysis, allowing thematic categorization at the individual, interpersonal, healthcare system/policy, and community levels.

Results: The analysis identified 10 main categories and 22 subcategories of facilitators and barriers linked to HIV care across socio-ecological levels. At the individual level, psychological readiness, HIV-related knowledge and perceptions, clinical conditions, and socioeconomic status shaped the linkage to care. Interpersonal support from family members, peers, and healthcare providers affected the decisions linked to care. At the healthcare system and community levels, service accessibility, stigma, and community engagement under the ongoing implementation of Universal Health Coverage (UHC) influenced the linkage to care in Bandung. A unique aspect of the present study lies in its emphasis on community engagement in the context of the ongoing implementation of UHC as a key facilitator, and service gaps at the primary care level and persistent stigma remains a key barriers in Bandung.

Conclusion: Multi-level factors shaped the linkage to HIV care in Bandung. Strengthening nurse- and peer-led navigation, expanding primary care services, promoting community participation, and scaling up structured professional guidance are key to reducing stigma and improving early engagement.

Background: Self-Injurious Behavior (SIB) is a behavior that can lead to mental health problems and may become a contributing factor to future suicide. Intervention and strategy have been reported to be effective in reducing and preventing SIB. However, there are no existing reviews that report it from the nursing perspective even though nurses play a crucial role in caring for individuals with SIB.

Purpose: This scoping review aims to identify nursing care interventions that can be used to reduce SIB.

Methods: The study was based on the five-stage methodological framework and was guided by the PRISMA-ScR. We searched from 2 to 9 June 2025 records identified from database Pubmed (n = 12105); CINAHL (n = 145807); Scopus (n = 99); Garuda (n = 46) and a total of 158057 literature screened, 4 studies published between 2015 and 2025 were included in the review. The key words in English were nursing care OR therapy AND adolescents AND adults, young AND non suicidal self-injury OR self-harm OR self-injurious behavior. While in Bahasa Indonesian were Intervensi Keperawatan OR Terapi Keperawatan AND Remaja AND Dewasa AND Self-Harm OR non-suicidal self-injury.

Result: We found 4 articles showing therapeutic interventions by nurses to reduce SIB in both clinical and non-clinical settings. Four types of interventions were used to reduce SIB, and recommended therapeutic nursing intervention in groups is group psychological nursing. Meanwhile, in hospital settings, Dialectical Behavior Therapy (DBT) is the recommended method, and in communities, a combination of psychoeducation and MBCT is recommended. Dhikr is recommended as a culturally practice.

Conclusion: Our findings highlight that four methods are effective in reducing SIB and provide valuable references for both clinical and non-clinical applications in children, adolescents, and adults. Our study indicates that the potential of four intervention can be used as a strategy in the mental health nursing and psychiatric area.

Background: Healthcare workers (HCWs) face heightened risks of stress, anxiety, depression, and burnout, particularly during and after the COVID-19 pandemic. Psychosocial interventions have been increasingly implemented, yet the evidence remains fragmented across diverse settings and modalities. This scoping review aimed to map current psychosocial interventions designed to improve mental health outcomes among HCWs.

Methods: Guided by the PRISMA-ScR framework, five databases (PubMed, Scopus, ScienceDirect, EBSCOhost, Google Scholar) were searched from January 2000 to September 2025. Eligible studies involved HCWs, assessed psychosocial interventions, and reported mental health outcomes. The Joanna Briggs Institute (JBI) appraisal tool was applied, and only studies scoring ≥70% were retained. Although multiple designs were eligible, only randomized controlled trials (RCTs) met the quality threshold and were included. Data were synthesized descriptively and thematically.

Results: Of 312 identified records, 15 RCTs (2021-2025) were included. Interventions were grouped into mindfulness and meditation programs (n=6), digital and mHealth approaches (n=5), and coaching or AI-assisted resilience training (n=4). Specifically, mindfulness interventions reduced stress and anxiety by up to 30% and consistently improved well-being. Notably, digital modalities-including mobile apps and internet-delivered cognitive behavioral therapy (CBT)-were widely used during the pandemic and demonstrated benefits for burnout, sleep quality, and resilience. Across all studies, coaching and AI-assisted interventions improved work engagement and reduced exhaustion, particularly in non-pandemic contexts.

Conclusion: Psychosocial interventions demonstrate strong potential to improve HCWs' mental health. Digital programs offer scalable support, while resilience-based approaches promote long-term well-being. Future research should examine implementation in low-resource settings, compare digital versus in-person modalities, and explore organizational-level strategies to complement individual interventions.

Objective: Hemifacial spasm (HFS) is a rare but significantly impactful neuromuscular disorder that affects patients' quality of life, yet research on healthcare providers' readiness to manage this condition remains limited. This study aims to investigate the knowledge, attitudes, and practices (KAP) toward microvascular decompression (MVD) for HFS among neurosurgeons.

Methods: This multicenter cross-sectional study was conducted between May and June 2024, involving multiple institutions across Eastern China. Data were collected through a structured questionnaire, which included sociodemographic information and KAP scores of participants.

Results: A total of 223 valid questionnaires were collected, 218 (97.76%) were males. Multivariable logistic regression analysis found that both higher knowledge scores (P = 0.013) and attitude scores (P = 0.001) were independently associated with positive practice. Path analysis showed that the presence of neurosurgical microsurgery equipment and instruments (P = 0.025), title (P < 0.001), past experience in diagnosis and treatment of HFS (P < 0.001), and past experience in MVD surgery for HFS (P < 0.001) had direct effects on knowledge. Knowledge (P < 0.001) had a direct effect on attitude. Further, knowledge (P < 0.001) and attitude (P < 0.001) had direct effects on practice.

Conclusion: Based on these findings, we recommend prioritizing the establishment of well-equipped surgical facilities, developing structured training programs that particularly benefit less experienced surgeons, and implementing regular assessment and education initiatives to enhance both knowledge and attitudes among neurosurgeons performing MVD procedures.

Purpose: This study aimed to evaluate patients' swallowing ability at the time of admission to community-based integrated care wards and to assess the importance of this evaluation.

Patients and methods: 77 older adult patients admitted to the wards between April 2023 and March 2024 participated in the study. Within 48 h of admission, an original screening tool and meal rounds were collaboratively administered by a multidisciplinary team to assess patients' oral and pharyngeal function and their mode of nutritional intake. Dysphagia diets were classified according to the Dysphagia Diet Classification 2021 and compared with the International Dysphagia Diet Standardization Initiative. Oral and pharyngeal function were assessed using the Food Intake LEVEL Scale (FILS) and standardized meal rounds. Fiberoptic endoscopic evaluation of swallowing was performed when necessary. Associations between changes in food intake routes and discharge destinations were analyzed using the chi-squared test, while changes in FILS scores were evaluated using the Wilcoxon signed-rank test.

Results: Aspiration pneumonia and cerebrovascular disorders were the most common illnesses. Many patients were safely transitioned from total or peripheral parenteral nutrition to oral intake, accompanied by significant improvements in FILS scores. The findings demonstrate the effectiveness of assessing swallowing ability and determining appropriate feeding routes in community-based integrated care wards.

Conclusion: This study could contribute to better establishing appropriate feeding methods and managing patient nutrition during hospitalization. By using multidisciplinary shared swallowing-assessment tools, safe transition to oral intake can be promoted without necessarily performing detailed examinations.

Introduction: Stunting remains a persistent public health challenge in Indonesia, with significant implications for children's long-term health and national development.The PRECEDE-PROCEED Model (PPM) offers a comprehensive framework for designing effective health education interventions, yet its application in community-based stunting prevention in Indonesia remains underexplored.

Purpose: The purpose of this study was to identify and launch an increase in maternal knowledge before and after providing a health promotion intervention on stunting prevention.

Patients and methods: The research method used was a pre-experimental study that used a one-group pre-test and post-test design involving 52 mothers of children under five years in Cimahi, West Java. A 20-item validated questionnaire was administered before and after a structured 90-minute health education session based on the PPM framework. Educational content focused on nutrition, hygiene, immunization, and child stimulation.

Results: Data were analyzed using the Wilcoxon Signed-Rank Test due to non-normal score distribution. Research results show participants' mean knowledge score increased significantly from 18.67 (SD = 1.79) to 19.69 (SD = 0.96) post-intervention (p = 0.00006). Most participants (73%) achieved a perfect score after the session, indicating a positive effect of the intervention. Reduced score variability suggests enhanced and more uniform knowledge dissemination.

Conclusion: A health promotion intervention using the PRECEDE-PROCEED Model effectively improved maternal knowledge of stunting prevention. The participatory and contextualized approach demonstrated strong potential for replication in community health settings across Indonesia. Further studies should explore long-term behavioral outcomes and scalability.

Research limitations: Pre-experimental research design without a control group, so no comparison group that does not receive the intervention. The sample size is relatively small and limited to one location. Outcome measurement is only on short-term maternal knowledge. Focus only on maternal knowledge without measuring other aspects related to stunting prevention.

Purpose: To construct sex-specific metabolic patterns and investigate their effect on renal function decline among individuals without chronic kidney disease (CKD).

Patients and methods: The subjects were from a community-based health survey in China from 2012 to 2018. 8511 eligible participants with at least three times of investigations were included. Metabolic patterns were constructed by Latent Profile Analysis based on total cholesterol, blood pressure, and fasting glucose. Renal function decline was defined as eGFR < 90 mL/[min•1.73m²]. The effect of metabolic patterns on renal function decline over time was evaluated using Generalized Estimating Equations (GEE).

Results: Women were classified into No Metabolic Abnormalities (NMA), Hypertension-Impaired Fasting Glucose-Borderline Dyslipidemia (HIB), and Hypertension-Hyperglycemia-Borderline Dyslipidemia (HHB). Men were classified into NMA, Hypertension-Impaired Fasting Glucose-Normal Total Cholesterol (HIN), and Hypertension-Hyperglycemia-Normal Total Cholesterol (HHN). Compared to NMA, the risk of renal function decline over time was approximately 1.33 times higher in the HIB group and 1.41 times higher in the HHB group (95% CIs: 1.29-1.37 and 1.25-1.59, respectively). Consistently, these groups showed a faster eGFR decline over time than NMA. For men, the risks of renal function decline increased by 26% per year in the HIN group compared to NMA (95% CI = 1.19-1.33). No such time-dependent association was observed in the HHN group. Both HIN and HHN groups showed no significant effect on accelerated eGFR decline.

Conclusion: Women with HIB and HHB, and men with HIN, have an accelerated risk of renal function decline. Earlier management of metabolic abnormalities is critical for kidney protection.

Objective: This study examined the impact of the medical-prevention integration model on the efficiency of medical resource utilization in the management of chronic diseases (primarily hypertension and diabetes) among older adults. The analysis focused on its ethical implications (eg, progress in urban-rural equity of resource allocation, residual disparities in underdeveloped regions, and potential biases in service access for disadvantaged groups) and economic effects, with the goal of informing evidence-based health policies to support the "Healthy China" strategy.

Methods: We included 10,236 adults aged ≥60 with chronic diseases from six counties in Guangdong, two rural counties in Sichuan, and one suburban area in Jiangsu. A mixed-methods approach was applied: quantitative analysis of medical costs and related indicators using the Heckman two-stage model, supplemented by qualitative case studies and semi-structured interviews. Indicators for economic performance, efficiency, and equity were constructed, with subgroup analyses by age and education.

Results: Model implementation was associated with significant efficiency gains: average annual per capita outpatient costs fell by 18.1%, hospitalization costs by 18.3%, chronic disease control rates rose by 13.6% (p<0.001), and emergency visits declined by 27.4%. The urban-rural control rate gap narrowed from 12.7% to 5.9% (53.2% reduction), though disparities remained (5% in Guangdong, 3% in Jiangsu, 11% in rural Sichuan). Subgroup analysis showed greater cost reductions for ages 60-70 (20.1%, p<0.01) than >70 (15.3%, p<0.05), and higher control rates among more educated participants (75.2% vs 59.7%, p<0.001).

Conclusion: The integration model improves efficiency and equity in chronic disease management, generating economic savings and reducing disparities. However, persistent regional gaps and barriers among vulnerable subgroups (eg, limited mobility in >70, low health literacy) require targeted interventions. Findings are generalizable to similar aging middle-income settings and support strengthening primary care and equitable resource allocation.

Background: The onset of rheumatoid arthritis (RA) most often occurs during the reproductive years. The chronic inflammatory state associated with the disease, along with the effects of therapeutic agents, contributes to a significantly higher incidence of adverse pregnancy outcomes compared to the general population. Standardized preconception management for childbearing-age patients with RA is an important prerequisite for achieving a safe pregnancy and promoting healthy offspring. However, existing evidence is scattered, and clinical practice lacks efficient evidence-based guidelines.

Objective: To identify, evaluate, and summarize the best available evidence on preconception care for childbearing age with RA, and to provide evidence-based guidance for clinical nursing practice.

Methods: A systematic search was conducted according to the "6S" pyramid model of evidence-based resources to identify evidence related to preconception management in childbearing-age patients with RA. Sources included clinical decision support systems, guidelines, databases, and professional association websites. The search covered all records from database inception until June 17, 2025.

Results: A total of 11 publications were included, comprising 3 guidelines, 5 expert consensuses, 2 clinical decisions, and 1 systematic review. From these sources, a comprehensive set of 23 best evidence recommendations was formed across seven key aspects: general principles, fertility risk assessment, preconception screening, pre-pregnancy medication adjustment, fertility preservation, weight and nutrition management, and psychological support. Among the evidence gathered, a strong recommendation was made for 15 items, while the remaining 8 received a weak recommendation.

Conclusion: This study provides a summary of best evidence for the preconception management of childbearing-age patients with RA, offering valuable guidance for clinical practice. To maximize patient benefits, healthcare providers should exercise careful clinical judgment when applying this evidence, taking into account the specific clinical context, individual patient circumstances, and preferences.

Trial registration: ES20258177.

Objective: To analyze the current status, research hotspots, and trends in the application of artificial intelligence (AI) in cardiovascular disease (CVD) using bibliometric methods, providing a reference for future research.

Methods: A systematic search was conducted in the WoSCC for relevant literature published from database inception to March 5, 2025. VOSviewer v.1.6.20 was used for co-occurrence analysis of institutions (≥10 publications) and authors (≥5 publications), and Scimago Graphica V1.0.25 was used to visualize collaboration networks among countries/regions. CiteSpace 6.3.R1 was employed for institutional co-occurrence analysis (≥5 publications), keyword co-occurrence, and clustering analysis.

Results: A total of 1738 relevant articles were included, with a gradual increase in annual publications, especially after 2018. The United States led in both publication volume and total citations. Harvard Medical School was the most prolific institution. Saba, Luca, and Suri, Jasjit S. were the most productive authors. 《IEEE ACCESS》was the journal with the most publications. High-frequency keywords included machine learning, coronary heart disease, and CVD, forming 10 clusters. Main research areas included AI in disease diagnosis, classification, biomarker discovery, and AI system design. Co-cited literature clusters into four AI-CVD directions: classification, risk prediction, algorithm refinement, imaging. In addition, issues such as the interpretability and clinical acceptance of AI data quality and patient privacy protection models cannot be ignored.

Conclusion: Research on AI in the field of CVD is still in a stage of rapid development. Currently, the hotspots in this field focus on the application of AI in CVD diagnosis and classification, the application of AI in CVD risk prediction, and the precise utilization of AI in CVD imaging. How to develop explainable AI models is a hot topic of research in the coming period.