Journal of Multidisciplinary Healthcare最新文献

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.

Erectile dysfunction (ED) is one of the most common sexual disorders in men, and its effective management requires a holistic approach involving the collaboration of healthcare professionals from various specialties. There is a reluctance to seek treatment despite the high prevalence. In the UAE, there are no region-specific guidelines to guide physicians about its management. To address this need, a panel comprising experts from urology, psychiatry, interventional cardiology, and clinical pharmacy convened in Dubai from 19 to 21 May 2023 to provide recommendations for the management of ED in the UAE. The panel reviewed the currently available data and international guidelines to formulate recommendations for managing the condition in the UAE. The panel recommended recognizing ED as an early sign of cardiovascular disease, addressing psychological concerns, and involving multidisciplinary collaboration for managing the condition. Patients with ED should be screened for other comorbidities. There is a need for a well-connected network of healthcare providers comprising psychologists, gynecologists, urologists, dieticians, physical therapists, pharmacists, yoga instructors, and nurses to treat patients with ED, and timely referrals within this network are necessary. Recognizing the psychological impact of the condition, providing counseling to couples and psychological support to the patient is critical. Shared decision-making about treatment, based on open and meaningful conversations is the need of the hour. Technology can be used for awareness and patient education. Understanding the burden of ED and developing a patient-centric collaborative framework involving various specialists is important for the early diagnosis and effective management of ED. These expert recommendations aim to standardize ED management in the UAE and enhance multidisciplinary collaboration.

Background: Physical restraint is commonly used in clinical settings to ensure patient safety, yet its application lacks standardization and may lead to adverse physical and psychological effects. There remains a significant gap in evidence-based guidelines tailored to nurses practices.

Objective: This study aimed to develop and validate clinical practice standards for physical restraint in hospitalized patients from a nurses staff perspective and to evaluate their impact on nurses knowledge, attitude, behaviors, and patient outcomes.

Methods: A multi-stage design was employed, including a cross-sectional survey, semi-structured interviews, a Delphi expert consultation, and a controlled trial. The study involved 202 nurses and 100 patients from a tertiary hospital in Chongqing, China. The intervention group received standardized training based on the newly developed restraint criteria, while the control group followed routine protocols.

Results: The expert consultation achieved high consensus (Cr = 0.85). Post-training, the intervention group showed significant improvements in knowledge, attitude, and practice scores (P < 0.05), and a reduction in restraint use and duration (P < 0.05). Although adverse event rates decreased in the intervention group, the differences were not statistically significant.

Conclusion: The developed standards effectively enhance nurses practice, reduce unnecessary restraint use, and maintain patient safety, supporting their integration into clinical nurses management.

Spinal disorders, such as intervertebral disc degeneration (IVDD) and spinal cord injury (SCI), pose substantial challenges in modern healthcare, exacerbated by an aging population and the limited effectiveness of current treatments. IVDD, characterized by extracellular matrix (ECM) degradation, dehydration of the nucleus pulposus, and inflammation, is a leading cause of chronic low back pain, affecting approximately 266 million people worldwide each year. Likewise, SCI, frequently resulting from traumatic incidents, can induce irreversible neurological impairment due to both primary mechanical injury and secondary inflammatory responses, encompassing glial scar formation and axonal disruption. Despite advancements in pain management, surgery, and cell therapies, these conditions remain difficult to treat effectively. This review examines recent developments in hydrogel materials for spinal surgery, with a focus on their applications in the treatment of IVDD and SCI. Hydrogels, due to their biocompatibility, tunable mechanical properties, and ability to mimic the native ECM, have shown enormous promise in spinal repair. Their high water content and porous structure enable the efficient delivery of drugs and cells, and their injectability makes them useful for minimally invasive procedures. Hydrogels offer potential in regenerating the nucleus pulposus, modulating inflammation, supporting axonal regrowth, and preventing fibrosis. Furthermore, their injectable and self-healing properties enable less invasive surgical interventions. While showing clear advantages, they continue to struggle with mechanical strength, controlled therapeutic delivery, and precise structural outcomes in 3D printing. Ongoing research is needed to optimize these properties for clinical applications. This review provides an overview of the biological mechanisms, material design, and fabrication techniques of hydrogels, aiming to support the future development of hydrogel-based therapies in spinal disorder treatment.

Objective: The spread of digital technologies has drawn attention to the health effects of problematic internet use (PIU). This study investigated whether PIU is associated with chronic low back pain, focusing on its neuropathic component and potential mediating factors.

Methods: A cross-sectional online survey was conducted among part-time university students aged 18-65 years. The questionnaire collected demographic, lifestyle, and health-related data, including depression, insomnia, and pain characteristics. Standardized instruments were used: the Problematic Internet Use Questionnaire (PIUQ), Beck Depression Inventory-Short Form (BDI-SF), Athens Insomnia Scale (AIS), and the painDETECT questionnaire. Statistical analyses included chi-square tests, correlations, hierarchical linear regression, and mediation modeling. Analyses were performed on the full sample (N = 550).

Results: The prevalence of chronic low back pain was 46.2%, with 12.2% reporting neuropathic pain. PIU was present in 8.4% of respondents, depression in 69.6%, and insomnia in 5.8%. Neuropathic pain correlated with PIU (r = 0.126, p < 0.05), depression (r = 0.44, p < 0.001), and insomnia (r = 0.33, p = 0.009). In regression analysis, depression (β = 0.256, p = 0.001), headache/migraine (β = 0.20, p = 0.002), smoking (β = 0.135, p = 0.030), and cardiovascular disease (β = 0.129, p = 0.045) were independent predictors of higher painDETECT scores. PIU was not a direct predictor but exerted significant indirect effects: mediation analyses confirmed indirect paths via depression (b = 0.08, p < 0.001) and insomnia (b = 0.05, p = 0.009).

Conclusion: Chronic low back pain is influenced by psychological, sleep, and lifestyle factors. Although PIU was not an independent predictor of neuropathic pain, it indirectly increased risk through depression and insomnia. Screening and management of these comorbidities should be incorporated into prevention and treatment strategies.

Purpose: Although artificial intelligence (AI) has garnered increasing attention in education and healthcare, examining the attitude and readiness of future nurses toward AI integration is crucial for creating successful curricula and promoting appropriate utilization of this technology.

Patients and methods: This cross-sectional study was conducted among 227 nursing students at King Saud University using two validated instruments: the General Attitudes toward Artificial Intelligence Scale and the Medical Artificial Intelligence Readiness Scale for Medical Students. Responses were recorded using a 5-point Likert scale. Descriptive and inferential statistics, including t-tests and correlation analyses, were employed to examine differences across study variables.

Results: Of the 227 participants, 48% (n = 109) were aged 18-24 years. Majority participants were women (60.4%, n = 137), and 39.6% (n = 90) were men. Nursing students generally demonstrated moderately positive attitudes toward AI. However, an independent-sample t-test indicated that women exhibited more negative attitudes toward AI than men (p = 0.013), and part-time students demonstrated a greater level of AI readiness than full-time students (p = 0.018). No significant differences were observed based on age, marital status, academic level, and/or training/experience. Significant positive correlations were identified between positive and negative attitudes and AI readiness.

Conclusion: The findings of this study may help nursing colleges to incorporate AI into their curricula. However, the study's cross-sectional design, single site setting, and short duration limit causal inference and generalizability.

Background: Non-alcoholic Fatty Liver Disease (NAFLD) is highly prevalent and increasingly recognized as a multisystem condition with bidirectional links to the brain-liver axis. While most prior work emphasized "liver-to-brain" effects, whether anxiety disorders increase the risk of Non-alcoholic Fatty Liver Disease remains unclear.

Methods: We employed Mendelian randomization (MR) analysis using Genome-wide association study (GWAS) data to investigate whether genetically predicted anxiety disorders play a causal role in NAFLD risk. We then validated our findings using a prospective cohort of 393,229 participants from the UK Biobank, with a median follow-up of 12.6 years.

Results: Our MR analysis provides suggestive evidence for a potential causal effect of genetically predicted anxiety disorders on NAFLD (odds ratio [OR] = 1.73, 95% confidence interval [CI]: 1.12-2.67, P = 0.013). This finding was further supported by the UK Biobank prospective study, which demonstrated that baseline anxiety was associated with increased incident NAFLD risk even after adjusting for potential confounding factors (hazard ratio [HR] = 1.630, 95% CI: 1.488-1.786, P < 0.001). Notably, participants with anxiety exhibited elevated liver fat content at follow-up magnetic resonance imaging, as assessed through follow-up magnetic resonance imaging, irrespective of gender (P < 0.001).

Conclusion: Our study provides converging evidence from genetic and observational data suggesting that anxiety disorders may be associated with an increased risk of NAFLD onset. This relationship necessitates a reconsideration of both NAFLD management and pharmacotherapy for anxiety disorders, advocating for a shift from a specialized clinical focus to a comprehensive community-level strategy for addressing non-communicable diseases (NCDs).